Season 1 X 18 : Babies & Bathwater

Original Airdate: 4/19/2005
Written by: Peter Blake & David Shore
Directed by: Bill Johnson
Transcript by: Mari


BEGINNING

[Opens on a car driving down a town/city road at night. Naomi Randolph, a pregnant woman, is driving her husband Sean home from a party.]

Sean: Did I say anything stupid? [Naomi smiles.] I had two drinks! [Naomi looks at him.] Three! [She looks at him again.] Okay, there was that last one.

Naomi: That’s okay, some day you’ll be pregnant and you can return the favor.

Sean: I feel like such an idiot sometimes.

Naomi: Oh!

Sean: You know, when the baby comes –

Naomi: You know what? You are going to be so great. You are. [He gives her a kiss on the cheek, and CGI time! We see the neurons of her brain going off like fireworks, Naomi’s head lolls back, and the car swerves to the other side of the road.]

Sean: Hey! [Sean grabs the wheel and pulls the car over to a parking space. Naomi wakes up.]

Naomi: Oh.

Sean: You all right?

Naomi: Uh, uh huh. [Sirens are heard behind them.] Oh, no. [The officer walks up.]

Officer: You know why I pulled you over?

Naomi: I - I’m so sorry, Officer, I must have, uh, dozed off.

Officer: Have you been drinking?

Naomi: No.

Sean: Of course she hasn’t.

Officer: Somebody has.

Sean: I’ve been drinking. [to Naomi] You all right?

Naomi: I, I’m not, I, uh –

Officer: How far along are you?

Naomi: Uh, almost, um –

Officer: Ma’am, step out of the vehicle. [Naomi gets out of the car.] Ma’am, walk to the rear of the car. [Naomi starts to do so, looking very dazed.]

Sean: Naomi, are you… Naomi? [Sean gets out of the car.] Naomi –

Officer: Sir, remain in the car!

Sean: Hey, listen, she’s not drunk, all right?

Officer: I will arrest you, sir.

Sean: She’s sick!

Officer: [into com] Badge 302, could you roll me another unit?

Sean: She’s not looking –

Officer: Get back in the car. [Officer pushes Sean against the car; at that moment, Naomi collapses.]

Sean: Naomi! [He rushes to her.] Call an ambulance!

[Opening credits.]

[Cut to Foreman looking at an MRI of Naomi’s brain.]

Foreman: Well, the good news is, it doesn’t look like a stroke. No bleeds, no clots.

Sean: Thank God.

Naomi: It sounds like there’s bad news.

Foreman: We got your blood work back. Some things are a little off. Your liver and kidneys aren’t working so well.

Sean: Why, what would cause that?

Naomi: It’s preeclampsia, isn’t it? I’m gonna miscarry, aren’t I?

Foreman: Preeclampsia is a possibility, but let’s not get ahead of ourselves.

Naomi: I’ve miscarried three times, I’m 39, we had to use in vitro, you’ve gotta make sure that the baby’s okay –

Sean: Let’s make sure that you’re okay, first.

Foreman: How about we take care of both of you at the same time. The nurse will be in soon to draw some blood; I’d like to run some more tests.

Naomi: Thank you, Doctor.

Sean: Thank you.

[Foreman leaves, and walks up to Chase, who is at the desk.]

Chase: Where is everybody?

Foreman: No one’s in the office?

Chase: No, haven’t heard from Cameron all day. You seen House?

Foreman: Heh. Look for a shallow grave with Vogler standing over it.

[Cut to House at his desk. Vogler is sitting across from him. Both look very solemn.]

House: You have a Stage 4 cancer. It’s metastasized to your liver. [Vogler looks shocked.] There’s a new drug called 8C 12 that’s shown promise in Phase 2 trials. It’s your best shot.

Vogler: Thank you, Doctor. You’ve been so good to me.

House: Well, I did publicly bash your company’s drug.

Vogler: When I think about how I treated you…

House: Oh, hey, come on. [House gets up and walks to behind Vogler, sans cane and limp. He rests his hands on Vogler’s shoulders.] There, there, there. [Vogler sniffles.]

Vogler: So, um, there is some hope?

House: Always. But just in case, I special-order an extra jumbo-size coffin.

Vogler: Hey!

House: Don’t thank me. It’s just who I am.

Foreman’s voice: Hey!

[Cut to a clinic room. House wakes up; he was sleeping on one of the clinic beds.]

Foreman: Up and at ‘em, big guy. [House blinks and rubs his eyes.]

House: Sorry, up late. Internet porn.

Chase: How come you’re not in your office?

House: Because there is a computer in my office. If I log on, romance will ensue. My wrist might fall off.

Foreman: Hiding because Vogler’s looking for you. That’s just pathetic.

House: I don’t like loud, angry giants threatening me with violence. How is that pathetic?

Chase: You think you can avoid firing one of us by hiding out here? He’ll find you sooner or later.

House: [getting a drink] I’m okay with later.

Foreman: [holds out chart] 39-year-old female, 28 weeks pregnant, G 4, P 0.

House: Three miscarriages? Gimme. [takes the file]

Foreman: Altered mental status and complete loss of coordination.

House: Tox screen?

Foreman: Negative for alcohol and drugs. She was on oxybutynin.

House: For incontinence.

Foreman: We took her off, but no change. BUN, creatinine are up, LFT slightly elevated.

Chase: Preeclampsia. Call the OB-GYN service and rub some prayer beads.

Foreman: BP’s normal; no preeclampsia in other pregnancies.

Chase: Because she didn’t carry long enough.

Foreman: The three miscarriages make me think it’s an underlying physiology.

House: Pregnancy-related autoimmunity. Too bad that Cameron quit, I could use an immunologist right now. We’ll see if you’re right; check the blood.

Foreman: Cameron quit?

House: Last night. And do an MRA for vasculitis, too.

Foreman: There is no way she quit! She got fired because you couldn’t swallow your pride!

House: An ultrasound? Excellent thought! And put her on magnesium, too, in case it is preeclampsia. [He takes a Vicodin.]

Chase: Sure. [He leaves, and Foreman follows him out.]

[Cut to Chase and Foreman standing in the elevator.]

Foreman: Here, pussy, pussy, pussy.

Chase: I didn’t do anything.

Foreman: Exactly my point.

Chase: You wanted me to yell at him? [They walk out, still talking.] What the hell would that have achieved? What, is he going to jump into his time machine and fix everything?

Foreman: When a dog dumps on the floor, do you pat its head and call it a genius? No, you smack it in the nose with a newspaper!

Chase: Dogs can learn things, House can’t.

Foreman: Coward.

Chase: Child. [They both plaster smiles on their faces as they reach Naomi’s room and open the door.]

Foreman: Hey, there! I brought my colleague along to help out.

Chase: Hi, I’m Dr. Chase.

Naomi: Hi.

[Cut to Chase performing the ultrasound on Naomi. Everything looks good on the screen.]

Chase: Well, ultrasound looks good. No sign of fetal distress.

Naomi: So it’s not preeclampsia?

Chase: Well, it still could be, but it hasn’t progressed, at least. We’re gonna put you on bed rest and monitor the baby.

Naomi: Okay. [She takes some food from her tray and eats it.]

Chase: We’ll give you some potassium and magnesium as well. So, we should keep the fluids running for now and check her again in an hour unless there are signs of fetal distress or – [Naomi begins to choke.]

Sean: Honey? Wha – uh, she’s choking!

Foreman: Lean forward.

Sean: What is, is she all right?

Foreman: It’s probably just some muscle weakness. [They put Naomi on her back, and Foreman starts to remove the offending food with tweezers.]

Sean: What do you mean, probably?

Foreman: Naomi, open up.

Chase: People choke, it could be nothing. [Foreman gets the piece of pear that was lodged in Naomi’s throat.] You all right?

Naomi: I can’t, I can’t, I can’t even swallow.

[Cut to the clinic, where House is looking at a baby. Her parents, Rachel and Joel, are standing close by.]

Joel: She gets sick a lot but this, this cold got really bad all of a sudden. And the fever… [to the baby] Shhhh, it’s okay.

House: It’s not a cold. [hands the baby back to Rachel] It’s pneumonia.

Rachel: Pneumonia?

House: Relax, pneumonia’s her second-biggest problem. She has gone from the twenty-fifth weight percentile to the third in one month. Now, I’m not a baby expert but I’m pretty sure they’re not supposed to shrink.

Rachel: Well, there’s this diet we put her on when we stopped breastfeeding –

Joel: But it’s healthy, raw food. We’re vegans. Almond milk, tofu, vegetables…

House: Raw food. If only her ancestors had mastered the secret of fire. Babies need fat, proteins, calories. Less important: sprouts and hemp. Starving babies is bad, and illegal in many cultures. I’m having her admitted.

Rachel: Is she gonna be all right?

House: Antibiotics for the pneumonia, IV feeding to get the weight up. Don’t worry, it’s a vegan IV.

[Cut to Naomi in the MRI machine.]

Chase: Don’t see any signs of vasculitis. Odd, since you’re always right about everything.

Foreman: Could be a different auto-immunity. Or you could bite me.

Naomi: Oh, no.

Chase: Naomi, you okay?

Naomi: I’m getting cramps. [Foreman and Chase rush out to her.]

Foreman: Strong?

Naomi: Yeah. Feels like my miscarriage.

Chase: It’s preterm labor.

Naomi: He’s too little, he won’t survive!

Foreman: She’s on magnesium already.

Chase: Fuse interbutoline, then. We’re going to give you some medicine, okay? Try to stop your labor.

Naomi: Okay. [They inject her with the medication.]

[Cut to House, peeking into his office. Seeing no Vogler, he walks in and looks at the papers on his desk. He turns to leave, and…]

House: Whoa! [Vogler is standing right in front of him, and he doesn’t look happy.] There you are, I’ve been looking everywhere for you. Uh, listen, you said I had to cut one of my people if I didn’t give that speech about your drug, and in fairness to your point of view, my speech really wasn’t the one you had in mind, so I’ve cut Cameron. Now we’re all squared away, right?

Vogler: In the morning, I expect you in my office with your letter of resignation and plans for a public apology, otherwise I’ll destroy you. [House looks a little shocked as Vogler walks off.]

House: So that’s a ‘no’ on us being squared away.

[Cut to House, Foreman and Chase in the Diagnostic office.]

Chase: She might make it to full term. Contractions are less frequent and not well organized.

Foreman: [to House, who is rummaging through the cabinets] Great to see you back in the office. I guess Vogler found you?

House: Yeah, we had a nice little chat. I really should have kept Cameron. She knew where to find the sugar.

Chase: It’s what I said. Preeclampsia. A little stress from the MRA, she pops straight into labor.

House: Ah ha! [He shakes a packet of sugar triumphantly.]

Foreman: What about the myasthenia?

Chase: Come on, she didn’t seem that weak.

Foreman: She choked, she couldn’t even swallow.

House: What did she choke on?

Foreman: Her food. The muscle weakness isn’t a symptom of preeclampsia.

House: What kind of food?

Foreman: A little bit of cooked pear, it doesn’t matter! It shows weakness.

House: She choked on soft, wet pear. Did she forget to take the bones out? That’s way past muscle weakness. Did you do an upper endoscopy?

Chase: You think there’s something obstructing her esophagus? [Wilson enters.]

Wilson: We’ve gotta talk.

House: Oooh. We’ve gotta talk. [as he leaves] And check her eyelids.

Foreman: Check her eyelids?

[Cut to House and Wilson walking down the hallway.]

Wilson: Special board meeting today, only one item on the agenda: you.

House: Well, enjoy the bagels. I’m untouchable.

Wilson: Huh. Right.

House: Any vote to revoke my tenure has to be unanimous. I’ve got you and maybe even Cuddy.

Wilson: Oh, well that settles it. Mr. Ruthless Corporate Raider will be stymied, go home, curl up on the floor of his shower and weep.

House: What can he do? I’ve got a contract.

Wilson: Does it say how much your team gets paid? Where your parking space is? If your car should be filled with horse manure? Vogler’s smart; he’s got some plan to get you.

House: Does it involve candy? Because I’m a sucker for chocolates. [Wilson gives him a look and walks away, House takes a Vicodin or two.]

[Cut to House checking in on the Kaplan baby.]

House: She’s doing better.

Rachel: Oh, thank God.

House: Technically, Alexander Fleming. He developed antibiotics. Pneumonia’s under control, and from now on, what say you stick with human food.

Joel: Absolutely, swear to God.

House: This time, that’s your guy. [House stars to leave, but is blocked by a bunch of people entering the room, including police officers.]

Ms. Friedman: Rachel and Joel Kaplan?

Rachel: Yes?

Officer: You’re under arrest. You have the right to remain silent…

Joel: What did we do?

Ms. Friedman: You’re being charged with child endangerment.

Rachel: What? How? We –

Ms. Friedman: Starving your kid. I’m from Social Services, we’re taking responsibility for your baby. [They all leave, leaving House standing there.]

[Cut to Cuddy’s office, where House storms in, quite upset.]

House: This is how Vogler’s gonna destroy me?

Cuddy: What did he do, grease your cane?

House: He had my patients arrested.

Cuddy: He didn’t, I did. The nurses were concerned and they called me. There was evidence of abuse; you took a big legal risk by not calling Social Services.

House: Those parents were not abusive, they’re idiots.

Cuddy: Oh, well that’s certainly a relief.

House: It was my call.

Cuddy: You made the wrong one.

House: You know, there’s a new biography of Quisling, I think you might like it.

Cuddy: Sure. No idea who that is.

House: Uh, Norwegian guy, World War II, traitor. The fact that I have to explain this kind of takes the edge off my flow.

Cuddy: I was protecting you.

House: From what? Cops aren’t gonna bust me. Disiplinary committee maybe gives me a slap on the wrist.

Cuddy: And Vogler has an excuse to get rid of you.

House: If I don’t give him one, he makes one up.

Cuddy: Vogler’s just one vote; he’s gotta convince the other eleven of us. I’m just trying to stop you from making that extra easy. [House leaves.]

[Cut to Foreman and Chase examining Naomi.]

Foreman: Sean, do your wife’s eyelids look any different than usual?

Sean: Um, maybe one is drooping a little bit, but you know, she’s tired, so…

Chase: Naomi, can you open your mouth for me and tilt your head back? This is gonna be a little uncomfortable. [He inserts the scope into her throat, and we see that there is a lump in her throat.] Yeah, there’s swelling, indenting the esophagus.

Sean: Is that why she choked?

Foreman: We’ll need to do an x-ray.

Naomi: What? No, the baby – you said no x-rays.

Foreman: It’s important.

[Cut to Wilson looking at the x-rays.]

Wilson: Three centimeter mass in her right upper lobe.

Foreman: Maybe it’s a granuloma.

House: No. There’s no calcification.

[Cut to Wilson talking to Naomi and Sean.]

Wilson: It’s small-cell lung cancer. The tumor’s starting to press against your esophagus. It hasn’t metastasized, but it has spread to other parts of your lungs so we can’t operate.

Sean: Wait, that doesn’t make sense. She had kidney failure and brain problems…

Wilson: Some cancer patients get what are called paraneoplastic syndromes. You were making antibodies to fight the tumor. It attacked other cells: your brain first, then your liver, kidneys… even the nerves that control your eyelids. That’s called Lambert-Eaton syndrome, it told us the tumor was in the lungs.

Naomi: How bad is it?

Wilson: Small-cell is the most aggressive kind of lung cancer. The five-year survival rate is only about ten to fifteen percent, which is why we need to start you on chemo and radiation right away.

Naomi: Not radiation, what about the baby?

Wilson: You’ll need a C-section before you can start the treatment; I can get you in first thing tomorrow morning.

Naomi: What are the chances my baby will survive?

Wilson: Pretty good. Twenty-eight weeks, so about eighty percent.

Naomi: No, wait, that’s one in five chance he’ll die?

Wilson: I really wouldn’t advise waiting.

Sean: Naomi, you’ve got to start this treatment right away –

Naomi: What happens if I wait?

Wilson: Twenty-nine weeks, survival rate is closer to ninety percent.

Naomi: I’m not doing the radiation.

Sean: You’ll die –

Naomi: Listen, you know the chances, they’re nothing, but a few more weeks will save the baby.

Sean: Listen, you’re depressed right now, and you’re not thinking right.

Naomi: Sweetie –

Sean: [to Wilson] Could you just, tell her, please?

Wilson: This cancer moves quick. The median survival’s two to four months. If you postpone, even for a week…

Naomi: I’m sorry, honey. [Sean looks broken.]

[Cut to the board room, where everyone is gathered, sans Wilson.]

Vogler: As most of you know, Gregory House recently gave a speech about me. [Wilson enters.] I’d like to return the favor.

Wilson: [sitting] Sorry.

Vogler: Dr. Wilson. I was hoping you were going to miss this one. A man is the sum of his actions. Here are a few of Dr. House’s. He violated a DNR and was charged with assault. He brought a termite into the OR and spat on a surgeon. He accepted a Corvette from a patient who was a known member of the New Jersey mafia.

Dr. Simpson: Ed, look –

Vogler: Edward.

Dr. Simpson: Edward. You look at anyone’s career, you can find things that are –

Vogler: These are the last three months. He’s personally had more complaints filed against him than any department in this hospital.

Wilson: Okay, he’s screwed up. He’s miserable, and he should probably reread the Ethics Code, but it works for him. He’s saved hundreds of lives.

Vogler: He is a drug addict who flaunts his addiction and refuses to get treatment. He is a disgrace and an embarrassment to this hospital. I’d go on, but it gets kinda mean, so I’m gonna keep this simple. House goes, or I go.

Cuddy: You shouldn’t personalize this.

Vogler: And by I, I mean my $100 million. How’s that for personalizing?

Cuddy: You gave us that money for a reason. Are you really willing to throw it all away because of one doctor?

Vogler: Gregory House is a symbol of everything wrong with the healthcare industry. Waste, insubordination, doctors preening like they’re kings and the hospital their own private fiefdom. Healthcare is a business, I’m gonna run it like one. I hereby move to revoke the tenure of Dr. Gregory House and terminate his employment at this hospital, effective immediately.

Female Doctor: Don’t you think we should discuss this –

Vogler: We just did.

Cuddy: We need time.

Vogler: The vote is on the table. All in favor? [There is silence in the boardroom. Awkward pauses ensue, until one doctor on Vogler’s right raises his hand. All of the rest of the hands in the room quickly go up, except for Cuddy’s and Wilson’s. Cuddy stares at Vogler, who stares back, and she sighs and raises her hand, which leaves…] Dr. Wilson?

Wilson: Opposed?

Vogler: The motion is defeated. Dr. Wilson, would you mind leaving the room, please?

Wilson: Excuse me?

Vogler: We’re gonna take another vote.

Wilson: Well, first of all, you can’t void my vote by making me stand in the hallway. And second, you should check the by-laws. You need notice and at least one business day before you can reconsider any matter.

Vogler: We’re voting on a different matter which you are… conflicted out of.

Wilson: How can I be conflicted?

Vogler: This vote is whether to dismiss Dr. James Wilson. [Wilson, a little annoyed, leaves.]

[Cut to House, Foreman and Chase in House’s office.]

Chase: Naomi is refusing to have the C-section. Her odds aren’t good enough.

House: They do suck. Where’s Wilson?

Foreman: Paged him twice.

Chase: She does this, she knows she’s gonna die.

Foreman: She’s saving her child. Cameron would point out that people are capable of sacrifice.

House: Cameron isn’t here.

Foreman: Perhaps proving her point.

House: You think this woman is making a rational decision?

Foreman: I think people can overcome their baser drives.

House: Pretty damn rarely. And not this time, this is purely biological. In evolutionary terms, the needs of the next generation are more important.

Chase: You’re saying she’s making the right call?

House: Darwin is, I’m not. The next generation is not my patient. We have to raise the odds for Mommy. And where the hell is Wilson? He’s the oncologist. [He leaves.]

Foreman: Good plan, cure cancer. Surprised no one ever thought of that before.

[Cut to House leaving his office. Joel and Rachel run up to him.]

Rachel: [to Joel] There he is. Dr. House!

House: You guys bust out?

Joel: We made bail. They won’t let us in our baby’s room.

House: Weird. You’d think they’d let you take her home while they figured out if you tried to kill her.

Joel: We’re good parents, we fed her whenever she was hungry.

Rachel: Big meals. We had no idea that diet was so bad for her.

Joel: The nutritionist said it had everything she needed!

House: The kid who stacks the free-range grapefruit in your health food store is not a nutritionist.

Rachel: But my uncle is. He went to college and everything. [House looks at them, and then picks up the phone at the desk.]

House: Foreman, I need a CT scan on…

Joel: Olive Kaplan.

House: Seriously? [Joel nods proudly.] Olive Kaplan. Check for abscesses or occult infections. [He hangs up; to the Kaplans] Bu-bye.

[Cut to House, walking into Wilson’s office.]

House: Listen, Vogler’s all about clinical trials, the hospital’s chock full of them. There’s got to be something for small-cell lung cancer. [House notices that Wilson is packing his stuff in boxes.] What are you doing?

Wilson: I got sacked.

House: Did you make a pass at Cuddy? Told you, she only has thighs for me.

Wilson: I voted to keep you.

House: So he’s getting rid of every board member who votes to keep me around?

Wilson: Yeah, every one of us.

House: Just you?

Wilson: Yeah.

House: But you’re only off the board, right? They couldn’t have got unanimous approval for you.

Wilson: Brown from Oncology voted no, so did Cuddy, Taylor and Peevey.

House: Eh, so you’re off the board, big deal. Frees up Wednesday nights for bowling. You’re still a doctor –

Wilson: Yeah, getting dumped looks great in Who’s Who. Vogler gave me the option of resigning, and I took it.

House: Big of him.

Wilson: I’ve got no kids, my marriage sucks; I’ve only got two things that work for me: this job and this stupid, screwed-up friendship, and neither mattered enough to you to give one lousy speech.

House: [quietly] They mattered. If I could do it all again –

Wilson: You’d do the same thing. Well, you’ll be gone soon, too.

House: Those clinical trials?

Wilson: I’ll make some calls. [takes the chart]

House: Thanks.

[Cut to Cuddy, doing a prostate exam on a patient in the clinic.]

Cuddy: It’s not cancer.

Patient: It’s not gonna kill me?

Cuddy: It’s hemorrhoids.

Patient: But all that blood… that can’t be right?

Cuddy: Looks worse than it is. [House walks in.]

House: Nice job of protecting me.

Cuddy: Can this wait?

House: His ass can wait. You saved my job by sacking Wilson?

Cuddy: What did you think would happen when you made that speech? You think he would just pout for a little while and we’d all forgive you? You don’t spit on the man who signs your paycheck. First Cameron, then Wilson – you’re next. [to patient] Pull your pants up.

House: So it’s about the money.

Cuddy: Of course it’s about the money. The money Vogler gave, he could have bought a few jets, maybe a baseball team, or just stuck it in Chase Manhattan and collected interested. But he gave it to us to buy equipment, to do research! You are a great doctor, House, but you are not worth $100 million.

[Cut to House talking to Dr. Prather, the oncologist running the trial.]

House: We’ve sequenced the DNA of the tumor cells. P53 gene mutation and codon 55. She’s perfect for your trial.

Prather: She’s pretty far advanced.

House: Well, you want easy cases, you picked the wrong speciality.

Prather: Otherwise in good health?

House: Excellent.

Prather: When can she start?

House: Middle of next week.

Prather: Cancer’s already stage 3, it’d be a waste of time.

House: She can start in two days.

[Cut to House walking to Naomi’s room with Foreman and Chase.]

Foreman: She can’t start in two days! She’s pregnant!

House: She won’t be in two days. I’ve scheduled a C-section.

Chase: She’d still have to wait a month. You can’t take part in an trials until 30 days after major sugery.

House: Well, it’s definitely surgery, but major?

Foreman: It’s not your call.

House: Again, a question of interpretation.

Chase: You’re scamming a doctor, now? Come on, Vogler’s looking for any excuse to can you.

House: Oh, I think he’s got a big bag of those already.

Foreman: These regulations aren’t just here to annoy you, okay? Doing this is dangerous to the patient.

House: Well, I’ll be sure to let her know that. Care to join me?

[Cut to House talking to Naomi and Sean.]

House: Angiogenesis inhibitors prevent the tumors from creating blood vessels. Without blood, the tumor starves.

Sean: That sounds great –

Naomi: What about the baby?

House: The treatment would be fatal to the baby. I’ve scheduled a C-section for later this afternoon. It’s in the trial phase right now, but so far complete remission in more than thirty percent of subjects.

Naomi: I told Dr. Foreman I didn’t want a C-section.

House: When your chances of living were less than a third of what they are now.

Naomi: Well, the baby’s premature, that –

House: Our pediatrics department has the best neonatal ICU in the state.

Naomi: No, his lungs, his brain, he’s not ready.

Sean: And he could be fine!

Naomi: You don’t know what it’s like, raising a sick child! [House looks up, interested.]

Sean: His odds are much better than yours are. You have to let them at least try this. [to House] Talk to her.

House: Okay. Leave the room. [Sean does so.] How long have you been taking oxybutynin?

Naomi: Uh, since I was about twenty.

House: Incontinence is pretty uncommon in a woman of your age. It’s even more bizarre in a woman in her twenties.

Naomi: I guess I haven’t had the best luck when it comes to my health.

House: Seems that way. You said to your husband, “You don’t know what it’s like, raising a sick child.” You didn’t say, “You don’t know what it would be like.” This is not your first child, is it? And he doesn’t know.

Naomi: I was eighteen. Got pregnant, got married. I had the most beautiful little girl, Grace. She had infantile Alexander’s disease.

House: I’m sorry.

Naomi: For two years we watched her die. My husband was, uh, my first husband was a, a great guy, but after that I couldn’t even look at him without thinking of her. I left him, I left my job, I left everthing –

House: Very moving story. Explains why you’re being so selfish.

Naomi: I’m willing to die to protect my husband.

House: Because it’s what you want. Your husband wants you to live.

Naomi: Well, he doesn’t understand…

House: Oh, who the hell does? Tragedies happen. You think that turning yourself into a disposable incubator for a few weeks is going to protect your baby from all the crap in this world, go ahead, die happy. I got no problems with people killing themselves, but don’t think it makes you a hero.

Naomi: [crying] Okay.

House: You’re scheduled for 4 P.M.

[Cut to the OR. Dr. Lim is getting ready for the surgery, but a nurse has a phone up to his ear.]

Lim: Yes, this is Dr. Lim. [The nurses are talking about various happenings, and the anesthesiologist begins to put Naomi under.]

Anesthesiologist: Count down from ten.

Naomi: Okay. Ten… nine… eight…

Sean: That seemed kind of fast, is she all right?

Anesthesiologist: She’s fine.

Lim: Wake her up. That was Vogler; surgery’s off.

[Cut to Vogler, walking down the stairs into the lobby. House comes out of the elevator and starts YELLING.]

House: HEY! You’re killing her!

Vogler: Really? See, I thought you were the one trying to ram her into a drug trial five minutes after surgery –

House: She knows the risks, she was fully informed –

Vogler: Well, the guy running the study sure wasn’t.

House: Not his life, not his call!

Vogler: His study, his call! [Cuddy comes out of the clinic to watch.]

House: Right, so she kicks off, his number look bad.

Vogler: The numbers look bad, the study looks bad!

House: Which would cost you money!

Vogler: And keep a life-saving protocol off the market!

House: One person, one blip in the data!

Vogler: You ever heard of the FDA? They eat blips for breakfast! One person should never endanger thousands!

House: Well, thank God you were here to save all those lives! [Vogler pauses, breathes, laughs, and shakes a finger at House.]

Vogler: The board’s meeting again this evening. Why don’t you settle down? Play some Game Boy. Why don’t you watch your soap? I hear they’re firing the handsome doctor today, boy, that should be a good one. [He walks off. House glares at Cuddy before he leaves.]

[Cut to Foreman and Chase in Naomi’s room.]

Sean: If we had the C-section anyway, we could still do the experimental treatment, right? We’d just have to wait thirty days.

Chase: Assuming the doctor running the trial isn’t too pissed off to let her in, yeah.

Naomi: And assuming I’m even healthy enough to – [She gasps, grabs Foreman, and the monitors all start to beep.]

Sean: Honey? Are you okay?

Chase: Stats are dropping. Down to the 80s. Stay with us, Naomi.

Sean: What’s going on?

Chase: We need you to leave the room. [CGI shot of a blood clot getting stuck in her lungs.]

Foreman: [to a nurse running in] Respiratory distress.

Sean: Could you just tell me what’s going on?

Chase: We’re trying to find out. [Sean is escorted from the room. Foreman is doing a quick ultrasound on the baby and Naomi’s lungs, while Chase looks down Naomi’s airway.]

Foreman: Still kicking.

Chase: Flash pulmonary edema?

Foreman: Lungs are clear. There it is.

Chase: Pulmonary embolus.

Foreman: Gotta get her to an OR.

[Cut to Foreman and Chase running with a bunch of nurses and techs to the OR. Sean is rushing after them.]

Sean: What happened?

Foreman: [breaking off from the group to talk to Sean] It’s an embolism. A blood clot. It’s fairly common with lung cancer. It’s not a [something] embolism, so blood’s still trickling through. We’ve been able to get Naomi breathing a little, but we need to remove the clot, and we need you to approve the treatment.

Sean: Yeah, whatever you have to do, just do it!

Foreman: It’s not that simple, okay. The best course for the baby would be an immediate C-section. The longer we postpone, the greater chance it’ll have brain damage from lack of oxygen.

Sean: Fine, whatever, just do it!

Foreman: Here’s the problem. The C-section would be very, very dangerous for Naomi.

Sean: Dangerous, like…

Foreman: In her current condition, there’s a real chance she wouldn’t survive. I’m sorry. [pause] Look, your wife’s unconscious, we need you to make a decision.

Sean: I just want her to live. No C-section. [Foreman nods and runs to the OR, leaving Sean standing in the hallway.]

[Cut to the OR.]

Foreman: Stats are still way down. We’ve got to push the streptokinase.

Chase: Too risky. Even if it dissolves the clot, she could still bleed out anyway.

Foreman: She’s hemodynamically compromised.

Chase: It’s not good for the baby.

Foreman: Dad doesn’t care.

Chase: [inserting a needle] Embolcine 250,000 units. [The monitors start to beep.]

Foreman: BP’s dropping. Pressers!

Chase: We don’t have time. We’ve gotta suck it out.

Foreman: Systolic BP’s 80. [Chase gets the clot out.] BP’s stabilizing, O2 stats rising. [House enters the OR, in scrubs and minus his cane.]

House: Did you get the clot?

Chase: I think so. She’s stabilized.

House: How long was her oxygen at that level?

Chase: Ten minutes?

House: Brain function compromised? [The monitors go off again.]

Chase: BP’s dropping. Up the dopamine. She’s not responding. How much?

Foreman: She’s up to 30 micrograms!

Chase: Is she septic? [House lifts the robe on her stomach to reveal a expanding purplish bruise.]

House: She’s bleeding into her abdomen.

Foreman: We won’t be able to stop it. I’ll go talk to the husband.

House: No, you stay here. [leaving] Keep her as stable as you can for as long as you can. [He leaves the OR to find Sean pacing outside of it.] She had trauma during the procedure. She’s bleeding into her abdomen. There’s nothing we can do; I’m sorry.

Sean: Um, no.

House: I need you to okay the C-section.

Sean: Yeah, that’s gonna kill her, right?

House: It probably will.

Sean: I can’t do that.

House: She’s dying either way. [Sean drops his coffee cup.]

Sean: I’m sorry, I’m – [House grabs his arms.]

House: Stay with me, Sean. I need your okay on this.

Sean: She makes the decisions, and I’m –

House: Right, and that’s gonna be tough from now on, but this decision is easy. You know what she’d want.

Sean: I can’t do it.

House: You make this call, only two things change. One: yeah, you feel guilty for killing your wife. Two: your baby lives. Naomi’s baby lives.

Sean: [sobbing] Okay, okay. [House reenters the OR, Sean sits in one of the chairs outside of it.]

[Cut to the OR, where the C-section is underway.]

Lim: He’s out; umbilical cord’s clamped.

Chase: No respiration.

Foreman: His lungs aren’t opening up.

Chase: They aren’t mature. [Chase and Foreman work on the baby.]

Foreman: Come on, take a breath. You know you can do it. [The monitors beep. Chase continues to work on the baby while Foreman walks over to Naomi.] What’ve you got?

Lim: Looks like v-fib.

Foreman: Pulse?

Lim: No. Paddles!

Chase: [rubbing the baby’s chest] Come on, come on.

Lim: Clear! [A shock.]

Foreman: Nothing.

Lim: Charging.

Chase: Come on, open up.

Foreman: [to Chase] How’s he doing?

Chase: He’s still not breathing; we’ve got to intubate. [He goes to get the equipment.]

Lim: Clear! [Another shock. Nothing happens to Naomi, but the baby starts to cry. As Naomi is shocked again, Chase tends to the now-breathing baby.]

[Cut to House sitting in the hallway.]

Cuddy: [to person she was walking with] Thank you. [to House] I’m late for the board meeting. [House gets up to walk with her.]

House: We need to talk.

Cuddy: I don’t want to hear it.

House: It’s about a patient.

Cuddy: The pregnant woman? She wasn’t qualified for that trial and I’m not going to apologize –

House: I’m not talking about her. At this point I think it’s best that I concentrate on patients who are still alive. [Cuddy looks surprised.] Pulmonary embolism. She bled out. Saved her son. [He hands Cuddy some films.] This is Olive Kaplan’s CT scan, the incredible shrinking baby. [Cuddy looks at it.]

Cuddy: Her thymus gland –

House: DiGeorge Syndrome. It’s genetic, can cause the gland to wither to nothing.

Cuddy: This is why she couldn’t gain weight.

House: Yeah.

Cuddy: I’ll call the police and Social Services and have all the charges withdrawn.

House: I’ve sent a test down to confirm; when it comes back you should start Olive on immunoglobulin replacement.

Cuddy: You’re not going to do it?

House: I assume I won’t be here.

[Cut to Sean, standing by the bed of his wife. Foreman walks in.]

Foreman: Your boy’s doing good. [Sean nods, and bends over to kiss Naomi.]

[Cut to the board meeting.]

Vogler: It’s the same motion as yesterday, people, same reasons. All those in favor of dismissing Gregory House raise a hand. [Everyone raises a hand except Cuddy.] Dr. Cuddy, you realize this is going to happen.

Cuddy: I can’t do it.

Vogler: You can’t abstain.

Cuddy: I’m not abstaining, I’m voting no.

Vogler: You’ve changed your mind since yesterday? What did he do, buy you dinner and roses? Threaten to drown your dog?

Cuddy: He did his job.

Vogler: Right. He saved another life.

Cuddy: Maybe.

Vogler: Good for him. It’s great. It’s not the point.

Cuddy: It’s what we do.

Vogler: And you could do it a lot better if you didn’t have to worry about some madman running around the hospital accountable to no one!

Cuddy: But that’s not the choice you’re giving us.

Vogler: House won’t listen to anyone –

Cuddy: And you’re not accountable to anybody, either! Because you think you own us.

Vogler: I move for the immediate dismissal of Dr. Lisa Cuddy.

Dr. Simpson: She’s upset, we all are. Why would you risk your career to save him? [Cuddy gives him an incredulous look.]

Cuddy: If you think House deserves to go, if you think I deserve to go, Wilson deserved to go, then vote yes. But if you’re doing this because you are afraid of losing his money, then he’s right! He does own you. [She stands to leave.] You have a choice. Maybe the last real one you’ll have here. [She leaves. Everyone looks at Vogler, and…]

[Cut to Wilson, popping the cork on a champagne bottle in House’s office! Yay! He, House, Foreman and Chase are drinking and throwing a Nerf football around.]

House: Cuddy is a genius, [Ball to Foreman] convincing four people to give up a fortune to save our sorry asses. [Cuddy walks in.] Dr. Cuddy! [He raises his glass.] The man of the hour. [Foreman throws the ball to her, which she catches. There are shouts of “Hey, hey!” and the like.]

Cuddy: What are you doing?

House: We’re drinking. I would have thought that was pretty obvious. [Ball is thrown to Chase, Cuddy picks up a glass.]

Cuddy: Well, to the great champion. Saved you, saved Wilson, saved the whole team. [She drinks the entire glass in one go.] Of course, none of them would have needed saving if you could actually get along with another human being.

House: Well, thank you, Miss Buzzkill.

Cuddy: Well, you only cost us $100 million. Could have saved some lives, could have made a few jobs, helped a few people. Yippee.

House: You voted to get rid of him.

Cuddy: The lesser of two evils. You should be mourning. I know I am.

[Closing montage. Clips of Sean holding his new baby and crying, Foreman watching through the glass wall; Joel and Rachel with Olive in her hospital room; Wilson unpacking his office; Chase turning off the lights and leaving Diagnostics, passing House in his office, who is working on a case and looking at CT scans. And good night!]


END

Season 1 X 17 : Role Model

Original Airdate: 4/12/2005
Written by: Matt Witten
Directed by: Peter O'Fallon
Transcript by: Mari

BEGINNING

[Episode opens on a big hall/lobby. Senator Gary Wright is making a speech to potential donors, his staff behind him.]

Senator: [to applause from the crowd] And the only thing wrong – the only thing wrong with the American dream is people. Too many people. Too many of us telling young people that the dream is dead. They told me that when I was growing up in the slums of Trenton, and they were wrong. They told me that when I decided to run for Senator with only $58 in my savings account and they were wrong! And they are still telling me that now, that I don’t have a chance: because I’m black, because I don’t have the right nose, because I still have only $58 in my savings account. [Crowd laughs. The Senator gets a bit of a pained look on his face, and we see him lick his lips and cover his mouth with his hand quickly. Strained -- ] With your help, we can keep that dream alive. [Clapping from the crowd.] And in closing – [The crowd starts to waver and blur in his field of vision, and his breathing quickens] – just… let me say… [His staffer quickly steps to his side.]

Staffer: Let ME say that you should all donate the legal maximum to the next President of the United States! [Loud clapping. Underneath, to Wright] Are you okay, do you need some water or something?

Senator: No, no, I’m fine, I’m fine, really. [He starts to make his way down the stairs, while dizzy. A man corners him on the stairway.]

Union Guy: A handsome guy like you, I bet you get 70% of the women.

Senator: Heh, here’s hoping.

Union Guy: Of course, it helps your wife died of cancer. [Senator gives him a very WTF kind of look.] I mean, I’m sorry, but the sympathy vote’s in your pocket.

Senator: Yeah, I appreciate your support.

Union Guy: Listen, Senator, my union has a hell of a war chest. [The Senator’s vision and hearingbegins to blur in and out.]

Senator: Um, I’ve always been strong on the union. [Senator Wright is sweating and swaying, and looks really sick.]

Union Guy: The thing is, you always go on in your speeches about the workers in Indonesia, Cambodia, Timbuktu –

Senator: Because I think we have… a moral, uh –

Union Guy: My union members are hurting. They don’t care about moral this or moral that. Are you all right? [To answer, the Senator vomits all over the union guy.]

Various staffers: Senator?

Union Guy: Hey! [to himself] The guys are gonna love that. [The Senator falls down the rest of the stairs to the flashing of the Press’ cameras.]

Various staffers: Tell him to breathe! Give him some room! Senator, are you all right?

[Opening credits!]

[House is in Vogler’s office.]

Vogler: The Senator’s suffering from nausea, headache, and mental confusion.

House: Yeah, bad sushi is so hard to diagnose.

Vogler: You’re being childish. Look, if his case is as trivial as you think it’ll take you three minutes to diagnose him.

House: Uh huh, three minutes that I could spend sitting on the toilet with the funny pages.

Vogler: You’re mad at me.

House: [closes the door] Nope. I never liked Cameron or Foreman.

Vogler: Do you know why I’m forcing you to fire one of them? Because you need to prove to me that you’re a team player. Now, if you did that, you wouldn’t need to go through this exercise.

House: Fine. I’ll hold the Senator’s hair while he upchucks.

Vogler: [as House is leaving] Oh, and by the way, I need you to give a speech at the National Cardiology Conference. Next week.

House: I don’t do speeches. I’m shy.

Vogler: Eastbrook Pharmaceuticals has developed a new ACE inhibitor. I would like you to extol the virtues of this breakthrough medication.

House: Eastbrook Pharmaceuticals… wait a second, don’t I own that company? Oh, no, that’s right, you do.

Vogler: Viopril is a significant improvement over the old version. All there in study. [He hands House a booklet of information.]

House: I know its price tag is significantly improved.

Vogler: [sighs] You can either give one ten minute talk and one three minute diagnosis or you can fire one of your pets. My understanding was that you believed in rationality above all else. [House grabs the Viopril information along with the Senator’s chart.]

House: [mutters as he leaves] Viopril…

[House and Foreman are checking out Senator Wright. Well, Foreman’s checking. House is playing on his Nintendo.]

Senator: I appreciate your keeping the media way.

Foreman: We’re keeping your staff away as well. You’re taking it easy, now.

Senator: I’m in the middle of a campaign.

Foreman: The fast we can get you better, the faster you can get out of here. Anyone else at the fundraiser get sick?

Senator: I don’t think so. And I don’t think that’s it, I’ve been under the weather for weeks, you know. Lots of traveling, supposed to be in the Sudan next week. [Beeps are heard from the corner, namely, from House’s gameboy.]

House: Helps me concentrate. [Puts down Nintendo, picks up Vicodin.] Even better than drugs. [He pops one to demonstrate.]

Foreman: Open your mouth, please. [Senator Wright does, and there’s a nasty scar on his tongue.] That’s quite a scar.

Senator: When I was six, I fell off the swings and bit my tongue. Couldn’t talk right for the longest time. Lots of teasing. But, you know, it just made me fight harder, speak up for those who can’t.

House: Yeah, yeah, yeah. Tongues heal too fast. Your political consultants have written you a nice story. In a tight race the lispers alone could put you over the top.

Senator: You a Republican, or you just hate all politicians?

House: I just find being forced to sit through drivel annoying.

Senator: You find sincerity annoying.

House: You’re a black kid from the ghetto who made it to Yale Law and the United States Senate. That’s a sufficiently mythical story, you don’t need to lie about your tongue. [Foreman has been checking the Senator’s reflexes; the left leg was okay, but the right didn’t move.] Must have missed it.

Senator: What’s wrong? [House tests the reflexes himself, no change.] What is it?

House: It’s not the food. It’s your brain. [to Foreman] Get an MRI and a lumbar puncture. [to Wright] Cancel your travel plans.

[Cut to Cameron, Chase, Foreman and House in the lab.]

Foreman: The LP showed no sign of infection and the MRI was fairly clean.

House: I guess we can tell him he’s fairly healthy and can go home.

Foreman: Well, there is something in Broca’s area, but it’s small, low intensity.

Chase: Most likely just background nose.

House: Care to bet your job on that? [Chase makes a face.] What was that?

Chase: What was what?

House: You got annoyed. That was clearly an annoyed face.

Chase: I get annoyed by glib remarks about our futures.

House: But last week you didn’t get annoyed, you made poopie in your pants. It’s weird, it’s almost like now you know you have nothing to worry about.

Cameron: Chase has nothing to worry about?

House: None of you has anything to worry about.

Cameron: What happened?

House: Vogler saw the error of his ways and repented. The lesion could be nothing. It could also be a brain tumor or infection. There’s only one way to find out which.

Foreman: You wanna cut into his brain.

House: Dangerous, I know. Especially as he’s a politician, his brain’s all twisted. But I weighed that against the risk of him stroking out before lunch. Call surgery, get it scheduled. [He leaves.]

[Cut to the clinic, where house is performing an ultrasound on Sarah, a blond thirtysomething.]

House: You’re not pregnant. [He hands her some tissues.]

Sarah: Well, I told you that. But there’s gotta be some other reason I’m still spotting.

House: Sure. You were pregnant. Based on your hormone levels, you had a miscarriage.

Sarah: I haven’t even been on a date.

House: [charting] Right, since it’s physically impossible to have sex without someone buying you dinner.

Sarah: I haven’t had sex since I split up with my husband. That was almost a year ago.

House: Fine, have it your way. Immaculate conception. [Editor’s note: #&@^!!]

Sarah: Um, what do I do?

House: Well, it’s obvious. Start a religion. [He leaves. As he walks out, Cuddy storms past him.

Cuddy: In my office.

House: [to the clinic nurse, conspiratorially] Afternoon delight. She just loves the hard wood. [House enters Cuddy’s office.]

Cuddy: You’re not doing a brain biopsy on a spot on a MRI.

House: Where’d you get that?

Cuddy: Not on an United States Senator.

House: Oh, just so I’m clear, if he was a janitor, that would be okay. Do you have a list?

Cuddy: A brain biopsy can cause permanent neurological damage.

House: Uh huh, whereas tumors are really good for brains, make ‘em grow big and strong. It’s my call.

Cuddy: No, it’s not.

House: You’re pulling rank on patient care?

Cuddy: It’s not my call, either.

[Cut to Cuddy and House confronting Senator Wright in a hospital bed.]

Cuddy: It’s up to you.

House: Either it’s a tumor or it’s an infection that the lumbar puncture didn’t pick up. Either way, if we don’t treat it immediately, it could kill you.

Cuddy: Or it could be nothing. Reading brain MRIs is not an exact science.

Senator: W-what caused my s-symptoms?

House: Wow, excellent question. Many doctors wouldn’t have gone there.

Cuddy: It could be a transient ischemic attack. You could make the argument for watching carefully for the time being.

House: Mmm, but you’d only make that argument if you were an administrator covering your own ass.

Cuddy: That’s absurd, and insulting.

House: Insulting, yes.

Senator: W-what will the voters think? If they find out I’ve had a b-brain biopsy?

House: This could leave you b-b-b-b-brain damaged, and you’re worried about NASCAR dads?

[Cut to Foreman and some other doctors performing the brain biopsy.]

[Cut to Wilson, Foreman, Cuddy and House looking at the results.]

Foreman: It’s not a brain tumor.

House: It’s not a bacterial infection, either.

Cuddy: So you biopsied his brain for nothing.

House: If that were true, would Dr. Wilson’s mouth be contorted into that ugly little shape?

Wilson: It’s toxoplasmosis.

Foreman: You sure?

House: Which means the Great Black Hope has full-blown AIDS. They’re gonna love that in Dubuque.

[Cut to Foreman and House talking to Senator Wright.]

Foreman: Toxoplasmosis is a fairly common fungus you can get from eating undercooked meat or touching cat feces. In rare cases the fungi travel up the blood stream and into the brain causing a lesion or inflammation.

Senator: [looks to both of them] So, what’s the prognosis?

Foreman: Toxo usually responds to treatment, but it only causes a lesion in your brain if your immune system is extremely weak to begin with. Senator, I’m afraid you have AIDS. As I’m sure –

Senator: No!

Foreman: As I’m sure you know, people with HIV can live a long time.

Senator: What else could do this to me?

Foreman: Theoretically, certain cancers –

House: If you have toxo in your brain, you have AIDS.

Senator: [forcefully and painfully] I do not have AIDS. I don’t sh-sh-shoot up drugs, I don’t sl-sleep with…

House: This is very bad news. I get that, and I sympathize. But we’ve gotta speed through the denial phase because you need antiretrovirals and you need them fast. [He hands the pills to Senator Wright.]

Senator: You haven’t even tested me for HIV!

Foreman: [quietly] We will.

House: But the toxo drugs are going to piss off your fungi, and when fungi get pissed – [Senator Wright throws the pills.]

Senator: I am not gonna take the pills.

House: You’re afraid word will leak out. Trust me, you’re not going to become President either way. They don’t call it the White House because of the paint job.

Senator: Here’s what you’re gonna do. You’re going to give me the drugs for the toxo only. You are going to test me for HIV under a false name. You are going to test me for cancer and anything else that could have done this to me. If I have cancer, I will deal with it, but I do not have AIDS.

[Cut to Cameron and Chase in the Diagnostic offices. Chase is playing with House’s giant fuzzy ball, and Cameron is looking online at a press release.]

Cameron: “Eastbrook Pharmaceuticals are pleased to announce that Dr. Gregory House will present the latest research on their exciting new ACE inhibitor.”

Chase: You’re making that up. That’s Vogler’s company.

Cameron: Press release. Doing an address at the North American Cardiology Conference. [Chase looks at the screen from behind Cameron.]

Chase: House never gives speeches. [House enters.]

House: But when I really believe in something… Gosh dang it, I’ve got a chance to make a difference here.

Chase: You made a deal with Vogler?

House: It’s all the rage. Everybody’s doing it. [Chase gives House a petty, pouty look and goes to sulk in a chair. Cameron walks over to House.]

Cameron: So, what’s the deal? You get to keep all of us if you flog his products?

House: One speech, no biggie. Foreman’s doing a bone marrow biopsy to check for cancer.

Chase: Cancer? The Senator’s got AIDS.

House: Cancer sounds better on a press release. I need you guys to rush the ELISA test for HIV. [He starts to walk into his office.]

Cameron: Thank you. For the speech.

House: When I said rush, I meant, you know, fast. Stat’s the word you doctors use, right?

Cameron: I know it’s hard for you –

House: Double stat? [Chase pats Cameron on the arm to follow him out, which she does.]

[Cut to Foreman performing a bone marrow biopsy on the Senator.]

Foreman: This may sting a little. [The Senator flinches.] Sorry.

Senator: It wasn’t the shot, it’s, um, my head, it’s killing me.

Foreman: You know, Senator, we don’t have to do this now. We can wait until your HIV test comes back.

Senator: [laughing] Guess you figure it’s gonna come back positive.

Foreman: Well, in my experience –

Senator: Patients lie. Politicians lie more. And black politicians –

Foreman: Whoa, I don’t think black politicians lie more than white politicians.

Senator: We lie less.

Foreman: You figure we’re morally superior?

Senator: [laughing again] I’ve got my theories. No, we, we just can’t get away with it. No one’s gonna gi-give us the benefit of the doubt. No one’s gonna cut us a second chance. And, and when it happens it’s not just a bad politician, it’s, it’s, it’s a bad role model, it’s a dis-discredit to the race. [looks at Foreman standing there, needle poised and ready] You ready?

Foreman: Yeah, yeah. Take a deep breath. [The Senator groans in pain as Foreman inserts the needle into his hip. Ow.]

[Cut to House, working on charts at the clinic desk. Cameron walks up.]

Cameron: Dr. House. I just wanted to –

House: You’re welcome, again.

Cameron: I want you to know how much I –

House: Got it. You’re grateful. Apparently you seem to think it’ll mean a lot to me to know that.

Cameron: Do you know why people believe in God?

House: I thought you didn’t believe in God.

Cameron: I don’t.

House: Well, then you better be making a very good point.

Cameron: Do you think they pray to Him and praise Him because they want Him to know how great He is? God already knows that.

House: Are you comparing me to God? I mean, that’s great, but just so you know, I’ve never made a tree.

Cameron: [smiling] I thank you because it means something to me. To be grateful for what I receive.

House: You are the most naïve atheist I’ve ever met.

Clinic nurse: Dr. House, you have a patient in Room One.

House: Thank God. [He walks off, but turns around.] People pray so that God won’t crush them like bugs. I’m not gonna crush you.

[Cut to Exam Room One, where Sarah is back with a mysterious bruise on her neck…]

Sarah: Petechial bruising? I don’t know if I’m pronouncing that right.

House: Gosh, the internet is such a wonderful tool.

Sarah: It could be leukemia.

House: Definitely possible. The more likely diagnosis is hickey.

Sarah: Well, it can’t be a hickey.

House: [exasperated] Why is everybody so ashamed of sex all of a sudden?

Sarah: I’m not having sex. I’ve barely even thought about sex since my marriage. [House pulls a hair from Sarah’s head.] Ow!

House: I say you’re having sex, you say you’re not. Either you’re lying, or I’m wrong. Or there’s some middle ground.

Sarah: You mean like oral?

House: I mean you’re having sex without knowing it. I’m testing you for booze, drugs and GHB.

Sarah: I don’t drink, and… what’s GHB?

House: The date rape drug. [He leaves.]

[Cut to Senator Wright looking at paperwork in his bed. House enters and hands him test results. He starts to pour a glass of water.]

House: It’s positive. [He hands the Senator the water and some pills.] Your T-cell count is eight, which means there’s a good chance you’ll die. I’m telling you this because we need to contact your sexual partners.

Senator: I’ve only had two girlfriends. Two, after my wife died. I used c-c-condoms.

House: You know the chances of you getting HIV from heterosexual sex with a condom?

Senator: Yes.

House: Some day there will be a black president. Some day there will be a gay president. Maybe there will even be a gay, black president. But one combination I do not see happening is gay, black, and dead. You need to stop lying to me.

Senator: It must be miserable, always assuming the worst in people.

House: Oh, cut the crap, you’re dying.

Senator: You’re clever, you’re witty, and you are a coward! You’re scared of taking chances.

House: I take chances all the time, it’s one of my worst qualities.

Senator: On people?

House: Wanting to believe the best about people doesn’t make it true.

Senator: Being afraid to believe it doesn’t make it false.

House: Well, that’s very moving. It’s a shame I don’t vote.

Senator: This is who I am. I believe in people. I’m not hiply cynical and I don’t make easy, snide remarks. I would rather think that people are good and be disappointed once and again. [House gets up and grabs a syringe and some rubber gloves from a cabinet.]

House: I need to draw some more blood.

[Cut to the Senator, alone. He sits up, and tries to get out of his bed. He stumbles, and realizes that his right leg is not working. After lifting it and dropping it on the floor a few times -- ]

Senator: NURSE!!

[Cut to Cuddy and House leaving House’s office.]

Cuddy: The antiretrovirals aren’t working.

House: That’s not surprising.

Cuddy: He’s just going to keep getting worse. You realize that, right?

House: Why are you spying on my case?

Cuddy: Why are you giving that speech next week? [House pushes the elevator button.] We’re both just doing what we have to do.

House: And you don’t see a problem with that?

Cuddy: Checking in on a patient? Yeah, wow, how do I look myself in the mirror?

House: You’re not the one being asked to perpetrate a fraud on the American people.

Cuddy: It’s a ten minute speech!

House: That I’ve been ordered to give.

Cuddy: Vogler’s drug works!

House: Don’t care.

Cuddy: Oh, why do you have to make everything so dramatic? [Elevator dings.]

House: Because I’m a very high-strung little lapdog. [as he enters the elevator] Ruff ruff ruff, rarr, ruff! [Cuddy looks faintly disgusted.]

[Cut to a nurse and another man helping the Senator back to his bed. The nurse grabs the medications -- ]

House: [standing in the back of the room] Nuh uh. No pills.

Senator: What’s going on?!?

House: The antiretrovirals aren’t working.

Senator: Why not?

House: Because you don’t have AIDS. [The Senator laughs.] The first test was a false positive. Happens one time in every five thousand.

Senator: You r-ran a second test.

House: Yeah. You’re still dying. The only difference is now we don’t know why.

[Cut to Foreman taking the Senator’s pulse. He notices that his right arm is twitching.]

[Cut to Cameron, Chase, Foreman, House and Wilson talking and eating outside.]

Foreman: He’s continuing to lose control of the muscles on his right side, his brain is getting foggier, and his T-cells are in the single digits.

Chase: Why are we doing this here?

House: So Cuddy can’t find us. Unless we find out the underlying disease, this guy’s lied to his last constituent.

Wilson: [looking at the chart] False negative on the PCR AIDS test?

House: Ran it twice.

Chase: Immunoglobulin deficiency?

House: No history of respiratory problems.

Cameron: Ideopathic T-cell deficiency.

House: Ideopathic, from the Latin meaning we’re idiots ‘cause we can’t figure out what’s causing it. [He takes a Vicodin.] Give him a whole body scan.

Cameron: You hate whole body scans.

House: ‘Cause they’re useless. Could probably scan everyone of us and find five different doodads that look like cancer. But, when you’re 4th-down, 100 to go, in the snow, you don’t call a running play up the middle. Unless you’re the Jets. [He walks away.]

Cameron: I hate sports metaphors.

[Cut to House and Wilson, walking into the hospital.]

Wilson: Why did you order the second AIDS test?

House: Standard procedure.

Wilson: Oh, well, that’s you. Mr. Standard Procedure. You suspected the first test was a false positive?

House: I knew he was going to Africa and I figured he was vaccinated for Hep A and B. That could cause a false positive.

Wilson: Yeah, but you knew that before you ordered the first test. What changed?

House: I should have ordered both.

Wilson: You were sure he had AIDS, then you talked to him, then you had doubts. What, what did he say?

House: He said he had not engaged in any risky behavior.

Wilson: Huh. And you believed him.

House: Well, he didn’t have any reason to lie –

Wilson: Everybody lies, except politicians? House, I do believe you’re a romantic. You just didn’t believe him, you believed in him. Do you want to come over tonight and watch old movies and cry? [House gives a great-looking smirk.] Dr. Cameron’s getting to you. Well, I guess you can’t be around that much niceness and not get any one you.

House: Is that why you haven’t put the moves on her?

Wilson: What makes you think I haven’t put the moves on her? [House stops and stares, then realizes he fell for Wilson’s trap.] Oh. Oh, boy! You’re in trouble. [Wilson laughs and walks off. House walks into Exam Room One, where Sarah awaits.]

House: You have restored my faith in the human race. You’re lying.

Sarah: No, I’m not lying.

House: I just got your results back. No GHB, no nothing. It means you’re having sex, and you’re lying about it.

Sarah: No, and I have a new symptom. I have a rash on my butt. [She smiles triumphantly.] Do you want to… [House nods, resigned. Sarah lowers her pants so House can see.] What is it?

House: It’s a carpet burn.

Sarah: No! It can’t be! Doctor, I love sex. I miss it. I haven’t had any in over a year.

House: Well, you managed to keep this appointment, so you have no short-term memory problem. Multiple personalities? Do you find yourself losing chunks of time? Do you wake up and you don’t remember falling asleep?

Sarah: No, I just wake up really exhausted.

House: Is something upsetting you?

Sarah: No. [House gives her a look.] My ex lives in the apartment downstairs. He’s always calling me, always wanting to get back together, complaining about mixed signals. Get out of my life, how much clearer can you get?

House: We have a sleep lab in the basement. If nothing else, it’ll get you away from your ex for a night.

[Cut to the Senator, going in for his full body scan.]

[Cut to the team looking at the results.]

Wilson: Slightly enlarged lymph node in his left armpit.

House: How slightly?

Wilson: Quarter mil. [Cuddy enters.]

Cuddy: Lymphoma?

House: Sure, or he’s had a cold in the last six months. [to Chase] What, you’ve got her on speed dial?

Cuddy: I just follow the scent of arrogance. [House makes a face.]

Chase: Another slightly enlarged node over here. Two more in his neck and one in his groin.

Wilson: And there’s a cyst in his liver.

Cameron: Looks complex. Central necrosis?

House: Spontaneous bleeding, it’s benign. I was rooting for a really cool tumor, instead we’re stuck with this crap.

Cuddy: Doesn’t matter. Once you find ‘em, you’ve gotta check ‘em.

House: Well, knock yourselves out. [Vogler enters.]

Vogler: I just saw Senator Wright, he looks like hell. That sushi must have been a lot worse than you thought.

House: Mr. Vogler, would you like a free whole body scan? A man of your stature should get himself checked at least three times a year.

Vogler: Here’s a few key points I want you to cover during your speech.

House: Fourteen pages. The audience will be comatose by paragraph two.

Vogler: Throw in a joke. [Vogler leaves.]

House: Dr. Chase. We need to talk.

[Cut to House and Chase walking in the hallway.]

House: How do you see this ending?

Chase: What ending?

House: I can’t fire you, so you have no reason to fear me, and therefore no reason to lie to me. You told Cuddy where I was. You told Vogler what I was doing. [pause]

Chase: Yeah.

House: So how can I work with you?

Chase: Well, you don’t have a choice. [Chase walks off.]

[Cut to Foreman, performing some more tests on a now doped-up Senator Wright.]

Foreman: This might hurt a little.

Senator: Lie to me.

Foreman: Okay. It’ll, uh, feel like a gentle massage.

Senator: House is a lousy teacher. You can’t lie for beans.

Foreman: Have you ever told any really big ones?

Senator: Oh, ho, I might be messed up, but I’m not that out of it, no no no no no… [The senator’s arm starts to convulse.]

Foreman: Strap his arm down.

Senator: Am I gonna be okay?

Foreman: I hope so.

[Cut to House and Wilson in House’s office. House is reading the report on Eastbrook.]

House: I am selling my soul.

Wilson: Just a little piece. And you are getting something in return.

House: I said I was selling it. I didn’t say I was giving it away. That would be immoral, and stupid. All they’ve done is added antacid.

Wilson: Does it work?

House: That’s not the point!

Wilson: Well, of course it’s the point! He’s not asking you to lie, he’s not asking you to do something illegal –

House: He’s not asking me to do anything.

Wilson: He’s not ordering you. He gave you a choice. You chose your staff. I know this isn’t easy for you. You’ll suffer. Vicodin sales in Jersey will triple. But you are doing a good thing. [Foreman enters Diagnostics with the test results, House gets up to see them.] Only you could feel like crap for doing something good.

Foreman: Kidney and liver cysts are both benign, and lymph nodes all came back clean.

House: His left armpit node has antibodies for CB 11.

Wilson: Well, not enough to indicate lymphoma.

House: We never tested for hairy-cell leukemia.

Wilson: No, but we would have picked it up somewhere besides one lymph node.

Chase: And his spleen isn’t enlarged.

House: Size isn’t everything. The spleen is the mother load for hairy-cells. Let’s cut it open.

Chase: You can’t biopsy his spleen. It’ll bleed like –

Cuddy: In the Senator’s condition, a spleen biopsy could easily cause sepsis and kill him!

House: Why do you do this to me? Now, if I kill him, I can’t tell the judge I had no idea of the risks involved.

Foreman: His brain’s turning into mush, and he’s at risk for more infections, so we have to do it.

House: See, that’ll sound much better in court. Okay, go tell our human pincushion we’ll be sticking him one more time. [As they all leave -- ] Cuddy. Don’t you hate doing this?

Cuddy: Yeah.

[Cut to the lab. Cameron is looking into a microscope as House enters and leans against a counter.]

Cameron: What’s up?

House: You like me. Why?

Cameron: That’s kind of a sad question.

House: Just trying to figure out what makes you tick. I am not warm and fuzzy and you are basically a stuffed animal made by grandma.

Cameron: I don’t think that’s why you’re asking. I think it’s because of the speech.

House: [muttering] Oh God, don’t try and pick me apart.

Cameron: Then why are you asking? What do you want to hear? [She walks closer to him, but House leaves.]

[Cut to Foreman, bringing a form for the Senator to sign.]

Foreman: Hey, Senator. We need to do one more biopsy, on your spleen.

Senator: [coughing and clearing his throat] I’ll have to sign lefty, my fingers aren’t working. [Foreman hands him the pen, but the Senator starts to cough and can’t stop. It sounds like he’s gasping for air.]

Foreman: You’ve been coughing a lot? Does it hurt?

Senator: [while wheezing] It’s like I can’t get air. Is that from the toxo?

Foreman: [while listening to his breathing] No, this is, this is new. You don’t need to sign, we can’t do the biopsy.

[Cut to the Senator, now hooked up to a breathing mask.]

[Cut to the team in the Daignostics office.]

Foreman: The Senator’s breathing is severely impaired. His O2 stat levels are at 89. His silver stain indicates pneumocystis carinii pneumonia.

Wilson: Another killer fungus. It’s consistent with hairy-cell leukemia.

Foreman: But we can’t biopsy his spleen. Respiratory distress? His platelets are 20 and dropping, his blood won’t clot worth a damn.

Cameron: There’s gotta be another way to diagnose hairy-cell.

Wilson: No, his bone marrow’s indeterminate, spleen’s the only way to go.

House: [standing by the window.] You know, when the Inuit go fishing, they don’t look for fish. [Every looks at House for a bit, but he remains silent.]

Wilson: [sighing] Why, Dr. House?

House: They look for the blue heron, because there’s no way to see the fish. But if there’s fish, there’s gonna be birds fishing. Now, if he’s got hairy-cell, what else are we gonna see circling overhead?

Chase: He should have all sorts of weird viruses.

Cameron: HTLV and ATLV.

House: We can test for them. Run the titers.

[Cut to the clinic. House is showing Sarah the results of the sleep lab.]

House: These were your brain waves at 2:45 AM. Now, here it comes, there’s an abrupt jump from slow-wave sleep. This indicates partial sleep arousal. The most common type is somnambulism – sleepwalking.

Sarah: That would explain why I’m so tired when I wake up.

House: Yes, and also why you were pregnant. And the hickies. And the carpet burn.

Sarah: I had sex in my sleep?

House: Sexsomnia is a documented disorder. You said your ex lives downstairs –

Sarah: I’ll kill him.

House: Okay, but he probably didn’t know that you were asleep. Sexsomniacs can act pretty normal. I’m going to write you a prescription for a low-dose antidepressant. It’ll let you sleep better. If you want to save yourself the $15 co-pay, you can have sex while you’re awake.

Sarah: He’s my ex, I –

House: You live in the same building, you haven’t had sex with anyone else for a year, you sleepwalk right into his arms. Call me crazy, but I’m sensing unresolved issues.

[Cut to House leaving the clinic. Foreman runs into him.]

Foreman: Negative for HTLV-1 and 2 and ATLV and everything else. It’s not hairy-cell. [He stops House.] Hey. You really gonna give that speech?

House: You’ve got an opinion, too?

Foreman: I’m a little surprised. Frankly, I thought you were too much of a self-absorbed ass to do this for us.

House: You’re welcome. He’s positive for Epstein-Barr.

Foreman: So what? It doesn’t point to hairy-cell, it’s irrelevant. [House pushes the chart at Foreman and walks off very quickly.]

[Cut to the Senator’s room. House enters, places his cane at the foot of the bed, then removes the Senator’s breathing mask. All of the Senator’s speech is compromised because of his stuttering and gasping for air.]

Senator: Hey!

House: You didn’t fall off the swings when you were eight.

Senator: Six!

House: Ever.

Senator: Give that back!

House: Uh uh. We have to talk. You had an epileptic seizure. That’s how you bit your tongue.

Senator: I haven’t had a seizure since I was –

House: What medication did you take?

Senator: No seizure since I was six. No drugs since I was ten!

House: Yeah, that’s it. Don’t worry about what the question is, don’t worry that you’re starting to feel dizzy, just stay on message.

Senator: [frantic now] My mother used to call it physofin –

House: Phenytoin?

Senator: Yeah! [House places the breathing mask back on the Senator’s face.] Okay, okay, you’re okay, it’s okay. Everybody lies.

[Cut to House in the Diagnostic office with his team.]

House: Senator Gary H. Wright of New Jersey had childhood epilepsy. He took phenytoin. That drug, with the Epstein-Barr virus, is associated with common variable immunodeficiency disease. T-cells down, B-cells down, it keeps you from forming enough antibodies. See, antibodies are basically your defensive line. [Cut to CGI shot describing what House is saying… minus the sports players.] And your brain is like the quarterback. And then the fungi are like blitzing linebackers, plunging up the middle. Your lungs are like… okay, you’ve got two quarterbacks –

Chase: CVID? That’s a type of immunoglobulin deficiency. I said that.

House: Yeah, well, it was a stupid idea when you said it. Then he got the respiratory problem and tested positive for Epstein-Barr.

Foreman: That’s pretty much a childhood disease.

House: Another reason why Chase’s suggestion was idiotic. He got it when he was a kid. Didn’t get any symptoms until now, it happens. It gets triggered by stress, like public speaking.

Cameron: So you’re basing your diagnosis on a disease that’s relatively common and a drug he took thirty years ago.

House: Start the senator on IV immunoglobulin stat. If he gets better, I’m right, if he dies, you’re right.

[Cut to Foreman hooking up the IV.]

[Cut to a shot of House, still looking at information on the ACE inhibitor.]

[Cut to House, lying on the floor of his office. Foreman rushes in.]

Foreman: Dr. House!

[Cut to House and Foreman checking the Senator’s reflexes. They work, now!]

House: You faked that.

Senator: No.

House: Say “antiretroviral”.

Senator: Antiretroviral.

House: Now say it three times fast.

Foreman: We just got back your latest blood results. Your white cells are up, your T-cells are back over 100.

Senator: Well, that’s good, right?

Foreman: In a week? That’s terrific. You’ll need medication for the rest of your life, but other than that, you’re fine.

Senator: Am I well enough to run for president?

House: Well, why not run for pope while you’re at it?

Foreman: Oh, come on. Kennedy had Addison’s, FDR had polio. Two of the best presidents in the last hundred years –

House: If they were running today they wouldn’t stand a chance.

Senator: So, you figure you’d be Surgeon General if you didn’t have the limp.

House: No, there’s things I can’t do, and like you said, I have to live with reality.

Senator: Well, [knocks on the hospital bed frame] then I’m running.

Foreman: Good for you.

Senator: No, don’t get excited, he’s right, I, uh, I won’t win.

House: Then why run?

Senator: Oh, I see, your point being the only way to make a difference is to win every fight. [House looks pensive.]

[Cut to the dinner where House is giving his speech. House is sitting up on stage, Vogler is behind the podium.]

Vogler: But hey, why listen to me? I own the company, I’m certainly not to be trusted, right? Dr. Gregg House, on the other hand, has a reputation. For integrity, among other things. [Crowd chuckles. Quick shot of Wilson, Cuddy, Chase and Cameron sitting at a table in the audience.] Ladies and gentlemen, Dr. Gregg House. [House stands up and walks to the podium to applause. The PPTH table looks slightly apprehensive, as if their jobs were riding on what is to happen next. Well, I guess when you think about it… We see Foreman for the first time, leaning against a doorway. House adjusts the microphone, and…]

House: [reading off a paper, very monotone] Eastbrook Pharmaceuticals’ extraordinary commitment to research excellence is exemplified by their new ACE inhibitor, a breakthrough medical approach that will protect millions from heart disease. [He looks up at the crowd, stuffs the paper in his pocket, and starts to walk away. The PPTH team gives looks of “That was it?”]

Vogler: [quietly, yet deadly] That’s not a speech.

House: I thought it was pithy. You got enough for a press release, anyhow.

Vogler: Foreman or Cameron? [House gives a little smile and goes back to the podium.]

House: A few things I forgot to mention. Ed Vogler is a brilliant businessman. A brilliant judge of people, and a man who has never lost a fight. You know how I know the new ACE inhibitor is good? Because the old one was good. The new one is really the same, it’s just more expensive. [Vogler does not look happy.] A lot more expensive. See, that’s another example of Ed’s brilliance. [At this point, Wilson looks mildly interested, Cuddy looks mad, and Chase and Cameron look like the world’s about to end.] Whenever one of his drugs is about to lose its patent he has his boys and girls alter it just a tiny bit and patent it all over again. Making not just a pointless new pill, but millions and millions of dollars. Which is good for everbody, right? [Cuddy is now shaking her head in disbelief, and Wilson is staring pointedly.] The patients, pish. Who cares, they’re just so damn sick! God obviously never liked them anyway. [Cuddy = furious; Wilson = facepalm. Chase downs his whole glass of wine, and Cameron is staring at the table’s centerpiece.] All the healthy people in the room, let’s have a big round of applause for Ed Vogler! [House claps, Foreman shakes his head, the rest of the room stays silent. Vogler, well, he doesn’t look happy at all. As House hands Vogler the paper -- ] I threw in a joke.

[Cut to House’s house. (Bwah. The real reason he’s not living in an apartment any more.) He’s sitting at the piano, ironically playing “High Hopes”. There are 12 unanswered messages on his machine. A knock at the door. House gets up to open it, sees who it is, waits a moment, and then opens the door to admit Cameron.]

House: I’m sorry. I should have taken a couple of extra Vicodin and just held my nose.

Cameron: I’m guessing you did take a couple extra Vicodin.

House: True.

Cameron: You don’t need to worry about firing anyone. I’m leaving.

House: Why? Is this another noble, self-sacrificing gesture? You trying to protect Foreman?

Cameron: No.

House: So this is just, “Don’t fire me, I quit.”

Cameron: I’m protecting myself. You asked me why I like you. You’re abrasive and rude, but I figured everything you do, you do it to help people. But I was wrong. You do it because it’s right. [Near tears, she extends her hand. House looks at her hand, and around the room, but doesn’t take it. She withdraws her hand.] There are only two ways I can deal with things. One is in my control. That’s to leave. [House looks like he might say something, but doesn’t.] Goodbye, House. [As House still doesn’t look at her, she walks out the door.]


END