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Tuesday, September 26, 2006

Season 3 X 04 : Lines in the Sand


Original Airdate: 9/26/2006
Written by: David Hoselton
Directed by: Newton Thomas Sigel
Transcript by: Jenna


(The scene opens on a man sitting at a table with severely autistic son Adam, trying to engage his interest to teach him something.)

Dominic: Follow my finger. [Adam pulls up his shirt so he doesn't have to see.] Adam, show me a bicycle. [He holds up a pad with stick-on pictures of objects. We see from Adam's point of view that things look exceptionally blurry and his interest is drawn to a fly.] Eyes here. Adam? Show me a bicycle.

[Adam finally extends his hand but picks up the picture of balls instead.]

Dominic: [Resigned.] No buddy, that's a ball. [Adam hides behind his t-shirt again.] Adam look at me, are you hungry? Show me what you want for lunch.

[Adam picks up the chalk and draws a squiggly line on the little black board in front of him. It is one of 4 that he has already drawn.]

(Scene moves on outside where Adam is eating his lunch and Dominic talks to his wife.)

Dominic: Still drawing those lines instead of looking at the cards.

[Adam has finished his lunch and is banging his glass on the table.]

Sarah: More juice?

Dominic: He wants more juice he has to ask for it. Adam? Buddy? Eyes here.

Sarah: He's tired Dom.

Dominic: Wouldn't be if we stuck to the schedule. Show me the juice, buddy.

Sarah: Think we've reached the point of diminished returns.

Dominic: [Sharply interrupting her.] He has to ask for it. Adam!

[Adam suddenly starts choking.]

Sarah: He's choking!

Dominic: That's impossible, it's mac and cheese.

[Adam grabs at his throat and suddenly starts screaming in agony.]


[OPENING CREDITS]


(Scene opens on the conference room in the morning, House throws a file down on the desk.)

House: 10-yr-old boy screams for his life for no reason.

Foreman: He's autistic, severely autistic. Can't talk, can't make eye contact. Screaming's probably his way of communicating.

[House looks around the office oddly.]

House: And he went to 3 different doctors who all said just that.

Foreman: Wow, so clearly that can't be the answer. His brain can't filter information, it's a constant assault on his senses I'd scream too.

House: Or it's something medical sounding like dysesthesia. Parents are convinced that there's something wrong with their son. [He suddenly walks out of the office; the Ducklings quickly get up and follow him.]

Cameron: Since when do we start believing parents? Or anyone? Where are we going?

House: Elevator. [He presses the button and waits for it.] Dad was on Wall Street, mom was a partner in an accounting firm, when their son was diagnosed with autism they both quit.

Foreman: So they're overprotective and scared, that's all the more reason to--

House: They've studied this kid, heard him scream a million times. Did 10 years of caring for him, this is the first time they've brought him to a hospital.

[Elevator arrives, they troop in.]

Foreman: ER checked his throat, no obstructions, nothing! Which means the only symptom was a scream, which is diagnostic of nothing.

Chase: [Beta Comment: Who, lately, always seems willing to give it a shot when the other two are being dismissive.] Kid clutched his chest, BP was elevated; maybe there was chest pain.

Foreman: ER said the heart was fine.

House: Don't be so quick to dismiss pain.

Cameron: Where are we going?

House: Down. Stool sample to check for parasites, blood culture to rule out infection and ANA for lupus.

Cameron: Because he screamed?

Chase: Could also be an environmental reaction; an allergy, dust, wheat, pollen, a toxin.

[They reach the ground floor and troop out into the lobby.]

House: Check the house. Run a lung ventilation scan. Lungs are in the chest too, right?

Foreman: I had a date last night, she screamed. Should we spend a 100,000 dollars testing her?

House: Of course not, this isn't a veterinary hospital. Zing! [He pushes the door open into the clinic.] Look, if you don't think this kid is worth saving--

Foreman: That's not what I'm saying!

House: Well that's too bad, it's a good point. Kid's just a lump with tonsils. You know what it's going to be like trying to put an autistic kid into a nuclear scanner? I don't envy you guys. [He opens the door to Cuddy's office and leaves them to their job.]

House: I want my old carpet back. [He bangs his cane on to her desk, she's on the phone.]

Cuddy: Err; we're going to have to do this later. A kid in the clinic had an accident. [She puts the phone down.] Generally when people are on the phone--

House: I want my old carpet back.

Cuddy: It was stained, with blood.

House: Yeah, my blood. Which makes the carpet part of me, I want it back. I want to be buried with it.

Cuddy: You think you can get me to do anything you want regardless of how stupid it is?

House: It's my office; it's where I work, where I think, where I save lives, allowing you to brag to rich people so they'll give you more money to spend on MRIs and low-cut tops. I want it back the way it was.

Cuddy: It's identical to the old carpet, except without the hazardous biological waste.

House: I shall not return to my office until every patented durable microfibre has been restored to its rightful place.

Cuddy: Inspiring. [She puts up her feet on the desk.] If you don't want to work in your office, work in the clinic. You don't want to work in the clinic, go home and don't get paid.

House: [Banging on the floor with his cane.] Attica! Attica! Attica! Attica! Attica! [Stops banging the cane and looks at her.] Attica?


(Scene changes to Adam playing a game on his Gameboy in his room in the hospital.)

Dominic: He just needs to finish this level.

Foreman: We only have the scanner for the next half hour, after that--

Dominic: Trust me; you don't want to move him until he's finished.

Foreman: The sooner we do this test, the sooner we can get you guys home.

Dominic: [Sits down next to Adam.] Adam? Do you think that--

[Adam shakes his head and tries to move away from Dominic's hand on his shoulder while making noises of displeasure.]

Dominic: 10 minutes tops.

Foreman: If he has a vascular disorder, we might not have--

Dominic: He might not have 10 minutes?

Foreman: I don't have 10 minutes. [He tries to snatch the Gameboy from Adam. Beta Comment: He obviously slept through class the day they discussed autism.]

Dominic: No! You don't want to do that! [Adam cries and starts screaming.] Adam! Adam! [Sarah tries to calm him down by hugging his head and making comforting sounds.]


(Scene changes to House doing his clinic duty, he is listening to a patient while learning his head on the top of his cane.)

Patient 1: I used Metamucil like the doctor told me and finally I was able to use the bathroom but I saw something in the toilet I couldn't identify. [She opens up her handbag and digs something out.] I wrapped it in tissue paper so you could take a look. [She offers it to him and he cringes back.]

(Scene shifts back to Foreman trying to get Adam strapped up for the test while he is screaming and fighting.)

Sarah: Can't you sedate him or something?

Foreman: Could if I didn't want the test results to mean anything.

(Scene goes back to the clinic.)

Patient 2: Painkillers, exercises, I even did that puncture thing, nothing works. Then this morning, I get up, my back feels great. I figured I'd better get down here right away.

[House looks down in despair and utter boredom.]

(Scene moves on to Chase and Cameron at the family's home taking samples of stuff.)

Cameron: [With a bottle of pills.] Big shocker, dad's depressed.

Chase: Save your time, SSRIs don't cause chest pain. [He puts something back in the fridge and looks at what is on the door.] Wow. Every minute of every day is booked. He eats, sleeps, plays his handheld.

Cameron: Not much of a life for them.

Chase: They chose to have a family; you don't get to decide what your kid's going to be like.

Cameron: Nobody chooses this.

[They move out into the backyard.]

Chase: It's funny. You get a normal kid, a parent works. You get a special kid that costs more; you quit and turn the backyard into a therapy circuit.

Cameron: Yes, if only you were handicapped, all the good times you could have had with dad. [He looks at her like 'Dude.']

(Scene moves back to the clinic, House [with stethoscope slung around his neck.] moves out of one clinic room and heaves a big sigh before moving into the next.)

[Ali, the stalker girl from the last episode is waiting inside.]

Ali: Hey doctor House.

House: Hello girl whose name I don't remember but whose dad I treated so I don't really know why she's here.

Ali: Ali. Umm... I think I caught what my dad has. The rhino thing.

House: Right. [He presses two fingers into two spots on her forehead.] Does that hurt?

Ali: A little. It's in my chest too.

House: Of course it is. [He puts the earpieces of the stethoscope back into his ear as she unzips her shirt... she doesn't have anything on underneath. House's jaw drops and he goes rather wide-eyed.] Kinda had access through the shirt, this'll work. [He listens to her heart.]

Ali: That feels good.

House: Exactly when did New Jersey run out of horny 17-yr-old boys?

Ali: About 5 weeks ago? It's been very lonely.

[They both laugh softly, Foreman barges in and Ali quickly zips her shirt back up. Foreman gives them an odd look.]

Foreman: The ventilation scan was normal, time to send him home.

House: Can't leave right now. [Turns back to Ali.] Well congratulations, you are the proud owner of your very own rhino thing.

Foreman: A rhinovirus? You can't leave because she has a cold?

House: Can't leave because Cuddy says I can't leave.

[Foreman does his eyebrow thing and closes the door.]


(Next scene, the whiteboard has been moved down the lobby of the clinic, House is sitting on the nurse's desk and the Ducklings are crowded around the board in the midst of the busy clinic.)

Foreman: All the tests are normal.

Brenda: Hey, don't start with me. We're backed up.

House: I know this is hard for all of us but thanks to doctor Cuddy I don't have an office so I have to work here.

Cameron: What'd she do to your office?

House: It's unusable. So, whatever's bothering him it wasn't his lungs. What about the kid's house?

[Brenda knocks on the door of Cuddy's office and moves off to do her thing.]

Cameron: There were some pesticides and some alcohol but the tox screen was negative.

Foreman: Which means there's nothing physically wrong with this kid.

House: We already had that discussion. Did we get a fecal smear? [He purposely says the last bit louder to ick out the people in the clinic.]

Chase: Should we do this some place else?

House: Nope, Cuddy says I have to work here.

Cuddy: [Walking out of her office.] No, I said you can work in your office or you had to work here.

House: And since I can't work in my office.

Cuddy: Is this your master plan? Disrupt hospital business until I replace your carpet?

House: Devious. Saw it in a James Bond movie. [Raising the volume.] Fecal smear, talk to me!

Cuddy: Get out of here.

House: Put back my carpet?

Cuddy: No! Get out of here!

House: Fecal matter, is there a sample we can look at?

Foreman: Parents have the smear the kit but the kid is constipated.

Cuddy: Do what you want, not replacing your carpet. [She smiles in victory and struts back into her office.]

House: Go up his rear and get a smear. Which reminds me, I kinda feel like a bagel. [He walks out of the clinic.]

Cameron: Carpets.


(Scene changes to Adam playing on his Gameboy again.)

[Foreman knocks and enters the room.]

Foreman: We need a stool sample. We should probably wait until he's finished playing that level, huh?

Sarah: I actually think he's a bit better today. He seems more like his old self.

Foreman: [All pompous and I-told-you-so.] It is possible that he was never sick.

Dominic: I guess we err... could have overreacted.

[Suddenly Adam starts gagging and spits out a lot of fluid.]

Dominic: Adam? Adam!

Sarah: Adam!


(Next scene, the team and the whiteboard are in Wilson's office.)

House: So what makes fluid fill the lining of a kid's lungs?

Cameron: Why are we in here? This is some sort of power play?

House: Yeah. So you stuck your finger in the kid and gave him a pleural effusion. [He moves stuff off the edge of Wilson's desk so he can perch on it.] You ever considered getting a manicure?

Foreman: I took the stool sample after his lungs failed.

Cameron: Or do you really have a problem with the carpeting? Change sets you off--

House: I said it was a power play, someone answers yes to option A, you don't move on to option B.

Chase: If there's a pleural effusion, we have to rule out heart failure. [Beta Comment: Still the only one actually on task.]

Cameron: Why now? Why a power play now?

House: I smelled weakness. Get the kid an echocardiogram. [He starts playing with the Zen garden on Wilson's desk when Wilson enters his office. He looks confused at seeing the team in there, the Ducklings look slightly embarrassed. Wilson looks at the name on his door.]

Wilson: That's funny; it says James Wilson, what a strange typo.

House: The fluid comes back in exudate; get him on broad spectrum antibiotics.

[The Ducklings walk out.]

Wilson: Thank you for coming.

Cameron: No problem.

House: Thought you wouldn't mind sharing offices for a while.

Wilson: You share stories, feelings... toys. You don't share offices.

House: That is so not Zen.

[Wilson snatches the Zen garden out of House's hands.]

Wilson: It was a gift, some doctors get those.

House: So you want mornings or afternoons?

Wilson: [Hangs up his lab coat.] You couldn't make Cuddy miserable so you're going to make me miserable so I can make Cuddy miserable on your behalf?

House: Yep.

Wilson: What makes you think I can make her miserable? [Starts rolling up his sleeves.]

House: Because you're good at that stuff.

Wilson: Ohhh, I'm nothing compared to you.

House: [Picks up a random toy.] Is there anything you'll throw out?

Wilson: That's a gift from an 11-yr-old patient of mine, she and I both knew it was a piece of junk and that's what made her laugh.

House: So you gotta keep it until she... [He draws his hand across his neck and makes an execution sound.]

Wilson: She already did.

[House pauses for a moment before he dumps it into the bin.]


(Scene moves on to Foreman trying to give the kid another test while he's screaming and fighting. His parents are helping to hold him down)

Foreman: Adam, I need you to stay still buddy!

Dominic: Okay, it's okay, I got him. Here we go.

[Foreman starts to ultrasound Adam's heart and looks worriedly on the screen at the result.]

Dominic: What? What is it? Is his heart ok?

Foreman: No.


(Next scene, the whiteboard has been set up in a little meeting room somewhere in the hospital. The Ducklings sit and listen to House in front of the whiteboard writing.)

Foreman: Echo suggested a conduction abnormality, EKG confirmed it.

Chase: Still doesn't explain the effusion. Pleural fluid was in exudate, we should be looking for something that explains both the heart and lung problems. An infection, parasite, cancer?

Foreman: Microbiology showed no organisms in the fluid so forget infection.

Cameron: It's not a power play. [House stops writing.] Doing a differential in the clinic makes sense - piss Cuddy off. Same thing with Wilson's office - works indirectly. But now we're in office space because you don't want to be in your own office which means this has nothing to do with Cuddy, you really are obsessed with your carpets. Which means--

[And just at that moment Cuddy and a few business-looking people walk into the room.]

Cuddy: What are you doing here? I have this room booked from 2 to 3.

House: [Turns around and feigns surprise.] Oh, 2 East coast time? [Cameron looks resigned.] I thought you meant Pacific, which is stupid of me I guess. [The Ducklings start to get up.] What about parasites?

Foreman: Stool sample's negative.

Cuddy: It's 2 o' clock.

House: Oh well, we should go then. [Ducklings are about to get up again.] That just leaves cancer. Get a lung biopsy.

Foreman: It took a half an hour to get a mask on the kid for the lung scan!

House: Well I'm sorry, was there somewhere you needed to be?

[The Ducklings get up and leave the room.]

Cuddy: House, can we talk?

[They walk out of the room and talk outside in the corridor against the railings as the business-type people Cuddy came with go into the room.]

House: Carpet?

Cuddy: Never.

House: Nothing to talk about.

Cuddy: Your girlfriend called the clinic 15 times looking for you today.

House: Huh. A lot to discuss, china patterns--

Cuddy: House, she's a stalker.

House: Right, couldn't be that she finds me interesting and attractive. Has to be that she's insane.

Cuddy: She's called you 15 times; your mother's not that interested in you.

House: Well maybe I'd be better adjusted if she was.

Cuddy: I'm notifying security.

House: Is this about the carpet? Do you think I'll back off if you block all my fun?

Cuddy: You better not be having fun!

House: I'm having fun. I'm not having sex.

Cuddy: She's dangerous!

House: She's not dangerous.

Cuddy: She's pretty.

House: She's pretty.

Cuddy: Men are stupid.

House: I'm with you so far.

Cuddy: I'm notifying security.

House: Oh, give her a break, she's not dangerous, she's... insightful. [Cuddy walks away and back into the meeting room. House presses himself up against the glass of the door and shouts into the room at all the business men and Cuddy.] You can't stop our love! [The business men are startled; Cuddy gives an embarrassed smile in response. House looks smug.]


(Next scene, Foreman knocks on Wilson's door and walks in.)

Foreman: Hey, you got a minute?

Wilson: Yeah.

Foreman: We have a 10-yr-old with pleural effusion and conduction abnormality but no heart failure.

Wilson: Was there a protein in the pleural fluid?

Foreman: Yeah, that's why we're thinking cancer, Non-Hodgkin's probably so we want to do a lung biopsy.

Wilson: Lung biopsies usually come back negative so biopsy a lymph node under the arm.

Foreman: That's probably something an Oncologist should do, right?

Wilson: There's nothing real tricky to it, just a biopsy.

Foreman: Still, just to be safe, you mind? [Wilson shakes his head.]

(Sneaky Foreman - next scene, Adam is screaming and fighting again as the nurses try to make him breathe from the mask to knock him out, Wilson heaves a big sigh as he waits to perform the biopsy.)

[House enters the room.]

House: For the love of god, can't somebody shut that kid up? Got people trying to work around here. [To Wilson.] Why don't you show him a teddy bear or something?

Dominic: Who are you?

House: Somebody you'll never send a gift to.

Wilson: This is doctor House, your son's doctor.

House: [He picks up the gas mask.] High test please. [To Adam.] Hey, hey, hey! [He puts the mask to his own nose and starts loudly breathing from it for Adam to see.]

Wilson: Out of vicodin?

Sarah: What are you doing?

House: Eating the red berries. [He keeps breathing from the mask and then tries to put the mask on Adam's nose and mouth. Adam isn't fighting as hard against it but is still protesting. House looks very high and keeps blinking a lot. He breaths from the mask again and then tries it on Adam. This time Adam accepts and is knocked out in a couple of seconds.]

Sarah: He trusted you.

House: No, that wasn't trust. That was self-preservation.

Dominic: No, that was huge. It was like a conversation.

House: [Tries to get up and unsteadily hangs on to the overhanging lights.] Monkey's afraid to eat the red berries until he sees another monkey eat them. Monkey see, monkey do, that's all it was. Your kid's still just as messed up as when we admitted him.

[Wilson starts the biopsy as House walks away and makes a huge stumble into a trolley in his highly unsteady state, Wilson makes a face to the parents as if to say it's ok, this happens all the time.]


(Later; House, Wilson and Cameron are doing tests on the biopsy samples in a lab later. Cameron is preparing slides and Wilson is looking at them. House still seems a little high and is staring a little dazedly at Cameron.)

Wilson: That was sensitive.

House: You have pretty hair.

Wilson: Hope is all those parents have going for them.

House: No, hope is what's making them miserable. What they should do is get a cocker spaniel. A dog would look them in the eye, wag his tail when he's happy, lick their face, show them love.

Cameron: Is it so wrong for them to want to have a normal child? It's normal to want to be normal.

House: Spoken like a true circle queen. See skinny socially privileged white people get to draw this neat little circle, and everyone inside the circle is normal, anyone outside the circle should be beaten, broken and reset so they can be brought into the circle. Failing that, they should be institutionalized or worse, pitied.

Cameron: So it's wrong to feel sorry for this little boy?

House: Why would you feel sorry for someone who gets to opt out of the inane courteous formalities which are utterly meaningless, insincere and therefore degrading? This kid doesn't have to pretend to be interested in your back pain or your excretions or your grandma's itchy place. Can you imagine how liberating it would be to live a life free of all the mind-numbing social niceties? I don't pity this kid, I envy him.

Wilson: Err, no cancer... because these aren't lymph cells.

Cameron: Then what are they?

Wilson: Liver cells.

[Cameron takes a look at the microscope and House transfers the image on to the computer screen.]

House: Wow. Liver cells under his arm. I wonder what he's got where his liver's supposed to be.


(Scene changes to House once again playing with the Zen garden on Wilson's desk, the Ducklings enter.)

House: Anyone got a clue how liver cells got into the kid's armpit?

[Foreman and Chase take the couch, House shoves the Zen garden into the bin and pats the space beside him on the edge of the desk and looks at Cameron]

House: Make yourself at home. So, think maybe Gray's Anatomy got it all wrong?

Foreman: Lymph system circulates fluid, not organ cells.

Cameron: Cancer cells break into the lymphatic system all the time.

Chase: But we're not talking about cancer cells.

House: So what's the difference between cancer cells and liver cells, why can one pass through walls but the other can't?

Cameron: Cancer cells are damaged lets them go into blood vessels, go wherever they want.

House: So if the liver cells are damaged...

Foreman: Liver isn't damaged. The tests were normal.

House: So if the liver cells are damaged -- it's theoretically possible to pass into the lymphatic system. Liver failure could also explain pleural effusion, even the heart issues.

Cameron: Liver cells are fine, he was immunized for Hep A and B and do you really think this kid is having unprotected sex or sharing needles?

House: Hmm, daddy does seem the type to use a rubber. So it's not viral. [He gets up and starts pacing.] Just leaves a lot of boozerosis.

Cameron: Our 10-yr-old boy does not having a drinking problem or cirrhosis.

Foreman: House, when we echoed his heart we got a piece of his liver, there was no scarring.

House: Cirrhosis explains the symptoms; heart problems, lungs.

Cameron: Look up cirrhosis in the dictionary, it means scarring.

Chase: Parents aren't doing or dosing this kid.

House: How would you know that? Kid can't talk. Why'd you think I took this case? He's not going to give away the ending.

Chase: They quit their jobs for him.

House: Yes, they are everything you'd want in a parent. Unfortunately their kid is nothing you'd want. When a baby is born, it's perfect; little fingers, little toes, plump, perfect, pink, and brimming with unbridled potential. Then it's downhill, some hills steeper than others. Parents get off on their kid's accomplishments. [House picks up one of Wilson's toys which then says "Bend over and relax".] Cute! They'll annoy you with trophy rooms and report cards. Hell they'll even show you a purple cow and tell you what a keen eye for color their kid has. [Wilson bursts into the office, looks annoyed and walks back out again.] But this kid, he doesn't smile, he doesn't hug them, he doesn't laugh. His parents get nothing, the right to brag that their kid picked orange juice out of a line-up.

Foreman: So you figure they slipped the kid a mickey so they don't have to deal.

House: Do a biopsy to confirm cirrhosis and don't try and pawn it off on Wilson, he's going to be busy with Cuddy.

[Chase and Foreman walk out and Cameron approaches House.]

House: My parents love me unconditionally. Get out of here.


(Scene moves on to Wilson talking to Cuddy as they walk down the stairs towards the ground floor.)

Wilson: Don't you think the restraining order's a little much? He's not actually going to have sex with a 17-yr-old patient.

Cuddy: I didn't think he was going to ask me to dig a blood-stained carpet out of a dumpster either.

Wilson: It might be easier in the long run.

[Wilson stops at the landing in between two flights of stairs.]

Cuddy: Are we stopping here so House doesn't find us?

Wilson: Unless you wanna make out?

Cuddy: You want me to surrender to House's coup?

Wilson: No, no, you proactively give him what he wants.

Cuddy: I defeat him by surrendering to him.

Wilson: He'll never see it coming. Look, I'll pay for it myself! What is it? A thousand bucks to carpet a room?

Cuddy: Actually it's 400.

Wilson: Ohhh!

Cuddy: Not doing it. [She continues walking down leaving a disappointed Wilson.]


(Foreman walks into Cuddy's office, House is sitting at her desk reading some papers.)

House: Liver biopsy?

Foreman: They're doing it now.

House: How's it going?

Foreman: Like a biopsy; needles, cells, screaming.

House: What'd you find in the stool sample?

Foreman: You were too busy bothering Cuddy, as discussed it was negative for parasites. Can we get out of here?

House: I didn't ask what you didn't find; I asked what you did find in the stool sample.

Foreman: Stool. And traces of iron, zinc, calcium carbonate, can we leave?

House: What's the matter? You afraid of the man?

[Foreman laughs scornfully but as he turns to the door, Cuddy walks in and he almost jumps in fright.]

House: Uh oh, too late.

Cuddy: Leave my stuff alone!

House: You're meeting with a Guggenheim in 15 minutes wearing that?

Cuddy: I'm going to count to 3 and then, I'm going to fire you. One.

House: Calcium carbonate, that's uhh... antidiarrheal, right?

Cuddy: Two.

House: Think that's significant? Think hard poops are significant? [Turns back to Cuddy.] Two and a half? Never threaten unless you're ready to deliver, makes you look weak. Thank god you don't have children.

[The phone starts ringing and House is about to pick it up when Cuddy snatches it out of his hand.]

Cuddy: Doctor Cuddy.

House: Take a message.

Cuddy: Your patient is being rushed to cardiac ICU.

House: Wow, that's like the one thing that would get me out of here.


(Scene shifts to Adam being rushed into the ICU.)

Cameron: [To the parents.] I'm sorry you can't come in here.

Dominic: What's going on?

[Chase and the nurses shift Adam off the gurney and on to a bed.]

Chase: He's in v-fib!

Nurse: [Brings the defibrillator.] Here you go. Charge.

Chase: Clear! Charging, clear! Charging, clear!


(Scene shifts now to House playing with Adam's blocks at the table in Adam's room.)

Cameron: He's stable for the moment, first degree atrioventricular block.

House: Okay, what else do we know?

Foreman: His liver's damaged, pleural effusion compromises lung function.

Chase: Biopsy was negative for cirrhosis. Parents didn't poison their son.

House: It's not his liver, his heart or his lungs. The calcium carbonate in his stool.

Chase: He's constipated, parents probably just overdid it.

House: Or they didn't do it at all. Calcium carbonate's also what's in chalk.

Foreman: So he ate some chalk, it isn't toxic, sure didn't cause the pleural effusion.

House: Forget the chalk.

Cameron: You just said it was about the chalk.

House: Yes, and then I said forget the chalk, you must be very confused. This kid's got pica. Take him to a buffet he's going to eat the table.

Chase: Old lead paint?

Cameron: Level of lead in the blood was normal. His tox screen was clean.

House: We're not looking for typical poisons we're looking for anything that he can put in his mouth; matches, spiders, bricks.

Chase: Pressure-treated wood used to contain arsenic.

House: Even better. [To Foreman.] Hansel, get samples of the gingerbread house; bag everything.


(Next scene is later in the day; House is wearing his leather jacket and is downstairs in the parking garage about to go home.)

[His bike is now in the middle of the parking garage and Ali is sitting on it.]

Ali: Hey.

House: You can get into a lot of trouble being here.

Ali: I wanted to see you.

House: Yeah, I got that. So did everyone else, they think you're a stalker.

Ali: One could argue those people might be jealous of your attention.

House: Yes I actually made that argument.

Ali: You going home?

House: That's the plan.

Ali: In Iceland the age of consent is 14.

House: I'm surprised that tourism isn't a bigger industry up there.

Ali: So today I'm jailbait but in 22 weeks anybody can do anything to me. Will I be so different in 22 weeks?

House: 22 weeks is enough for an embryo to grow arms and legs.

Ali: It's just a line; an arbitrary line drawn by a bunch of sad old men in robes.

House: Yeah, who cares what judges think.

Ali: Didn't think of you as a guy who followed rules just because they were rules.

House: You are over 10 years younger than me. [Ali makes a face.] I said over.

[There's the sound of an elevator dinging before Cuddy appears.]

House: Gotta go!

Cuddy: House.

House: Doctor Cuddy, do you happen to know the way to the Icelandic consulate? This young woman, a stranger to me, was just asking directions.

Cuddy: Security was going to call the police; I don't want to do that to you. Go home.

House: She needed a ride.

Cuddy: She got here on her own she can get home on her own. Now! [Ali grudgingly gets off House's bike.] And if I see you on hospital grounds again, I will call the police.

[Ali gives House a sweet smile accompanied by a "do me" look before walking off, House blinks at her and Cuddy gives a shocked look.]

House: After that look I'm feeling a little frisky, looks like you're up.

Cuddy: I'm ovulating, let's go.

House: The frisky it went away.

Cuddy: House, this isn't a game.

House: If I leave her alone can I have my carpet back?

Cuddy: No.

House: If I forget about my carpet can I have her?

[Cuddy doesn't bother to reply and he swings his cane and slides it into his bag like a ninja slides his sword back into a sheath strapped to his back. It's just terribly cool.]


(We see scenes of Foreman at the family home taking samples and pulling a plant up from inside a tunnel that's part of Adam's playground.)


(Next day, House is playing Adam's Gameboy on his bed when the Ducklings walk in.)

Foreman: Jimson weed. Found a small patch of it in his backyard. Jimson weed contains atropine. Poor man's acid. Our kid's been tripping on Lucy in the Sky with Cubic Zirconium; explains the pleural effusion, the heart arrhythmias.

Cameron: Meeting here will do nothing to upset Cuddy.

House: I'm not trying to upset Cuddy; I'm trying to figure out what's wrong with the patient. Continue.

Foreman: Done.

Chase: Jimson weed doesn't explain the screaming.

House: You've obviously never had a bad trip.

Cameron: I would have thought you'd try to accomplish two goals at once.

House: Why can't you be more like the other age inappropriate girls who have a thing for me? Just accept me for me. Continue.

Chase: Treatment for Jimson weed OD is physostigmine. Kid's got heart issues, the two don't mix. We better make sure that's what he's got.

Foreman: Serum from the lab in Patterson is 3 days minimum.

Chase: He won't survive 3 days.

House: What time does he wake up?

Cameron: 7.35am.

House: Then what? Walk me through it.

Cameron: 7.40 - 7.50 he goes to the toilet, washes his face, what does this matter?

House: I'm trying to prove he ate the plant.

Foreman: His schedule has nothing to do with Jimson weed.

House: There are two possibilities, either the parents saw him eat the plant or the kid has unsupervised time and eats plants instead of playing blocks.

Chase: Even if you find 15 minutes of free time outside doesn't mean he spent it eating a bush.

House: So what do we do? Nothing? Wait for the kid to tell us? What?

[House gathers his stuff and gets up off the bed.]

Cameron: Where are you going?

House: To talk to him.


(Scene moves to the ICU, House walks in on the family.)

House: Ever see your son eat a bush?

Sarah: I haven't.

Dominic: I've only ever seen him eat leftover--

House: Adam! [The boy opens his eyes a little droopily.] Did you eat something at your house, something that made you sick? I need you to show me what you ate. [Adam makes protesting noises.]

Dominic: He can't answer you.

House: Neither can you. [House takes one of the learning boards that Adam has and starts sticking pictures on it as he talks to illustrate his point.] This is your backyard; you may know it as Mel's Diner. Here's your sandbox, your jungle gym, under it is this. [He picks up a photo of the Jimson weed and puts it on the board.] I need to know if you ate this, Adam. [Adam isn't really looking and is still making protesting noises.]

Dominic: He doesn't know what you want.

House: Adam, you have to tell me because if you don't, [He picks up the Gameboy and shows the game over screen on it.] it'll be game over, you'll be dead.

Dominic: What the hell are you doing?

House: Show me what you ate. Adam! Show me what you ate.

[Adam slowly reaches out his hand and pulls at the picture of the sandbox and holds it in his hand. Suddenly his right eyeball does a flip in its socket and does a 360.]

Dominic: Adam?

Sarah: Honey? Adam!


(Next scene is in the hospital's chapel, two grieving strangers are inside sitting quietly when the Ducklings come in.)

House: [At the podium in the front of the room, talking in a spot-on Southern accent.] Come on in, brothers and sister. Welcome to the house of the Lord!

Cameron: House, come on, the chapel?

House: [One of the strangers leaves. House points to the whiteboard next to him on the podium.] We have been blessed with the miracle of a new symptom. Brother can you testify as to why this poor child's eyeball rolled back into his head? [Uses his cane to point at Chase.]

Chase: It's consistent with Jimson weed poisoning, ocular paralysis. [The other stranger gets up to leave.] Sorry.

House: The wicked shall deceive ye because they have turned from the Lord and are idiots, his ocular muscle didn't paralyze, it pirouetted.

Cameron: MS.

House: It is easier for a wise man to gain access to heaven!

Cameron: Can you stop doing that? Just say not MS.

Chase: Stroke, bleed in the brain.

House: [Back to his normal American accent.] We'd be seeing other symptoms besides a single eye misalignment, like a coma, and you've already testified.

Foreman: It's a tumor.

Cameron: And all the imaging just missed it?

Foreman: It's a micro tumor. Started in his lung which caused the pleural effusion, then it metastasized to his liver which made it slough cells. And then went to his brain behind the eye which caused it to roll back into his head.

House: So he has 3 tumors and we missed all of them. What's the opposite of a miracle?

Foreman: I've a better chance of finding it now that I know exactly where to look. So, unless you have a better idea, I'm going to go CT his head and then if I have to, remove his eye.

House: You remove this kid's eye he's only going to be half as good at not making eye contact.


(Next scene, House is eating crisps, daydreaming and sitting in front of the wall fountain of cascading water that we saw in 2.19 House vs. God.)

Cuddy: Hello? Hello? Hello? [House finally looks up.] I have sad news for you. She doesn't love you.

House: You're ugly when you're jealous.

Cuddy: She showed up at my house last night, came on to me.

House: She's even more perfect than I thought.

Cuddy: House! She's sick.

House: You say sick, I say freestyling.

Cuddy: The girl will have sex with an invertebrate.

House: Come on, you're not that bad.

Cuddy: She has a problem. You're not doing her any favors by indulging her!

House: Why would you lie like this? Do you not have room in your heart for love?

Cuddy: You don't believe me.

House: I didn't believe the kids when they said that Suzie was sleeping with Johnny. Didn't believe them then I don't believe them now, I don't care that Suzie married Johnny, he's mine.

[Cuddy looks baffled by this.]

Cuddy: She has a mole on her right breast just below the nipple.

House: [Softly.] No she doesn't.

Cuddy: You've seen her breasts?!

House: It was a medical exam. I was listening to her heart; it went "Greg House, Greg House, Greg House".

Cuddy: Fine, I'm lying. But she did come back, she's locked up in my office, I was hoping you could talk to her, put an end to this.


(House walks into Cuddy's office where Ali is waiting.)

[Almost everything he says to her is quoted from Casablanca but she doesn't realize that.]

House: Listen to me; do you have any idea what you'd have to look forward to if you stayed with me? Nine chances out of ten we'd both wind up in a jail.

Ali: You're only saying that to make me go.

House: I'm saying it 'coz it's true. Inside of us, we both know that you belong with Victor. [She looks confused.] Is there a Victor in your class? [She shakes her head.] Well if you're not with someone your age, you'll regret it; maybe not today, maybe not tomorrow, but soon and for the rest of your life.

Ali: [Starting to cry.] What about us?

House: We'll always have Fresno. I'm no good at being noble but it doesn't take much to see that the problems of two little people don't amount to a hill of beans in this crazy world. Someday you'll understand that. [He raises her chin.] Now, now, here's looking at you-- [He notices that her tears are milky.] Damn. Was there an earthquake when you were in Fresno?

Ali: What?

House: I ask all my girlfriends that.

Ali: Umm... yeah a little one.

House: Damn.

Ali: What? What is it?

House: It's not love, you have spore in your brain; Coccidioides immitis. California's full of them, they get an earthquake they get released into the air, you breathe it in you get a cold, turns into sinus congestion, aches, weakness, milky tears and sometimes loss of inhibition and judgment. Damn! [He takes up a prescription pad.]

Ali: So loving you, wanting to have sex with you is all just the spores talking?

House: [Hands her a prescription.] You'll probably live. Damn!


(Later the day, House is playing with a slinky in Adam's room when he sees the board full of squiggly lines that Adam drew on his blackboard. He suddenly realizes something and rushes off.)

(Scene moves to House bursting into an OR.)

House: Hey! Don't touch his eye!

Surgeon: This is an appendectomy.

House: Like I said, don't touch his eye.


(And then House walks into the ICU where Foreman and the parents are still waiting beside Adam's bed.)

House: Why isn't he in surgery?

Foreman: Some emergency bumped him; we've got another room in 10 minutes.

House: Better not take him in, kill the lights. [He sits on Adam's bed.] He's seeing them all the time.

Foreman: What are you looking for?

House: [Using a light to peer into Adam's pupil.] He's telling us what he's seeing, telling us exactly what was wrong with him, drawing them for us over and over again. Nobody knew how to speak autistic. When I asked him what he ate he even told me that. [He holds up the picture of the sandbox.]

Dominic: What are you talking about? What was he seeing?

House: [Peers into the pupil again and now we can see the squiggly lines Adam was drawing... they're worms.] Hello my pretties. It's not a tumor, Foreman, it's worms swimming in his eye. Animal makes potty in the sandbox, boy plays in the sandbox, boy eats the sand, you can probably tell where this is going by now.

Foreman: Stool samples were negative for parasites.

House: Raccoon roundworms are not excreted by their human host.

Foreman: Cameron tested the sand.

House: All of it? Worms spread from his gut to the rest of his body. Attacked his lungs, that's what made him scream and caused the effusion. [CGI of all this as House explains.] Invade his liver sending dead liver cells coursing through his system, it attacked his eye and the muscles surrounding it making his eyeball do a back flip. Laser photo coagulation can fix the eye and high dose of benzimidazole should kill the worms.

Dominic: Wait a minute, that's it? He's going to be ok?

House: Good news, he's going to be with you for a long, long time.


(Much later, Wilson walks into Cuddy's office with a big book.)

Wilson: I'm going to read you something. "Asperger's syndrome is a mild and rare form of autism. It is typically characterized by difficulty establishing friendships and playing with peers, trouble accepting conventional social rules, and they dislike any change in setting or routine"... or broadloom. Doesn't say that last part but you get my point.

Cuddy: House doesn't have Asperger's, diagnosis is much simpler; he's a jerk.

Wilson: Why do you think he took this case? Because he believes these parents? Because he wants to help a young boy? He sees himself in this kid and he's trying to help himself. He doesn't want this, he needs it.


(Later House is sitting on a couch in front of Adam's room watching the family as they prepare to leave; Wilson comes up and leans on the pillar next to the couch.)

Wilson: You're not autistic; you don't even have Asperger's. You wish you did, it would exempt you from the rules, give you freedom, absolve you of responsibility, let you date 17-yr-olds. But most important it would mean that you're not just a jerk.

House: At what point does a person endlessly lecturing someone make him a jerk? [Silence for a while as they watch the family.] First tongue kiss, an 8 on the happiness scale. (Possibly harking back to the scale Wilson was talking about in 3.01 Meaning.) Your child being snatched back from the brink of death, that's a 10. They're clocking in at a very tepid 6.5 because they know what they have to go back to.

[The family walks up to House.]

Dominic: Listen... thanks.

Sarah: You saved his life.

House: Yeah I know, see ya.

[Adam walks up to House without making any eye contact, and then hands House his Gameboy. House takes it and Adam makes eye contact with him for a couple of seconds, but it's enough. He walks away again and the parents are almost in tears, so ecstatic to see such progress from their son.]

Dominic: You're so good! [Dominic kisses his son on the head and both parents smile thankfully at House as they walk on.]

Wilson: That was a 10.


(Last scene, a guy is rolling out the old carpet in the conference room to reveal the bloodstains. House watches on as Cameron walks up to him and stands next to him)

Cameron: All change is bad? It's not true you know.

(Scene closes to Waiting on an Angel by Ben Harper.)



Waiting on an angel
One to carry me home
Hope you come to see me soon
Cause I don't want to go alone
I don't want to go alone

I don't want to go alone

Tuesday, September 19, 2006

Season 3 X 03 : Informed Consent


Original Airdate: 9/19/2006
Written by: David Foster
Directed by: Laura Innes
Transcript by: Kat & Justine


(Scene opens in a research lab, rats, surgical equipment and a doctor all appear over the background of J.S. Bach's "Cello Suite No. 1 in G Major, Prelude".)

Doctor [To the lab rat he's just plucked from a cage.]: You're not gonna make this easy, are you? [He picks up a syringe.] Unfortunately; as much as I admire your spirit, je ne sais rien.


[He puts the rat to sleep, starts autopsy recorder.] Subject anesthetized with .5 cc of sodium pentobarbital. Transfected with human hepatic cancer cells; underwent six rounds of intra-abdominal treatment with DS-22.

[He uses scalpel to start cutting.] Vertical incision through the rectus sheath opens the abdominal cavity. Incision extended into [Coughs.] thorax. [Coughs again, loosens collar, appears to be having trouble breathing.]

Liver appears normal in color, no apparent scarring or [Coughs as he turns liver over.] - Damn it! Cancerous tumor is still present, on the right lobe. 1.12 cm in diameter. No reduction.

[Coughs and begins gasping. Picks up another rat but drops it; continues wheezing and gasping. Falls to knees. CGI of liquid in his trachea emptying into his lungs and filling them. He passes out with eyes open, looking dead; the rat he dropped falls onto his chest and begins nibbling at his lower lip.]

[OPENING CREDITS]

(Scene opens on the conference room in the morning. He pushes door open with his cane. The ducklings look at him puzzled that he's using the cane again.]

House: 71 year old cancer research specialist. Minor tremors, localized melanoma removed 2 years ago, cataracts. And he can't breathe. Also, disregard the facial lacerations. They're creepy, but unfortunately irrelevant. [He winks.] Don't you wanna know why?

Cameron: You... have your cane.

House: No, why the lacerations are creepy. He was about to dissect one of his lab rats when he collapsed. The little vermin seized the day, so to speak and went medieval on his ass. [The Ducklings stare at him with frowns.] What, my fly open?

Foreman: So the... the pain's returned.

House: There was no pain, he was unconscious. I'm guessing, because he wasn't able to breathe.

Cameron: We're talking about you.

House: Obviously. I'm obviously not. What is it with you people? I don't use the cane, you're shocked. I use the cane...

Cameron: We're just concerned.

House: About the wrong person. I can breathe. Ezra Powell on the other hand, is gonna die.

Foreman: THE Ezra Powell???

Chase: The researcher? The guy who wrote that textbook?

House: *That* textbook, THE textbook.

Cameron: Wait - there's actually another doctor you admire?

House: I... admire lots of doctors. 'Course most of them look a lot better in knee socks than Ezra Powell, but seeing as they can all breathe.

Chase: Oxygenation is through the floor and lungs are full of fluid. Gotta be his heart; could be amyloidosis. [He holds up the chest x-ray.]

Foreman: Or his lungs; probably from using and inhaling toxic chemicals in his lab. [Camera focuses on House, grimacing in pain.]

Chase: It's not the lungs. Chest x-ray is clean.

Foreman: So's his EKG, it's not his heart.

House: You're being too nice. [He looks up at them.] Outside the hospital he can't breathe, inside the hospital he can. Means we help, at least enough to screw with our test results. The source of the problem's either in his heart or his lungs. So all we gotta do is stop helping, put a little pressure on him, and see which gives out first.

Chase: At 71, we get his heart or lungs to give out we might not get 'em to give in again.

House: That's why we're gonna do it in a hospital. Put him on an incline treadmill and do a stress EKG. [He grabs a donut and limps into his office with the cane.]

Foreman: So much for the admiration.


(Scene changes to a procedure room; Cameron is helping Powell start the stress test.)

Cameron: Let's get you started. [Powell can't quite get out of the wheelchair.] I'll turn your oxygen up.

Powell [Getting on the treadmill.]: I... I worked with Williams on the first protocol for this machine.

Cameron: Everyone still uses it.

Powell: Except for Williams. He died four years ago.

Cameron: I'm sorry.

Powell [Nodding.]: He was 84. He died parasailing. He was always [Gasps.] an idiot.

Cameron [Smiling.]: You okay? [Powell begins to walk.] Hang in there. You know the protocol's only a few minutes.

(Inside the viewing room watching Cameron, Powell and the monitors.)

Foreman: His heart rate's flat. We don't get it past 130, we're not gonna see anything.

Chase: And if he falls and breaks a hip, we're not gonna see anything
Either; except an increase in our malpractice insurance.

Cameron [Joining them.]: I figured House might go back to the pills, but if he's using his cane he's right back to where he was before. Maybe even worse.

Chase: Luckily he'll handle it in a stoic, grown-up fashion -- he'd never take it out on us. [Foreman nods.]


Powell [Panting hard now.]: I can't. I... I gotta stop.

Cameron [Through the intercom from the viewing room.]: Just a little longer.

[Powell stumbles.]

Foreman: His heartbeat's only 90. I'm gonna increase the incline.

[Cameron goes into the procedure room with Powell.]

Powell: I gotta stop. I... I... I gotta get off.

Cameron: You're doing great, just a little faster, okay?

Powell: I don't need a cheerleader, I need oxygen.

Cameron [Pushes stop button on the treadmill.]: Stop, this isn't working.


(Exiting elevator on the first floor.)

House: His heart rate barely got above 90.

Cameron: He can't breathe, there's too much fluid in his lungs.

House [Extremely sarcastic and animated.]: REALLY!? He's got FLUID in his lungs, whatever are we gonna do?? Oh yeah, now I remember. [Hands results back to her.] Put him on a treadmill and run him like one of his rats on a wheel.

Cameron: He can't run, he can hardly walk.

House: It's 'cause he's not trying hard enough. If he was, his heart rate would go up.

Cameron: Exercising with a lung full of your own bodily fluids tends to hurt.

House: They don't call it a stress test for nothing. Do it again.

Cameron: He's drowning!

House [Entering clinic.]: Then pull him outta the pool, and... Do. It. Again.

[Powell's room, he's having his lungs aspirated by Chase.]

Powell [Coughing]: I'm assuming this isn't your idea of a long term solution.

Cameron: We need to get rid of the fluid in your lungs, so you'll be able to do the test.

Powell [Nodding.]: To see if it's my heart, or my lungs.

Cameron: Exactly.

Powell: My money's on both. [Sighs.] I've been in and out of the hospital for the past year. I'm old. And sick. I'm getting older and sicker. Not a very interesting differential, but... [Grimaces in pain as the needle goes in.] Oh!

Chase: I'm in. [Tight shot on the syringe and Powell grimacing.]


(In the Clinic. House has a tongue depressor in a bald guy's mouth and is shining a light in. A young blonde teenager, presumably the bald guy's daughter, is in the room watching.)

Dad [Talking despite the tongue depressor.]: You don't need a $400 handbag.

House: It's kinda hard to check your throat when you're flapping your gums around.

Dad [Around tongue depressor.]: Oh... sorry.

Daughter: But it's for the fall formal.

House [Substituting for Dad, in a faux fatherly voice.]: He doesn't care if it's for the presidential inauguration.

Dad [Agreeing around the tongue depressor.]: Uh huh.

Daughter: But I'm using Marissa's old dress, it's free.

House [In Dad voice.]: Yeah, you know what else is free? The roof over your head, the food you eat, [The girl frowns at House.] your phone, your computer. [He takes the tongue depressor out of Dad's mouth and addresses him.] How long have you been congested?

Dad: All week, ever since we got back from Fresno.

House [Feeling Dad's glands.]: Fresno. That's in France, right? See the Parthenon?

[The girl leans back against counter and smiles at House.]

Dad: Uh, California. I've got no appetite, I'm aching all over, I'm weak...

House [Pushing 2 fingers on the guy's forehead sinuses and interrupting.]: Does that hurt?

Dad: Yeah.

House [To daughter.]: Does his voice always have that unattractive nasal tone?

Daughter [Laughs.]: Totally.

House [Smiling at her slightly.]: I'm gonna take that giggle as a no. Fever, aches, weakness, loss of appetite. [Daughter is smiling at House again.] You been having any anal sex with I.V. drug users lately?

Dad [Offended.]: Of course not, I'm married.

House [Nods.]: You think she might've been having--

Dad and Daughter [Simultaneously, and shocked.]: NO!!

House [Nods.]: It's probably a rhinovirus. [He starts filling out a prescription.]

Dad: What's that?

House: Cold. [He hands him the slip of paper.] Take this 4 times a day, and stay off airplanes. Flying cesspools.

[House goes to leave, juggling the file, the cane and the doorknob; he drops the file.]

Daughter [Rushing over to help him pick up the papers.]: Oops! [Straightening up and beaming at House as she hands them back.] You dropped something. If there's anything else you can think of, please call.

[House stares at her. At this moment Cameron runs up and looks between the two of them.]

House [Turning to Cameron.]: Yes?

Cameron: He's... too old and weak.

[Daughter is still beaming at House and arches her eyebrows at him. Cameron gives her a look. House looks from one to the other and starts to look awkward. With one last look at the girl he leaves, closing the door behind him.]

[Back in the procedure room Powell is doing the test on a machine where you use the arms to pedal instead of the treadmill.]

Powell: Yeah, this is way better. This'll work. [Grunts.]

Cameron: Just try.

House [In the viewing room.]: There are 20 words to describe chest pain -- burning, squeezing, stabbing, tearing -- each one diagnostically useful. For that you have to thank Dr. Powell's textbook. There are no words to describe degrees of what he's feeling right now -- shortness of breath. If he'd worked on those issues, there would be. Because he never would have given up until he had an answer.

Cameron [Assisting Powell.]: This isn't working.

[House comes into the room with them.]

Powell: Dr. House...

House: Please don't get up. I'm sure you're very busy. [He gets a syringe from a cart.] I'm just gonna try and speed things up a little.

Cameron: Is that Epi? That's not the protocol.

House [Injecting into Powell's IV.]: No, the protocol, is what you tried to do and failed each time. [All are staring at him like he's mad. The machine starts to beep as Powell's heart rate increases.] Over 100... now we're getting somewhere. How's it look, Foreman?

Foreman [Through intercom.]: No EKG changes.

House [With raised eyebrows.]: Then we push harder.

Cameron: House, you're gonna kill him.

Powell [Gasping.]: No, he's right, let him -- let him do it.

House: See? That's why he doesn't have to wear knee socks.

Cameron [Firmly.]: He can't breathe.

[House injects part of a second syringe of Epi into the IV and the monitor starts beeping wildly.]

House: 130. [Powell looks scared, and like he can't breathe.] The magic number. Nothing here. Foreman?

Foreman: Still no sign of blockage.

House: Which means it's not the heart. So it must be the lungs. [Goes over to the cart to put the syringe down, not to get another syringe to calm the guy.] See? That wasn't so hard, was it?

[Cameron gets it and comes over to inject.]

Powell: No! Just -- give me the rest of the epinephrine.

Cameron: The test is over, it's okay, we're gonna stabilize you.

Powell: No! [Grabs her arm, then more softly.] No. Just let me die.

Cameron: You're not gonna die.

Powell [Gasping.]: Yes, I a-am.

Cameron: We'll find a treatment.

Powell [Staggered.]: I don't wanna live like this. Please. I'm begging you. [Gasps.] Kill me.

[Cam's eyebrows raise and she looks at him sympathetically.]


(In House's Office)

Cameron: He says no more tests. He wants to die, and he wants us to help him do it.

House [Walking past her with his red mug into the conference room.]: And I want to play a little game I like to call 'Block My Spike' with Misty Mae.

Cameron: He's thought this through; it's not an impulsive decision.

House: Neither is mine. He's depressed. He'll feel much better after we cure him.

Chase: He's seen all the tests we've seen. Even if we figure out what was causing the lung damage, it's too late to reverse it.

House: You can't know that without knowing what's wrong.

Chase [Firmly.]: It's his call.

Foreman: So what do we do? We put a plastic bag over his head and get it over with?

Chase: No. We give him a syringe full of morphine. [The others turn to look at him.] Every doctor I've ever practiced with has done it. They don't want to, they don't like to, but that's the way it is.

Foreman [Shaking his head.]: I haven't, I won't.

Cameron: I couldn't do it either.

Chase [Incredulous.]: You just said we should respect his decision.

Cameron: Respect it doesn't necessarily mean we honor it.

Chase: Right. Just means we talk about it. [Pause.] At some point, do no harm has to mean allowing nature to take its course, not stubbornly standing in the way of it.

[House is pacing, chewing on a coffee stirrer, and listening.]

Foreman: Sticking a metal syringe into a plastic I.V. line and pumping in a lethal dose of morphine is not letting nature take its course. Not according to the state of New Jersey.

Cameron: So it's better we allow him to slowly suffocate in his own plasma?

Foreman: Whose side are you on, senator? First respect his wishes, then invade Iraq, then get the troops home. Make up your mind.

House: Wow. [The ducklings snap to attention.] Certainly a lot of interesting things to consider. Stress EKG rules out the heart, which means something's gotta be attacking his lungs. Mycoplasmas or strep pneumo, which probably means it's too late to do anything about it. We could try levofloxacin.

Cameron: Coming up with a new treatment isn't gonna do us any good unless we convince him it's worth trying.

House: Oh, come on. He's old, and sick, and tiny. We can do whatever we want to him.

[Everyone's beepers go off at once, and they exchange grim looks.]


(In Powell's room, a nurse is helping him back into bed as the ducklings enter.)

Cameron: What happened?

Nurse: I don't know. Must've fallen out of bed and got the nasal canula wrapped around his neck somehow.

Cameron: Ezra, what are you doing?

Powell [As the nurse adjusts his oxygen]: I don't wanna live hooked to machines, too weak to wipe my own ass.

House [Coming into the room behind the others.]: Why would you wanna wipe your own ass when you can have someone do it for you?

Powell: You're wasting your time. There must be other patients you could actually help.

House: No, all services rendered on a first-come, first-served basis.

Powell: I won't consent! To any more tests. And if anyone tries to so much as touch me, I'll press charges for assault.

House [Nods.]: Okay well you heard the man; he wants everyone to leave him alone. [To the nurse.] Why don't you go first. [Nurse stares at him.] GET OUT! [She glares at him, but leaves. House sits on the bed.] You came to me, I didn't come to you.

Powell: I figured you'd have the guts to do what had to be done, if it came to that.

House [Looking at him shrewdly.]: We're nowhere near that. It's time to test your lungs. [He uses his cane to grab a breath meter from the bedside cart, and puts the hose end into Powell's mouth. Powell struggles.] Breathe! You have to exhale sometime.

Foreman [Rushing over.]: Stop!

Cameron [Pulling on House's shoulders.]: House, you're hurting him.

House: You're hurting me. [They let go, Powell begins to cough, spitting out the meter.] Fine; you don't help us, we don't help you. [House faces him and speaks slowly.] Your lungs slowly fill with fluid. You gasp to catch every breath but never can. Every breath is petrifying. It'll be slow, painful; torturous.

Powell: We don't choose our birth, and we don't choose our death.

House: What if you could? How 'bout we make a deal? Give me one more day. If I don't find out exactly what's wrong with you by then, I help you die.

Cameron: House! [Foreman shakes his head.]

House: 24 hours. Come on, it's not gonna kill you.

Powell: Ha. [Nods.]


(Cut to hallway.)

House [Looking for ideas.]: Old guy. Lungs. Fluid. Go.

Foreman: You canNOT help him kill himself.

House: Of course I can. Chase says we do it all the time. [Chase rolls his eyes.]

Cameron: Cuddy's not gonna let you...

House: Enough! You don't want me to kill him. Fine. Here's a big shock; I don't wanna kill him either. How do I not kill him? By you guys doing your job. We have 24 hours to figure out what's wrong with him. [Impatiently waiting for ideas from the ducklings.] Tick tock, tick tock.

Chase: I'll draw cultures. Pneumonia; should be bacteria in his blood.

House: It's gonna take longer than 24 hours.

Chase: Not if I spin down the sample. Separate off the buffy coat, then gram stain for bacteria.

House: [Nods.] Great. Do an amylase, D-dimer, C-reactive peptide, get a urine, and do a bronchial sputum while you're at it. [He indicates Cameron.] You check his home and lab for radiation and toxins. [He indicates Foreman.] And do a bone marrow biopsy.

Foreman: All of that in 24 hours?

House: Nah. Whatever you don't get done you can finish at the autopsy.

(Long montage sequence of the Ducklings at work: Cameron examining Powell's house, and lab; the other two taking samples, doing tests, cultures; all three doing research reading, waking each other up when they doze off, drinking coffee.)

House [Coming into lab with a bagel the next morning, in laughing tone.]: Wow. You guys look like crap. [They say nothing.] Whaddya got?

Chase [Very tired voice, looking at his hands.]: Purple dye on my fingers.

House: What'd the bone marrow biopsy show?

Foreman: Don't have the results.

House: What? What've you been doing all night?

Cameron: JELLO shots and wild sex, what else? [House looks shocked, then narrows his eyes suspiciously at Cameron.]

Foreman: No bacteria in the blood cultures. We still have some cooking, but so far, nothing.

Chase: Nothing in the urine.

Cameron: Lab was clean enough to do surgery in, because well, they *do*. There was no sign of viruses or fleas on any of the rats.

[House's phone rings.]

House [Answering it.]: Yeah. -- Who? - Well... tell her to call the clinic. Then tell her to leave a message, and I'll get back to her. [Cameron frowns suspiciously, obviously having an idea of who is on the phone.] Then tell her to leave a personal message. [He hangs up.]

Cameron: Who's that?

House: Your prot�g�. What are these?

Cameron: Dictation tapes. He records everything.

House: Why?

Cameron: Because he's a diligent researcher?

House: Or he's losing his memory.

Cameron: A lot of people dictate their notes.

House: Yes, we could assume that, and we'd have nothing. Or we could assume it's a symptom, in which case whatever's in his lungs, is also in his brain. Unless you got something more promising.

Cameron: I'll go get an MRI of his head.

House: Keep testing 'til you find something. I'm going to my office to rest for awhile. [They all glare after him.]

(In the MRI room.)

Powell [Being helped by Cameron onto the platform.]: It's been a long time since I took an anatomy [He coughs.] class, but I'm pretty sure you're moving farther and farther away from my lungs. Running out of places to look aren't you?

Cameron: Doesn't mean we're gonna stop looking.

Powell: No, not for six more hours.

Cameron: You want us to fail?

Powell: No, but you will.


(Meanwhile back in the lab with Wilson and House.)

Wilson: No abnormal nuclei means no leukemia; he a drinker?

House: Not according to the history.

Wilson: Which means yes, he drinks, which gives us a nice mundane explanation for the acellularity.

House: Or he's telling the truth. Which means fungus is still on the table.

Wilson: But your entire view of human nature gets destroyed. [He shrugs.] Six of one, half a dozen of the other.

[Cameron enters.]

House: Bad news fast. Good news you can take your time.

Cameron: Head is clean. You were wrong, his faculties are intact.

House: Too bad. If his brain was addled, we wouldn't have to listen to anything he says.

Wilson: Hand me the 10% KOH.

Cameron: It's 4 o'clock; we have nothing to tell him.

House: Then we have no reason to talk to him. We still haven't ruled out fungus.

Wilson: Yup, we have. No buds, no hyphae.

House: [Sighs.] Okay. Next procedure; we sneak in, turn back the clock. [Wilson smiles, Cameron looks forlorn.]


(Powell's room, House enters followed by all the ducklings.)

Powell: Whole team. Must [Coughs.] be bad news.

House: Nope. Bone marrow biopsy revealed multiple myeloma. [Chase and Foreman exchange looks.] It's not good news, but there are some treatments. [Cameron is staring at House] We have to draw some blood...

Powell: What about my breathing?

House: Associated hyperviscosity syndrome; gummed up the blood vessels in your lungs.

Powell: Dr. Chase said my calcium is normal.

House: Mm. We call him Dr. Idiot. [Chase rolls his eyes, Foreman crosses his arms.]

Powell: There's no M-protein in my urine.

House: Odd presentation.

Powell: So odd that Dr. Cameron doesn't believe it either. [House turns and glares at her.]

House: Just give me 12 more hours.

Powell: We had a deal. No more tests.

House: Fair enough. Give me six more hours. [Powell purses his lips.] Listen; there is no evidence that you are terminal.

Powell: You a man of your word or not?

House: No, as a matter of fact, I'm not.

Powell: Fine. Then discharge me. [House looks beaten.] My lungs will slowly fill with fluid, I'll gasp to catch every breath, but never can.
Every breath will be petrifying. It'll be slow, painful; torturous. You really gonna let me die like that? [House looks around and leaves.]


[Cut to House brooding in his office. Footage that we have seen from 'Meaning'. Not even the same outfit. Poor edit/continuity.]

[Chase and Foreman sitting pensively outside the office, brooding.]

[More House brooding.]

[Cameron brooding in Ezra's room. Shot goes to Ezra, face twitching in pain.]

[Last House brooding shot. This time, a close-up on his face.]

[Chase and Foreman see House leaving his office.]

Foreman: Where you going?

House [Yells over his shoulder.]: Nowhere.

[Chase and Foreman look at each other then decide to follow.]


(Cut to Ezra's room. House walks in, soon followed by Chase and Foreman. House walks over to Ezra's bed and lays down his cane followed by a small kit.)

House: Everybody who can walk should get outta here. [House takes morphine and a syringe out of the kit.]

Cameron: You can't do that.

House: Can't do what? Administer a prescription painkiller to a patient who's in pain? Go. Make sure somebody sees you downstairs in the cafeteria.

Foreman: I can't let you do this. [He walks over to House, who is filling the syringe, to stop him.]

Ezra: [Gasping in between words.] Either I die in pain or I just die; that's what the argument is here.

Foreman: No it's about whether you die or we murder you.

House: [Holding up syringe, while talking to Foreman.] What's gonna happen here is that someone's getting a butt-load of morphine. I'm not sure exactly who at this point. [Foreman takes a moment to think it over, and then leaves the room in a huff.]

Cameron: I can't be a part of this. [She leaves the room as well.]

[House looks at Chase, who looks back for second, then goes over to the door, closes it, and shuts the blinds.]

Ezra: [Quietly, to House.] Thank you. [House gives a quick nod.] I've always wondered exactly what was on the other side.

House: Nothing. [House injects the morphine into Ezra's IV. Ezra flatlines. House and Chase stand there solemnly for a few moments. Then House looks at his watch. House grabs the bed and pulls it away from the wall.]

Chase: What are you doing?

House: Getting a laryngoscope. [House grabs a laryngoscope.] Don't just stand there, help.

Chase: But you told him -

House: [Interrupting.] Yeah. A little something I like to call a lie. Bad I know, but it's way further down the list than murder. [He intubates Ezra and starts to pump the ambu bag.] He's unconscious. No more whining. I'm gonna keep testing him. [Chase looks confused and indignant.] Go get a ventilator, not gonna do this all night.


(Scene opens with Ezra on ventilator, House's voice over the image.)

House: We can legally assume that he'd consent to whatever a reasonable person would consent to. [Cut to House's office.]

Cameron: And a reasonable person would obviously consent to being put in a coma against their will just to satisfy your curiosity.

House: [Fake exasperation with a *hint* of real exasperation.] I try to kill him, you're mad. I don't kill him you're mad.

Cameron: All he wanted was some dignity.

House: Were you in that room with him? Was he wearing a tux while he was choking on his own plasma? Keep doing the tests. Take your time, do it right. Go. [Turns to look at the MRI.] Get to work. [House studies the MRI for a couple of seconds, obviously expecting the ducklings to go do his bidding.] Wait! [He turns in his chair. Ducklings haven't moved, and House is a twinge embarrassed for yelling, but tries not to let it show.] Cameron, why'd you do these cuts so far down on this MRI of his head?

Cameron: I wanted to get his brain-stem and his C-spine, make sure his diaphragm wasn't paralyzed.

House: You also caught the top of his lungs. There's scarring. [Cameron is staring at him.] You do know that you can't really pierce me with your stares.

Chase: Lung scarring along with the bad bone marrow points to an autoimmune disease. Could be pulmonary fibrosis.

Foreman: Or Lupus.

House: He can kill himself after we get him better. Start him on an IVIG for the Lupus, and get a colonoscopy. Lupus could be hiding there.

[Chase and Foreman turn to leave, but notice that Cameron doesn't move. House looks up, and noticing this also, looks at her.]

Cameron: I can't do this. [She leaves.]

House: Drama queen.


(Cut to Ezra's room. Chase and Foreman are in there doing colonoscopy.)

Foreman: Ascending colon's clean.

Chase: Moving into the sigmoid.

Foreman: Sure could use a little more help around here.

Chase: [With slight sarcasm.] She's doing what she believes in.

Foreman: Yeah. If she was acting on principle, she'd be in here trying to stop us. All she's doing is running away from the principle so she won't have to feel uncomfortable facing it.

Chase: And if you were acting on principle, you would have called the cops when you thought House was killing the guy.

Foreman: [Ignoring Chase.] Better hurry up.

Chase: Why?

[Quick cut to Nurse Brenda watching Chase and Foreman working.]

Foreman: I don't think she's gonna have a problem deciding what to tell Cuddy. [Ezra's heart monitor starts beeping.] O2 sats 89 and dropping.


(Cut to hallway outside of House's office. House is leaving his office. As he's exiting, Cuddy intercepts him.)

House: Thought you were only supposed to put on a pound a week during your last trimester.

Cuddy: [Sighs.] I'm not pregnant. I heard about your little stunt with Dr. Powell.

House: [Makes a drawn out whining sound.] Not really a stunt. More of a trick, a ruse, a hoodwink.

Cuddy: A lie.

House: Ok. Lying is sometimes good, right? Like when you're trying to teach someone a lesson about humility, or something. All I'm trying to do is save his life. He's not gonna learn anything; I just thought the same principle might apply.

Cuddy: It does.

House: I coulda just let him die.

Cuddy: Not gonna get sued for keeping him alive.

House: Well, we could; we completely disregarded his wishes.

Cuddy: Do you want me to disagree with you? [Turns to House, they stop walking. Sarcastically.] Want me to yell at you?

House: It is comforting.

Cuddy: We're doctors: We treat patients, we don't kill them.

House: [Raises voice, speaking into her lapel pin as though it is a microphone.] How right you are, Dr. Cuddy! We also don't pad our bills, swipe samples from the pharmacy, or fantasize about the teenage daughters of our patients, either.

Cuddy: True, better be true, and you're a pig.

[House goes to leave, Cuddy lightly grabs his arm to stop him, and he turns back to face her.]

Cuddy: I'm sorry about your leg.

House: Yeah. [Walks away.] We really should spend some time talking about that. [Cuddy sighs.]

[Foreman has appeared at the end of the hallway; House walks over to him.]

Foreman: The IVIG made him worse. O2 stats plummeted.

House: [Sighs.] So we know it's not Lupus. What else could it be?

Chase: Idiopathic pulmonary fibrosis.

House: Gonna need an open lung biopsy to confirm. [House goes into a lounge; Chase and Foreman follow.]

Foreman: So, now we're going to operate on the guy?

House: Unless you've invented a new way of doing an open lung biopsy.


(Shift to House walking over to a shower area where we find Cameron sitting.)

House: When you searched Dr. Powell's office, did you find a copy of the January, 1967 Massachusetts Medical Journal?

Cameron: Why?

House: I just figured, if you're not doing any work, you might like something to pass the time. Centerfold's a killer. [House walks away, leaving Cameron curious.]


(Cut to House's office. House is throwing his ball against the wall with his cane.)

House: [Fake cheering of an audience. Wilson enters.]

Wilson: How's your leg?

House: It hurts. [Sighs.] It's gonna keep on hurting. You gonna keep on asking?

Wilson: How's Ezra Powell?

House: Resting comfortably.

Wilson: Hmm, that's not what Cameron says.

House: I hate practicing medicine in high school.

Wilson: He's not asking you to help him kill himself; he's just asking for help. The disease will kill him.

House: I know what he was asking for; I just said 'no'.

Wilson: You've done it before. Plenty of times.

House: To patients that I knew were terminal.

Wilson: [Annoyed.] Oh, give me a break. This has nothing to do with saving a life; you just can't bear the thought of a patient dying before you've been able to figure out why.

House: If we're gonna keep refusing to cure patients just to reign in my ego then we might start having a little problem with patient recruitment. [House's pager goes off.]

Wilson: [Snidely.] Worried about meeting your one patient a week quota?

House: [Leaving.] I'm a cripple, remember. Accommodations must be made.


(Cut to Ezra in surgery - Chase and Foreman operating)

Chase: Sample of the left lobe isolated, and removed. Clamp. [Cut to House watching surgery from above. Cameron walks in.]

Cameron: Why'd you have me look up that article?

House: Didn't you find it interesting?

Cameron: He injected newborn babies with radioactive agents just to see if they'd urethral reflux.

House: He was curious.

Cameron: He didn't even tell their parents he was doing an experiment.

House: He wasn't doing anything his peers weren't doing.

Cameron: His peers at Tuskegee and Willowbrook?!

House: He ignored the rights of the few to save many.

Cameron: So you're okay with what he did.

House: Doesn't matter what I think. It's what you think that's relevant.

Cameron: Because, if I think less of him, I'll help you more? You're wrong. The fact that a patient did bad things doesn't change anything. He still deserves to have some control over his own body.

House: If he had control of his own body, he'd be dead.

Cameron: Some control. We can withhold treatment without killing him.

House: No you can't! You either help him live, or you help him die; you can't have it both ways. [Chase looks up at House from the operating room and shakes his head.]

House: Well I guess it's not IPF. [Ezra's heart monitor starts beeping.]

House: Well, maybe he'll die right now. Make everything easy for all of us. [He leaves and Cameron is alone in the observation room.]


(Cut to the operating room.)

Foreman: Heart rate's fast.

Chase: BP's low. [House takes stethoscope from random surgeon, then checks Ezra with it.]

House: No breath sounds on the right side; he's dropped his right lung. [Removes stethoscope.] Air's building up in his chest, compressing his heart. [House makes an incision in Ezra, and places a chest tube in him, which re-inflates the lung.]

Chase: Heart rate's decreasing.

Foreman: BP's stabilizing. [House sews up Ezra to hold the tube in place. While doing this he accidentally hits his right hand. There is no reaction from Ezra. Again, House prods - purposefully, this time - and there is still no response. House goes to test Ezra's left foot.]

Chase: What are you doing? [House prods Ezra's left foot, and it twitches.]

House: Withdraws from pain stimuli on the left side, but not the right.

Foreman: Those are just reflex arcs; he's under anesthesia.

House: Or he's lost sensation in some places.

Chase: Or the hypoxia from the arrest stunned his CNS.

House: Only one way to tell. Do some ATA sensory evoked potentials.

Foreman: We can't do that while he's in a coma.

House: Only two ways to tell. Get a hammer and check his deep tendon reflexes.

Chase: Won't work. He needs muscle relaxants to be on the ventilator.

House: [Long blink, thinking.] Only one more way to tell. Pupillary reflexes.

Foreman: All that tests is the brainstem.

House: See, I was right; only one way to tell. Do some ATA sensory evoked potentials.

Foreman: I just said we can't do that while he's in a coma.

House: So wake him up. [House leaves.]



(Shift to a close-up on Ezra's face; he's sleeping. He opens his eyes blinking a few times. The camera goes to House, whose image is fuzzy at first and then becomes clear.)

House: Don't go towards the light. You'll fall and break your hip.
[The ventilator is removed from Ezra's mouth, and he coughs for a few seconds, and then looks around confused.]

Ezra: What's happening? I --

House: You took a little nap.

Ezra: No, I... I told you I didn't want --

House: [Interrupting.] Sorry, little deaf in one ear. Your bone marrow was hypocellular; we ruled out lupus and pulmonary fibrosis, but it looks like it could be attacking your nerves.

Ezra: So, this is all a waste, a huge fail... [Gasps.] failure. Impossible, you're Gregory House.

House: We need to attach some sensors to your skin.

Ezra: No.

House: Look, we can't do what you want; we've assigned a nurse to watch you so you can't do it either. So, you might as well just let us do the test.

Ezra: No. I wanna be discharged.

Chase: You can't be discharged; you've got two chest tubes in.

Ezra: Then take them out!

House: Oh, get over yourself. The ventilator puffed up your lungs; you'll be fine for a few hours. Just let us run the tests. [Ezra rips off some leads that were attached to him.]

House: Ok. But first, let's clean you up a little. [He grabs a glass of water and splashes a few drops of it on Ezra's chest.] That feel nice?

Foreman: [Curious.] What are you trying to prove?

House: Just cleaning him up. What's it look like? [He walks over to the end of Ezra's bed, lifts up the sheet and sticks his head behind it.] Pay no attention to the man behind the curtain. House runs his thumb down Ezra's right foot, and there is no reaction. He does the same to his left, and this time the foot twitches.]

Ezra: Get out!

House: Okay, I'm going already. Can't you see I'm a cripple? [House leaves.]


(Cut to hallway, Chase and Foreman following House.)

Foreman: Ok, so you got me curious.

House: I was right; whatever is attacking his lungs is attacking his nerves.

Chase: You got that by splashing ice water on him?

House: No sensation in the left leg, abdomen, right arm. Technology's overrated.

Foreman: That means the clean MRI of his brain means it's just affecting the peripheral nerves.

House: And bone marrow.

Chase: Kawasaki's would explain the kidney failure.

Foreman: Or lymphoma.

Chase: Or sarcoidosis.

House: All potentially treatable. Question is which. We need to catch the little bastards in the act. What's the largest organ?

Chase: Skin.

House: We need to get a piece. [House leaves them standing there.]

Foreman: Sure, we'll just wait until he leaves his room without his skin, sneak in, and take a piece. [Chase snickers.]


(Cut to the conference room; where Cameron is, again, just sitting.)

House: I want you to get a skin sample for a biopsy.

Cameron: And I wanna get a foot massage from Johnny Damon.

House: [Walking towards the desk.] Kawasaki's disease, lymphoma, and sarcoidosis are all treatable.

Cameron: And it could be a hundred other things that aren't treatable. You have no idea.

House: But you do; you know everything.

Cameron: I didn't say that I -

House: [Slams cane down on desk.] Exactly! You can't decided if we're helping or hurting him; if he's good or bad; or if you want paper, plastic, or a burlap sack. Do your damn job. [House starts to leave.]

Cameron: I'm not gonna lie to him.

House: Fine, tell the truth. Just get me a pound of flesh.


(Cut to Ezra's room. Cameron enters.)

Ezra: What do you want?

Cameron: House wants to biopsy your skin; he sent me to get it.

Ezra: [With slight surprise.] Oh. And you agreed.

Cameron: I had nothing to do with putting you in a coma or any of the subsequent tests.

Ezra: Which brings us to now.

Cameron: I read some of your articles.

Ezra: There were a lot of them.

Cameron: 1967 Massachusetts Medical Journal. You radiated babies. Just like that. No forms, no questions, nothing. Who knows how many cancers you caused.

Ezra: I don't know. What I do know is we discovered techniques that prevent fatal kidney failures in hundreds of thousands of other kids.

Cameron: You're not sorry.

Ezra: I don't regret what I did. Informed consent, patient rights - holds back research. [Cameron takes the tool to get the sample and slices Ezra, who groans in surprise and pain.] What the hell are you doing?

Cameron: Informed consent is holding back our diagnosis.

Ezra: Good for you. Finally standing up for something; acting on what you believe.


(Cut to clinic. House pops a Vicodin.)

Ali: Dr. House? [House looks over in surprise.] Hi, how are you?

House: Not as good as you think I am.

Ali: Don't worry, I'm not stalking you. My dad just lost his medicine; he had to come back for another prescription.

House: Yeah, right. He's moving it on the street, isn't he?

Ali: [Laughs] Yeah, my dad, the meth king pin. [House starts to walk away.]

Ali: Why haven't you returned any of my calls?

House: [He stops and thinks.] I plan to. In a couple of years.

Ali: I was just calling to say 'thank you.' And to tell you how impressed I was; you diagnosed my dad by just looking at him.

House: Felt his glands, too. [Ali gives a slight laugh.]

Ali: Oh, there's my dad; I gotta go.

House: Yeah. Me too.

Ali: [While walking away.] Oh, and, you really don't have to wait a couple of years to return my calls. Just six months; till I turn 18.
[Turns around and we see her red thong, which House looks at, then raises his eyebrows and gives a slight smile. Then, an "Aha!" moment.]


(Cut to ducklings in lab.)

Chase: [At a microscope as House enters.] It's not Kawasaki's, either. What's next?

House: Congo red.

Chase: Amyloidosis?

House: What the hell else would I mean by 'Congo red?'

Cameron: It's not on the list.

Foreman: There's no reason for it to be on the list.

House: An abnormal protein is building up inside the cells of his body; shutting down his organs one by one. Explains everything; the infiltrates on the x-ray, the bone marrow, kidney failure.

Foreman: We rejected amyloidosis, because it didn't fit the first symptom we found. It would affect his heart.

House: It did.

Cameron: It wasn't on the stress test.

House: We didn't push him hard enough. [To Chase.] Add the stain; let's find out.

Chase: Congo red added.

House: Change the polarization of the light, already. [Results confirm that it is amyloidosis.]

Cameron: That means it should be treatable.

Foreman: How the hell you pull that out of --

House: [Interrupting.] Not outta mine. I had a muse.

Chase: Oh, God. Protein type AA. [Everyone looks disheartened -- And House hands Cameron a candy bar.]


(Cut to Ezra's room. House walks in with his poker face.)

Ezra: Dr. House.

House: You have amyloidosis; it's in your lungs, kidneys, bone marrow, and brain.

Ezra: Why should I believe you now?

House: If I was lying, I wouldn't tell you the subtype is AA. It's terminal.

Ezra: Congratulations, you got your answer. [House looks so defeated, quite the opposite of Ezra's slight smile]


(Medley of scenes: Ezra shaking in his bed; House, defeated in his office, pops a Vicodin; Cameron thinking in the lounge shower area. The music is Into Dust by Mazzy Star.)

(Cut to House's office the next day. House walks in and goes over to his desk. There is a present sitting there. He unwraps it; it's a calendar, 'Fresno by night.' He opens to the marked month, March, and it says 'Six months... and counting.' House rolls his eyes with a slight smile, and puts the calendar down. Cuddy walks in and shuts the door.)

Cuddy: Ezra Powell passed away last night. I'm sure you already knew about that.

House: [Shakes his head a little.] No. I just got in.

Cuddy: The nurse charted at 2 AM; he was stable. Breathing labored, but regular. And at 2:30 he suddenly stopped. [House is thinking.] You know anything about that?

House: If I did, would you really wanna know? [Cuddy nods and then leaves.]


(Cut to Ezra's body being cleaned up. Mazzy Star's "Dust" starts to play.)


(Cut to Cameron in chapel, crying. You can see House next to her, barely in the shot.)

House: [Puts his hand on her shoulder.] I'm proud of you.

[House leaves. Show ends on Cameron's grieved face.]


I could possibly be fading
Or have something more to gain
I could feel myself growing colder
I could feel myself under your fate
Under your fate

Tuesday, September 12, 2006

Season 3 X 02 : Cane & Able


Original Airdate: 9/12/2006
Written by: Lawrence Kaplow, David Shore, Garret Lerner & Russel Friend
Directed by: Daniel Sackheim
Transcript by: Mari


[Opens on a mother opening the bedroom door on a young boy.]

Clancy: Mom! I'm thirsty.

Mom: I just gave you water.

Clancy: I want juice.

Mom: It's bedtime. Close your eyes and go to sleep. [She leaves.]

Clancy: Mom! [His dad opens the door.]

Dad: What do you want, Clance?

Clancy: Oh. Hi, Dad.

Dad: Go to bed.

Clancy: Can I turn the TV on?

Dad: TV is only for the day.

Clancy: I'll keep the volume down; I just like the light.

Dad: Go to bed.

Clancy: Dad, what if... [Whispers.] what if they come to get me again?

Dad: Nobody is coming to get you, okay? Go to bed, now. [Clancy puts on his glasses - making him look like a little Harry Potter - and turns on the TV, with the sound off. It starts to change channels without him doing anything. Then, things start to fall off the shelves, and a bright light and strong wind flies through his shutters. He screams.]

[The next morning.]

Dad: Come on Clancy, it's time to get up. [Clancy is no where to be found.] I guess he's already up.

Mom: Well, that's a first.

Dad: I'll, uh, I'll see if he needs breakfast. Hey, Clance, you hungry? [Mom goes and turns off the TV.] Hon, he's not down here!

Mom: You sure? Clancy? Clancy? Clancy! Where are you? Sweetie, are you hiding? [The parents start to search throughout the house.]

Dad: Clancy!

Mom: Where is he?

Dad: Clancy!

Mom: Clancy!

Dad: You're going to be in big trouble when I find you!

Mom: Honey, come out right now! Wherever you are, this is not funny!

Dad: Clance!

Mom: Clancy! [The shot widens to Clancy, lying on the grass outside, with a large bloodstain on the back of his pants.]

[Credits!]

[Cut to House, in his flat, tying up his sneakers in preparation for a run. He grabs his iPod shuffle, goes out the door, and comes back 10 seconds later with his hand on his right leg. He goes to his coat pocket and grabs some Vicodin, toes off his shoes, and limps off.]

[Cut to House entering the hospital lobby.]

Wilson: Ah. Where's the sweat and the B.O? You've taken such pride bathing us in your personal musk.

House: Showered at home.

Cuddy: And yet you're earlier than usual.

House: Is this an intervention? It's a little late, since I'm not using drugs anymore. I am, however, still hooked on phonics.

Cuddy: If you still did your morning run and showered at home you'd be later than usual.

House: Thought of you in the shower.

Cuddy: How's your leg? You seem to be favoring your left side.

House: I was hanging down my right pant leg yesterday. Makes all the difference in the world. [Gets into the elevator.]

Wilson: You've taken the stairs every day.

House: Do I need a restraining order?

Cuddy: You slack on your rehab, the muscle will weaken, and your leg will hurt again. [House closes the elevator door.]

Wilson: Looks like the ketamine treatment might not stick.

Cuddy: Or maybe we've made him depressed because we're lying to him. Telling him he got that case wrong.

Wilson: We didn't hurt him. The pain isn't -

Cuddy: He gets depressed, he stops exercising. He stops exercising, the muscle atrophies. The muscle atrophies, the pain returns.

Wilson: Maybe he stops exercising because the giant hole in his leg actually hurts.

Cuddy: The ketamine could work perfectly and he would still be back on his cane, popping Vicodin again.

Wilson: You can't tell him. He got lucky; there was no medical -

Cuddy: He was right!

Wilson: We tell him he was right, and we're feeding his addiction. Without Vicodin, he's only got one to focus on.

Cuddy: Well, he's not going to OD on puzzles.

Wilson: No, it's not going to hurt HIM. But he could just as easily have killed that patient. We have a tiny window of time here where House may be healthy enough to change and, based on that limp, the window's closing fast.

[Diagnostics.]

Chase: Kid is a product of an in vitro fertilization pregnancy. Had all his vaccinations, fractured his right ulna at age three, chicken pox at age five -

House: He ever get his feelings hurt? I'll need to know that, too.

Foreman: You are 0 for 1 since you came back. You just want to make sure -

Cameron: Rectal bleeding plus alien abduction fantasy is most likely sexual abuse. Penetration causes the bleed, trauma causes the fantasy.

Foreman: ER ran a rape kit, found no evidence of tearing, semen, or pubic hairs.

Chase: Maybe we should talk to the kid.

House: Why, in case he's telling the truth? You're a believer, aren't you?

Chase: Well, I'm just not arrogant enough to think that of the 50 billion galaxies, 100 billion stars per galaxy, and 10 million billion planets in the universe that we're the only ones with life.

House: No. But I'm guessing we're the only ones who like shoving things through our back doors.

Foreman: There is new research indicating a link between neurological problems and bleeding disorders.

House: Perfect. Especially if there were neurological problems.

Foreman: What part of "hallucinating an alien abduction" isn't neurological?

House: Well, why is that a hallucination?

Chase: What? You think the kid -

House: He's having nightmares. Nightmares aren't a symptom of anything, other than wanting to sleep with Mommy. Which just leaves us with one symptom: the bloody tuchas, which can easily be explained by a GI problem or a bleeding disorder. Check his coags with PT, PTT, and bleeding time. And prep him for endoscopies from above and below.

[Cut to Chase taking samples from Clancy.]

Chase: We're going to make a tiny nick in your forearm, okay? And we're going to time how long it takes for you to stop bleeding. Now, this is going to sting a little, so you might want to look the other way. [Chase nicks him and put the scalpel down.]

Clancy: Are those windows locked?

Chase: Those windows don't even open, they're just here to let sunshine in.

Clancy: Good, 'cause they know I'm here.

Mom: Clancy, don't bother the doctor with this stuff.

Chase: No, it's okay. How do they know you're here?

Clancy: They put a chip in my neck so they can keep track of me. I can feel it back there.

Mom: Clancy, you know there is nothing back there.

Clancy: There is!

Chase: Let me see. Lean forward.

Clancy: And they have this other thing, and they put it in between these two ribs, always on this side, and then they move it around my insides. It hurts.

Chase: You know what, Clancy? I think I might have found the chip back there. And I think I might be able to get it out.

Clancy: Really?

Chase: Mm hmm. [Quick wink to the parents.] Okay, lean forwards. Now hold very still, okay? [He picks at Clancy's neck with some tweezers.] Got it!

Clancy: I'm seven, not three. All you did was pinch my neck.

Chase: Sorry.

[Cut to the team in the hallway.]

Chase: His alien abduction story... the level of detail is... I don't know where he gets it from. The parents say he doesn't watch sci-fi, he doesn't read comic books -

House: Great! You do any of that medical stuff we talked about?

Foreman: Upper and lower endoscopies were clean.

House: So it's a simple bleeding disorder.

Chase: No, blood tests were all normal. And he clotted in six minutes.

House: So it's a simple bleeding disorder and you screwed up the test.

Chase: I didn't screw up the test!

House: So it's a UFO, unidentified flowing orifice. Either you screwed up the test, or I screwed up my analysis of this case. If you screwed up, I don't have to cry myself to sleep. It's a simple bleeding disorder. Foreman, redo the test.

Chase: How could I screw up a simple bleeding time test?

Foreman: Maybe you were abducted; lost time.

[Cut to Foreman leaving Clancy's room.]

Foreman: Kid's got a bleeding disorder.

House: You sure?

Foreman: Had to stop the bleeding myself after 25 minutes.

[Cut to them entering Diagnostics; Chase is working at the table.]

House: So you're saying Chase did screw up.

Chase: Or Foreman screwed up.

Foreman: Big hand points to minutes. Maybe you got them mixed up?

House: Oh, snap! Foreman's playing the dozens; you're at a cultural disadvantage here. Take a few minutes to think up a witty retort.

Cameron: So we have contradicting bleeding time tests. If we run labs to check his clotting factors we can confirm which one's right.

House: Yeah, testing, nice idea. Way better than trying to guess which doctor's incompetent. Much better than the paperwork, too.

Chase: [Who really has been thinking up a retort.] Hey, Foreman. Your momma's so fat, when her beeper goes off, people think she's backing up. [And... no. Denied.]

[Cut to Chase, later, entering Clancy's room, but Clancy's not in his bed. Chase wakes up his mother.]

Chase: Where's Clancy?

Mom: He's asleep, he's -

[Cut to House, about to leave the hospital.]

Chase: House! Clancy's gone missing.

House: Oh, no! Well, you take Alpha Centauri, Foreman can look on Tatooine, and Cameron can set up an intergalactic checkpoint. Let's pray he hasn't gone into hyperdrive! We'll never catch him.

[Cut to Clancy, in a bathroom somewhere in the hospital. He's digging into his neck with some sharp implement. Chase barges in.]

Chase: Clancy?

Clancy: I had to go where there was no windows, so I could get the chip out, like you said!

Chase: Oh, God.

Clancy: I can feel it, I just can't grab it -

Chase: Clancy, stop! There is no chip! We're going to clean you up, and we're going to go back to your room. You can't do things like this. Your parents... [Chase stops, because he sees something shiny through the blood.]

[Diagnostics.]

House: Results came back. The lab cannot identify the metal. They said it might not even be terrestrial.

Chase: Really?

House: No, you idiot! It's titanium. Like from a surgical pin, like the kind the kid had inserted into his broken arm four years ago, nice medical history.

Chase: That pin was removed six months after -

House: So what, a little piece broke off during removal.

Chase: Titanium is used to build nuclear subs, pieces don't just break off.

House: Tell that to the guys on the Kursk.

Chase: And how exactly did it get from his arm to the back of his neck?

Foreman: Body attacks any foreign object. Inflammatory reaction could have eroded into a vein, fragment gets a free ride.

Chase: To his lungs, maybe. Not his neck.

House: Yeah. An alien chip makes more sense. The real mystery is you didn't actually screw up. [He stumbles.]

Cameron: You okay?

House: Fine. I tripped. Kid carved a hole in the back of his neck, apparently didn't bleed to death. Now that's weird.

Foreman: He clotted on his own?

House: Sure did. So first there was no bleeding disorder, then there was, now there's not again.

Cameron: Which is impossible.

Chase: Or Foreman screwed up. Two out of three tests agree with my findings.

House: Lucky for us, the fourth test will be the charm.

[Cut to the team and Clancy's parents in the hallway.]

Mom: So you're just going to keep cutting him, until what?

Foreman: This test is different. We'll draw some blood and see if any clotting factors are low or missing.

Dad: But why haven't the other tests -

Chase: We've had three results that haven't been consistent. One of them must be wrong.

Foreman: Or two of them. [They look at each other.]

Mom: Is it possible the problem isn't his blood? It's just psychological? I mean, he almost killed himself.

Chase: He wasn't trying to hurt himself.

Mom: No, he was just looking for an alien tracking device.

[Clinic.]

Cameron: I have time for one more.

Brenda: I don't blame you for spending extra time down here. Heard the Artist-Formerly-Known-as-Gimp is back upstairs. [Cameron tries to take it a chart off the counter.] Oh, Dr. Cuddy wants that one.

Cameron: She's busy, I'll take it. [Cameron enters the exam room and sees Richard, the patient from last week.] Oh, my God! You're, uh, you're okay!

Richard: Have we met?

Cameron: I was one of your doctors. You were in a vegetative state when you left here last week.

Richard: Addison's disease. All I needed was cortisol, and my brain turned on like a switch.

Cameron: This is amazing!

Richard: Surprised you didn't know.

Cameron: How would I know?

Richard: Not quite my old self yet. Baby steps, the doctors tell me.

Cameron: With rehab you'll do great. What hospital did you go to? How would I -

Richard: I want to have sex with my wife.

Cameron: Oh.

Richard: And I was hoping that maybe you could -

Cameron: Viagra. You're here for Viagra?

Richard: A bucketful would be nice. [He grins. Cuddy enters; Richard stands with aid of walker.] Dr. Cuddy! Hi!

[Cuddy's office.]

Cameron: It's completely unethical!

Cuddy: He was reckless with a patient.

Cameron: He was right!

Cuddy: But he didn't know that. He needs at least some glimmer of humility.

Cameron: Why does he need that? Because other people have that? Why does he need to be like other people?

Cuddy: He needs to be less reckless.

Cameron: Well, you did it. He's dismissing symptoms, looking for easy solutions, he's in pain...

Cuddy: How much pain?

Cameron: Why? You know this is affecting him, don't you?

Cuddy: Telling him that he got his last case right won't do anything to help him.

Cameron: It'll make him less depressed.

Cuddy: Which might not help his leg.

Cameron: But you don't know!

Cuddy: Just let me run a PET scan on his parietal thalamic area to see if it's sensing pain. If it is, the ketamine isn't working anymore and he's headed for a huge crash. If it's not, the leg pain is my fault and I will tell him the truth.

[Cut to Chase doing yet another test on poor Clancy.]

Chase: Too tight?

Clancy: My parents think I'm crazy.

Chase: No, they don't. They're just worried about you, that's all.

Clancy: I'm not weird! It's just that weird things keep happening to me.

Chase: Slight pinch.

Clancy: If you make me better, do you think the aliens will leave me alone?

Chase: I don't think they're going to be bothering you for much longer.

Clancy: You lying again?

Chase: No. We figure this out, and everything's going to be okay. [As Chase draws blood, Clancy sees his arm turn white and his veins green. He begins to have trouble breathing.] Still with us? [Now Chase's hands look like they belong to an alien. The monitors beep.] Pulmonary edema, stage two hypertensive crisis!

Mom: What is happening?

Chase: Wait outside! Get him oxygen and start him on an IV drip of sodium nitroprusside. Get them outside!

[Cut to House and Chase in a hallway.]

Chase: He's in ICU, systolic is hovering around 170, I left instructions to lower it slowly so we don't risk hypoperfusing his organs.

House: Tradeoff being that leaving his blood pressure that high risks stroke, MI, and blindness.

Chase: I'm open to suggestions.

House: Solve the case. Kidneys could -

Chase: Kidneys are clean. [They enter the lab.]

House: [Fingers crossed.] Tell me he's a mutant human hybrid.

Foreman: It is a bleeding disorder. Clancy tested positive for von Willenbrand's.

Chase: I didn't screw up. How could he clot on his own two out of three times?

Cameron: Maybe he cheated.

Chase: Right. Kids always cheat on their bleeding time tests.

House: She was being metaphorical. Trying to sound like me. I have no idea what you meant, but I could smell what the Rock was cooking.

Cameron: I meant, he's clotting right now and he's in hypertensive crisis. Maybe the two are related. What if he was hypertensive the other two times that he clotted?

House: Hypertensive crisis can activate clotting factors. Even someone low on von Willenbrand's could theoretically clot.

Chase: And the first time Clancy clotted he was all worked up recounting his alien abduction; he could have easily have been hypertensive.

House: I know I get worked up when I cut microchip tracking implants out of my neck.

Cameron: Sounds like a cheat to me.

House: Yeah, we get it. Okay, what's the differential for a seven-year-old boy suffering multiple hypertensive crises?

[Cut to Chase talking to Clancy's parents outside the ICU.]

Chase: We think the problem is in your son's heart. We need to do a procedure called a transesophageal echo.

Dad: Okay, and that will fix his heart?

Chase: That will tell us where the problem is. Hopefully. Then we can fix him. Listen, this isn't really part of my job, but... he's worried that you think he's crazy.

Mom: Well, isn't he?

Chase: There are still plenty of other explanations for what's going on. It's important he knows you believe in him, even if you don't.

[Cut to the team looking at the echo.]

Foreman: It's clean, his heart isn't the problem.

House: Why don't I have hi-def in my office? I'm a department head!

Chase: There are no structural defects.

Cameron: Valves are intact.

House: Tissue characterization is impossible when the pixels are the size of Legos.

[Cut to some room with a plasma screen.]

House: See, this is what I'm talking about. Foreman, you've got to steal this thing for me.

Foreman: Let me ring up one of the homies.

Chase: The clearer the image, the clearer it is that there are no masses, no clots, no tears. The problem's got to be somewhere else.

House: We're gonna need a bigger boat.

[Cut to the team watching in a movie theatre.]

Foreman: You're wrong, House.

Chase: Think he'll make us break into the IMAX before he admits it?

House: There.

Foreman: Where?

House: Right there. Left side, no movement. [Cameron freezes the shot.] Well, don't freeze it! Something's not moving, how do you see something not move if nothing's moving? [She restarts it.] I need the laser pointer.

Cameron: We don't have a laser pointer.

House: Well, why not? Who's going to take us seriously if we don't have a laser pointer? Right here! [He jumps to point at the spot on the screen; as he lands he grimaces and clutches at his leg.] A few thousand myocytes not beating with the rest.

Chase: So you found an arrhythmia.

House: That's not an arrhythmia, that's a no-rhythmia. Myocytes contract, these aren't moving at all. Go get me those myocytes; I want to talk to them in my office.

[Cut to Cuddy entering House's office.]

Cuddy: How's the kid doing?

House: Heart nearly exploded. Still beating, though. Most of it, anyway. Why do they bother putting age restrictions on these things when all you have to do is click, "Yes, I am 18"? Even a 17-year-old can figure that out.

Cuddy: What's going on with the leg?

House: First, tell me what's going on with the boobs.

Cuddy: If you're feeling pain -

House: They're firmer.

Cuddy: It's called an underwire. I want to get a PET scan of your brain.

House: I think it's hormones.

Cuddy: As long as there's no increased activity in the thalamus -

House: Looks to me like those puppies are going into the dairy business.

Cuddy: -- Then the pain can be good. It could be muscle regenerating. After you work out, you get sore. Pain doesn't mean the ketamine failed.

House: Guess I should be saying 'mazel tov.' Who gets to pass out the cigars?

Cuddy: I'm not pregnant. I need to get a PET scan of your brain.

House: Boy or girl? You got a name picked out?

Cuddy: I'm not pregnant!

House: My leg doesn't hurt.

Cuddy: You're in denial!

House: No, I'm not! Oh, you got me. If I thought my leg was deteriorating, don't you think I'd want to take steps to prevent that?

Cuddy: [Sighs.] Okay. [House's beeper beeps.]

House: Gotta go. [As he leaves, he fake stumbles. Cuddy helps him up; He gives her a look with a "ha".]

[Lab.]

Chase: Here's Clancy's DNA, and here's the DNA from the piece of that heart we just biopsied. [They don't match.]

House: That is impossible. Run it again.

Foreman: We already did. And once more after that.

Cameron: The genes from Clancy's myocytes don't match the genes from the rest of his body.

Chase: Alien DNA.

[Diagnostics.]

House: Anybody watch any X-Files that inspired an explanation?

Foreman: There are ways DNA could become mutated. Extreme UV radiation.

House: That much sun, he'd be dying with a healthy bronze glow.

Cameron: Nitrous acid or ethidium bromide exposure.

House: So first Daddy was a rapist, now he's a chemist.

Chase: Various species of fungus have been proven mutagenic.

House: Not unless the kid's been eating barrels of celery or living in Indonesia, or both. [While this is going on, House has limped from the whiteboard to lean over the table.]

Cameron: Is your leg hurting?

House: Is that question helping?

Cameron: You're leaning.

House: You're sitting.

Cameron: You're evading.

House: My head's hurting. Please, someone give me a plausible, terrestrial explanation for this kid's alien DNA.

Foreman: We could search his home for toxins, fungals, and radiation.

Chase: Who cares what caused it? A kid comes in with strep, we don't conduct a search to see which classmate he got it from; we cure it. We know he's got this stuff inside of him; let's get a scalpel and cut it out.

Cameron: Where do we cut? Chances are it's not just in his heart.

Foreman: Well, we got lucky with the heart. Myocytes contract, we can see that these weren't working. I don't know how the hell we're going to find it anywhere else.

Cameron: What if we find the heart cells with the bad DNA and we tag them?

House: Can you phrase that in the form of a metaphor?

Cameron: It's the same way we search for cancer. The bad DNA creates a unique protein on the surface of the affected cells. We create an antibody that recognizes only that protein and we flush it throughout his system, and the similar cells light up like light bulbs.

House: Okay, let's do that.

[Cut to Cameron walking up to Wilson and Cuddy on the second floor balcony.]

Cameron: You have to tell him.

Cuddy: He said he wasn't in any pain.

Cameron: He's lying.

Wilson: Of course he's lying.

Cuddy: We need another plan.

Wilson: Don't talk about it that way.

Cuddy: What way?

Wilson: Plan. Sounds like we're conspiring against him.

Cameron: I'm going to tell him.

Wilson: No, you're not.

Cameron: Then come up with a cunning plan, and fast. [She stalks off.]

Cuddy: She's not nearly as delightful as she thinks she is.

[Cut to Chase administering a scan to Clancy. Cameron and Foreman are in the side room.]

Clancy: What's this machine do?

Chase: Makes a lot of noise and it's going to help us figure out what's wrong with you.

Foreman: You think House has lost his step?

Cameron: He's fine. There - clump of affected cells in the bone marrow of the femur. Explains the intermittent bleeding disorder.

Foreman: 'Cause I don't need to subject myself to House's torture if there's no upside.

Cameron: I'm telling you, he's fine. We missed some affected areas in his heart, explains the continuing hypertensive issues.

Foreman: You said the last case really threw him, and now suddenly-

Cameron: I was wrong.

Foreman: So you changed your mind? Why? His brilliant ideas in this case have all been yours.

Cameron: There's the reason for him needing glasses, apparently it's a symptom. Means the condition predates -

Foreman: You don't change your mind without a reason. What do you know?

Cameron: House didn't blow the last case. Cuddy cured the guy using House's idea. Cuddy and Wilson are trying to teach him some humility. Scan is complete. 3 hot spots but nothing in his brain. House's original theory was right - it is not neurological.

[Cut to surgery on Clancy. The conversation is from the post-op.]

Dad: Is he going to be able to walk?

Chase: His leg should be functional after some rehab.

Mom: Functional? What does that mean, he'll be able to walk, but not run? He'll have a limp?

Chase: If everything goes well he'll walk, he'll run; he'll probably be even stronger than he is now. When we close him up, we'll move over to his other leg, snake a catheter up through the femoral artery, and into his heart. [CG shot of this being done.] Once the affected areas are removed, his normal tissue will step back in and do its job. He should have no more problems with his blood pressure. After confirming those areas are clear, we'll start our final procedure. We're going to insert a needle through the pupil and get rid of the abnormal cells in the retina.

[Cut to Chase looking into Clancy's eyes.]

Chase: Close your right eye. Can you see my face?

Clancy: Yeah! It's clear!

Chase: You can throw away your glasses. We got it all. Get some sleep, you're going home tomorrow.

Clancy: Thank you. [Polite kid.]

[Cut to Wilson entering House's office.]

Wilson: You want to go for a run?

House: What do you want?

Wilson: I want you to run. [He throws House a bottle of Vicodin.]

House: When did you become an enabler?

Wilson: I'm enabling you to exercise. Vicodin blocks the pain, you get through your rehab, muscle strength increases, and pain decreases.

House: I'd rather not become dependant on pain pills to get through my day. [He throws them back.]

Wilson: You're just like any other patient - running away from knowledge that won't make you happy.

House: I'm as happy as a pig in poop.

Wilson: You're scared the ketamine treatment's wearing off. That it was just a tortuous window of the good life.

House: What part of poop didn't you understand?

Wilson: How can you be so sure it isn't just a sore muscle?

House: It's my leg. We've known each other a long time.

Wilson: You're not always right, House. You've proven that lately.

[Cut to House running on the treadmill, stopping because of the pain, and then taking Vicodin. He limps back onto the treadmill and runs again.]

[Cut to Clancy, who we see being lifted up off of his bed and levitated through a light in the window.]

[Cut to the real world, where Clancy is seizing in bed.]

Mom: What's happening to him?

Chase: He's seizing. I need clonazepam!

Dad: I thought you got it all!

Chase: [Under his breath.] Yeah, yell at me, that'll fix the kid.

[Cut to the team in House's office.]

Cameron: Obviously we missed some foreign tissue. There's something still in him.

Foreman: The hallucinations and seizures indicate problems in the temporal lobe. Sorry, House, it is neurological. Looks like you're wrong, again.

Chase: We didn't miss anything. Brain scan was completely clean.

House: Our tag must not have penetrated the blood-brain barrier. Don't use an IV this time; get it right into the brain.

[Cut to Clancy, back in the scan.]

Cameron: No cells are lighting up. His brain is clean. It is not neurological.

[Cut to the team walking in the hallway. House is limping.]

Foreman: His symptoms are neurological; his condition has to be neurological!

Cameron: His scan was clean, twice! It's not there! [House sits making them pause.]

House: What if it is there but didn't show up on the scan? What if the tag just doesn't work in his brain? Brain cells are structurally different, express a different protein.

Chase: So how are we going to find it? [House walks away.]

Cameron: Where are we going?

House: I am going to think.

[Cut to House in his office, bouncing his ball around, staring at the whiteboard, pacing, and...]

House: Send the kid home.

Cameron: What do you mean?

House: Make sure his blood pressure's stabilized and send him home.

Chase: Like nothing ever happened?

House: We cured his bleeding disorder, removed all the damaged cells we could find.

Chase: We don't know that we fixed anything, it's only been a day. Maybe these symptoms come and go like the blood disorder.

House: It's more probable that his remaining symptoms are just a nightmare.

Foreman: He had a convulsion.

House: May be epilepsy, may be psychological, may be nothing. If the kid gets sick again it'll give us another clue, we can start searching again. If he doesn't, it doesn't matter. Send him home.

[Cut to the parking garage, where House is about to drive off on his motorbike.]

Cuddy: House! You're just giving up on this kid?

House: You've got to know when to stop.

Cuddy: You don't stop, you never stop, you just keep on going until you come up with something so insane that it's usually right.

House: Except on my last case.

Cuddy: Don't be pathetic. Just forget the last case. This kid obviously has something wrong with him.

House: When did you develop such strong opinions about my patients? Last week you were convinced that my patient wasn't sick, now you're convinced this one is.

Cuddy: This one is a young boy. His parents are desperate. Just get together with your team, spend a few extra hours -

House: Well, I guess we could amputate his left leg. That's where we found most of it. Maybe we could just remove his affected eye completely.

Cuddy: If you have reason to believe that that might help -

House: I'm not going to start lopping off body parts, but it's interesting that you'd give me the green light.

Cuddy: I just want you to do something.

House: You've been overly supportive this entire week. Either you're hormonal or you're guilt-ridden. And it's too early in the pregnancy for this to be hormonal.

Cuddy: I'm not pregnant.

House: Then what did you do wrong?

Cuddy: He had Addison's, your last patient. You were right. I gave him one shot of cortisol and he woke up like Rip van Winkle.

House: [To Cuddy's belly.] Oh, your mommy's in such trouble. She's such a liar! That's why you don't have a daddy. That's why she had to - [And... epiphany.]

[Cut to House entering Diagnostics.]

House: How does one person end up with two different sets of DNA?

Foreman: We've been through this.

House: Our assumptions are faulty.

Chase: We've confirmed two different sets of DNA, we re-ran the sequence.

House: I didn't say the lab work was faulty, I said our assumptions were faulty. We assumed he's a person.

Foreman: Of course, the aliens didn't just visit him, they replaced him.

House: Well, you're being silly. What if he's not a person, what if he's two persons?

Cameron: I'm not getting the metaphor.

House: No metaphor. Chase, you said the mom used in vitro fertilization, right?

Chase: Yeah, they had trouble conceiving.

House: The kid was right all along, he was implanted with something. Back when he was really young, I mean really young, I mean twelve cells young. In vitro increases the likelihood of twinning.

Cameron: But he doesn't have a twin.

House: Not walking around. But in vitro fertilization costs about 25 grand a pop. [CGI of... well, cells merging.] So doctors implant about two to six embryos to make sure you get your money's worth. Problem is, there's not always enough bedrooms for all of the kiddies. Two brothers get stuck sharing, there's no bunk beds, so they cuddle up to keep warm. They never untangle. He's two people in one. It's called chimerism.

[Scene morphs to House telling the parents.]

House: Unfortunately, his brother's like a bad doubles partner. The guy just takes up space, gets in the way. Clancy's body thinks that he's going to put away the easy winners, but his brother just keeps swatting the balls into the net. We've got to get him off the court.

Mom: So does that mean you can find the bad cells in his brain, or not?

House: Sure, abandon the metaphor. Fine. Clancy thinks differently than his brother because he thinks. If we induce an alien abduction -

Dad: Wait, what the hell are you talking about?

House: The foreign DNA has got to be in a portion of your son's brain that makes him believe that he's being abducted. We stimulate those neurons with an electric probe; we can trick your son's brain into hallucinating. And your son's neurons will light up, and his brother's cells will remain dark. Those are the ones we cut out.

Mom: You're talking about brain surgery.

House: I'm talking about really cool brain surgery. One of your sons will die, but the taller one won't be so annoying any more.

[Cut to Clancy being prepped for surgery.]

Clancy: So I have a twin?

Chase: Not really. What's on the card?

Clancy: Light bulb.

House: Start us out at ten. [House is doing the brain surgery. Wait, what? Clancy's arm twitches.]

Clancy: I'm not doing that.

House: That was all me, kid. Sorry.

Foreman: You're in motor function. Try two centimeters back.

Clancy: He lives inside me?

Chase: Sort of. [House hits another part of Clancy's brain.]

Clancy: Hee, that tickles! Stop tickling my feet!

Foreman: You're in sensory, getting closer.

Chase: What do you see on this one?

Clancy: Moon and stars. So I am kind of weird?

Chase: We're all kind of weird. [House touches his brain again.]

Clancy: NO!

Chase: Clancy?

Foreman: We've got something.

Chase: What do you see?

Clancy: The light. Here they come, I think.

Foreman: Brain waves indicate mild hallucination. Neurons lighting up.

House: Any dark spots?

Foreman: Area's too fuzzy. Hallucination isn't strong enough.

House: Well, turn up the juice.

Chase: His blood pressure's already 160/110. Any higher and -

House: Riding the short bus is better than not breathing. Take us to 100.

Foreman: Area's still too fuzzy to make any kind of distinction.

House: Crank it up higher!

Chase: You've already exceeded the preset maximum. Next step's brain damage.

House: [In front of Clancy's face.] They're going to get you! They're coming through the walls. They're going to take you, torture you! You'll never see your parents again. [And all the CGI guys on House weep for joy, because all they really want to do is work in sci-fi, and here it is, an alien abduction scene, complete with bizarre probes.]

Alien (Chase): Clancy, can you hear me? [The alien fades back into Chase.] Clancy?

Clancy: You got them.

Chase: Yep, we got them all.

House: Close him up.

Chase: Everything's going to be normal again.

[Cut to House entering Wilson's office.]

House: You believe what Cuddy tried to pull?

Wilson: What now?

House: She lied to me. She cured my patient with my diagnosis, then lied to me about it.

Wilson: That doesn't sound like her.

House: You're right. It does sound like you, though.

Wilson: What exactly did Cuddy tell you?

House: Nothing that your body language isn't telling me right now. So, what was the plan? That I'd feel so humble by missing a case that I'd reevaluate my entire life, question nature, truth, and goodness and become Cameron?

Wilson: Something like that. More that if we told you the truth; that you'd solved the case based on absolutely no medical proof, that you'd think you were God. And I was worried your wings would melt.

House: God doesn't limp. [House leaves and Wilson looks very, very tired.]

[Cut to House entering his flat. He limps to his closet and pulls his cane out of his golf clubs, and gimps off to the song 'Gravity' by John Mayer.]

Oh I'll never know what makes this man
With all the love that his heart can stand
Dream of ways to throw it all away

Oh Gravity is working against me
And gravity wants to bring me down

[End!]