Season 3 X 14: Insensitive
Original Airdate: 2/13/2007
Written by: Matthew V. Lewis
Directed by: Deran Serafian
Transcript by: Jane
[In a car. It is snowing and the windshield wipers are going.)
Hannah: I'm okay. Let's just go home.
Cynthia: You're getting checked out.
Hannah: I tripped on the ice. Eight other kids tripped. This is embarrassing.
Cynthia: You said you were just going to hang with your friends. I turn around and you're out there on the ice.
Hannah: I'm fine.
Cynthia: You don't know that. You fell. Awkwardly.
Hannah: No, I didn't.
Cynthia: You don't know how to fall.
Hannah: I'm sixteen. I've been falling a lot. I think I'm getting the hang of it. And I checked.
(Hannah turns on car radio. Rock music. Cynthia turns it off)
Cynthia: And now the doctors are going to check.
Hannah: You don't think that you're over reacting? I don't need you to fix every boo-boo.
Cynthia: Then stop getting them.
Hannah: I was just playing around with my friends. I was having fun.
Cynthia: You know you can't do that.
Hannah: Oh, I can't have fun?
Cynthia: You know what I mean. I'm gonna have a talk with your friends.
Hannah: No.
Cynthia: And tell them that they need to stop...
Hannah: No! I don't want you freaking them out! Fine. Fine, we'll go to the hospital. But they're going to tell you that I'm fine and they're going to tell you that you don't need to worry about...
(Bright lights fill the car as a truck approaches. Cut to the car after the accident.)
Hannah: Mom? Mom! (yells) Hello? (Hannah unbuckles her seat belt and moves to her mother.) Mom, you gotta wake up. No one's coming. Mom! (She shakes her mother, then sees cell phone on the floor. Grabs it, dials.)
Operator: 911. What's your emergency?
Hannah: We got into an accident on the canal road just outside Kingston. My mom's unconscious.
Operator: Are you all right?
Hannah: (looks at piece of metal sticking out of her leg) I'm fine. (hangs up) Mom. Mom.
[Opening Credits]
[House walks into Emergency Room. He sees Wendy.]
House: Where's Foreman?
Wendy: He's down here somewhere.
House: Somewhere. Very helpful.
Wendy: Do you have any idea when he's getting out tonight?
House: Sometime.
Wendy: I realize you can't predict. I just thought you might be able to estimate. It's Valentine's Day. I've planned a surprise getaway.
House: Getaway.
Wendy: Mmm-hmm.
House: (speaking slower.) Getaway. (Wendy looks puzzled.) Get away. (with a disgusted look, she does so.)
[Cut to Foreman examining Hannah.]
Hannah: Is my mom okay?
Foreman: She's gone to surgery.
House: Foreman. Your girlfriend wants to know if you're available for Valentine's. Act surprised. What are you doing down here?
Foreman: There's a snowstorm. E.R.'s short staffed. We're all supposed to be here. You're supposed to be here. You're an ass. Act surprised. (to Hannah) This could sting a little. (House lounges in corner, watching Foreman clean a cut on Hannah's leg)
Hannah: Ow. (flinches) Can we hurry this up?
Foreman: Make sure that ...
House: Take your time. What's your name?
Hannah: Hannah Morgenthal.
House: You have CIPA, Hannah Morgenthal.
Hannah: No, I don't.
House: We have to do x-rays to make sure you don't have internal injuries. Blood test to make sure no infections. An EEG for neurological anomalies and biopsy a spinal nerve.
Foreman: Whoa, whoa. Congenital Insensitivity to Pain is one of the rarest conditions on the planet. There's only been about sixty documented cases.
House: Yeah, and I have seven reasons to think that she's one of them.
Foreman: She says she's not.
House: And that's reason number one. She knew what it was without us telling her. Two, she's still went from the snow but she's not shivering. That's odd. Unless she can't sweat or feel hot and cold.
Hannah: The ambulance was warm. I want to see my mother.
House: Three, scarring around the lip and tongue. When she was a baby she chewed on herself without feeling it.
Hannah: I fell through a window when I was a kid.
House: Four, when you cleaned the wound she flexed into the cleaner instead of away from it. It's hard to fake pain when you've never felt it. Takes an imaginative leap, Ms. Morgenthal. That's one of them Jew names. Ashkenazys are a higher risk group.
Foreman: On the other hand, she says she doesn't have it. And she'd be dead by now if she'd never been diagnosed.
House: They killed our Lord. Are you going to trust them? She wants to see her mom. If she admits having CIPA she knows we're not letting her go anywhere without a battery of tests.
Foreman: You said you had seven reasons.
House: I pulled a number out of the air. What, five isn't enough?
Foreman: Five lame reasons aren't. I'm taking her to see her mom as... (House whacks Hannah on the shin with his cane. No reaction. Foreman looks at House.)
House: I could hit her again if six aren't enough. Do the tests. (Hannah sighs, resigned.)
[Cut to House entering Cuddy's office.]
House: Need to bail on the E.R. I got a case. Why are you wearing perfume?
Cuddy: Is this a real case or one of those imaginary cases that happen when you're bored?
House: CIPA.
Cuddy: CIPA is a diagnosis. Diagnoses happen at the end of cases.
House: She's got no idea what's going on in her body. There's gotta be something wrong.
Cuddy: In other words, she could be perfectly healthy but you're curious about someone who can't feel pain because you always feel pain so you want to go exploring.
House: She was in a car accident. She needs x-rays, blood tests, EEG, nerve biopsy. I also note that, although the snow was coming down in sheets this morning, you left your hat at home and used ear muffs.
Cuddy: Do your tests, except for the...
House: So, while everyone else was just worrying about getting in, you were concerned with about "hat head." Blind dates are never a good idea. Only reason to wear a scarf like that is as a beacon to identify you in a crowd.
Cuddy: Do your tests. Except for the nerve biopsy.
House: I need the nerve biopsy.
Cuddy: You'd risk paralyzing her.
House: But it's neurological.
Cuddy: You have no evidence of that.
House: She tripped.
Cuddy: Do you have any evidence other than the fact that a typically clumsy CIPA patient tripped on an icy day? (House shakes his head) If the EEG reveals a problem, we can talk then.
House: (leaving) You could have left the scarf at home and just told him you'd be wearing a look of desperation.
[Cut to procedure room. Chase and Cameron at computer screens, Foreman standing.]
Chase: Spiking on leads C3 and O2.
Cameron: She could be going into a seizure.
Hannah: Hello!
Foreman: I think there's a simpler explanation.
Hannah: You're not going to find anything. I'm fine. I wanna see my mom. (She is pulling all the electrodes off.)
[Cut to House's office]
House: So, sedate her.
Foreman: She won't consent.
House: She's a teenager.
Foreman: No dad, mom's still in surgery. What do you want us to do? Hold her down?
House: Well, only until you inject her with a sedative. Then you can let her go.
Foreman: We tried.
House: Seriously?
Foreman: She's strong and doesn't care. We'd have broken something before we could get her to sit still enough to inject her.
House: So, break her arm. She won't mind.
Foreman: You're cranky.
House: I'm in pain. Let's go break her arm.
[Cut to hallway]
House: Nurse Shortie, your biz-nitch, how long are you gonna waste her time.
Foreman: I'm so glad we're walking somewhere. Another sixty feet and this conversation is over.
House: When you guys are out of this program, Cameron will find somebody. Chase will find eight somebodies. And you'll be alone.
Foreman: Thirty feet.
House: You'll date and you'll date. But you're the ultimate Darwinian. You've got to fight for everything. Anybody else would just slow you down.
Foreman: I'm still with her, aren't I?
House: Yeah. I can only imagine it's because she hasn't given you an excuse to break up and you don't have the guts to recognize your own reality. (opens procedure room door)
[Cut to procedure room]
Hannah: I want to see my mother.
House: Hi again. I'm sure I can say this without being condescending, but then you'd get the false impression that I respect you so - you're a kid, you're scared, you're stalling. Grow up.
Hannah: I'm not scared. I'm never scared.
House: See? How juvenile was that? You can't feel pain. Nothing left but pleasure. Why don't you tell me how wonderful that is?
Hannah: It sucks.
House: Better than being in pain all the time. Get in the chair.
Hannah: Every morning I have to check my eyes to make sure I didn't scratch a cornea in my sleep.
House: Oh God, stop. I'm in a pool of tears here.
Hannah: I can't cry.
House: Neither can I. Every morning I check my eyes for jaundice in case the Vicodin's finally shot my liver.
Hannah: I can't run anywhere without examining all my toes for swelling.
House: I can't run.
Hannah: Boys can't hold me for too long because I can overheat.
House: Girls can't hold me for too long because I only pay for an hour.
Hannah: I need an alarm on my watch to remind me to go to the bathroom. You know how many humiliating experiences before I thought of that.
House: The bathroom's 50 feet from my office. Every drink of water I weigh the pros and cons,
Hannah: After everything I do, I self-check: Mouth, tongue, gums for cuts. Count teeth, check temperature. Fingers, toes and joints for swelling, skin for bruises.
House: I got shot.
Hannah: I sat on the stove when I was three. Want to see the coil marks?
House: Yeah.
Hannah: You think I'm lying?
House: You think I just wanna check out your tuchus, as your people would say. (As she stands and turns to show him her butt, he uncaps syringe and injects her. She turns back and he shows her the empty syringe. Fellows catch her as she slumps down.) Put her in the chair and run the damn test. If she moves again, give her nitrous.
Cameron: You weren't shot because of leg pain, you were shot because you're a jerk.
House: Some think the two are connected.
[Cut to hospital room. A doctor is being paged. Cameron is preparing to take Hannah's temperature.]
Hannah: He didn't have to do that.
Cameron: Yeah, he did.
Hannah: I'm sick?
Cameron: No, your EEG was normal. X-rays showed no breaks, blood test showed no infections, urine indicated no... (Hannah's head falls back on pillow. She's convulsing.) Hannah? (She pulls the thermometer from Hannah's mouth. Turns on intercom over the bed) Call a code. Oh, God. (to staff coming through the door) Need ice packs and cooling blankets. Got saline in there? (pulls sheet off Hannah.)
Nurse: She's not flushed. She's not sweaty. You must be...
Cameron: She has a temperature of 105. (pours pitcher of water over Hannah. She and nurse place cold packs.)
[Cut to view of unconscious Hannah then to Diagnostics Office]
House: Wow. She's actually sick.
Cameron: We've got her temperature down below boiling. Could be infection.
House: No. LP showed normal proteins and no white blood cells.
Chase: High billirubin. Could be a liver problem.
House: Nope. Transaminases were normal.
Foreman: Could be drugs. She's smoked pot since she was eleven.
House: No again. Tox screen was clean.
Foreman: We're doing this case backwards. We do the tests and then she gets sick?
Cameron: Maybe we did something to her. Maybe she got sick after the tests. We should rerun them.
House: And biopsy a spinal nerve.
Foreman: You want to risk paralysis because she's got a fever?
House: I want to risk paralysis because I don't know what's causing the fever. If it's neurological...
Foreman: It's a fever.
House: In a CIPA patient. Obviously things are a little different in her upstairs wiring.
Chase: And have been since the day she was born.
House: Yah. It's much more likely that whatever it is was cleverly waiting and hiding until you guys were done testing. (Takes coat and starts out door)
Chase: Where are you going?
House: You're all against this, right? And, you're all going to stand on principle and refuse to do it, right? I'm going to get Cuddy's approval.
[Cut to OR, Cynthia is still in surgery. Nurse hanging bags on IV pole. Chase and Cameron are in the observation deck.]
Cameron: How long are we going to keep Hannah in the dark about her mother?
Chase: Long as possible.
Cameron: Side air bag should be standard.
Chase: I'm sure she'll agree.
Cameron: She should know her mother's situation.
Chase: Breaking that news is that surgeon's problem.
Foreman: Any word from House?
Cameron: No.
Chase: No.
Foreman: Maybe Cuddy will say no.
Chase: (laughs) Cuddy never says no.
Cameron: That's not true.
Chase: Nobody ever says no. We don't say no.
Foreman: You don't say no.
Chase: He'll come back. He'll browbeat us. He'll give us seven reasons and eventually we'll fold. We all will. Not just me. The only way we can avoid biopsying this kid's spine is to find the answer some other way.
Foreman: All the tests were negative.
Chase: We need a better history.
Cameron: How much more paperwork do you need? We've got pediatric records, a few dozen E.R. records, our own admission questionnaire.
Chase: What's the first question?
Cameron: Insurance coverage.
Chase: Okay. Second question.
Foreman: Just make your point.
Chase: Where does it hurt? If we knew where it hurt, we could diagnose her.
Foreman: You do know CIPA means she can't feel pain.
Chase: No. CIPA means she's insensitive to pain. She still has scattered nerve fibers that could conduct pain but the signals don't make it to the brain. What if we give her more pain signals? A lot more pain signals. Maybe some of them might get through.
Cameron: You want to torture her?
Chase: No. Yes, we do this to anybody else, it's torture. Doing it to her, it's no different than pricking her finger. We keep poking sharp sticks into her, eventually we'll find the part that's already tender.
[Cut to a coffee house. Cuddy is with a man]
Don: So, what does a dean of medicine do?
Cuddy: Oh, can we please not talk about that. I will talk about anything else, but I'm just trying to get away from work.
Don: Metaphorically. Because, geographically the coffee place around the corner from the hospital probably isn't the furthest you could get.
Cuddy: Well the snow.
Don: Roads are clearing. But it's a good place to beat a retreat from. Do you usually expect your dates to go wrong?
Cuddy: Experience has taught me to have an escape route.
Don: Well, low expectations, that's in my favor.
Cuddy: (Smiles. Then she sees House through the window. Her face falls) Whatever happens, I need you to understand that there are certain aspects to my life, I'm not happy about.
House: (enters) I need the nerve biopsy.
Cuddy: And you had to come here personally to tell me that. And how did you even know I was here?
House: I had to bring the file. This is the most noncommittal location within walking distance. You left your car keys on your desk. (turns to Don. Loudly) Greg House. You two must have met online. Either that or you've got a friend who secretly hates you.
Don: Uh, Don Herrick. Yeah, we connected through singleballroomdancelovers.com.
House: Why would he volunteer that information?
Don: Why would I hide it?
House: You didn't tell him that anything he said will be held against you? (to Don) So, what line of work are you in?
Don: Uh, auto maintenance. Changing oil and filters.
House: Great, my place overcharges. You can't trust anything you guys say. So, where are you located?
Don: In fourteen states. I own Eastern Lube. (House's face falls, trying to look unimpressed. Cuddy closes the file.)
Cuddy: Most CIPA complications are infection and she's got a fever. LP? Urine?
House: Clean. Normal. Same with the white blood cell count.
Cuddy: Cancer?
House: Nothing on the scan. I think it's her nerves messing with the temperature control. Amyloid, sarcoid, there's a lot of candidates. I want a biopsy.
Cuddy: Fine. If that's what you need, go get it.
House: (leans close to Cuddy's ear and announces loudly) He seems a lot nicer than that one from Wicca needs a daddy figure dot com. (Grabs a cookie from their table and leaves.)
[Cut to procedure room]
Chase: (dipping Hannah's hands in vats of water) One of these is warm and the other is very hot. Start here. Move to the hot one, just a few second. Then back. We're gonna monitor activity in your brain while you do it. If you feel any response to the heat, it could indicate a vascular problem.
Hannah: (puts hand in cold water) How's my mom doing?
Chase: She's okay. Do you feel anything?
Hannah: No. (moves hand to hot water) What does "okay" mean?
Chase: (looking at thermal images on computer) She's still in surgery. They tell me it's going okay. You can take your hand out.
Hannah: And you didn't ask anything else?
Chase: Take your hand out of the water!
Hannah: What's going on with my mother? (Chase makes a dash from the monitoring room)
Chase: Hannah. (pulls her hand from the hot water) You just got second degree burns.
Hannah: I'll be fine. What's going on with my mother? Is she gonna die?
Chase: They said she's okay. Surgery this long is typical when there are internal injuries.
[Cut to another procedure room. Hannah's head is in a frame]
Foreman: Naloxone and kinase proteins in.
Hannah: And that's gonna make me feel pain? I didn't feel anything when you guys screwed this thing into my head.
Foreman: They'll replace missing chemicals in your nerves. Heightened sensitivity. We're going to be drilling directly into your skull. A response should indicate sarcoma.
Hannah: What does it feel like?
Foreman: It...hurts. Um...sorry. Bone pain is the worst there is. You need to let me know as soon as you feel anything. She's ready. (Surgeon puts the drill in place)
Hannah: So, what? I just sit here while you guys drill a hole in me? You wanna talk?
Foreman: Just you and your mom, huh? You two must be pretty close.
Hannah: We were. Until I got arrested. The third time.
Foreman: Drugs?
Hannah: Fights.
Foreman: You got an advantage.
Hannah: Not really. Never know when to stop.
Foreman: You piss a lot of people off or you just trying to piss off your mom? Those are pretty much the only two choices you have. Hannah? (she's looking around, nervous) You want us to stop? (Hannah reaches for the metal frame) Stop the drill. Stop the drill! (Foreman holds the frame while the surgeon removes the drill. Hannah is making squealing pain/panic noises. Foreman removes the frame.) It's okay. What'd you feel? Where did you feel it? Hannah, I need to know how it hurt. (Hannah smiles then pushes past Foreman and runs out of the room.) Hannah!
[Cut to House's office. Wilson enters.]
Wilson: I am so tired of this. Did you know that the new nurse from cardiology is sleeping with that weird lawyer from the board?
House: (eating) The guy with eleven fingers?
Wilson: He has eleven fingers?
House: How do you not notice that?
Wilson: The nurse used to be a man.
House: She's not anymore?
Wilson: But we can't talk about that.
House: I thought we were.
Wilson: We were supposed to talk about that. I came here to talk about that. But on the way up, I ran into Cameron. You've got a CIPA patient.
House: Mmmm. Tranny nurse is more interesting.
Wilson: Oh it's way more interesting. But instead, I've got to be your damn conscience. I'm tired of being your conscience. I don't enjoy being your conscience.
House: No one enjoys�
Wilson: You're studying her....
House: She's actually sick.
Wilson: Which you found out after you took her on.
House: I was curious. Since I'm not a cat, that's not dangerous.
Wilson: I don't think that metaphor was designed to actually warn cats. You don't care about her illness, you care about CIPA. Which means your focus is going to be on getting your answer, not hers.
House: Thank you. Forewarned is forearmed.
Wilson: What do you think you're going to figure out? You think her lack of pain is somehow the answer to your pain.
House: I think if you'd stop talking to Cameron then right now we could be ranking nurses in order of doability.
Foreman: (enters) Need you.
House: What did the nerve biopsy show?
Foreman: Never did it.
House: Well then, do it.
Foreman: Can't.
House: Why?
Foreman: She's going to jump off the lobby balcony.
House: And you think I can catch her? (Foreman dashes out.)
[Cut to balcony]
Hannah: Get away from me.
Cameron: I'm not going to hurt you.
Hannah: Yes you are. You're just jealous that I can do anything.
Cameron: Hannah, you're having a paranoid delusion.
Hannah: I don't believe you.
Chase: (to Cameron) Think she would?
Hannah: This is real. You want me to be in pain. You even said so.
Chase: If we wanted to hurt you, we'd let you jump.
Hannah: Just let me see my mother.
Cameron: Fine. We'll take you to her OR observation room.
Hannah: I don't believe you.
Foreman: Your mother is fine. I just spoke to her surgeon.
Hannah: I don't believe you.
Chase: Hannah! What do you want from us? What do you want us to do?
Hannah: I can't feel my legs.
Foreman: You're trying to pull the same stunt in ten minutes.
Hannah: I'm not pretending. They don't hurt, they're just not there. (she falls. Shot of her lying on the floor below. She moves.)
[Cut to Hannah's room.]
Cameron: Anything? We're not looking for pain. Anything at all? Pressure?
Hannah: Nothing.
Cameron: You have six broken bones, a fever, a concussion, erratic heart rhythms and a complete lack of sensation below the waist.
Hannah: I feel fine. Is my mother out of surgery yet?
Cameron: Not yet.
[Cut to Diagnostics Office? Two light tables hold about a dozen x-rays.]
House: This is excellent.
Cameron: The paranoia seems to have dissipated but her vitals keep getting worse. She could be dead in hours.
House: But if you're going to die a miserable, lingering death, pain free is the way to do it. Are we sure the fall didn't cause the paralysis?
Chase: The paralysis caused the fall. Spine's clean. No veritable fractures or spinal cord compression.
House: Even better. The nuttiness and paralysis means there's definitely a neurological component.
Foreman: Could be a nerve disease.
House: Which is why we need to look at the nerve that you didn't biopsy.
Chase: There are other tests...
House: HIV? Syphilis? She was negative for all STDs. Vascular? No, ANA was negative. Cerebral clot? No, MRI was...
Cameron: Thyroid storm.
Foreman: Makes sense given her glucose reation was slow and her potassium is down.
House: Yeah. I'll check with an endocrinologist.
Cameron: Bennett's on call.
House: Perfect.
[Cut to door to a house. House knocks with his cane. Door opens. It's Cuddy]
Cuddy: Nooooo.
House: Need a consult.
Cuddy: I already okayed your nerve biopsy.
House: I need an endocrinologist.
Cuddy: Bennett's on call.
House: Won't pick up. His cell phone must be broken.
Cuddy: Mine's working.
House: Had to give you the file.
Cuddy: (reading) I assume you're thinking thyroid storm. You done a hormone panel?
House: Normal. TSH was on the low side. Is that a cheery fire I hear crackling nearby?
Cuddy: No. What about CPK enzymes?
House: Elevated. 275. Of course, people light fires for themselves. But then they don't deny it. He's here.
Cuddy: CPK isn't high enough. Potassium's what you'd expect because of the bronchodilators.
House: (looks at her then looks skyward in exaggerated manner) Oh my God. You're not wearing a bra.
Cuddy: It's not thyroid storm.
House: You just met him.
Cuddy: I like him. And I like sex. Do I need to stitch a letter on my tops?
House: No. But it might be worth taking out an ad in the local papers.
Cuddy: (taking a couple of steps forward) Do you like me, House? I was on the phone with Bennett 15 minutes ago. His cell phone's working. You're M.O is to avoid me at all costs. And suddenly you need my input on every move you make. I can only assume it's because I'm on a date.
House: When we met, I noticed...
Cuddy: You noticed he was a Shriner because of the way he parted his hair. You noticed he was a momma's boy because of the way he blinked his left eye. I'm not interested. I'm not impressed. There are only two reasons anyone would want to screw with me tonight. Either they're an altruistic, decent person who's worried about my well being. Or, they want me for themself.
House: You left out the third option. Evil bastard who just wants to mess with other people's happiness.
Cuddy: Goodnight House. (she goes in, closing the door. Goes to living room) We won't be bothered again.
Don: (putting on his shoes) It's late. I should go.
Cuddy: Why?
Don: I part my hair on the left and I'm a Shriner?
Cuddy: (covering face with hands) You heard the conversation. I'm not interested in him.
Don: I don't blame you.
Cuddy: I only said those things so he wouldn't come back.
Don: I don't really care about my job. I do it well. I provide a service. But my goal was always to make enough money to do the things I really like. Music. Travel.
Cuddy: I like those things too.
Don: You like them but they're not really important to you. I don't know whether it's House, your job or if you just thrive on conflict but... You should hear yourself when you're talking to him. Nothing else in the world's going on. You're focused, confident, compelling. Don't... don't take this the wrong way, but I'd like to go out with that woman.
Cuddy: I can get her on the phone. (Don kisser her on the cheek and leaves)
[Cut to House's office]
Cameron: Where did you go? She's getting worse.
House: It's not thyroid storm. Get me a spinal nerve.
Chase: There are still other tests.
House: She just said the girl's getting worse. You really want to wait? (Drops file on his desk. Looks around, confused.)
Cameron: (as House heads into the hall, followed by fellows) We'll be risking infection. Maybe make the paralysis worse.
House: (leaving office) It is worse. We're making it worse than worse? Do the biopsy.
Chase: You could paralyze her and get no useful information.
House: Do the biopsy.
Foreman: You're thinking peripheral neuropathy. We should take a nerve a little further away from the spine.
House: A little further from the truth. We're talking paralysis. Good chance the spine is relevant. This thing is progressing. It could kill her in hours. (opens door to Wilson's office. Wilson is reading. House holds out his hand.) Give me back my papers.
Wilson: (to fellows) Is he asking for a spinal nerve?
Cameron: How did you know?
Wilson: Give us a minute? (Fellows leave, closing door) Did you know they recently found a protein that speeds up nerve growth? Fascinating stuff. If you put that protein with the insulation from a spinal nerve, you could grow your own little garden. If that spinal nerve...
House: Yeah, yeah, yeah, yeah. If it happened to come from a person with CIPA I could grow pain-free nerves and graft them into my own leg. What an evil plan.
Wilson: You'd have to be on immunosupressors for life. Risk of infection. Shorter life span...
House: Shorter, but normal.
Wilson: Usually jealousy expresses itself by trying to destroy what someone has. You're more ambitious. You actually want to change medical fact to get this thing you...
House: Medical fact changes all the time.
Wilson: You're risking your patient's life.
House: That's how medical fact changes. A doctor risks...
Wilson: To serve their patient health, not their own.
House: This is medically justified.
Wilson: Are you sure? Are you sure that you're the right one to be making this call.
[Cut to hallway where the fellows are waiting]
House: Biopsy whatever nerve you figure you can safely get at. God, Wilson's annoying.
[Cut to lab. Cameron and Foreman are running tests.]
Cameron: Past 3 a.m. on Valentine's Day night. I assume you had a date with Wendy.
Foreman: She'll survive. She knows the deal.
Cameron: You're lucky.
Foreman: I know.
Cameron: Someday, when there's time, I would like to actually have a social life.
Foreman: Someday? Come on. If there's one thing a good-looking woman can have whenever she wants, it's a social life.
Cameron: You mean a sex life.
Foreman: There's nothing wrong with a little companionship 'til the real thing comes along.
Cameron: I had the real thing. Forgive me if I don't want to settle.
Foreman: Right.
Cameron: What does that mean?
Foreman: Nothing.
Cameron: You think I didn't have the real thing?
Foreman: I have no idea what you had.
Cameron: And yet you're judging it.
Foreman: It's late. I'm cranky. Sorry.
Cameron: I didn't have the real thing. How could you even know?
Foreman: You married a dying man. You thought six months, a year, it'll be tough. But then I'll recover and I'll have the rest of my life. It's like willingly getting the flu or joining the Peace Corps. Short term.
Cameron: Wow, you nailed it. It was basically like a wasted weekend.
Foreman: The sacrifices you made were huge. But they were at the height of your love for him. Commitment is only commitment because it has no expiration date. You stand next to someone and watch them floss for 30 years like my parents have, then ask for sacrifices. That's how you know the real thing. Cameron, I wasn't criticizing you. People who avoid commitment are people who know what a big thing it is.
Cameron: (looking into microscope) This isn't right.
[Cut to House entering lab.]
Foreman: CIPA can't cause this much degeneration.
Chase: A few nerve fibers we teased out of the center had some insulation left. But the insulation around the bundles is stripped bare.
Cameron: Means damage must be coming from the outside in.
House: Which means it's secondary demyelination. Which means the source is somewhere else. Which tells us it's not a nerve disease means it's something systemic that's affecting the nerves. Which mean we need to... (to Cameron) Where are you going?
Cameron: Kid's mom is finally out of surgery
House: I'll be right back.
[Cut to hallway as House follows Cameron.]
House: So what?
Cameron: Hannah should see her.
House: Yes, immediately after we're done chatting about saving her life. Most likely causes are metabolic.
Cameron: They found brain swelling. They're prepping her mother for another surgery.
House: Again, so what? Get a nurse to take the kid. There are more than sixty different metabolic conditions that could account for what she's got. There are only three of you guys.
Cameron: She's scared.
House: She should be. She'll die if we don't diagnose her.
Cameron: So, diagnose her.
[Cut to Cynthia's room.]
Hannah: Mom.
Cynthia: (moans and turns toward Hannah.) How... (she pulls off her oxygen mask) How bad is it? Are you okay?
Hannah: I'm okay, mom. I'll get better. I always get better.
Cynthia: Are you checking yourself? Your temperature?
Hannah: Mom, could you just let it go. You shouldn't be worrying.
Cynthia: Baby, I'm sorry. I should have seen that car coming.
Hannah: No. Mom, I did this to myself. I screwed up. You were right. You were right and I was wrong.
Cynthia: No. No.
Hannah: I shouldn't have gone out on the ice. And I shouldn't have fallen down. And I shouldn't have made you rush me to an E.R. for the tenth time this year. (monitors start beeping) Mom? Mom?
Cameron: You okay? We're gonna have to take her back to surgery. Hannah, your BP is way up. We need to get you some rest.
Hannah: (touching hand to eyes) My hand's wet.
Cameron: You're crying.
Hannah: I can't cry. Oh. My head's killing me.
[Cut to Diagnostics Office]
House: So, what does the pain tell us?
Chase: No tingling, no itching. So we can rule out...
Foreman: It tells us nothing. It wasn't physical pain, it was emotional.
House: Exactly. What were they doing when she got the headache?
Chase: Saying goodbye.
House: You said they were arguing.
Cameron: They weren't really arguing. She was just frustrated.
House: What were they arguing about?
Cameron: Whose fault it was.
House: Peripheral neuropathy, fever and intermittent paranoia. Lots of metabolic conditions can explain those things. But what if we add guilt?
Chase: Guilt as a symptom?
House: Alzheimer's can cause euphoria. Pain causes depression. And B12 deficiency causes guilt along with all that other stuff.
Foreman: If she felt guilty, she wouldn't be making her mother's life miserable. She wouldn't be getting into fights, getting arrested...
Cameron: Maybe she's fighting because she feels guilty. She's showing her mom she can take stupid risks and still be safe. Means her mom can let go.
Foreman: Which is rational. If guilt is a symptom it's caused by the illness, not by a thought process. And it would have to be new.
Cameron: A couple of years ago she was a model student.
Chase: This is pointless. If the headache was caused by the illness, it means she has a B12 deficiency. If it's just because she was sad, it's meaningless. How the hell do we test for that?
House: We don't. Give her a shot of B12. If she gets better, I was right.
Foreman: We already did. (holding chart) The E.R. gave her B12 when she was admitted, part of a multivitamin supplement. Apparently she's just sad.
[Cut to Wilson's office. He's doing paperwork and eating a sandwich.]
House: (entering) Why are you still here?
Wilson: Trying to get a couple of patients into a drug trial. Paperwork's due tomorrow. Why are you here?
House: I still haven't figured out why.
Wilson: No, I meant here. In my office.
House: Just dumped a cool B12 theory. Moved on to leukemia. (drops file on Wilson's desk.)
Wilson: Very pedestrian.
House: I'm not happy. Her white blood cell count was low. But the ones she's got... Just a whole lot of eosinophils.
Wilson: The immunoglobulin E level's borderline. If you want to be one hundred percent sure, check the bone marrow.
House: Team's doing a biopsy right now. (sits) So it turns out, the weird lawyer knew that she used to be a man.
Wilson: And he's cool with that?
House: Turns out that his previous girlfriend also used to be a man.
Wilson: Ho, ho.
House: Yeah. (reaches over and grabs half of Wilson's sandwich.)
Wilson: Is it possible for you to just watch me eat. Or do you get some primeval thrill out of beating the other hunters to the food. (House freezes for a moment. He throws the sandwich and leaves.) See you later.
[Cut to procedure room]
Hannah: You still haven't figured out that I don't need sedation.
Chase: It's so you don't move during the procedure.
House: Is that nitrous? What are you, trying to kill her? You gave her nitrous during the EEG. That's what made this thing rear it's ugly head.
Chase: What thing?
House: B12 deficiency.
Foreman: Are you having d�j� vu? We've had this conversation. She was given B12. She didn't get better.
House: Because someone else ate it. Get an abdominal MRI.
Hannah: What? What are you doing? (pulling away from them on the gurney, hysterical) Don't touch me. Don't touch me.
House: See. There she goes. Another paranoid delusion. She's going downhill. Forget the MRI. We need an O.R.
Hannah: Leave me alone.
[Cut to gurney being pushed through stainless steel doors. Another operation in the O.R. has already begun.]
Female Surgeon: Occupied.
House: Her hernia can wait. (he is pulling on gown as he talks. No mask.)
Hannah: Help. They're trying to kill me.
House: Okay. You can either believe that we really are trying to kill her... or you can assume that she's suffering from a medical condition. Seeing as this is a hospital and we're all dressed like doctors and there are easier ways to kill somebody...
Surgeon: Bev, help them.
House: I'm going to need iodine, scalpel numbers 10 and 15, forceps and a largish salad bowl. (Hannah continues to struggle as House starts to bare her midriff.) Okay. Hold her down. Come on, weenies, she's in a cast. Swab. (Swabs Hannah's belly, hands it back to Bev.) Fifteen.
Surgeon: You're not going to anesthetize her?
House: Relax. It's just a magic trick. (As he begins to cut her stomach, Hannah starts screaming as loud as she can.) She's faking it. (to Hannah) We're not falling for it this time. (Hannah drops her head back on the gurney, defeated.) Okay, keep that retracted. (House works at the incision for a moment.) Forceps. (House starts to pull a tape worm out of Hannah, narrating in an exaggerated 1950s documentary voice) Lake fishing can be fun. It can bring the generations together. (Back to his normal voice) If you don't cook that trout or perch well, you'll be giving room and board to this fellow. By free board, I mean all the B12 you can take in.
Bev: I could have a tapeworm in me?
House: Not likely. You'd be in a lot of pain. (As he continues to pull the tapeworm out, a nurse snaps a picture with her cell phone.)
Foreman: It's gotta be twenty five feet long.
House: Damn. World record's over sixty.
[Cut to Cynthia being wheeled into Hannah's room.]
Chase: Hannah. Wake up. Somebody here to see you. She's got limited motion on her left side. You might have to take care of her for a while. (Hannah starts to get up to lean over to her mom) Whoa, whoa, whoa, whoa. You don't feel it, but you're about to rip your stitches out. Take care of yourself. Then you can take care of her.
[Cut to locker room. Foreman is at open locker. Wendy enters]
Wendy: You haven't gone home.
Foreman: Sorry I screwed up Valentine's Day.
Wendy: I'm dating a doctor. I'd be an idiot to expect anything else.
Foreman: I did get you a gift. (Handing her a large envelope) MGH - best teaching hospital in Boston. Wanna be a nurse practitioner, that's as good as it gets. (He moves away while she stares at "gift) I made a few calls and, you're in if you want in.
Wendy: This is why you've been helping me get my surgical hours for accreditation.
Foreman: I thought you wanted...
Wendy: (over) Stupid. You've got ten feet of personal space around you. I step forward, you step back.
Foreman: I've shared a lot of things with you.
Wendy: Which is why you're breaking up with me. You can't stand to be close.
Foreman: Wendy, you think I'll stay with you because you're angry with me?
Wendy: I'm upset. Because I care. Only you'd expect an argument to be rational. You and that ass boss of yours. (leaves)
[Cut to Cuddy sleeping alone in bed. Music playing, continues through next scenes]
[Cut to Hannah's and Cynthia's room]
Wilson: (in doorway with House) You could ask her for the spinal nerve.
House: She's got no reason to give it.
Wilson: She owes you.
House: The hospital will send her a bill.
Wilson: I'm just saying, if you wanna do it, do it while her B12 is still low. Guilt can be your friend. (they walk down the hall) Breakfast?
House: Yeah.
[Cut to lobby. Cameron and Chase step off elevator. An orderly, carrying flowers, get on.]
Chase: Happy Valentine's Day.
Cameron: A holiday that only applies to people who are already paired up. For everyone else it's Wednesday.
Chase: Wow. Thank you for that dash of cold water.
Cameron: Don't get me wrong. I still think true love's out there it's just very far away. Possibly in another galaxy. We may need to develop faster than light travel before we can make contact. (They walk outside) So I'm thinking we should have sex.
Chase: That makes sense.
Cameron: Despite the wisdom of pop songs. there's no point in putting our lives on hold 'til love comes along. We're both healthy and busy people. We work together so it's convenient.
Chase: Like microwave pizza?
Cameron: And of all the people I work with, you're the one I'm least likely to fall in love with.
Chase: Like... microwave pizza.
Cameron: The point here is to make things simpler, not more complicated. Someday there'll be time to get serious about someone. Meanwhile, we already had sex once and didn't get weird about it. So...
Chase: I get it. I get it. So, what if I'm offended by your judgement.
Cameron: Then you're not the man I'm looking for. (She walks off, he smiles and follows.)
