season 2 3-19

episode 3:

HUMPTY DUMPTY
Aired 9/27/05
Alfredo, a construction worker at Cuddy’s house, complains that his asthma is acting up. She asks him to finish the job. Alfredo falls off the roof onto the concrete.

An ambulance races Cuddy and Alfredo to the hospital. He can’t breathe, and Cuddy notices two of the fingers on his right hand have turned purple. At the hospital, the doctors try to figure out the cause of this. House suggests disseminated intravascular coagulopathy. House asks his team for a cervical MRI and treatment for DIC.

Stacy tells Cuddy that, for legal reasons, she should stay away from Alfredo. Stacy is sure that Cuddy will feel guilty, apologize and offer to pay his bills. The hospital doesn’t need that. Cuddy is concerned that Alfredo could lose his hand and then his livelihood.

Alfredo demands to be released so he can go back to work. Chase notices that a third finger is turning purple. Cameron finds that Alfredo isn’t clotting properly, which would mean minor DIC. House points out that if the hand is dying, it could move up the arm and further. Cuddy orders a stronger medicine -- human activated protein C. The staff is shocked. House points out that this treatment is only for severe sepsis. It is incredibly dangerous and could cause internal bleeding, strokes and more. Cuddy tells them to do it anyway.

Wilson notes to House that he would’ve ordered protein C as well. Suddenly, Alfredo screams for help because he can’t move his arm. Chase tells Cuddy that the protein C caused bleeding in Alfredo’s brain. The treatment is stopped and Alfredo is rushed into neurosurgery. Cuddy observes the surgery.

The surgery fixes the bleed. As Cameron examines him, Alfredo suffers from a coughing fit. A chest x-ray shows lung infiltration. His fingers become darker and he has a fever. Cuddy tries to connect this to Alfredo’s falling off her roof. Foreman suggests pneumonia, and Cuddy admits that it is a possibility because Alfredo asked to leave the job. House asks Cuddy to check Alfredo’s house to look for possible causes. House secretly has Foreman and Chase investigate Cuddy’s house as well since Alfredo has been there for the past three weeks.

Cuddy and Cameron find a rat killed by a trap under Alfredo’s dresser. The scars on Alfredo’s hand must be rat bites. He has streptobacillus, which fits the symptoms perfectly. In Cuddy’s bathroom, House notices a fuzzy, black aspergillus fungus on the pipes underneath the sink. Looking an x-ray, Cuddy agrees that fungal pneumonia is more likely. Cameron points out that the treatment for aspergillosis is amphotericin, which is hugely dangerous.

Stacy asks House to take it easy on Cuddy because she actually feels for patients. They’re not just a puzzle to her. Meanwhile, Alfredo’s little brother tells Cameron that Alfredo hasn’t peed since yesterday afternoon. Cameron is concerned, and she immediately tells House that the amphotericin might have destroyed Alfredo’s kidneys. Alfredo’s mother overhears this and begins crying.

The team reviews what they know. The cause is not aspergillus nor rat bite fever. Alfredo tested negative for moraxella, nocradia and cryptococcus. DIC wouldn’t cause a fever this high. House takes Alfredo’s temperature and sees that the patient’s right hand is starting to rot.

House wants to amputate the hand but Cuddy refuses to let that happen. She blames it on the medicine they gave him. If Alfredo loses that hand, he loses his jobs. House comments that this isn’t medical thinking. House tells Stacy that Cuddy now agrees to the amputation and he begs for legal clearance. Cuddy tells Alfredo that it is necessary, and he tearfully agrees to the procedure.

During surgery, the fingers on the other hand start to turn purple. The team gathers afterwards with the news that Alfredo’s O2 stats are down to 88 and his lungs are giving out. House wonders about endocarditis, which is an infected heart with little bacterial cauliflowers clinging to its valves. One may have broken off and traveled through the bloodstream to the right hand. Cuddy points out that they tested Alfredo for endocarditis and he was negative. House asks what infection causes pneumonia and culture-negative endocarditis.

Chase puts forward psittacosis, but Alfredo doesn’t have any pet parrots. House orders a round of doxycycline, which Cuddy notes will make the clotting problems even worse. Cameron points out that, if House is wrong, Alfredo will lose his hands and feet. House and Cuddy barge into Alfredo’s room. House asks the mother, in perfect Spanish, where Alfredo usually works on Saturday night. She says that he doesn’t work. House knows that she’s lying. House realizes that Alfredo works the cockfights on Saturday night.

Cuddy and Foreman head down to the warehouse district and find a cockfight. They see Alfredo’s brother carrying cages of dead birds. Cuddy calls House with the news. House says he put Alfredo on the psittacosis meds as soon as she left. Cuddy later gives Alfredo the diagnosis. He’s going to be okay.

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Episode 4:

TB OR NOT TB
Aired 11/1/05
Dr. Sebastian Charles emerges from a plane in a remote African village. He’s arrived with tuberculosis medicine for the villagers, who greet him warmly. Back in the states, Dr. Charles gives a presentation to the board of Stoia-Tucker Pharmaceuticals and implores them to provide more medicine from the poor. During the presentation, Dr. Charles collapses and seizes.

Charles thinks he has TB and Cuddy agrees with him. House quickly declares that it’s not TB. Dr. Charles asks to sit on the differential with the rest of the team. Charles is positive that he suffers from TB and his backers only want the second opinion. Dr. Charles orders himself a round a tests to confirm it.

House calls his team back to the office to figure out other illnesses. Chase notices an abnormal heart rhythm which would explain the man passing out. Cameron orders a stress test and an echocardiogram, but the results are normal. The EKG isn’t. House suggests a tilt table test, which Foreman says never works. House assures him that it will.

The test is going fine until House turns the speed way up. Charles complains that he’s about to throw up and faint. The new speed reveals an abnormal P-R interval. Charles is going to need a pacemaker, and surgery is scheduled for the afternoon.

Cameron seems quite impressed with Charles’s sense of being a do-gooder. He tries to persuade Cameron to join him in Africa and offers to discuss it over dinner. But during a brief walk, Charles feels faint, then vomits and passes out.

The team reconvenes to figure out new problems. Foreman thinks the headaches point to a neurological source and he offers up acoustic neuroma, which is a brain tumor that causes all of these problems. House orders an MRI. Charles slides into the machine. Cameron sees that the MRI is clear, showing no tumor. But the PPD she implanted two days to test for TB is clearly positive.

She reports her findings to House, who’s unimpressed. He knew Charles would have TB because he’s been in the jungle so long. He complains that now that Cameron has proven Charles’s diagnosis for him, he’ll refuse to submit to any more tests. She counters that every symptom screams TB.

In Charles’s room, Cameron delivers a cupful of pills for his resistant strain of TB. Looking at the pills, he realizes that two years’ worth of pills would cost $10,000. Thinking of poor mothers who can’t afford any pills, Charles decides not to take them. He thinks if he dies, people might pay more attention to his story and the problem with big pharmaceutical companies.

House goes over the symptoms of increased heart rate, night sweats and a loss of consciousness. If it’s not a tumor, then what else could it be? Foreman counts down the list: Fabry’s, autonomic dysregulation syndrome and Shy-Drager syndrome. House complains to Cuddy that Charles is refusing treatment. She lets House know that Charles has called a press conference. He asked her to be there to confirm the diagnosis and prognosis.

Cameron is offering Charles comfort when House barges into the room. Promising Charles third world treatment, he takes his cell phone, throws it down the toilet, turns off the TV and throws everything on the floor. He yells at Charles that he can’t ask to be treated like a villager and then call for a public press conference.

Charles later speaks to the press from his bed as House and Wilson watch from another room. House notices that Charles doesn’t seem right. His internal heating and ventilation should be off, which means he can’t produce sweat. With the heat in the room cranked way up and under the glare of the news lights, Charles should be bright red. But he isn’t and he is sweating like crazy.

House marches into the press conference. He notices that Charles is disoriented. His heart fails and Cameron tries to shock him back. House yells into one of the cameras that this isn’t TB. Later, House spells it out for Charles. He has low sugar in his cerebrospinal fluid, a classic finding of TB. But his heart failed under heat and stress, which isn’t TB. They have about a dozen symptoms on the diagnosis board. House tells Charles that unless they know which ones come from TB and which ones don’t, they can’t treat him. House offers Charles the TB meds, but he still refuses to take them. If Charles doesn’t take them, House will let him die. Then House will call his own press conference and announce that he didn’t die of TB. Charles’s sponsors will have to find another disease.

Charles begins the regimen of TB pills and tests. Gradually, the team begins crossing off symptoms. The team is left with P-R variability, syncope, headaches and low CSF sugar, which is from the TB that they just cured. So what else causes this low sugar? High insulin levels, for one. House suggests a very tiny tumor and, more precisely, a nesidioblastoma, which is an abnormal growth of the insulin secreting cells in one’s pancreas. This causes only intermittent secretion of insulin, usually in response to stress.

House and the team take Charles into surgery. They’re going to poke around where they think the tumor is and see what happens. They will inject calcium into the pancreas, which will cause the beta cells to release insulin. If there are too many beta cells because of a tumor, Charles’ blood sugar will drop precipitously. This is exactly what happens. Surgery is scheduled to remove the tumor.

In his room days later, Charles is packing up his stuff. Cameron hands him a six month supply of meds. He asks her to come to Africa with the refill, but she refuses because she is interested in House. As Charles leaves, he is engulfed by a media swarm. House points out to Wilson that since he saved Charles’ life, by default, he should get credit for every poor child Charles saves from here on out.

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Episode 5:

DADDY’S BOY
Aired 11/8/05
Carnell Hall and his father Ken celebrate Carnell’s graduation from Princeton. Ken thinks Carnell’s mother would have been so proud of him. That night, Carnell enjoys one last frat party. He begins to feel a series of electric shocks before convulsing on the floor.

Wilson leads House’s team through Carnell’s symptoms -- painful shocks, headaches, nausea and drowsiness. House glances at the board and immediately tosses off possible explanations. Wilson shoots down each with already completed test results. Aside from the obvious diseases, House thinks something is missing. They need to find out what it is.

Cameron, Chase and Foreman run a battery of tests, but still come up empty. They report to House that there is nothing missing. House directs them to examine the fatal car accident that killed the patient’s mother several years ago. In broad daylight, she veered off a straight road. House wants a DNA analysis.

Foreman swabs the inside of Carnell’s cheek and tells him they’re checking for NF2, an inherited disease that causes abnormal growths on the cranial nerves. The doctors witness Carnell defecating in his bed, but he had no idea that he did it. He didn’t feel a thing. Back in House’s office, sphincter paralysis has been added to the white board. That, combined with shocks, usually equals Miller Fisher syndrome. Yet Chase points out that a stool sample testing negative for botulinism rules that out. Foreman mentions that the DNA test revealed no NF2 markers.

Foreman throws out transverse myelitis, which could have caused the symptoms. They don’t know, however, what is causing the transverse myelitis. Foreman wonders if the infection is gone but the memory of it remains in the body -- as in molecular mimicry. House likes this idea, and orders an immunoglobulin level and an electrophoresis.

House gets a call from his own mother. She and his father have a long layover in Newark, but House tells her that he already has dinner plans. While Foreman and Chase draw cerebrospinal fluid from Carnell, Cameron peels off and tells Wilson about the House parents coming to town. She wants him to invite them as a surprise.

Carnell asks his father to get him a soda. While he’s gone, Carnell confesses to the doctors that he recently went to Jamaica with some friends. House thinks maybe Carnell got exposed to some pesticides, possibly through smoking marijuana. House orders them to start Carnell on an IV of pralidoxime. Foreman chafes because there is no evidence to support a poisoning diagnosis.

In the parking lot that night, House accuses Wilson of going behind his back to invite his parents over for dinner. Wilson reluctantly admits that he did. If House doesn’t tell his parents the truth, then Wilson plans to see him at seven for dinner.

The next morning, Cuddy and Foreman drop in on Carnell, only to find him voraciously eating breakfast. They’re amazed that the treatment is working, but the shocks have only decreased and not disappeared completely. His white blood cell count is still low. House is alerted that Carnell has the chills and his temperature has spiked up to 106. House admits to Ken that he has no idea what’s happening to his son.

House adds fever to the white board. The team is stumped. Carnell wasn’t actually recovering but merely feeling better. Yesterday he had no fever or infection. House orders antibiotics and another round of tests. He also orders Cameron to track down Carnell’s friends that made the Jamaica trip.

House catches up with Cuddy to volunteer for clinic duty. However, she is aware of the dinner plans and will be attending Wilson’s party as well. Cuddy implores House to just go to dinner because it will make his mother happy. He replies that it’s not his mom who’s the problem. It’s his father.

Cameron reports that one of Carnell’s friends had a rash, but nobody else had any health issues. House has her bring the friend Taddy in so they can have a look at him. Cuddy instructs Cameron to let House believe that his parents arrived early so that he will visit the rash-stricken Taddy himself. Just then, Chase and Foreman find Carnell bleeding into his abdomen. They rush him into surgery.

The infection has caused a perforation in the colon, which means the antibiotics aren’t working. Cameron begins to lie to House about his parents when Cuddy enters with news -- Carnell’s friend Taddy began vomiting blood and will be delivered by ambulance within ten minutes.

When Taddy is wheeled in, House immediately cuts open the boy’s pants and asks if he and Carnell had sex in Jamaica. Taddy denies this, and explains that he only took Carnell away as a break from working in his dad’s scrap metal junkyard. This gives House an epiphany and he rushes off to Carnell’s room. House asks Ken about any odd scrap Carnell might have handled recently. Ken says he found an old plumb and put it on a key chain for Carnell so he’d always remember where he came from. House demands to know where it is.

After Cameron discovers that Carnell’s old clothes are in a bureau, Houses orders Chase and Foreman to take the bureau to radiology without opening it. House runs a Geiger counter over the bureau and it goes crazy. Foreman later explains to Ken that the piece of metal was radioactive, and anybody who had contact with it will need immediate treatment for Radiation Sickness by transfusion. Carnell had so much exposure that he’s going to need a bone marrow transplant. Additionally, there’s a tumor inside his spinal cord which is causing the symptoms.

A surgeon should be able to remove the tumor, but surgery on somebody as hemopoetically compromised as Carnell is very risky. Carnell is wheeled off to a sterile isolation room. House’s parents arrive and visit him in the office. He tells them he can’t make it to dinner tonight, but they persuade him to have a quick sandwich in the cafeteria.

The surgeon successfully removes the tumor but Carnell begins hemorrhaging. In the waiting room, Chase gives Ken the news that Carnell will not likely be able to fight off infections because his white cell count keeps falling. After surgery, Ken visits Carnell in the sterile room. Carnell tells his father that he’s scared. Ken says that he will be fine and has nothing to fear.

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Episode 6:

SPIN
Aired 11/15/05
During a race, famous cyclist Jeff Hastert gasps for air and then collapses. At the hospital, Stacy rushes into House’s office to remind him to renew his credentials. Cuddy interrupts with the details on Jeff. House asks Cuddy to fire Stacy for pestering him about paperwork. He’s not interested Jeff’s case because it’s probably due to steroids. Yet he becomes intrigued when Cuddy notes that Jeff doesn’t deny using performance-enhancing drugs.

Jeff lists for House the numerous ways medical science has given him an edge. On that list is blood doping. House and the team run through the symptoms. Jeff has tested normal for everything, and suffers from no clot or edema. Something is still causing respiratory distress. Foreman thinks an air bubble may have been caused by a poor injection. House asks for a VQ scan, which confirms that there is a bubble in Jeff’s lungs.

Chase threads a Swan-Ganz catheter into a chest vein. He finds the bubble and begins sucking it out. Suddenly, Jeff starts to drool and the team searches for what is causing the muscle weakness. House calls for a muscle biopsy, which reveals Jeff tests negative for polymyositis, ALS and lupus. With the patient still suffering from muscle weakness, House wonders whether the normal results are actually substandard for an athlete like Jeff. Chase tosses out encephalitis, and House asks for a lumbar puncture to rule it out.

Foreman starts the puncture but Jeff’s arms begin twitching. He gasps for air and lapses into respiratory arrest. Foreman intubates. The puncture comes back negative for encephalitis. House again wonders if wonders if Chase screwed up the embolectomy and pierced something. Either this could be why Jeff is losing blood or he’s simply not producing enough. That acute anemia combined with a muscular disorder equals paraneoplastic syndrome or cancer.

Wilson performs a bone marrow biopsy. Jeff worries that something he took may have caused the cancer. Wilson hands Cameron a phone message, and he realizes that she called a newspaper to tip them off about Jeff cheating in the races. This has been weighing on her since he was admitted.

A chest x-ray shows that Jeff is negative for bleeds, and House declares that the patient has cancer. Wilson says that Jeff does not have cancer because he has pure red cell aplasia instead. This comes as a surprise to the doctors, since PRCA can’t just suddenly manifest. Cameron thinks Jeff is lying about being on EPO.

As the doctors weigh their options, Cuddy and Stacy enter with news of the leak. Stacy will be sitting in with them until this is resolved. House wonders why somebody would leak a cancer diagnosis to make Jeff look bad. Then he realizes it’s because he’s on EPO. House barges into Jeff’s room and tells him that acute PRCA is most commonly caused by EPO. Jeff still denies it.

House questions whether Jeff’s ever-present manager was secretly injecting him. He considers checking her cell phone for the newspaper’s number. The manager tells Jeff that a comeback from cancer will boost his image. Jeff instantly fires his manager.

That night, Foreman keeps a watch on the sleeping Jeff and he notices that something is wrong. The next morning, Foreman reports that Jeff’s red blood cell count plummeted to 16 percent. The drugs should really be flushing out of his system by now. House posits that maybe Jeff wasn’t using EPO.

Foreman mentions that he performed a transfusion and House is struck with an idea. He orders a CT scan on Jeff’s neck, which reveals a thymoma. These are usually present in the chest. The team wants to know how House figured this out. House explains that they had scanned his chest so much, so it obviously wasn’t there. Perhaps Jeff didn’t have acute PRCA but had a chronic version instead. The constant blood doping served as the transfusions Jeff would need for such severe anemia.

House walks into Jeff’s room, jabs a syringe into the man’s thigh and proclaims him healed. Jeff immediately starts feeling better. House informs him that the thymoma is usually associated with PRCA and myasthenia gravis. They can take Jeff’s thymus out and everything else will be manageable. The miracle shot he gave him was only diagnostic.

Later that night, House limps through the empty hospital towards the therapist’s office. He tells a maintenance man that he forgot his cane in that room and asks to be let in. once inside, House roots through a file drawer and finds Stacy’s psychiatric evaluation. He begins reading the notes on her.

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Episode 7:

HUNTING
Aired 11/22/05
House admits to Wilson that he made copies of Stacy's psychiatric evaluation. Wilson is aghast at the breach of ethics. House is incredibly intrigued to find out that things are rough between Stacey and Mark. The couple isn't even having sex.

A man named Kalvin Ryan waits outside House's place, and House is quite familiar with the man because he's practically been stalking him. Kalvin begs House to examine his file, but one quick look at the man's appearance is all House needs to declare that it's AIDS. He advises Kalvin to get his T-cell count re-checked, which Kalvin says he's already done.

Kalvin collapses and begins wheezing. Wilson realizes that the patient is going into anaphylactic shock. Later, Stacy informs House that Kalvin has stated that he will press charges for assault is House refuses to treat him. House presents the case to his team. Foreman and Cameron note that, according to his file, Kalvin recently tested negative for TB, PCP, MAC, CMV and HSV. His T-cell count is at 200. They don't agree with House that an infection is a foregone conclusion.

Kalvin's new meds have rebounded his immune system and dropped his viral load. He's getting better, but also getting sicker. House wonders if the new meds woke up Kalvin's immune system to cause an old infection to restart. He orders an x-ray to find the old infection and steroids for treatment.

Trying to impress Stacy, House visits her home to help her kill a rat. While there, he subtly tries to sabotage her marriage by offering observations that just happen to match the thoughts in her psych profile. The doctors call, informing House that Kalvin's lungs are too scarred for any infections to show on the x-ray. House orders a round of meds to treat the last three infections Kalvin was known to have had.

Kalvin coughs blood that splatters across Cameron's face. The hospital's infection control officer informs her that she'll be given post-exposure prophylaxis and three anti-viral medications. She will also be tested for HIV at six weeks, three months and six months. House is more interested in what the cough means because it's a new symptom. He has Chase and Cameron check Kalvin's pills for toxins.

In Kalvin's home, they find no interesting medicines. Yet they do find photographs that Kalvin took of smashed up light bulbs. The bulbs date to the 1930s, when fluorescent lights contained large amounts of beryllium. Beryllium dust inflames the lungs, causing them to be rigid, which makes it difficult to breathe. Cameron creates a small incision on Kalvin's back in order to biopsy his lungs for beryllium exposure.

Meanwhile, House tries to capture Stacy's rat instead of killing it. House noticed that the rat is tilting its head, which indicates an infection or a brain tumor. This could have been caused by something in the house which could affect Mark and Stacy. House begins laying out cheese spiked with antibiotics.

Back at the hospital, Kalvin complains of chest pains and he is struggling to breathe. He is bleeding from his lungs into the area around his heart. Foreman plunges a needle into Kalvin's chest. The syringe begins to fill with a clear fluid instead of blood. This indicates a tumor in Kalvin's heart.

Wilson reports that a CT scan confirmed the tumor, along with several smaller ones in the lungs. He is sure that it is non-Hodgkins lymphoma. Cameron thinks it could be sarcoidosis, and she asks to do the Kveim Siltzbach test. This stops the doctors in their tracks because the test isn't FDA approved. House knows that Cameron can't resist the strained relationship between Kalvin and his father.

That night, Stacy and House stake out the rat. He notes that the rat's urine indicate toxins from cigarette smoke. Stacy admits to blowing her smoke into the vents. The rat then walks right into one of the traps and is caged.

Cameron calls Chase over to her apartment. She had a discussion with Kalvin and he told her that the discovery of his HIV finally allowed him to let go of worrying about what other people thought. Kalvin had needled her about being too uptight. Cameron decides to let loose and experiment. After taking some of Kalvin's meth, she drags Chase into her bedroom for a wild night.

The next morning at the hospital, Cameron and House arrive to find Kalvin arguing with his father. House asks why Kalvin feels like he needs to apologize if the dad is the one who kicked him out. After some heated back and forth, Kalvin's father says that Kalvin killed his mother.

Cameron explains that Kalvin had lied. Mom's kidneys were failing and Kalvin was a match. He was also HIV positive and couldn't donate his organs. House gets the results of the Kveim test which indicate the patient is negative for sarcoidosis. Wilson breaks the news to Kalvin that he most likely has lymphoma. They will need to get a sample of the tumor even though it is dangerously close to his aorta.

House is discussing the rat's infection with Wilson when he notices that Kalvin's father is still sweating. House has Wilson cancel Kalvin's biopsy because it isn't the problem. House brings the father and son together to ask if they used to hunt foxes together. He then explains that the masses in Kalvin's chest aren't tumors but parasitic cysts from a bug called echinococcosis, which comes from touching a dead fox.

House asks Kalvin's father to take a blood test to determine whether they have the same symptoms. The dad chafes at the idea, so House goads the man about his dead wife until he punches House. This allows House to hit him in the kidney with his cane which ruptures one of the man's liver cysts. He falls into an anaphylactic shock, which is the same thing that happened to Kalvin earlier.

Kalvin and his father successfully recover from surgery. Afterwards, Cameron accuses Kalvin of lying to her about loosening up. She notes that he hasn't had a single visitor. Cameron accuses him of trying to self-destruct because of his mother's death.

House visits with Stacy about his latest assault. He tries to bait her into admitting that she's not sleeping with Mark, but Stacy realizes that his extreme confidence about their relationship must mean that he read her file. She throws him out of her office.

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Episode 8:

THE MISTAKE
Aired 11/29/05
Stacy informs House and Chase that their scheduled peer review disciplinary hearing has been moved up to the next day. Since this is Chase’s first experience with the process, Stacy wants to walk him through it.

A mother named Kayla watches her daughters perform at an elementary school talent show when she feels a sharp pain. She doubles over and screams out in agony. Kayla is admitted with multiple joint and stomach pains. In a neurological exam, Foreman notices some inflammation of the iris. The team begins running through possibilities. Suspecting an STD, Chase gives her a pelvic exam. He finds some ulcerization and prescribes some meds.

The next day, Kayla returns to the hospital with pustules on her arm. This confirms Chase’s feelings that it’s Behcet’s, and he sends her off to get an appointment with rheumatology. He also prescribes a stronger antacid after she mentions increased stomach pain. Chase later admits that not asking further about the stomach pain was a mistake -- a mistake that’s at the heart of this matter.

An hour later, Chase has a nurse call Kayla back in, thinking she had something else important to say. Yet she is wheeled in by the EMTs after vomiting massive amounts of blood. This is a sure sign of a bleeding ulcer. Chase cauterizes the ulcer, but Kayla’s blood pressure still drops. She also has a perforated ulcer, and Chase orders her into an OR.

The perforation caused sepsis, damaging Kayla’s liver and kidneys. Despite making every effort to avoid doing so, Stacy is forced to talk to House about why Chase screwed up. House doesn’t think he did, but House was actually highly critical of Chase at the moment. He yelled at him for not asking the patient simple questions.

Stacy asks Chase why he didn’t ask those two simple questions. He’s just as resistant and defensive as he was earlier. Stacy wants to know what happened after the surgery. Chase says that Kayla developed clots because the sepsis had lowered her blood pressure so much. Her liver was shot and she needed a transplant. Chase and House badger Cuddy into putting Kayla on the liver transplant list. House even admits that this all happened because of Chase’s mistake.

Kayla’s brother Sam doesn’t want to wait for a donor and offers his own kidney. House somehow convinces the hospital’s transplant surgeon to perform the live transplant, which is a risky maneuver. He had actually threatened to tell the surgeon’s wife that the surgeon was sleeping with one of the nurses. Stacy advises House not to proffer this blackmail information to the committee.

Two months after the transplant, Kayla is back for a follow up exam with Chase. Noting a fever, Chase sends Kayla for cultures and a chest x-ray. Then the fever spikes. Foreman theorizes that Kayla is rejecting the new liver. Chase insists it is an infection. Sam comes into the office demanding more treatment for his sister. House notes his homemade tattoo, and Sam admits that he has hepatitis C. He had paid off a technician to say he was clean. What’s worse, Sam’s liver also had an undiagnosed hepatoma, which grew faster in Kayla. So Sam’s liver gave Kayla both hep C and cancer.

The official malpractice lawsuit arrives and it seeks punitive damages of $10 million. What hasn’t Chase told them? After Kayla’s cancer blacklisted her from the transplant list, Sam finds a black market liver and had planned to take Kayla to Mexico City for a transplant. Before she could leave, Chase admits his mistake to Kayla. He said he had acted too hastily. He pleads with her to forgo the operation, which would certainly kill her.

Stacy points out that this admission wouldn’t warrant the lawsuit. Sam later had returned to Chase for a follow-up. What happened in that meeting? Chase had confessed to Sam that he killed Kayla by not listening to her. He was hung over and just wanted to go home. Sam became enraged. House asks to see Chase outside. He knows that Chase lied to Sam because he wanted Sam to sue the hospital. The guilt he’s feeling over Kayla forced him to.

What really happened is that Chase received a call from his stepmother with news that his father died right as Kayla came back into the clinic. House advises Chase to tell the truth so that the hospital can settle. He can continue to lie and lose his career.

After testimony from both House and Chase, the committee reaches a decision. Although Dr. Chase had lied, he will only be suspended for one week because he was reacting to his father’s death. Although there is no evidence of a lack of supervision from House, there is a litany of troubling complaints and issues surrounding him. The committee recommends that House’s practice be overseen for a period of one month by a doctor of Cuddy’s choosing. Cuddy has chosen Dr. Foreman to oversee House.

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Episode 9:

DECEPTION
Aired 12/13/05
House is playing the horses at an off–track betting parlor when he strikes up a flirtatious chat with a woman named Anica. She collapses and begins convulsing. House doesn’t help, but instructs someone else to call an ambulance. Yet when he notices red streaks on Anica’s stomach, House has the paramedics take her to Princeton–Plainsboro and ask for a Dr. House.

The team reviews the case: a woman with grand mal and inexplicable bruising. Her platelets are 89, she’s anemic and she had a blood alcohol level of .13 in the middle of the afternoon. Foreman thinks she’s an alcoholic and Chase considers that she might be a hooker with an STD. House notes that her bruises are not petichieal so she’s not an alcoholic or DIC. And no sign of fever or infection rules out STDs. Cameron suggests Cushing’s, and House wants them to start from there. Foreman, flexing his authority, orders House to draw a patient history.

House complains to Cuddy about the new set up, but she only reinforces Foreman’s power. Yet she mentions that, if there’s a screw up, then it is Foreman’s problem. He won’t be able to fall back on House. House has Anica fill out her own patient history form while he studies her racing report. They continue flirting, and Anica tells him that her sex life is barren right now. She just moved here with no job and she doesn’t know anybody. While looking at her bruises again, House notes that she must have been moving away from somewhere else. He floats the possibility of Cushing’s, which Anica says she suffered from a year ago. She had brain surgery to remove an adenoma from her pituitary. House is intrigued.

House and Foreman observe her go through an MRI. Foreman doesn’t see any re-growth, and House thinks this is because it is too small to see as a microadenoma. Foreman asks about Anica’s lumbar puncture results, but House didn’t do one because he knew what the illness was. Foreman orders him to do the procedure, which House performs as Cameron watches. House cannot get the needle inserted and Anica’s blood pressure and pulse begin to rise. House asks a nurse for an IV lopressor drip.

Foreman adds hypertensive crisis to the white board. House is as convinced as ever that the cause is Cushing’s. House admits to intentionally mangling the LP because Cushing’s plus stress equals hypertensive crisis. Foreman thinks she’s merely detoxing from alcoholism. Chase wonders if the tumor could be somewhere else, so House requests a pan-man scan before Anica dies from a cortisol overdose. Foreman agrees. Yet he says that when House doesn’t find anything, then he has to put Anica on a lithium taper and enter her in the rehab clinic.

Chase and Cameron oversee Anica’s CT scan. Cameron complains that Foreman was put in charge and she wasn’t even asked. Chase helpfully points out that maybe Cameron isn’t the person to hire when you need to say no to House.

House gamely tries to make Foreman’s life miserable. After ordering MRIs for the entire maternity ward, he piles up a year’s worth of discharge summaries that he has neglected and require Foreman’s signature. Foreman tells House that he can’t be broken.

Chase and Cameron discover a mass on Anica’s pancreas. It’s most likely malignant and inoperable, giving Anica two months to live. Cameron breaks the news to Anica and tells her they need to biopsy the mass to know exactly what’s happening. Anica calmly signs off on the procedure.

Foreman informs House that the biopsy was negative for pancreatic cancer. The team reconvenes, and Foreman again insists on alcoholism. Cameron wonders why Anica barely read the procedure consent form. Perhaps she knows that there’s nothing wrong with her. She might be faking everything and injecting herself with ACTH. Her behavior suggests Munchausen’s. Foreman sends House and Cameron to break into Anica’s apartment to look for syringes and such.

Cameron finds two notes at Anica’s apartment. One is for an ophthalmologist appointment and the other is for a gynecologist appointment. Cameron claims that multiple appointments with multiple doctors is a sure sign of Munchausen’s. House explains that a tumor pressing on the optic nerve would explain the continually changing eye prescriptions. They accuse each other of looking for evidence to support their own hypotheses. Cameron reminds House that it’s no longer his call.

Back at the hospital, both doctors press Foreman to side with their diagnoses. With Anica’s consent, Foreman authorizes a venous sampling to check for Cushing’s. This causes House to chastise Foreman for being a coward and taking the easy way out. Cameron barges into Anica’s room with the consent forms, accusing her of being mentally ill and seeking attention from doctors. Now she has to grant them permission for a completely unnecessary procedure. Anica angrily signs the form.

Foreman complains to Cuddy that House is driving him crazy. He wants to know why he was saddled with this job. Cuddy raves about Foreman’s organization. Clinic time is being logged, forms are being completed and filed and she is being correctly copied on procedures. House still gets to play the mad scientist while the department is running smoothly. She wants to know whether Foreman might be interested in making this job more than just pretend.

Before Anica can be sampled, Foreman receives a call. They need to delay the procedure. Cameron inquires whether Anica’s urine has turned orange. The drug rifampin causes this, and Cameron just happened to leave a bottle of pills labeled “danger” in Anica’s room. The bottle actually contained antibiotics. A Munchausen’s patient would have taken them because she couldn’t resist dangerous pills. Cameron set all this up to prove her theory. House is shocked by Cameron’s turn.

House peers through Anica’s medical file. Anica tearfully begs Cameron to believe that she didn’t do this to herself. Cameron explains that, once the rifampin wears off, Anica will be discharged with a psych referral. Chase notes that Anica stuck to her story 100%. House tells Foreman that Anica’s records show that she’s been hospitalized for different reasons each time but there is always one constant – she has low HCT. Her anemia is real. House suggests Munchausen’s and aplastic anemia. The team isn’t convinced. House pleads to prove it with a blood test. Foreman relents, but only allows House to use existing extra blood. He can’t approach Anica.

House shoves the results in Foreman’s face. Anica’s Epstein-Barr titers are through the roof. It is the most common cause of aplastic anemia. Foreman notices that this sample also has evidence of Sickle Cell. Either something has changed or this isn’t Anica’s blood. House admits that he has lied, and again asks for a biopsy. Foreman refuses. House approaches Chase, and after prodding and threatening, Chase agrees.

Yet before he can do anything, Foreman and Cuddy intercept Chase. House sees that his plan is going nowhere and Anica has been discharged. He races outside to catch her and give her the news that she has aplastic anemia. House tells her that, because she’s also sick in the head, he needs to inject her with a drug that will make her seem sick in order to confirm his diagnosis. Yet there’s a catch: if she has actually done anything to herself to cause anemia, then this plan will kill her. House injects her and then walks back inside. Anica collapses and begins convulsing.

The next day, Cameron hands Foreman Anica’s chart which shows that her white count is down. He can’t believe House’s anemia prediction was right. Foreman meets with Anica and gives her the options. She can either receive a bone marrow transplant or live with a regimen of transfusions and injections.

Anica undergoes the bone marrow transplant. Cameron, Wilson, Foreman and Chase all witness the procedure. House sits in Anica’s room with her racing forms and he notices a weird smell. After sniffing Anica’s pillow and bra, he rushes into the observation room and orders them to stop the test. Anica doesn’t have aplastic anemia. She has an infection. There was no fever because the Cushing’s suppressed her immune system. Cameron says that if that were true, then the white count would be through the roof and not low. House doesn’t explain the white count.

Cameron demands one explanation and House offers colchicine. Foreman realizes exactly what House did. House leads the team into the nuclear room and nicks Anica’s finger. Smelly brown pus oozes out. The bruises that Cushing’s gave her made a home for bacteria. House asks Foreman if maybe they should get her started on Augmentin.

That night, House admits to Wilson that he’s kind of enjoying having Foreman in charge. Foreman tells Cuddy that he’d like to run the department. She lets him know that House kept Anica at the hospital after Foreman discharged her. If not for House, she’d be dead.

_________________
House is awesome. Dont hate

Episode 10:

FAILURE TO COMMUNICATE
Aired 1/10/06
A famous writer named Fletcher Stone toasts an outgoing magazine editor named Greta. He collapses during his speech, but when he comes to he can only speak gibberish, using completely incorrect words in sentences.

At the hospital, Cuddy asks Foreman to recommend a diagnostic department since House is currently out of town. Fletcher had a blow to the head followed by aphasia. Foreman sarcastically recommends another neurologist – one that House wanted to hire until he saw Foreman's credentials. Cuddy relents and gives Foreman the file.

Foreman and team begin the examination. Fletcher thinks he’s speaking normally, but when he searches for a word he picks the wrong one. He has also lost the ability to write, which is called agraphia. Greta arrives at the hospital and tells the doctors that Fletcher didn’t trip. He simply keeled over.

House and Stacy go to Baltimore to prepare for a Medicaid billing hearing. Stacy advises him not to defend his ridiculous billing practices. The administrator, noting that House rated all of his cases as fives on the difficulty scale, decides that Medicaid will have to examine every single case.

Chase and Cameron chafe under Foreman’s leadership. They believe that the blunt trauma caused everything, but Foreman wonders if a stroke occurred beforehand. The doctors draw blood and hook up an EEG in search of a clot that could have possibly moved to the brain. Fletcher begins to struggle for breath and his O2 stats drop. The doctors rush to intubate.

Looking at an x-ray, Foreman notices fluid in Fletcher’s lungs. A seizure could not have caused both aphasia and fluid in the lungs. The stroke could not have caused those symptoms either, unless Fletcher suffered from an abnormal heart rhythm. Chase hands Foreman a fax indicating that Fletcher’s urine tested positive for amphetamines, which do not cause pulmonary edema unless they are smoked. Fletcher claimed in one of his books that he gave up drugs and changed his life. Could he be lying?

House turns to Wilson for the scoop because Cuddy called him about the case. Wilson tells him about the tox screen and that Fletcher’s high temperature. House thinks that this rules out drugs. Foreman throws out encephalitis and meningitis as the obvious suspect. He recommends a course of antibiotics. Cameron wonders if it’s an autoimmune disease. House calls the team and asks why they haven’t called him for advice.

House orders antibiotics for meningitis and encephalitis, saying that the team will be screwed if it turns out to be autoimmune deficiency. He demands an MRI and a family history for genetic issues. After House hangs up, Cameron reminds Foreman who’s really in charge. The team begins to interview Fletcher, his wife and his former editor for a recent history. Chase sends Fletcher through the MRI. The scan shows a little brain swelling and scarring, but not in the area that’s currently affected by aphasia.

Back in Baltimore, a blizzard has delayed House’s flight. Although she intentionally booked a later flight home to avoid him, Stacy runs into House in the airport.

Chase says that if Fletcher has meningitis, they need to do a lumbar puncture to identify it. Foreman says that if they are doing an LP on a patient with edema it could paralyze him. Cameron wants to know what House thinks, but Foreman reports that House’s cell phone is out of service. They need more information in order to act, so Foreman suggests breaking into Fletcher’s place.

At the airport, House continues asking Stacy about her crucifix. He has noticed that she wasn’t wearing it earlier and he knows that she’s never gone a day without it. She refuses to answer.

Later that night, Foreman and Chase pore through Fletcher’s office, finding caffeine pills and amphetamines. This matches up with Fletcher’s admission. They also uncover Topamax, an anticonvulsant that wasn’t even prescribed to him. Chase wonders if they should check the home as well, but Foreman knows that Fletcher’s wife is there. Chase wonders if she’s hiding something. They check the house and find nothing.

In Baltimore, House continues to hector Stacy about the crucifix. She tells him to drop it. When she realizes that such an anomaly is driving House crazy, she decides to torment him by keeping quiet. Stacy finally blurts out that she and Mark had a fight, causing her to rush out of the house prematurely. She is becoming aware that Mark is slowly pushing her out of his life by constantly fighting about nothing. Feeling guilty, House now tries to console her.

Cameron is summoned to Fletcher’s room. He’s in pain and holding up a fork. She guesses that he has a metallic taste in his mouth. Wilson calls Stacy’s cell looking for House. He lets him know that Fletcher has a metallic taste and kidney failure. House phones his now-stumped team. Foreman again suggests the lumbar puncture, but House warns them that they have to do it perfectly. He also chides the team for being too gentle with Fletcher. They need to care him with the likelihood of death because it’s the only way they’ll get the truth.

Foreman and Chase meet with Fletcher and his wife to instill fear into him. He denies holding anything back. Cameron performs the LP. Fletcher quickly rolls over and tries to confess something to her, but he only manages to say, “I couldn’t tackle the bear! They took my stain!”

At the airport, an announcement is made that no flights will be arriving or departing until the next morning. Stacy, who booked a room at the airport hotel, invites House because his leg can’t handle sleeping on a cot. Up in the room, House tries to find out exactly where their relationship stands. She explains that they’re like spicy curry: House is abrasive and strong like the chili peppers, but no matter how much you love hot curry, it will eventually burn your mouth. You avoid it for awhile until you start craving it again. House and Stacy kiss.

The phone rings, and the doctors report that the LP showed an infection. Cameron pipes up that Fletcher tried to confess something to her, and House tries to figure out the meanings of “bear” and “stain.” The word Fletcher actually wants to use could be related to those words by meaning or by sounds. They could also simply mean nothing.

The doctors begin throwing words at Fletcher to translate stain and bear. Pain? Brain? Bare naked? Fletcher repeatedly shakes his head. In Baltimore, House sits alone in an abandoned airport corridor. He’s written Fletcher’s phrases on the wall and stares at them, searching for a meaning. Stacy comes down to join him.

House calls the doctors to see what they’ve learned. Cameron points out that Fletcher mentioned stain once before, during the MRI. She thinks maybe he can only tell them things when his wife isn’t in the room. The doctors wake Cuddy up so they can bring her in to distract Fletcher’s wife.

Later that morning, Stacy finds House to let him know that his plane has been boarding for 20 minutes. He ignores her and calls the hospital, where he’s patched through to Fletcher’s room. He reiterates that they took his stain, and Foreman runs down the list of words they’ve assembled. Fletcher says yes to brain. House has a realization – bear means polar bear. Fletcher nods that he is bipolar. That would explain the Topamax, the risky job and the drug use.

House posits that Fletcher had to hide his bipolar disorder to maintain his job. When he fell in love, he wanted that life and was forced to make a change. House mentions bilateral cingulotomy, a surgical procedure that some people claim helps mood disorders. As House talks, Fletcher pounds the bed. House says that it wasn’t the surgery, but a bug Fletcher picked up on his trip to South America for the surgery.

Fletcher’s wife slips into the room. She wants to know if this is all true. House forges on and tells his team to get some blood on a slide under a microscope. Foreman spots cerebral malaria. Although a person with a microscope could have picked this up immediately, computers can’t. Foreman chides himself for the misstep. Cameron tries to reassure him, saying they live in an electronic age.

At the airport, Stacy and House prepare to board their plane. Discussing Fletcher’s case, they bring up that sometimes people want to change so badly for love but simply can’t. People also need that love. So what to do?

_________________
House is awesome. Dont hate

Episode 11:

NEED TO KNOW
Aired 2/7/06
Back from Baltimore, House jaunts into the hospital. Cuddy and Wilson are immediately suspicious about his good mood. House happily admits to Wilson that he kissed Stacy on the trip. Wilson barges into Stacy’s office demanding to know what happened in Baltimore. He angrily reminds her that the last time she left House, Wilson was left picking up the pieces. He has done so for five years.

Margo Dalton, a 30-something, do-everything mother, notices her arm twitching. This causes her to accidentally plow her car through her garage door. Her husband Ted rushes out to find Margo’s body flailing wildly.

The team reviews what they already know. Margo has had a year-long fertility regimen, which explains the excess estrogen in her system. House orders a pregnancy test and an MRI. He wants to know if the problem is in her head or in her uterus.

Margo’s MRI comes back clear. The problem isn’t neurological or pregnancy-related. They will run a genetic test for Huntington’s and put her on Tamoxifen to counteract the estrogen. Margo is upset that this will undo all of her fertility treatments.

Foreman reports to House that, with hypervigilance and sudden irritability, the patient is now defining Huntington’s. Yet House thinks the progression is too fast to be Huntington’s. Chase notes that Huntington’s patients don’t advance to psychosis so quickly. Suddenly, Foreman gets a page and they rush to Margo’s room where she is having a psychotic episode. This is contrary to Chase’s statement.

Margo tests positive for Huntington’s and the team is stumped. House starts thinking about Margo’s packed daily schedule and he wonders whether cocaine might be a possibility. He sends Cameron and Foreman to search Margo’s house. House then heads off to discuss Stacy with Wilson. He wants to know what Wilson said to her.

Foreman and Cameron find a bottle of Ritalin in Margo’s car. House connects the dots: Ritalin combined with estrogen explains the flailing and psychosis. She was clean when she entered the hospital, which caused all of the symptoms to die out. House wants to discharge her, but Foreman warns that they will need a confirmation before they can do that.

Ted and his daughter, Stella, sit besides Margo’s bed. House starts talking to the little girl. Margo tries to deny using drugs, but House waves the tox screen results in front of the family. She admits to Ted that she was taking Stella’s Ritalin. Then she sees that House was only waving a cafeteria menu around.

Later that night, House drops by Stacy’s office. She announces that she’s moving back home now that her husband Mark is improving. House says that he loves her and doesn’t want her to leave.

Margo is walking out of the hospital with Ted when she stops. A blood cot moves into her brain and becomes lodged. Margo collapses to the ground.

Cameron calls House at home with news of Margo’s stroke. House rolls over in bed and tells Stacy that he has to go back to the hospital. The doctors wait for House because they saw him leave earlier with Stacy. Cameron reports to House that the Ritalin didn’t cause the stroke. House wonders if maybe the Ritalin and the fertility meds were competing. Cameron realizes that fertility treatments can cause endometrial cancer, which Chase mentions could cause a stroke. House orders an MRI of Margo’s uterus.

While the team runs the test, Stacy and House meet on the hospital roof. She hasn’t told Mark, but she doesn’t know what she is going to do. House wants her to decide between him and Mark.

The test results come back negative for cancer. House insists that it is in there, and he demands that they find it. Before Chase can start a biopsy, Margo’s BP drops and blood starts to pour from her vagina. Chase uses an ultrasound wand to find the internal bleeding as Margo passes out. Chase lets Ted know that the bleeding stemmed from the liver and flowed through the Fallopian tubes. Margo does have a tumor in her liver but more tests will determine if it’s cancer.

Foreman tells House that they can’t biopsy Margo’s tumor because it is vascular. Before House can react, Mark interrupts. He wants to know why Stacy won’t talk to him. House just walks off but Mark follows. House tries walking up the stairs to get away, but Mark drags himself out of his wheelchair and pulls himself up the stairs. House calmly walks away.

Back in the office, House is confused by the liver tumor because the symptoms don’t add up. House asks the team what they know about Margo as a woman. Why does she want another child in her busy life? The Ritalin caused the psychosis, but only one other thing explains the clot and the tumor: birth control pills.

House wakes up Margo and asks if she wants a hysterectomy. He accuses her of sneaking birth control because she doesn’t want a baby even though Ted does. She denies it. House tells Margo that her tumor is benign and will disappear if she goes off birth control. He wants to cancel the surgery and she can explain to her husband why. Margo again denies that she’s on the Pill.

House tells Cuddy that he’s calling off Margo’s surgery but Cuddy won’t have it because the surgery is underway. The tumor is benign. Foreman later informs Ted and Margo about the results and, without saying too much, says the symptoms will disappear. When Ted leaves the room, Margo asks Foreman to tell her husband that she can’t undergo more fertility treatments. Foreman refuses to lie, so she asks for birth control that won’t cause her to be sick. Foreman warns her that the continued lies will eventually kill her.

That night, Stacy slips into House’s office. She is planning to tell Mark tonight about their tryst. She wants to stay with House. He advises her not to do it. House will never change his ways, but Mark is willing to do whatever it takes to make their relationship work. House won’t and cannot make her happy. House walks out, leaving Stacy in tears

_________________
House is awesome. Dont hate

Episode 12:

DISTRACTIONS
Aired 2/14/06
A sixteen year old named Adam convinces his father Doug to let him drive their ATV. Adam’s eye twitches and he physically cannot control the brakes. Doug is thrown from the bike. He watches in horror as Adam crashes the bike and his body is engulfed in flames.

House reads a friend’s article in an Indian medical journal. Foreman reports that Adam’s heart is suffering from tachycardia and his potassium is low, even though the burn unit is pumping him full of liquids. This could be caused by amphetamines or bacteria or even cardiomyopathy. Yet the skin burned off Adam’s chest means they can’t get an EKG. The team needs to figure out why his heart has shut down so that the burn unit can treat his skin. House thinks they can use a Belgian device from the turn of the century called a Galvanometer. First, they have to find one.

Cuddy is startled to find out that her office scheduled a lecture by a neurologist named Dr. Weber. Unfortunately, Cuddy’s assistant quit because she “couldn’t deal.” Cuddy sees that she didn’t sign the memo, and House admits to forging it. Yet House is more interested in the coma patient who’s showing signs of a migraine headache. House had given the man migraine prevention medicine and then nitroglycerine, which induced the headache. Cuddy is appalled at House’s lack of ethics.

Cameron explains to Doug and his wife Emily that they don’t know if Adam’s heart problems are connected to the burns. They tell her that Adam doesn’t use drugs. Foreman and Chase hook Adam up to the Galvanometer. The boy’s hands and feet are immersed in pots of water. The heart waves at first seem normal, and then suddenly, Adam convulses as if he was being electrocuted. They turn off the machine, but he continues to spasm.

The team runs through why Adam may have suffered a seizure. It could be caused by adrenoleukodystrophy, a virus of the brain, or multiple sclerosis. Yet his burns prevent them from performing an MRI, CT scan or lumbar puncture to find out. There’s no other way to look at a brain. House suggests a sonogram, because he performed one on the coma patient earlier. He didn’t use an MRA because he was doing “something illegal.” They may not get a definitive diagnosis with a sonogram, but M.S. patients’ more reactive neurons may turn up something.

Cuddy awkwardly introduces Dr. Weber to the lecture hall. He is from a center in India and he is there to talk about headaches. House sits in the back, wearing a baseball cap and sunglasses. Wilson notes House’s presence and realizes that House went to medical school with Weber. Weber won an internship that House didn’t get. He also is the one who got House thrown out for cheating. “He’s a bad scientist,” House says. House has been stalking Weber for twenty years and plans to humiliate him.

Chase props Adam’s eyes open and shows him flash cards. Foreman monitors on a sonogram whether Adam has any brain activity. Foreman interrupts House’s lecture to tell him about the bleeding they found in Adam’s brain. Yet House refuses to leave Weber’s lecture. He tells Foreman to fix the bleed.

House challenges Weber’s breakthrough theory on a drug that actually prevents a migraine. He says aloud that Weber published this in an obscure journal in India so that he could get a pharmaceutical company to fund his studies. Weber suddenly recognizes House. He thinks this is just an old school rivalry. House says that he tested Weber’s medicine on a coma patient. It doesn’t work.

Chase inserts a platinum wire coil into Adam’s femoral artery as Foreman follows him with the sonogram. Afterwards, they place Adam in a hyperbaric chamber as they discuss what could be disrupting brain function. They think they can rule out M.S. Suddenly, Adam wakes up in the chamber. His breathing is rapid, but Foreman sees that what Adam is experiencing is an orgasm. They call for an anesthesiologist.

In his darkened office, House shoots himself up with Weber’s migraine medicine. He then injects himself with nitroglycerin, which has a side effect of migraine headaches. Cameron rushes in to tell him about Adam’s orgasm, but House begins to suffer from intense migraine pain.

Foreman treats House for the headache and tells him not to move around. House doesn’t listen and goes into his outer office to hear the team’s theories on Adam. He lies on the floor as they come up with an idea that sensory information is getting misinterpreted by the medial forebrain. Good feels bad and bad feels good. They list a slew of infections that could affect the forebrain, but Cameron wonders if it’s merely a regular infection festering in the burned skin. Unfortunately, they don’t have time to wait for the burns to heal to find out if this is the cause.

Even in his altered state, House comes up with an alternate idea. Several thousand maggots are placed on Adam’s chest to eat the dead flesh and clean the wounds. This will also kill the bacteria that thrive in injured tissue.

House tells Wilson that he must prove that he still has a migraine even after taking Weber’s medicine. Wilson accuses House of using pain as a distraction because he pushed away Stacy, the love of his life.

Later, the team finds House asleep in his office. Foreman is concerned because he should have recovered from his migraine by now. They report that the maggots have treated the burns but that Adam’s brain waves are still all over the map. The infection wasn’t causing the brain dysfunction. House says they should perform a cervical tap lumbar puncture even though it could paralyze the boy.

Foreman gets the parents to sign a consent form to perform the cervical tap. He then inserts a 25 gauge needle between the C2 and C3 areas on Adam’s neck. The needle isn’t penetrating, and Foreman begins to force it. Chase panics when Adam’s blood pressure spikes. He warns Foreman to stop, but Foreman is successful and collects CSF.

Foreman reports to House that Adam doesn’t have M.S. or an infection. House goes to the burn unit and forces the anesthesiologist to wake Adam up. He does, and Adam cries out from the immense amount of pain. House asks him if he experienced any tingling or numbness before the accident. Adam manages to say that he urinated in his pants before he blacked out. House quickly injects Adam’s IV to make him pass out.

House calls for the team to assemble. He takes a shower in the doctor’s lounge. He’s wasted and starts to hallucinate. Cameron finds him and is furious that he took drugs while Adam is fighting for his life.

She tells Foreman and Chase about House. Suddenly, House enters, feeling fine. He has come to the conclusion that Adam is depressed. The urination and blacking out mean that Adam had seized even before they had tested his heart. A tox screen didn’t catch anti-depressants because there are so many drugs in his system from the burn treatment. His brain might be suffering from Serotonin Storm, but if it’s something else, then the treatment might kill him. House wants to wake Adam up again, but the anesthesiologist ratted him out to the parents.

House confronts the parents in the waiting area and asks if their son is depressed. He tells them that Adam suffered a seizure, which caused him to crash the bike. House wants to know if he is taking anti-depressants. The parents say no. Their son tells them everything.

The team has ruled out just about everything that could cause the seizure disorder. House goes back to the burn unit, ready to wake him up. Doug retrieves Foreman, who tries to stop House. House sees a perfect circular burn on Adam’s wrist even though the boy’s forearms are not burned. There is also a nicotine stain on his fingers.

House goes out and asks the parents if their son smokes. Doug quickly says that he would kill Adam if he did. House lets them know that Adam does smoke and was trying to quit. The cheap no-smoke meds are also anti-depressants. Adam can be treated and will recover.

Cuddy accuses House of dropping acid. He informs her that LSD acts on serotonin receptors in the brain to stop a migraine and anti-depressants short-circuit the LSD. Yet House doesn’t cop to doing any of this. Weber storms in and thanks House for ruining his clinical trials by sending the pharmaceutical company an email about his facts. “We’re even,” House says.

Later than night, House is paid an expected visit by a young woman. She introduces herself. “I’m looking for a distraction,” he says, letting her in.

_________________
House is awesome. Dont hate

Episode 13:

SKIN DEEP
Aired 2/20/06
Fifteen year-old model Alexandra Simms waits impatiently backstage at a fashion show. Her manager father, Martin, hands her a pill to steady her nerves. She washes it down with a glass of champagne. On the runway, Alex starts seeing double and stumbles. When another model asks her if she is fine, Alex punches the girl. Chaos ensues and Alex collapses in the mess.

House limps through the hospital, struggling more than usual with his leg. Wilson thinks the increased pain could actually be good sign that his nerves are regenerating. House brushes off his optimism. Cuddy approaches with a new patient file. A teen model has sudden aggressive behavior and cataplexy.

House drops into Alex’s room. The cataplexy checks out with Alex’s story, and House asks about sweats and other recent ailments. She claims to have been nauseous lately. Cameron waits in the hallway to grill House about his newfound interaction with patients. He orders her to do the tests and tox screen.

The tox screen reveals Valium and heroin in Alex’s urine. Cameron notes that a positive test doesn’t mean Alex is an addict. Chase wonders whether this is related to the fact that Alex has yet to menstruate. They also consider bulimia and the patient’s newly developed breasts. During the brainstorming, House’s leg buckles and he nearly falls. Even with addiction, Alex’s symptoms could be neurological, which points to juvenile MS or Parkinson’s. House orders a detox program at super speed. He wants them to put Alex in a coma and pump her full of naltrexone, which cuts the detoxification procedure from four weeks to one night.

Foreman explains the procedure to Martin, who agrees despite the risks. Chase and Foreman prepare to put an incredibly nervous Alex into an induced coma. Alex’s heart rate dips below 30 before flat lining. Nurses rush in and go to work on the girl. Martin finds House and demands that he pull Alex out of the coma. House explains that this option is even worse. The must see the procedure through.

Alex regains consciousness from her coma. She tells Chase that she feels fine. Alex tearfully apologizes to her father for using drugs. Chase begins to hook up a potassium IV, and Alex repeats what she just said. Back in the office, Foreman reports anterograde amnesia and short term memory loss which is evidence of a hypoxic brain injury. Foreman blames House for pushing the rapid detox. House points out that Alex would have to flatline for longer than she did for hypoxia to kick in.

House suggests that Alex suffers from post-traumatic stress disorder. She looks too good to be a heroin addict. With Daddy constantly by her side, House thinks Martin is either a very good father or a very bad one. He suspects sexual abuse, and orders an MRI and LP. If Alex’s brain comes back normal, House will have his proof. Out in the hallway, Foreman accuses House of letting his increasing leg pain influence his judgment. He’s trying to rush through this case. House turns and loudly asks Martin if he’s molesting his own daughter.

Alex goes through the MRI. Yet she has an involuntary shoulder twitch which will mar the MRI. Cameron thinks they should skip right to the LP. Slipping into a men’s room for privacy, House continues pressing Martin. He denies abusing his daughter. House asks if Martin loves Alex enough to admit what he did, since psychological conditions can manifest into physical problems. Martin confesses that it happened once.

House finds Cameron and Chase in the lab and happily reports that he was right. It is now time to move Alex onto a psych referral. Chase shows House the results of the LP, which show elevated proteins in Alex’s CSF. It wasn’t hypoxia and it wasn’t even the sexual abuse.

Cameron presses House to report Martin to child services, but House wants to finish the case first. Foreman starts running down the list of problems that would cause elevated proteins in the CSF: viral encephalitis, CNSV, Creutzfeldt-Jakob disease. House thinks they need to skip straight to a brain biopsy. The team is hesitant because this is too rash, but House is convinced that it is the only thing they have time for. They must perform a burr hole biopsy to remove a small section of brain tissue.

Wilson tells House that he heard about Alex flat lining. He wonders if the leg is affecting his judgment. House quietly confesses that he needs Wilson’s help. Meanwhile, Cameron goes to Cuddy about House not reporting Martin.

The biopsy gets underway while Wilson performs an MRI on House. Cuddy barges in, demanding to know about Martin. If House doesn’t turn Martin in, he’s fired. Wilson gives House the results that his MRI looks the same as it did two years ago. It might be psychological pain manifesting itself as physical pain, caused by House’s misery over driving Stacy away. House refuses to accept this.

The biopsy on Alex shows that she does not have a white matter disease. That leaves grey matter, which uncorks a range of possibilities which can’t be tested. House asks if what they are seeing could merely be smoke signals from a tumor. If Alex had cancer anywhere in her body, she could have paraneoplastic syndrome which would cause antibodies to attack her brain. Foreman counters that this is rare in a 15 year old, but House points out this is no ordinary teen. What’s more, it explains everything.

House squeezes an IV line on Alex and she immediately starts twitching. When he releases it, she stops. House explains that IVIG vacuums her blood and neutralizes the stuff that makes her twitch. Although Martin and Alex are excited by the development, House explains that merely proves that she has cancer.

That night, House asks Cuddy for a favor. He wants a shot of morphine in his spine. She refuses and tells him to take a Vicodin because morphine is too extreme. Desperate, House pulls down his pants and exposes his scarred and mangled leg. His skin has been indented by the lack of muscle. Cuddy agrees to the shot.

Alex receives an MRI, a mammogram and a bone marrow biopsy among other tests. Wilson can’t find any cancer but House insists that he is wrong because nothing else could explain the IVIG. Wilson is adamant that she does not have cancer. House retreats to his team and asks for a differential diagnosis. Chase wonders if the protein level was an anomaly. It might really be the post-traumatic stress disorder from Martin’s molestation. Alex saw House fiddle with the IV line so it could all be in her subconscious. House tells Chase to change Alex’s IV, but don’t inform her that he is replacing it with saline. They will see if the twitching returns.

As the doctors wait, a social worker from Child Services interviews Alex. The social worker exits and informs the doctors that no charges will be pressed because Martin denies telling House. Alex says that nothing happened. Cameron goes into the room and tries to convince Alex to tell the truth. Alex doesn’t go back on her statement. When Cameron presses, Alex admits that she seduced Martin and got him drunk because she wanted to have sex with him. She also slept with her photographer, her financial manager and her tutor. It’s the only way to get what she wants. The twitching returns.

House asks Cameron, who performed Alex’s vaginal examination, if she had pubic hair. Cameron says that there wasn’t much. House wonders about Alex’s real age and he schedules another MRI. Cameron complains that an earlier MRI showed no tumor but only undersized ovaries. The new screen finally shows what House has been looking for. It looks like a tumor, but it isn’t.

Martin asks House if they found cancer. He says there is a tumor on Alex’s left internal testicle. House explains that Alex has male pseudohermaphroditism. All humans start out as girls but then get differentiated by genes. With men, the ovaries develop into testes and drop. But in about 1 in 150,000 pregnancies, something else happens. Alex is completely immune to testosterone. She is full of pure estrogen, which explains the clear skin and perfect breasts. When they remove her testicles, she will be fine. Alex does not handle this news well.

House approaches Cuddy for another shot of morphine. She thinks it’s curious that the pain returned after House solved Alex’s case. He says he only wants a shot, not a psych session. Cuddy calmly tells him that when she administered the shot, it was only a placebo full of saline. House realizes his pain is indeed in his mind.

_________________
House is awesome. Dont hate

Episode 14:

CLUELESS
Aired 3/28/06
Maria Palko steps out of the shower and finds a masked man in her bathroom. The man drags Maria to her bed and she fights him off. The man begins struggling to breathe. Maria calls an ambulance for the man, who is actually her husband Bob. Their rape fantasy had an unexpected end.

Another interesting couple prepares for the day. Wilson is staying at House’s apartment during his separation. House is bothered by Wilson’s habits, and he orders him out only one night. Wilson promises to be moved by the next day.

At the hospital, Bob explains to Cameron that he has dry throat and a feeling that his tongue is swelling. Two previous doctors tested him for food allergies before referring him to House. The Palkos are remarkably open about their sex life during the examination. They reveal that they recently had a threesome with Maria’s old college roommate. House wonders if the problem is actually in Bob’s lungs. He orders more blood drawn, a chest VT and a body plethysmograph.

Bob sits inside an egg-shaped body pod, holding a tube in his mouth. Maria watched while Cameron runs the test. Their conversation turns to the couple’s unusual sex life. Maria defends the effort, saying that marriages fail because people don’t want to change.

The team reports that House was correct in the lung diagnosis. The plethysmograph revealed decreased lung capacity and the CT showed lung scarring. The team is convinced that Bob has interstitial pulmonary fibrosis. However, with all common reasons are ruled out, they don’t know the cause. Since Bob’s condition is currently stable, House wants to wait until the cause presents itself in another fashion.

Suddenly, bright red patches of skin emerge on Bob’s chest. The team reconvenes to figure out what causes itchy splotches and lung scarring. Foreman suggests lupus. House is hit with the realization that heavy metal toxicity might be the problem. House orders the team to search the Palko house. They also need to test Bob’s hair for lead, mercury and arsenic. Perhaps the Mexican resort that Bob and Maria vacationed at cooks with such metals. Maybe they recently repainted or made plumbing repairs.

At home that night, House asks Wilson if he thinks somebody could suffer lung damage after eating out of a pot painted with lead paint. Wilson replies that it would require months of daily eating.

Foreman searches the fastidious Palko house and finds an ant. House wants to know what type of ant. When Foreman tells him it was medium and brown, House rules out poisonous ants. A tox screen also disqualifies lead, mercury or arsenic, but House wants the tests run again. The team begins to resist House’s thoughts on heavy metals. He orders treatment for lead poisoning.

Chase is performing a scratch test on Bob’s back when he patient begins agonizing over a burning pain in his feet. This rules out food allergies. House thinks this is another sign of heavy metals, but Cameron insists that another hair and blood test ruled out any possible exposure. The team is paged to Bob’s room. He again struggles to breathe. They attempt to intubate, but Bob begins coughing up vomit. There is too much to be suctioned off, so the team is forced to perform a tracheotomy to help him breathe.

Foreman reports that Bob’s urine has elevated proteins and red blood cells. He stands by his theory of lupus, and House insists that the cause is a heavy metal. Foreman wants to run an ANA but House points out that they’ve already treated for lupus with no results. Unless House can prove his metal idea, Foreman plans to start a new treatment for lupus.

House considers whether Maria is poisoning her husband. He wants Cameron to search Maria, but she objects. House decides to do it himself. He corners Maria and tells her his suspicions. He searches her purse and asks for permission to examine her vagina because it is the only place she could be hiding something since she hasn’t left the hospital. Maria, Cameron and Cuddy all refuse to allow the search.

Foreman wheels Bob into an isolation room and the patient immediately seizes. Foreman races into the hallway for the crash cart and shocks Bob back to life. As House and Wilson observe Maria’s concern for her husband, House begins to doubt his theory on poisoning.

The team reconvenes in the office. Foreman is confident that what’s happening to Bob is the definition of lupus. Chase suggests a different treatment, and House mentions interferon, which treats neither lupus nor heavy metal toxicity. Yet House thinks it’s about all they can do right now for a viral infection. House says the lupus treatment has wiped out Bob’s immune system which is what invited the current viral infection. Foreman points out that interferon will make lupus even worse. House strongly orders interferon.

That night, Bob and Maria are alone in the isolation room. Bob tells her that he sat behind in her high school to cheat off her during a test. They’ve had a long history and he loves her. Maria refuses to say she loves him because he’s not dying, and she doesn’t want to say goodbye. After a moment, she gives in and says it.

The next morning, Foreman tells House that the interferon isn’t working. House wants an increased dosage. Yet tests for every virus they can think of are all coming up negative. House repeats his instructions to up the dosage. Later, House looks at a gold wedding band and has another epiphany. He calls Cameron and asks if Maria has a family history of arthritis. When Cameron confirms this, House orders Cameron to stop the interferon, run a heavy metal screen for gold and prevent Maria from using the bathroom.

The doctors are stunned as they read the results of the tox screen. House, meanwhile, races home and pulls a wooden box from underneath his bed. House searches through a selection of small glass vials in the box until he finds the one he’s after. At the hospital, the doctors are trying to prevent Maria from using the bathroom. House arrives, looking for Maria. When he founds out she’s heading for the bathroom, House barges into the ladies room in search of her.

He finds her coming out of a stall and grabs her hands. House says that the damage to Bob’s lungs is permanent, but the coma and kidney damage are reversible. He should also regain all neurological functioning. Despite Maria’s complete confusion, House continues. He says that nitric acid, mixed with gold, turns bright purple. Maria’s hands are stained purple. House accuses Maria of sprinkling Bob’s food with gold sodium thiomalate, an arthritis remedy that’s out of date in the U.S. but still popular in Mexico. Maria denies it, but Chase reports that the tox screen for gold was off the charts.

Two police officers walk Maria out of the hospital in handcuffs. Cameron reports that they have started chelation therapy, but Bob will need a lung transplant. House doesn’t mind. He’s too pleased at having been proven right once again.

_________________
House is awesome. Dont hate

Episode 16:

SAFE
Aired 4/4/06
Teenage Dan shows up at his girlfriend Melinda’s house. Melinda’s mother Barbara makes Dan scrub up before being allowed in her daughter’s bedroom. Melinda, who just received a transplant, complains to him about her crazy mother not letting her out of the house anymore. Dan and Melinda kiss, but hives breakout on her skin. Melinda begins to gasp for air and she swells up. Barbara quickly injects her with a shot of epinephrine for allergy attacks. She then accuses Dan of doing something wrong.

At their apartment, Wilson tells House that Cuddy called about a girl in anaphylactic shock. House would rather talk about their new living arrangement, but Wilson piques his interest. Although the girl is immuno-compromised, the attack happened while she was in a clean room.

The team is confused by Melinda’s case. A person who received a transplant six months ago shouldn’t need a clean room. The team settles on one of three lies. Either the boyfriend brought something in and is lying about it or the girl snuck out and is lying about it. The room might also not be hypoallergenic and the parents are lying about it. House orders a recheck of all parties and the room.

Foreman quizzes the family on their recent history. He doesn’t see any reason for Melinda to stay home. Barbara pulls Foreman into the hall and explains that allergic reactions have almost killed Melinda four times already. Once it caused her to lose control while driving, which is what lead to the heart transplant. Barbara feels she’s not protective enough.

Cameron and Chase examine Melinda’s bedroom. One window isn’t rigged to the home alarm system, and a nearby tree provides easy access. Was Dan doing some nocturnal climbing? At the hospital, Dan admits to Chase and Cameron that he snuck in Friday night and they had unplanned, unprotected sex. The doctors ask him for a semen sample so they can check Melinda for a semen allergy.

The test proves that she isn’t allergic. Cameron assumes that Dan took every precaution before their encounter, but House wants facts. He pulls Dan out of Melinda’s room and interrogates him on whether he has been taking antibiotics or penicillin. Dan admits that a friend’s dad had some leftover penicillin, so Dan took it to prevent exposing Melinda to anything. He had no idea that she could have been allergic to penicillin or that he could have spread it to her through his sperm.

Cameron and Chase break the news to Barbara that Melinda is being released. Yet they don’t tell her the specifics of this latest attack. Suddenly, Melinda begins gasping for breath and she vomits. Cameron realizes that this isn’t an allergic attack. It is Melinda’s heart.

The team reconvenes, now looking at congestive heart failure and anaphylactic shock which are two puzzle pieces from two different puzzles. Cameron suggests that the first episode wasn’t anaphylaxsis but cyclosporine toxicity. House seems skeptical, and Foreman wonders what if it actually is two separate, totally unrelated incidents. House can’t see how the two would be tied together, but Foreman presses to only look for a heart failure cause.

Foreman and Cameron perform a CT scan, but find no sign of coronary disease. Then they run blood work to rule out infections and a biopsy to rule out rejections. Melinda begins to worry that she’s going to lose this heart. She knows the transplant only gives her five to ten more years, and she begs Foreman to convince her mother to allow her to enjoy the time she has left.

While at the apartment, House asks Wilson if he can think of anything that would tie together anaphylaxsis and heart failure. He questions if it is even possible for anaphylaxsis to not be anaphylaxsis, even if it responds to epinephrine. Wilson is too aggravated by House as a roommate to think of an answer.

The blood work and biopsy both come back negative. Foreman and the parents head back to Melinda’s room but it is empty. Cuddy calls in a security alert. Noticing that Melinda left her clothes behind, they figure she must still be in the building. Foreman thinks she wants to be outside, and he races for the roof. He finds Melinda on the top stair. She complains that her mother is completely overbearing. Foreman patiently explains that she just had heart failure. Melinda cries that this all means that her mother was right all along. As they begin to walk back downstairs, Foreman notices that the girl has an odd gait.

Foreman examines Melinda in front of her parents. The steppage gait is a sign of extreme weakness or partial paralysis. Foreman then sees twitching above Melinda’s knee and informs the family that it’s fasciculation, which means that the paralysis is ascending.

With the paralysis ascending at this rate, the team knows it will Melinda’s lungs in a few days. House wants to tie together the heart, anaphylaxsis and paralysis, but Foreman wants to focus on the paralysis first, since that’s what will kill Melinda in the short run. He suggests Guillain-Barre based on the speed of advancement. House agrees with Foreman’s line of thinking and orders an LP and an EMG.

The tests, which ruled out polio and West Nile virus, seem to point to Guillain-Barre, a disease in which the immune response goes haywire and begins attacking the peripheral nerves. Fortunately, it usually responds well to plasmapheresis. They begin the treatment.

The first treatment is ineffective. Melinda begins to sink into depression. Foreman explains to Barbara that mood swings are common with the medications, but Barbara believes that her daughter has finally given up. Melinda again begins gasping for breath. Chase quickly determines that it is not an allergy attack. Foreman, realizing the paralysis has reached Melinda’s lungs, intubates.

Chase and Foreman call House. The paralysis is moving too fast to be Guillain-Barre. Cuddy wants an MRI to rule out a spinal lesion. The team reconvenes, searching for a new explanation. What if the boyfriend snuck in some food during the tryst and she developed botulism? House asks the team to inject a rat with Melinda’s blood. If it develops botulism, their theory will be confirmed. Meanwhile, House is heading downstairs to browbeat Melinda into admitting whatever she’s been hiding.

As Cuddy slides Melinda into a CT scan, House and Foreman interrupt. House accosts Melinda about the night Dan snuck in. He explains that Dan’s penicillin caused her anaphylactic shock. Yet Melinda tells House that Dan actually took clindamycin, the same medicine that she uses. She saw the bottle. House and Foreman immediately realize this means the anaphylaxsis is still unexplained. Everything is connected.

When Melinda says that Dan hopped the fence before climbing, House says Dan must’ve dragged a tick in with him. House combs Melinda’s body to look for it. Foreman reminds him that they checked for insect bites earlier and Cuddy scoffs at House’s line of thinking. Melinda drops into heart failure. Foreman administers atropine. Cuddy calls for a bag of dopamine, then orders House and his tick search out of the room. Wilson says they have to get Melinda up to the ICU.

Wilson and Foreman wheel Melinda into an elevator. House blocks Cuddy from entering, then stops to elevator to continue his tick mission. Foreman hooks up one more bag of atropine, which buys House three more minutes. Melinda’s heart rate drops to 56.

Cuddy and Melinda’s parents race upstairs, only to find out that the elevator has been stopped. Cuddy angrily tries to cover. Inside the elevator, House is still adamant about the tick as Melinda’s heart rate drops to 45. Foreman restarts the elevator. House thinks of one last place to check, and finds the tick in her vagina. The elevator doors open, and House holds the tick as Melinda stabilizes.

_________________
House is awesome. Dont hate

Episode 17:

ALL IN
Aired 4/11/06
Young Ian Alston learns to ride a bicycle. When his father picks him up off the bike, he finds blood all over the back of boy’s pants.

House, Wilson and Cuddy play poker at a Casino Night fundraiser for the hospital. A doctor alerts Cuddy that Ian is in the ER. The boy has bloody diarrhea, and although he is hemodynamically stable at the moment, he is developing coordination problems. Cuddy orders some fluids and says she’ll check on him during her rounds. House asks about the heart rate and inquires if a head scan has been done. Cuddy just wants to focus on the cards, but House quits the game to go check on the boy.
In the ER, I an has no problem following House’s finger with his eyes. House then asks Ian to grab his cane, and Ian struggles to grasp it. House tells the Alstons that Ian’s brain is losing control of his muscles. House goes back to the benefit to grab Chase. He wants the others to meet him upstairs.

House tells the team that there are two cases with identical symptoms, but one patient is six years old and the other is over seventy. He explains that many years ago he had a 73-year old female patient with this exact progression of symptoms, but she died before he could solve the case. Ian already has bloody diarrhea and ataxia. The previous patient, Esther, progressed from there to kidney failure in only 80 minutes. She died in less than a day.

The team is skeptical, figuring that Ian merely has food poisoning. House considers Erdheim-Chester, a disease that Chase mentions has only been recorded 200 times in history. House thinks he could have found case number 201 had Esther’s family allowed an autopsy. He orders a colonoscopy for Ian. Cameron explains to the parents that Erdheim-Chester is an abnormal growth of some of the cells that fight infection. During the colonscopy, Foreman thinks they’ve found the purple papules that House was looking for. Chase is skeptical, figuring House is merely obsessed with a patient he lost long ago.

The papules are biopsied, but come up negative for Erdheim-Chester. House then requests a kidney biopsy. He examines the urine bag attached to the boy. The liquid is brown, which means Ian’s kidneys are shutting down. Ian is reaching Esther’s third symptom.

The team reconvenes to figure out the symptoms. Chase suggests E. Coli, but House points out he tried that last time. Cameron throws out lymphoma. House agrees that this is a possibility and asks for a blood smear and an MRI. They want to alert Cuddy that her original theory of gastroenteritis is not the cause, but House would rather not tell her anything in case she disagrees and interferes. House calls Wilson at the tables and asks him to keep Cuddy occupied.

The MRI shows that the base of Ian’s brain has been infiltrated by a small mass, likely related to the pituitary. Pituitary failure was the fourth of Esther’s symptoms. It also somewhat confirms lymphoma, although none of them actually saw it. The blood fact offers a contrary diagnosis. House walks out of the office.

The team finds him breaking into the commissary to get some coffee. He says that the next stop in the disease’s progression is the liver. Growing frustrated, House orders the team to give Ian every drug they can think of that will protect the liver.

Chase informs House that the liver is holding, but Ian’s platelets are dropping. Oddly, House is encouraged. This is a new symptom, different from anything Esther experienced. Ian begins gasping for breath as Foreman and Chase rush to help him.

House writes respiratory distress on the white board under Ian’s symptoms. Respiratory failure was the last of Esther’s symptoms before death. Feeling hopeless, House pushes the white board over. With Ian now on a ventilator, the team again tries to analyze the progression of symptoms. Ian is moving even faster than Esther did. Cameron tosses out that the interferon they put Ian on could possibly affect a type of leukemia. House calls Wilson for advice. Wilson comes upstairs to examine Ian’s blood, but doesn’t see anything askew.

Wilson suggests Kawasaki’s disease, in which antibodies eat the inside of the arteries, slowly choking off blood to major organs. Intrigued by the possibility, House prepares to search Ian’s coronary arteries for the disease, but the arteries are clear of aneurysms and the blood flow is normal. As he is about to shut down the scan, Chase notices a mass in Ian’s right atrial valve. House immediately readies to perform a biopsy.

During the procedure, Ian goes into cardiac arrest. It takes repeated attempts, but House is able to shock the boy back to life. House goes back to the biopsy, which Chase thinks is reckless after eight minutes of arrest.

Back in the office, the team begins throwing other possible diseases against the wall. Cuddy, having been alerted to Ian’s plight by the Alstons, barges into House’s office and angrily accuses him of giving the young boy brain damage. She thinks he’s still obsessed with Esther’s case twelve years later. She orders him to stay away from Ian. When Cuddy leaves, House plows ahead anyway. He hands Cameron the piece of mass they extracted and asks how many tests they can complete. She thinks they can do three, even though there are seven potential diseases on their board. They elect to start with histiocytosis, figuring Cuddy will be smart enough to test for sarcoidosis on her own.

The test for histiocytosis is negative, so they turn back to the board. House opts to test for tubular sclerosis, mainly because the test for that is more reliable. Sclerosis also comes up negative. House is now stumped. He stands on his office balcony, lost in thought. Wilson comes out to report how he triumphed in the poker tournament by hiding his pocket aces. The story leads House to an epiphany about what else could have been hiding.

House realizes that when they tested for Erdheim-Chester earlier, it hadn’t progressed far enough. He wants to use the last available piece of mass to test for it again. This time, the test confirms the ultra-rare disease. The team immediately starts the proper treatment.

_________________
House is awesome. Dont hate

Episode 18:

SLEEPING DOGS LIE
Aired 4/18/06
Hannah Ward lies in bed, unable to sleep, next to her girlfriend, Max. Hannah has had many sleepless nights. In the morning, Max finds Hannah in the bathroom next to an empty bottle of sleeping pills. Her eyes are wide open and she’s banging her head against the wall.

Cuddy wakes House from a nap to inform him of Hannah’s case. He is disinterested until he learns that Hannah hasn’t slept in ten days. The brain shuts down without REM sleep. Five sleepless nights would bring on insanity with ten causing death. Cuddy points out that the longest anybody has ever survived without sleep is eleven days. On top of that, Hannah downed an entire bottle of sleeping pills with no effect. House is intrigued.
The team dismisses infection, schizophrenia and drugs as a root cause for Hannah’s sleeplessness. House wants them to consider optic nerve disease because sleep is initially controlled by external light cues. Hannah’s brain might not be able to interpret or receive those clues due to an optic problem.

In a soundproof sleep lab, Cameron photographs Hannah’s retina and optic nerve. Foreman notices that Hannah has fallen asleep. Her EEG shows normal, stage one brain waves. Then Hannah quickly wakes up.

Foreman reports to House that the tests for optic nerve disease and ocular pressure proved negative. Hannah slept, but only for up to one minute. A CT showed no tumors, clots or seizure disorder. Hannah sleeps but cannot remain asleep. House figures that Hannah is sick but not sick enough to present symptoms. He orders the team to keep her awake at all times. Depriving her of the few minutes she does sleep will stress her body. This will help them determine what’s afflicting her.

Cameron and Foreman take the first shift, waking up Hannah when she drifts off. Each time, she denies falling asleep. Then they notice a pool of blood on the bed sheets. House thinks the rectal bleeding is either a clotting disorder or colon tumor, so Chase heads off to perform a colonoscopy. House makes it clear that Hannah needs to be kept awake through the procedure. She will not be given sedatives unless a tumor is found.

Hannah screams and strains as Chase performs the colonoscopy. Blood begins to drain from her nostrils as she struggles to breathe. Cameron reports that the rectal exam showed traces of nasal matters. Was a massive sinus hemorrhage draining down her throat and out the back? House thinks about the poison ivy that was noted in Hannah’s recent history. The rash developed around the same time as the insomnia. A rash plus sleep disturbances equals Wegener’s Granulomatosis. House orders a large dose of corticosteroid treatment and an upper airway biopsy to confirm Wegener’s.

Chase performs the biopsy when Hannah’s eyes start to dart about. She is experiencing REM with her eyes wide open. She then quickly snaps out of it. House rules out REM, dismissing it as a movement. This also rules out Wegener’s. Chase throws out the notion of allergies because Max got Hannah a dog about a month ago but sent it back when Hannah was allergic. House seriously doubts it because the poison ivy treatment should have suppressed any allergic reaction. He thinks Hannah was lying about being allergic. A dog is a commitment and she intended to break up with Max. He agrees to check for allergies.

During the test, Cameron inquires about Hannah’s relationship status. While Max is out of the room, Hannah admits that she was going to end their long-term relationship. Hannah then complains of a pain. Cameron rolls her over and is shocked to discover the woman’s entire abdomen covered with dark bruises. The team struggles to come up with new explanations for Hannah’s massive internal bleeding. Foreman reports that Hannah’s liver is dead. She needs a transplant and they only have six hours to determine what’s affecting her. House points out that Max donated blood to Hannah, so they must be a match. Cameron can’t imagine asking somebody who’s about to be dumped for half of her liver.

House tells Hannah that she’s in acute liver failure and will lapse into a coma in a few hours. Max can’t believe they’re just giving up, but House says even with a new liver, toxins will continue to build. Max, however, realizes that a new liver will allow the doctors more time to make a diagnosis. She pushes House to go forward with the transplant. House successfully manipulated the situation.

They now have another 36 hours to diagnose the patient. House, however, did not tell Max that Hannah is planning to dump her. As the team searches for causes, Cameron frets that they are ignoring an ethical dilemma. House quickly tires of her questions and shouts that if they tell Max and she changes her mind, then Hannah will die. Foreman and Chase continue throwing out possible explanations. House tells the team to put Hannah through a battery of tests that. He threatens to fire anyone who tells Max about Hannah’s intentions.

Without sharing too many details, House consults Cuddy about the conflicting interests between Hannah and Max. She wants to know what he is hiding. He explains that the two options are for her to satisfy her curiosity or remain ignorant and help keep Hannah alive. Cuddy begins taking Max through the detailed steps of a transplant. Max is vigilant about going through with the procedure.

Cameron begins performing an endoscopy on Hannah, which entails a long tube inserted down her throat to swab her stomach for mushroom spores. While sliding the tube, Cameron begins to lay the guilt on Hannah. Max is undergoing painful procedures and will risk her life with the transplant. If Hannah truly loved her, she would tell her the truth. Hannah knows that if she tells Max, she dies.

Max gets clearance for surgery. Foreman and Chase report that tests were negative for Wilson’s Disease. House realizes that if those are two are here with him, then Cameron is alone with Hannah and Max. Cameron rolls Hannah’s gurney next to Max and leaves them alone for a moment. As Hannah is about to confess to Max, House interrupts. He orders the surgeons to get started.

Max’s heart stops during the transplant operation. House pulls Cameron away from observation to focus on Hannah, who is in recovery. The surgeons shock Max back to life. Wilson joins the team to discuss Hannah’s situation. Wilson points out that the immunosuppressants they have Hannah on would hide any possible cancer diagnoses. House is aware that they need to retreat. They will stop the immunosuppressant drugs in order to retest Hannah.

Hannah starts to reject her new liver. House is not surprised, but her normal white count is odd because it should be very low. Foreman suggests an infection. The team rapidly fires out a long list of infections, shooting each one down for various reasons. Typhoid fever seems to fit, but Hannah hasn’t been abroad. House begins to think about the dog that Max brought home. He asks Cameron where the breeder is located.

House takes his team to Hannah’s room. He immediately goes for her upper arm, where he finds a grotesque growth. Using a syringe, he withdraws a thick, black ooze and hands the syringe to Chase. House tells Chase to inform the CDC that they have a patient with the plague. He then explains to his confused team that the Blue Barrel Kennel, where the dog came from, is located in the Southwest. Fleas in that area occasionally carry the plague. A small percentage of plague cases present with severe sleep disturbance. House orders Hannah started on large doses of streptomycin sulfate, gentamicin and tetracycline.

After a few days, Cameron finds Max in the hallway and stops for a chat. Max admits to Cameron that she knew that Hannah was going to leave her. Hannah told a friend and the friend let it slip. Cameron is shocked that Max knew the truth and still went through with the transplant. Max smiles and says there’s no way that Hannah can leave her now.

_________________
House is awesome. Dont hate

Episode 19:

HOUSE VS. GOD
Aired 4/25/06
Charismatic 15-year old Boyd Mullins preaches to the congregation inside a storefront church. He places his hand on the forehead of an old woman with a walker, then pulls the walker away. With the crowd’s encouragement, the woman takes a few steps on her own. Boyd offers praise to the Lord, then collapses to the ground, clutching his stomach.

At the hospital, Foreman tells Boyd that he doesn’t have an intestinal blockage. Cameron draws blood and Boyd thanks her for the painless procedure. He claims that God told him she was kind. Boyd’s father, Walter, helpfully explains that God speaks to Boyd quite frequently. Cameron observes that Boyd’s urine is dilute, which could mean his kidneys aren’t functioning properly.

The team presents the case to House, who can’t get past the idea that God talks to Boyd. Chase tries to move things along with the report that the only medical issue showing up in the blood work is low sodium. Both Addison’s and cirrhosis tested negatively. House orders his staff to monitor Boyd’s saline intake. He wants to talk to this preacher boy himself.

House presses Boyd on issues of faith, but he holds his own with qualified responses. Noting that Boyd is lucid, House finds it curious that he is being treated in a hospital when his preaching keeps others from medical help.

Wilson meets with Grace, a terminal cancer patient. She’s losing the battle and seems resigned to it. Wilson assures her that the right combination of pain meds exists and that he will find it. House summons Wilson to the balcony and explains that Boyd merely watches people and deduces their problems. He then gives them advice that he claims God passed on to him. This is some kind of power trip. Wilson smirks at the similarities between Boyd and House. The boy’s symptoms are massive cramps and low sodium. House thinks he was probably drinking water nonstop since God told him to purify his body. The water intake would lead to low sodium, which would cause cramping. House wasn’t looking to Wilson for medical advice. He just wanted to rant about seemingly intelligent people believing in religion.

Boyd slowly shuffles through the halls singing a gospel hymn. He’s having a singing seizure which is a partial seizure in which people repeat lines from songs. Chase tries to lead him back to his room, but Boyd doesn’t respond. He stumbles across Grace, puts his hand on her head and says that all things are possible in faith. Boyd calls upon the Lord to heal her. Wilson intervenes and has Chase get Boyd back to his room.

House wonders if they should have Boyd ask God what’s wrong with him. Or else they should just do an MRI. Wilson barges in, enraged that they let Boyd roam the hallways and taunt Grace with false cures. She thinks she feels a little better but that’s just a placebo effect. It will be up to Wilson to pick her back up when it isn’t true.

House passes the whiteboard in his office and notices a little scoreboard putting the tally at “God 2, House 1.” Boyd comes in and notes the score. House quickly points out that the game isn’t over. Boyd wonders if God is in the lead because he healed Grace when she came back to his room. House counters that Boyd simply likes messing with people and giving them a rush. But when the endorphins wear off and the pain returns, Boyd is long gone. Boyd claims that doesn’t happen. House asks if he’s ever done studies on his track record. Boyd defensively claims that God told him it was so.

Boyd says that he can tell House looks for excuses to be alone. House dismisses this as a simple trick of deduction because of his gruff exterior. He asks Boyd for more specifics from God. Boyd says that God wants House to invite Dr. Wilson to his poker game. House stops in his tracks. Wilson does want to be a part of House’s game this week, but how did Boyd know the game even existed? House accosts Wilson, but he claims that he has never talked to Boyd beyond the encounter with Grace in the hallway.

Chase shows House the MRI images and points out a small, abnormal area. House declares it to be tuberous sclerosis. It certainly would explain all of the symptoms, including the chats with God. House gives himself one more point on the scoreboard.

Wilson tells Grace a story about a doctor that the Catholic church keeps at Lourdes. While thousands of cases say people claim to feel better, the Vatican recognizes only a handful of miracles. Grace insists that she likes the view that Boyd is providing. Wilson warns her about facing reality. He offers to take new images of her liver.

Foreman and Chase break the news about tuberous sclerosis to Walter and Boyd. The disease causes small tumors to grow throughout the body, and his are expanding. They will need to perform brain surgery to remove them. This will cure his chemical imbalance, the seizures and his auditory hallucinations.

Boyd refuses the surgery. House wants Cuddy to call the lawyers, but she wants him to talk to the patient first. Yet he must approach it not as an adversary, but more like Wilson does with his patients. House finds Wilson and asks him to speak with Boyd because Cuddy requested him to do so. Wilson only agrees to do it if House lets him in the poker game. House relents.

Wilson approaches Boyd to find out why he doesn’t want the tumors removed. The patient answers that God put them there for a reason. House can’t stand this, and he charges that God is everywhere and doesn’t need to send messages to Boyd’s brain. Boyd admits to Wilson that his visions have been blurry lately. Wilson points out that this means the tumors are growing and putting pressure on his optic nerve. He asks Boyd if he thinks God wants him to die. Walter replies that God gives the most trials to his chosen ones.

Wilson asks if Boyd thinks he is a saint because the one hallmark of a saint is humility. If he rejects surgery because he thinks he’s special, then he’s not a true saint. True humility would force a person to at least consider the possibility that he simply has an illness. Boyd is troubled by this logic. House then congratulates Wilson on his powers of manipulation. He also wants him to bring pretzels to poker night.

House is at home when Wilson stops by with some images of Grace’s cancer to prove that Boyd didn’t heal her. The images showed that Grace’s tumor has decreased in size. House is struck by the revelation, and he asks Wilson not to share this information with Boyd.

The next morning, House demands that Chase get him every single scrap of medical information that exists on Grace. She thinks Boyd saved her life. Cuddy mentions that Boyd and Walter have withdrawn permission for surgery, but she is putting the lawyers on it. She also has her doubts about Grace’s tumor. House thinks that the only way to save Boyd is to prove that Grace is still dying. The scoreboard now reads God 3, House 2.

The team pores over Grace’s records, searching for possible mistakes and mis-readings. Suspecting a delayed reaction from radiation, Chase scans Grace’s home with a radiation counter. All he finds are four kinds of pain pills and an experimental LED device that’s sold over the internet to stop pain. He calls House, who tells him to keep looking.

During poker night, House turns to Wilson and wonders how Boyd would have found out about their game. The only person he’s been talking to is Grace. Why would Wilson tell Grace about the game? Perhaps Grace is more than just a patient. House concludes that Wilson has been sleeping with Grace. Wilson has no response. They argue. Wilson says that it happened one night when her ride didn’t show up. House realizes that Wilson didn’t find an apartment of his own after all. He moved in with Grace.

House accuses Wilson of having a fetish for needy people. He needs to heal them. Wilson counters that House is only angry because he couldn’t tell that Wilson was hiding something. He hates Boyd because the boy is in more control than he is. This is also why religion annoys House. If it’s true, then House definitely has no control over his world.

At the hospital, Walter tells Foreman and Cameron that Boyd is checking out because God said he was fine. Walter pleads with them to talk to his son.

House gets a call that Boyd has contracted a fever and is delirious. Since tuberous sclerosis doesn’t cause fever, House and Wilson head to the hospital.

In front of the team, House declares that Boyd does have tuberous sclerosis, but it is only a mild case. They must perform an LP. Boyd resists, claiming that God told him not to use any more medical science. God will handle it. Foreman informs Walter that his son is delirious and that the decision is ultimately his. Boyd begs Walter to have faith. Walter tells the doctor that they don’t know what’s wrong with Boyd, but God does so it is in his hands. House tracks down Wilson for another speech to the family.

Wilson implores House to consider other solutions. The infection might be unrelated and he simply picked it up at the hospital. House reaches an epiphany. Boyd gave Grace a virus, which went on to attack her tumor. Researchers everywhere are experimenting with virii to fight cancer. Wilson thinks this theory is a reach and points out that the research virii have been genetically modified. House mentions herpes virii are most prone to attack cancer cells. Wilson realizes that herpes encephalitis would fit all of the symptoms.

House walks into Boyd’s room and orders him to strip. House is looking for the sores that are symptomatic of herpes encephalitis, mentioning to Walter that Boyd contracted it through sex. This would explain why he was guzzling water to purify his body. As Boyd begs his father to have faith, Walter instructs the boy to take off his clothes. He pulls down his pants, revealing a sore near his left hip.

A few days later, Boyd knocks on House’s door. Walter forced him to apologize. House walks over to his whiteboard, where the score is still 3-2. House asks Chase for his third point, knowing that Chase was running the scoreboard all along.

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House is awesome. Dont hate