house spoilers

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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 invire 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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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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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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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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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

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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?

[angelblue]

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.