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#47Meaning (2006/9/5)
At a family barbecue, Arlene McNeil watches in horror as her husband Richard, drives his motorized wheelchair into the pool and immediately sinks to the bottom.

On a beautiful fall day, House jogs through a park. At the hospital, Cuddy and Wilson discuss whether or not House would be interested in Richard's case. A sweaty House bursts into the office, boasting that he ran eight miles to work. Aware that the ketamine treatment can wear off , Cuddy wonders if he's feeling any pain. House declares that it's been two months pain-free and he thanks her for the ketamine-induced coma. He looks over the case files and decides to take on two. One is Richard's case. The other involves a 26-year old named Caren who became paralyzed when she snapped her neck during a yoga pose. X-rays show no evidence of spinal injury.

Wilson questions why he took Richard's case even though there is no diagnostic work to be done. House is intrigued by the suicide attempt and claims that's he is now a changed man. Wilson doesn't buy it. House barrels into his office and starts discussing the cases before his staff can get into the niceties on his return to work. He becomes distracted by a spot of blood on the floor. It is his blood from the gunshot wound. He stares at it for a few moments, and then orders his staff to redo the tests on Caren and add an electromyogram. He then calls for an O2 mask for Richard so that he can perform tendon surgery on him. Richard's leg muscles are atrophied, and House wants to make him more comfortable.

As Richard undergoes surgery, his son Mark insists that his father would never try to kill himself. House scoffs that the boy cannot know a man who hasn't spoken for six years. House points out that if he did in fact try to kill himself, then that means he's still present in mind. This reassures the family.

Cameron witnesses Arlene thanking House. She is incredibly curious to know what Arlene was thanking him for. Does this mean House has changed? House, of course, says nothing.

House learns that when they inserted the conduction pin for the EMG, Caren flinched. He picks up a lighter and holds it to Caren's foot. She screams and jerks her foot away. Caren insists that she's not faking, but House instructs his team to discharge her.

Later that night, Wilson asks House about observing Richard's surgery with the family. Wilson realizes that the hallucination House had in his coma made him realize he wanted his life to have meaning. So he took an easy case to simply make a family feel better. Although House doesn't deny this, he says he felt nothing when Arlene thanked him. Wilson advises him that his emotions, like his leg, had atrophied from disuse. He just needs to keep rehabbing his emotions. Before any further introspection can take place, Cameron comes to get House with a new issue involving Caren. She is struggling to breathe.

Strolling into her room, House informs Caren that she's either faking it or she has pleural effusion. If she does indeed have fluid building up around her lungs, House will have to stab her in the back with a very big needle. House holds up the needle for Caren to see it, but she continues gasping. House notices something and has the team hold the patient down. He jams the needle into her chest. As he pulls up the plunger, the syringe fills with red liquid. They realize that Caren's problem is in her heart.

The next day, the team discusses Caren's case. House wonders if the paralysis was a delusion, indicating a neurological problem. Foreman recognizes that he's leading up to a vascular tumor in her spine, but Cameron and Chase point out that the platelets are normal and Caren has been scanned thoroughly. House wants them to open her up and find the problem.

House notes that Richard's heart rate has elevated. Deducting that he's still in pain from surgery, House ups his morphine. Arlene thanks House for actually caring about Richard's quality of life. Every other doctor has just wanted to fix him. House thinks about her words and leaves the room. Cameron, who has been observing from the hall, confronts him when he comes out. She's all too eager to remind him about his past cynicism in the face of her optimistic hope. House changes the subject by asking her to dinner. Once again, House is in control of the relationship.

Cuddy summons House into her office to complain about the planned random search of Caren's spine. House tries to barter with her, but has no success. Yet after a few more tests turn up negative, the exploratory surgery is scheduled. The surgical team preps Caren, and House sees something from the observatory. He bursts into the OR and shows Caren's big toe to the surgeon. The nail is dark, corrugated and splintered. House has a clue.

Caren sits up in her room sipping orange juice as Foreman checks on her. He reveals that she had scurvy, which causes the arms and legs to fill with blood, making movement difficult. Caren talks about her modified Atkins diet and Foreman says that has given her a lack of vitamin C.

House makes one last check on Richard as Arlene prepares for discharge. She again thanks him and House advises putting Richard in a facility. She says she can't abandon Richard. When she goes to lift him from his bed, Richard makes a low, guttural, gurgling sound. House asks Richard to do it again. House announces to Arlene that Richard is talking.

House enters his office carrying a box overflowing with eight years of medical files on Richard. House tells the team Richard grunted last night, then instructs them to review Richard's history with the grunting in mind. House then goes outside to skateboard but feels a twinge of pain in his leg. He immediately stops riding and walks back inside.

After poring through the files all day, Cameron, Foreman and Chase have written down the 214 symptoms Richard has experienced in the last eight years. Looking over the extensive list, House thinks that abdominal pain plus everything else could mean a pancreatic cyst. Cameron quickly points out that abdominal pain is one symptom that Richard never had. House counters with the fact that Richard could never vocalize the symptom. He orders an upper endoscopic ultrasound.

Chase and Foreman prepare for the procedure. Before inserting the scope, Chase asks Foreman to bring the crash cart closer, figuring they're going to need it shortly when Richard's throat closes on the scope. Chase slides the scope down into Richard's stomach and they see that the pancreas looks clean. Before they can continue, Richard's throat does indeed close. They perform an emergency tracheotomy.

Reviewing the details of the procedure, House tries to figure out why a sedated throat would collapse. He realizes that the muscles actually locked down. Since the brain is supposed to tell muscles to contract and relax at the same time, something was blocking a relax message from the brain to the throat. Cameron stops House and begs him to let this case go and stop torturing Richard to satisfy his own curiosity. House thinks about a few microtumors in the meninges of Richard's brain and considers looking at the brain lining.

In the CT room, Chase injects contrast material into Richard's spine and slides him into the scanner. He is forced to stop the test when he notices blood trickling from Richard's ear.

The team finds House in a light board room, surrounded by eight years' worth of x-rays and scans. Chase reports that a surgeon repaired Richard's CSF leak. House asks Foreman to walk him through the brain scans throughout the years. House then wants to do five millimeter cuts through the occipital and hypothalamic regions. While both Foreman and Cameron refuse to keep putting Richard through risky tests, Chase is still up for it.

Despite House's persistence, Cuddy decides to discharge Richard the next morning. That night, House goes for another run. Dripping with sweat, he jumps into a fountain to cool down and the water gives him an idea. He rushes over to Cuddy's house and pounds on the window in the middle of the night. She rouses from her sleep and opens the window to find House immediately launching into his theory. Richard's brain is on fire because of an imbalance. He drove his wheelchair into the pool because he couldn't regulate his body temperature. He had hypothalamic dysregulation. Cuddy refuses to allow any more treatment -- not even a simple cortisol shot that House claims will prove his theory.

The next morning, Arlene and Mark wheel Richard out of the hospital. But Cuddy stops them before they reach the door and injects Richard with cortisol. She then looks into Richard's eyes waiting for a reaction, but there is none. Suddenly, Richard goes into spasms. He moves his arm and undoes the seat belt on his wheelchair and slowly stands. Cuddy tears up as she watches the family's joyful hug.

Cuddy is about to track down House to tell him what happened when Wilson stops her. Calling it a lucky guess, Wilson says it's more important for House to learn to be reined in.

Late that night, alone in the hospital, House sneaks into Wilson's office. He finds Wilson's prescription pad and writes himself out a scrip for Vicodin.
#48Cane and Able (2006/9/12)
A young boy named Clancy refuses to go to sleep and thinks "they" are out to get him. He turns on his TV. Suddenly, the channels begin changing and the room begins to rattle. A blindingly white light comes into the room. In the morning, Clancy's father Todd finds his son on the front lawn, face down. A large blood spot is on his behind.

House laces up for another jog. After leaving the house, he immediately comes back inside, grabbing his leg. He limps into the hospital. Cuddy and Wilson notice this, but House ignores them and takes the elevator instead of the stairs. Cuddy worries that House is depressed about his last case, causing him to slack on rehab. Wilson emphasizes that House only made a lucky guess. He still doesn't think they should tell him that the cortisol worked.

The team introduces House to Clancy's case. Cameron theorizes that rectal bleeding and alien abduction sightings are most likely sexual abuse, because trauma can cause the fantasy. Foreman deftly points out that the ER found no evidence of rectal tearing, semen or pubic hairs. House, rejecting hallucinations as a possibility, asks for a full set of coagulants and endoscopies from both ends.

Chase nicks Clancy's arm to time how long it takes him to stop bleeding. He clots with no problems. Clancy asks if the windows are locked because "they" know he's in the hospital. "They" put a chip in his neck to keep track of him that Clancy can feel. Chase pinches Clancy's neck with forceps, pretending to remove the chip. Clancy doesn't buy it.

Foreman and Chase report that both endoscopies were clean and the bleeding test was fine. House wonders if Chase screwed up the test. Later that night, Foreman tells House that he performed another bleed test on his own and it took twenty-five minutes to stop the bleeding. Cameron sensibly suggests running labs to check Clancy's clotting factors. Chase heads to Clancy's room for the new test. The boy is missing.

Chase finds Clancy in the men's room. He claims that he needed a windowless room so he could remove the chip. Chase cleans up the massive amount of blood from Clancy's neck and realizes there is something metal in the gash.

The metal is titanium from a surgical pin inserted into Clancy's broken arm from four years ago. House thinks that a small piece broke off and migrated. Chase finds it hard to believe that titanium could break. Even if it did migrate, how would it end up in the neck? House is more interested in the fact that Clancy cut open the back of his neck and clotted without bleeding to death. The case has changed from no bleeding disorder to a bleeding disorder and then back to being fine.

The team performs yet another blood test on Clancy. His mother, Stephanie, wonders if this was all in his mind because he had been looking for an alien tracking device.

Cameron receives a file on a returning patient and is stunned to find out that it's Richard McNeil, the paralyzed patient that House supposedly could not fix. McNeil is walking with assistance. He was afflicted with Addison's disease, and the cortisol shot turned his brain on like a switch. Cuddy comes in, dismayed to see that the patient she's been trying to hide from House is now out in the open.

Clancy suffers a pulmonary edema when blood is being drawn. Doctors rush in and frantically work to bring him back to life. Clancy holds steady but has a high blood pressure. Foreman discovers that Clancy does have a blood disorder, but it is von Willebrand disease. The doctors are baffled by the inconsistent test results. Cameron, referencing the high blood pressure, wonders if it is connected. Hypertensive crises can activate clotting factors.

They perform a transesophegeal echo to identify the problems in Clancy's heart, but the echo reveals nothing. House, determined to find something, insists that a small part of the heart isn't beating along with the rest. His team is unimpressed by a basic arrthymia. House instructs them to bring him a sample of the non-beating myocytes.

Cuddy tells House that she wants to do a PET scan on him to determine if his increasing leg pain is a positive or negative sign. House assures her that if he thought his leg was deteriorating, he would've been taking preventative measures by now.

Chase compares Clancy's DNA against the DNA taken from the heart. They don't match. House is at a loss for words. The team sequesters in the office for a differential. Wondering if the alien DNA is confined only to the heart, Cameron suggests introducing an antibody that recognizes only the protein from the other DNA and flush it through the body. If it shows up anywhere else, they will be able to find the DNA in other parts of the body.

They administer a PET scan on Clancy and spot a clump of affected cells in the bone marrow of the boy's femur. They also spot more cells in his heart and left eye. However, there is nothing in his brain, meaning Clancy's problem is not neurological. Surgery begins to remove the abnormal cells from each area. The normal tissue will begin to replace the removed areas and Clancy should be fine in time.

Wilson finds House in his office and tosses him a bottle of Vicodin. If he's so sure his leg is fine, why not take the pills so he can get through rehab? Wilson remarks that, lately, House hasn't always been right. Later, House hits the treadmill but runs with a noticeable limp. He gives into the pain and pops a couple of Vicodin. This allows him to keep jogging.

Clancy is asleep when the hospital room begins to rattle and the white light reappears in the window. Clancy floats above the bed. In reality, he is having a seizure. Chase rushes into the room as Clancy flails wildly.

The next morning, Foreman reports that the hallucinations and seizures indicate problems in the temporal lobe. Figuring that their antibody tag didn't penetrate the blood brain barrier, House asks them to go straight into the brain. Yet another PET scan of the brain is totally clean. House wonders if it's possible that something is there, but the antibody isn't affecting the brain proteins, which have a different cell structure. House retreats to his office to think in private.

After some deliberations, House instructs the team to send Clancy home. If they removed the affected cells and the brain was clean, there's nothing more they can do. Cuddy rushes to catch up with House in the parking garage, demanding to know why he's giving up on Clancy. House, knowing that Cuddy is displaying an unusual level of interest in his patients lately, asks what she's hiding. Cuddy admits that House was right about McNeil's case. A single shot of cortisol cured him. House thinks about what this means, mocks Cuddy for needing in vitro fertilization, and then is hit with a revelation.

Barging into the office, House asks his team how a person could end up with two strands of DNA. Referencing Stephanie's in vitro treatments, House asks if Clancy could be a twin. Two embryos in the IVF treatment bonded and Clancy is two people in one, a condition called chimerism. Now they have to cut out the second strain of DNA, some of which is in the brain.

Believing that the alien DNA was causing the visions, House plan to stimulate a hallucination during brain surgery. This will cause the secondary cells to light up so they can be removed. Both the plan and the surgery work perfectly.

House tracks down Wilson in order to gloat. He makes it clear that he beat their little scheme. Yet when he returns home alone, House pulls out one of his canes and starts using it.
#49Informed Consent (2006/9/19)
An aging scientist named Ezra Powell begins sweating and gasping for breath. He collapses to the floor.

The next day, House limps into the office with cane in hand. He gives his team the particulars of the latest case. They would rather talk about his cane, but House ignores every attempt to do so. House asks them to focus on Ezra, who cannot breathe. Chase and Foreman immediately recognize Ezra's name from his renowned research. From the file, Chase sees that Ezra's oxygenation has bottomed out and his lungs are full of fluid. He suggests amyloidosis. House would rather put the patient on a treadmill to figure out if the problem is in the heart or in the lungs.

The doctors submit Ezra to the test, but he can't move fast enough to provide real results. As they wait for him, they discuss the return of House's pain and what that means for them. Cameron wonders if there is anything they can do to help. Before she can continue, Ezra has trouble breathing. Unfortunately, his heart rate never got above 90 which renders the test useless. House advises Cameron to drain Ezra's lungs and perform the test again.

Cameron still can't get Ezra's heart rate up even after his lungs were drained of fluid. He is simply too old and weak. House injects epinephrine into Ezra's IV and this causes the heart rate to spike to 130. Nothing turns up on the EKG, meaning that the problem isn't in the heart. House leaves the room and Cameron starts to remove the epinephrine from the IV. Ezra begs her to leave it in. He wants to die.

Cameron informs the team about Ezra's wishes. House and Foreman are greatly opposed to euthanasia, and the others argue about what to do. Suddenly, every pager in the room goes off. The team rushes to Ezra's room, where they find a nurse helping him back into his bed. The nurse found Ezra hanging off the bed with his tubes around his throat. Ezra refuses to consent to any more tests. House tries to force him into a breath test, but Foreman and Cameron stop him. House goes into exact detail about how he will die as his lungs fill with fluid, but Ezra isn't swayed. House asks him for one more day. If he can't figure out what it is in 24 hours, he'll assist Ezra in dying.

The doctors immediately get to work on a battery of tests, rushing to beat the clock. Cameron checks Ezra's laboratory for toxins. The next morning, House casually strolls into the lab and sees that his team has been working all night. He quickly notes a stack of tapes. Cameron explains that Ezra dictates his notes in the lab. House wonders if that indicates that he's losing his memory. He orders an MRI to see if there's a problem with Ezra's brain.

A full day passes and the team comes up with nothing. House lies to Ezra and says that the bone marrow biopsy revealed multiple myeloma. They will need to draw some blood to start treatments. However, Ezra isn't buying it. He knows that none of his tests have shown any indications of myeloma. House begs for more time, but Ezra refuses. There's nothing the team can do but retreat to their offices.

House is deep in thought for hours. Finally, he pulls a leather case from his desk and heads for Ezra's room. The team follows, bewildered. House unfolds the case, pulls out a syringe and vial and orders the team to leave the room. He wants them to make sure somebody sees them in another part of the hospital. Foreman steps in, but House orders him out of the way. Cameron is in tears. Chase draws the blinds. House injects the IV and Ezra goes limp. House quickly grabs the crash cart and asks Chase to help. House gets a laryngoscope and intubates Ezra so they can continue testing him.

House examines Ezra's MRI and notices scarring on the top of his lungs. This, combined with the bad bone marrow, could indicate lupus. Foreman reports that the IVIG made Ezra worse, ruling out lupus. House asks Cameron to return to Ezra's lab and find the January 1967 Massachusetts Medical Journal. There's something in there that she might be interested in. In the meantime, he has Chase biopsy Ezra's lungs and the results are negative.

Cameron reads the article and learns that Ezra once injected newborn babies with radioactive agents just to see if they had urethral reflux. House is confident that Ezra's experiment, which was performed without consent, nicely reflects what he's doing now. If Cameron thinks less of Ezra, she may change her mind and start helping them out. Yet she doesn't bite.

Ezra crashes as the team finishes up the surgery. His right lung has collapsed, so House creates an incision in the chest to relieve pressure. He notices that Ezra reacts to pain stimuli on his left side but not his right. They need to wake Ezra up from his coma to run a somatosensory evoked potentials test to investigate.

House considers Ezra's lack of sensation and orders a skin biopsy. He now suspects Kawasaki's disease, lymphoma and sarcoidosis. The skin sample rules out sarcoidosis, so he throws out amyloidosis. The team counters that it didn't show up in his heart. House presses, and Chase adds it to the stain. The slide immediately changes. The good news is that House was right. The bad news is that it's protein type AA.

House informs Ezra that he has amyloidosis and, with a subtype AA, it is terminal. Ezra congratulates him on a successful diagnosis.

The next morning, Cuddy informs House that Ezra died overnight. The nurse charted that he was stable at 1:00am, but his breathing suddenly stopped at 1:30. Cuddy questions whether House knows anything about that. House asks if she would even want to know the truth.
#50Lines in the Sand (2006/9/26)
A man named Dominic tries to teach his severely autistic son, Adam, to identify shapes and words. Adam doesn't speak and does not have much success identifying the images. Adam begins clutching his chest and screaming frantically.

House is curious about Adam's case. He finds it interesting that, in the ten years of closely caring for their boy who screams frequently, this is the first time the parents have admitted him to the hospital. Foreman and the other doctors simply dismiss the case, citing Adam's severe affliction and his parents' natural overprotective nature. House orders a stool sample to check for parasites, a blood culture to rule out infection and an ANA for lupus.

House barges into Cuddy's office and demands his old, bloodstained carpet which she had replaced. She turns him down. House refuses to use his office.

Foreman and Cameron strap a struggling Adam into a scanner for his first test. The ventilation scan is normal so Adam can be sent home. Yet House wants a fecal smear test. The boys parents tell Foreman that they may have overreacted. Adam begins to gag and cough before spraying mucus out of his mouth. Foreman is now convinced that something is wrong.

Avoiding his own office, House convenes a team meeting in Wilson's office. He orders an echocardiogram and antibiotics if the fluid returns. Adam screams maniacally as Foreman tries to administer the echo. The echo and an EKG confirm a conduction abnormality. Chase, thinking about the effusion, suggests they look for something that explains both the heart and lung problems. House wonders if cancer is present and he calls for a lung biopsy.

Foreman approaches Wilson about Adam's case. There is pleural effusion and conduction abnormality, but an absence of heart failure. He asks Wilson the oncologist if they should perform a lymph node biopsy, and Wilson agrees. During the biopsy, Adam screams once again and the doctors aren't able to hold a gas mask over his face for anesthetization. House comes in and takes a few breaths from the mask himself. This makes Adam accept the mask. He slowly falls under. His parents think it's a miracle that their boy finally had some kind of conversation with somebody. House dismisses it as simple copycat behavior.

Wilson studies the biopsy. He doesn't find cancer, but he does make an astonishing discovery. The cells under Adam's arm are liver cells. The team meets once again in Wilson's office to figure out a possible explanation. House focuses on liver damage, specifically cirrhosis. The team refutes because the echo showed no scarring on the liver and other tests were negative. House theorizes that damaged liver cells -- like cancer cells -- could work their way into the bloodstream and move north. He suggests that perhaps the parents who have been devastated by such a difficult child might have slipped something to him. House wants a liver biopsy to confirm cirrhosis.

Tired of finding House in his office, Wilson corners Cuddy and begs her to put the dirty carpet back. When she refuses, House camps out in her office to discuss Adam's stool sample with Foreman. It had traces of iron, zinc and calcium carbonate. House is intrigued by the carbonate, which is an anti-diarrheal.

Adam is rushed to the cardiac ICU where he must be shocked back to life. His liver is damaged, his heart has abnormal pathways and pleural effusion has compromised his lung function. Yet the biopsy was negative for cirrhosis. House still suspects the parents but notes that Adam has pica, which means he will eat anything put in front of him. House asks Foreman to inspect the home for matches, spiders, mortar and anything suspicious that Adam would put in his mouth.

After a thorough search of the home, Foreman informs House that he found a small patch of Jimson Weed in the backyard. Jimson Weed contains atropine, which is the poor man's acid. It explains the pleural effusion and the arrhythmias. Yet the treatment for that is physostigmine, which doesn't mix with heart issues. They need to be sure before proceeding.

House shows Adam a picture of Jimson Weed and asks if he ate it. Adam instead points to a picture of his sandbox and then his eyes roll back into his head. House presents the new symptom to his team. Foreman wonders if there are tumors, but the team is skeptical that they would have missed that. Foreman plans on performing a CT scan. If that doesn't work, he'll remove the eye.

House sits in Adam's empty hospital room, thinking. When he sees the picture of the sandbox and a chalkboard with wavy lines, something hits him. He rushes to the prep room and calls of Foreman's surgery. House has them darken the room so that he can examine Adam's eyes with a light. Since Adam can't speak normally, he drew squiggly lines over and over again to explain what he was seeing. Worms swimming in his eye. A raccoon used Adam's sandbox for litter and Adam ate what it left behind. The worms spread from his stomach to the rest of his body into the liver, the lungs and the eye. Laser photocoagulation will fix the eye, and a high dose of benzimidazole will kill the worms.

Wilson enters Cuddy's office with a medical textbook. “Asperger's Syndrome is a mild and rare form of Autism. It is typically characterized by difficulty establishing friendships and playing with peers, trouble accepting conventional social rules and they dislike any change in setting or routine,” he reads. Cuddy scoffs at the notion that House has Asperger's, but Wilson mentions the fuss over the change in carpet. He theorizes that House took Adam's case because he saw himself in the boy.

Wilson later finds House in the hallway and tells him that he knows he doesn't suffer from Asperger's. He wishes he did because it would free him from any social responsibility. Instead, he has to face the fact that he's simply a jerk. Adam and his parents are leaving the hospital, and Adam stops to give his cherished PSP to House. Adam looks straight at House, making eye contact for the first time in his life.

That night, House watches as a carpenter unrolls his old bloody carpet in his office.
#51Fools for Love (2006/10/30)
A young, interracial couple is among the hostage victims of a diner robbery. Jeremy bludgeons one robber's head with a napkin dispenser and smashes the other's head into the floor. His wife Tracy gasps for air. Her throat is swelling shut.

At the hospital, Cameron notes that the woman has Anaphylaxsis-like throat swelling. House is more interested in the fact that Jeremy and Tracy got married at age twenty. Cameron reports that the woman is not suffering an allergic reaction, but House is again distracted by Wilson chatting animatedly with an attractive new nurse.

House summons a laparotomy for the patient, but one was already performed and it was clean. Noticing marijuana in Tracy's tox screen, Chase theorizes about salmonella from the pot. Foreman calls it a stretch. Without a better idea, House goes ahead and orders floroquinolone for the salmonella.

House attends to clinic rounds and encounters a patient named Michael Tritter who has a rash on his genitals. House quickly writes off the dryness as being a symptom of Tritter's nicotine gum. Tritter asks for a swab to be tested, but House moves on. As House goes to leave the exam room, Tritter kicks out the cane and House trips. Tritter coldly mentions that when you treat people like a jerk, you get treated like a jerk in return. House agrees to take a swab and has Tritter bend over with his pants down. Yet House inserts a thermometer in Tritter's rectum, claiming that he's checking for fever. House walks out, leaving Tritter standing prone in the room.

Foreman visits Tracy to administer the floroquinolone. He inquires about the couple's drug use and is met with hostility from Jeremy. Tracy starts to have an allergic reaction to the antibiotics. Foreman relays this information to House, who realizes that the salmonella was a stretch as Foreman had predicted. House changes his thinking to exercise-based anaphylaxis, figuring that adrenaline from the robbery pushed Tracy's heart rate to the limit.

House puts Tracy on a treadmill to re-enact the stress level of the robbery. Seeing his wife struggling, Jeremy begins to get irritated and jumpy. He clutches his stomach and chest in pain. Jeremy is put in a hospital bed next to Tracy.

Talking through the case, House leads his team into the locker room and breaks into the new nurse's locker, looking for evidence of a relationship with Wilson. He finds a flyer for a jazz festival, but nothing else related to music. Foreman thinks this is ridiculous. House bets him $100 that the nurse is dating Wilson. Much more interested in their latest case, Cameron points out that Jeremy and Tracy either caught the disease from each other or they were subjected to it in the same place. House orders an environmental check.

While searching the couple's tiny studio apartment, Chase finds a box of condoms in Jeremy's jacket. Foreman, knowing what House's reaction will be, wants to ignore it. Chase insists on bringing it back to the hospital. House calls for a genital swab on each patient. Tracy reveals that she already knows about the condoms. They had a recent pregnancy scare and were being extra cautious.

Although the STD tests are clean, Tracy's abdominal pain is getting worse. House orders her removed from the steroids. If she gets a fever, then it is an infection. If not, the problem is environmental. Tracy hallucinates that Jeremy's father is in their room demanding that his son leave her. She screams and Foreman rushes into the room. He can see in her eye that fluid is leaking from the blood vessels in her brain, causing tissue to swell. Tracy lapses into a coma.

The team examines Tracy's MRI and notice aberrations all over her brain stem. Comparing this to Jeremy's chest x-ray, House wonders about sarcoidosis. The team is unconvinced, so House decides to consult Wilson, a sarcoidosis specialist. Wilson disagrees with House's assessment, but House reports back to the team that Wilson said it was sarcoidosis. He orders methotrexate as treatment and a biopsy to be sure of his theory. This stops the team. They know a biopsy on the brain stem is likely to cause brain damage. House is ready to press ahead.

Cameron informs Cuddy about what's happening. She refuses to let House near Jeremy because he will walk all over him. House asks whether Wilson can perform the biopsy on his behalf and Cuddy agrees. Wilson presents the options to Jeremy, but Jeremy would rather have the procedure performed on him instead since they share the same disease. Wilson points out that Tracy could die before his symptoms present. Jeremy won't change his mind. He asks them to stop treating him so that his symptoms come out.

House is frustrated and hides in an empty patient room. The doctors follow, nervous about what he's up to. House wants to inject Jeremy with naloxone in order to subject him to intense pain so that he will relent on the biopsy. The team wants to stop him and he reluctantly hands over the vial. After House leaves, the doctors realize he handed them a different vial. Foreman rushes to Jeremy's room and finds House injecting the naloxone. Jeremy writhes in pain. House badgers Jeremy to consent to the test on Tracy, but he still refuses. The pain only seems to strengthen his resolve because he thinks his symptoms are getting worse and now he is closer to his own biopsy.

Cuddy pulls House into her office where Michael Tritter is waiting for him. Tritter wants an apology, although he's really looking for humiliation. He wants House to think twice about his actions in the future. House refuses.

Jeremy's state has become worse. However, it's not in his brain and he doesn't have sarcoidosis. His intestines are rotting. Both Jeremy's and Tracy's conditions continue to deteriorate. Chase figures Jeremy for ischemic bowel, which means they'll need to remove a few feet of intestine. Foreman thinks that Jeremy likely has small cell vasculitis and Tracy has porphyria, which means their diseases may not be environmental or infectious. It may just be a coincidence. House orders hematin to treat Tracy's porphyria and the removal of Jeremy's dead bowel for a biopsy.

Foreman makes a shocking discovery in the biopsy. Jeremy's bowel isn't dead. The elevated lactic acid levels in Jeremy's stomach leave no other option. But when House looks at the microscope himself, he realizes that Foreman is correct. The bowel is basically fine. House asks the team to go back to the very beginning of their diagnostic process. Jeremy and Tracy grew up next door to each other and ran off to get married after Jeremy's racist, drug-addled father beat him up. House wonders whether it was really racism over Tracy's color or whether Jeremy's dad just didn't like this particular girl. House thinks about Tracy's eyes. They're green.

House realizes that each of the patients has hereditary angioedema. Defective DNA is keeping them from making a critical protein. Jeremy's father must have had an affair with the neighbor that produced Tracy. House orders his team to start treating them for the disease. This brings Tracy out of her coma.

After House's hunch pays off, he wonders who will tell the couple the truth. Foreman thinks they should alert them to the genetic disease but keep their lineage a secret. House wants him to inform the patients or else he will do it himself.

Foreman prescribes Tracy and Jeremy daily pills which will stabilize them because angioedema is treatable. They ask Foreman how they both caught the disease, and he is forced to tell them that it is genetic. Neither of them catches on, so he explains that the hospital has concluded that they have the same father. Tracy gets sick to her stomach. She is lighter-skinned than her parents and people always mention that she and Jeremy have the same eyes.

Later that night, Chase asks Foreman to cover for a few hours over the weekend. Foreman replies that he is going out of town. House realizes that Foreman is the one dating the new nurse. House grumbles that it isn't fair to bet when you already know the outcome, but he still forks over the money.

House speeds home on his motorcycle that night and he's pulled over by police officer Michael Tritter. House scoffs at the idea of a ticket. Tritter, however, noted that he witnessed House pop a pill while examining him earlier in the day. Tritter deems House belligerent and under the influence of a narcotic. He reaches into House's jacket and pulls out of handful of Vicodin. Tritter asks to see a prescription for the drug. When House doesn't produce one, Tritter arrests him for possession.
#52Que Sera Sera (2006/11/7)
Firefighters are called to the residence of George Hagel, a 600-pound man who has died. As a team of firefighters tries to lift George's body, somebody in the room passes gas. That somebody is George. The chief checks and finds that George still has a pulse.

Cuddy brings George's file to Chase, Foreman and Cameron. House isn't in yet. Cuddy informs the doctors that George is in a coma, but his blood sugar is normal, his cholesterol is lower than hers, his tox screen was clean and there's no sign of trauma. The team is astonished by this news. Cuddy wonders where House is.

Well, he's in a holding cell at the police station. Frustrated, he tells Tritter to let him go. Tritter suggests arraigning him instead. Finally, Wilson appears and posts House's bail. House meets Wilson outside and Wilson immediately hands him a bottle of pills. House assures Wilson that he's innocent and Tritter just wanted to punish him.

The doctors are mulling over George's case and House's whereabouts when House suddenly pops into the office. House quickly orders the team to start treating George for Pickwickian Syndrome. Foreman counters that George's CO2 and oxygen stats are normal, but House points out that they're only normal for an average-sized person. House also wants a detailed medical history. Search his house and talk to his neighbors if you need.

George's neighbor, Sophie, allows Cameron into George's apartment. She surprised by how tidy and orderly the place. The place also has a high-end kitchen, including a wine cellar. Sophie informs Cameron that George loves cooking and frequently prepares four-course gourmet meals for himself. He also has prostitutes visit on occasion.

House is working clinic duty when he spots Tritter in the lobby. Tritter says he was merely bringing Cuddy up to speed on the arrest. Conspicuously popping a pill before Tritter, House advises him to quit while he's ahead. Tritter eyes up House, then leaves. Foreman and Cameron approach with the information that intubation and steroids have had no effect on George. Thus, they're ruling out Pickwick's. House suggests blood clots in the brain and orders either an MRI or a CT scan. Problem is, those machines have weight limits well under what George weighs. House suggests that they just start treatment then.

Knowing that blind treatment could possibly kill George, the team tries to MRI him. Cameron thinks it'll work if they just get his head inside the machine, but Foreman worries that George will break the table, ruining a million-dollar machine. Adamant that George deserves the same standard of care as anybody else, Cameron assembles a team of nurses to hoist George onto the table. Incidentally, she lies about George's weight to get them to help.

Cuddy finds House in his office and hands him contact information for the best defense lawyer in the county. The moment she leaves, House crumbles the paper and throws it out. Elsewhere, the doctors find nothing out of the ordinary on George's MRI. As they begin to weigh their options, George comes to life and starts screaming. As Foreman and Chase struggle to pull him out, the MRI bed breaks with a loud crack.

House and the team reconvene to discuss what they know. They don't know much. A calm, but angry, Cuddy enters asking about the machine. House blames his staff for disobeying his orders to start treatment. Cuddy isn't buying it, but Cameron pipes up and admits what happened. Foreman wonders about hormones. Acute adrenal insufficiency could possibly cause a coma. He wants to do an ACTH stimulation test and check George's skin for acanthosis nigricans. Cameron, focusing on the prostitutes, wants to run a full STD check. Chase suggests doing nothing, and if George doesn't get worse, figure it was a hematoma that dissipated. House considers, then decide to go with all of the theories.

Foreman and Cameron begin their tests on George, who insists he's fine. Every doctor he's ever seen has checked his hormones, then his blood pressure. And the results are always the same. He asks the doctors when he can leave the hospital. Foreman and Cameron finish the tests, then report back to House that the skin exam and ACTH stimulation were normal, and the blood and urine were negative for chlamydia, herpes and syphilis. House is intrigued by the mystery, but Foreman then reports that George is asking to be discharged.

House shuffles over to George's room, where he finds him eating dinner. House tells George that he awoke from a coma caused by an unknown condition and wanted to leave the hospital. So either George isn't in his right mind or he knows what the condition is. House guesses at various conditions, but George angrily insists that he doesn't know what's wrong. He's not depressed, he just doesn't want to stay there. House gets a cell phone call and leaves.

The call was about House's apartment, which has been ransacked. As he looks around, he sees Tritter in his hallway with two uniformed officers. Tritter coolly informs House that they're executing a search warrant. Tritter holds up an evidence bag full of pills and estimates that it must hold over six hundred Vicodin. Most DAs would say that shows intent to traffic. House scoffs, pointing out that each pill is held in a prescription bottle. Tritter agrees, but theorizes that if House is so unprofessional and unethical, maybe it's possible that some of those bottles are in other's names. Or came from forged prescriptions. Or simply stolen. But House has nothing to worry about, right?

The next morning, House instructs his team to send George home. Cameron resists, but House is more interested in tracking down Wilson and finding out what he told Tritter. Wilson assures House that he merely told Tritter he prescribed the Vicodin.

As George is wheeled out of the hospital, Cameron makes a last gasp attempt to convince him to stay. George explains that he simply loves food. Whatever is going to happen, will happen. George stands from his wheelchair and prepares to walk out of the hospital as Cameron begs him to sit. George takes a few unsure steps and then collapses through a plate glass wall.

Foreman, Cameron and House gather. Foreman explains that disorientation and loss of balance could mean a neurofibromatosis. House mentions that that's inherited, claiming one of his diagnoses was correct. Cameron argues that the disorientation isn't a key symptom. And she would know becausecshe gave George three grams of phenytoin. She didn't think he should be discharged and knew that would force him to stay.

Looking at the discharge report, House notices that George didn't eat his breakfast, which seems odds for him. Coma, fever and loss of appetite stem from Chagas. Cameron is doubtful, as George hasn't been out of the country before. House points out that his food has. House wants a sample of George's CNS to determine which bugs are in his brain. But since George is too big for an LP, they'll have to drill into his head. After some badgering from Cameron, George agrees to the test.

During the test, Foreman prods George's brain and George begins screaming that he can't see. The nurses struggle to hold him down. After the procedure, Foreman and Cameron inform House that there's no inflammation in the optic nerve and the retina is intact. There was also no sign of Chagas. House wonders if they missed a tumor in the MRI. Or perhaps it's diabetes, as evidence by the blindness and coma. He wants them to test George once more.

Cameron tries to give George some glucose water to drink, but he angrily slaps it away. They argue until George says that he's been fat all his life, but sick only recently. If she wants to look for a disease that has nothing to do with his size, he'll help them. Otherwise, leave him alone.

House meets with his new lawyer, Howard Gemeiner. Howard advise a plea bargain, which House has no interest in. So Howard quotes House his exorbitant fees, which House reluctantly accepts. When House returns to the hospital. Cameron asks how things went with the lawyer. House is disappointed that his secret is out. Moving on, Foreman says tests for MS were negative and Cameron says tests for diabetes were unperformed.

House barges into George's room and accosts him about the diabetes test. House tries to forces the glucose drink on George, who strenuously resists. As they struggle, House notices George's fingers. He limps out of the room. Cameron and Foreman follow. House orders x-rays of George's hands and feet. Then a bronchial test, a sputum cytology and a CSF check for anti-hu antibodies. House thinks George has lung cancer. When the doctors are skeptical, House asks if they've felt George's fingers. His hands are clubbed.

They take x-rays and are stunned when they realize House was right. George has ossifying periostitis on the ends of his fingers. After the tests are analyzed, Cameron enters George's room to tell him they've confirmed small cell lung carcinoma. That caused a paraneoplastic neurologic syndrome, which in turn caused the coma and blindness. It's inoperable, but radiation treatment is available. However, that will only buy him a few months. A year at the most.

In Wilson's hotel room that night, Tritter is asking Wilson if he really wrote all of those prescriptions for House. Wilson admits that House can difficult, but he truly is in pain and needs that medicine, which is why Wilson prescribed it. Tritter pulls out a few scrips and shows them to Wilson. He points out that the signatures on some of them look different from others. Tritter notes that Wilson looks surprised. Covering, Wilson says that sometimes he gets bored and signs his name differently. Tritter tells Wilson he'll give a second to reconsider his answer. Because if he's lying, they'll find out. Wilson sticks to his story. Tritter thanks him and leaves.
#53Son of Coma Guy (2006/11/14)
Firefighters are called to the residence of George Hagel, a 600-pound man who has died. As a team of firefighters tries to lift George's body, somebody in the room passes gas. That somebody is George. The chief checks and finds that George still has a pulse.

Cuddy brings George's file to Chase, Foreman and Cameron. House isn't in yet. Cuddy informs the doctors that George is in a coma, but his blood sugar is normal, his cholesterol is lower than hers, his tox screen was clean and there's no sign of trauma. The team is astonished by this news. Cuddy wonders where House is.

Well, he's in a holding cell at the police station. Frustrated, he tells Tritter to let him go. Tritter suggests arraigning him instead. Finally, Wilson appears and posts House's bail. House meets Wilson outside and Wilson immediately hands him a bottle of pills. House assures Wilson that he's innocent and Tritter just wanted to punish him.

The doctors are mulling over George's case and House's whereabouts when House suddenly pops into the office. House quickly orders the team to start treating George for Pickwickian Syndrome. Foreman counters that George's CO2 and oxygen stats are normal, but House points out that they're only normal for an average-sized person. House also wants a detailed medical history. Search his house and talk to his neighbors if you need.

George's neighbor, Sophie, allows Cameron into George's apartment. She surprised by how tidy and orderly the place. The place also has a high-end kitchen, including a wine cellar. Sophie informs Cameron that George loves cooking and frequently prepares four-course gourmet meals for himself. He also has prostitutes visit on occasion.

House is working clinic duty when he spots Tritter in the lobby. Tritter says he was merely bringing Cuddy up to speed on the arrest. Conspicuously popping a pill before Tritter, House advises him to quit while he's ahead. Tritter eyes up House, then leaves. Foreman and Cameron approach with the information that intubation and steroids have had no effect on George. Thus, they're ruling out Pickwick's. House suggests blood clots in the brain and orders either an MRI or a CT scan. Problem is, those machines have weight limits well under what George weighs. House suggests that they just start treatment then.

Knowing that blind treatment could possibly kill George, the team tries to MRI him. Cameron thinks it'll work if they just get his head inside the machine, but Foreman worries that George will break the table, ruining a million-dollar machine. Adamant that George deserves the same standard of care as anybody else, Cameron assembles a team of nurses to hoist George onto the table. Incidentally, she lies about George's weight to get them to help.

Cuddy finds House in his office and hands him contact information for the best defense lawyer in the county. The moment she leaves, House crumbles the paper and throws it out. Elsewhere, the doctors find nothing out of the ordinary on George's MRI. As they begin to weigh their options, George comes to life and starts screaming. As Foreman and Chase struggle to pull him out, the MRI bed breaks with a loud crack.

House and the team reconvene to discuss what they know. They don't know much. A calm, but angry, Cuddy enters asking about the machine. House blames his staff for disobeying his orders to start treatment. Cuddy isn't buying it, but Cameron pipes up and admits what happened. Foreman wonders about hormones. Acute adrenal insufficiency could possibly cause a coma. He wants to do an ACTH stimulation test and check George's skin for acanthosis nigricans. Cameron, focusing on the prostitutes, wants to run a full STD check. Chase suggests doing nothing, and if George doesn't get worse, figure it was a hematoma that dissipated. House considers, then decide to go with all of the theories.

Foreman and Cameron begin their tests on George, who insists he's fine. Every doctor he's ever seen has checked his hormones, then his blood pressure. And the results are always the same. He asks the doctors when he can leave the hospital. Foreman and Cameron finish the tests, then report back to House that the skin exam and ACTH stimulation were normal, and the blood and urine were negative for chlamydia, herpes and syphilis. House is intrigued by the mystery, but Foreman then reports that George is asking to be discharged.

House shuffles over to George's room, where he finds him eating dinner. House tells George that he awoke from a coma caused by an unknown condition and wanted to leave the hospital. So either George isn't in his right mind or he knows what the condition is. House guesses at various conditions, but George angrily insists that he doesn't know what's wrong. He's not depressed, he just doesn't want to stay there. House gets a cell phone call and leaves.

The call was about House's apartment, which has been ransacked. As he looks around, he sees Tritter in his hallway with two uniformed officers. Tritter coolly informs House that they're executing a search warrant. Tritter holds up an evidence bag full of pills and estimates that it must hold over six hundred Vicodin. Most DAs would say that shows intent to traffic. House scoffs, pointing out that each pill is held in a prescription bottle. Tritter agrees, but theorizes that if House is so unprofessional and unethical, maybe it's possible that some of those bottles are in other's names. Or came from forged prescriptions. Or simply stolen. But House has nothing to worry about, right?

The next morning, House instructs his team to send George home. Cameron resists, but House is more interested in tracking down Wilson and finding out what he told Tritter. Wilson assures House that he merely told Tritter he prescribed the Vicodin.

As George is wheeled out of the hospital, Cameron makes a last gasp attempt to convince him to stay. George explains that he simply loves food. Whatever is going to happen, will happen. George stands from his wheelchair and prepares to walk out of the hospital as Cameron begs him to sit. George takes a few unsure steps and then collapses through a plate glass wall.

Foreman, Cameron and House gather. Foreman explains that disorientation and loss of balance could mean a neurofibromatosis. House mentions that that's inherited, claiming one of his diagnoses was correct. Cameron argues that the disorientation isn't a key symptom. And she would know becausecshe gave George three grams of phenytoin. She didn't think he should be discharged and knew that would force him to stay.

Looking at the discharge report, House notices that George didn't eat his breakfast, which seems odds for him. Coma, fever and loss of appetite stem from Chagas. Cameron is doubtful, as George hasn't been out of the country before. House points out that his food has. House wants a sample of George's CNS to determine which bugs are in his brain. But since George is too big for an LP, they'll have to drill into his head. After some badgering from Cameron, George agrees to the test.

During the test, Foreman prods George's brain and George begins screaming that he can't see. The nurses struggle to hold him down. After the procedure, Foreman and Cameron inform House that there's no inflammation in the optic nerve and the retina is intact. There was also no sign of Chagas. House wonders if they missed a tumor in the MRI. Or perhaps it's diabetes, as evidence by the blindness and coma. He wants them to test George once more.

Cameron tries to give George some glucose water to drink, but he angrily slaps it away. They argue until George says that he's been fat all his life, but sick only recently. If she wants to look for a disease that has nothing to do with his size, he'll help them. Otherwise, leave him alone.

House meets with his new lawyer, Howard Gemeiner. Howard advise a plea bargain, which House has no interest in. So Howard quotes House his exorbitant fees, which House reluctantly accepts. When House returns to the hospital. Cameron asks how things went with the lawyer. House is disappointed that his secret is out. Moving on, Foreman says tests for MS were negative and Cameron says tests for diabetes were unperformed.

House barges into George's room and accosts him about the diabetes test. House tries to forces the glucose drink on George, who strenuously resists. As they struggle, House notices George's fingers. He limps out of the room. Cameron and Foreman follow. House orders x-rays of George's hands and feet. Then a bronchial test, a sputum cytology and a CSF check for anti-hu antibodies. House thinks George has lung cancer. When the doctors are skeptical, House asks if they've felt George's fingers. His hands are clubbed.

They take x-rays and are stunned when they realize House was right. George has ossifying periostitis on the ends of his fingers. After the tests are analyzed, Cameron enters George's room to tell him they've confirmed small cell lung carcinoma. That caused a paraneoplastic neurologic syndrome, which in turn caused the coma and blindness. It's inoperable, but radiation treatment is available. However, that will only buy him a few months. A year at the most.

In Wilson's hotel room that night, Tritter is asking Wilson if he really wrote all of those prescriptions for House. Wilson admits that House can difficult, but he truly is in pain and needs that medicine, which is why Wilson prescribed it. Tritter pulls out a few scrips and shows them to Wilson. He points out that the signatures on some of them look different from others. Tritter notes that Wilson looks surprised. Covering, Wilson says that sometimes he gets bored and signs his name differently. Tritter tells Wilson he'll give a second to reconsider his answer. Because if he's lying, they'll find out. Wilson sticks to his story. Tritter thanks him and leaves.
#54Whac-A-Mole (2006/11/21)
It's a children's birthday party at a family restaurant and arcade. A teenage waiter, Jack, rushes a birthday cake to a party, ignoring his younger sister, Kama, and her requests for more soda. The restaurant mascot comes out for the traditional birthday dance and Jack vomits all over the table in the middle of dancing. Then his heart stops.

Paramedics rush to the scene and try to shock Jack back to life. Standing with her younger brother, Will, Kama pleads with the paramedics to save their brother. The paramedics advise Kama to call their parents and Kama says that their parents died. Jack is all they have left.

Wilson emerges from his hotel in the morning to find that his car is being seized on Tritter's orders. At the hospital, the team reviews Jack's case with House. He had a heart attack, but an echo showed no abnormalities. Cameron reads from Jack's file: fatigue, night sweats and weight loss preceding heart attack. House wonders about the itchy feet also listed.

Ignoring his team, House writes his diagnosis on a piece of paper, seals it in an envelope and tapes it to the white board. He then announces a game to his team. They get one test each and the clock runs out at lunch. If House is right, Jack lives. If not, well, then it's a very cruel game.

The doctors study Jack's file, with Chase paying particular attention to the page House was on when he wrote down his diagnosis -- the patient history. When his parents died, Jack quit using drugs and quit smoking. Thinking bacterial, Chase plans to do a blood culture. Foreman's going for an MRI. Cameron is keeping her test a secret.

Chase is working on Jack when House strolls into the room. He asks Jack about his itchy feet before inquiring about the drug use. In front of his younger siblings, Jack admits to previous drug use, but says he's clean now. House thinks it's all lies.

Foreman slides Jack into an MRI. House, hovering in the control room, gets on the microphone and again presses Jack about his drug use. Then he asks how Jack managed to go from two packs of cigarettes a day to nothing just cold turkey. Foreman, finding this relevant, asks Jack to answer. Jack explains that he didn't really quit. He just sorta lost the taste for smoking. A smug House asks Foreman if he thinks that's an important bit of information.

Now it's Cameron's turn. She injects Jack with a substance to see if his heart attack was caused by a spasm in the vessels surrounding the heart. House, naturally, pops in on this test as well. House observes that Cameron's injection has had no effect.

Cuddy notices Wilson's late arrival. Wilson testily announces that his car is being held hostage until he rolls over on House for Tritter. Cuddy nervously points out that any conviction for House will cost the hospital. Wilson, still testy, tells her to relax before heading to the pharmacy to find out why all of his prescriptions have been bounced back recently. The pharmacist informs Wilson that his DEA number has been suspended. This is not good.

House confronts his team will the results of the tests. They all whiffed. But Jack did have positive titers for Hepatitis A. House wonders who ordered that particular test. It must've been somebody who knew what persistent vomiting, itchy feet and a sudden distaste for nicotine have in common. That somebody being House. Foreman points out that Hepatitis A doesn't explain the heart attack. But the puking does. And Hepatitis A explains the puking.

Wilson shuffles in with the news that the DEA revoked his prescription privileges. House tells him to relax. Tritter is just trying to squeeze him until he gives in. Wilson tells House he's going to use his team to do his prescribing until everything is straightened out. After ordering his team to start Jack on IVIG and handing his diagnosis envelope to Cameron, House follows Wilson out of the office. Cameron opens and reads what's inside. The note predicts that Chase would do a blood test for bacteria, Foreman would do an MRI and be too stubborn to check the lungs and Cameron would look for a spasm.

The next day, Foreman ambles in to Jack's room with good news. The Hepatitis A has cleared his system so they can unhook the IV and Jack can go home tomorrow. Will asks Jack if his arm hurts and Jack says it doesn't. Will asks why it's bleeding and when Jack holds his arm aloft, blood is pouring down his foreman from the IV connection. Then blood begins to trickle from his ear and nose.

Later, Foreman informs House that a high PT and PTT on Jack's blood panel have confirmed a coagulopathy. House finds it interesting that after they cured the Hepatitis A, something new popped up. He asks what infections cause DIC. Cameron mentions that kids don't wash their hands after using the bathroom. Jack's place of employment is probably teeming with E. Coli, Eikenella and strep. Chase thinks about a food-borne toxin. House orders Foreman to give Jack an LP, Chase to sample some of Jack's vomit from the restaurant and to have Cameron check the place for the diseases she mentioned.

After the meeting breaks up, House pulls Chase aside and asks for a prescription for Vicodin. When Chase resists, House makes it an order. But Chase declines, saying he'd rather lose his job than his medical license.

Wilson has pulled Cameron into his office and is running down his patients and the drugs they need. Cameron balks, saying that she'll need to examine the patients before putting her name on any prescriptions. Especially with Tritter watching them.

Behind the restaurant, Chase goes through the dumpsters with one of Jack's co-workers. The guy explains that they don't use any toxic cleaning products since kids put everything in their mouths, then directs Chase to the bin holding the trash from Jack's last day there.

Foreman performs the LP on Jack. After the procedure is completed, Foreman puts his hands on Jack's side to roll him over. One of Jack's ribs snaps and he screams out in pain. When Foreman informs House of this, and explains that he barely put any pressure on Jack, House recognizes osteomyelitis. The infection has spread to Jack's bones.

House, whose pain has been increasing without his Vicodin, has been given a new cane by the hospital physical therapy. A four-pronged metal job. The doctors are quick to mock it when House tracks them down in the lab. Foreman breaks the news about osteomyelitis to his colleagues. Jack has syphilis. But Cameron's blood test shows that he's also positive for Eikenella. As the doctors try to process this, Chase announces that his test for botulism has also come back positive.

The next morning, Foreman informs House that they managed to clear all three infections from Jack's system, but now he's having seizures every few hours. House figures he must be immuno-compromised. But his blood work was negative for HIV and lymphoma. House goes back to drug use. Despite the clean tox screen, perhaps some drugs were trapped in Jack's fat cells. With his vomiting and rapid weight loss, perhaps they've come out to play. If they can make Jack lose more weight, maybe they can trigger another attack.

The doctors sit in the hospital sauna with Jack. He insists that he's off drugs. He was high the night the cops told him about his parents and the first thing he did was laugh. That was enough to clean him up. Jack then falls to the floor and has another seizure. Foreman reports back to House that Jack was completely drug-free at the time of the seizure, and he's still having them every few hours whether he's in a sauna or not. House, figuring that something besides infection is causing the seizures, orders another brain scan.

Foreman gives Jack another MRI. His brain stem is clean. So is the midbrain. But when they cut to an axial view, they realize that Jack's brain is now riddled with tumors. The doctors press House to start radiation treatment, but House has two concerns. First, the radiation would destroy the little immune system Jack has remaining. Second, he finds it hard to believe several tumors just suddenly appeared from nowhere. Maybe it's fungus. He instructs the team to stick a needle in Jack's brain and make an extraction. If it's liquid, he's right. Solid, they're right. With that, House pops his last remaining Vicodin and angrily tosses the empty bottle in the trash.

House barges into Cuddy's office and asks for a Vicodin prescription. Cuddy smiles, knowing if House is approaching her, his staff stood up to his bullying. Cuddy pulls out her pad and writes a scrip, acknowledging that if she cuts him off, the police will assume House doesn't really need the meds. But before she hands over the paper, Cuddy notices House massaging his aching shoulder. That's a change. She asks him what's changed in his life recently. House stops. He's on the verge of an epiphany.

Foreman returns from the brain surgery on Jack. The marks on the MRI were abscesses from a fungal infection. Aspergillis. Thinking that his parents' death could be enough of a trauma to trigger Jack's genetic illness, House begins running down everything that's gone wrong. He decides that they need to introduce new infections and see what happens.

House informs Jack that each of the four possible genetic conditions is most susceptible to a different type of infection. House pulls out a spray bottle from his pocket. Inside is a cocktail of serratia, meningococcis, cepacia and rhinovirus. Whichever germ strikes first will give them their answer. If it's meningococcis, Jack will have another seizure. Serratia will shut down his lungs. Cepacia means a heart attack and rhinovirus means... he'll sneeze. House spritzes Jack's face.

The doctors begin shifts at Jack's bedside. Hours later, his lungs begin to shut down. Serratia wins. The next morning, House pronounces it Chronic Granulomatosis Disease. Jack needs a bone marrow transplant to reboot his immune system. Fortunately, Will is a match. But when Foreman explains the situation to Jack, he's angry that the doctors pressured his younger brother. Foreman tries to persuade Jack to consent to the transplant, explaining that Jack will constantly get sick from the germs he'll contact every day. He'll constantly be in and out of the hospital. Jack agrees to the procedure, but not until Will is 18 and can decide for himself.

House scoffs at Jack's decision. He thinks he's running from something. House brings Foreman back into Jack's room and tells Jack they found a bone marrow match in the registry. No Will, so they can proceed. Jack counters that he could die, but House sees through this. He keeps pushing Jack until he breaks down and admits that he's too young to be a father to Kama and Will. Having proven his point, House leaves Foreman and Jack alone in the room.

That night, House finds Wilson in his office. Wilson announces that he's shutting down his practice and referring his patients to other oncologists. House chides him for overreacting and Wilson erupts, screaming that he can't put his patients on hold while waiting for House to release Cameron from her duty to sign prescriptions. House sarcastically asks if he should turn himself in and Wilson snaps that that's exactly what he should do. Show Tritter some remorse. Promise to get help. House bristles that he doesn't need any help. Wilson tells him to get out.

Elsewhere, a social worker stands in Jack's room with Kama and Will. Jack tries to sell them on the orphanage and promises that he'll still be able to see them. Foreman is crushed as he observes this moment from the hallway.
#55Finding Judas (2006/11/28)
A man named Rob doesn't understand why his daughter Alice is not interested in the rides at the carnival. On one ride, the little girl begins clutching her stomach and screaming in agony.

At the hospital, Rob argues with his ex-wife, Edie, about taking Alice on the ride. Cameron is more interested in Alice's medical history, which does not indicate any abdominal problems. Edie snipes that Rob only had Alice for two days and she ended up in the hospital.

House pulls Cuddy out of a meeting with two potential financial donors. He wants his pills. She walks over to the pharmacy, grabs a cup with two Vicodin in it and hands it to House. His days of free-flowing pills are over. No doctor in the hospital will make a move now that Tritter is watching them.

As the doctors mull over Alice's case, House barges into the office, heads straights to a textbook where he has hidden a bottle of pills cut inside the pages. House then takes a quick glance at Alice's CT scan and declares gallstones. Although six year-olds don't get them, they could be vanishing gallstones. He considers that Alice had one and it passed, but more are probably hiding in her gallbladder. House orders an ultrasound. If he's right, they can remove the gallbladder in order to biopsy the stones.

The team performs the ultrasound and they bicker over Chase's eagerness to adhere to House's instant diagnosis. Yet Alice does indeed have gallstones. Chase breaks the news to the parents, along with the plan to remove Alice's gallbladder for a biopsy. Rob quickly agrees to the procedure, but Edie doesn't.

Cuddy finds Tritter in an office poring over boxes of files. She accuses him of making this personal, and asks if he thinks Wilson deserves to have his life turned upside down. Tritter says this is how he gets what he wants. If squeezing Wilson doesn't work, it will eventually work on Foreman or her.

House berates Edie for refusing to consent to Alice's surgery. Edie stands her ground, pointing out that gallstones are basically harmless. House brings a judge into the hospital and attempts to bully the woman. The judge turns to Cuddy for her opinion on House. Cuddy agrees with the judge that House is indeed a jerk, but he does know what he's talking about. The judge orders the surgery.

The procedure goes well, but the biopsy is negative. Edie bitterly points out that her opinion about the surgery as unnecessary has been proven correct. Alice begins complaining that her stomach hurts, so Foreman takes a quick peek. He finds a blistering rash breaking out across her midsection.

The next day, House questions the team about the rash. His doctors are more concerned with why their bank accounts have been frozen. They demand that he talk to Tritter and do something about their money. House tries to get past this, and he instructs his team to do a scratch test on Alice for allergies, which is what Cameron suspects. When the allergy tests are negative, they are to start broad-spectrum antibiotics. House thinks it is a bacterial infection.

The scratch test gets many results. Each one has come back with a positive allergy result. Looking at Alice's back, House still rejects allergies and points to bacteria as the cause. He is sure that bacteria got into the scratches. Chase insists that infections radiate, which isn't what Alice's rash is doing.

House gives Alice of bite of the peanut butter sandwich he's holding. He then asks Foreman and Chase if Alice is allergic to everything except peanuts. Chase points out that if she is allergic, then antibiotics could cause a massive reaction. House again insists that she isn't allergic. Chase moves to grab the antibiotics, but Foreman stops him. He tells him that he is correct and should stand up to House for once. But before Chase can start an IV, Rob steps in and refuses to allow it.

The case is reverted again to the judge, and House argues against the father's decision. The judge becomes tired of House contrasting the parents on every decision and she grants temporary guardianship to Cuddy. Against using broad-spectrum antibiotics in the event that Alice is allergic, Cuddy decides to allow just one antibiotic -- metronidazole -- as a test.

Tritter interrogates Foreman and mentions Foreman's brother, Marcus, who is doing time on a drug charge. If Foreman testifies against House, Tritter will see to it that Marcus is free within two months. Foreman still doesn't budge. Tritter observes that Foreman is just as cold as House. Yet he is convinced Foreman will take this deal because he hates hypocrisy. House has had a thousand chances, and Foreman himself has had a couple. Marcus only got one chance.

Cuddy checks in on Alice, who sleeps peacefully. There doesn't seem to be any reaction to the metronidazole. The parents fight about Rob's decision to withhold antibiotics and Edie angrily declares that she's suing for full custody as soon as they get out of the hospital. Alice's heart starts racing and her blood pressure rises. Cuddy realizes that the parents' arguing is giving Alice an anxiety attack. She kicks them out of the room.

The next morning, Chase announces that Tritter froze his accounts as well. Edie comes into their office wondering where Alice and Rob are. Chase rushes off to get security and sees Rob holding an unconscious Alice in his arms. She's as stiff as a board.

House mocks Cuddy's decision to skip broad-spectrum antibiotics. Foreman injects Alice with diazepam to relax her and points out that muscle rigidity is almost exclusively neurological. Cameron guesses at neuroaxonal dystrophy. Ignoring the patient, House starts yelling at Cuddy to give him more pills. She refuses.

House accosts Rob and Edie about which one of them gave Alice an aspirin. He believes that Alice has Reye's syndrome. When a child with an infection takes adult aspirin, it affects the brain and liver. Neither of them did, but Edie says that a babysitter might have administered them the night before she came to the hospital. House orders Cuddy to put Alice on charcoal hemoperfusion, and then he demands more pills for himself. Cuddy pulls a bottle out of her pocket and taps two pills into House's palm.

Cameron gets her turn to sit down with Tritter. She refuses to participate, so Tritter brings up her past. She used to be somebody who always did the right thing until she starting working with House.

Chase meets with Tritter in the hospital cafeteria. Tritter explains that he's going to unfreeze Cameron and Foreman's accounts, but not Chase's. They both know that Chase's account never was frozen. Chase lied about that to the others so it wouldn't look like he had been singled out. Yet now that the accounts are open, people will notice the two of them having a very pleasant lunch in the cafeteria. House will eventually put two and two together.

Cuddy explains the procedure to Alice. The little girl admits that she is scared of her parents. As soon as she's better, her parents will split up again. As the procedure is underway, Alice starts screaming that her arm hurts. Foreman suspects it might be a clot, so Alice is rushed into surgery.

Foreman successfully removes the clot, but Alice's body temperature begins increasing. The O.R. is out of ice packs and cooling blankets, and they need to cool Alice down before her brain melts. Cuddy yanks the wires out of the monitors and takes Alice into her arms. She rushes the girl into a cold shower. Cuddy shows House the rash that has returned to Alice's arm. Increasingly tense over his pain and the Tritter debacle, House angrily declares that he was right about the broad-spectrum antibiotics. He then icily tells Cuddy it's a good thing she failed to become a mother because she sucks at it.

House launches into a differential diagnosis with the team. With the arm rash, they never treated Alice's arm. Yet now it is so intense that simple antibiotics won't work. The team has no answer. Cameron says that Tritter released their accounts. The team all suspects that somebody talked. Cameron finally throws out Rocky Mountain Spotted Fever and House orders doxycycline as a treatment.

The next morning, Foreman reports that the treatment didn't work. The rash is getting worse and spreading to her leg. House thinks that the infection has morphed and moved into Alice's muscle sheath. Foreman realizes that House is referring to necrotizing fasciitis, for which there is no cure. The only treatment is amputation. The team is loathe to amputate Alice's arm and leg with a confirmed diagnosis. House points out that they've waited too long and don't have time for a culture. If the rash spreads, Alice will die. The doctors continue to resist. House, in physical agony, snaps that just because Alice is cute doesn't mean she cannot have flesh-eating bacteria. Cute kids die and innocent doctors go to jail. He remarks that cowards like Chase, Foreman and Cameron won't stand up and do what's right.

House stomps into Cuddy's office looking for pills and the consent to amputate Alice's limbs. Cuddy and House break the news to Rob and Edie. They realize they have no other choice. Alice is sent into surgery. At the same time, the doctors sit in their office complaining about House. Cameron, still thinking about Alice, mentions the rashes. Perhaps Alice is allergic to surgical equipment. Chase, bored, begins shining a laser pointer on Foreman. Foreman complains that he's going to burn his retinas. Chase suddenly has an epiphany.

Chase races out to the lobby and finds House, shouting that he has to stop the surgery. Alice doesn't have necrotizing fasciitis. She has erythropoietic protoporphyria, which is a genetic condition that makes her allergic to light. Alice got worse every time she went under surgical lights. When Rob took her outside, she stiffened. House tells Chase to get out of his way. When he doesn't, House punches Chase in the face. Even House seems shocked by what he just did. Chase is still focused on Alice, and replies that light damages the blood cells. The damaged cells contain protoporphyrin build-up in the liver which shuts it down.

The call comes into the operating room as the scalpel moves toward Alice's shoulder. The surgeon stops just in time. Cuddy explains to Rob and Edie that Alice has always had this genetic condition, but it reaches critical mass around this age. Alice's life will be complicated but she'll live. When Rob and Edie ask how their daughter contracted the disease, Cuddy lies and says that both parents must be carriers to pass the disease along. She fears that another argument will break out.

That night, Chase finds Wilson in the doctors' lounge. He mentions that House screwed up Alice's case, but Wilson says that has happened before. Yet this time, when Chase told House what Alice's real condition was, House simply didn't care.

Wilson approaches Tritter and tells him he's going to need thirty pieces of silver.
#56Merry Little Christmas (2006/12/12)
House limps into the hospital on a snowy day. The Christmas decorations in the lobby do not warm his icy heart. Neither does the sight of Wilson and Tritter waiting for him. Wilson explains that he worked out a deal after he told Tritter that he didn't write the prescriptions. The D.A. is offering House two months in a rehab facility in exchange for a guilty plea. House coldly tells them to get out of his office. Tritter says that he only has three days to make a decision.

House barges in on Cuddy as she is seeing a clinic patient, who is a 15-year old dwarf named Abigail. The mother of the girl, Maddy, is equally diminutive. House demands his pills from Cuddy and offers to take the case in exchange. He rudely assumes that it is relatively simple because the girl has a popped lung. Maddy notes that both she and her daughter have Cartilage-Hair Hypoplasia. House grabs the case file, again asks for his pills and retreats to the office to find his team.

The team would rather talk about Wilson's deal with Tritter, and they think House should take it. House moves on to the unexplained lung collapse and anemia. Realizing that many dwarves have compromised immune systems, rendering most tests inapplicable, House schedules a gallium scan.

Cameron explains to Abigail that gallium is a radioactive isotope that will travel through her veins. Any bright spots that show up could indicate infection. While Cameron is setting up the test, House and the mother continually fire jabs at each other. Maddy gives just as good as she's getting. House is quite amused and intrigued by this little firebrand.

Cuddy upbraids Wilson for making a deal with Tritter without consulting her first. He knows that House will never take any deal. Wilson suggests they stop House's Vicodin supply. When the pain becomes unbearable, offer him pills in exchange for taking the deal. Cuddy worries about the effect House's detoxing with have on his patient.

The gallium scan on Abigail shows nothing. Although House thinks the liver scans out, every part of the girl's body is glowing brightly in the scan except for the liver. Why? Cuddy rips into the office and announces that House is off the case. Furthermore, his treatment privileges have been revoked until he accepts Tritter's deal. She's also cutting off his Vicodin and taking over Abigail's case herself. Her first order of business is an MRI of Abigail's lungs. The team exits and House warns Cuddy that she's going to come to him begging with help on the case long before he comes to her begging for pills.

The MRI is clean, but Abigail begins vomiting blood during the test. House was right about the girl's liver failing. The team will perform a liver biopsy in search of cirrhosis, hepatoma or other causes. Foreman sneaks word to House that his thoughts on the liver were accurate in the hopes that House will point him in the right direction. House offers him one theory in exchange for Foreman jimmying open one drawer for him. If that drawer just happens to be where Cuddy is hiding Vicodin, so be it. As Foreman works to pick the lock, House explains that the problem Abigail has is global. It started in the liver but will spread in short order. He should focus on the pancreas. House eagerly opens the drawer, but there's no Vicodin inside.

Cuddy returns with the results on the test that Foreman ordered. It was negative. Cuddy and Wilson are quite aware that Foreman was led in this direction by House. The liver biopsy indicated severe duct inflammation, so it's time to turn their attention back to the liver.

House sits in an examination room at a 24-hour clinic. He claims he had a fall and Princeton-Plainsboro discharged him with directions to a clinic. The clinic doctor offers some pain medication and House invents various reasons that different prescriptions won't work to steer the doctor toward Vicodin. However, the clinic isn't allowed to prescribe opiates to new patients. Enraged, House rails that gabapentin -- the doctor's original drug recommendation -- is for nerve damage. Realizing that House is a medical professional, the clinic doctor calls security. House shuffles out.

Foreman and Wilson prepare Abigail for her next liver test, but she falls unconscious. Checking her airway, Foreman notes that her breath smells fruity. Wilson recognizes diabetic ketoacidosis. Abigail's pancreas is failing, as House had predicted. Grasping for answers, Cuddy orders an LP for lymphoma as well as an antibody test for lupus.

Cameron sneaks off to House's apartment to talk about Abigail. When he opens the door, Cameron is shocked that he's in such bad shape. Noticing a cut on his arm, she forces her way in. She cleans the cuts and sees that each is straight. House cut himself on purpose because it releases endorphins and endorphins relieve pain. House asks if Abigail has been sick lately, then suggests Still's disease.

When Cameron returns to the hospital, Cuddy asks what House said. She is the one who sent Cameron to him. Her report of Still's disease is disappointing because it is virtually unable to be confirmed. Cuddy asks how he is doing. When Cameron pointedly says they can trust his judgment, Cuddy orders the treatment.

House ambles into the hospital and asks Wilson for a prescription to help stop the vomiting from detox. Wilson advises him to go into rehab, where he can get the drug. House checks the case file that Wilson left behind, then barges into a room where Wilson is consoling an elderly widow whose husband just died. House makes a racket about being strung out and still able to come up with a better diagnosis than Wilson. The widow begs him to leave and he heads out. Wilson realizes that House could've made this scene anyway. He searches House's pocket and finds a bottle of oxycodone that House stole from the dead man's bedside. Wilson asks House if he's sure that he doesn't have a drug problem. In shame for once, House limps out.

Cuddy tells Wilson that Abigail is responding to treatment and that House's diagnosis was correct. Wilson is despondent that he never even considered Still's disease. Later, Wilson sees Tritter. He argues that drug addicts hurt people, but House saves lives and makes right decisions that nobody else could ever make. Wilson won't testify against him. Tritter threatens that, based on previous statements, Wilson will be sent to jail. His refusal to testify won't protect House, either.

Cameron is called to Abigail's room when the girl starts bleeding from her mouth and ears. House heads to the hospital pharmacy to pick up a prescription. The pharmacist points out that it's for Dr. Wilson. House claims he's picking it up as a favor, badgering the pharmacist into handing over the pills. Drugs in hand, House retreats to a lonely stairwell and immediately pops some pills.

Abigail is on the verge of a multi-system failure and the doctors have no idea why. Cuddy tracks down House in the hospital cafeteria and tells him that the diagnosis was not Still's disease. They are desperate for answers, so she offers him pills in exchange for a look at the case. Yet he is acting loopy enough to alert Cameron to the fact that he found some pills already. Ignoring Cuddy and talking to a young girl in the cafeteria, House has an epiphany. They need to x-ray Abigail's leg.

The leg is more than fine. It has normal growth plates, which should be impossible in a dwarf. Wilson is still trying to figure out how House got his hands on more pills. Barreling ahead, House explains that they all assumed Abigail was a dwarf because her mother is one. Because Abigail doesn't have the skeletal structure of a dwarf, she clearly has a growth problem caused by a pituitary issue. The only thing that connects pituitary problems with the lungs, liver and pancreas is Langerhans cell histiocytosis, which is a group of idiopathic disorders. The doctors' hunches about cancer or autoimmune issues were both somewhat correct.

Popping a few more pills, House explains the issue to Abigail and her mother. With some chemotherapy, the removal of Abigail's granuloma and a round of growth hormone pills, Abigail will begin to grow to a normal size.

That night is Christmas Eve. House sits at home, staring at a pill bottle. He picks up the phone and leaves a message to his parents, wishing them a Merry Christmas. Then he hangs up and downs more pills before chugging a glass of whiskey. On Christmas morning, Wilson comes by and finds House face down on the floor in a puddle of vomit. Next to him is the prescription bottle that House stole from the pharmacy. Wilson recognizes the name of his dead patient on the label of the empty bottle.

Later that afternoon, having scraped himself off the floor, House swings by Tritter's office to take him up on his offer. Yet the deal is now off the table. Tritter has found some new evidence and no longer needs Wilson to bring down House. Tritter saw the pharmacy log and noticed that Wilson's dead patient picked up his oxycodone. House realizes that he is in serious trouble.
#57Words and Deeds (2007/1/9)
As emergency workers struggle to douse a raging blaze, a firefighter named Derek Hoyt walks out of the burning building intact. Suddenly, he gasps for air and becomes delirious. When he staggers back towards the building, he complains of being freezing.

Cameron examines Derek, who is covered in skin grafts. His last procedure was six months ago. His body temperature is wildly swinging up and down. She wants to refer him to House, who is currently at a preliminary hearing pleading not guilty to all charges. The judge sets an evidence hearing for a later date.

Back at the hospital, House gets the details on Derek's case. Thinking of the skin grafts, Chase suggests a hospital-acquired infection. House orders a blood culture and a round of antibiotics. Cuddy summons House to her office and orders him to talk to Tritter. She blames the entire situation on House. Tritter kept setting traps for him, and House continually fell into them. House actually seems somewhat chastened.

Cameron visits Derek and explains they think he has Mercer Disease, a common bacterial infection contracted in the hospital. Derek asks if Mercer makes everything look blue. Cameron immediately realizes that it's something else entirely. House suggests male menopause or really high estrogen and low testosterone levels. He instructs his team to run a hormone panel.

The doctors attempt to draw blood from Derek, but when they get the needles into his arms, he freaks out and demands that they be removed. He grabs Cameron and begins choking her as Foreman tries to restrain him. Foreman injects a sedative and Derek goes limp.

A very contrite House pays a visit to Tritter. He admits that he can be described as anything from arrogant to unhinged, but he has to act that way because of the constant, crushing pain he deals with. His pain can be described as intolerable only on a good day. He knows that he has handled it incorrectly. Tritter thanks him, but is sure that House didn't mean a word of it. Tritter says he will see him at the hearing.

Back at the hospital, the team updates House on Derek's case. They insist it has to be neurological. Foreman wants a CT for a frontal lobe tumor and an LP for meningitis. An absent House agrees and leaves. The team chases after him, wondering why he isn't shooting down their ideas. He says it is because he has to go upstairs and check himself into rehab.

Without House, the team starts their first differential diagnosis. Cameron immediately wants to consult House, but Foreman and Chase think this is their chance to grow up. And with House undergoing detox, he won't be much help. Chase recalls an old House comment: "Everybody lies." With all of the skin grafts Derek has had, he must be in tremendous pain. He must be hiding his pain to keep his job. They need to find the pain. Suddenly they are paged. Derek cannot breathe.

Chase quickly recognizes a heart attack and they stabilize him, but realizes it won't last long. Derek has been hiding a series of chest pains. Now they have to figure out what's causing these attacks. Cameron goes to see House and finds him puking in his rehab dorm room. House advises them to look for an external or environmental cause that all three attacks share in common.

After some thought, the doctors summon Derek's firefighting partner, Amy. Derek then suffers another attack. The doctors perform a battery of tests on Amy, who's clean of any spores, molds, toxins or possible physical causes. Cameron asks Derek if he's in love with Amy. He is unable to admit to it because Amy is engaged to his brother.

The team reports back to House to figure out a plan. When they theorizes that the only way to cure Derek is to end his love for Amy, House has a radical solution. They can fry his brain to clear any thoughts of Amy. A procedure like that will need Cuddy's permission, and the doctors are actually able to talk her into it.

Cameron explains the planned procedure to Derek. This electroshock therapy will wipe out Derek's memory. His feelings for Amy, his firefighter training and his childhood. Cameron begs Derek to tell Amy how he feels. If not, he's choosing to wipe out his entire life for a secret.

Tritter pays a visit to House in rehab because Cuddy goaded him into it. He's still not going to talk to the DA. House rails that Tritter's word means nothing. Tritter says he'll never trust an addict, and even House's actions lie.

The doctors perform the procedure on Derek and then test his mental faculties. They bring Amy and his brother in. Derek has no memory of either of them. The team informs House that everything has basically worked out. Later, Cameron and Amy observe Derek through a window. Cameron congratulates Amy on her upcoming wedding, but Amy has no idea what Cameron is talking about. She's not marrying Derek's brother nor do they even date.

The doctors place an emergency call to House, who's at his evidence hearing. Derek's memories were false. They fried his brain for nothing and whatever was plaguing him is still there. They talk through the symptoms and House orders his team to set up Derek with a selective vertebral angiography. As House limps out of court, the judge threatens to find him in contempt. He leaves anyway.

House has realized that all of Derek's issues go back to the initial thoughts on menopause. The test reveals spinal meningioma pressing on an artery and affecting Derek's brain. They need to schedule surgery to remove it.

At the trial, Cuddy is on the stand when House barges back in. The DA shows Cuddy the pharmacy log and asks if this indicates that House stole oxycodone from Wilson's dead patient. Cuddy explains that it does not. The DA states that Cuddy testified earlier that it did, but she presses on. Dr. Wilson informed her that House had tried to steal the same patient's oxycodone before, so Cuddy went down to the pharmacy and swapped out bottles. House stole a placebo. She has a pharmacy inventory report reflecting her order. Tritter vehemently protests that this report is obviously forged. The judge asks why Cuddy didn't come forward with this evidence earlier. Cuddy admits that she never thought it would come to this point. The judge, while making a point to chide House, declares that Tritter tried to make an example out of House and dismisses the case based on both Cuddy's testimony and her efforts to protect House. However, House is still guilty of contempt for walking out earlier, so it's a night in jail for him.

As the bailiff leads House out, Tritter stops him. House bristles for a threat, but Tritter merely wishes him luck and says he hopes he's been wrong about him.

At the hospital, Cameron explains to Derek that this latest treatment has worked. He can move on and begin creating new memories.

That night, Cuddy and Wilson visit House in jail. Cuddy is angry that House forced her to forge evidence and perjure herself. She makes it clear that she owns him now. It may entail clinic duty, unruly patients or extra hours. Whatever she wants, he's going to do it. She walks off. Wilson slips House a cup of medication from the rehab supervisor. House greedily gulps it down. Wilson realizes that the rehab supervisor has been slipping House Vicodin. House smiles, proud of his scheme. Wilson, distraught and despondent, worries that nothing has changed.
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