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House MD - 3.13 Needle in a Haystack

Originally Aired: Feb 6 2007

Written by: David Foster
Directed by: Peter O'Fallon

Transcribed by: Jane (poeia)


DISCLAIMER: We don't own "HOUSE." It's owned by FOX and NBC/Universal, and produced by Heel and Toe Films and Bad Hat Harry Productions. This transcript is unofficial, and should UNDER NO CIRCUMSTANCES be copied or distributed, especially for commercial use.



[After a snowstorm. Car parked in plowed spot. Frosted over windows. Cut to interior. Leah and Stevie are making out.]

Stevie: Wait. We shouldn’t…We shouldn’t be doing this.

Leah: What? You’re not having fun.

Stevie: (laughing) It’s not that. I just…

Leah: You’d rather be with the boys?

Stevie: No!

Leah: Well then, come on.

[Knock on car window. Leah sits up and lowers the window. A flashlight shines in on Stevie.]

Cop: You kids need any help?

Leah: No. No, we’re fine.

Cop: Car trouble?

Leah: No.

Cop: Then why are you here?

Leah: Uh, we’re just talking.

Cop: Does she do all the talking?

Stevie: Uh. Most of it.

Cop: (laughing) I know what that’s like. I’m going to come back through here in ten minutes. And, if you’re still here, I’m going to call your parents.

Stevie: Yes sir. Thank you.

[Leah rolls window back up. They laugh.]

Leah: Now, where were we?

Steve: We were going.

Leah: Nine minutes. (She takes off her shirt, lays on him and starts kissing his neck. He’s not enjoying it. Makes noises like he’s having trouble breathing.) Sweetie, what’s wrong? Oh my god! (Opens car door and goes out, shouting) Help! Someone help me! (Stevie continues to choke as Leah runs around to driver’s seat and gets in.)

OPENING CREDITS

[House, driving a blue 4-door on snow-covered streets, stops and looks at sign “Parking for J. Whitner, M.D.” Confused, he looks around and sees space with “Parking for House, M.D.” He pulls into the space and steps out into a puddle. Unfolds collapsible cane and squishes down a hallway in PPTH. Foreman joins him]

Foreman: Sixteen year old. Respiratory arrest.

House: The only thing I hate more than a thief is a crippled thief.

Foreman: Yeah, me too. No sign of trauma. No history of asthma or allerg…

House: (interrupting) Who the hell is J. Whitner?

Foreman: No idea. Stevie Lippa, his EKG and Echocardiogram were normal.

House: Normal is good. Send him home. (Entering Diagnostics Office.) J. Whitner. Doctor. Who is he and where do I find him?

Cameron: She’s a new researcher. Works with Erechevsky.

Chase: Is she hot?

Cameron: She’s in a wheelchair.

Chase: Doesn’t mean she’s not hot.

House: Just means she can’t bend over. So Cuddy has to bend over backward.

Foreman: Sixteen year old kid. ER workup revealed a bloody pleural effusion.

House: That’s odd.

Foreman: Yeah. That occurred to me.

House: What took you so long to mention it?

Foreman: No tumors or pneumonia on the CT.

Chase: He passed out while making out. If he’s into sex, drugs and rock and roll can’t be that far behind. I’m guessing cocaine.

Foreman: Tox screen was clean.

Cameron: Just means he wasn’t on drugs, not that he hasn’t been using drugs.

House: (Looking at scan on light board) Looks like a plumbing problem to me. Leaky pipes.

Foreman: If he popped an aneurysm he’d be in the morgue, not the ER.

House: That’s why you’re going to do a venogram instead of an arteriogram. This isn’t a high pressure burst, it’s a low pressure leak.

Chase: It still could have been drugs that cause the pipes to corrode in the first place.

House: So go look under his mattress. See if he’s got any pills or powders stashed with the hand lotion.

[Cut to lab. House looks at door, operates automatic door opener. A woman in a motorized wheelchair approaches.]

House: Sweet ride. I asked for the one with the sissy bar and the banana seat but Santa gave me this instead. (shows cane) I guess that’s what I get for being naughty.

Whitner: You must be Dr. House.

House: Yeah. So, looks like there’s been some sort of mix-up at the parking office.

Whitner: They had to move me closer to the door.

House: Had to? You don’t look like the type to pull a weapon.

Whitner: Wheelchair.

House: Cane. I think you should do the honorable thing. Let me have my space back.

Whitner: Oh, well, uh. Since you ask so nicely…wheelchair.

House: Cane. Walking long distances makes my leg hurt.

Whitner: And it’s easy for me.

House: Course not. Pushing that little lever. Thumb muscles must burn. I’m sure the last ten yards are pure torture.

Whitner: Crossing the parking lot is dangerous. Cars can’t see me.

House: You ever hit a patch of black ice with a cane?

Whitner: No. Gosh, on account of the fact that I can’t walk. Maybe you should ask the parking office for some crampons.

House: This is about who can most easily cross the parking lot. You’re the winner.

Whitner: Oh, and the prize is apparently a parking space. (House leaves)

[Cut to Stevie’s room. He is coughing. Leah is holding his hand.]

Foreman: There’s still no answer at either one of your parents’ cell numbers. Is there any other way we might be able to contact them?

Stevie: No. They’re at a conference. They probably had to turn them off or something.

Leah: What does it matter where they are? I mean he’s in pain. You gotta do something.

Foreman: We need them to sign this.

Leah: Why can’t he just sign the papers? He’s sixteen.

Foreman: Still not an adult.

Leah: Then call my parents. They know him. And they’ll take responsibility, do whatever you need.

Foreman: I can’t.

Leah: You can’t just let him sit here in agony until his parents finally decide…

Stevie: Leah, it’s okay.

Leah: No. It’s not.

Stevie: I feel like there’s an anvil sitting on my chest. (Monitor alarm goes off. Foreman pulls out stethoscope and listens to Stevie’s chest.)

Foreman: You win. We’re doing the venogram now. We’ll deal with the fallout later.

[Cut to procedure room. Stevie’s veins are projected on screen.]

Stevie: My fingers feel wet.

Foreman: That’s just the dye. Your nerves can’t tell the difference between the cold inside your body and the wet outside your body.

Stevie: The nerves can’t tell the difference or the brain can’t interpret the difference?

Foreman: A little of both. You like science? (Pulls the screen closer with his foot. Stevie looks at it.)

Stevie: Looks like a diffusion pattern.

Foreman: That’s because it’s the venous side. Low pressure.

Stevie: So Graham’s Law applies.

Foreman: You taking physics already?

Stevie: No. Just sort of read up on my own.

Foreman: Had to teach myself a lot of stuff too. School sucked where I grew up. You go to public or private?

Stevie: Public. Nick has to be in the pulmonary veins to get in my lungs, right?

Foreman: Yup.

Stevie: I don’t see anything, do you?

Foreman: No.

Stevie: Doesn’t make sense. How can I have a bloody effusion without any bleeding?

[Cut to a house. Chase enters, followed by Cameron.]

Cameron: This is putrid.

Chase: Put food-borne parasites and infections on the list to check on. I’ll take the bedroom.

[Cameron continues to walk through the downstairs as Chase goes upstairs. Cut to Chase opening a door.]

Woman: Oh. (Couple in bed. She falls out. They pull covers around themselves during following.)

Chase: Oh. Sorry. I didn’t know there was anyone… We were just…

Woman: I have a gun.

Man: Look, you can take whatever you want. My wallet’s in my suit. (Cameron runs upstairs.)

Woman: Freeze. (Cameron jumps and puts hands up.)

Man: I’m calling the cops.

Chase: Okay. You don’t have a gun. And you’re not calling the cops.

Man: Oh no, I’m calling the cops. Unless you two get out of here right now.

Chase: Unless? Who calls the cops “unless” a burglar does something. You don’t want to have to explain the affair.

Woman: We’re not having an affair.

Chase: He’s got a ring. You don’t. And judging from the state of the kitchen downstairs and the half-vacuumed bedroom, I’m guessing you’re a better lover than you are a maid.

Woman: Maid? You son of a bitch. I’m not a maid, okay? This is my house, not his.

Chase: Ah, sorry.

Woman. And what’s wrong with my kitchen?

Cameron: Nothing. We’re sorry. We’re just here to help Stevie.

Woman: Who’s Stevie?

Cameron: Your…son?

Woman: Huh?

[Cut to Stevie’s room.]

Chase: It was the address you gave.

Stevie: The ER must have written it down wrong.

Cameron: Or you lied because you don’t want us to talk to your parents.

Stevie: I gave you their phone numbers.

Foreman: You gave us some numbers. We haven’t been able to reach anyone.

Stevie: I told you, they must be in a conference.

Leah: He’s lying.

Stevie: Leah.

Leah: He’s Romany. A gypsy.

Cameron: So you don’t have a home?

Stevie: Of course we do. What, next you’re going to ask about dancing about campfires and stealing children? This is why I don’t tell people.

Leah: They share everything with each other and nothing with the gadje. The outsiders.

Stevie: Sharing information with outsiders has not gone so well for my people.

Foreman: Well, right now, you’re making you more vulnerable by lying to us.

Stevie: You can’t go to my house. You’ll pollute it.

Foreman: All we’re going to do is look around.

Leah: Your presence is enough.

Stevie: My parents take it seriously. It’s spiritual as much as it is physical.

Chase: (to Leah) You know where he lives?

Stevie: Don’t. Look, I’ll tell you whatever you need to know.

Chase: If we can’t trust your answers…

Stevie: I drink sometimes. Okay, I’ve smoked pot. I’ll tell you anything. The truth. You just… (coughs) you can’t go in my home.

Cameron: The pot wouldn’t cause a bleeding problem. A pesticide on the pot could. Where did you get it?

Stevie: Some kid at school.

Leah: Stevie! He got the pot from me. He doesn’t even go to school. His parents made him drop out.

Stevie: I’m home schooled.

Leah: He reads books.

Foreman: What else are you lying about? Is your father really a professor?

Stevie: He’s a salesman.

Leah: They buy and sell anything they can get their hands on.

Foreman: They. So you’re with your dad while he’s making these deals.

Leah: He was just in Chicago, a week ago.

Foreman: You fly?

Stevie: No. My dad’s got a truck.

[Cut to Cuddy’s office]

Cuddy: (laughs) You can’t be serious.

House: Actually I can. (Makes “serious” face) See. It’s my space and I want it back.

Cuddy: It’s not your space. It’s the hospital’s space. And the hospital thinks the person who’s worse off should get the better space. Your application for a handicapped space says you can walk 50 yards.

House: And Whitner’s says she can roll 50 miles between oil changes. I can’t change my leg.

Cuddy: The space I moved you to is only 46 yards away from the front door. I measured. You’ll be fine.

House: Great. So I can collapse four yards into the lobby instead of outside in the cold.

Cuddy: As long as it’s not in my office.

House: You know who won the New York City marathon six years in a row? Guy in a wheelchair!

Cuddy: Then go get yourself one and leave me alone.

House: Give me my space, I’ll be happy to roll around in one all day.

Cuddy: You couldn’t last a week in a wheelchair.

House: Wanna bet?

[Cut to wheelchair in a hallway. Pan up to see it is House. The fellows approach.]

Cameron: What’s wrong with you?

House: Nothing that a week off my feet won’t solve.

Foreman: Venogram’s negative. No leak.

House: You mean you couldn’t find the leak.

Cameron: Is your leg worse?

House: No. My parking spot is. Blood is only made inside the circulatory system. Which means when you find outside…

Foreman: There’s no leak. I even checked lymphatics.

Cameron: You’re going to spend a week in a wheelchair just to get a parking closer to the front door.

House: Easier than chopping off my legs.

Foreman: We’ve ruled out toxins and drugs.

Chase: Kind of. He’s Romany. Apparently they feel the need to keep secrets so it’s hard to know anything for sure.

House: Yeah. He’s also a human being. Which means you shouldn’t be trusting him to begin with. Stop relying on his answers and find some on your own.

Foreman: It’s a deep vein thrombosis. The kid spent 16 hours in the back seat of an old pickup. Causes a clot and makes its way to his lungs. We should do an arteriogram and find the clot and bust it with tPA.

House: Or we should find the leak.

Foreman: There’s no leak.

House: Hey. You can’t yell at a guy in a wheelchair. This is a slow leak. You gotta speed it up. Thin his blood, redo the venogram.

Cameron: That could cause a massive bleed.

House: (backing onto elevator) Excellent. Massive will be even easier to find. Pardon me. I guess you guys are going to have to get the next one.

[Cut to procedure room]

Stevie: I thought you were redoing the venogram?

Foreman: As soon as we’re done with the arteriogram.

Cameron: Okay. You’re going to feel a little poke.

Stevie: (to Foreman) Can you maybe do that?

Cameron: It’s okay, it’s just your leg. I don’t have to go any further than this.

Foreman: (puts up x-ray) Take a look at this. Bones of your forearm.

Stevie: Uh. Radius and ulna.

Foreman: How about the wrist?

Stevie: Um. Lunate. Hamate, The…

Cameron: Scared lovers try positions they can’t handle. (Foreman and Stevie look at her) It’s a mnemonic for the wrist bones. It’s the only way I can remember them.

Stevie: Ow.

Foreman: You all right?

Stevie: Ow, my stomach.

Foreman: You hit something?

Cameron: I haven’t started.

Foreman: Lie flat.

Stevie: Oh, no I can’t. It hurts too much.

Cameron: I’m getting out.

Foreman: It’s the only chance to see what’s going on.

Cameron: If he moves, I could shred his artery.

Stevie: Get it out, now!

Foreman: It’s going to be okay, Stevie. Just inject the dye.

Cameron: Dye’s going into his liver but it’s not coming out.

Foreman: The clot’s gotta be constricting the flow in the hepatic vein.

Cameron: It’s not constricting it, it’s completely blocking it. His whole liver’s fried.

[Cut to House wheeling into clinic. Bumps into Foreman]

Foreman: Ow. The kid’s liver’s failing because of massive clots blocking his hepatic vein. How can he have both a bleed and a clot?

House: (flipping open charts – the clinic desk is just above his armpit level.) It’s not a clot. You must have blocked the vein with a catheter wire.

Cameron: Not a chance.

Chase: Increased pressure downstream could also stop the blood.

Foreman: There’s no heart failure or cirrhosis. Means it has to be a clot.

House: Massive clots block veins, they don’t even leak. Since he clearly has some kind of… (puts the charts together, can’t reach the box they go in.)

Cuddy: You having a little problem?

House: (to nurse) Would you mind? (she takes them) Boy, that was humiliating. How does Whitner make it through the day?

Cuddy: Pride goeth before the fall.

House: Lucky for me, I’m sitting in one of these babies. So, what other theories can I shoot down?

Cameron: DIC would explain both the…

House: His platelets are normal. His PCT isn’t elevated.

Chase: Leukemia?

House: Normal CBC and…differential? You guys are still thinking like doctors when you should be thinking like plumbers. Come on, I wanna see some butt crack. Something inside the liver is punching holes in the pipes. Blood bleeds through the openings, sticks to the intruder, forms a mass.

Foreman: A clot.

House: A mass.

Chase: A cancer, a tumor could erode a blood vessel.

Foreman: So could a granuloma from tuberculosis or sarcoidosis.

House: Do a CT, MRI, sputum and ACE level. Excuse me, sorry, cripple coming through.

[Cut to Clinic exam room]

Mother: He says his throat hurts.

House: That phrasing means you think it doesn’t.

Mother: No, I don’t.

House: Good enough for me. (starts to leave)

Mother: Where are you going?

House: Mothers know best. Get yourself a sucker on the way out.

Mother: Look, I think he’s just faking so he doesn’t have to go to school.

House: How did you know I was a truant officer?

Mother: I told him he had a choice – go to school or the doctor.

House: Right. He’s wasting your precious time so you decided to waste mine. How thoughtful. I’m in a wheelchair so I can’t examine him all the way up there. (to Jack) Hop down. My life is just one horror after another. Open.

Mother: (peering in) Does it look like it hurts?

House: Nope. (he crashes into table and pulls out a huge syringe)

Mother: What’s that?

House: Syringe. I’m with you. Make him hate the doctor’s office more than he hates school.

Mother: That’s okay. I don’t… I don’t think that…

House: It’s just saline. It hurts like hell when it’s injected directly into the muscle. (Jack hides behind mom) So, what do you think? Arm or ass?

Mother: I think he’s learned his lesson.

House: Oh, I don’t know. You’d better check. Jack, is your mommy a big, fat idiot? (Jack nods) Well, what do you know! I guess you were right.

[Cut to MRI. Stevie going in.]

Foreman: Just hold still, Stevie. This shouldn’t take long.

Stevie: (nods) Sorry, I’m guessing the mike in this thing doesn’t pick up nods.

Cameron: Smart kid.

Foreman: Too bad it’s all going to go to waste.

Chase: Nothing wrong with being a salesman.

Foreman: He should be able to pursue his own life, not be stuck helping his parents sell old toasters.

Cameron: He’s still young. You never know what he’ll wind up doing.

Foreman: Listen, unless he goes back to school, I know exactly what he’ll end up doing. Wait. Is that a lesion?

Chase: Magnifying times 5.

Cameron: It’s a granuloma.

Foreman: That means Wegener’s is most likely. (noise as door to room is opened)

Judy: Stevie

Stevie: Mom, is that you?

Franklin: Hey, hey.

Judy: Get him out of this now.

Foreman: Your son is sick. The sign on the door says…

Franklin: The sign says “no metal.” We took everything off.

Foreman: It says “no admittance.”

Franklin: What’s wrong with our son?

Cameron: We don’t know yet.

Judy: He’s not going to die, is he?

Foreman: Your son is very ill. We’re still trying to figure out why. Which is why we need you to leave the room. (they leave)

[Cut to parking lot. House is wheeling across the snow toward his car. He sideslips into it and stops with a big grin on his face and his tongue sticking out. He opens the passenger-side front door.]

Foreman: What are you going to do now?

House: Oh, now I’ve gotta slide my butt from one padded seat to another. What if I bump my knee?

Foreman: MRI showed a granuloma in his liver.

House: (swings into car) Fantastic. Wanna give me a hand here? (indicates wheelchair)

Foreman: No. Clotting, bleeding and a granuloma equals Wegener’s.

House: I know. That’s why I said “fantastic.” I was being sincere. Now give me a hand.

Foreman: Wouldn’t be fair. We’re going to biopsy the liver to confirm.

House: It wouldn’t be fair not to. People are good and kind and gentle and help people in wheelchairs.

Foreman: No.

House: You do.

Foreman: No, I don’t.

House: Foreman, forget the biopsy. His liver will be gone before you get the results. Start treatment with cyclophosphamide before the Wegener’s punches a hole in another pipe. (Foreman leaves as House wrestles chair into car. He can’t reach the door to close it. Turns on car, backs up quickly and brakes hard. The door slams shut. Smug grin.)

[Cut to Stevie’s room. He is eating soup.]

Foreman: What’s with the clothes? You’re not getting discharged.

Stevie: I know. It… it’s my parents. They insist I wear this stuff.

Foreman: We insist on our own gown, food and furnishings for a reason.

Stevie: It… my, my chest burns. Are you sure the treatments are working?

Foreman: Wegener’s causes the body to attack itself. It doesn’t get undone overnight. Be patient.

Judy: (enters and starts unfolding a blanket) Where’s your soup?

Foreman: It’s in the garbage.

Judy: It has willow bark extract.

Foreman: Willow bark extract is basically aspirin.

Judy: Yes, for the fever.

Foreman: He’s already on meds. Our meds. We can’t risk any adverse interactions. We need all this stuff to go. We need to control this environment.

Franklin: So do we. People get sick for a reason, because something in their life is out of balance.

Stevie: Dad. He’s a doctor. He doesn’t want to hear your talk.

Judy: Balance is just starting to be restored now that that girl is gone.

Foreman: That girl took pretty good care of your son while you were away.

Judy: Yes, we can see that.

Foreman: All this stuff may make him feel more comfortable but it’s not gonna…

Franklin: How long is this treatment gonna take?

Foreman: We should start to see some improvement in his liver functions soon.

Judy: (skeptical) Soon! Very scientific.

Stevie: I’m sorry.

Foreman: Be back in a little bit to check on you.

[Cut to men’s room. House wheels in.]

Wilson: Ah yes, if it isn’t Dr. Ironside.

House: (removing gloves) Ah, if it isn’t Dr. I-Had-No-Friends-When-I-Was-Growing-Up-So-All-I-Did-Was-Watch-TV-By-Myself-Which-Is-Why-I-Can-Now-Make-Constant-Pop-Culture-References-Which-No-One-Understands-But-Me.

Wilson: That’s my name. Don’t wear it out. (House starts to stand) Uh uh.

House: (sits back down) Safe from Cuddy but I guess not from her trusted ratcomplice.

Wilson: (stepping away from the urinal, buckling his belt) Reasonable people don’t debate the relative merits of their handicaps.

House: Reasonable people make rules based on evidence. Like difficulty covering a distance – say 50 yards. Not some pre-ordained patheticness scale.

Wilson: Last I checked, pig-headedness was not the eighth heavenly virtue.

House: It’s only pig-headed if you’re wrong. If you’re right we call it sticking to your principles. (backs chair into stall and closes door)

Wilson: Give it up. You’re demeaning yourself.

House: That’s what they told Rosa Parks.

Wilson: Don’t stand up in there. I’m watching your feet. (leaves)

[Cut to Stevie’s room]

Franklin: Get out of our home!

Leah: This is not a home. It’s certainly not…

Judy: It’s our home as long as our son is here.

Stevie: Mom, dad, would you just please just calm down.

Franklin: You’re not family. You have no right to be here.

Leah: What are you going to do? Throw me out? You can’t even touch the gadje.

Judy: I’ll touch you.

Foreman: What is going on?

Leah: I’m the one who brought him here. I should be able to see how he’s doing.

Judy: He wouldn’t even need to be here if it weren’t for you.

Leah: Right. I’m so unclean, I caused his liver to shut down.

Foreman: Enough. No one is leaving.

Franklin: He’s our son and we want her out of here.

Stevie: Uhhhhh! (doubles over) Uhhh uhhh, it hurts!

Foreman: Is it your stomach again?

Stevie: Uh uh uh, no.

Wilson: What? (peels back blanket. lots of blood around groin)

Stevie: Uhfh!

[Cut to Diagnostics Office]

Foreman: Liver’s actually improving. We plug one hole and end up poking another.

House: We talking about the patient or how to get a raise from Cuddy?

Foreman: The Wegener’s treatment gave him a massive hemorrhage in his bladder.

House: Which means… it’s Wegener’s.

Foreman: What did I just say?

Cameron: We were treating him for Wegener’s when everything went wrong.

House: Not everything.

Foreman: Yeah. It was a very lovely day outside. On the other hand, the treatment made him worse!

House: The treatment made his bladder worse, not his liver.

Chase: Clot in the liver is breaking up.

House: And MRI, sputum and ACE ruled out TB, sarcoidosis and lymphoma. Which leaves us with…

Cameron: Still could be a cancer with multiple…

House: A cancer we can’t see on MRI, CT or blood tests?

Foreman: It’s Wegener’s.

House: It’s not the wrong diagnosis. It’s the wrong treatment.

Foreman: We could increase immunosuppression. Add methotrexate.

Chase: We can’t give methotrexate to a kid who’s already had lung problems.

House: (doing wheelies) Methotrexate is carpet bombing. Hits everything. We need a smart bomb. We don’t suppress the immune system. We change it. Immune modulation. FT-28. His antibodies are attacking his blood vessels. The irritation causes them to bleed and clot. We change his immune system so the antibodies don’t interact with his blood vessels but work fine everywhere else.

Cameron: FT-28 is still experimental. It’s not FDA approved.

House: It’s worked for Crohn’s Disease and Rheumatoid Arthritis.

Chase: He doesn’t have Crohn’s or arthritis.

House: Let’s say that he does. And start the treatment.

[Cut to hallway outside Stevie’s room]

Franklin: Absolutely not. My people have been experimented on before. Never again.

Foreman: Mr. Lippa, with all due respect, comparing this hospital with Auschwitz…It’s ridiculous. And FT-28’s been proven safe in hundreds…

Franklin: Why do they always say you can trust them? Why would they say anything else? Why do they think we would listen?

Foreman: Hey, hey, hey. Do you think I don’t understand what it’s like to come from a people who’ve been enslaved, mistreated and experimented on? Tuskegee went on for 28 years after World War II.

Franklin: And the laws that made it illegal for the Romany to even set foot in this state were still on the books until 1998. It’s not ancient history.

Foreman: Conventional therapy hasn’t worked. Your son may be dying. He needs a targeted approach and you need to trust us.

Judy: I’m sorry. A lifetime of experiences tells me I can’t trust you and the past three days have done nothing to change that.

Franklin: We want our son treated, not experimented on. If you don’t know how to do that, then just tell us so we can take him someplace where they do.

[Cut to hallway]

House: They’re absolutely right. Stay away from that unproven experimental stuff. Much better to stick with the moving the furniture until he gets better approach.

Foreman: Yes, you’re right. We’re going to have to come up with something else.

House: You mean another last ditch desperation move? You got anything? Go back and don’t take “no” for an answer. What kind of salesman are you?

Foreman: The kind who avoids the house with the crazy couple who put tin foil over their windows.

House: They got money for tin foil, they got money for whatever you’re selling.

Foreman: What’s that mean? (House sees Dr. Whitner coming down the hall, starts maneuvering to intercept her)

House: It means that if they don’t trust you, you should earn that lack of trust.

Foreman: What does paying for tin foil mean?

House: Why should I have to answer all the questions? (wedges Whitner against the wall) Ooops. Sorry, still getting used to the power steering. (Foreman leaves) I assume you’ve heard the news.

Whitner: I’m not worried. From what I hear, what you lack in shame, you also lack in willpower.

House: My will may be weak but my backbone is strong. And pain-free now that I’ve stopped using the cane. Of course it’s harder to look down Cuddy’s shirt. But then the vantage point on her ass is much improved. But then that’s just me – always looking on the bright side. I’m the guy who said her c-cups are half full.

Whitner: They are nice, aren’t they?

House: (growling noise) No, no, no, no, no. You’re not going to win me over that easily. You may have a wheel. That doesn’t mean you get the grease. You gotta squeak.

[Cut to Stevie’s room. Lots of visitors.]

Franklin: What’s that?

Foreman: It’s a cyclophosphamide. We’re continuing the standard treatment as you requested. Um, I have to ask everyone to leave the room for a few minutes while I apply some bandages.

Judy: Why do we have to leave?

Foreman: Uh, they’re for his penis. (Franklin gestures and they all file out)

Stevie: You lied to them. The bleeding stopped. I don’t need any bandages.

Foreman: We need to change your treatment. But your parents won’t let us. They’ve got it in their minds that we want to try some sort of inhuman experiment on you.

Stevie: The treatment is experimental?

Foreman: FT-28’s been through extensive clinical trials. It’s also been used successfully for other conditions.

Stevie: The fact that you’re recommending experimental treatment means that you have no other options.

Foreman: I’m sorry. We stop the pleural effusions, your liver almost fails. We save your liver, the bladder fails. If we don’t get ahead of the curve on this…

Stevie: What do you need me to do?

Foreman: Take the medicine but don’t tell your parents.

Stevie: I don’t like lying to my parents.

Foreman: The rest of the world, though…

Stevie: The rest of the world, I can’t trust.

Foreman: You can trust me.

Stevie: How do I know?

Foreman: Because if you do this, then tell your parents, I lose my license.

Stevie: (nods) Ow. Ow, ow, ow. God! (doubles over)

Foreman: (to intercom) Get in here.

[Cut to OR]

Dr. Simpson: Wow. Spleen basically exploded, huh. Got another bleeder. 2-O silk on a stick. Got it. (House watches from gallery. Surgeon puts spleen in bowl) I believe you ordered your meat rare.

Foreman: Keep him open. If I confirm Wegener’s, we might as well stage the disease while he’s still on the table.

House: (on intercom) What’s taking so long? (rings for elevator)

Foreman: External capsules ruptured but still intact. No signs of a clot or a bleed. Normal follicles, normal lymphoid tissue.

House: The spleen is ripped to shreds. There’s gotta be granulomas. Keep looking.

Dr. Simpson: Come on. We can’t leave Humpty Dumpty like this forever.

Foreman: I don’t see anything but normal spleen. No granuloma.

Nurse: Means no Wegener’s.

Dr. Simpson: That’s all I need to know. Let’s go, people.

House: Run his bowel.

Dr. Simpson: No need. I’m closing. (House rings for elevator, glancing over his back where the operation is proceding.) Suture.

(House starts down stairs in his wheelchair. Barges into OR)

House: Run his bowel.

Dr. Simpson: Nothing suspicious in the spleen. Get him out of here.

House: You missed it. He had a granuloma in his liver.

Dr. Simpson: No, it was just scar tissue. Looked like a granuloma on the MRI but it’s not. I don’t know why I’m debating this. Pass me the Kelly clamp. I’m closing.

House: (standing, wearing one glove and a half-on gown but no mask) Not unless you’re going to sew my hand in this kid’s stomach.

Dr. Simpson: Get out of there. He’s unstable.

House: He’s got Wegener’s. Which means he’s got granulomas.

Dr. Simpson: I’m calling my lawyer.

House: It’s only 26 feet. If he were an ostrich, you’d have a 46 foot wait.

Foreman: Blood pressure’s dropping.

House: (running bowel) Hang another bag of Ringer’s lactate.

Nurse: I’m having nothing to do with this.

House: Foreman, hang another bag…

Foreman: Ringer’s lactate. Got it.

House: Come on, come on. It’s gotta be in here. (finishes) But it’s not.

Dr. Simpson: Mind if we close?

House: Well, it’s a good thing we never sold him on FT-28. His parents were right.

[Cut to Stevie’s room. Parents hug. Cut to Diagnostics Office.]

Cameron: There’s no way his parents are going to let us near him again.

Foreman: They won’t be able to transfer him until he’s recovered from the surgery.

Chase: You can add the surgical team to the list of people who won’t let us near him.

House: Bleeds, clots, bleeds, clots. Spleen explodes.

Foreman: We should test him for Von Willebrand’s.

House: Or, let’s play tic tac toe. Okay, Xs are bleeds, Os are clots. Started in the lungs, right? What did we do?

Foreman: CT, sputum, two venograms.

House: (marking a human body chart) That’s one bleed, one clot. Then what?

Foreman: Liver shut down. MRI, labs. Treated with cyclophosphamide.

House: Whereupon, he peed out three units of O negative. And a bleed.

Cameron: Where is this going?

House: I don’t know yet. What’s next?

Chase: Bladder, kidney.

Foreman: High resolution CT scan and UA and urine sediment.

House: GI tract?

Chase: You ran the small bowel in the OR.

House: Large bowel is fixed to the abdominal wall. I didn’t run that.

Cameron: Because there’s not reason to. He hasn’t been having any symptoms in his bowels.

House: Do a colonoscopy.

Cameron: Because he’s had no symptoms?

House: You lose your keys, the first thing you do is look everywhere you might logically have placed them. When you don’t find them, then you start looking in other places – the medicine cabinet, freezer, mailbox. We need to look in this kid’s mailbox.

Cameron: Why don’t we x-ray his feet? They’re fine too.

House: Because we need to take the center square to block. (holds up chart)

Cameron: Okay, even if that did make sense, it’s kind of hard to do a colonoscopy on a kid you can’t get near.

Foreman: He’s in the ICU now. His parents only have limited visiting privileges. (leaves)

House: I like that kid. He’s got spunk. (leaves, followed by Chase. Cameron stands there)

[Cut to waiting area outside ICU. Foreman peeks around a corner. House peeks around a corner.]

House: Can’t talk now. On guard duty.

Wilson: You’re still in that thing.

House: What thing? Oh this? Forgot it was even there.

Wilson: You know, even if you manage not to get struck down by a bolt of lightening and make it a week, Cuddy’s not going to give you the space. She can’t.

House: A bet’s a bet.

Wilson: Yes. And that rule outranks the Americans with Disabilities Act. You think you’ve got logic on your side. But Whitner’s got the legal system. And legal beats logic every time. Just ask OJ.

House: You’re right.

Wilson: I am?

House: Yeah.

Wilson: So you’re doing this even though you know you’ve got no legal leg to stand on.

House: Who needs legs when you got wheels. I’m gonna get that spot. (loudly) No way Cuddy is going to gyp me.

Franklin: What’d you say?

House: I’ll see you later. Gonna have them yelling at me for the next 20 minutes.

[Cut to ICU]

Chase: Mucosa looks normal, healthy. No lonely diverticular.

Foreman: Blood pressure’s dropping. He’s bleeding again.

Chase: I’m in his colon.

Foreman: (looks out to check on House’s argument with the Lippas) Hurry up.

Chase: I am. There’s nothing there.

Foreman: Wait, wait. What’s that.

Cameron: The reflection?

Foreman: No, it’s something. Looks like a…

[Cut to hallway. Foreman is talking to the Lippas]

Foreman: Toothpick.

Franklin: Are you sure?

Foreman: He must have swallowed it accidentally and just figured he’d digest it eventually. When you two were making out in the car he must have folded awkwardly, pushed the toothpick through the wall of the intestine and into the lung. Then it moved on to his liver and made its way to his bladder and spleen.

Leah: So that’s it. He’s going to be okay.

Foreman: Yup. Small holes. It shouldn’t take that long to heal now that we’ve got it out.

Franklin: See. See what you did?

Leah: Me?

Judy: If you hadn’t been kissing him…

Leah: That’s what you heard? It was the toothpick. It was that disgusting habit.

Franklin: It would have passed right through if he hadn’t been writhing around. Isn’t that right? (but Foreman has left)

[Cut to Stevie’s room. Foreman shows him toothpick in a vial]

Stevie: That’s it?

Foreman: Yeah. That’s it. Wood absorbs water. Becomes the same density as the tissue around it. That’s why it didn’t show up on the CT or MRI.

Stevie: That’s cool. I mean, not cool for me but… A lot of damage for something so small.

Foreman: You know, the lab here, they have a paid intern position. It’s usually given to one of the kids from the universities but, if you want, I could probably get you an interview. There’s some entry level stuff, some gofer work. But you’d also have access to a lot of cool things.

Stevie: Thanks, for everything, but I can’t.

Foreman: Yes you can. Stevie, you’re bright. You have more curiosity than 90% of the doctors on this staff.

Stevie: Ah. It’s not that. It’s just… I go to work every day with my family, you know? People I’ve known my whole life. I don’t wanna lose that.

Foreman: You could have both.

Stevie: No I can’t.

Foreman: Because they don’t want to let you. They shouldn’t be making you choose.

Stevie: Maybe not but, they are. I’m choosing them.

Foreman: Change is hard. Trust me. I know. But it worked out for me.

Stevie: You’re a successful doctor. Your name is on journal articles. I would love that. It’s just, I see you with doctors Chase and Cameron and you all got empty ring fingers. You’re alone.

[Cut to exterior. House is leaving]

Cuddy: Oh ho ho ho.

House: This is my last day living the life of leisure. So, are you going to tell Dr. Whitner she’s out of my space or can I?

Cuddy: Why would I do that?

House: Because, you said that you would. And lying is wrong.

Cuddy: I said I would give you the space if you made it a whole week…

House: Which I...

Cuddy: You didn’t. The bet didn’t stipulate that you had to be in the chair for a week unless you had to barge into an operating room and shove your hands in a kid’s bowels.

House: How’d you know about that?

Cuddy: You lost.

House: I saved a life. Two minutes out of the chair to save a kid’s life.

Cuddy: You lost, House.

House: I earned that space.

Cuddy: No you didn’t.

House: I earn that space every day I limp into that building and do my damn job.

Cuddy: You lo-hos-ost.

House: Hey (lurches out of chair and lurches up to Cuddy) You were never going to give me that space, were you? I saw Whitner the other day. She knew about the bet. Didn’t seem that worried.

Cuddy: She knew I’d win.

House: She doesn’t know me. In fact she doesn’t know anything except what you tell her. And you told her that you were never going to give me that space, didn’t you? Just tell me – do you at least feel a little guilty? If you want to teach me lessons, don’t make commitments you can’t keep. (Cuddy heads toward the hospital, House turns to parking lot. Wilson approaches)

Wilson: How’s it going?

House: How guilty does she look?

Wilson: Hmm. About an eight.

House: That space is mine. Veni, vidi, vici.

[Closing montage. Stevie wheeled to exit by his dad. Stands up. Mom hugs him. Foreman, dressed to leave, watches from balcony. At door, Stevie turns, makes eye contact with Foreman. They both nod. House limping toward parking lot. Foreman having dinner. Fully laid out table. Reading something on a clipboard. House reaches lot. Workman is fixing sign to say “Parking for House, M.D.”]


Tags: season 3
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    Originally Aired: May 19, 2008 Written by: Peter Blake, David Foster, Russel Friend & Garrett Lerner Directed by: Katie Jacobs Transcribed by:…

  • House MD – 4.15 House's Head

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  • House MD - 4.16 Wilson's Heart

    Originally Aired: May 19, 2008 Written by: Peter Blake, David Foster, Russel Friend & Garrett Lerner Directed by: Katie Jacobs Transcribed by:…

  • House MD – 4.15 House's Head

    Originally Aired: May 12, 2008 Written by: Peter Blake, David Foster, Russel Friend & Garrett Lerner Story by: Doris Egan Directed by: Greg…

  • House MD – 4.14 Living the Dream

    Originally Aired May 5, 2008 Written by Sara Hess & Liz Friedman Directed by: David Straiton Transcribed by: Jane (poeia)…