doc_on_duty (doc_on_duty) wrote in clinic_duty,

House MD - 1.09 DNR

Originally Aired: Feb 1 2005

Written by: David Foster
Directed by: Fred Keller

Transcribed by: Mari (musikologie)

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.

[A recording studio. A guy is doing sound board tests, another is practicing drum riffs. Another is playing a few notes on the guitar. Brandy is seated at the piano.]

Brandy: This is a really nice room!

Tommy: Yeah, it sounds thick. Too bad he’s not coming.

Brandy: Look, I talked to him myself. He’ll be here.

Tommy: Right.

Brandy: You’re the one who said the song could use a horn part, so I got the best. John Henry!

Tommy: You think I’m stupid?

Brandy: Of course I do, but that’s not the point. [She starts to play the piano.] He’ll be here, okay? [Guitar Guy nods doubtfully.]

[Cut to a car. John Henry and Cora are seated in the back.]

John: [to driver] Take a left up ahead.

Cora: South Street? I cancelled this gig. You said you didn’t want to do any sessions for a while.

John: For a while. I called her; I un-cancelled it.

Cora: But you up to it?

John: Let’s find out.

[Cut to the studio.]

Tommy: [playing on his guitar and singing] You lied to me, John Henry’s never gonna show up!

Brandy: Will you stop?

Tommy: [stops playing] It’s been, like, two hours.

Brandy: And we will keep waiting. I mean, you’ve heard this guy play and you know what he does, so can you just shut up, Tommy? [The door opens. Cora, John Henry and the driver enters. We see that John is in a wheelchair.]

Brandy: Oh, my God!

John: Am I late? [Brandy laughs.]

[Cut to the recording session. The opening where John comes in is played for him.]

Brandy: You need to hear it again?

John: Nope, I get it. Let’s try one. See what we get. Let’s do it. [Brandy starts up the music again. John starts to play the trumpet on his cue. After a few beats he starts to look uncomfortable, and then starts coughing. He drops his trumpet, and Cora rushes to him.]

Cora: John! You okay? You okay? [She loosens his tie.]

John: I can’t breathe, I can’t breathe. [coughing]

Cora: Call an ambulance! Now! [Someone in the recording booth does so, as John stops moving.]

[Opening credits.]

[Cut to House entering Cuddy’s office.]

House: I want in.

Cuddy: John Henry Giles, you a fan of his music?

House: He’s a musician? That paralysis thing, guy can’t walk for two years and nobody knows why, that seems mildly interesting.

Cuddy: Forget his paralysis.

House: Tell that to the rest of his bowling team.

Cuddy: As far as this hospital is concerned, this is a simple case of lobar pneumonia. Boring.

House: But that “not walking” thing, that could turn into something serious!

Cuddy: Marty Hamilton is his primary physician out in California. He’s dealing with the paralysis.

House: Know all about it. Multiple treatments, multiple surgeries. Making real progress. Fixed everything but the legs.

Cuddy: Dr. Hamilton already called and asked for your team. And by team, I don’t mean you.

House: Like I always say, there’s no “I” in “team”. There is a “me”, though, if you jumble it up. [They leave her office.]

Cuddy: Foreman did his residency with Hamilton.

House: I know. I did accidentally glance at his resume before I hired him.

Cuddy: He wants someone he can trust.

House: He must have spoken to Foreman’s parole officer.

Cuddy: Someone who will stick to the pneumonia. John Henry’s on an experimental protocol for the paralysis.

House: I respect that. I’m not going to get in his way.

Cuddy: It’s Foreman’s case. [She walks away.]

House: It’s pneumonia, he can handle it. Guy’s already paralyzed, how badly can he screw it up?

[Cut to the diagnostic offices. Cameron is looking through some medical books, as is Chase. House is fooling with his cane. Foreman is at the board.]

Foreman: So, what are his stats?

Chase: Staying in the 90s on the nasal canula.

Foreman: Coughing up much sputa?

Cameron: Almost none, he seems to be stabilized.

Foreman: Dr. House, is there anything back from Micro?

House: Not yet. You gonna fire me?

Foreman: You can make up for it by washing my car.

House: Oh, this is fun. [Chase smiles.]

Foreman: Let’s keep him on the broad-spectrum antibiotics, and since he’s displaying septic physiology, draw blood for adrenal and thyroid function. [Cameron and Chase stand up, but House’s feet resting on the table block their path.]

House: How about the paralysis?

Foreman: We’re sticking to the pneumonia.

House: Well, you certainly are, boss. Like a wet tongue sticks to dry ice. [Chase and Cameron sit.]

Foreman: The paralysis has already been diagnosed by Dr. Hamilton. It’s ALS.

House: Lou Gehrig’s disease. It’s a lovely diagnosis. They make movies about it. No tests, no treatment. It’s a disease of exclusion –

Foreman: -- because Hamilton has excluded everything else.

House: I haven’t. [He gets up and takes the board marker from Foreman.] What else could it be?

Chase: Guillain-Barre, which would be reversible.

House: Excellent. [He starts to write, but Foreman takes the marker away from him.]

Foreman: No, the progression of the paralysis would be symmetric. This wasn’t.

Cameron: Transverse myelitis.

Foreman: Hamilton tested for it. Negative. And he was negative for masses, and AVM, and –

Chase: Antibodies could be attacking the nerve. Multifocal motor neuropathy.

House: Uncommon, but it fits. It’s also treatable. Did Hamilton try putting the guy on IVIG?

Foreman: No, because the MRI showed –

House: Well, let’s do an MRI of our own. [Chase and Cameron get up.]

Foreman: Guys? It’s my case. [They sit down again.] ALS fits. It even predicts the pneumonia. The paralysis is progressive.

House: It’s a death sentence.

Foreman: That doesn’t make it wrong.

[Cut to John’s hospital room, where a Bose stereo system is playing jazz. Foreman is taking blood samples. John turns the music off with a remote.]

John: So, you think the breathing stuff is connected to my ALS?

Foreman: It makes sense.

John: So, it’s just gonna get worse, huh?

Foreman: Well, Dr. Hamilton –

John: Great guy. Really smart doctor, but his treatment obviously isn’t working. Do you think I’m gonna die here, or you think I’m gonna get to go back home first?

Foreman: An MRI would give us a better idea –

John: An MRI? Come on. For pneumonia?

Foreman: Well, Dr. House thinks we should test for –

John: House? Yeah, I heard about him. Obsessive son-of-a-bitch?

Foreman: [chuckling] That’s him.

John: So, who do you think is right? Hamilton or House?

Foreman: They’re both excellent physicians.

John: Come on. One of ‘em says ALS, the other one says not ALS… you gotta pick one, son.

Foreman: [sighs] Everything points to ALS.

John: Then no MRI. And I want one of them papers that say I, I don’t want nothin’ done if something go bad.

Foreman: A DNR? Mr. Giles, you don’t want to rush things –

John: It’s been two years, I ain’t rushing. I wanna sign one. Now, while my arm still works.

[Cut to a shot of a record player playing one of John’s albums. As the shot backs up, we see that House is listening to it with headphones, conducting with his arm, while lying on the floor of his office, his feet propped up on a chair. Foreman walks in.]

Foreman: He signed a DNR.

House: [takes headphones off] He rhymes with dinner?

Foreman: He signed a DNR.

House: Oh. That makes more sense. You tell him it might not be ALS?

Foreman: No.

House: Well, no wonder he signed. Who wouldn’t?

Foreman: I started him on IV steroids and ancinthroid. (sp?)

House: Great. If it was my case, I’d be adding a little IVIG to the mix.

Foreman: For his pneumonia?

House: That’s my story and I’m sticking to it.

Foreman: He doesn’t want anything done. No treatment.

House: DNR means “do not resuscitate”, not “do not treat”. You do nothing, it doesn’t matter which one of us is right. [He puts his headphones back on.] And hang on to that DNR. That signature could be worth a lot of money real soon. [Foreman leaves.]

[Cut to Foreman talking on his cell in the hallway.]

Foreman: This is Dr. Foreman. What’s Mr. Giles’s status? Okay, increase the steroids to 100mg every 12 hours, and, ah, start him on IVIG. Yeah, I’m sure. One gram per kilo.

[Cut to the clinic, good old Exam Room 1.]

Willie: My nature isn’t what it used to be. The little man has lost some bounce in his step. [House looks like he’s trying to looks sympathetic.] He needs to crank it up, have himself some fun this weekend. [confidentially] He wants the blue pills.

House: You’re talking about your penis in the third person.

Willie: Me and him, two people.

House: Separate vacations? That’d be a drag for one of you. I don’t think you need the pills. I think you have a conflict of medications. You need to up your insulin to “chocolate chip ice cream” levels.

Willie: Insulin?

House: Yeah, you remember. That’s the stuff you take for the diabetes that you forgot to tell the nurse about. Your hands. No hair, which means nerve damage. And your shoes look about two sizes too small which means you’ve lost sensation in your feet. And then there’s your pants.

Willie: My pants tell you I have diabetes?

House: No, they tell me you’re an idiot. Powdered sugar on the right pant leg. Based on the two napkins in your right pocket, I’m willing to bet it’s not your first donut of the day. [House’s beeper beeps, it says “Code Blue – John Henry Giles – Rm. 324”. House gives Willie a prescription.]

Willie: You’re giving me the pills?

House: Sure, why not? If you’ve got heart disease from ignoring the diabetes they’ll kill you. Otherwise, you two have a fun weekend. [House leaves as Willie looks at the prescription skeptically.]

[Cut to John’s room. Chase is listening to his breathing with a stethoscope; Cameron walks in.]

Chase: 0-2 stats are dropping.

Cameron: Breath sounds?

Chase: Junky.

Cameron: Mucus plug?

Foreman: No, it’s our mistake. He’s sludging from the IVIG. Blood can’t get through to his lungs.

Cameron: Start Heparin. 500ccs, IV push.

Chase: He won’t last long enough for it to work. We’ve got to intubate him, stat. [Cameron starts to bring over the equipment.]

Foreman: We can’t! He’s DNR.

Chase: What?! [Cameron, Chase, and Foreman are left standing around his bed.]

[Cut to Cora in the elevator with a bag from the Princeton Record Exchange full of CDs.]

Doctor in Elevator: Someone likes music.

Cora: Oh, yeah.

[Cut to House entering John’s room. Chase is standing by the door, Foreman is sitting by the bed, and Cameron is standing by the foot of the bed. (And can I just say that hey have very spacious hospital rooms! Golly! Okay, I’m done.)]

House: His stats are in the 70s. How long has he been like this?

Chase: 10 minutes.

House: Well, why aren’t you doing –

Foreman: The IVIG put him into respiratory failure.

House: You put him on the IVIG?

Foreman: We did this.

House: So undo it! Chase!

Foreman: It’s too late! We killed him.

House: Nobody killed him! He’s not dead! Chase, intubate him!

Chase: He’s DNR. [House looks at them all, and shoves his cane at Chase. He starts to intubate John himself.]

Foreman: What are you doing? You can’t do this!

House: Bag.

Foreman: You can’t do this!

House: Bag! [He grabs the bag himself and starts to ventilate. Cora walks in.] He had a bad reaction to some medicine we gave him.

Cora: What did you just do?

Cameron: He saved his life.

[Cut to a later shot. John is now hooked up to a ventilator. Cut to the four doctors walking into the diagnosing office.]

Chase: He’s stable on the ventilator. Oxygenating well.

House: The IVIG made him worse, which means multifocal motoneuropathy was a bad diagnosis. Okay, what’s really wrong with him?

Foreman: What’s wrong with you?

House: Everyone knows what’s wrong with me. What’s wrong with him is much more interesting.

Foreman: You tubed him and he didn’t wanna be tubed! He has a legal paper saying just that.

House: To intubate or not to intubate, that is the big ethical question. Actually, I was hoping we could avoid it, maybe just practice some medicine.

Foreman: There’s no question. It’s the patient’s decision –

House: -- if the patient is competent to make it, if his thyroid numbers aren’t making him sad.

Foreman: Oh, my God. You don’t believe that.

Cameron: His thyroid levels were a little –

Foreman: It’s nothing. Do not defend him.

House: Why did he sign that DNR?

Foreman: I didn’t talk him into –

House: No, he signed the DNR ‘cause he didn’t want a slow and painful death from ALS. What was happening to him had nothing to do with his ALS.

Foreman: Right! Exactly! It’s the IVIG, you screwed up! You’re not gonna let him die because you screwed up!

House: Technically, your case. You screwed up. Is that what this is about? Looking bad in front of your old boss?

Foreman: You assaulted that man.

House: Fine. I’ll never do it again.

Foreman: Yes, you will.

House: All the more reason this debate is pointless. [Foreman leaves.]

House: His lungs are worse. Any theories? [Cameron looks to see where Foreman went.] Oh, I’m sure he just went to the little boys’ room. Come on, people.

Chase: Uh, vasculitis?

House: Wouldn’t likely hit both lungs.

Cameron: It could be Wegener’s granulomatosis. [A woman in a skirt suit that would make Cuddy proud walks in.]

Woman: Dr. House? [House looks surprised.]

House: Cuddy sent me a stripper again? Ah, love that woman. So thoughtful.

Woman: [smirking] Sorry. [She hands House a paper and leaves. House hands the paper to Cameron.]

Chase: There are case reports of Wegener’s hitting both the legs and the spine.

House: Well, it’s not great, but it’s better than ALS. At least it’s treatable.

Cameron: [looking at the paper] It’s a restraining order. You’re not to come within 50 feet of John Henry Giles, and they’ve asked the DA to file criminal charges for battery. [slight pause]

House: Cameron, test the blood for c-ANCA.

Cameron: These are criminal charges. They aren’t going to let you take blood to make more tests.

House: He has blood left in the lab, just add on the c-ANCA. [to Chase] Foreman’s still got you doing bronchioscopic suctioning for the pneumonia?

Chase: Every four hours.

House: Well, while you’re down in his lungs, grab a biopsy. We’ll need it to confirm Wegener’s. And move the patient to the second floor ICU.

Chase: Why?

House: It’s right above the clinic. I’m pretty sure it’s 50 feet in any direction. It’s nice having a court order saying you don’t have to work clinic duty. [He goes and sits in his office.]

[Cut to the clinic. Cuddy is talking to a couple of patients. House comes to the doorway and stops.]

House: [yelling] Dr. Cuddy!

Cuddy: [to patients] Excuse me.

House: You paged me.

Cuddy: Why the yelling?

House: His bed is behind that wall. The plaintiff’s. I can’t, you know, come any closer.

Cuddy: It’s right over the clinic. Very cute.

House: Can we get the lecture over with, because I’ve got a, actually, I’ve got nothing to do. Take your time.

Cuddy: You need a lawyer?

House: You don’t have a problem with what I did?

Cuddy: When I hired you, I knew you were insane. I will continue to try and stop you from doing insane things, but once they’re done…. Trying to convince an insane person not to do insane things is, in itself, insane, so when I hired you I also set aside $50,000 a year for legal expenses. So far you’ve come in under budget.

House: Great. Any chance you could help me run some tests?

Cuddy: Dr. Foreman called Dr. Hamilton. He’s flying in from L.A.

House: You can talk to him.

Cuddy: Dr. Hamilton is flying in as a friend of John Henry’s to pull the plug. [pause]

House: Yeah. I need a lawyer.

[Cut to the courthouse.]

House’s attorney: Your Honor, on behalf of Gregory House, we have convened an emergency session of this court to bring a motion requesting John Henry Giles remain on life support.

Judge Winter: Mr. House faces criminal charges for battery against… John Henry Giles. You beat up a guy in a wheelchair?

House’s attorney: Dr. House is alleged to have forced a tube down Mr. Giles’ throat against his will. [House stands up.]

House: A medical tube, saving his life.

Judge Winter: Dr. House, please let your attorney speak for you. [House’s attorney makes a noise in the back of his throat.]

House: I’m sorry, your Honor. I was way out of line. [He sits.]

Judge Winter: So, uh, your client forced the patient into this position, [Cora shakes her head at House (very cryptically, I might say)] and now he wants a court order to force the patient to stay that way.

House’s attorney: Without the tube, there’s a high likelihood that Mr. Giles will die.

Judge Winter: Well, I assume the patient knows that, he had a DNR. That’s why your client is facing criminal charges, right?

House’s attorney: Exactly. And Mr. Giles’ death will violate my client’s Sixth Amendment right.

Judge Winter: The right to face his accuser. [He smiles.] That’s clever, huh?

Giles’ attorney: Your Honor [he stands], in Commonwealth of Pennsylvania v. Hozelton, the 3rd district ruled that a defendant may not use that status to rule against a felony charge [he fades out. Wilson, who’s sitting behind House, leans forward to talk to him.]

Wilson: Why are you doing this? It’s not going to keep you out of jail.

House: No.

Wilson: Even if you win, the restraining order and battery charge stay in place. What have you gained?

House: Time.

Wilson: To diagnose him? You can’t get near him!

House: I don’t want to get near him.

Wilson: You know how some doctors have the Messiah complex, they need to save the world? You’ve got the Rubik’s complex, you need to solve the puzzle.

House: Are you done, or do you have more references to 1980s fads? I’m trying to listen to this. [He turns back to the topic at hand, tugging at his shirt collar.]

House’s attorney: That DNR may not be valid. The patient was suffering from depression brought on from a thyroid imbalance.

Judge Winter: The DNR order was witnessed by Dr. House’s own staff, a, a Dr. Foreman. [House stands.]

House: My staff are idiots. I’m sure you know what it’s like, your Honor.

Judge Winter: Sit down! [House sits.]

House’s attorney: The validity of the DNR is a question of fact. Dr. House should have the opportunity to make his argument at a full trial.

Judge Winter: And this poor guy has gotta stay on life support until we can schedule a trial. [House stands.]

House: Your Honor –

Judge Winter: Dr. House, I will hold you in contempt if you don’t sit down.

House: I have a medical issue.

Judge Winter: If it pertains to this case your attorney should –

House: It doesn’t. Do you have any history of heart disease in your family? [Giles’ attorney scoffs.]

Giles’ attorney: Your Honor!

House: Your fingers. They show signs of clubbing, which indicate a health problem. Remember Bart Giamotti? Same thing, just dropped dead one day. Please see your doctor.

Giles’ attorney: He’s admitted this isn’t relevant. Can we please get back to the motion?

House: Of course, I’m sorry. [He sits.]

Giles’ attorney: Your Honor, a person’s right to control the treatment of their own body is fundamental to understanding this case. A long line of -- [He fades out. The judge is examining his fingers in the light of the lamp.]

[Cut to Wilson and House walking out of the elevator of the courthouse.]

Wilson: Congratulations, impressive legal argument.

House: I watched Matlock last night. [He pulls off his tie.]

Wilson: Oh, say no more. I didn’t notice any clubbing on the judge’s fingers.

House: Neither did I.

Wilson: So, the family history thing…

House: Every family has some history of heart disease.

Wilson: And mental illness.

[Cut to the pathology lab. House enters to meet up with Cameron and Chase.]

Chase: Biopsy only shows inflammation.

House: Start him on Cytoxan.

Cameron: You’re diagnosing Wegener’s based on a little inflammation?

House: Well, unfortunately I think we’ve exhausted all the tests we can do in the capacity as the doctors he doesn’t want doing tests on him.

Cameron: But you don’t --

House: We’ll know I’m right if he starts walking.

Chase: You can’t do any more tests, but you want me to treat him?

House: The medicine’s in the pharmacy, patient’s immobilized in the ICU. Sounds like a simple geography problem.

Cameron: Are you asking us to jeopardize our medical licenses for this treatment?

[Cut to John’s room. House enters with an IV drip, and starts to hook it up. John shakes his head, but House does it anyway. As he leaves, he runs into…]

Dr. Hamilton: Can I help you?

House: Uh, I’m Dr. House, I’m –

Hamilton: Gregg, right? I’m Marty Hamilton, John Henry’s doctor. [He extends his hand, House just looks at it.] We should talk.

[Cut to House’s office.]

Hamilton: I’d appreciate any list of medications, anything like that.

House: I’ve started him on Cytoxan.

Hamilton: For Wegener’s, right? Look, Gregg. I checked you out, you know? I know you’re a good doctor. You have to appreciate that I’m a good doctor, too.

House: Why?

Hamilton: Wegener’s is one of the first things I looked for. The biopsy and the blood tests were negative, just like yours.

House: There’s an error rate, Marty.

Hamilton: And there’s a time to let go. Look, I’m gonna take him off the ventilator, and John Henry’s gonna die. He’s accepted that. [Foreman enters.]

Foreman: Dr. Hamilton. Hey! [They great each other, with much smiling and back slapping and “dude, can’t you see we’re totally friends” kind of attutide. House looks on with interest.] Listen, Dr. Hamilton, I’m sorry. [House raises his eyebrows.] I should have never put your patient on IVIG.

Hamilton: It’s not your fault, Eric.

House: No, it’s mine. Eric.

Hamilton: That’s not what I said. [to Foreman] Everyone asks about you back in L.A.

Foreman: How’s the old place doing? [They start to chat.]

House: Oh, this is wonderful. [They stop chatting.] But before you guys break out the oil, I should point out you can’t pull the plug; I have a court order.

Hamilton: You used to, but –

House: I have the right to face my accuser. Judge said so.

Hamilton: Not if no one’s accusing you. All the charges have been dropped.

House: He doesn’t have to die.

Foreman: It’s not Wegener’s.

[John’s hospital room. Cora, Hamilton, et al are gathered in his room. House and Wilson are watching through the glass walls.]

House: If it’s Wegener’s, his lungs won’t be able to handle it. As soon as they pull that plug he’ll die.

Wilson: That’s why they call it pulling the plug. [Inside the room, John nods. House turns away for a second.]

Cora: I’m gonna miss you. [She kisses him on the cheek. John starts to cry a bit. Hamilton takes off the ventilator, and… John keeps breathing!]

Foreman: [pulling out his stethoscope] He’s still breathing!

Hamilton: His 0-2 stats are holding.

Foreman: He’s holding his own.

Wilson: He’s still breathing.

House: It’s not Wegener’s. Wrong again. [He walks off.]

[Cut to the Diagnostic office. Wilson and House are walking in.]

Wilson: He’s stable, but one of his arms is now paralyzed.

House: The real question is, why is he still alive?

Wilson: Do you think he’s just being stubborn?

Foreman: He’s alive because you were wrong. It’s not Wegener’s.

House: Yeah, seem to be doing that a lot, lately. People keep living because of my mistakes.

Cameron: Progression of the paralysis pretty much confirms Hamilton was right. It’s ALS.

House: Assuming this is a progression of his paralysis.

Chase: He can’t move his arm.

House: Yes, his arm is paralyzed. Yes, his legs are paralyzed. Why is everyone so gung-ho to connect those two conditions? You could think I’m wrong, but that’s no reason to stop thinking?

Foreman: How about this one? He’s not our patient.

House: Nope, not good enough.

Cameron: He could have suffered a stroke when he was intubated. [Foreman looks at her.] Well, blood clots are common in intubated patients. The inactivity causes –

House: Not interested in why. Let’s get an MR-angiogram for an embolic stroke.

Foreman: He doesn’t want you treating him!

House: They dropped the court order.

Wilson: Yeah, and that girl dropped the charges against Kobe. Doesn’t mean that he should call her and see if she’s free to get a sundae.

House: Good point, but I can go within 50 feet of him now.

[Cut to John’s room.]

Hamilton: If you need anything, page me. Any time.

John: Okay. [Hamilton leaves. John starts coughing. House, who was hiding behind a column in the lobby, comes into the room.] Get outta here.

House: Sure. That makes sense. You hate me for saving your life. In fairness to your side, you were also dying because of me, so –

John: You know I didn’t wanna be saved.

House: That’s what’s interesting. Your thyroid was low, but not low enough to cause depression.

John: So, you came here to tell me that even if I can’t walk I can still hear the birds sing? Enjoy the rainbow, and feeling the sun shine on my face?

House: Those things are fun. Okay, life sucks. Your life sucks more than most. It’s not as bad as some, which is depressing all by itself. But do me a favor. Just let me find out what’s wrong with you. And if you still want to kill yourself, I’ll give you a hand. That sound fair?

John: Yeah, sure. I’ll stick around to indulge your obsession. It’s over. I lost my air. The session the other night, with those kids? That was a test to see if I could still play. I can’t.

House: And that’s all you are? A musician?

John: I got one thing, same as you.

House: Really? Apparently, you know me better than I know you.

John: I know that limp. I know the empty ring finger. And that obsessive nature of yours, that’s a big secret. You don’t risk jail and your career just to save somebody who doesn’t want to be saved unless you got something, anything, one thing. The reason normal people got wives and kids and hobbies, whatever. That’s because they don’t got that one thing that hits them that hard and that true. I got music, you got this. The thing you think about all the time, the thing that keeps you south of normal. Yeah, makes us great, makes us the best. All we miss out on is everything else. No woman waiting at home after work with the drink and the kiss, that ain’t gonna happen for us.

House: That’s why God made microwaves.

John: Yeah, but when it’s over, it’s over.

House: Yeah. [He walks to the door and opens it. Suddenly, he walks back and starts to undo the cords connecting John to the monitors.]

John: What are you doing?

House: It’s not over for me. Either you’re gonna call the cops again, or we’re doing this. [He starts to wheel John’s bed out the door.] If you wanna die, you can do it just as easily inside an MRI machine. [At this point, the nurses at the desk are looking at House like he’s crazy. Hee!]

[Cut to a fancy restaurant. Hamilton and Foreman are eating lunch.]

Hamilton: So, I go back to L.A. I’m doing the Dana lectures again this year.

Foreman: Wow. That’s quite an honor. [Their salads arrive.]

Hamilton: It’s all political.

Foreman: To be honest, you’ve earned it.

Hamilton: I got lucky on a couple studies I was doing. It all sells tickets. You remember last year’s lectures, don’t you?

Foreman: I remember the cigar bar afterwards.

Hamilton: The only reason to attend the thing: cigars and pool. [Foreman laughs.] You enjoy working with Dr. House?

Foreman: Not the word I’d use.

Hamilton: We work too hard not to enjoy ourselves, right? Hmm. You seeing anybody?

Foreman: Kinda sorta.

Hamilton: Serious?

Foreman: I don’t know. Could be.

Hamilton: You think she would enjoy L.A.?

[Cut to Chase and Cameron working on the MRA. Foreman enters.]

Foreman: Hamilton offered me a job.

Cameron: You gonna take it?

Foreman: I haven’t decided.

Cameron: You already have the most prestigious fellowship.

Foreman: It’s a partnership. [They look at him.] Three times the money, car allowance, moving expense, pension plan, the chance to work for a guy who gives a crap what other people think.

Chase: So, why didn’t you just tell him yes?

Foreman: I made a commitment here.

Chase: Right.

Cameron: House would let you out of it in a heartbeat.

Foreman: Or he wouldn’t, just to jerk me around. Would you guys have taken the job?

Chase: Don’t need the money.

Cameron: I’m not like you. I don’t hate House.

Foreman: You guys really don’t have a problem with him, with what he did?

Chase: He knows we disagree with his choice.

Foreman: Choice? Chase, it’s not apples and oranges, its right and wrong. And he does it like he doesn’t care! He assaults the guy and moves on to the next differential diagnosis like it’s nothing –

Cameron: What do you want from him? More hand-wringing, more torment? You want him to cry himself to sleep at night?

Foreman: Yeah! Yeah, I want some clue that he knows it’s a big deal. That it scares him, that it matters.

Chase: [looking at the screen] Whoa, whoa, whoa, what’s that?

Cameron: It was a stroke!

Chase: Well done, Cameron.

Cameron: House called it. The arm and legs are unrelated.

Foreman: You make enough calls, one of them is bound to be right.

Chase: Yeah, he’s just a lucky, lucky guy.

Foreman: Listen, listen, I just think it wouldn’t hurt him to learn a little humility. [We see that House has been standing behind Foreman. Whoops!]

House: So, what’s the verdict?

Cameron: Embolus. The arm problem’s caused by a clot.

Chase: There’s a good chance we can still bust the clot with tPA.

House: Do it. See what happens to his arm.

[Cut to John’s room. Cora and Hamilton are there, Foreman is explaining the situation.]

Foreman: We found a blood clot in your brain. We’d like to start you on heparin, it’s a blood thinner.

John: What are the side effects?

Foreman: Well, your lungs are kind of chewed up from the pneumonia. Good chance there’ll be an effusion.

Cora: Bleeding?

Hamilton: Into his lungs.

Foreman: It’s our best chance to give you back the use of your arm.

John: I don’t need my arm without my air.

Foreman: The damage would likely be minimal.

John: No. [Foreman looks to Hamilton.]

Hamilton: It’s his call.

Foreman: Or we could do an embolectomy. Basically, we’d go in and pull the clot out.

Cora: He’s saying no to drugs and you’re recommending brain surgery?

Hamilton: Bypasses risk to the lungs.

Foreman: It’ll either help your arm, or –

John: Or it’ll kill me.

Foreman: From your point of view, it’s a win-win.

John: Okay.

Foreman: We’ll set up the procedure for today.

[Cut to the OR. Cameron and Chase are performing the procedure.]

Chase: We’re in your carotid artery. This is going to take us all the way up into your brain.

Cameron: You all right?

John: Yes. [We see a shot of the screen, showing the line going up his artery into his brain. It moves to a CGI shot of inside the head as Cameron explains.]

Cameron: The sludge is blocking the blood flow to the part of the brain that controls your arm. All done. You still okay?

John: I think so.

[Cut to House’s office, where he is talking to Foreman.]

Foreman: I don’t know, I guess… It’s just with Dr. Hamilton here, I notice a difference in styles.

House: His style involves humility. [small pause] Another difference in our styles: I don’t care much for apologies. You can go.

Foreman: I didn’t know you were standing there when I said that, okay? It was completely rude.

House: Do you mean genuine humility? You know, with all the self-doubt and the self-questioning, or Hamilton’s polite, patronizing “Aw, shucks” humility?

Foreman: You’re both excellent doctors.

House: Thank you. And humility is an important quality. Especially if you’re wrong a lot.

Foreman: You’ve been wrong every step of the way.

House: Of course, when you’re right, self-doubt doesn’t help anybody, does it? [His beeper goes off.] We gotta go.

[Cut to House and Foreman walking into John’s room. Hamilton and Cora are there.]

Hamilton: Congratulations, Gregg.

House: [mutters to Foreman] Congratulations… [aloud] Why, Marty?

Cora: John woke up, he can use his arm.

John: [demonstrates] Thank you.

Hamilton: Now look, I know we’ve had our differences, but I think when a person does something well [House picks up the phone] it ought to be recognized.

House: The phone works. Next time you want to make me feel all warm and fuzzy, leave a message. [He taps John’s leg.] Don’t get me wrong, I’m overcome with joy.

John: Doc?

Hamilton: Yeah?

House: What?

John: You just touched my leg.

House: What, you gonna charge me with assault again?

John: No, I felt it.

[Cut to House walking into the Diagnostic office with Chase and Cameron.]

House: He now has feeling all the way up to calf. This is the way medicine evolved. Patients sometimes get better. You have no idea why, but unless you give a reason they won’t pay you. Anybody notice if there’s a full moon?

Cameron: You’re saying he just spontaneously got better?

House: No, I’m saying let’s rule out the lunar god and go from there.

Chase: Something he’s on is working.

[Cut to Hamilton and Foreman walking in a hallway.]

Hamilton: The enzyme replacement protocol is working, reversing the ALS.

Foreman: The timing doesn’t seem suspicious to you?

Hamilton: Heh heh, do you think Dr. House will see it that way? Figure it’s his medication doing the job?

Foreman: I’m sure he will.

[Cut to House’s office.]

House: It’s one of ours.

Cameron: How do we figure out which drug is doing the trick?

House: Easy. We stop all of them.

Cameron: One of those drugs is helping him.

House: And the rest? Steroids, antibiotics, anti-inflammatories, they’re toxic if we leave him on all of them.

Cameron: He’ll walk again.

House: Yeah, to his own funeral.

Chase: But if we stop everything, he’ll get worse.

House: True. And then we’ll add our medications back, one at a time. If he gets better, then we’ll have our answer.

Cameron: And if he doesn’t get better?

House: Then we’re in trouble. Not as much as he is. I suppose that was your point.

[Cut to Foreman and House in a hallway.]

Foreman: I assume you want me to convince Hamilton to stop his treatments, too?

House: Don’t care.

Foreman: You know at least five of the medications are part of his protocol?

House: If his stuff was helping the guy would be playing tennis six months ago. It’s our round of treatment that’s helping.

Foreman: Right. So that’s what you’ll stop.

[Cut to Wilson and House, in a clinic exam room.]

Wilson: So your philosophy is, “If they don’t want treatment, they get it shoved down their throat, but if it might cure their paralysis, whoa, better slow down.”

House: Yeah. [We see that they’re watching General Hospital on the portable TV.] My old philosophy used to be “Live and let live,” but I’m taking this needlepoint class and they gave us these really big pillows.

Wilson: What’s your philosophy on employee relations?

House: That’s a very tiny pillow.

Wilson: Great. Sounds like you know what you’re doing. [A knock. Hamilton enters.]

Hamilton: Gregg. Can I have a word?

House: Can it wait for the commercial, Marty? Say “hi” to my friend, Jimmy.

Hamilton: Pleasure. Your diagnostic trial –

House: Seriously, commercial’s in about five minutes.

Hamilton: -- it’s a dangerous game.

House: Only if we’re watching in the bathtub.

Hamilton: I need to know exactly what medications you were giving John Henry.

House: Forget it. And if Foreman tells you what John Henry used to be on –

Hamilton: You’re gonna fire him?

House: Nope. Make him live out every day of his two-year contract.

Wilson: Foreman asked to leave?

House: Not yet.

Hamilton: But how do you know I made him an –

House: You’re a polite twit, but you’re not an idiot.

Hamilton: I need to know what medications you’ve taken him off of.

House: Wait a second. You’re not an idiot. You need to know what medications I’ve stopped, because…

[Cut to John’s room. House is poking John’s leg.

House: He’s getting worse. [He whacks John’s leg with a clipboard. Nothing.] [to Foreman] Right now you still work for me. Come on!

[Cut to House and the ducklings. in the hallway.]

House: No feeling, no wiggling. The bad news is, John Henry’s back where he started. The good news is, Hamilton looks bad.

Foreman: Yeah, it’s not whether you win or lose, it’s whether the other guy loses.

House: What was the first thing we put him on?

Chase: Steroids, for the pneumonia.

House: Well, put him back on them. Give them 24 hours, see what happens.

Cameron: His lungs aren’t great. It might cause another respiratory collapse.

House: Sure hope not. I didn’t much like that lawyer. And get an MRI.

Foreman: He already got one. And an MRA.

House: Well, obviously something is different now. Do it again. Chase, take care of the scan. Cameron, put him on the steroids. [to Foreman] We should probably talk, huh?

[Cut to John going into the MRI.]

Chase: Thin cuts.

Cameron: What levels?

Chase: T9 through the quarter-equinus, same as the last time. You really think House would let Foreman out of his contract?

Cameron: He has to. If he doesn’t, he’s telling Foreman he needs him. House can’t handle that. [She looks closely at the screen.] Oh, my God!

[Cut to House and Foreman in House’s office.]

House: I checked him out. He’s a great doctor. You think he’s better than I am?

Foreman: This about your ego?

House: Answer the question. It’s not going to change my opinion of myself. Might affect my opinion of you, but that shouldn’t affect your opinion of yourself. Now I’m getting confused. If you think he’s a better doctor than I am, then you should take the job. Otherwise, you should get him to buy you two or three more nostalgic lunches and politely decline.

Foreman: It’s that simple? I should just ignore the mockery and abuse?

House: Oh, how do I abuse you?

Foreman: How do you not? If I make a mistake –

House: I hold you accountable, so what?

Foreman: Dr. Hamilton forgives. He’s capable of moving on.

House: That is not what he does!

Foreman: I screwed up his case, he told me –

House: He never said you were forgiven. I was there, he said it wasn’t your fault.

Foreman: So?

House: So, it was. You took a chance, you did something great. You were wrong, but it was still great. You should feel great that it was great. You should feel like crap that it was wrong. That’s the difference between him and me. He thinks you do your job, and what will be, will be. I think that what I do and what you do matters. He sleeps better at night. He shouldn’t. [Cameron and Chase come running in.]

Cameron: Arteriovenous malformation.

Chase: Intradural, compressing his spine. [Chase puts up the scans.]

House: Causing his paralysis.

Foreman: How could Hamilton have missed an AVM?

House: Well, we missed it, too. ‘Cause it wasn’t there before.

Chase: You saying it just grew overnight?

House: No. It was on the spine, it wasn’t on the MRI. [He points to the scan from a few days ago.] Same anatomic location.

Cameron: It’s not there.

House: Well, what is there?

Chase: Nothing.

House: Or something that looks like nothing.

Cameron: Background noise, static.

Chase: Scar tissue? Inflammation?

Foreman: If it’s inflammation, the steroids would have shrunk it down.

House: Revealing the AVM, which has always been there, hiding behind its own swelling. We remove that, he’ll walk again.

[Cut to the OR, where they are removing the AVM. Next, back to John’s room, where Cora is there for John when he wakes up. We next see John going through physical therapy on his legs.]

[Cut to lobby of the hospital. House has got his Vicodin bottle out. John comes out of the elevator, walking with a cane, his trumpet under one arm.]

John: Dr. House! Cora’s meeting me outside with a limo. I’m being discharged.

House: Fifty bucks says I can beat you to the curb. [John laughs.]

John: Thanks for sticking with the case.

House: I can’t do anything else. [He takes the Vicodin.] You’re much more easily amused when you can walk.

John: How bizarre. I’m guessing you weren’t exactly Mr. Sunshine even before your leg got messed up. [John hands House his trumpet as “It’s a Wonderful World” starts to play. Aw.] I want you to have this.

House: Wow.

John: You can sell it if you want to, just promise me you won’t play it. [House smiles.] How many of those pills you taking?

House: I’m in pain.

John: Yeah. Aren’t we all? [pause] So, where do you buy these things, do they have cane stores?

House: Oh, don’t worry about it. You’ll be jogging before you need a second one. [Foreman comes out a side door.] See you tomorrow, Eric.

The End

Tags: season 1

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