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House MD – 5.10 Let Them Eat Cake

Originally Aired: December 2, 2008

Written by: Russel Friend & Garrett Lerner
Directed by: Deran Sarafian

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.



[Open on a stadium. Emmy, in a black running suit, climbs a couple of rows to the top of the bleachers, facing away from the field. Behind her are 8 or 10 people in red hoodies and black pants. They are climbing the stairs, going past Emmy as she films a commercial.]

Emmy: Do you want a lean body for summer? Well, the time to start is now. No gimmicks, no crash diets, and absolutely no drugs. Think healthy and be healthy. You can start now. Just pick up the phone and become the best you you can be.

[As Irv, a heavy man, reaches her, sweating profusely, he falls. The rest of the group in red keep climbing.]

Irv: Ohh.

Director: Cut! Going again.

Irv: Sorry, did I mess up the commercial?

Emmy: No, it's fine. Are you okay?

Irv: Ah, I think it's cramps. Oh, I have burning on my side.

Emmy: Sit down, take a few minutes, and catch your breath. Everybody else keep running!

[Some of the extras have reached the top of the stadium. They turn and pass Emmy on the way down.]

Director: We're not filming.

Emmy: We don't do this for the cameras. We do it for ourselves.

Director: [quietly, to Emmy] We can't go again with him sitting there.

Emmy: Fine, um, but that felt phony. At least let me get a little workout. Maybe if I’m breathing as hard as they are, I won't seem like such an evil task master.

Director: All right, take five, guys.

Emmy: [to Irv] How you feeling?

Irv: I think I’m ready to do this.

Emmy: You sure? [Irv stands.] That's it. That's the way to fight through. [She gets into position to walk up the bleachers next to him.] All right, concentrate on those knees. Lean into it. And lift.

Irv: Lifting.

Emmy: Come on, push it!

Irv: Lifting.

Emmy: Come on, you're almost at the top. Those eight steps are the difference between fat and thin. Seven, six, five, four! One more! Nice job! [Irv reaches the top a throws his arms high in celebration.] You feel that burn? That's your body carving out its new shape.

Irv: Okay.

Emmy: Don't sit. Just take it slow on the way down.

Irv: [whispers] Oh, boy. [He walks down a couple of steps until he is abreast with Emmy. She looks a little spacy.] Are you okay?

[Emmy falls over and rolls down the bleachers. She comes to a stop where the camera crew is sitting. The lighting guy pulls a light stand away. The crew and Irv group around her.]

[Opening Credits]

[House arrives for the day. He gets into the elevator. As the doors start to close, Cuddy runs up and joins him.]

Cuddy: Any idea why we're getting half as many requests for you as usual?

House: Democrats' health care plan?

Cuddy: At least we have one case that looks intriguing. 30-year-old fitness trainer suddenly can't breathe. Collapses and breaks her ankle. [He grabs the file and starts reading.] That's it? You're not gonna argue why this case is beneath you?

House: No point. I'm in an elevator. Can't run away.

Cuddy: You can't run away anyway.

House: That's just mean. [They get off the elevator and walk down the hall side by side.] Why are we still together?

Cuddy: We are going to our office.

House: Pronoun confusion. Starts kicking in once you pass child-bearing age.

Cuddy: Well, that's just mean. My office was recently destroyed. I thought I’d use the office of the doctor directly responsible. [She blocks the door to House’s office with her arm.]

House: I think the patient holding the gun to my head was actually the one directly responsible.

Cuddy: My desk won't fit in his cell. You can use our outer office.

[He watches as Cuddy makes herself at home at his desk.]

[Cut to the Diagnostics Conference Room. House enters. Taub and Kutner are at the table.]

House: Where's Foreman and Thirteen?

Taub: Down in the GRC. Thirteen started her clinical trials today.

Kutner: What's Cuddy doing in your office?

House: Other than throwing off the feng shui with her ass that faces all eight sides of the bagua at once?

Cuddy: [calling from House’s office] These walls aren't soundproof.

House: I'm well aware. [to Kutner and Taub] Normal CT means that her lung problem has the distinction of having nothing to do with her lungs.

Taub: [looking at a photo from the file] Steroids. No one looks this fit without cheating. Anabolic steroids hack away at the immune system, left her open to a pulmonary infection.

House: [looking at the picture] Wow. Muscles and curves. My penis is so confused.

Kutner: She's not on steroids. Her program's all about getting in shape naturally — exercising, eating right.

Taub: And you know this because?

Kutner: She has infomercials to sell her DVDs. What? I'm up late a lot.

House: And you actually believe what you see on TV. Go run the labs.

Cuddy: [loudly] The labs are back. And there's no sign of steroid use. Can someone please read her file?

House: Can someone please stop backseat differentialating?

Kutner: What about allergies? She goes jogging every morning. Inhales car fumes during rush hour.

Cuddy: [joining them] Perfect, except that she was jogging half a mile from the nearest road. In the cold. Cold air hits the lungs, sets off an attack. Exercise-induced asthma.

House: Nice try. Except EIA doesn't account for the elevated BP, if you'd read the file. [to Taub and Kutner] Come on. Before the shrieking harpy melts my brain.

[They follow House into the hallway.]

Taub: Her BP's fine.

House: I know.

Kutner: Exercise-induced asthma actually fits.

House: I know. You know. She can't know.

Taub: The only good way to test for EIA is to recreate the conditions in which the attack occurred. But we can't exactly make her run out in the cold on a broken ankle.

House: Get creative. [He fakes giving Taub Emmy’s photo. When he reaches for it, House gives it to Kutner.]

[Cut to the clinical trials area. Thirteen sits in the waiting area, alone. A nurse enters a treatment room. Thirteen turns and sees Janice, a patient with advanced Huntington’s. Her body jerks uncontrollably.]

[Cut to a flashback of young Remy standing at the kitchen sink. She looks into the bedroom. Her mother is sitting on the bed, her body jerking like Janice’s. Mr. Hadley goes to help her. He sees Remy.]

Mr. Hadley: It's gonna be okay. [He closes the bedroom door.]

[Cut to the nurse closing the door to the treatment room.]

[Cut to a refrigerated room in the morgue. Two bodies are at the edge of the frame, their feet, with toe tags, are visible. Kutner and Taub are wearing overcoats. Emmy, wearing just her hospital gown, is using exercise machine that works the arms like a stationary bicycle works the legs. She’s hooked up to a blood pressure monitor.]

Taub: Any shortness of breath? Tightness in your chest?

Emmy: Feeling pretty good actually.

Kutner: Not even breathing hard. O2 stats and lung capacity are still well within range.

Taub: Your cuff's slipping down. You want to stop for a moment?

Emmy: I'd rather not. Haven't had any exercise in two days.

Taub: Take it you don't get a lot of fat in your diet.

Emmy: I take it from your tone you think that's a bad thing.

Taub: Do you ever indulge?

Emmy: Ha. There's more to life than indulging your every whim.

Taub: I didn't say every. But a whim every now and then can make life a little —

Kutner: You okay? Trouble breathing?

Emmy: [She has the same spacy look she had before she fell.] No, I feel fine. Why?

[She falls over. Taub catches her while Kutner gets an Ambu bag.]

Taub: [checking her neck] No pulse. This isn't asthma.

[Cut to clinical trials treatment room. Thirteen is tapping her fingers on a machine.]

Thirteen: There a lot of other people in the trial?

Foreman: I'm taking over the people that already started it at Mercy. So pretty full. Stop. [He resets the machine.] One more time. No talking.

Thirteen: I shouldn't be here. It's nepotism. I know the guy running the drug trials, so I get a spot.

Foreman: You have Huntington’s, so you get a spot. Stop. One more time. Just the fingers. No mouth.

Thirteen: The point of this thing is to improve neural cell longevity. Which doesn't matter much before symptoms. So you should give my spot to someone —

Foreman: Shut up. Stop. You can stop feeling guilty. Your best tapping rate was .004 taps per millisecond. Means your nerves have started degenerating.

[Cut to Diagnostics. House is in the conference room, peeking at Cuddy who is still at his desk. She’s awkwardly bouncing the big ball. He comes to the doorway.]

House: You wanna work in here? Fine. Me too. We'll split the desk, 50-50. That side's yours. This side's mine.

Cuddy: You're right. There's plenty of space here. Neither one of us needs all of it.

House: So that's your strategy. Taking the high road. It's not gonna work.

Cuddy: Huh? Did you say something? I couldn't hear you from all the way over here on my side of the desk.

Taub: [entering with Kutner] Patient's heart stopped.

Kutner: We shocked her back to sinus rhythm. She's stable. Test didn't set it off. Her EKG was normal.

House: Well, she's consistent. The lung problems had nothing to do with her lungs. A heart problem that has nothing to do with her heart. Something is strangling her system.

Kutner: Carcinoid tumor?

House: Find it, cut it out.

[Cut to Taub and Kutner performing a scan on Emmy.]

Kutner: Can a leaking breast implant cause joint pain?

Taub: No. And she clearly doesn't have implants. Or joint pain. What's going on?

Kutner: Got another patient. I set up an online second opinion clinic. People who don't like or trust their doctors e-mail symptoms. I can knock off four or five cases over lunch. Clear two grand by e-mailing them back. Ascending colon's clean.

Taub: That's got to be illegal.

Kutner: Only in nine states, and this isn't one of them. Legal notice spells out it doesn't replace doctor's visits. So there's no opportunity for malpractice.

Taub: How come you haven't said anything about this?

Kutner: It's no big secret. I guess I’m just not very chatty.

Taub: You told us when you renewed your subscription to National Geographic.

Kutner: Small intestine looks clean. Moving into the pylorus.

Taub: So you don't mind if I tell House?

Kutner: Actually House may sort of mind because I sort of set it up in House's name. Nothing in the bile duct.

Taub: And by "set it up in his name," you mean?

Kutner: I mean it's Dr. Gregory House's second opinion clinic with medical advice direct from Dr. Gregory House.

Taub: You're insane. With two days to live.

Kutner: House is never gonna find out.

Taub: He will if I tell him. Or you cut me in for 30% and I keep your secret safe.

Kutner: That's blackmail.

Taub: Yes. Moving into the — [He stares at the screen.] Whoa —

Kutner: That's her stomach? [The scan is on the screen.] It's the size of a shot glass.

Taub: Because our patient's a big, fat cheater.

[Cut to House’s office. He puts a picture of Emmy when she was fat on the light board. Cuddy is at the desk, talking on the phone.]

House: Subtle. No way you geniuses could've spotted this.

Taub: Gastric bypass surgery. She had her stomach stapled. Then had the records from her files pulled so it wouldn't ruin their DVD sales.

Cuddy: [into the phone] Hold on a second. [She puts her hand over the mouthpiece and turns to House.] Can you do this outside?

House: I could, but that would defeat the purpose of doing it here. Where are the smart guys?

Taub: If you mean Foreman and Thirteen, apparently the first appointment of the drug trial's an all-day thing.

House: I said yes to this?

Kutner: Her gastric bypass procedure could cause —

House: Forget the bypass. Treat her like a fat girl.

Taub: Should we treat her like a 60-year-old Asian man too? She's not fat.

House: Not on the outside. But on the inside, she's still tons of fun.

Kutner: When she was obese, she probably had type two diabetes. Could've left her with permanent nerve damage.

House: Ten points for doing what I said. Minus ten points for doing it badly. If this was diabetes-induced nerve damage, it would've kicked in years ago. [Turns to his desk. Cuddy is still on the phone. Loudly] Have you seen my balls?

Cuddy: Can you hold on a second? [She puts the phone against her shoulder and turns to listen to House.]

House: My balls. Have you seen my balls? Giant one and the red one.

Cuddy: Your plan isn't gonna work.

House: Of course it is. I try to make you miserable to make you leave. You deny that it's making you miserable. You try to make me miserable so I’ll stop making you miserable. And eventually you will leave, citing reasons that have nothing to do with misery.

Cuddy: [searching in her purse] You're not bothering me.

House: Step one complete.

Cuddy: [into the phone] I'm gonna call you from my cell. [She hangs up.] And then I will come back in here. [She dials the cell.] Hey. Yeah, I just had to explain to him that I had his balls and he's not getting them back. [She pats House on the arm as she walks past him.] Excuse me.

Kutner: Sleep apnea explains —

House: Apnea would've disappeared when she shrank.

Taub: Not if it destroyed the musculature of her trachea.

Kutner: Apnea cuts off oxygen to the brain. The resulting neurological damage —

House: She been snoring?

Taub: She didn't mention it.

House: Did she mention feeling tired after a full night's sleep?

Kutner: No, but —

House: [staring at the photo] This isn't apnea. And this is a stupid room to be doing a DDX in.

[He walks out.]

[Cut to clinical trials treatment room. House enters, followed by Kutner and Taub.]

House: Cliff notes. Gastric bypass only makes her skinny on the outside. On the inside, we have heart and lung issues not caused by heart and lung issues.

Foreman: Private area, House. It can wait.

Thirteen: You need to consider side effects from her gastric bypass surgery.

Kutner: Forget the bypass.

House: Let the dying girl finish.

Kutner: You said forget the —

House: Tssss. Dr. Thirteen has the floor.

Thirteen: Bypass could create malabsorption issues. Leads to low potassium.

House: Very stupid. Her potassium's fine.

Kutner: But her intestines aren't. Gastric bypass could cause malabsorption by creating a blind loop of bowel. It ulcerates during exercise. Bacteria get loose in the bloodstream. Migrate to the heart and lungs.

House: Very not stupid. Bacteria in the bowels means there's bacteria in the poop. Get some and test it.

[Taub and Kutner leave.]

Foreman: He could've come up with SIBO anywhere else in the hospital. You didn't need to come down here and screw with us.

House: But her wrong idea led to his right one. It was vital screwing.

[Cut to Emmy’s room. Taub is holding a bedpan.]

Taub: We think your surgery might've caused an infection called SIBO. The stool test will help us to confirm. Put some of what you're full of in here.

Emmy: If surgery could somehow make you taller, wouldn't you do it?

Taub: Sure. But I wouldn't call a meeting of the Lollipop Guild and tell them they can grow if they work real hard at it.

Emmy: I don't tell anyone not to get gastric bypass. I tell them how to get healthy. How to improve their lives.

Taub: Yeah, by telling them to do what you were unwilling to.

Emmy: I was willing to do anything. Thyroid, hormones, crash diets — none of it worked. My body was like a prison. When I got the surgery, I got healthy. And when I got healthy, I got happy.

Taub: I'm not sure you're happy. But if you are, being healthy didn't do it. Being pretty did. Poop in the bedpan. [He taps it with his pen and leaves.]

[Cut to Cuddy’s office. It’s a mess.]

Wilson: House's office? Really?

Cuddy: Did he send you here to beg for it back?

Wilson: Well, there are dozens of other doctors —

Cuddy: Other doctors actually use their offices for crazy stuff like seeing patients. Not throwing a ball against the wall and calling it work.

Wilson: It's his process. That ball saves lives.

Cuddy: Did he give you talking points?

Wilson: Yeah, but I added one of my own. Don't take his office and pretend like all you're doing is taking his office. You chose his room because you want to be there. But sitting near him and hoping isn't gonna get it done.

Cuddy: Leave here now, or I’ll take your office.

Wilson: No, you won't.

[Cut to Kutner and Taub in the lab.]

Kutner: The boob lady e-mailed me again complaining of chronic fatigue now. She's convinced the implants are responsible.

Taub: They're not.

Kutner: I told her. She says something is, and if I don't find out what she's gonna complain to the licensing board. [Taub chuckles.] It's not funny.

Taub: It is. You just can't appreciate it because it's gonna destroy your career.

House: [standing behind them, unnoticed] What happened? He call Foreman "clean and articulate" again? It is surprising.

Taub: Clinic patients just whining.

House: What's the poop?

Kutner: It's gonna take about an hour to spin down the sample.

House: What are we looking for?

Kutner: You don't know?

House: I'm doing my famous Socrates impression. Think I really nailed the accent.

Taub: High fat content indicates SIBO.

House: And what does fat do in water? [He’s at the sink with the tap turned on.]

Kutner: It floats.

House: What else floats in water?

[He plops a large vat of water on the table next to Taub.] Correct answer is a duck. If it doesn't float, Kutner missed the boat. [He opens the equipment, picks up the stool sample in his gloved hand and drops it in the bucket. All three of them peer into the bucket.]

House: Looks like I was wrong to dismiss apnea. You guys can stay up all night gloating in the sleep lab. [He drops the glove on the bucket and leaves.]

[Cut to the sleep lab. Emmy is asleep with a c-pap mask on her face and an array of electrodes attached to her forehead. Kutner and Taub watch from the observation room. Kutner is looking at the “boob lady’s” x-rays.]

Kutner: What about all that scar tissue around the implant? Could that be —

Taub: That amount of encapsulation's perfectly normal.

Kutner: Well, I gotta tell her something.

Taub: Tell her to find a decent plastic surgeon who can correct the placement —

Kutner: Yeah, that's what she wants to hear, she's sick and she's lopsided.

Taub: Tell her it's a virus. It probably is, and it'll get her off your back for a few — [He looks at the sleep monitor.] Emmy’s EEG is flatlining.

[Emmy’s bed is empty.]

Kutner: Where would she have gone?

[Cut to Rehab. Emmy has found a treadmill and she’s running. Her leg is still in a cast.]

Emmy: Hey, I looked for you guys in the control room, but you seemed busy.

Kutner: [turning off the treadmill] Get off there. Last time you exercised, you had a cardiac incident.

Emmy: I feel fine.

Taub: You felt fine last time.

Emmy: I only slept a couple hours, but I feel great. Can I get one of those machines?

Kutner: You're running on a broken ankle.

Emmy: It doesn't hurt.

Taub: And your leg is bleeding. [He gets a syringe and sticks her in the calf, just above the bloody cast.] You feel that?

Emmy: [shaking her head] What does that mean?

[He gives her a “significant” look.]

[Cut to hallway. The whole team is walking with House.]

Taub: Numbness in her left foot is ascending into her leg.

House: How did she manage to sneak out for a run?

Kutner: She said she needed to use the bathroom.

House: You two get the results of the sleep apnea test, or did those need to use the bathroom too?

Kutner: Alpha waves on the EEG ruled it out.

[They walk into House’s office. All of them make disgusted faces.]

Cuddy: I was mixing some hydrogen sulfide for good and valid reasons and must've spilled some on my side. Did it waft over to your side?

House: Cunning plan. You do realize it’s gonna stink for hours — on both sides.

Cuddy: Oh, would you look at the time? I hope your patient isn't still sick… Forcing you to stay here all night.

[Cut to a hallway where the DDX continues.]

Thirteen: Ascending numbness means her nerves are breaking down.

Taub: Or her brain.

House: Or both.

Foreman: We've gotta go.

Thirteen: Let me finish. I'll meet you down there.

Foreman: You were 15 minutes late yesterday. I don't want you to develop bad habits.

Thirteen: Appreciate the life lesson, but 15 minutes give or take isn't gonna make a difference. Get started on your other patients. I'll be down there when we're done here.

House: Way to know where your bread is buttered, sister. [raising his hand for a high five] Up high!

Thirteen: [ignoring his hand] If the problem's in her brain, it could be MS.

Kutner: Or early onset Parkinson’s.

Taub: But if it's her nerves, it could be transverse myelitis.

House: Or a million other things. We're gonna stay in the dark until we can figure out if her electrical problem is in her power station or in the high-tension wires. [They stare at him.] Power station's the brain. Wires are the nerves. Go run an NCV test.

[House looks at this deserted office as they leave.]

[Cut to treatment room. Taub is attaching electrodes to Emmy’s legs.]

Taub: The test will measure the amount of time it'll take this electrical impulse to travel along your nerves.

Emmy: Will it hurt?

Taub: No. Give me your arm.

Emmy: You can ask nicely.

Taub: I learned at med school you don't actually cure with kindness.

Emmy: You're right. I'm a hypocrite. But I don't have a choice.

Taub: Not really interested in your rationalizations.

Emmy: If I’m open about the gastric bypass, no one would listen to me anymore.

Taub: You mean no one would buy your DVDs.

Emmy: It's not about the DVD sales. I'm helping people. My clients are making themselves healthy. They're living better lives. Can you honestly tell me you've never done anything hypocritical? [Taub doesn’t say anything.] I'm sure you had good reasons.

Taub: Give me your arm… please? [Her arm is shaking as she raises it about six inches off the bed.] Keep your arm raised.

[She has trouble keeping her arm up.]

Emmy: Does this mean something is wrong with my nerves?

Taub: No. It's your muscles. We don't need to run this test. It's not what we thought.

[Cut to clinical trials waiting room. Foreman enters. No one is there. He looks at this pocket watch.]

[Cut to an elevator. Kutner and Taub are there. DeeDee, a heavily tattooed blonde wearing a midriff-baring vest, stands behind them. Kutner keeps looking at her.]

Taub: She has muscle weakness. Could indicate myasthenia gravis.

Kutner: Yep.

Taub: Also could be some kind of toxin.

Kutner: [to DeeDee] Excuse me, are you going up to the personnel floors?

DeeDee: I'm going to see Dr. House.

Taub: Do you have an appointment with him?

DeeDee: We've been e-mailing. Joint pain and fatigue thanks to these. [She grabs her breasts.]

Kutner: I'm sure it's nothing.

DeeDee: Oh, and now this. [She runs her hand through her long hair and drops a clump of it on the floor.]

[The elevator doors open. House is on a bench directly in front of them. They both steer her back into the elevator.]

Kutner: He's actually downstairs.

Taub: Uh, gone. Gone for the day. But, uh, we work for him. We can set you up in the ER. [She shrugs.]

[Cut to the elevator. Taub and Kutner are in it alone.]

Taub: The antibiotics will make her feel better. She's outta here by morning.

Kutner: If it is a staph infection.

Taub: It's gotta be. She has sleeves of tattoos and piercings from God knows where.

[The elevator doors open. As they step off, Taub talks loudly for House’s benefit.]

Taub: She has muscle weakness. Could indicate myasthenia gravis.

House: I had the weirdest dream. You guys did the test in a reasonable amount of time and came back here before I had time to fall asleep. [winces] You guys still smell that?

Kutner: Maybe you should just let her have your office.

House: Or… [Sean Connery imitation] She sends one of yours to the hospital, send one of hers to the morgue. It's not myasthenia gravis. Her breathing's improving and the weakness is in her extremities.

[Cut to Cuddy’s office. Taub and Kutner follow House in.]

Kutner: Could be a botulinum reaction.

Taub: I don't think sabotaging your boss' office is a wise counterattack.

House: All that is needed for evil to succeed is for good men to do nothing. [He hands Taub his cane and picks up a sledge hammer.]

Kutner: She probably used a lot of botox to tighten up her skin.

House: True. [He limps into the bathroom.] Could also be any kind of heavy metal toxicity. PSP or arsenic from eating too much seafood. Cadmium from bad bottled water. Lead or nickel from canned fruits or natural grains.

[He raises the sledge hammer and drops it in the toilet bowl. The front half shatters.]

Taub: I don't think replacing that was part of the renovation plans.

House: It is now. Lucky for us, we can treat all those toxins with the same thing: chelation.

[Cut to Thirteen’s apartment. She enters. Foreman is already there, waiting for her.]

Foreman: You never showed up.

Thirteen: Get out of my house.

Foreman: I wanted to find proof that you were slipping back into your self-destructive pattern. Confirm you weren't worth my time. Instead, I found this. [He holds up a notebook.] You followed all of my instructions to the letter. Probably better than any patient I have. So why are you the only one who can't show up for appointments?

Thirteen: I came down right after I was finished with House. You were in your office with another patient. And there was another patient in the waiting room.

Foreman: Janice.

Thirteen: I'm well-aware of what's gonna happen to my body over the next eight to ten years. I do not need a visual reminder every time I walk into that place.

Foreman: That's understandable. It's human. And you need to get over it. Now you show up on time tomorrow, or you don't show up at all.

[Knocking is heard. It echoes as the scene cuts to flashback. Remy is on her bed with the door closed.]

Mr. Hadley: [through the door] Your mom is leaving. You're gonna regret this the rest of your life.

[Cut back to Thirteen in the present.]

[Cut to Emmy’s room. She’s just lying there.]

[Cut to stairwell. House is at the vending machine. All four fellows sit on the stairs above him.]

Taub: The chelation didn't work. Her muscles are still deteriorating.

House: That rules out toxins. So what else can go wrong when the Hindenburg deflates?

Taub: Why aren't we doing this in your office?

House: Obviously because it would be stupid to do this in an office with no furniture. Cuddy… overreacted to my overreaction.

Thirteen: Coronaro-cardiac fistula. Even a small hole could cause —

House: This started in the lungs, not the heart. And why are you leaning on a 45-degree angle away from Foreman?

Thirteen: [sitting up] I'm sitting straight.

House: Trouble in the land of false hope?

Foreman: Everything is fine. Austrian syndrome.

House: Nice deflection. But our patient doesn't drink. She's a health nut. And even if I was a cynical guy and thought that she was a liar, I'd have done a tox screen, which would've come back negative for alcohol. You should come to these gatherings more often. Keep you from looking like an idiot. [Kutner’s beeper goes off.] Are you making book, or did something else happen to our patient?

Kutner: Personal. I'll put it on vibrate.

Taub: [His beeper goes off. He puts it on vibrate.] Guillain-Barré. Usually starts as a muscle pain patients compare to the pain of over-exercising.

House: So who's paging you? Your wife? Does it worry you that she paged Kutner first?

Foreman: Guillain-Barré fits. Patient didn't notice the initial symptoms because it's no different than how she feels every day. Her muscle weakness is the precursor to full paralysis.

House: Gastric bypass probably set it off. Oh, at what price beauty? Go start her on plasmapheresis.

[The fellows leave. House sits on the stairs.]

[Cut to the ER. DeeDee is gowned and sitting/crouching on a bed.]

DeeDee: [singing] She put de lime in de coconut. She drank it all up. She put de lime in de coconut. She drank it all up.

[Kutner, Taub and Cameron are staring at her.]

Kutner: DeeDee.

DeeDee: She put de lime in de coconut. She drank it all up.

Kutner: Can you stop singing?

DeeDee: She put de lime in de coconut, call de doctor, woke him up an’ say.

Cameron: Musical automatism. She could be having a partial seizure right now. You need to get House.

DeeDee: Doctor! Ain't der notin I can take, I say

Taub: DeeDee!

DeeDee: Doctor! To relieve my bellyache, I say

Cameron: Yelling at her is not going to be an effective treatment.

Kutner: She's faking. It's a cry for attention.

DeeDee: Doctor! She put de lime in de coconut

Cameron: Her brain could be misfiring.

DeeDee: She call de doctor, woke him up.

Kutner: Right, a rare neurological disorder is far more likely than a cry for attention. I mean, nothing about this woman screams "look at me."

DeeDee: I say Doctor! Ain’t der notin I can take, I say

Cameron: [pulling DeeDee’s hair back] On the other hand, look at her. [DeeDee is bleeding from her ear.] She needs a full neurological work-up.

DeeDee: Doctor! To relieve my bellyache. I say Doctor!

Cameron: Get House!

[DeeDee continues singing, less and less intelligibly.]

[Cut to Emmy’s room.]

Emmy: Ultimate irony. Killed myself trying to make myself healthy.

Taub: You're not dying, okay? This disease is manageable.

Emmy: Better start getting used to that wheelchair. Self-pity doesn't suit you.

Emmy: Just take me down to the —

Taub: No. You're strong enough to walk. Come on, get your ass out of bed and walk.

[She gets up and slowly walks, holding onto her IV pole. Taub holds her other arm.]

[Cut to the cafeteria. Kutner is eating with Chase and Cameron.]

Kutner: Could be an aneurysm. We've got to control her blood pressure. Start her on a calcium channel blocker.

Chase: Or… you could tell House.

Kutner: I can't tell House.

Cameron: You'll be in trouble. On the other hand, she's sick.

Kutner: She's singing.

Chase: And bleeding out of her ears, and losing her hair. And an aneurysm doesn't explain her joint pain.

Kutner: Wilson's disease does.

Cameron: No Kayser-Fleischer rings.

Kutner: Anorexia.

Chase: Now you're just desperate.

Kutner: Biliary tumor causing paraneoplastic syndrome.

Chase: That might actually fit. I'll scan to confirm.

Kutner: You'd do that for me?

Chase: You don't have the time. Which means I can ask for 25% of your income and you'll give it to me.

[Cut to Wilson’s office. House spreads a blueprint out on the desk, holding one side down with his cane and the other with a paperweight.]

Wilson: You going over the fence?

House: Took three visits, but I finally convinced the contractor that I’m Cuddy's boss. And all the office renovation plans need to go through me.

Wilson: You did do the math on this, right? Screwing with her office means her renovations will take longer. Means she will be in your office longer.

House: [marking an area on the blueprint] See there? I'm having a bidet put in instead of a toilet. Not in addition to. Instead of. You want to know what happened to the old toilet?

Wilson: She'll be with you where you claim to not want her.

House: I smashed it with a sledgehammer.

Wilson: I think in some ancient cultures that was actually considered a proposal of marriage.

House: Is this fun for you? Analyzing everyone else's fun away?

Wilson: Ask her out. It'll cost the hospital a lot less.

[Cut to Emmy’s room.]

Taub: I brought some visitors. Cheer you up. It's okay. Come on in, guys.

[The people from the commercial enter.]

Irv: We're all staying on your plan. Nobody's cheating.

Emmy: That's great. [He sits on the bed.] Uh, you're on my arm.

Irv: We found out about your gastric bypass. How could you lie to us like that?

Emmy: The doctors told you? [He shifts on the bed.] You're really hurting my arm.

Irv: You're not the best you you can be. You're a fraud. You're a self-hating fat person.

Emmy: You're really hurting me.

Irv: Feel the burn.

Other Visitors: Burn! Burn! [They close in on her, chanting.]

Emmy: Help! [She screams then sits up in bed. She’s alone.] Get off of me! Get off of me! Get off of me!

[Cut to the Diagnostics Conference Room. It is empty except for the sink. House lies on the floor, twirling his cane. Thirteen, Taub and Kutner sit against the wall.]

Taub: Mood congruent hallucinations.

Kutner: Means it's not Guillain-Barré.

Thirteen: Which means whatever it is, it's now in her brain. [She gets up to leave.]

House: Where are you going?

Thirteen: Sorry. Treatment.

House: Does Foreman schedule your appointments by numbers on the clock or just by when I’m in the middle of something?

Thirteen: Sorry if I’m dying at a bad time for you. Could be CNS lymphoma. [She leaves.]

House: [calling after her] So losing the 200 pounds was just a coincidence? [He gets up.]

Taub: What about a prion disease?

House: If her brain is slowly turning into a Swiss cheese, there's not a lot we can do.

Taub: There are some possible treatments.

House: Get a brain biopsy to confirm.

Cuddy: You're not cutting into this woman's brain before you test.

[She’s sitting on the floor of House’s empty office. She’s wearing a pencil skirt and stilettos. She jumps up and heads for the conference room.]

House: That is the test.

Cuddy: Not for CNS lymphoma, which is a perfectly legitimate diagnosis. One you can test for non-invasively.

House: You're obviously not opposed to being invasive.

Cuddy: Rule out CNS lymphoma first. Then rule out astrocytoma, then rule out other brain tumors…

[House makes a fist and blows into it. He opens his hand, as a magician would, to show that it’s empty.]

House: I hereby declare them ruled out.

Cudddy: Run the tests. You can do a brain biopsy, but only as a last resort. [She returns to his office.]

House: [following her] Start running down Cuddy's list of diseases it's not. [Taub and Kutner get up.]

[Cut to the office. Cuddy is squatting on the floor.]

House: You're not stopping me for medical reasons. You're stopping me… because you have the hots for me.

Cuddy: You're still here because you have the hots for me.

House: Evidenced by the fact that I’m the one who moved into your office.

Cuddy: It's the biggest office. And I’m not the one that destroyed —

House: Why are you dressed like that? Why do you try so hard to get my attention? Are you screwing with me?

Cuddy: Are you screwing with me?

House: That depends on your answer.

[They stare at each other.]

Cuddy: Everybody knows this is going somewhere. [pause] I think we're supposed to kiss now.

House: We already did that. [He puts his hand on her breast.] It seemed like the logical next step.

Cuddy: Really? I'm an idiot for being surprised.

[She turns to leave. His hand is still on her breast.]

House: Can you leave these?

[She looks at him. He drops his hand and she walks out, leaving him alone in the empty office with his head bowed.]

[Cut to clinical trials area. Thirteen enters. Janice is there, trying to get her jacket off. Foreman enters.]

Thirteen: I'll keep coming, but can you change my appointment time?

Foreman: Can't. Schedule's full. You're stuck with her. Might as well get to know her. [He leaves. Thirteen looks at Janice.]

[Cut to flashback. Mrs. Hadley is in the station wagon. Mr. Hadley closes her car door and looks up at Remy who is staring out her window. He waves for her to come down. In the car, Mrs. Hadley’s body jerks uncontrollably.]

[Cut to the present. Thirteen stares at Janice then goes over to help her with her jacket.]

[Cut to Taub wheeling Emmy down a hallway.]

Taub: Your head MRI was clean. Means you don't have CNS lymphoma.

Emmy: What's next on the list?

Taub: Other types of brain tumors.

Emmy: Can we stop at the cafeteria?

Taub: I can have something brought up for you. What do you want?

Emmy: Chocolate cake.

Taub: You can't give up. We're gonna figure this out.

Emmy: What am I supposed to be hoping for? That you find a brain tumor? What else could it be? You were so hard on me about lying. How about you take some of your own advice and tell me the truth? What's next on the list?

Taub: Prion disease.

Emmy: And if that's what I got, how bad?

Taub: There are a few treatments, but there's no guarantee. I'm sorry.

Emmy: And you won't let me have a piece of cake?

[Taub smiles slightly and goes back to pushing her wheelchair.]

[Cut to House’s office. The furniture is back. House sits on the visitor’s side of the desk, holding his oversized tennis ball.]

Taub: [entering] Uh, where's Cuddy? It's not CNS lymphoma.

House: I know.

Taub: She's getting worse. You want me to find Cuddy and get her approval for the brain biopsy?

House: When you were philandering with impunity, how did that feel?

Taub: Superficially, I loved it. But deep down, I think I was miserable. Why? What's going on?

House: You weren't miserable. You gave something away to make a relationship work. You rationalize that you're getting something back.

Taub: Okay, I’m gonna go get Cuddy's approval for the brain biopsy.

House: Leave 'em there. I'm gonna do the biopsy myself. [He leaves.]

[Cut to the hall as they get off the elevator and head for Emmy’s room. Taub follows House.]

Taub: Cuddy wanted us to eliminate seven different things.

House: Cuddy doesn't always get what she wants.

Taub: Bad idea to get into a power play with somebody who has the power.

House: You're fired. Just reinforcing your point.

[They enter Emmy’s room.]

Taub: Whatever personal drama you're playing out, you'd be a lot smarter to —

[He stops. They both stare. Emmy is standing with her broken leg on a chair, doing stretches.]

House: Thought you said she was sick.

[Cut to Diagnostics. House is standing in the doorway between his office and the conference room. He’s resting his chin on his cane handle.]

House: Sick people don't spontaneously get better.

Thirteen: Yes, they do. It's called an immune system.

House: Sick people who are sick enough to make it to me don't spontaneously get better. Not as pithy, but yeah, technically more accurate. What's the last thing you gave her?

Taub: I took her for an MRI looking for —

House: MRIs detect. They don't treat. What did you give her after the MRI?

Taub: I didn't give her anything. She got depressed at the lack of direction. We went to the cafeteria for some chocolate cake. Took her to her room, hung a banana bag, let her rest.

House: You gave her cake.

Taub: She asked for it. I figured —

House: You figured you'd let me play 20 questions instead of just telling me. [He leaves. Taub follows.]

[Cut to Emmy’s room. She’s lying on her bed, staring at the ceiling. Taub enters, followed by House, pushing a cart. There’s a blue tablecloth on the cart and a large cake saver.]

House: Feeling crappy again? I brought your cure. [He pulls off the lid of the cake container and gives it to Taub. There’s a whole, chocolate-frosted, two-layer cake inside.] I'd give you an IV of this stuff, but the frosting tends to get stuck in the little tubes.

Emmy: Is this a joke?

House: It's not a joke. Not a lie. Not an attempt to defraud in any way. It's an actual licensed physician with an actual diagnosis. Hereditary coproporphyria. [He brings a forkful to her and she turns her head away.] Your face is genetically blessed. Your body chemistry is slightly less so. [He eats the cake.] Doesn't make enough of a certain enzyme that I can't pronounce, but it's apparently important for your liver and everything else. Treatment is a high carb diet rich in sugar. When you were a porker, you were self-medicating.

Emmy: So this is treatable.

Taub: We just have to reverse your gastric bypass and get you back on a high carb, glucose-enriched diet.

House: The best you you could be is a lot more you. [He brings another forkful of cake to her.] Open the hangar. Here comes the plane.

Emmy: There's nothing else you can try?

Taub: No. There's a drug that manages the symptoms, but it's not a cure.

Emmy: Let's try that.

Taub: You don't want to have the surgery?

House: Understand. There's not many people who have the guts to admit they'd rather be pretty than healthy. The income's better and you get more action. I'll start you on your drug treatment right away. [He leaves.]

[Cut to Taub and Kutner entering the ER.]

Taub: I bought it. I bought that it was really about trying to make people's lives a little better.

Kutner: You're surprised she's superficial? You're a plastic surgeon. This is the human condition.

Taub: No, she's a freak.

Kutner: Every time you put someone under to bob their nose, you were risking their life.

[They reach the main ER area. Kutner stops.]

Taub: What?

Kutner: No singing. She's better.

[They head to the bay DeeDee was in. Kutner pulls the curtain. The bed is empty. A nurse is there, filling out some forms.]

Kutner: No one was supposed to let my patient leave her bed.

Nurse: She had a respiratory arrest. We coded her nearly 20 minutes, but she didn't make it.

[Kutner and Taub stare at each other in horror.]

[Cut to Cuddy’s office. She and Wilson are entering.]

Cuddy: House is an unemotional child incapable of intimacy or romance. Trust me, it's done. [She looks at the newly furnished office.] It’s perfect.

Wilson: I like the desk. Lot of character.

Cuddy: That's not the one I ordered. [She runs her hands over it.] This is my desk from med school.

Wilson: You have it in storage or something?

Cuddy: My mom did.

Wilson: That was sweet of her to do that.

Cuddy: She didn't. My mom has no idea I’m redoing my office. [She stands behind the desk with a smile on her face.]

[Cut to clinical trials area. Foreman is putting on his overcoat. Thirteen enters.]

Thirteen: I lied to you the other night. That woman in the waiting room, she didn't freak me out about my future. She freaked me out about my past.

Foreman: Your mother. Must've been horrible watching her die.

Thirteen: I wanted her to die. She just… yelled so much. And for no reason. Just screamed at me in front of my friends. My father tried to explain to me that her brain was literally shrinking, that she didn't mean it. That it was the disease, but I didn't care. I hated her. I never said good-bye. And she died with me hating her.

[Foreman holds her in a hug.]

[Cut to the morgue. DeeDee is on a table, draped with a sheet up to her armpits. Her skin is gray.]

Taub: Did Chase test for the biliary tumor?

Kutner: Said it was negative. Said she was stable when he left her. Should've found more time. We should've —

Taub: House is gonna kill us.

House: Slowly. [They turn. He’s standing behind them.] And painfully. You're not only idiots, you're frauds. Fraudulent idiots. Fraudulent idiotic killers, as it turns out.

Kutner: House, this was really my —

House: Your fault? Yeah! For pretending to be me when you're not even competent. [He throws a file at Kutner.] And your fault for not ratting him out while the patient was still alive. What she had was easily treatable. She could've been fine. Damn treatment's so simple. [He stares at her.] Might still be possible.

[He hangs his cane on a lamp and climbs on the table.]

Kutner: House… [House starts chest compression.] House, she's clearly dead.

[As Taub and Kutner watch, DeeDee inhales loudly. They both jump back several feet, terrified. DeeDee sits up, laughing as House gets off the table.]

Kutner: She was dead.

House: She wasn't dead. She wasn't even sick, you moron. [DeeDee raises her hand and House gives her a high five.] Seriously, how good was she? No formal training. At least not in acting.

DeeDee: Did you see their faces?

House: I think we may have an anal hygiene violation there.

Taub: So the CT.

House: That was from a patient three years ago. It was hard to find. But the hair and make-up, getting Chase and Cameron to play along, much easier.

Kutner: We deserved it. I'll take down the website before —

House: Take it down? Are you kidding? It's way too lucrative to shut it down. For Chase, for me. I earn 50% for letting you use my name. Chop chop. Go to work. First dollars go to expenses. I booked our little thespian here for two full days. That's three G's I owe her.

DeeDee: And you still got 3 hours left.

House: Do I?

[He smiles slightly.]

[Cut to Cuddy getting off the elevator. She walks down the hall, smiling to herself. She reaches House’s office and stops. House and DeeDee are there, talking. House has his motorcycle jacket on and is holding his helmet. DeeDee reaches across the inches that separate them to straighten the front of his jacket in a very intimate gesture. The smile on Cuddy’s face disappears as she watches them. She pivots and walks back toward the elevator quickly.]

[The End]

Tags: season 5
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