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House MD – 5.13 Big Baby

Originally Aired: January 26, 2009

Written by: David Foster & Lawrence Kaplow
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 schoolroom. Several children are running around. A boy and a girl sit at a table, shaking glitter on paper. Sarah, one of the teachers, walks around, observing. Another teacher sits with some of the children at a table. Johnny, one of the older students, stares at the next table.]

Sarah: Let's stay focused, Johnny. [He continues to stare.] What are you looking at?

Johnny: [looking at the seated teacher] Who is she?

Sarah: That's Miss Cindy, Zeke's new aide.

Johnny: What happened to his old aide?

Sarah: She got married. [She leans over to help him with his art.] So, first, you want to rub the glue on the paper in any shapes you like.

Johnny: Why do people get married?

Sarah: Because they love each other.

Johnny: Why aren't you married?

Sarah: I haven't found the person I love yet, because I spend all of my time loving you. [She gooses him and he giggles.]

Johnny: Does that mean we can get married?

Sarah: Well, love comes in many types, and there's lots of it to go around.

[Johnny opens a jar. A lot of green glitter lands on Jessica, who is sitting next to him.]

Jessica: Oh, my snow is ruined.

Sarah: It's not ruined. Oh, it's pretty. [coming over to her] See, look, I like the green.

Jessica: Who ever heard of green snow?

Sarah: It's magical. [Jessica pees on her seat. She starts to sniffle. Sarah hugs her.] Come here. We'll get you cleaned up, okay? It's okay. [She sees blood on Jessica’s sweater.] Ooh, are you okay?

[Sarah coughs and ends up with a handful of blood with more in her mouth. The children look scared. Sarah passes out on the floor. One child leans over her and say “Hey, hey, hey.”]

[Opening credits]

[Cut to House entering the cafeteria. He lurches over to the counter, grabs a bagel from a basket and starts to leave. Cameron enters. She’s wearing a blue dress instead of her usual scrubs.]

Cameron: You gonna pay for that?

House: Nice of you to offer. Now I can actually get some cream cheese.

Cameron: 29-year-old teacher. She works with special needs children. She —

House: Love what you're wearing. Brings out the blue of the case file, which means it's not from the ER. So why are you here? [He tears open a packet of cream cheese with his teeth.]

Cameron: Because Dr. Cuddy is not here. She's decided to spend some more time at home with the baby for a while. I'm taking over some of her day-to-day responsibilities, like babysitting you.

House: Interesting. You have your whole life ahead of you. So why would Cuddy want you to die so young?

Cameron: She figured I'd spent three years working for you. I was inoculated.

House: Good. Fun. You get to exercise your newfound power. I squirm under your thumb, resent the student becoming the teacher, and then push comes to shove, and we all get to realize what our real roles should be. Then you put out. [He takes a bite of his bagel.]

Cameron: That's why I took the job.

[She hands him the file and leaves. House stares after her, chewing his bagel and cream cheese and tilting his head.]

[Cut to House entering the Diagnostics Conference Room. The whole team is at the table. House paces around the room during the DDX.]

House: 29-year-old Special Ed Teacher coughs up blood all over Corky. No dyspnea, no weight loss. [to Foreman] Why are you smirking?

Foreman: Never thought I'd see the day you were taking orders from Cameron.

Kutner: Cameron's in charge?

Thirteen: When did that happen?

Kutner: You're gonna destroy her, aren't you?

House: I am going to do my job. If that involves leaving her a rotting pulp…

Foreman: Cameron’s gonna mark her territory. She'll probably over compensate and destroy you.

Taub: Bleeding ulcer.

Thirteen: [reading the file] Scope of the stomach and lungs were clean, yet she continues to spit up blood from both her stomach and lungs.

Foreman: That means it's probably something wrong with the blood itself — Leukemia, Von Willebrand's.

Thirteen: Thoracic tumor is a better fit. Erodes into her airway and esophagus —

House: Oh, will you two stop it already?

Thirteen: Stop what?

House: Disagreeing.

Thirteen: Okay, which one of us shouldn't have an opinion?

House: It's not an opinion. It's a smoke screen. Toss out a lame idea, instead of agreeing with Foreman's better idea because you're worried that'll confirm that he's boldly gone where no man has gone before.

Kutner: You slept with Foreman?

Thirteen: Sorry. You were busy.

Foreman: Drop it, House. We're seeing each other, end of discussion. Anything else isn't relevant.

House: It's extremely relevant. Apparently, it colors everything. Now I have no idea if you have differing opinions because you have differing opinions or because you're just trying to prove that you can think for yourselves.

Thirteen: How about you just judge our ideas on their own merit?

House: Oh, you don't want me to do that. Go run a bleeding-time test, confirm our patient's blood is screwy, then you can come back and pretend to disagree about why.

[He heads for his office as the team gets ready to leave.]

[Cut to Sarah’s room. Thirteen has a clipboard and a stopwatch. Kutner cuts Sarah’s arm.]

Thirteen: Time zero.

Kutner: [to Sarah] I'm impressed. You didn't even flinch.

Sarah: I just went to my happy place.

Thirteen: [opening her eyes wide] We cannot let House anywhere near this woman.

Kutner: Where is your happy place?

Sarah: My class. With them. [She nods toward the nightstand which has framed pictures of her students.]

Thirteen: Passed the first mark.

Kutner: It's a great thing you do.

Sarah: Not really. Most kids, typical children, you hand them a pair of scissors, and they cut. Well, Tony, he's got CP and when I gave him the scissors, we went on a journey together, learning to get his fingers in those holes, to hold the scissors apart, to hold the paper. I mean, when he finally learned to cut, we both just wept with joy.

[Thirteen and Kutner smile at each other.]

Kutner: If you ever meet our boss, just yes or no answers, okay?

Thirteen: [examining Sarah’s arm] It's not slowing up. No sign of clotting.

Sarah: So there is something wrong with my blood?

Kutner: Don't worry, we'll run some lab tests to find out which clotting factor is off and then —

Sarah: I'm not worried.

Kutner: Must be one hell of a happy place.

[Cut to Cuddy’s house. She’s in a rocking chair with Rachel. Wilson is there.]

Wilson: She's beautiful.

Cuddy: I know. I'm lucky.

Wilson: Absolutely. What's she like?

Cuddy: She's eight weeks old. Are you asking me about her politics or her sense of humor?

Wilson: My cousin had a kid. They acted like they knew the thing from the time it was two minutes old. I just… I just thought…

Cuddy: She cries, she eats, and she poops.

[She stares at him, tearful, then turns her head and pinches the bridge of her nose.]

Wilson: What's wrong?

Cuddy: I don't feel anything.

Wilson: You're tired.

Cuddy: I'm not sleep deprived. She sleeps fine. I'm obviously not hormonal. I know I'm supposed to feel amazement. I'm supposed to love her. I just… I don't feel anything at all. Sorry. Maybe I am just tired. Um. Thank you for stopping by. I'm okay.

Wilson: Lisa… if you're…

Cuddy: I am feeding her, I'm changing her, and I'm burping her. I'm doing everything I'm supposed to do. She will be okay. Please go back to work.

[Wilson puts his hand on her shoulder as he leaves.]

[Cut to a patient hallway at PPTH.]

Thirteen: It is the blood, but the clotting proteins aren't the problem.

Foreman: It's her platelets, looked like they had bite marks in them.

House: So now you're agreeing? Either you folded because I gave you crap, or you broke up, or —

Foreman: We disagree, you blame our relationship. We agree, you blame our relationship. Don't you see a problem there?

House: Yes. Don't you?

Taub: Could be lymphoma.

House: Not with normal LDH.

Kutner: ITP fits. We should start her on methotrexate.

House: Absolutely, and total body irradiation.

[They reach the elevator. House pushes the button.]

Taub: Because she failed a bleeding-time test?

Kutner: TBI will promote cancers, kill her digestive tract.

House: Don't forget, stop her from bleeding into her brain.

Kutner: It's premature, reckless, and potentially lethal.

House: True. Must be somebody's job to stop me from being reckless and irresponsible. [He gets in the elevator.] Nobody can stop me from being premature. [He chortles goofily as the doors close on him.]

[Cut to Cuddy’s office. Cameron is behind the desk. She’s on the phone and sorting through some papers. She looks up as House enters.]

House: Got a patient with ITP. Need to hit her with radiation.

Cameron: [to person on the phone] I'm gonna have to call you back. [to House] Methotrexate.

House: Good point. On the other hand, if she bleeds in her brain, she's gonna need a Special Ed class of her own.

Cameron: Fine.

House: Really?

Cameron: Yeah, if you think it's right, do it.

House: Hmmm. Some people thought you were gonna be brutal, marking your territory.

Cameron: Who?

House: Nobody. Just because I call him nobody doesn't make me a racist.

Cameron: I'm not gonna play games. If you come to me with a request and it makes medical sense, I’ll say yes.

House: I need oral sex. I'm pretty sure biological imperative qualifies as medical sense.

Cameron: Can I return my phone call now?

House: I don't really see how that's gonna be possible.

[She picks up the phone and opens a folder of papers. House leaves.]

[Cut to hallway. Thirteen and Foreman are waiting for House as the elevator door opens.]

Thirteen: Patient won't respond to methotrexate. Bleeding time hasn't improved.

House: You have a medical dilemma for me. I have one for you. I need a reason to not do total body irradiation.

Foreman: Other than that Cameron said you can’t.

House: She said I can.

Kutner: Then why don't we just do it?

House: Because it's premature, reckless, and potentially lethal.

Kutner: Then why don't we just don't do it?

House: Because that would let Cameron in on the fact that I never intended to do it.

Taub: This is gonna be convoluted, isn't it?

House: I figured I'd ask for something really crazy, so she'd shoot me down and get the whole "I can control House" thing out of her perky little system. So the next time I went back and asked for something marginally crazy, it would seem marginally reasonable, and she'd say yes. So, yeah, slightly convoluted.

Taub: You're screwed.

Thirteen: Unless we irradiate her. Without the radiation. We book the nuclear lab. We fill out the paperwork. We bring the patient down there. We do everything but flip the switch.

House: Go. Do. Don't flip.

Taub: And is there anything we should be doing, you know, to actually help the patient?

House: Trust me. In the long term, this'll help all our patients. In the short term, double the dose of methotrexate and add prednisone.

[Cut to the cafeteria. Chase is eating. Foreman is sharing his booth.]

Chase: Cameron's got the keys to the castle.

Foreman: This trial I'm running — the drug really seems to be working.

Chase: She's kind of liking the power. I think I'm kind of liking her liking it.

Foreman: I'm not sure what I'm gonna do about Thirteen.

Chase: She's sort of dressing like Cuddy.

Foreman: She's on the placebo.

Chase: You can't possibly know that.

Foreman: Accidents happen. I found out.

Chase: You cannot tell her. You'd be compromising the trial. She knows she had a 50/50 chance of not being on the drug. If you feel like you're lying to her, too bad.

Foreman: I don't want to tell her. I want to put her on the real drug.

Chase: And you want me to tell you that that's okay?

Foreman: Her trial results are already compromised, just from the fact that I know. As long as she's wasting her time, why not give her something that might actually help her?

Chase: Valid point, except for the fact that it's a load of crap. Don't be an idiot.

[Cut to Thirteen and Taub monitoring Sarah in radiation where they won’t be flipping the switch.]

Sarah: So how long until we start the procedure?

Thirteen: We already started. Told you you wouldn't feel a thing.

Taub: You should lie back. Just stay real still.

[Thirteen and Taub go back to watching “Fletch” on TV.]

Pan Am Clerk: I'm afraid there is someone sitting next to you.

Fletch: Oh, for — God, God, God!

Sarah: I have to pee. Can we, like, call a time out for a minute, let me go to the bathroom?

Thirteen: Yeah, sure. We'll just start up again when you're done.

Sarah: Thanks. Sorry. I… I didn't realize I had to go.

Taub: No problem.

[She sits on the side of the table and slides off, unconscious. Taub and Thirteen run in from the booth.]

Thirteen: Sarah?

Taub: [checking her neck] No pulse. Get the paddles.

[She grabs the defibrillator and charges it.]

Thirteen: Clear!

Taub: Got a pulse. It's not ITP. She clearly doesn't need fake radiation.

[Cut to Radiology viewing room.]

Kutner: No structural defects in her heart.

Thirteen: What about a calcified valve or a patent foramen ovale?

Taub: Transthoracic echo and bubble studies show nothing. Her heart's clean.

Thirteen: The patient said she had to go pee. Maybe when she got up, she started to urinate. Increased the vagal tone, caused arrhythmia, and stopped her heart.

House: Who has to go pee in the middle of a nuclear procedure?

Kutner: It wasn't really a nuclear procedure.

House: She didn't know that. [The others look at him.] People don't die from peeing.

Kutner: Heavy metal, toxin.

Taub: Drugs or alcohol.

Thirteen: Or her own body is making a toxin. Cold agglutinins. Abnormal protein gets activated by cold temperatures.

Forbes: Like the classroom with the broken heater and the cold metal table in the procedure room.

House: Oh, for God's sake, get a room. Immerse her in an ice bath. The cold will activate her cold agglutinins.

Kutner: Causing her heart to race.

House: Confirming our diagnosis.

Kutner: And giving her another heart attack.

House: Lucky for me, there's a flaxen-haired maiden who loves to say yes.

[Cut to Cuddy’s office. Cameron is there. Cuddy enters, wearing slacks and a sweater.]

Cuddy: How in the world could you approve total body irradiation for a patient with possible ITP?

Cameron: It was the right call.

Cuddy: There is no medical justification for that kind of —

Cameron: Not medically, no. Absolutely no medical rationalization. I had to say yes because House wanted me to say no.

Cuddy: You think he was bluffing.

Cameron: I'm the new kid. He had to test me.

Cuddy: Don't get cute. Don't engage him. Do not play his games, because you will lose.

Cameron: You hired me to do this job. Let me do it.

[House bursts in.]

House: Oh, I'm sorry. Looks like you guys are in the middle of a conversation. I can wait till Cuddy leaves. [He makes himself comfortable in an armchair.] You are gonna leave soon, aren't you? I mean, the nurses have got your baby out there. Not that they're gonna kidnap it or anything, but I figured that the new mother brings the baby to work because she wants to listen to all the cooing.

Cameron: If you're gonna wait, you can wait outside.

House: Unless the new mother brings the baby to work because she wants to dump the baby, because she hates the baby and thinks she made a big mistake. [Long pause as Cuddy and Cameron stare at House.] You can't trust that Wilson guy with anything.

Cameron: Lisa, are you —

Cuddy: It's not a big deal. I was having a bad day.

House: Is Wilson gonna be in trouble?

Cuddy: For betraying my trust in a vulnerable time? No. Why would that bother me?

House: He was worried, made a bad choice. It's not a big deal. I know it seems like crap, you probably feel like crap, but it's not. Legally, you haven't adopted her yet. There's no obligations, no strings. It can be undone tomorrow. Emotionally, you'll feel guilty for a while, but the kid… She won't even know you existed.

Cuddy: You saying I should give her back?

House: Much better than having a mother who doesn't give a crap.

Cuddy: Thanks. I'm just gonna go drop it off at the pound. [She leaves.]

Cameron: What did you want?

[Cut to the lobby. The team is waiting as House comes out of the clinic.]

House: We got a green light. Go draw the patient's blood.

Thirteen: Why?

House: To see if it clumps in the cold.

Thirteen: She's making you confirm your theory before you treat?

House: She approved the bath. Just thought we ought to do a test to confirm.

Kutner: That's more of a yellow light, isn't it?

Taub: So she lets you nuke the patient, no problem, but makes you jump through hoops to give her a bath? Why would she do that?

Forman: I think she was playing you.

House: [getting on the elevator] Go draw the blood.

[Cut to Sarah’s room. Kutner enters. Johnny is standing next to the bed. Tammy sits in a chair.]

Kutner: Didn't realize the nurses allowed any visitors in here.

Sarah: They don't. [to Johnny] We'll just do these problems, and then you have to go, okay?

Johnny: Okay.

Kutner: I need to draw some blood. I had a crush on my teacher in fourth grade… and fifth.

Tammy: It's more that Johnny was a nonverbal autistic. Then for Sarah, he talks, makes eye contact. He's like a regular kid. Since she got sick, he started going back away from us. I had to bring him in for a visit.

Kutner: I'll tell you what, I'll close the blinds so the nurses don't ask questions. You can stay as long as you want. We should have the results in about an hour.

Sarah: I'll be here. [He closes the blinds and leaves as Sarah looks at what Johnny’s been doing.] Good job.

[Cut to the lab. Foreman and Thirteen are running the tests. He puts something in one of the machine.

Foreman: One minute at 39 degrees.

[Thirteen knocks something off the counter. Foreman catches it.]

Thirteen: Oh, damn, sorry.

Foreman: You all right?

Thirteen: Don't be paranoid. I feel great. Didn't expect the meds to work this quickly.

Foreman: Let's not get ahead of ourselves. You might not even be on the real drug.

Thirteen: Several patients have shown improvement. I know my test results have been better. I know I have more energy.

Foreman: You ever hear the term placebo effect?

Thirteen: I guess I do have a few reasons to feel good. [She puts her hand on his.] But let's not get ahead of ourselves. You're good, but not "curing Huntington’s" good.

Foreman: Good.

[The machine beeps. Foreman takes the blood out with a pair of tongs.]

Thirteen: It's clumped. House was right. Ice bath's on.

[Cut to Cuddy’s office. Cameron is organizing the desktop. Foreman answers.]

Foreman: Got a sec?

Cameron: Don't be an idiot.

[He thinks for a moment then leaves.]

[Cut to Sarah in the ice bath. She’s wired with electrodes and shivering.]

Kutner: I know it's hard, but you need to stay in there for three minutes.

Sarah: [chattering] It's okay.

[Cut to the observation booth. Taub is there. House enters.]

Taub: You come to procedures now?

House: Only the ones that might involve stopping the patient's heart.

Taub: Cameron tell you to be here?

House: Shut up.

Kutner: Tell me about Jonathan. How'd you get him to come out of hiding?

Sarah: He was extremely sensitive to touch, yet he had a… a tactile fascination with newspaper. I mean, he wouldn't read it. He would just… just touch it, crinkle it. I thought maybe that was a way in. Papier mâché and… and it was. He let me into his world.

House: Please tell her that talking will ruin the test.

Sarah: All the kids — I try to become a part of them, and then have them become a part of me.

House: How much longer till the heart attack?

Kutner: I wanted to be a doctor from the time I was eight years old. Never wanted to be a pediatrician, though.

House: Now they're both talking.

Sarah: Well, I wanted to be a sociologist. I was supposed to observe a class. I was sent to room 214, but I went to room 241 instead. It was a Special Ed class, and I just… I just felt at home.

Thirteen: Time. Heart rate's normal.

Kutner: You can get out now.

Taub: It's not cold agglutinins.

House: I'm not surprised. She obviously has brain damage. [Taub looks at him.] Seriously.

[Cut to the Diagnostics Conference Room.]

Taub: She screwed up a room number six years ago, and you decide she has brain damage?

House: Transposed digits. Classic marker for number confusion. Means she has a lesion in her left parahippocampal region.

Kutner: I misdialed a phone number this morning. Must be contagious.

House: She also forgot to pee before your fake test.

Kutner: So she has a small bladder.

House: Shows an inability to predict the future.

Thirteen: Also located in the left hemisphere of the brain, close to the parahippocampal region.

House: Means the damage is ongoing.

Taub: Two subtle clues, six years apart. That's hardly compelling evidence.

House: I'm compelled.

Foreman: That's not what this is. Every time a decent person comes in, you set out to prove that they have brain damage.

House: I never said her deranged personality was a symptom.

Foreman: You don't need to. I've been here five years. I can hear your thoughts from my apartment.

House: Can you hear me now?

Foreman: Move onto another organ.

House: I did.

Kutner: The screwed up numbers and forgetting to pee points to her being a human being. The platelet dysfunction and cardiac arrest points to a pancreatic tumor.

House: Or multiple sclerosis. The brain is like the Internet, packets of information constantly flowing from one area to another. Plaques in her brain are like a bad server, slow down the flow. If it's in the parahippocampus, it'll spread to the brain stem, which means it'll be the lungs next. Brain biopsy will show you the plaques.

Kutner: Or we could not cut into her brain. It's just her pancreas. We should do an ERCP.

House: Well, we could settle this with rock, paper, scissors, but, unfortunately, there are people who adjudicate these disputes.

[Cut to Cuddy’s office. Cameron is behind the desk. House and Kutner are standing and arguing.]

Kutner: A pancreatic tumor is much more likely to kill her.

House: Not this week, not next week, not next month.

Kutner: The number confusions six years ago. You don't think we have time for an ERCP?

House: The heart attack was six hours ago. Now, maybe it's planning to go into hiding for a couple years, or maybe it's gonna hit her lungs.

Cameron: Stop! We have to assume it's the brain.

House: I'll go fire up the biopsy drill.

Cameron: No, we had to assume it's the brain until we prove otherwise. Do an MRI, T-2 images.

House: You want me to do another test?

Cameron: You should be able to see the MS plaques. If they exist, you can do your biopsy.

House: No. You wanna say yes. You know you should say yes. But you also think that this job is about standing up to me. So you're not gonna say yes. You're not gonna say no. You're just gonna waste time. And the patient's brain, or pancreas, or whatever is wrong with her is not gonna wait for you to impress your boss. So pick one, either him or me.

Cameron: Do the MRI.

[House walks out and slams the door.]

[Cut to Wilson’s office. He’s doing paperwork. Cuddy enters.]

Wilson: [looking at his watch] You still here? The whole point of giving Cameron the job was so that you could —

Cuddy: I don't wanna go home. [She puts the carrier down and sits facing Wilson.] House told me I should give her back. Instead of being offended, I've been wondering if he's right.

Wilson: He's not. He never is, not when it's anything personal, or human, or…

Cuddy: No, he's always cold. He's always an ass, but he's very rarely just wrong. I've read every bonding and attachment book there is. I feel like I'm in prison at home. I feel like I'm free here.

Wilson: Parents make sacrifices.

Cuddy: I don't know if I want to. I'm not proud of this. I feel terrible. I feel like a failure. But she deserves to be loved.

Wilson: I… I… I don't know what to say.

[Cut to the House’s Office. They’re all staring at the MRI images on his light board.]

Foreman: No plaques on the left hemisphere.

Taub: Or the right.

Kutner: Even magnified images of her hippocampal region, nothing.

House: This is surprising.

Kutner: So can we cancel the biopsy?

House: Go ahead with the ERCP.

[Thirteen, Kutner and Taub leave. Foreman stays. House goes to his desk and sits down.]

Foreman: I need to talk to you about Remy.

House: Who?

Foreman: Thirteen.

House: What did you call her?

Foreman: She's on placebo.

House: And you want to change that. I'm the last person you'd ever come to for ethical advice, literally, which means you've already asked every other person, and no one's given you the answer you want.

Foreman: Or I respect your opinion, and I want to hear what comes to your mind.

House: Has she invited any of her lesbian friends into bed with you?

Foreman: I was mistaken. [He starts to leave.]

House: Drug gonna cure her?

Foreman: [turning back] It looks promising, reducing symptoms.

House: No cure then. So, the pros are you might delay the onset of symptoms, give her an extra year, maybe three. She's still dead before you're 45. The question is, are those few years worth risking the rest of your life in medicine?

Foreman: No.

House: There, that wasn't so hard, was it?

Foreman: Thank you.

House: You're welcome. [Foreman turns to leave again.] Unless you love her. [Foreman turns and stares at House.] If you love her, then you do stupid things.

[Cut to procedure room where the ERCP is in progress. It seems to involve running a black garden hose down her throat.]

Kutner: Common bile duct is clear.

Taub: No filling defects in the biliary tree.

Kutner: Oh, God.

Thirteen: What?

Kutner: It's her lungs. House was right. O2 sat's down to 89.

Taub: Increase to 100% O2.

Thirteen: Better get out.

[Kutner pulls the hose out. Sarah starts coughing. Thirteen holds an oxygen mask to her face.]

Kutner: Do we have to tell him?

[Cut to Sarah’s room.]

[Cut to the Diagnostics Conference Room.]

Foreman: The surgeons were able to drain the pleural effusions. The patient's breathing on her own, but she's still pretty weak.

House: Lung failure proves that one of us was right. Who said “brain”?

Kutner: Yes, you predicted that her lungs would fail, but the MRI was negative for MS.

House: I was right about the where, but not the what. A picornavirus could cause localized demyelination that the MRI wouldn't pick up. If we run a nerve-conduction study on the surface of her brain we'll see the dead spots.

Taub: Are you talking about cutting into her skull?

House: Actually, I'm talking about cutting off her skull, exposing her brain.

Kutner: A pancreatic tumor could still fit. It explains the heart, the blood, and her lungs.

Thirteen: ERCP was negative.

House: [leaning over to hold Thirteen’s hands] And she agrees with me because she agrees with me, right, sweetie?

Kutner: All we need is a more sensitive test. Endoscopic ultrasound.

House: [turning and grabbing one of Kutner’s hands in both of his] Just accept that you've been proven wrong.

Kutner: [adding his other hand to the pile] You were also proven wrong. Why don't I get a second test?

House: Because if I'm right about the brain, then we don't have time to indulge your wrongness.

Kutner: [getting up to leave] Let me know when Cameron says yes to cutting off our patient's skull. I'll be doing the endoscopic ultrasound.

[Taub follows him out.]

[Cut to Cuddy’s office. Cameron is sitting on the couch, reading a page from a chart. House opens the door a few inches and sticks his head in.]

House: Good news. [He comes the rest of the way in.] I don't need your approval for some crazy, unproven treatment. I just need to do a test.

Cameron: You wanna remove your patient's skull.

House: Remind me to revoke Kutner’s telephone privileges.

Cameron: I didn't realize that was an AMA-approved treatment for MS.

House: Not searching for MS, but what set it off — equine encephalitis. Turned a cool breeze of MS into a Cat 5 storm.

Cameron: I didn't realize your patient was a horse.

House: There's been human cases.

Cameron: Not when it's 30 degrees outside. Transmission is by mosquito.

House: So she got bitten six months ago, or it's some other infection. Whatever it is, it's running rampant in the left side of her brain. When I get in there, I’ll get you the specifics.

Cameron: You're asking me to let you cut off the top of someone's head. I need more than, "I'll know it when I see it."

House: So you want proof before you let me go looking for the proof? This is the test.

Cameron: You have to give me something.

House: Cuddy's gonna love you. The patient, on the other hand, is gonna hate you until the day she dies next week. Actually, this idiot will probably forgive you. [He leaves.]

[Cut to the view of Sarah’s schoolroom from inside the wall vent. Foreman is there, removing the vent cover.

Foreman: [to Thirteen] You gonna help or what?

Thirteen: I want kids.

Foreman: Um, I think these kids are already spoken for.

Thirteen: Not now. But since we're dating, I just thought you should know.

Foreman: But I thought, because of your illness —

Thirteen: So did I. Even when I didn't know if I had it or not, I just assumed I couldn't take the chance, but now… Even though I know I have it, it feels like… an option.

[Cut to Cuddy’s home. She answers the door. Wilson is there with a gift bag.]

Cuddy: You really don't have to keep buying me things.

Wilson: Just open it.

Cuddy: This is nice. [It’s a picture frame.]

Wilson: The picture is actually your gift. That's your baby. I took her picture to one of those places that does that age-enhancement thing. And according to the kid who works there, this is a pretty good approximation of what your daughter will look like 18 years from now.

Cuddy: That's, uh, sort of cool.

Wilson: Right now she's just this weird little creature that sleeps and poops and cries. But that… is who she's gonna be. You will be teaching her how to ride a bike, giving her advice about friends and school and having her heart broken. She'll ignore most of it, but some of it'll stick. You're gonna be there for her through all of that. You just have to get through this part. That's all.

Cuddy: It's very sweet. I'll pay you back for the photo. [She puts it on the table and looks at it.]

Wilson: Don't worry about it. It's just the picture that came with the frame. You can chuck it.

[Cut to Cuddy’s office door opening. Cameron looks up. House’s cane is across the doorway. Next a file and a baggie appear, held over the cane. Then House appears. He enters.]

House: Kid with a raging viral syndrome and three dead mosquitoes. I'm off to storm the Bastille.

Cameron: [looking at a vial inside the baggie] These aren't mosquitoes.

House: Fruit flies. Close enough.

Cameron: Acute viral nasopharyngitis? One of her students has the common cold?

House: Team's not what it used to be. On the other hand, Kutner ran his endoscopic ultrasound, didn't find peep.

Cameron: So disproving it's her pancreas proves it's her brain?

House: Yes. You used to do this job, remember? That's what used to pass for evidence.

Cameron: Now I do this job. You brought me three dead bugs and a runny nose.

House: I can't find you the proof you want because it's trapped inside her head. And the only way I can get at it is to cut it open and rip it out, which is apparently the one test you won't let me run. So either I do this, or I do nothing.

Cameron: What do you want me to do? Say yes just because you're House?

House: I'd certainly like that, yeah.

Cameron: [handing him back the file] Yes.

[He takes the file and leaves.]

[Cut to the OR prep room. Kutner enters, tying on his hat. House, in scrubs and a hat, is washing his hands properly.]

Kutner: Cameron actually said yes?

House: Nope, I'm just obsessive about clean cuticles.

Kutner: Sawing off the top of her skull and placing electrodes on her brain is insane.

House: Right, we should be retesting her pancreas for the umpteenth time.

Kutner: You're skipping steps because it's Cameron. You haven't figured her out yet, and you want to see how far you can push.

House: I'm skipping steps because our patient is skipping steps on the way to being dead. If you've got a better idea…

Kutner: We should remove her spleen. Splenic lymphoma explains the damaged platelets, the heart, the lungs.

House: If this doesn't work, the spleen's all yours. [He heads into the OR] Unless I kill her, of course.

[Cut to the OR. There’s a frame over Sarah’s head. Her brain is exposed.]

House: Not only will this allow us to clock your brain's processing speed, you'll also get free cable for the first three months. [Sarah laughs slightly. House sits in front of her, wearing a mask but no gloves. He shows her a flash card.] What's this?

Sarah: A blue car. Is that part of the test?

House: Nope, my lease is up next month. You like? [She smiles wanly.] I'm gonna ask you a series of questions designed to stimulate left-brain function — logic, reasoning, problem-solving. Or as my mentor, Old Ben, liked to call it, "The dark side." If we find slow areas, we know we found damage. We treat. You go home. Ready?

Sarah: I'd nod yes, but I can't move my head.

House: [showing another flash card] This pen is red. Its ink is red. Is all ink red?

Sarah: No.

Cameron: Nerve conduction's 12. 8 meters per second. Right within range.

[Cut to the observation deck. Kutner is on the phone.]

Kutner: Cameron's letting him cut into our patient's skull based on nothing but dead bugs and someone else's runny nose.

[Looking down at the OR from the observation deck.]

House: There are two pints in a quart, four quarts in a gallon. How many pints in five gallons?

Cuddy: [on the phone via loud speaker] House, step away from the patient. [Rachel is crying in the background.]

Sarah: Who's that?

Cuddy: [to Rachel] Okay, all right.

House: That's my old boss. [loudly] And by "old," I don't mean "former."

[Intercut between Cuddy’s house and the OR.]

Cuddy: Insulting me is not gonna make me go away.

House: You're not here. Obviously I'm not trying to make you go away. [He holds up another flashcard.] Hint — the answer is a number.

Sarah: Um, 40?

Cameron: 12.4 meters per second. Conduction is still normal.

Cuddy: Dr. Cameron, you're actually assisting him with this?

Cameron: Yes, because I'm actually familiar with this case.

Cuddy: [trying to calm Rachel while she talks] Well, I'm familiar enough to know that cutting into this woman's brain is not necessary.

Sarah: Is she serious?

House: Well, she's certainly not funny. Put the phone down. Pick up the baby. Make us all happy.

Cuddy: [doing just that] Okay, settle down, baby. It's okay. We'll be done in a minute. [over the loud speaker] House, I can call security. I can —

Cameron: BP's dropping.

House: Get it back up. I got a whole stack of these.

Cuddy: Give her ten CCs dopamine.

Cameron: Already am, thanks. Your baby needs you a lot more than we do.

Cuddy: You aren't hungry, and you aren't wet. I don't know what it is.

Sarah: Oh, that is so annoying. Can you make it stop?

House: Baby's crying is annoying you? [to Cameron] What's her nerve conduction?

Cameron: 14.3. It's actually speeding up. But her BP's 80 over palp. We're gonna have to stop.

[Sarah raises her hands to her temples and winces from the noise.]

House: That doesn't make any sense.

Cameron: The fact that you're wrong doesn't make any sense, or the fact that believed that you were right? BP's still dropping. She's gonna stroke. I'm giving her ten more CCs, and I'm putting an end to this.

Cuddy: Okay, Rachel, quiet down! I need you to be quiet!

Sarah: Please, turn that phone off!

House: Why does the baby annoy you, but no one else does? I mean, you're right about her, but —

Cuddy: [crying] I don't know what you want! I will give you anything that you want! I don't know what it is! Tell me! Please, just help me! Please! [Rachel stops crying.] Really? That worked?

Cameron: She's stable. We're finished here. Close her up.

[Cuddy, looking at Rachel, laughs and cries at the same time.]

[Cut to the OR. House, Kutner and Cameron are the only ones there. Nothing has been cleaned away from the surgery.]

Kutner: How long until we can perform the splenectomy?

Cameron: Can't dose her with anesthesia till the last batch completely clears.

House: How come the baby annoyed her?

Kutner: We should get her in there as soon as we can.

Cameron: Two hours at least.

Kutner: Her blood pressure's in the tank. I hope she lasts two hours.

House: What was different? Our patient loves all things annoying.

Cameron: She'd love this conversation.

House: She's an earth mother, takes in the freaks and rejects of humanity and tells them they're a-okay. So what was different?

Cameron: Her head was open, you were asking her questions, a baby was crying.

House: She had low blood pressure. According to the laws of physics, low blood pressure causes light-headedness, chest pain, but not annoyance.

[Cut to House’s office at night. He’s in the Eames chair with his legs on the ottoman. He’s playing with the ball and staring at the white board. Low BP, Int. Bleeding, Abnormal Platelets, Pleural Effusion and Cardiac Arrest are written on it. Cuddy, carrying Rachel, enters.]

Cuddy: Move your feet.

House: You decided to keep her. Thank you for telling me. You can go now.

[She sits on the ottoman.]

Cuddy: I talked to her. We connected.

House: You talked at her. You had a chemical reaction.

Cuddy: Are you trying to annoy me?

House: I'm trying to explain you.

Cuddy: I know it doesn't make any sense, but it was real. It was there. You want to hold her? [to Rachel] Come here. Come say hi.

House: [taking the baby] You think we'll bond?

[He holds the baby for several seconds. She vomits on his face and neck. Cuddy laughs.]

House: Is that cute?

Cuddy: A little.

House: If I threw up on you, you'd be pissed.

Cuddy: Your puke isn't as cute.

[She hands him a napkin and takes Rachel. He tries to clean himself off.]

House: That's 'cause of your hips. If she would've just gestated a little longer, her stomach sphincter would be fully mature. But, no, we have to walk upright, which means that baby's head is too big for mommy's hips. And by the way, your hips may be an evolutionary improvement. So we've evolved to find baby puke cute, 'cause otherwise we'd kill them all before they became functional. [He freezes, thinking, then stands and starts to leave.] Bonding's over. I got to go see another baby.

[Cut to Recovery Room. Kutner is doing ultrasound on Sarah’s abdomen.]

Sarah: So I can just live spleen-free?

Kutner: Plenty of people live perfectly normal lives without —

House: [entering] Spleen's fine.

Kutner: It's not her brain.

House: Of course it's her brain.

Kutner: You looked at her brain. You took off her skull. You found nothing.

House: Didn't look in the right part. Didn't look in the heart part. [He grabs the ultrasound wand and runs it over Sarah’s chest.] In the womb, blood has to bypass the lungs, since they don't work yet. When we're born, we take our first big breath, lungs expand, and the ductus closes. Yours didn't. [He points at the image on the screen.]

Kutner: She has a patent ductus arteriosis.

House: When you get stressed, your blood pressure goes up and forces open the ductus. Blood takes a little detour, makes it leak from your nose, your stomach, your lungs, and, more significantly, keeps it flowing to the right side of your brain and away from your left. Which means that when you get stressed, you get unstressed. That's why you're so good with those annoying kids. And why, when your blood pressure dropped, you were able to identify Cuddy as an annoying human being. Good news is we can fix the heart. Bad news for the annoying kids. [He leaves.]

[Cut to Cuddy’s house. Cameron is there, admiring Rachel.]

Cameron: She's incredible.

Cuddy: Thank you. Great work today. I should've trusted your instincts. I will in the future.

Cameron: I quit.

Cuddy: I think I just apologized. If you want, I can get down on my knees.

Cameron: It's not because of you. I approved an insane procedure with no proof, no evidence, no —

Cuddy: You made the right call. The problem was a brain problem. Without the procedure, House never notices the increased left-brain function. She'd be dead if you hadn't said yes.

Cameron: I know. But… I'll always say yes to House. I studied under him. He's in my head. And if you gave anyone else this job, they would always say no, because… well, because they should. House is insane.

Cuddy: Which leaves me.

Cameron: I'm sorry.

[Musical montage. Cut to Sarah, in her bed. Johnny runs in.]

Sarah: Hey, buddy! [He bumps into the bed tray, spilling a glass of cranberry juice on her.] It's okay, buddy. Come here. [She hugs him.] Oh, I missed you so much. I missed you.

[House watches from the doorway, then leaves.]

[Cut to a refrigerator. Foreman’s hand takes an IV bag labeled “Patient # 118” from inside. He puts a new label, “Patient # 213” on the bag. Thirteen approaches, smiling. He smiles back at her.]

[Cut to Cuddy running to get to the office. She has her coat over her arm and she’s checking her in her briefcase. The nanny, holding Rachel, is in the doorway behind her. Cuddy runs back and past them. On her way back out she stops to kiss and pet the baby. She starts to leave again. She’s part-way down the hall when Rachel cries. Cuddy freezes, conflicted. Then she leaves.]

The End

Tags: season 5
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