doc_on_duty (doc_on_duty) wrote in clinic_duty,

House MD - 7.02 Selfish

Original Air Date: : September 27, 2010

Written by: Eli Attie
Directed by: Daniel Attias

Transcribed by: vicpei

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.

The scene opens in a skateboard park. A teenage girl (Della) is making an -expert- exhibition. As she rolls around, gaining speed, we get glimpses of kids in wheelchairs, a banner, and people cheering her from the balcony. It's a fundraiser.

Announcer : Let's hear it for Della Carr.

Boy in wheelchair : Dude, your sister kicks serious ass.

Hugo : Competed in the boys' league this year. Kicked their asses too. (Della ends her round in front of the kids. Most of them are in wheelchairs, some have crutches).

Hugo : Nice job, Del. You—

Della : I went faster on the 50-50. You were right. All right, who wants a turn now? (All the boys lift their arm. She laughs, takes her helmet off and starts to push her brother's wheelchair). Yeah, yeah, I'm a little biased.

(Della start running and pushing her brother's wheelchair on the skate park. The banner on the balcony says “SHREDDING FOR A CURE. DONATE HERE”).

Della : Whoo!

Hugo : Whoa!

(Cut to the balcony, where Claire, Della's mother, is speaking excitedly) : Custom decks. Start the bidding at 400 bucks. Trust me, the kids'll force their parents to buy them. (Her husband comes to her).

George : You got to see this. (He takes her to the handrail and they look at Della running around pushing Hugo. George looks at his wife).

George : You made a great event today, hon. (They smile at each other).

Della : Fast enough for you?

Hugo : I'm already in a wheelchair. What are you so afraid of? (Della suddenly let go of the wheelchair and stops. The wheelchair gains speed. Della looks away, falls hard on the floor and doesn't move any more).

Hugo : That wasn't what I meant. (He turns around and sees his sister on the floor). Della? You okay? Mom! Dad!

(Parents and other skaters run to Della, still unconscious).


(Cut to PPTH parking lot. The camera shows House's bike, parked in a handicapped place, then moves on to House, leaning on a car trunk, a new skull cane on his shoulder. He is clearly waiting for Cuddy, who walks from her car. He lifts himself from the car and reaches for her hand. They walk to the elevator.)

House : We got to stop parking like this. People are gonna talk.

Cuddy : Well, that's why I plan on doing some talking first. (She pats his arm). I want us to formally report our relationship to Human Resources.

House : Okay. You get them, I'll cover everybody else. (He pushes the elevator button with the tip of his cane).

Cuddy : I would appreciate it if we could keep it quiet until we had that meeting.

House : It's gonna be hard with me grabbing your ass all day.

Cuddy : Grabbing stops at the threshold... (House grabs her ass, firmly; she jumps a little)... of the parking garage.

House : Handicapped plates. I got special access. (She smiles and frees herself; they enter the elevator).

Cuddy : I just don't want our relationship affecting our jobs. Or the other way around. (Elevator closes.)

(Cut to PPTH lobby. House and Cuddy enter together, by separate doors.)

House (Loudly) : Why, Dr. Cuddy, how was your weekend? (He gives her an exaggerated wink).

Cuddy : I got a call about a case for you. 14-year-old. EMTs think her heart stopped—

House (still loudly) : Sounds great.

Cuddy : You haven't seen it yet.

House : I sense something fascinating about it.

Cuddy (voice low) : I'm gonna get us in to see HR this afternoon. Think you can hold your tongue till then? (She gives him the file).

House (whines) : Mom... (Seriously) Fine. People are gonna know soon enough. I think I can hold it till lunch. (He almost smiles. Cuddy smiles back and goes to her office. House watch her going and looks quite happy.)

(Cut to Diagnostics room. All is quiet. The team is sitting around the table, busy reading the file. Wilson is here, reading, too. House is walking around the table. He whistles. He leans over Foreman's shoulder, pretending to read.)

House : I'm seeing Cuddy. (All heads up). Generally, without her clothes on. Use your imagination. Hope it's got a wide-angle lens. (He chuckles. They all stare at him, looking confused. He takes back the file Wilson was reading). You don't actually need that.

Wilson (getting up) : I'm gonna check my office for whoopee cushions.

House : This is not a prank.

Wilson : This is not me walking out the door. (He leaves).

Taub : Really? You and Cuddy?

House : For realz. Foreman can translate. So Junior Miss everything — skateboarder, basketballer, science clubber, seal clubber (Pauses). I'm actually guessing with that last one. Healthy one day, heart arrhythmia the next.

Taub : Are you sure it's a good idea to be yanking on the chain of command?

Foreman (convinced) : Way to go, House. I'm surprised you two didn't get together sooner.

Chase (his eyes did not leave the file) : EKG, echo and head CT are all spotless. There's nothing on her neurological exam.

House : Interesting. (He points his cane at Foreman, then Taub, then Chase) In favor, indignant, indifferent. Think I'd like a female perspective. Or Thirteen's. Where is she?

Taub : She's gone.

Foreman : She said she was taking a leave of absence. (He takes out Thirteen's letter, and hands it to House, who reads it). Wanted us to think it was for a Huntington's study in Rome. They've never heard of her.

Taub: Cell and home phone are disconnected. Apartment's already been vacated. And what's with the death's head cane?

House (still reading) : They didn't have a death's ass cane in my size. (Looks up). Well, I guess we'll just have to wait. (He throws the letter on the table). Conditions that cause intermittent heart arrhythmias.

Taub : Three years, you've been trying to game out Thirteen. Now you don't care?

House : Sorry. Not caring about Thirteen is not part of the differential for heart arrhythmia, but you do get a home version of the game.

Chase (still looking engrossed in the case) : Patient's brother has severe, congenital muscular dystrophy. Life expectancy of about 25. If she's had a latent case of it...

House : Wouldn't be sudden onset. Foreman!

Foreman : Do you know something about Thirteen that we don't?

House : She's entitled to her privacy. Just as I'm entitled to a diagnosis.

Taub : And you're glossing over Thirteen's departure because you actually respect somebody's privacy?

House : I agree. It's weird of me not to care. So either I'm a changed man because of Cuddy, or I'm pretending to be a changed man because I do know something about Thirteen and I'm trying to throw you off the scent, or I've just gone nutty bananas because I lost a patient. All of which you are free to discuss (Articulating) after I get a diagnosis.

Chase (doing serious doctoring) : If it's Long QT Syndrome, any startling stimulus in that skate park could have triggered the arrhythmia. Loud noise, flashing lights.

House : Scare the patient to death to confirm Long QT. (They all frown. House shrugs). Fine. If you insist, do it in a room with one of those thingamabobs that brings people back to life.

(Cut to PPTH corridor. Foreman and Taub are walking to the elevator.)

Foreman : Scare test is insane.

Taub : Scare test is legitimate. Simulates real world conditions. This fling with Cuddy is insane. Flare gun? Scary enough?

Foreman : How about just telling her we're planning this stupid test? And I'm hoping House and Cuddy are more than just a fling. It's clearly mellowed him out. He didn't even care about Thirteen.

Taub : Right. The guy who ordered us to stop the patient's heart has mellowed out. It's gonna be horrible because it's doomed, which is just gonna make House 50 times more of a crank. (Has an epiphany). Firecrackers! We can hide 'em under one of those covered food trays. (Taub leaves hastily. Foreman looks worried).

(Cut to Wilson's office. Wilson is sitting behind his desk. House enters).

House : Find any itching powder in your hanky? Any fake poo in your desk drawer?

Wilson : Yes, the lack of dime-store pranks is proof that you're actually dating Cuddy, and not just mocking me for being worried about you.

House (extending his arms) : What do I have to do to prove this to you? Tattoo a cane on her inner thigh? Tattoo her inner thigh on my cane? (Cuddy enters).

Cuddy : You told everybody, didn't you?

House : Repeatedly. This one's not buying it. Need a little help.

Cuddy : I'm not selling it. It's time for our meeting at Human Resources.

House (to Wilson, thoughtfully) : Hmm. Human Resources. Now, why would I need to go to Human Resources?

Wilson : House, you've been to Human Resources 74 times in the last six weeks.

House : Never after doing this. (He bends down to kiss Cuddy, who stops him).

Wilson : Well, I'm convinced.

House (pleading, to Cuddy) : Come on. One peck. Just enough to arouse him a little.

Wilson : I – hey, I'm not even...

House (turns back to Wilson) I didn't mean you. (Wilson looks confused).

Cudddy : If I confirm it, can we leave?

House (nodding, voice soft) : Yes.

Cuddy (turns back to Wilson) : It's true. (Wilson raises a suspicious eyebrow. She rolls her eyes, takes House by the chin and kisses him briefly on the mouth.)

Wilson (still unconvinced) : I've been more passionate with my great aunt.

House (raising his left arm, enthusiastic) : Mabel? Up high! (Cuddy, deadly serious, moves her right arm and grabs House's crotch. He doesn't move at all. The camera changes and we see Wilson's face, frozen, looking at House's crotch level and then at Cuddy).

Cuddy (still stone faced) : We done here? (Cut to House's face. He is silent but his eyes are sparkling. Wilson, still looking at crotch level, gives an imperceptible nod, wordlessly. Cuddy leaves.)

House (smiling) : She didn't even ask me to cough. (he goes after her and calls) Think you straightened out my limp a little. (Realisation dawns on Wilson, who manages a small smile while looking still startled).

(Cut to Human Resource office. Ernest Griffin is sitting, with a notepad on his desk and a pen. He looks attentive, professional, and a little puzzled, at House and Cuddy sitting at the other side of the desk).

HR guy : How would you describe the exact nature of the relationship?

House (Helpful) : You ever see Wild Kingdom? Those insects that rip their partner's heads off after copulating? (He turns to Cuddy for approval. There is an akward silence. Ernest Griffin considers this and starts to write it down. Cuddy, who was preparing to speak, stops and looks startled.)

Cuddy : It's a sexual relationship.

House : Go slowly now. He's writing it down.

Cuddy : I believe that I can still supervise Dr. House effectively, but we both want to follow hospital policy to the letter.

HR guy : Our concern is to make sure that there's no conflict of interest, no liability for the hospital.

House (entertained) : You think we're gonna sue if things go south? (Confidently) Let me tell you. She actually does go—

Cuddy : House. Let him talk. (She tries hard not to smile, does not look at House and intently listens to HR guy. House stares at her and looks like he really enjoys it).

HR guy : I, uh, know that you're not going to sue, because you are both going to sign love contracts. (Handles them contracts). Consensual relationship agreements.

House (perusing the file) : Well, obviously outside counsel will have to review the crotchless undies clause.

HR guy : Uh, we'll also need to watch for any favoritism toward Dr. House. (House takes out a pen, hands it to Cuddy; she signs the file).

House : Does that mean she has to sleep with everyone?

Cuddy (mischievously) : I promise not to give him a raise or a promotion of any kind.

House : There's got to be a joke there about keeping up with inflation.

HR guy : Or bias against him. Are there any supervisory issues with Dr. House's current case load?

(Cuddy gives House his pen back; he signs. They both give their file back to Ernest Griffin).

House : No, her case is solved. Patient has Long QT. Gonna scare her into cardiac arrest to confirm it.

Cuddy : No, we're not.

House : Okay, no, we're not. (He pockets the pen). See? Everything's under control. (He smiles).

(Cut to PPTH corridor. House and Cuddy are on their way back to work).

Cuddy : I know you're still planning your ridiculous scare test. The patient is nowhere near sick enough to justify the risk. An angiogram and an E.P. study are much safer and very effective.

House : Fair point. Not doing the scare test. (Cuddy stops walking. House turns back to her). I'd invite you to watch me not doing the test, but having not done it many times before, trust me, it's pretty not interesting.

(Cuddy still looks unconvinced. House rolls his eyes, gets his phone, dials with speaker on. Taub answers).

Taub : House?

House : Scare test was not approved. Do an angio and E.P. study instead.

Taub : First of all, that's not as effective as— (House shuts the phone. Cuddy nods and leaves).

(Cut to Della's room. Foreman and Taub are preparing Della for her tests).

George : How come you're not doing the more specialized test?

Taub : This test is virtually just as effective. And Dr. House puts a premium on patient safety.

Hugo : But frequently changes his mind.

Della : Hugo, give him a break. I'm fine.

Foreman : You should go to the bathroom before we go. We've been hydrating you for quite a while.

Della : I don't have to pee.

Taub : Once we start the test, you won't be able to move for at least an hour.

Della : I really don't have to pee.

Foreman : How much fluid have we given her?

Taub (looking at the chart) : 2.5 liters. When's the last time you went to the bathroom?

Della : Last night, I guess. (Foreman and Taub look at each other).

Claire : What does that mean?

Foreman : Your daughter's kidneys seem to be failing.

(Cut to Diagnostics office).

House (looking through the blinds) : So what could cause her heart to stop and her urine not to drop?

Taub : House, I was expecting your relationship with Cuddy to complicate our work long-term. (House turns back, gives him a patient, fake-polite look). I am now concerned it might be affecting us short-term. All due respect.

House : None taken. I listen to Cuddy all the time. She's my boss. Also yours, by the way.

Taub : You'd listen, then tell her she's being an idiot, and do whatever you want.

House : I find I can skip the idiot part when she's not being an idiot, and since the scare test would have led to the same dead end, she was right to stop it. Which means your problem's about you.

Taub : This should be interesting.

House : Losers love company. And if even a misanthrope like me has a chance at happiness, it's gonna be pretty lonely on that landfill of loserdom you call a marriage. (Taub looks a little hurt, Foreman smiles. House opens the patient's file). Heart, kidneys, go.

Foreman : Could be Fabry disease. Lipid deposition in her tissues.

Chase : Dad's history was clean.

Foreman : What about protein deposits? They wouldn't show in her parents' history.

House : Amyloidosis. Explains both the symptoms. Marrow transplant to treat. Brother's a match. (Gives Taub the file) Confirm and do.

(Cut to the Clinic. House is sitting in an exam room, facing an Old Guy with a cap and a Very Old Guy with glasses).

Very Old Guy, Maurice : I been experiencing fatigue, and — and weakness.

House : Wouldn't have anything to do with the fact that you're... 102 years old.

Old Guy, Sidney : Usually he's strong as an ox.

House : 102-year-old ox.

Sidney : He has tingling in his feet and his legs. I want a full battery of tests.

House : Carbon dating?

Sidney : I'll pay cash if it's not covered.

House : That's nice of you to float your friend.

Sidney : He's not my friend. He's my father. He's 22 years older than me.

House (looking closely) : Well, that's true, he's definitely had his jowls done. Statistically, if he didn't have these symptoms, he'd be like most people of his age — dead for the past several decades.

Maurice : Do the tests. I'm sick.

House : You have a bad case of natural causes.

Sidney (voice rising) : Do the damn tests.

House : If the vial fills with sand, we take that as a bad sign.

(Cut to Della's room. Taub is at her side. Her parents are standing at the foot of her bed).

Della : Hugo should be here. Why'd you ask him to leave?

Taub : We wanted to be able to discuss this openly.

Della : But it obviously affects him.

Calire : Honey, let the doctor finish.

Taub : It's a standard procedure. We use general anesthesia, harvest a very small amount of—

Della : No. I'm not taking my brother's marrow.

George : Del, it's—

Taub : These harvests are harmless. With the meds we give, there's almost no pain, almost no risk of infection.

Della : Almost? His life's hard enough as it is.

(Cut to the clinic. House is busy scribbling in patient files. He doesn't look at Taub while talking).

Taub : Small problem with the treatment.

House : Patient won't take marrow from steel wheels?

Taub : We're finding another match. And how do you know?

House : What other problem could there be with a problem-free procedure? Boy's sports, science club, she's living his life, not hers. (He puts the file away, takes another, looks at Taub). Makes sense she's being a self-denying moron.

Taub : She loves her brother. She's thinking selflessly. How is that at all—

House: Being moronic? Mm. If I can only think of a harm-free medical treatment she turned down lately.

Taub : You're right. If everyone were more selfish, the world would be a better place.

House : See? I can skip the idiot part when you're not being an idiot. (He turns to leave the Clinic. Wilson is leaning in the doorframe, arms crossed, with a huge smile on his face).

House : Yeah, I had that same facial expression for the first 48 hours. Had another one too, but only for 15 seconds at a time. (They pass the door and walk together, as usual).

Wilson : I'm happy for you. You're happy for you. This is huge. So who's gonna supervise you?

House : Cuddy.

Wilson : Well, I guess maybe that can work.

House : Maybe? Nothing's changed.

Wilson : You showed up for clinic hours. (Emphatically). Voluntarily.

House (he stops walking and faces Wilson) : Fine. A little bit has changed.

Wilson : House, everything's changed. You're sleeping together. You want something from her besides a sign-off on scaring your patient to death.

House : You talked to Taub.

Wilson : He's worried about you.

House : He's a jerk.

Wilson : I'm worried too.

House : Do I need to say it?

Wilson : I want this to work.

House : I'm not doing anything differently. She changed my mind about one diagnostic test. And she was right. (He enters the elevator). Even though it's your emotional default, stop worrying. (He bows a little). I can handle it. (Elevator closes).

(Cut to Della's room. Taub is giving her meds, in a cup, with a glass of water).

Taub : I hear you're a pretty fierce skateboarder.

Della (smiling) : I do okay.

Taub : All your activities, don't they seem like things a 16-year-old boy would do? Some people might think you're trying to live his life for him.

Della (nods) : I am. Sort of. Um, I got into skateboarding when some of Hugo's classmates did, and he realized he could never do it. (She looks outside of the room, where Chase is talking to her parents and Hugo). It's the same with a lot of things. We live through it together.

Taub : And you're not worried you're being selfless to the point of self-denial?

Della : You've never been inspired by someone?

Taub : Why don't you take your pills? (He turns away. Della swallows, coughs, gasps, begins to spit out lots of blood).

Taub (putting on gloves) : Need some help in here. (Chase turns and rushes in the room. Della is still coughing blood).

Taub : Hemothorax. We need to bronch her now.

Chase : Clear an O.R. She's drowning in her own blood.

Taub : It's not amyloidosis. (Chase, Taub and a nurse take Della's bed to the OR. Taub is giving her oxygen. She gasps.)

(Cut to OR, where Della is undergoing a bronchoscopy. House and Cuddy are upside in the watching room).

House : She's bleeding to death. Out of her lung. I want to fill a quarter of it with foam.

Cuddy : That'd stop the bleeding, all right.

House : Thought it made more sense than diet and exercise.

Cuddy : And if she doesn't have enough lung function left, you'll have killed her.

House (slowly and quietly) : The only alternative is slowly suturing the lung, hoping that the bleeding stops in time and she doesn't die on her own. But we would walk away with clean hands. Except for all the blood.

Cuddy : You're right. Faster and riskier's better. Foam the lung. (She goes downstairs. House turns back to the OR).

Chase : Got a green light?

House(pushing the speaker button, frowning) : No. Suture the lung.

Chase : Scalpel, rib spreader. (House is thinking hard).

(Cut to Wilson's office. House shuts the door behind him and slouches in a chair).

House : I can't handle it.

Wilson (folds the letter he was reading) : What happened?

House (rubs his nose, gestures a lot with his left hand, looks defeated) : She said "yes," and I heard "no." I didn't actually hear "no." But I just... was sure that's what she meant. Way she tilted her head and half-arched her eyebrow. What do I even care what she meant? She said yes. That's all that matters. I'm screwing this up.

Wilson : It's not completely bad, House. You care enough to pull your punches. That's not a bad thing. But you and Cuddy have got to figure out a way of avoiding this problem. Set some ground rules.

House : Yeah (Wilson looks genuinely surprised). I have to avoid this problem. If I can restrict our interactions to places where neither of us are wearing pants...

Wilson : Yeah, that's not avoiding the problem, that's avoiding the issue.

House : Since avoidance is my plan for dealing with the issue, technically, that's not avoiding it. (He seems relieved). Thanks.

Wilson : No problem. (He goes back to whatever paperwork he was doing before).

(Cut to House office, where the team is waiting for him. He enters).

Chase : Stitching worked.

Taub : This time. No guarantee bowing to Cuddy will work next time. (House gives him a look).

House : Heart arrhythmia, kidney failure, and now bleeding lung.

Taub : I don't want to criticize your girlfriend, but—

House : Hey, you've been on me for years to respect someone's opinion (He starts packing). Just 'cause I had to go outside this group to find one I respect. (Taub raises his eyebrows).

Foreman : Multi-system involvement centered in the lung. Sarcoidosis?

Chase : Doesn't explain the hemothorax.

Foreman: TB can affect all three organs.

Taub : Skin test was negative.

Foreman : What about Goodpasture's? Affects the lungs, kidneys.

House : And autoimmune explains the out of the blue arrhythmia. Goodpasture's it is. Immunosuppressants and plasmapheresis to treat, kidney biopsy to confirm. (He takes his backpack and leaves).

(Cut to PPTH lobby. House gets out of the elevator).

Sidney (walking fast and calling) : Dr. House.

House : Don't tell me, your father's hairline is receding, and he needs more tests.

Sidney : He's 102. His next test is an autopsy. Look, I love the old man, but I got to get him out of the damn house. He can't do anything without me. He needs to be in a care facility.

House : Well, so tell him. He's a big boy now.

Sidney : I can't. I'm his whole life. But if it comes from a doctor... (He holds out his wallet and slips House a twenty).

House : That's very generous. When you were 30.

Sidney (gives him another twenty) : Pretend to run the tests, and then tell him... He can't live with me anymore.

(Cut to House's bedroom, where House and Cuddy are cuddling, naked. He is stroking her arm while she curls up on his right side).

Cuddy : I didn't run into you all afternoon. I missed you.

House : Busy day.

Cuddy : Maybe we should plan on lunch tomorrow.

House : Problem is, at lunch you tend to wear tops.(Cuddy smiles widely. He lifts the sheet and takes a look). This is much better. (Cuddy laughs. He smiles and kisses her forehead, then lifts himself and prepares to kiss her properly. The phone rings. Cuddy frowns. He reaches for his phone and answers. During the whole conversation, Cuddy caresses his forearm and traces one of his veins).

House : Cuddy and I are naked. So I'm having trouble focusing. Use small words.

Foreman (He and Chase are in the lab, near a computer screen) : Kidney biopsy was clean, so we rechecked the piece of her lung from the O.R.

House : You lost me. Sorry, who is this calling again?

Chase : It's not Goodpasture's. There's intimal thickening of the blood vessels.

Foreman: And lymphocytic infiltrate. We tested for LAM. It's positive.

Chase: Plus her lung's fried. She needs a donor lung to live, which is the only treatment for LAM, anyway.

Foreman : Taub's gone to the transplant committee. They may have found a donor lung.

House : So this call is purely expositional. (He shuts his cell phone and throws it away, then goes back to kissing Cuddy).

Cuddy (with absolutely no conviction) : I should really get dressed. I told the nanny I'd be home by 9 :00.

House : And I slipped the nanny 40 bucks, told her to stay till 10 :00.

Cuddy :Really?

House (playfully) : Mm-hmm, really. (Cuddy brings him back to her. They kiss again).

(Cut to PPTH corridor. George and Claire are pacing. Chase and Taub join them).

Chase : Good news. (The parents hug).

(Cut to Della's face, asleep. She is intubated).

(Cut to the OR, where the surgical team is performing the lung transplant, with Foreman's voice over).

Foreman : Surgery was uneventful, but the donor lung started failing about an hour into recovery.

(Cut to the Diagnostics office, where the team is sitting).

Taub : We know we're right about LAM. Tests confirmed it.

House : That leaves us with two options. Body's rejecting the new lung or we should have rejected the new lung because it's infected.

Chase : Let's biopsy, see which one it is.

Taub : No guarantee we'd hit the affected spot.

Foreman : If we give steroids for rejection, it'd make an infection worse. If we give antibiotics for infection, it'd make rejection worse.

House : Which worse is worse?

Chase : If we treat for infection and we're wrong, she'll be dead within hours.

House : And if we treat for rejection and we're wrong?

Taub : She'll probably hang on a day or two.

Foreman : You're assuming her rejection's hyperacute. Odds are, it isn't.

House : Gotta head off the worst worse first. I studied under Dr. Seuss. Start with IV methylprednisolone for hyperacute rejection. If that fails, we'll switch her to broad-spectrum antibiotics and hope we're not too late. (They all get up and leave, except Taub who does not move and looks at his nails.)

House : Cat got your legs?

Taub (matter-of-factly) : We just decided to give meds that could kill the patient based on a guess. You need approval from Cuddy, and she'll want to take the safer course, and you're gonna fold like an origami crane, so... (He takes the file). I'll just wait here till we get our actual orders.

House : Fine. You do it. (Taub freezes, file in hand). Tell her she's being an idiot for always choosing the safer course. She's sitting on her ample, if well-formed, bureaucratic ass while our patient's dying. We'll see who folds like an origami shrimp.

Taub : You want me to get Cuddy's approval?

House : I gotta be somewhere important.

Taub : Sitting at your desk?

House : I'm running late. (He turns back to his office. Taub gets up and goes to see Cuddy).

(Cut to House's shoes, under his desk, then to House. He is reading with a pencil in his hand and his reading glasses on. Maurice enters his office).

Maurice : Forget the tests.

House (quitting his glasses) : I think Junior might have a few words to say about that.

Maurice : I love him, but he can't let go.

House (smirking, leaning back in his chair) : 40 bucks says he can.

Maurice : I can't do anything without him helping me like I'm senile. If I go back there, I'm gonna rip his throat out.

House : You sure you won't warm up to him over time?

Maurice (gets a hundred dollars note out of his pocket and hands it to House, who takes it) : Skip the blood work. (House suppress a smile). Tell my son it's grim news. I need to be in a nursing home. A private room. (Pause) Make it a suite.

House : Be our little secret. (He pockets the note. Maurice goes to leave, but is stuck by a Very Angry Cuddy briskly entering House's office. Taub follows).

Cuddy (threateningly) : I sit around on my bureaucratic ass?

Taub : I was relaying your words.

House (Wide-eyed) : I said well-formed. I said well-formed! (to Taub) What were you—

Taub : I needed to be aggressive.

House : You're an idiot.

Taub : She was siding with Foreman's analysis.

Cuddy : The odds are against it being hyperacute rejection.

House : Stop. I agree with you (He gives a little sigh. Taub is speechless). That was our analysis from the start. (to Taub) If you've got a problem with a team decision, you come to me. (to Cuddy, sheepishly) I'm sorry. I-I'll deal with him later. (Pleadingly) I said well-formed. (Cuddy leaves. House bends his head in defeat).

House (to Taub) : People who have not seen Cuddy naked should not throw stones.

Maurice (approvingly) : She does have great cans. (House gives him a look).

(Cut to PPTH corridor).

Taub (indignant) : Cuddy has House on such a short leash, she might as well start giving him chew toys.

Chase : Let's give the antibiotics at least another hour.

Taub : Amazing. And House hasn't given you one ounce of grief for your complete lack of interest in his love life?

Chase : Did it ever occur to you that House is just happy and could give a crap about other people's lives because of it?

Taub : Well, that's ironic and depressing. And by that logic, the reason you don't give a crap is because you're happy, which means you've got someone new giving you chew toys.

Chase : You're one-fourth right.

Taub : Wait. Are you saying... (pagers beep) You're dating four women? (Chase cocks his head. They both look at their pagers and run away).

(Cut to Della's room, where all the alarms are beeping. Nurses are busy changing fluids. Chase and Taub rush in).

Chase : BP's dropping. Means the antibiotics aren't working.

Taub : Put her in Trendelenburg.

George : Can you save the lung?

Taub : Believe it or not, we got a better chance now. This means rejection, not infection.

Chase : Start her on IV methylprednisolone right away.

(Cut to the cafeteria. House is sitting in front of a plate, thinking, frowning. Wilson sits next to him).

Wilson : Wow. You hate salad. She's really got you tied up in knots.

House (He rubs his face) : I caved. Through an intermediary. I need a plan "C."

Wilson : What you need is a plan that you actually develop with Cuddy. (He takes a fork and eats salad from House's plate. House looks at him, worried. Taub and Chase enter the Cafeteria and stop at the table).

Taub : Antibiotics didn't work and then steroids didn't work.

Chase : The new lung's ruined, and it's not rejection or infection. The only two options were wrong.

House : Unless it's not LAM.

Chase : It is LAM. The tests were positive.

House : Then the tests have to be wrong.

(The cook comes with a plate of fries. He hands it to House) : Deep-fryer's working again. (Pointing at the salad) Still working on that?

House : No, it was here when I sat down. I need to think. (He gets up and leaves. Wilson stills, fork in hand).

(Cut to House's fingers. He is playing with a miniature skateboard. His head is on his left hand. He is thinking, standing in front of Della's room).

Hugo : I want to make sure you're trying everything to save my sister.

House : Everything? Well, that must be it. See, I thought you guys checked the box marked, "try every other thing."

Hugo (voice trembling) : I'm the one that's supposed to die first. I'm the damaged one, not her. She never even gets a cold.

House : Damage has a way of spreading to everyone around you. For example, your obvious emotional damage is now making me have a philosophical conversation instead of dealing with your sister. See how that might be damaging? (House starts to leave, then stops and turn back to Hugo). Never?

(Cut to Della's room. Claire is sitting next to her daughter. We hear the door opening and House enters).

House : When was the last time you had a cold? Any minor aches, swelling, anything?

(Della mumbles something).

Claire : It's been years. She never gets colds.

House : I didn't ask when's the last time she mentioned it. I asked when she had one — even a tiny one. (He takes her oxygen mask away so she can speak).

Della : It's nothing. Sometimes my ears ache a little.

House (sighing) : So now tell me the rest of the nothing.

Della : M–my chest... Soreness. Some congestion.

George : You never said anything about that.

Della : I barely noticed it until that skateboarding tournament in Denver.

House : How long ago?

Della : A... year? Cold's nothing when I think of what Hugo goes through every day. (House puts her mask back in place).

House : Yeah, we get it. Your brother, the Saint. His sister, the Martyr. (He leaves the room. Taubs runs after him).

House : Thank God you followed me. Now you can go back to the transplant committee while I get confirmation.

Taub : Confirmation of what?

House : What causes low-level cold symptoms for a year, can ruin two lungs, is immune to drug therapies, and gets worse in cities nicknamed “Mile-High”?

Taub : A clotting disorder?

House : She has a nasty case of sickle cell trait. Her heart arrhythmia wasn't sudden at all. Screwed-up blood cells screwed-up the blood vessels, which gave us a screwed-up positive for LAM. If she'd told us about her symptoms sooner — like ever — she might not be dying. You were right after all.

Taub : I never said sickle—

House : If everyone were more selfish, the world would be a better place.

Taub : So she's gonna die.

House : Unless we can find—

Taub : She burned through one donor lung. Transplant committee's never gonna give her a second one.

House : Well, then I guess you're right again. (Thinking) Unless we don't need their approval.

(Cut to the Lab. House is working on a computer. Cuddy comes to him. During the whole following exchange, she argues with her usual tone, House is surprisingly quiet).

Cuddy : You can't advise your patient's parents to take marrow and half a lung from their son!

House : I guess I can just chat with them about the weather. Blood tests just confirmed sickle cell trait. So they might be curious about the only treatment option. Though we are having weird weather lately.

Cuddy : There is a huge reason not to take lungs from living patients.

House : So their siblings can die?

Cuddy : Their son has CMD. As it is, he's gonna die of respiratory failure by 25. We could cut whatever time he has left in half.

House : That qualifies as a bad reason for them to reject the idea. It's a much worse reason for them not to get the choice.

Cuddy : It's coercive to tell them! You ever hear of "do no harm"?

House : That was second year, right? 'Cause I had mono all that fall.

Cuddy : Their son's not even our patient. Why don't we just take half a lung from some guy in the clinic with a toothache?

House : That's a great idea. Now we can give the parents two options.

Cuddy (firmly) : We don't compromise one life for another.

House (pauses, then nods) : Okay. (He gets up and starts leaving).

Cuddy : Okay? Seriously! (House turns back ands puffs).

House : You made an argument. If you don't want me to defer to you, why make it at all?

Cuddy (coming closer) : But are you deferring to me just because we're seeing each other?

House (nods) : Maybe. (Raises eyebrows and admits it) Yeah. I think so. This is screwing me up. Why is it not screwing you up?

Cuddy (whispers) : It is. I don't know why I okayed you foaming that lung. I realized it was wrong as soon as I said it.

House (whispers too) : I knew it! I knew 'cause you tilted your head.

Cuddy (quietly) : House... we are screwing this up. I'm gonna call HR, find someone else to supervise you as soon as I can.

(Cut to an exterior view of PPTH, then to the clinic, where House is back with the two Old Guys).

House : I've got your... test results. (He shows them a manila envelope labeled “test results”). You have the metabolism, blood counts, liver and kidney function of a 92-year-old. Which is great, 'cause you're 102. What's not so great is the average life expectancy is 78. It is my recommendation that you move into a home with round-the-clock care.

Sidney : Oh... I can't believe it! (Winks and put his arm around his father's shoulders).

Maurice : Can't my son give me round-the-clock care?

House : Not unless you've done your two-year certification in tiburon swab technology. (Maurice winks and nods in approval. House nods back, slightly).

Sidney : There must be some other way. Just because he has a little tingling and some trouble feeling hot and cold and some difficulty—

House : You can't feel hot and cold?

Maurice : Not lately. But at my age...

House : Show me your teeth. (He does so). Dentures. Fairly worn. I'm guessing ten years old. (The corner of his mouth twitches). Show me your denture cream. (Maurice searches in his pocket).

Sidney : Why would he carry denture cream?

House : Because... (Maurice hands him a tube. House takes it and reads the label). He has... zinc poisoning. But to get it from denture cream, he'd have to take so much of it — trust me, he never leaves home without it.

Sidney : How much do you use, pop?

Maurice : About a tube a day. I buy it online (House smiles lightly). So what does this mean?

House : Bizarrely, it explains all your symptoms. Better-fitting dentures, you'll be fine. Medically, there's no reason to go anywhere. (Maurice and Sidney look at each other. House starts to leave, changes his mind, sighs, turns back and holds out his wallet. He gives Maurice his one hundred back and hands Sidney a twenty). Hospital rebate. You might wanna... put it towards couples therapy.

(Cut to PPTH at night. George is waiting in House's office. He is leaning on the back of a chair, turning around when House enters the room. He looks and sounds exhausted).

George : The transplant committee's... never gonna give my daughter another lung, are they?

House : No.

George : Are there any other options?

House : We're looking into it.

George : Looking into what? Please. Tell me. Give me some kind of hope.

House : I'm afraid I can't do that.

George (on the verge of tears) : We're talking about my daughter's life. What can't you tell me? If there's any... chance you can save her, anything you can try...

House : We can take marrow and half a lung from your son. It would likely shorten his life significantly. He'd never be able to go on a respirator if he needed to. Most people with CMD need to as their respiratory function declines.

George : How long... do we have to decide?

House : Morning at the latest.

George (little laugh, almost inaudible) : Thank you.

(Cut to PPTH corridor. George and Claire have a conversation not audible under somber music. They discuss, argue, and hug).

(Cut to Della's room. Taub is checking on her. She wants to speak, and he takes her mask away).

Della : Where are my parents?

Taub : They're probably dealing with committee issues or something.

Della : They were arguing. I saw my mom crying. Looked like my dad was yelling at her.

Taub : They care about you a lot. (He puts the mask back on her face. She takes it away).

Della : Hugo was a marrow match?

Taub : We're way past that now.

Della : They want a lung from him too. Is that what this is about?

Taub (softly) : No. It's nothing you need to worry about. Everybody's working on getting you the best care possible. (He puts the mask back in place).

(Cut to PPTH corridor. Claire is sobbing.)

Claire : How do they expect us to go on from here?

George : We make a choice... And we live with it.

Claire : There's no living with it. No matter what we decide.

(Running footsteps are heard. It's Chase and a nurse. Claire and George look at each other and run after them).

(Cut to the stairs. Della is lying on the landing. Foreman is ventilating her through a mask. Chase joins with a breathing bag).

Foreman : Still cold and clammy. She had a respiratory arrest.

Claire : Oh, my God! What is she doing here?

Taub : She figured out what was going on.

Chase : She's pinking up.

Taub : She must have yanked off her IVs and oxygen. Came here to die. (George and Claire cry. Della is lifted on a gurney).

(Cut to Della's room. She's back in her bed. Claire and Hugo are at her side. We hear Taub and Foreman voices over).

Taub : By unhooking herself from everything, she delivered a hypoxic insult to her body that started a downward spiral.

Foreman : If you're gonna make a decision, you're running out of time.

(Cut to PPTH corridor where Taub and Foreman are in front of the parents. House is watching from the side. Cuddy comes behind him).

Cuddy : HR can't find you a new supervisor.

House : How come?

Cuddy : Because you're unsupervisable, House. Two department chairs threatened to quit.

House : Well, I guess we're stuck with each other.

Cuddy : I have no idea why I'm making this call, or if it's the right call to make. But if you feel strongly about presenting the parents your treatment option, you can do it.

Houses : Thank you, I will. (Pause) Several hours ago.

Cuddy : You told them?

House : I told him. He came to my office. I'm sorry.

Cuddy : Well... I should probably be more mad at you.

House : Yeah.

George (hugging Claire) : Dr. House? We've decided. We're not gonna take the lung from my son.

Cuddy : She's still on the waiting list. We're gonna do whatever we can do find her another—

House (suddenly sounding furious) : What ginormous crack pipe have you people been sucking on?

Cuddy : House! (During the whole following exchange, they yell at each other) :

House : Are you gonna pretend that you're not choosing your own daughter's death?

Claire : Our daughter doesn't want it.

House : Probably doesn't wanna floss her teeth either. She's a mindless teenybopper.

Cuddy : Don't put this on them.

House : What do you mean, put it on? It is on them! As much as they may wanna pass the lung here!

Cuddy : Of course they do! You're handing them an impossible choice.

House : Life has handed them a crappy choice, and they're picking the crappier option — trading who knows how many healthy decades for four or five years in which roller boy will be a limp rag.

Cuddy : Not everything is a math equation.

House : Do you need me to explain the difference between decade and year?

Cuddy : Their son is a human being. You know what they are, right? Intrinsic value. We don't get to decide—

House : And we do it every day. If the two of them needed the same lung—

Cuddy : He needs to keep the one he's got. You don't get to play God by ripping out—

House : That train left the station when we learned to do transplants. The rest is just paper-pushing. Of course, now we're on to your real area of expertise.

Cuddy : Oh, I thought we were moving on to yours — bullying your patients into embracing your own lack of a moral— (As she turns, we see Hugo who has been listening).

Claire : Hugo. Honey.

George : We didn't mean for you to hear any of this. Hugo, please!

(Hugo wheels himself to his sister's bedside, where she is dozing. He takes her hand, wakes her up).

Hugo : I want you to take half my lung.

Della (from behind her mask) : No. I'm not.

Hugo : You do so many great things. I just watch. I get to watch and coach and cheer. But that's not me out there. It never will be. If you take this piece of me, carry it with you... then I really can share in everything you do. (The parents stare at them). This is the great thing I can do with my life. Don't make me live without you.

(Della cries and takes Hugo's hand. The parents join them into the bedroom. They are all crying. House and Cuddy turn back and slowly go to the elevator).

House : We got lucky. (Pushes the elevator button with his cane). I did give them an impossible choice. The kid took it away from them.

Cuddy : That fight... was the first honest interaction you and I have had since we came back to work. If we are painfully, brutally honest with each other, maybe we'll get lucky again.

House (listens, nods slightly) : You've got a big ass. (He grabs it. Cuddy smiles at him, intertwines her fingers with his on her bottom, takes his hand and leads him to the elevator).

(Elevator bell dings).

Tags: season 7

  • Episode Guide

    In Progress Pilot Summary: Rebecca, a kindergarten teacher, collapses in front of her students and is taken to Princeton-Plainsboro Teaching…

  • House MD - 1.22 The Honeymoon

    Originally Aired: May 24 2004 Written by: Lawrence Kaplow & John Mankiewicz Directed by: Fred Keller Transcribed by: Mari (…

  • House MD - 1.21 Three Stories

    Originally Aired: May 17 2005 Written by: David Shore Directed by: Paris Barclay Transcribed by: Mari (musikologie) DISCLAIMER: We…

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  • Episode Guide

    In Progress Pilot Summary: Rebecca, a kindergarten teacher, collapses in front of her students and is taken to Princeton-Plainsboro Teaching…

  • House MD - 1.22 The Honeymoon

    Originally Aired: May 24 2004 Written by: Lawrence Kaplow & John Mankiewicz Directed by: Fred Keller Transcribed by: Mari (…

  • House MD - 1.21 Three Stories

    Originally Aired: May 17 2005 Written by: David Shore Directed by: Paris Barclay Transcribed by: Mari (musikologie) DISCLAIMER: We…