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House MD - 1.17 Role Model

Originally Aired: April 12 2003

Written by: Matt Witten
Directed by: Peter O'Fallon

Transcribed by: Mari (musikologie)


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



[Episode opens on a big hall/lobby. Senator Gary Wright is making a speech to potential donors, his staff behind him.]

Senator: [to applause from the crowd] And the only thing wrong – the only thing wrong with the American dream is people. Too many people. Too many of us telling young people that the dream is dead. They told me that when I was growing up in the slums of Trenton, and they were wrong. They told me that when I decided to run for Senator with only $58 in my savings account and they were wrong! And they are still telling me that now, that I don’t have a chance: because I’m black, because I don’t have the right nose, because I still have only $58 in my savings account. [Crowd laughs. The Senator gets a bit of a pained look on his face, and we see him lick his lips and cover his mouth with his hand quickly. Strained -- ] With your help, we can keep that dream alive. [Clapping from the crowd.] And in closing – [The crowd starts to waver and blur in his field of vision, and his breathing quickens] – just… let me say… [His staffer quickly steps to his side.]

Staffer: Let ME say that you should all donate the legal maximum to the next President of the United States! [Loud clapping. Underneath, to Wright] Are you okay, do you need some water or something?

Senator: No, no, I’m fine, I’m fine, really. [He starts to make his way down the stairs, while dizzy. A man corners him on the stairway.]

Union Guy: A handsome guy like you, I bet you get 70% of the women.

Senator: Heh, here’s hoping.

Union Guy: Of course, it helps your wife died of cancer. [Senator gives him a very WTF kind of look.] I mean, I’m sorry, but the sympathy vote’s in your pocket.

Senator: Yeah, I appreciate your support.

Union Guy: Listen, Senator, my union has a hell of a war chest. [The Senator’s vision and hearingbegins to blur in and out.]

Senator: Um, I’ve always been strong on the union. [Senator Wright is sweating and swaying, and looks really sick.]

Union Guy: The thing is, you always go on in your speeches about the workers in Indonesia, Cambodia, Timbuktu –

Senator: Because I think we have… a moral, uh –

Union Guy: My union members are hurting. They don’t care about moral this or moral that. Are you all right? [To answer, the Senator vomits all over the union guy.]

Various staffers: Senator?

Union Guy: Hey! [to himself] The guys are gonna love that. [The Senator falls down the rest of the stairs to the flashing of the Press’ cameras.]

Various staffers: Tell him to breathe! Give him some room! Senator, are you all right?

[Opening credits!]

[House is in Vogler’s office.]

Vogler: The Senator’s suffering from nausea, headache, and mental confusion.

House: Yeah, bad sushi is so hard to diagnose.

Vogler: You’re being childish. Look, if his case is as trivial as you think it’ll take you three minutes to diagnose him.

House: Uh huh, three minutes that I could spend sitting on the toilet with the funny pages.

Vogler: You’re mad at me.

House: [closes the door] Nope. I never liked Cameron or Foreman.

Vogler: Do you know why I’m forcing you to fire one of them? Because you need to prove to me that you’re a team player. Now, if you did that, you wouldn’t need to go through this exercise.

House: Fine. I’ll hold the Senator’s hair while he upchucks.

Vogler: [as House is leaving] Oh, and by the way, I need you to give a speech at the National Cardiology Conference. Next week.

House: I don’t do speeches. I’m shy.

Vogler: Eastbrook Pharmaceuticals has developed a new ACE inhibitor. I would like you to extol the virtues of this breakthrough medication.

House: Eastbrook Pharmaceuticals… wait a second, don’t I own that company? Oh, no, that’s right, you do.

Vogler: Viopril is a significant improvement over the old version. All there in the study. [He hands House a booklet of information.]

House: I know its price tag is significantly improved.

Vogler: [sighs] You can either give one ten minute talk and one three minute diagnosis or you can fire one of your pets. My understanding was that you believed in rationality above all else. [House grabs the Viopril information along with the Senator’s chart.]

House: [mutters as he leaves] Viopril…

[House and Foreman are checking out Senator Wright. Well, Foreman’s checking. House is playing on his Nintendo.]

Senator: I appreciate your keeping the media way.

Foreman: We’re keeping your staff away as well. You’re taking it easy, now.

Senator: I’m in the middle of a campaign.

Foreman: The faster we can get you better, the faster you can get out of here. Anyone else at the fundraiser get sick?

Senator: I don’t think so. And I don’t think that’s it, I’ve been under the weather for weeks, you know. Lots of traveling, supposed to be in the Sudan next week. [Beeps are heard from the corner, namely, from House’s gameboy.]

House: Helps me concentrate. [Puts down Nintendo, picks up Vicodin.] Even better than drugs. [He pops one to demonstrate.]

Foreman: Open your mouth, please. [Senator Wright does, and there’s a nasty scar on his tongue.] That’s quite a scar.

Senator: When I was six, I fell off the swings and bit my tongue. Couldn’t talk right for the longest time. Lots of teasing. But, you know, it just made me fight harder, speak up for those who can’t.

House: Yeah, yeah, yeah. Tongues heal too fast. Your political consultants have written you a nice story. In a tight race the lispers alone could put you over the top.

Senator: You a Republican, or you just hate all politicians?

House: I just find being forced to sit through drivel annoying.

Senator: You find sincerity annoying.

House: You’re a black kid from the ghetto who made it to Yale Law and the United States Senate. That’s a sufficiently mythical story, you don’t need to lie about your tongue. [Foreman has been checking the Senator’s reflexes; the left leg was okay, but the right didn’t move.] Must have missed it.

Senator: What’s wrong? [House tests the reflexes himself, no change.] What is it?

House: It’s not the food. It’s your brain. [to Foreman] Get an MRI and a lumbar puncture. [to Wright] Cancel your travel plans.

[Cut to Cameron, Chase, Foreman and House in the lab.]

Foreman: The LP showed no sign of infection and the MRI was fairly clean.

House: I guess we can tell him he’s fairly healthy and can go home.

Foreman: Well, there is something in Broca’s area, but it’s small, low intensity.

Chase: Most likely just background nose.

House: Care to bet your job on that? [Chase makes a face.] What was that?

Chase: What was what?

House: You got annoyed. That was clearly an annoyed face.

Chase: I get annoyed by glib remarks about our futures.

House: But last week you didn’t get annoyed, you made poopie in your pants. It’s weird, it’s almost like now you know you have nothing to worry about.

Cameron: Chase has nothing to worry about?

House: None of you has anything to worry about.

Cameron: What happened?

House: Vogler saw the error of his ways and repented. The lesion could be nothing. It could also be a brain tumor or infection. There’s only one way to find out which.

Foreman: You wanna cut into his brain.

House: Dangerous, I know. Especially as he’s a politician, his brain’s all twisted. But I weighed that against the risk of him stroking out before lunch. Call surgery, get it scheduled. [He leaves.]

[Cut to the clinic, where House is performing an ultrasound on Sarah, a blond thirtysomething.]

House: You’re not pregnant. [He hands her some tissues.]

Sarah: Well, I told you that. But there’s gotta be some other reason I’m still spotting.

House: Sure. You were pregnant. Based on your hormone levels, you had a miscarriage.

Sarah: I haven’t even been on a date.

House: [charting] Right, since it’s physically impossible to have sex without someone buying you dinner.

Sarah: I haven’t had sex since I split up with my husband. That was almost a year ago.

House: Fine, have it your way. Immaculate conception.

Sarah: Um, what do I do?

House: Well, it’s obvious. Start a religion. [He leaves. As he walks out, Cuddy storms past him.

Cuddy: In my office.

House: [to the clinic nurse, conspiratorially] Afternoon delight. She just loves the hard wood. [House enters Cuddy’s office.]

Cuddy: You’re not doing a brain biopsy on a spot on a MRI.

House: Where’d you get that?

Cuddy: Not on an United States Senator.

House: Oh, just so I’m clear, if he was a janitor, that would be okay. Do you have a list?

Cuddy: A brain biopsy can cause permanent neurological damage.

House: Uh huh, whereas tumors are really good for brains, make ‘em grow big and strong. It’s my call.

Cuddy: No, it’s not.

House: You’re pulling rank on patient care?

Cuddy: It’s not my call, either.

[Cut to Cuddy and House confronting Senator Wright in a hospital bed.]

Cuddy: It’s up to you.

House: Either it’s a tumor or it’s an infection that the lumbar puncture didn’t pick up. Either way, if we don’t treat it immediately, it could kill you.

Cuddy: Or it could be nothing. Reading brain MRIs is not an exact science.

Senator: W-what caused my s-symptoms?

House: Wow, excellent question. Many doctors wouldn’t have gone there.

Cuddy: It could be a transient ischemic attack. You could make the argument for watching carefully for the time being.

House: Mmm, but you’d only make that argument if you were an administrator covering your own ass.

Cuddy: That’s absurd, and insulting.

House: Insulting, yes.

Senator: W-what will the voters think? If they find out I’ve had a b-brain biopsy?

House: This could leave you b-b-b-b-brain damaged, and you’re worried about NASCAR dads?

[Cut to Foreman and some other doctors performing the brain biopsy.]

[Cut to Wilson, Foreman, Cuddy and House looking at the results.]

Foreman: It’s not a brain tumor.

House: It’s not a bacterial infection, either.

Cuddy: So you biopsied his brain for nothing.

House: If that were true, would Dr. Wilson’s mouth be contorted into that ugly little shape?

Wilson: It’s toxoplasmosis.

Foreman: You sure?

House: Which means the Great Black Hope has full-blown AIDS. They’re gonna love that in Dubuque.

[Cut to Foreman and House talking to Senator Wright.]

Foreman: Toxoplasmosis is a fairly common fungus you can get from eating undercooked meat or touching cat feces. In rare cases the fungi travel up the blood stream and into the brain causing a lesion or inflammation.

Senator: [looks to both of them] So, what’s the prognosis?

Foreman: Toxo usually responds to treatment, but it only causes a lesion in your brain if your immune system is extremely weak to begin with. Senator, I’m afraid you have AIDS. As I’m sure –

Senator: No!

Foreman: As I’m sure you know, people with HIV can live a long time.

Senator: What else could do this to me?

Foreman: Theoretically, certain cancers –

House: If you have toxo in your brain, you have AIDS.

Senator: [forcefully and painfully] I do not have AIDS. I don’t sh-sh-shoot up drugs, I don’t sl-sleep with…

House: This is very bad news. I get that, and I sympathize. But we’ve gotta speed through the denial phase because you need antiretrovirals and you need them fast. [He hands the pills to Senator Wright.]

Senator: You haven’t even tested me for HIV!

Foreman: [quietly] We will.

House: But the toxo drugs are going to piss off your fungi, and when fungi get pissed – [Senator Wright throws the pills.]

Senator: I am not gonna take the pills.

House: You’re afraid word will leak out. Trust me, you’re not going to become President either way. They don’t call it the White House because of the paint job.

Senator: Here’s what you’re gonna do. You’re going to give me the drugs for the toxo only. You are going to test me for HIV under a false name. You are going to test me for cancer and anything else that could have done this to me. If I have cancer, I will deal with it, but I do not have AIDS.

[Cut to Cameron and Chase in the Diagnostic offices. Chase is playing with House’s giant fuzzy ball, and Cameron is looking online at a press release.]

Cameron: “Eastbrook Pharmaceuticals are pleased to announce that Dr. Gregory House will present the latest research on their exciting new ACE inhibitor.”

Chase: You’re making that up. That’s Vogler’s company.

Cameron: Press release. Doing an address at the North American Cardiology Conference. [Chase looks at the screen from behind Cameron.]

Chase: House never gives speeches. [House enters.]

House: But when I really believe in something… Gosh dang it, I’ve got a chance to make a difference here.

Chase: You made a deal with Vogler?

House: It’s all the rage. Everybody’s doing it. [Chase gives House a petty, pouty look and goes to sulk in a chair. Cameron walks over to House.]

Cameron: So, what’s the deal? You get to keep all of us if you plug his products?

House: One speech, no biggie. Foreman’s doing a bone marrow biopsy to check for cancer.

Chase: Cancer? The Senator’s got AIDS.

House: Cancer sounds better on a press release. I need you guys to rush the ELISA test for HIV. [He starts to walk into his office.]

Cameron: Thank you. For the speech.

House: When I said rush, I meant, you know, fast. Stat’s the word you doctors use, right?

Cameron: I know it’s hard for you –

House: Double stat? [Chase pats Cameron on the arm to follow him out, which she does.]

[Cut to Foreman performing a bone marrow biopsy on the Senator.]

Foreman: This may sting a little. [The Senator flinches.] Sorry.

Senator: It wasn’t the shot, it’s, um, my head, it’s killing me.

Foreman: You know, Senator, we don’t have to do this now. We can wait until your HIV test comes back.

Senator: [laughing] Guess you figure it’s gonna come back positive.

Foreman: Well, in my experience –

Senator: Patients lie. Politicians lie more. And black politicians –

Foreman: Whoa, I don’t think black politicians lie more than white politicians.

Senator: We lie less.

Foreman: You figure we’re morally superior?

Senator: [laughing again] I’ve got my theories. No, we, we just can’t get away with it. No one’s gonna gi-give us the benefit of the doubt. No one’s gonna cut us a second chance. And, and when it happens it’s not just a bad politician, it’s, it’s, it’s a bad role model, it’s a dis-discredit to the race. [looks at Foreman standing there, needle poised and ready] You ready?

Foreman: Yeah, yeah. Take a deep breath. [The Senator groans in pain as Foreman inserts the needle into his hip. Ow.]

[Cut to House, working on charts at the clinic desk. Cameron walks up.]

Cameron: Dr. House. I just wanted to –

House: You’re welcome, again.

Cameron: I want you to know how much I –

House: Got it. You’re grateful. Apparently you seem to think it’ll mean a lot to me to know that.

Cameron: Do you know why people believe in God?

House: I thought you didn’t believe in God.

Cameron: I don’t.

House: Well, then you better be making a very good point.

Cameron: Do you think they pray to Him and praise Him because they want Him to know how great He is? God already knows that.

House: Are you comparing me to God? I mean, that’s great, but just so you know, I’ve never made a tree.

Cameron: [smiling] I thank you because it means something to me. To be grateful for what I receive.

House: You are the most naïve atheist I’ve ever met.

Clinic nurse: Dr. House, you have a patient in Room One.

House: Thank God. [He walks off, but turns around.] People pray so that God won’t crush them like bugs. I’m not gonna crush you.

[Cut to Exam Room One, where Sarah is back with a mysterious bruise on her neck…]

Sarah: Petechial bruising? I don’t know if I’m pronouncing that right.

House: Gosh, the internet is such a wonderful tool.

Sarah: It could be leukemia.

House: Definitely possible. The more likely diagnosis is hickey.

Sarah: Well, it can’t be a hickey.

House: [exasperated] Why is everybody so ashamed of sex all of a sudden?

Sarah: I’m not having sex. I’ve barely even thought about sex since my marriage. [House pulls a hair from Sarah’s head.] Ow!

House: I say you’re having sex, you say you’re not. Either you’re lying, or I’m wrong. Or there’s some middle ground.

Sarah: You mean like oral?

House: I mean you’re having sex without knowing it. I’m testing you for booze, drugs and GHB.

Sarah: I don’t drink, and… what’s GHB?

House: The date rape drug. [He leaves.]

[Cut to Senator Wright looking at paperwork in his bed. House enters and hands him test results. He starts to pour a glass of water.]

House: It’s positive. [He hands the Senator the water and some pills.] Your T-cell count is eight, which means there’s a good chance you’ll die. I’m telling you this because we need to contact your sexual partners.

Senator: I’ve only had two girlfriends. Two, after my wife died. I used c-c-condoms.

House: You know the chances of you getting HIV from heterosexual sex with a condom?

Senator: Yes.

House: Some day there will be a black president. Some day there will be a gay president. Maybe there will even be a gay, black president. But one combination I do not see happening is gay, black, and dead. You need to stop lying to me.

Senator: It must be miserable, always assuming the worst in people.

House: Oh, cut the crap, you’re dying.

Senator: You’re clever, you’re witty, and you are a coward! You’re scared of taking chances.

House: I take chances all the time, it’s one of my worst qualities.

Senator: On people?

House: Wanting to believe the best about people doesn’t make it true.

Senator: Being afraid to believe it doesn’t make it false.

House: Well, that’s very moving. It’s a shame I don’t vote.

Senator: This is who I am. I believe in people. I’m not hiply cynical and I don’t make easy, snide remarks. I would rather think that people are good and be disappointed once and again. [House gets up and grabs a syringe and some rubber gloves from a cabinet.]

House: I need to draw some more blood.

[Cut to the Senator, alone. He sits up, and tries to get out of his bed. He stumbles, and realizes that his right leg is not working. After lifting it and dropping it on the floor a few times -- ]

Senator: NURSE!!

[Cut to Cuddy and House leaving House’s office.]

Cuddy: The antiretrovirals aren’t working.

House: That’s not surprising.

Cuddy: He’s just going to keep getting worse. You realize that, right?

House: Why are you spying on my case?

Cuddy: Why are you giving that speech next week? [House pushes the elevator button.] We’re both just doing what we have to do.

House: And you don’t see a problem with that?

Cuddy: Checking in on a patient? Yeah, wow, how do I look myself in the mirror?

House: You’re not the one being asked to perpetrate a fraud on the American people.

Cuddy: It’s a ten minute speech!

House: That I’ve been ordered to give.

Cuddy: Vogler’s drug works!

House: Don’t care.

Cuddy: Oh, why do you have to make everything so dramatic? [Elevator dings.]

House: Because I’m a very high-strung little lapdog. [as he enters the elevator] Ruff ruff ruff, rarr, ruff! [Cuddy looks faintly disgusted.]

[Cut to a nurse and another man helping the Senator back to his bed. The nurse grabs the medications -- ]

House: [standing in the back of the room] Nuh uh. No pills.

Senator: What’s going on?!?

House: The antiretrovirals aren’t working.

Senator: Why not?

House: Because you don’t have AIDS. [The Senator laughs.] The first test was a false positive. Happens one time in every five thousand.

Senator: You r-ran a second test.

House: Yeah. You’re still dying. The only difference is now we don’t know why.

[Cut to Foreman taking the Senator’s pulse. He notices that his right arm is twitching.]

[Cut to Cameron, Chase, Foreman, House and Wilson talking and eating outside.]

Foreman: He’s continuing to lose control of the muscles on his right side, his brain is getting foggier, and his T-cells are in the single digits.

Chase: Why are we doing this here?

House: So Cuddy can’t find us. Unless we find out the underlying disease, this guy’s lied to his last constituent.

Wilson: [looking at the chart] False negative on the PCR AIDS test?

House: Ran it twice.

Chase: Immunoglobulin deficiency?

House: No history of respiratory problems.

Cameron: Idiopathic T-cell deficiency.

House: Idiopathic, from the Latin meaning we’re idiots ‘cause we can’t figure out what’s causing it. [He takes a Vicodin.] Give him a whole body scan.

Cameron: You hate whole body scans.

House: ‘Cause they’re useless. Could probably scan everyone of us and find five different doodads that look like cancer. But, when you’re 4th-down, 100 to go, in the snow, you don’t call a running play up the middle. Unless you’re the Jets. [He walks away.]

Cameron: I hate sports metaphors.

[Cut to House and Wilson, walking into the hospital.]

Wilson: Why did you order the second AIDS test?

House: Standard procedure.

Wilson: Oh, well, that’s you. Mr. Standard Procedure. You suspected the first test was a false positive?

House: I knew he was going to Africa and I figured he was vaccinated for Hep A and B. That could cause a false positive.

Wilson: Yeah, but you knew that before you ordered the first test. What changed?

House: I should have ordered both.

Wilson: You were sure he had AIDS, then you talked to him, then you had doubts. What, what did he say?

House: He said he had not engaged in any risky behavior.

Wilson: Huh. And you believed him.

House: Well, he didn’t have any reason to lie –

Wilson: Everybody lies, except politicians? House, I do believe you’re a romantic. You didn’t just believe him, you believed in him. Do you want to come over tonight and watch old movies and cry? [House gives a great-looking smirk.] Dr. Cameron’s getting to you. Well, I guess you can’t be around that much niceness and not get any on you.

House: Is that why you haven’t put the moves on her?

Wilson: What makes you think I haven’t put the moves on her? [House stops and stares, then realizes he fell for Wilson’s trap.] Oh. Oh, boy! You’re in trouble. [Wilson laughs and walks off. House walks into Exam Room One, where Sarah awaits.]

House: You have restored my faith in the human race. You’re lying.

Sarah: No, I’m not lying.

House: I just got your results back. No GHB, no nothing. It means you’re having sex, and you’re lying about it.

Sarah: No, and I have a new symptom. I have a rash on my butt. [She smiles triumphantly.] Do you want to… [House nods, resigned. Sarah lowers her pants so House can see.] What is it?

House: It’s a carpet burn.

Sarah: No! It can’t be! Doctor, I love sex. I miss it. I haven’t had any in over a year.

House; Well, you managed to keep this appointment, so you have no short-term memory problem. Multiple personalities? Do you find yourself losing chunks of time? Do you wake up and you don’t remember falling asleep?

Sarah: No, I just wake up really exhausted.

House: Is something upsetting you?

Sarah: No. [House gives her a look.] My ex lives in the apartment downstairs. He’s always calling me, always wanting to get back together, complaining about mixed signals. Get out of my life, how much clearer can you get?

House: We have a sleep lab in the basement. If nothing else, it’ll get you away from your ex for a night.

[Cut to the Senator, going in for his full body scan.]

[Cut to the team looking at the results.]

Wilson: Slightly enlarged lymph node in his left armpit.

House: How slightly?

Wilson: Quarter mil. [Cuddy enters.]

Cuddy: Lymphoma?

House: Sure, or he’s had a cold in the last six months. [to Chase] What, you’ve got her on speed dial?

Cuddy: I just follow the scent of arrogance. [House makes a face.]

Chase: Another slightly enlarged node over here. Two more in his neck and one in his groin.

Wilson: And there’s a cyst in his liver.

Cameron: Looks complex. Central necrosis?

House: Spontaneous bleeding, it’s benign. I was rooting for a really cool tumor, instead we’re stuck with this crap.

Cuddy: Doesn’t matter. Once you find ‘em, you’ve gotta check ‘em.

House: Well, knock yourselves out. [Vogler enters.]

Vogler: I just saw Senator Wright, he looks like hell. That sushi must have been a lot worse than you thought.

House: Mr. Vogler, would you like a free whole body scan? A man of your stature should get himself checked at least three times a year.

Vogler: Here’s a few key points I want you to cover during your speech.

House: Fourteen pages. The audience will be comatose by paragraph two.

Vogler: Throw in a joke. [Vogler leaves.]

House: Dr. Chase. We need to talk.

[Cut to House and Chase walking in the hallway.]

House: How do you see this ending?

Chase: What ending?

House: I can’t fire you, so you have no reason to fear me, and therefore no reason to lie to me. You told Cuddy where I was. You told Vogler what I was doing. [pause]

Chase: Yeah.

House: So how can I work with you?

Chase: Well, you don’t have a choice. [Chase walks off.]

[Cut to Foreman, performing some more tests on a now doped-up Senator Wright.]

Foreman: This might hurt a little.

Senator: Lie to me.

Foreman: Okay. It’ll, uh, feel like a gentle massage.

Senator: House is a lousy teacher. You can’t lie for beans.

Foreman: Have you ever told any really big ones?

Senator: Oh, ho, I might be messed up, but I’m not that out of it, no no no no no… [The senator’s arm starts to convulse.]

Foreman: Strap his arm down.

Senator: Am I gonna be okay?

Foreman: I hope so.

[Cut to House and Wilson in House’s office. House is reading the report on Eastbrook.]

House: I am selling my soul.

Wilson: Just a little piece. And you are getting something in return.

House: I said I was selling it. I didn’t say I was giving it away. That would be immoral, and stupid. All they’ve done is added antacid.

Wilson: Does it work?

House: That’s not the point!

Wilson: Well, of course it’s the point! He’s not asking you to lie, he’s not asking you to do something illegal –

House: He’s not asking me to do anything.

Wilson: He’s not ordering you. He gave you a choice. You chose your staff. I know this isn’t easy for you. You’ll suffer. Vicodin sales in Jersey will triple. But you are doing a good thing. [Foreman enters Diagnostics with the test results, House gets up to see them.] Only you could feel like crap for doing something good.

Foreman: Kidney and liver cysts are both benign, and lymph nodes all came back clean.

House: His left armpit node has antibodies for CB 11.

Wilson: Well, not enough to indicate lymphoma.

House: We never tested for hairy-cell leukemia.

Wilson: No, but we would have picked it up somewhere besides one lymph node.

Chase: And his spleen isn’t enlarged.

House: Size isn’t everything. The spleen is the mother lode for hairy-cells. Let’s cut it open.

Chase: You can’t biopsy his spleen. It’ll bleed like –

Cuddy: In the Senator’s condition, a spleen biopsy could easily cause sepsis and kill him!

House: Why do you do this to me? Now, if I kill him, I can’t tell the judge I had no idea of the risks involved.

Foreman: His brain’s turning into mush, and he’s at risk for more infections, so we have to do it.

House: See, that’ll sound much better in court. Okay, go tell our human pincushion we’ll be sticking him one more time. [As they all leave -- ] Cuddy. Don’t you hate doing this?

Cuddy: Yeah.

[Cut to the lab. Cameron is looking into a microscope as House enters and leans against a counter.]

Cameron: What’s up?

House: You like me. Why?

Cameron: That’s kind of a sad question.

House: Just trying to figure out what makes you tick. I am not warm and fuzzy and you are basically a stuffed animal made by grandma.

Cameron: I don’t think that’s why you’re asking. I think it’s because of the speech.

House: [muttering] Oh God, don’t try and pick me apart.

Cameron: Then why are you asking? What do you want to hear? [She walks closer to him, but House leaves.]

[Cut to Foreman, bringing a form for the Senator to sign.]

Foreman: Hey, Senator. We need to do one more biopsy, on your spleen.

Senator: [coughing and clearing his throat] I’ll have to sign lefty, my fingers aren’t working. [Foreman hands him the pen, but the Senator starts to cough and can’t stop. It sounds like he’s gasping for air.]

Foreman: You’ve been coughing a lot? Does it hurt?

Senator: [while wheezing] It’s like I can’t get air. Is that from the toxo?

Foreman: [while listening to his breathing] No, this is, this is new. You don’t need to sign, we can’t do the biopsy.

[Cut to the Senator, now hooked up to a breathing mask.]

[Cut to the team in the Daignostics office.]

Foreman: The Senator’s breathing is severely impaired. His O2 stat levels are at 89. His silver stain indicates pneumocystis carinii pneumonia.

Wilson: Another killer fungus. It’s consistent with hairy-cell leukemia.

Foreman: But we can’t biopsy his spleen. Respiratory distress? His platelets are 20 and dropping, his blood won’t clot worth a damn.

Cameron: There’s gotta be another way to diagnose hairy-cell.

Wilson: No, his bone marrow’s indeterminate, spleen’s the only way to go.

House: [standing by the window.] You know, when the Inuit go fishing, they don’t look for fish. [Every looks at House for a bit, but he remains silent.]

Wilson: [sighing] Why, Dr. House?

House: They look for the blue heron, because there’s no way to see the fish. But if there’s fish, there’s gonna be birds fishing. Now, if he’s got hairy-cell, what else are we gonna see circling overhead?

Chase: He should have all sorts of weird viruses.

Cameron: HTLV and ATLV.

House: We can test for them. Run the titers.

[Cut to the clinic. House is showing Sarah the results of the sleep lab.]

House: These were your brain waves at 2:45 AM. Now, here it comes, there’s an abrupt jump from slow-wave sleep. This indicates partial sleep arousal. The most common type is somnambulism – sleepwalking.

Sarah: That would explain why I’m so tired when I wake up.

House: Yes, and also why you were pregnant. And the hickies. And the carpet burn.

Sarah: I had sex in my sleep?

House: Sexsomnia is a documented disorder. You said your ex lives downstairs –

Sarah: I’ll kill him.

House: Okay, but he probably didn’t know that you were asleep. Sexsomniacs can act pretty normal. I’m going to write you a prescription for a low-dose antidepressant. It’ll let you sleep better. If you want to save yourself the $15 co-pay, you can have sex while you’re awake.

Sarah: He’s my ex, I –

House: You live in the same building, you haven’t had sex with anyone else for a year, you sleepwalk right into his arms. Call me crazy, but I’m sensing unresolved issues.

[Cut to House leaving the clinic. Foreman runs into him.]

Foreman: Negative for HTLV-1 and 2 and ATLV and everything else. It’s not hairy-cell. [He stops House.] Hey. You really gonna give that speech?

House: You’ve got an opinion, too?

Foreman: I’m a little surprised. Frankly, I thought you were too much of a self-absorbed ass to do this for us.

House: You’re welcome. He’s positive for Epstein-Barr.

Foreman: So what? It doesn’t point to hairy-cell, it’s irrelevant. [House pushes the chart at Foreman and walks off very quickly.]

[Cut to the Senator’s room. House enters, places his cane at the foot of the bed, then removes the Senator’s breathing mask. All of the Senator’s speech is compromised because of his stuttering and gasping for air.]

Senator: Hey!

House: You didn’t fall off the swings when you were eight.

Senator: Six!

House: Ever.

Senator: Give that back!

House: Uh uh. We have to talk. You had an epileptic seizure. That’s how you bit your tongue.

Senator: I haven’t had a seizure since I was –

House: What medication did you take?

Senator: No seizure since I was six. No drugs since I was ten!

House: Yeah, that’s it. Don’t worry about what the question is, don’t worry that you’re starting to feel dizzy, just stay on message.

Senator: [frantic now] My mother used to call it physofin –

House: Phenytoin?

Senator: Yeah! [House places the breathing mask back on the Senator’s face.] Okay, okay, you’re okay, it’s okay. Everybody lies.

[Cut to House in the Diagnostic office with his team.]

House: Senator Gary H. Wright of New Jersey had childhood epilepsy. He took phenytoin. That drug, with the Epstein-Barr virus, is associated with common variable immunodeficiency disease. T-cells down, B-cells down, it keeps you from forming enough antibodies. See, antibodies are basically your defensive line. [Cut to CGI shot describing what House is saying… minus the sports players.] And your brain is like the quarterback. And then the fungi are like blitzing linebackers, plunging up the middle. Your lungs are like… okay, you’ve got two quarterbacks –

Chase: CVID? That’s a type of immunoglobulin deficiency. I said that.

House: Yeah, well, it was a stupid idea when you said it. Then he got the respiratory problem and tested positive for Epstein-Barr.

Foreman: That’s pretty much a childhood disease.

House: Another reason why Chase’s suggestion was idiotic. He got it when he was a kid. Didn’t get any symptoms until now, it happens. It gets triggered by stress, like public speaking.

Cameron: So you’re basing your diagnosis on a disease that’s relatively common and a drug he took thirty years ago.

House: Start the senator on IV immunoglobulin stat. If he gets better, I’m right, if he dies, you’re right.

[Cut to Foreman hooking up the IV.]

[Cut to a shot of House, still looking at information on the ACE inhibitor.]

[Cut to House, lying on the floor of his office. Foreman rushes in.]

Foreman: Dr. House!

[Cut to House and Foreman checking the Senator’s reflexes. They work, now!]

House: You faked that.

Senator: No.

House: Say “antiretroviral”.

Senator: Antiretroviral.

House: Now say it three times fast.

Foreman: We just got back your latest blood results. Your white cells are up, your T-cells are back over 100.

Senator: Well, that’s good, right?

Foreman: In a week? That’s terrific. You’ll need medication for the rest of your life, but other than that, you’re fine.

Senator: Am I well enough to run for president?

House: Well, why not run for pope while you’re at it?

Foreman: Oh, come on. Kennedy had Addison’s, FDR had polio. Two of the best presidents in the last hundred years –

House: If they were running today they wouldn’t stand a chance.

Senator: So, you figure you’d be Surgeon General if you didn’t have the limp.

House: No, there’s things I can’t do, and like you said, I have to live with reality.

Senator: Well, [knocks on the hospital bed frame] then I’m running.

Foreman: Good for you.

Senator: No, don’t get excited, he’s right, I, uh, I won’t win.

House: Then why run?

Senator: Oh, I see, your point being the only way to make a difference is to win every fight. [House looks pensive.]

[Cut to the dinner where House is giving his speech. House is sitting up on stage, Vogler is behind the podium.]

Vogler: But hey, why listen to me? I own the company, I’m certainly not to be trusted, right? Dr. Gregg House, on the other hand, has a reputation. For integrity, among other things. [Crowd chuckles. Quick shot of Wilson, Cuddy, Chase and Cameron sitting at a table in the audience.] Ladies and gentlemen, Dr. Gregg House. [House stands up and walks to the podium to applause. The PPTH table looks slightly apprehensive, as if their jobs were riding on what is to happen next. Well, I guess when you think about it… We see Foreman for the first time, leaning against a doorway. House adjusts the microphone, and…]

House: [reading off a paper, very monotone] Eastbrook Pharmaceuticals’ extraordinary commitment to research excellence is exemplified by their new ACE inhibitor, a breakthrough medical approach that will protect millions from heart disease. [He looks up at the crowd, stuffs the paper in his pocket, and starts to walk away. The PPTH team gives looks of “That was it?”]

Vogler: [quietly, yet deadly] That’s not a speech.

House: I thought it was pithy. You got enough for a press release, anyhow.

Vogler: Foreman or Cameron? [House gives a little smile and goes back to the podium.]

House: A few things I forgot to mention. Ed Vogler is a brilliant businessman. A brilliant judge of people, and a man who has never lost a fight. You know how I know the new ACE inhibitor is good? Because the old one was good. The new one is really the same, it’s just more expensive. [Vogler does not look happy.] A lot more expensive. See, that’s another example of Ed’s brilliance. [At this point, Wilson looks mildly interested, Cuddy looks mad, and Chase and Cameron look like the world’s about to end.] Whenever one of his drugs is about to lose its patent he has his boys and girls alter it just a tiny bit and patent it all over again. Making not just a pointless new pill, but millions and millions of dollars. Which is good for everbody, right? [Cuddy is now shaking her head in disbelief, and Wilson is staring pointedly.] The patients, pish. Who cares, they’re just so damn sick! God obviously never liked them anyway. [Cuddy = furious; Wilson = facepalm. Chase downs his whole glass of wine, and Cameron is staring at the table’s centerpiece.] All the healthy people in the room, let’s have a big round of applause for Ed Vogler! [House claps, Foreman shakes his head, the rest of the room stays silent. Vogler, well, he doesn’t look happy at all. As House hands Vogler the paper -- ] I threw in a joke.

[Cut to House’s house. (Bwah. The real reason he’s not living in an apartment any more.) He’s sitting at the piano, ironically playing “High Hopes”. There are 12 unanswered messages on his machine. A knock at the door. House gets up to open it, sees who it is, waits a moment, and then opens the door to admit Cameron.]

House: I’m sorry. I should have taken a couple of extra Vicodin and just held my nose.

Cameron: I’m guessing you did take a couple extra Vicodin.

House: True.

Cameron: You don’t need to worry about firing anyone. I’m leaving.

House: Why? Is this another noble, self-sacrificing gesture? You trying to protect Foreman?

Cameron: No.

House: So this is just, “Don’t fire me, I quit.”

Cameron: I’m protecting myself. You asked me why I like you. You’re abrasive and rude, but I figured everything you do, you do it to help people. But I was wrong. You do it because it’s right. [Near tears, she extends her hand. House looks at her hand, and around the room, but doesn’t take it. She withdraws her hand.] There are only two ways I can deal with things. One is in my control. That’s to leave. [House looks like he might say something, but doesn’t.] Goodbye, House. [As House still doesn’t look at her, she walks out the door.]


The End

Tags: season 1
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