House MD S2E13 - English Transcript

Ugh. I think I'm gonna puke. Not on this dress. I'm serious. Kate Moss was doing this at 13. You have two years on her. Yeah, that's what I like to see. You got this. Next show, you're bride. Did Austin just offer you bride? It wasn't a real offer, Dad. He was just being nice. These shoes are gonna be impossible to walk in. You've done this a hundred times before, all right? The runway's just a little bit longer here. One of the girls said Madonna's in the front row. Sweetie, sweetie, hey, come on, come on. You gonna be able to do this? Hmm? All right, come here, come here. Here, hold this. The doctor gave me these for anxiety, all right. It'll calm you down. Here. Come on, it's okay. Austin: Where's Alex? Alex, you're up! Go, go, go, go! Knock 'em out. Are you okay? Aah! Alex! Original Airdate (FOX): 20 February-2006 "Desire" by Ryan Adams # Two hearts fading like a flower # # And all this waiting for the power # # For some answer to this fire # # Sinking slowly # # The water's higher # # Mmm, desire # # Desire # # With no secrets # # No obsession # # This time I'm speeding with no direction # # Without a reason # # What is this fire # # Burning slowly # # My one and only # # Mmm, desire # # Desire # Wilson: How'd you get here? By osmosis. No helmet? Didn't seem like riding weather. And the fact that you can barely stand upright had nothing to do with it? - Infarctions hurt. That's what they do. - House! Worsening pain could actually be a good thing. Means the nerves might be regenerating. Could be good, could be bad. Thanks for the differential. Any other options? Have you ever considered a career as a motivational speaker? - Why don't you check out some rehab? - I did the rehab thing. One session. And you didn't even finish that session. The guy wanted me to visualize the healing. I can do that home. At least let me get you an MRI. It's a very simple equation. More pain, more pills. Teenage supermodel. Presented with double vision, sudden aggressive behavior, cataplexy-- You had me at teenage supermodel. - You okay? - Mm-hmm. Wow. You should be a model. Are you really 15? Who are you? I'll be the one saving her life today. Assuming she's dying. Who are you? He's my father. Any idea what's wrong with her? Well, from the looks of it, not a single thing. Probably should stop staring and check out the file. So, what set off the brawl? She stand in your light? I didn't even know her. I didn't know what happened. Look, I know some models are notorious for hissy fits. But Alex, I've never even seen her get angry. Even when she was a kid she was-- I'm sure she was delightful in her youth. And then you passed out. I was passed out, but I wasn't. I knew what was going on, but I couldn't move or talk. Yeah, that sounds like a medical thing. It's called cataplexy. Cat fight and cataplexy on the catwalk. Cool. How much were you drinking? She only had one sip of champagne. Forget it. We'll find out from the tox screen. All right, look. I gave her a ***. Do you think that's what did this? No. How long have you had the sweats? - A couple of days. - Any other complaints? Uh, my stomach's been bothering me. And I've been feeling a little nauseous. Okay. Here's how this works. My lackeys will be by shortly to draw some blood, collect some urine, any other fluids you got. They'll do some other doctorly stuff. And we'll be in touch. Since when do you voluntarily go see patients? - Have you seen her? - She's 15. Yeah, but there's something about her. Something in her eyes. A kind of maturity. Yeah, yeah. She's an old soul. This is creepy even for you. She's a fashion model on the cover of magazines. They hold her up as the *** ideal, but the law says we can't touch her for three more years. How hypocritical is that? Did the history reveal anything, oh, I don't know, medically relevant? History, right. I knew I was forgetting something. You should do one of those while you're running the labs and the tox screen. Labs show *** and *** in her urine. A supermodel on smack. Shocker. Oh, Alex. I expected so much more from you. *** chic is so five years ago. Okay. Let's start crossing out withdrawal symptoms. A positive test means she tried it once. Doesn't mean she's an addict. She's only 15. There's no age limit on addiction. He's right. She's never menstruated. Sounds like a symptom of drug addiction to me. Or bulimia. Or her age. Some girls don't start till their mid to late teens. Evidence to the contrary. The rounded hips. The perfectly sculpted, bountiful ***. Chase: Implants. I've seen some of her photos. They've grown dramatically since last summer. Symptomatic of turning 14. Two clinic hours says that those love apples are handcrafted by God. Whoa! I thought you didn't believe in God. I do now. You're on. Could we talk about her health instead of her ***? It could be relevant. Come on, Cameron. There's nothing to be ashamed of. Many women develop ***-- No, I'm fine. Even if she is an addict, a lot of her symptoms-- the cataplexy, the violence-- they could be neurological. We chalk this up to drugs, we could be releasing her with Juvenile MS or Parkinson's or-- So detox her. Fine. We'll set her up on a program. They'll wean her onto the methadone-- And in four weeks we'll know you're right. Or we'll know that Cameron's right, and the pretty girl will do Milan next Fall in a wheelchair. Put her in a coma and pump her full of naltrexone. Cut the four weeks to one night. The lab reports show that your daughter had *** in her system. Were you aware of her drug use? No. We think she's suffering from withdrawal symptoms. Detoxing generally takes several weeks. The danger is that if the drugs are masking some of other illness, it could worsen before we've weaned her off of the ***. Well, how much worse? We don't know because we don't know what's wrong. There is a rapid detox procedure. We flush her system with an opioid antagonist. It'll end her addiction overnight. But the process is dangerous because we have to induce a coma. It also means that if she ever relapses, there's a good chance she'll overdose because her body won't react to the drug. So either way I'm-- I'm risking her life. Do you have to tell her how dangerous it is? Is it dangerous? There are certain risks. We've gone over them with your father. And he's not worried? He's your dad. He's always gonna worry. But he knows we're gonna take good care of you. Oh. Everything's starting to hurt. My legs. *** withdrawal is an extremely painful process. But we're gonna put you to sleep. You won't feel a thing. Promise? I promise. It was a pretty stupid thing to do, huh? Getting hooked on drugs? Yeah, not the best move you've ever made. Alex: I just--I thought it would be fun. Chase: You don't have to explain to us. A lot of the other girls were-- When you wake up, you'll feel a lot better. [Monitor starts beeping] Nurse. Nurse! You son of a ***! You killed her. - She's not dead. - She had a heart attack. She's stable now. The anesthesia-- Get her out of that coma. Don't think so. Stop this. All right, I-I don't consent anymore. I want to do the slow detox. Did you ever get a paper cut? A really nasty one between the fingers? Multiply that by about a billion and it'll just barely approach the kind of suffering she'll experience if we wake her right now. We're committed to this. She's out till morning. Go get a book. I haven't slept in weeks. Because my teeth hurt. Dentist couldn't find any cavities. And I'm getting these headaches. Oh, poor you. I think I'm going crazy. And my stomach. I roll out of bed, and I want to puke. I take it your married. You must be psychic. You must be witty. When's she due? - How'd you know she was-- - Because I'm doing her. You've got Couvade Syndrome. Which is just a fancy way of saying you should stop whining. Millions of women have got the same thing. They're not bugging me. You're suffering from sympathetic pregnancy. Gotta go. People dying. The whole circle of life thing. - It's all in my head? - Nope. It's all in your hormones. Good news is no one's gonna lecture you if you smoke and get drunk. Shouldn't she be awake by now? It's only been a half an hour since we stopped the medicine. Well, you said that's how long it would take. I said it would take about half an hour. Well, couldn't this mean something-- So far, it means nothing. She had a heart attack. She could have brain damage. She could have something-- She's opening her eyes. Alex? You okay? Can you hear me? Hmm. I got the cute doctor. Huh. Do you feel any pain? Good. Let us know if anything changes. If your stomach doesn't feel right, anything. Hey. Are you mad at me, Daddy? I let you down. No, no. Not at all, sweetie. I-- I should've been more mature. I should've handled the pressure. Stop, stop. We're gonna get you better, all right? Nothing else matters. Excuse me. We've got you on what we call a banana bag. Plenty of vitamins, nutrients. I got the cute doctor. Are you mad at me, Daddy? I let you down. What's going on? I should've been more mature. I should've handled the pressure. What's wrong with her? Anterograde amnesia, short-term memory loss. Evidence of a hypoxic brain injury. Might be a result of getting cut off from the oxygen when she flatlined. Probably the result of that rapid detox you told us to push on her. You gonna put that down? You gonna sulk? I'm not gonna indulge you. Treatment of hypoxic brain injuries consist of-- [Exhales] Cameron, Chase, and the dark one. Foreman, right? Patient flatlined for, like, 30 seconds. Gotta be oxygen deprived for longer than that to lose brain function. - We can't be sure how long she was-- - Her brain's fine. Memory loss. You're saying that's not a neurological symptom? No, I'm saying what I'm saying. Her brain's fine. She's faking? She's got post traumatic stress disorder. We got models fighting in Iraq now? Show me a woman on *** who looks like that, and I'll show you a woman who's been sexually abused. That's your proof? That she's good-looking? He manages her career. Travels the world with her. At her side 24/7. He's either a very good dad or a very bad dad. House: You saw that touckhus. Would the fact that she's your daughter really stop you? Oh. Her brain is running away from reality. When the drugs can't do it anymore, it starts to shut down. Your theory has the advantages of being completely unprovable and completely exculpating you. When you guys are done talking, do an MRI and an LP. When her brain checks out as normal, then we'll know that Daddy really, really loves her. Where's House? Said he was in too much pain to work. Who's covering? He called 15 minutes after his shift started. It's too late to find anybody. - Exam room one. - Ugh. - Hi. - Where's Dr. House? Wish I knew. Huh. What's the problem? It's personal. And it's so personal he didn't bother writing anything in your chart. It's getting worse. What is? It's personal. - Fine. You can wait. - Doctor. I tell you what. I am gonna give you Dr. House's personal pager number. Why would your mind go to abuse so fast? 'Cause I had a funny uncle. You were abused? What? No. Why would your mind go to that so fast? I just had a funny uncle. Great stories, always filthy. I don't know if it's something with this case, or you got something personal going on. The whole break-up thing. - It's personal. - House. Your pain is affecting your decision-making. You got a problem with a call I make, question the call. Don't make it personal. Are you saying pain can't affect your mood? If I'm right about the pain, you're gonna want to rush everything. Which is what you're doing. Don't. Thank you. Are you doing your daughter? What? We should probably talk privately, huh? Come on, walk with me. - I'm not-- - He's not. I'm sure he's not. She is a babe, though. We're gonna need you to keep still. I am. What do you think that means? It's either neurological or psychological. The only thing we know for sure is it's gonna screw up the MRI results, which is gonna make House think he's right. This is a waste of time. Let's just get the LP. I should take your head off. Your glands are fine. See, now you're my patient. You got doctor-patient confidentiality. No worries. So, what did you do to her? - Why would you possibly think-- - Hard to imagine anyone not wanting to nail her. - You son of a-- - It's a compliment. A heart-shaped ***. Those perfect, perky all-natural ***. That is my daughter you're talking about! No, that's your daughter you were talking about. "She just instinctively knows how to walk. " "Designers just love that heart-shaped ***, those perfect, perky--" I'm her manager. I have to promote her. Oh, that makes sense. So you compartmentalize. When you're dealing with the press, you're her manager. When you're helping with homework, you're her dad. When you're making sweet, sweet love, - you're her manager. - All right. Do you love her? - I have never touched her. - Do you love her? What are you doing? You trying to trap me into saying-- Do you love her enough to admit that you slept with her? Psychology conditions can manifest themselves in physical problems. Sometimes, these can be extreme enough to kill. There are treatments, but only if there's a diagnosis. Are you gonna admit that you slept with your daughter or are you just gonna let her die? One time. PTSD. Get her a psych referral and pack her bags. He did her. Don't think so. Daddy thinks so. Could be mistaken. He said he was drunk. Maybe it was some other daughter. Elevated proteins in her CSF. You're wrong about PTSD, and I was wrong about the hypoxic brain injury. Daddy didn't do this to her. And neither did we. We have to call Child Protective Services. Doctor-patient confidentiality-- Doesn't apply in abuse cases. You know that. Cameron: We're mandated to report *** abuse. Is it okay if I save her life first? Or do you want to make sure that Daddy doesn't get visitation rights to the gravesite? Okay, elevated proteins in her CSF could mean dozens of different things. Viral encephalitis. CNSV. Creutzfeldt-Jakob disease? So we're just gonna leave a child molester in the same room as his victim? It's got windows. Fine. Arrest him. Use Cuddy's handcuffs. If you're too distracted to deal with this because your leg hurts, then-- Yeah, I'm distracted! I'm all hung up on this 15-year-old patient who's cataplectic, can't remember what she had for lunch, and is rapidly losing control of her body. And I want her father here in case they got any more secrets that I need to know about. Now, if you're not too distracted, go take out a piece of her brain. Stick it under a microscope. Wilson! Whoa, whoa, whoa! You really think we need to jump straight to brain biopsy? Nope. Let's continue playing pin the diagnosis on the supermodel until she's dead. Heard you killed your supermodel. Only for a minute. Just for my own clarity, how many more patients do you have to kill before you admit this leg thing just might be a problem? Three. I need your help. We're gonna do something called a burr hole biopsy. We drill a small opening in the back of your skull. Doctor, maybe you and I should talk about this first. No. I just think Alex doesn't need to be overwhelmed right now. I think she should have a say in what happens to her body. We're gonna remove a small piece of brain tissue. Do--do you have to shave my hair? Hair grows back. I guess I won't remember anyways. There's a good chance the amnesia's only temporary. Okay. Find a way to kick up the contribution. What did House do now? House, this is God. Look, I'm a little busy right now. Not supposed to talk during these things. You got time Thursday? Let me check. Oh, I've got a plague. How about Friday? You'll have to check with Cameron. Oh, damn it. She always wants to know why bad things happen. Like I'm gonna come up with a new answer this time. House. Quick, God. Smite the evil witch! Are you sitting on evidence that your patient was sexually abused by her father? God, why have you forsaken me? Cuddy: Don't worry. I've contacted Child Services for you. I left you get away with more than anyone in this hospital. Shielding a child abuser isn't covered. Cooperate with this investigation, or I'll fire you. Chase: What do you think House is gonna do to you? No idea. Well, you did the right thing. If you hadn't gone to Cuddy, I would've. If this guy had known we had to report him, he'd never have told House the truth. She's a child. She needs to be protected. She dropped out of high school to make millions of dollars. Why does she need more protection than some crack *** shivering in the clinic waiting room? I think you're just afraid to *** House off. There's that too. MRI looks exactly the same as it did two years ago. Nerves don't seem to be regenerating. I figured as much. Several different researchers have proven psychological pain can manifest as physical pain. You think I have a conversion disorder? You want me to see a shrink? Brilliant idea sending Stacy away. It's really done wonders for you. Listen, none of this has anything to do with Stacy. Right. Giant coincidence that you've gone completely off the rails since she left. Inducing migraines, worsening leg pain-- Ow! Aw. You miss Stacy too? Brain biopsy shows no white matter disease. Cameron, you gonna go tell Cuddy? Or has she already got you wired for sound? I had to do what I thought was right. So white is out. That just leaves gray. Foreman: Neuronal ceroid lipofuscinosis. Heller Syndrome. Any one of the mitochondrial encephalopathies. Am I in trouble? You had to do what you thought was right. They call it gray area 'cause you never really know what's there. We can't test for any of those things. So I'm not in trouble? You can torture yourself all you want. What if everything we're seeing is just smoke signals? Okay. Who's sending them? Tumor. If has cancer anywhere in her body, she could also have paraneoplastic syndrome, which would be causing antibodies to attack her brain. Antibodies are stupid that way. Paraneoplastic syndrome's awfully rare in a 15-year-old. like that are awfully rare. It would explain the aggressive behavior, the cataplexy, the memory loss, even the twitching. It's perfect. What if it's not? We could waste weeks searching for a tumor that we don't even know is there. Then let's make sure it is there. There's no test for paraneoplastic syndrome. Sure there is. The squeeze the tube test. What did the biopsy tell you? It wasn't definitive. But the twitching should stop right about Now. Oh, my God. House: Could've just been a coincidence. Twitching does tend to stop and start. Let's be sure. IVIG vacuums her blood. Neutralizes the stuff that's making her twitch. It's actually kind of cool. Wonder if I could make you dance. Enough. This is unbelievable. You did it. You fixed her. No. All I did was prove that she has cancer. I need a favor. I'm not in a giving mood. It'll help us both. I need a shot of morphine in my spine. If your leg hurts, take your Vicodin. It's not enough. Get a syringe. Morphine is extreme, even for you. Yeah, read that on the insert. Get one of your lackeys to do it. I don't want them knowing. That you're on the road to becoming a junkie? That I'm in this much pain. I don't want them questioning my judgment. I can't ask Wilson because he figures it's all in my head. Well, I agree with him. I'm going home. Well, what about this? What are you doing? Is this in my head? 'Cause I could swear I remember a thigh muscle being here. I'll get a syringe. - It's gotta be cancer. - It's not cancer. You seem to be back to your old miserable self. So I just randomly predicted she'd respond to IVIG? Her twitches are gone. Her memory's getting better. What did you take? If the increased pain was psychological, no drug's gonna help. If you think it'll help, the drugs will help. - Power of the mind. - You're right. The more I talk to you, the more the pain floods back. Knew the twins were real. Chase owes me. - You check the pancreas? - Oh, come on! You're just making up organs now, aren't you? We checked the pancreas. - Obviously you've taken something. - You check the bones? There are a lot of bones, I think. And none of them have cancer. Ovaries? There's no mass. If anything, they're undersized. No leukemia, no Hodgkin's. We checked everything. Unless they've invented a new organ, it's not cancer. Differential diagnosis. It's gotta be cancer. There's gotta be something we missed. You gotta learn to let go, Foreman. Maybe the protein level was some sort of anomaly. It might still just be PTSD. Just PTSD? Yeah, Daddy's diddling her. Nothing to worry about. Chase: Okay, let me rephrase. Maybe the protein level was some sort of anomaly. Oh, my God! It might be PTSD! If it was PTSD, the twitching wouldn't have magically disappeared when we started the IVIG. Mmm, wrong. What it wouldn't have done was medically disappear. Nothing to stop it from magically disappearing. She was watching me stop and start the medicine. You think she's faking? Not consciously. But if her subconscious is trying to get away from it all, cancer's gotta be a lovely vacation spot. Tell her you've gotta give her a fresh IV. Don't tell her you're starting her on saline. We'll see if the twitching comes back. How long has the social worker been in there? Just went in. She was in with the dad before. You switch the girl's IV? About half an hour ago. When is she gonna start twitching? If she's gonna start twitching, another few minutes. We've gotta wait for the remaining IVIG to clear her system. That was quick. What's gonna happen? What did you think was gonna happen? - The father had sex-- - Do you have any medical evidence of that? - He admitted-- - He denies that conversation ever took place. - She-- - She denies it too. I'm sure you meant well. [Alex flipping through TV channels] You have to tell her the truth. Nothing happened. You don't have to be afraid of him. They can protect you. From what? Things are fine. You think things are fine. They're not. He's my dad. He's abusing you. He's not a bad person. I seduced him. You're the child. He's the adult. - He has the responsibility-- - I got him drunk. I had to get him drunk. I wanted to have sex with him. You're sexually attracted to your father? No. But by sleeping with him, now he lets me do whatever I want. I also slept with my photographer, my financial manager, and my tutor. If I hadn't, I'd be getting Cs and posing for newspaper ads back in Detroit. Hmm. Come on. We all do it. No, we don't. After you father slept with you, you were traumatized. My dad was last. You've never taken a run at your boss or a professor or somebody else you needed? You're 15. You're smart. You don't have to-- I am not that smart. I am that beautiful. What's wrong with me? Aw! George, get your butt over here! George: Help me! How did you get my pager number? Please! Problem is if I give you an epidural, you won't be able to feel when to push. - You're not funny! - Pretty sure I am. You just can't appreciate it because you're in pain. George, if you don't get off your *** and help me-- Oh, shut up! Got yourself the perfect man: a woman. He's got more estrogen coursing through his veins than-- Oh! Aw! Ohhhhhh! - Who did her vaginal exam? - I did. Did she have hair? What are you getting at? Right now I'm getting at whether or not she had hair down there. Uh, not much. She manipulative yet completely docile. Everybody tells us that outburst on the catwalk was out of character. She's never had a period. You're thinking this is hormonal? I'm thinking she's the ultimate woman. I-I need to schedule an MRI. The twitching stopped. Because we changed your medicine back to the real stuff. Stop talking. You gave me fake medicine? That's what I said. In the vain hope that you wouldn't feel the need to also say it. Stop talking. Wilson already did an ultrasound. Said her ovaries were undersized. The ultrasound would be the way to go if you were looking for ovarian cancer. What are we looking for? That. Oh, my God. Looks like a tumor, doesn't it? But those are-- Yep. We found a tumor. She has cancer? Technically, no. So it's not cancer? No, it's cancer. But he has cancer. On his left ***. I don't have testicles. She's not a guy. His DNA says you're wrong. Frogs and snails and puppy dog tails. You've got male pseudohermaphroditism. See, we all start out as girls. And then we're differentiated based on our genes. The ovaries develop into *** and drop. But in about 1 and 150,000 pregnancies a fetus with an XY chromosome, a boy, develops into something else. Like you. Your *** never descended because you're immune to testosterone. You're pure estrogen. Which is why you get heightened female characteristics. Clear skin. Great ***. The ultimate woman is a man. Nature's cruel, huh? This is obviously a joke. This is--is impossible. No, a joke would be me calling you a ***. See the difference? I'll schedule him for surgery. No. You're wrong. I'm a girl. Look at me! How can you say I'm not a girl? See? They're all looking at me. I'm-- I'm beautiful! That anger, that's just the cancer talking. Put your clothes back on. I'm gonna cut your balls off. Then you'll be fine. How's the patient? Post-op. I set him/her up for a psych visit. Calling her "him/her" isn't really helping. Good news is I don't think Dad's gonna be sleeping with him/her again. See, now it's gross. I need another shot. When did the pain start coming back? A few hours ago. About an hour after you solved the case? If I wanted to be psychoanalyzed, I'd get Wilson to give me the shot. Same dosage? If you'd be comfortable, I might be able to deal with a few less cc's of morphine. It wasn't morphine. What did you give me? - I told you I wanted-- - It was saline. I gave you a placebo. [Piano playing Bach's French Suite #5 in G Major Allemande] "Desire" by Ryan Adams # You know me # # You don't mind waiting # # You just can't show me # # But God I'm praying # # That you'll find me # # And that you'll see me # # That'll you run and never tire # # Mmm, desire # # Desire #