House MD S5E2 - English Transcript

Bring it up about six more feet. Okay, you can go ahead and start dropping it. Class is over. What's going on? Who are you? I'm a doctor. Did you have a corneal transplant Yes. Every patient who had a transplanted organ from that donor is dead or dying. You got a purse? I feel fine. I don't mean to scare you, but so did the others. House - Season 05 Episode 02 "Not a cancer" One living, one almost dead. Four fully dead. Nothing in common except their donor. Carl got a new heart and lung. Liver kills him. Tibalt got a new liver, lung killed him. Holly got a new kidney, her heart blows up. And Frank, the old guy gasping for breath upstairs, he got an intestinal graft, his pancreas is failing. All within eight months of each other. And in each case, serious complications came on suddenly and without warning. Which means arrhythmia, massive pulmonary embolus, or cerebral bleed. What did Wilson do for me? If the donor had an infection that somehow slipped by a screening, - it could lay dormant. - Five organ systems hit. Would need five infections for it to somehow slip by screening. Oh, sure, he made me laugh on a rainy day, made me see the colors I never knew None of the donated organs were hit. Whatever they got is from the donor's blood. - That wouldn't help us narrow down. - To who. Corneal transplants are bloodless. It means Apple's gonna be fine. You secure enough in that theory to send her home? I guess we could wait till we figure out what's wrong with Frank. On the other hand Gilbert Gottfried makes me laugh. And how many colors are there really? Once you got red, blue and green He paid for your lunch, liked monster trucks, and was your conscience. - Autoimmune disease. - A. N. A. Autopsy of all victims were normal. Wouldn't cover vasculitis. - Henoch-Schonlein purpura - Antiphospholipid antibodies, normal. - Then that leaves cancer. - Cancers have names. They have a progression. They affect specific organs. Bone cancer can't turn into liver cancer. Forget cancer. It's cancer. It's not cancer. You're right, of course. What was I thinking? No single type of cancer blew up three organs in the chest while also herniating in the fighter's brain stem - The fighter's irrelevant. - You don't like coincidences. It'd be a coincidence if six transplant recipients had nothing else wrong with them. Like being an idiot, which leads to getting your head knocked off. The others had cancer. Four autopsies and about Redo the thousand tests and the four autopsies. Taub, Kutner, check out the donor. Find out which cancer. He didn't die of cancer. His head got chopped off in an industrial accident. Find out which cancer would've killed him. Check the home and office for carcinogens, toxins. He's been dead for four years. I guess his home's been rented to someone else. Find out which cancer killed them. Did I forget you? You can check out the patient's eye. Put this on Dr. O'shea. And some chips. - Forget your wallet, House? - No. I'll take care of it. Check. Are you following me? Word is you're into monster trucks. - My kids like it. - But not you? Predator's okay, but I think the California crusher is overrated. Are you checking me out? You're astute. No. - How many pills did you just take? - Vicodin, opioids, some b12. Need a little kick in the afternoon. You got a problem with that? I think I'm falling in love. Her right eye's failing. No, it's not. Everyone else's transplanted organs were fine. It means her eye is fine. - We need to remove the eye. - It's her only working eye. We could remove the other one, but since it's not killing her, I thought this way was less insane. Do you have some ethical problem with what I'm doing that you could express in a unique way which might make me think that I'm wrong even though I'll never admit it? Yes. You are funny. The problem's not in her eye. It's in her head. You wanna come over, watch Prescription Passion at my place tonight? - You know I'm not gay, right? - Neither am I. If you don't want to have sex, that's cool with me. - I'm not coming over to your home. - I'll grow on you. L P E Do I have to be in the same room as him? Whatever he's got, you've got. - Fifth line. - Are you sure? Pretty sure. Fifth line. Am I gonna die? Can we talk about something besides you for a moment? Like maybe the fifth line? F E O S P. Damn. I'm sorry. We need to remove your eye. My eye? A moment ago, you thought you were dying. Blind's actually good news. Unfortunately, he's wrong. - You just did the test. - She didn't squint. Which means the eye thinks it's fine. - It was wrong. - I know. The eye doesn't think. The brain thinks, which means if the thinking's wrong, the brain's wrong. Which means it's spread to the brain, which means it's too late for us to remove the eye. Which means We're gonna have to remove your whole head. Don't worry. It doesn't hurt. Hallucination. That's a brain thing, right? can cause hallucination. Doesn't mean it's neurological. It does if one of the other organ recipients also had a brain issue. - Did he just drop his hands? - No, none of them had brain issues. If his pupils dilated, if his pupils were fixed, if there was a twitch He got hit in the head, he died, no mystery. - That was your point. - Yesterday. You live, you learn. Who shot this? Guy who runs the gym has a camera. Uploads the nasty stuff online. Can't see the dead guy's face. I can't see his face, can't see the twitch, can't see the pupils. We know the tennis player had a heart problem. We can maybe tie that to the tuba player's lungs, and then somehow tie both those things, to the construction worker's liver, and then possibly meander over to Frank's pancreatic failure, but nothing causes simultaneous brain and heart problems. Cancer made no sense. The head and heart make less than no sense. That makes no sense. I know I was making a point. Oh, good. I thought you were an idiot. Why are you talking? Oh, the guy doing manual labor can't have an opinion? I might be a genius who just happens to have a passion for fixing coffee machines. No, I'm obviously not, but that's rude to make assumptions about people. Donor's history came up clean. - Did he just laugh? - No, no, I sneezed. He's a genius coffee repairman. Coffee repairman who wears argyle socks? I thought I already talked about not judging. What kind of idiot wears argyle socks with construction boots? I'm not an idiot. I'm just I'm not good at disguises. Who is he? He's apparently a very bad private investigator. Why is he pretending to fix the coffee machine? Because I wanted to find out what you guys found out before I find out what he found out. So I can find out if I need a private investigator. So, nu? There's no history of unusual infections, no international travel in the 12 months No, seriously, that's how I sneeze. He was in Madrid and the Bahamas. - Credit card receipts showed no - Girlfriend paid. - There is no girlfriend. - She was his high school sweetie. She's married to his best friend. I know. She had a kid four years ago. Timing fits. She's still pretty hot though. - You find out anything medical? - The kid has a tummy ache. Also, the dead guy was exposed to mercury, mold, and hydrous perchloric acid because their sex pad was next to a garage that was demolished after those toxins were found. Oh, yeah, that will be $2,300. - I'll get you a check. - No, I don't take checks. - You think I'm gonna stop payment? - Aren't you? Of course, I am. $2,300. That's insane. Actually, that price includes footage of the boxing match from four different angles. I got their names. Four of them had digital cameras, which I composited like NASA did for the pics of Mars. You know, the rovers and all that. Pupils were dilated. He didn't drop his hands, which means he maintained muscle tensity. Say it. You were right. God, that was petty of me. He maintained muscle tensity, but was momentarily distracted when he got hit. - That's a temporal lobe seizure. - Does that P. I. guy mean we don't have to break into people's homes anymore? It's why you went to medical school. I'm not gonna take that away from you. - He's better than we are. - And costs more. - Gonna biopsy the brain. - No. - Say it. - You were right, but no. Temporal lobe controls speech, hearing, memory. She loses those things, she's gonna be a terrific date, but beyond that We cut out a piece of it, good chance she's a vegetable. Nothing to hear, nothing to say, nothing to look back on. You're right. She has so much to live for. Do we have another patient who's almost finished with all their living? So it's okay to stab his brain because he's old? No, it's okay to stab his brain because he's dead if you don't. Get the widow to say yes. No. The lung inflammation is a complication of the pancreatic failure, which is reversible. This is actually his best chance. If we can find out what's wrong How can a test that will probably kill him? - I didn't say. - You said it was extremely risky. - What does extremely mean? - Please. I'm sorry. I can't. I have a husband. I have a two-year-old daughter. Her name is Julia. You'd be saving her mother. I think you're lying. You haven't had one visitor. Not one phone call since you've been here. Does she have a child? No. But her life is still worth - More than my husband's? - I lied to save my life. Wouldn't you? Not at another human being's expense. No, you'd just rob me of my only chance your husband can struggle to breathe for a few more days. Just shut up. I don't want to hear from you. You want to hate me so you won't feel guilty. Frank? Give me a scalpel. Charge. He's coding. Clear. Clear. Clear. Clear. Clear. Clear. - Did you get the consent? - No. Tell Foreman to get it. Old people are scared of black people. It won't matter. Patient's dead. Save the brain. Don't need consent for an autopsy. Well, at best, we're gonna bat one for six on this one. Thin slices through the parietal and temporal lobes were clean. Occipital and frontotemporal regions were also Brain's clean. Moving on. To where? We've gone from making no sense, to making less sense, and then taken a step backwards. Each of these people were killed by one thing that attacked one organ. But never the same organ. - The donor had two things wrong? - Or six things wrong? Metabolic diseases specialize. Everything else specializes, - but cancer plays the field. - You're back to cancer? Metastasis is just a fancy word for screws around. - Any type of cancer? - I don't know. There would be evidence of cancer. There is. We just haven't found it yet. You need it to be cancer so you have an excuse to talk to Wilson. Give me something else that explains this constellation of patients, - then you can call me an ***. - I didn't call you an ***. Perforated intestine. If this thing started as normal bacteria living in the intestines but got into a blood vessel through a vascular anomaly in the bowel wall, then they would affect every organ through the blood stream. It screws up everything. For everyone. It's a long shot, it is possible I'm an ***. Ironically, we need to do a colonoscopy to confirm. We checked apple inside and out when she came in. She's clean. The anomaly must be intermittent or they would've died within a day. She's getting abdominal pain, shove a tube up her rear before it can get away. And test anyone else with stomach pain. - Everyone else is dead. - Not everyone. The one thing the donor gave to each of these people is his DNA. Anyone else have his DNA? You want to do a colonoscopy on a healthy four-year-old? She has a tummy ache. If Kutner's right, it's not a tummy ache, it's a fatal brain or heart or lung or liver or pancreas ache. I'm not gonna scare the hell out of the poor kid's mom because of a long shot corollary to a long shot theory. Fine. Tell her the truth. Then ask if Daddy knows who the real Daddy is. Does she have to be awake? We need her to tell us when it hurts. She'll get over it. Your husband might not have. What if a kid wants ice cream? The sign outside says "closed". Dr. O'shea's not right for you. - What'd you find out? - Why are you investigating him? 'Cause I need to know if he lends money interest-free. What did you find out? I want some ice cream. Not until you learn to read. - You're supposed to trust friends. - I don't know the guy. - I got no logical reason - To be his friend? Have you never seen an after-school special? That's part of the pleasure of friendship: trusting without absolute evidence and then being rewarded for that trust. You're taking pictures of a guy who's having an affair with his sister. And you're lecturing me about the rewards of trust. There are two types of people that hire me. Actually, there are three, but the third's irrelevant to the point I want to make. You have a special rate plan for being a pain in the ***? One type wants to find out that they're right, the other type that they're wrong. - Which type am I? - You're the third type. You lead with the irrelevant types? The one that doesn't care because they've hired me to investigate the wrong person. - That's an actual type? - You want me to check out Wilson. - You want to find out if - How do you know about Wilson? What do I do for a living? Have you been checking me out? - I've been paying for that? - So far, you haven't paid for anything. You want to find out he's pining, if there's something about him that will tell you he's gonna come back or something you can use to make him come back. Is there? No, no, there's nothing. Sorry. That will be $900. I gotta go. I'll get you a check. Colonoscopy was clean. Then that just leaves cancer. The fact that the kid's colonoscopy was negative doesn't prove anything. Yes, the fact that it didn't prove anything didn't prove anything. Excellent point. We don't know if the kid inherited anything. Even if she did, Kutner's theory is that the thing's intermittent. The opening would have to be open shortly before death. Unfortunately, we can't know when shortly before death is until shortly after death. And that seems like an obstacle. What if there was a way around that? Then we're kind of all sweating over nothing. Not around death, around death as an obstacle. We need to see his colon at work. You do know what death means, right? Without a living system, there's not enough pressure to get fluid. Life we can't create, yet, but pressure's easy. We use the same high pressure water jet, we use to test cardiac workload. I mean, he's not gonna be awake to tell us where it hurts - It's not gonna - Do it. - It's kinda stuck. - It's more than stuck. The bowel's been dead for six hours. No matter what you shoot up there, it's closed. - This is nuts. - It's adjustable. It's working. - Not much. - Increase the pressure. The endoscope's bowing. Push on the stomach. Those are normal bodily fluids. Yeah, normal bodily sewage. Put the pressure back on. That's the end. No leaks. Wait. What's that? - That's dark 'cause I'm at the end. - What if you're not at the end? What if it's a core lesion? Maybe a little more pressure? Not too much. If it is the end and we It's finally accelerating. Apple's heart rate has become irregular. Breathing is labored. Colonoscopy's still showing no leaks. What if it is autoimmune? What if we don't have conversations we've already had? Four out of the five didn't linger. They got sick and died. We don't have time to dismiss things we've already dismissed. Nothing fits. See, that's an example of a conversation we've already had. She's sick. Something fits. - MS? - No! From now on, no one says anything unless no one's said it before. - Where are you going? - You guys start immuno-gels on her CSF to look for hidden protein markers. Start sequencing her genes. I start treatment. - Treatment for what? - Cancer. It's not cancer. Chemo's toxic. It's something. Which means we should treat her for something. She's fine. - Where's her chart? - You rang emergency to get her chart? I know. That was bad of me. But I'm sure the chart must be attached to the bed so that gimp doctors don't have to look all over the place while patients die. Thank you so much. And some peppermint tea when you get a chance. I need you to sign something. Consent to chemotherapy. You found cancer? Then, - you have tests indicating - Nope. - Then why should I sign it? - That's a good question. It deserves a complicated answer. Placebo effect. People have confidence in doctors, they have confidence in diagnoses, confidence in medicine. Sometimes they get a little better just because they think they will. And that can make us think that the wrong answer is the right answer. Which is very bad. So you do have proof that it's cancer but you can't tell me because it might affect the way I react to the medicine? If that were true, and it would certainly make sense, do you think I could tell you that it's true? I was practically blind before the transplant. Didn't you cover all this personal stuff with Dr. Foreman? You don't care who I used to be? You're a post-corneal transplant math teacher. I deduced that you were a blind math teacher. I was an architect. You gave up architecture after you could see? The world was ugly. You think the world would be any different if your leg was fine? Think you'd be any different if your leg was fine? I mean, the doctors told me that my life was gonna be so much better once I could see. I would date, I would dance, but the guys I hated dancing with before I hate dancing with after. My parents were still dead. I was still alone. - You're fun. - You don't seem all that different. I haven't given up. Wilson's got a new job, hasn't started yet, but - So who are we following? - See that lady up there? - You point at the target? - No. No, I'm following the one halfway in between that point and that point. Pretty. Who hired you? No one. I just like her. - You're stalking her? - No. I followed her out of that bookstore back there. You are stalking her, just not for very long. So what else can you tell me that I might care about? He attends this grief counseling thing twice a week where they go around the room and cry about who's dead. Cameron's been to his house several times, they talk about death and losing loved ones. What What are you If she turns her head, she's gonna see that we're walking the wrong direction. No, she won't. I'm very nondescript. - I'm not. - Then you stay four feet behind me. How do you know what they're talking about? I'm in the same grief counseling group. I recently lost my mother. You'd get laid more often if you told them you lost a kid. I didn't lose a kid. You're a P. I. who can't lie? I can lie. I'm just not all that good at it. Dr. Cuddy's been over to Wilson's twice and phoned a bunch of times. Foreman called him. And the rest of the time Wilson's been reading meditation books and magazines about restoring barns. Are you following me? Are you lying? Lesson one: commit. It's making me uncomfortable. Sorry. You're very pretty. More uncomfortable. She's not your type. Your type is much stupider than her. - What did Wilson say about me? - You've never come up. In the grief counseling or in the other Anywhere, I got three bugs in his home and one in his car. If I didn't know you, I wouldn't even know you existed. Which is good news. Only two things you ignore Things that aren't important and things you wish weren't important, and wishing never works. - She's better. - I can tell at once. Vomiting's a side effect of the chemo. Her heart rate's stabilized, breathing's good. Amylase and triglycerides are both coming down. I guess it's working. Can't believe it. It's cancer. It's not cancer. Labs show that our patient is healthier. She's gonna get sicker. Then she's gonna die. I brought thai food. - What did you see in her? - Nothing. It's not cancer. All the tests say it's not cancer. - They've always said it's not cancer. - Treatment proves it's cancer. Treatment proves it could be cancer. It's not cancer. This was your diagnosis. - I never thought it was cancer. - You treated for cancer. I thought that what she had acted like cancer. If it acts like cancer, maybe it'll respond like cancer. It did. 'cause it's cancer. We have to find something that walks like cancer, talks like cancer, tastes like cancer, but isn't cancer. No, we don't. Better is better. Who cares why? I do. And so does tetrault. Who? The dead tuba player. Tibalt. The point is, he died last, but he died. Which means she's gonna die too. Tibalt wasn't receiving cancer medication. There's a cancer drug that's used off-label for arthritis. - There's no record of arthritis. - You interviewed all the tuba students? With pain in his hands, he can't play. - Then it wasn't in his hands. - So why do we care about his students? One of them is canadian. Brought him methotrexate so he could hide his arthritis. Already couldn't afford his insurance. And that little piece of business cost me $700. I'll pass it on to the patient with a steep mark-up. This makes no sense. I know. She's dead unless we can find what's cancer but not cancer. Something's missing. I need an epiphany. What are you billing out at? $300 an hour? Here's four. There are other oncologists. Better oncologists. But I need you. Let me describe the symptoms, problems, issues, and say whatever you feel like saying, until something triggers an idea in my head. - That's not the way it works. - You have a way of thinking things. It's sloppy, it's undisciplined, it's not very linear. It complements mine. It drives me down avenues that I wouldn't otherwise - Please go away. - Cancer, but not cancer. Responds to cancer treatment, but there's no How are you? Don't do this. Please. Please. Don't do this. I'm trying to move on. By hanging out with Cameron, talking to Cuddy, Foreman, but not me. I paid a private investigator to spy on you. You didn't. You wanna move on from me, you got to deal with me, talk to me. You had no right We're not friends anymore. There's no trust to be breached. I can have you followed, I can call you names, tell your secrets. Foreman did a CT. Temporal and frontoparietal regions are normal. Occipital lobe, normal. I have the right to walk away from you, House. There's a world beyond you. You need to realize that, and even if you don't I'm moving on. The next time you knock, i'm not answering. Nothing yet. Keep talking. I'm sorry. You charge me for listening in on my own conversations? Yeah, why wouldn't i? - How many friends do you have? - 17. Seriously? You have a list? No, I knew this conversation was really about you, so I just gave you an answer so you could get back to your train of thought. Well done. I have one. Had one. Friends are important. - You're gonna miss - Shut up. Friends allow you to not sit in a room by yourself. - Are you charging me for this? - Are we friends? - No. - Then yes. Do you wanna be my friend? No. You scare me a little. He thinks if he's not a friend, he can't talk to me. We can talk, - we can be two human beings talking - I'm with him. Didn't mean to interrupt. Yes, you did. I was in the middle of a sentence. Yes, I did. You're repeating yourself. I'm grateful. Make your point. It's like that "cancer, but not cancer" thing you were talking about. Friends are friends, customers are customers, and everything else is everything else. If it's not, nothing's nothing. And anything can be anything. What? The world is not as ugly as she thinks it is. Cancer, but not cancer. Doesn't make any sense unless Brain, but not brain. Occipital lobe's normal. But her eyes suck. That lobe should be compensating. Since it's not, that tells me that something's in there that shouldn't be in there. Brain, but not brain. Why are you in my office? To find the anomaly, I need to chop off the top of her head. Pretty sure I need your approval for that. I'm gonna trust your first instinct. I'm not usually confused when you say things like that. I'm ordering her cancer treatment to be continued. Why does it cost $2,300 to fix a coffee machine? Cancer stem cells are real. They explain everything. They're like embryonic stem cells. They become whatever they want. Donor had them, the recipients got them. They floated around, they landed on an organ, got bathed in cytomes and partially differentiated. And the key word there is partially. In the tuba player, they became lung, but not lung. In the tennis player Heart, but not heart. Stop me if you've figured out the pattern. They looked as if they belonged, but they weren't doing their jobs. And when they were really needed, boom. Chemo worked because cells are basically tumors. Chemo shrunk them. You're still gonna say no, aren't you? You've no proof. - I have the brain scan. - The normal brain scan. This is why I need to take off her head. - To treat or to prove you're right? - To treat. Chemo's not killing anything. It's just hiding the real problem. She's gonna crash. If we wait until she does crash, it might be too late. So the next step is what? I say no, and then you do something to make her crash so that I'll think you've proven your theory? - I would never do that. - No, you won't. You might want to check her I. V. from here, it looks like saline instead of chemo. Yeah, they look identical. Still. You should probably check. You switched her meds? How could i? I had no access. - Close her back up. - Do the surgery. - There's no reason to - No reason not to. The stupidly dangerous part is already over with. We're ready with the neural net. Is that someone's brain? Except for the part that isn't brain. Hey, that's the patient I you said she'd be fine. I'm a better liar than you are. I swapped her meds. I mean, she's got a brain problem. I coulda killed her. The neural net will show us how fast her neurons are firing. If there's something in the way, say brain that's not brain, the normal neural impulses will be sucked into a vortex because they're not able to do their job. The computer will then process it and give us a picture of where to cut. Cool. Excuse me? Sorry, I thought that's what you wanted to hear. You think all this is amazingly cool. And you have no one else, so you're paying a guy to listen. Sorry Just trying to save you some cash. - I'm on the clock. - Why wouldn't you be? You think this is interesting to me? I see it. - Can you get it? - I think so. Turns out you didn't kill her. Cool. You owe me $5,000. Why are you just standing there, dr. House? How'd you know who it is? I can smell you. Like you're a field of roses. Peppermint tea. You ever hear of the boy who cried wolf? Never really bought that. I don't care how often a kid cries he's being eaten by a wolf, mom's gonna come running. The world is ugly. People kill. They go hungry. Just proving a point. - People are ***. - Why are you telling me this stuff? Because the world is not as ugly as you think it is. Your transplanted cornea's fine, your eye is fine, but your brain wasn't working right. I'm gonna take the gauze off your eyes now. - It's gonna be bright. - I know. The brain cells that weren't brain cells were in the way of processing visual information correctly. After the transplant, you could see, but not see. I could see. I could read. Yeah, but it was dull, or foggy, or gray. I don't know. What I do know is that you were not seeing what everyone else was seeing. And now? Things are gonna be Beautiful? Things'll be what they are. How do I look? You look sad. Hey. Is there any way I could put you on retainer?