House MD S2E24 - English Transcript

He's got a temperature of 103. And why do we care? Because we're human beings. It's what we do. He said he was at a luncheon meeting. You took his history? Guy looks like Harpo. You should see him. You asked him what book he's currently reading. it's hilarious to watch him try and talk. I asked him anything I could think of. Favorite color: "Boo. " Favorite dessert topping? Trust me, you never know what fact may prove the key to saving your life. Whipped cream. I asked him if he was sure. Where are you going? You're an ***. I know. Where are you going? This is either a toxin, an infection, or an allergic reaction. I assume you gave him epi, so that rules out allergies. Put him on antibiotics in case it's an infection. And if it's a toxin, we'll keep him here overnight, let the swelling go down, send him home. I'm going to the movies. Which one of you is House? The skinny brunette. No, that's Dr. Cameron. I'm skinny. How do you know her name? I was a patient of yours. Oh, well, if you want to leave the chocolates downstairs-- Stay! Stay away from him. Shocking, isn't it? Who'd want to hurt you? You're pathetic. Judging by the growth, I'd say I've been unconscious for two days. Have you been sitting there the whole time? No. Judging by the oily buildup in your hair, I'd say you're lying. I was scared. Pardon me for caring. Did I lose any organs? The bullet to your abdomen pierced your stomach, nicked the bowel, lodged in the posterior rib. Well, I always say, if you're gonna get shot, do it in a hospital. The one in your neck-- I don't remember that one. Went right through, severed your jugular. The shooter turns out to be a guy-- don't care. You don't care why a guy walked into a hospital and shot a doctor? Shot you? I assume his reasoning was faulty. So what was it? Infection? The surgery went fine. You've had no post-op-- not me. Patient. Harpo. You just got shot, House. You should rest. I got shot. Diagnostically boring. Big fat tongue, on the other hand endlessly entertaining. We biopsied his tongue. and it was negative. And the blood tests were negative. I didn't say we did blood tests. You don't biopsy a tongue unless you have to biopsy a tongue. And you don't have to biopsy a tongue unless you've already come up with nothing on a routine battery of tests which don't involve torturing your patient. Any new symptoms? Other than the increased intracranial pressure? Any guesses on how I figured that one out? You knew the next step would be a lumbar puncture. A lumbar puncture would almost certainly give us a definitive answer. Since we don't have a definitive answer, we must not have done an LP, and the most common reason to not do an LP is increased intracranial pressure. He was shot by security trying to-- House, what are you-- House. I'm talking to Cuddy. Lie down. You've got to be in pain. Not today. Today I'm on morphine. You're going to rip your stitches out. Check Harpo's trash. Forget about the patient. Come on. You're curious. Trash? You don't know what I'm talking about but you know it's good. You can't just be walking around. Well, then stop me. You've lost blood-- - physically stop me. - You could damage� - You can�t. Because that would involve physically touching me, and then things would t so sexually charged-- I'm twice your size. Get your hands off me. Everything that lives, eats. Everything that eats, poops. That's why every organ has a sanitation department. The lymph system. Whatever's doing the damage is dumping its waste in there. That's what you meant by trash. Biopsy the lymph node under the jaw. I'm sorry, I know it's crazy, but there's no other place. It's the ICU. It stands for intensive care. He needs intensive care, so do you. He needs to be shot again. He is handcuffed to his bed. He is sedated. He's not going to hurt you. If your security was any good, I wouldn't have been shot in the first place. He is where he's supposed to be. Where you're supposed to be-- - who did my surgery? Gillick, why? You going to send him a fruit basket? He screwed up. It's annoying enough dealing with your vicodin habit. Quit upping your morphine. I'm not. I'm reducing it. And you're not in pain? I'm feeling better. Gillick is very good. Your recovery time-- my stomach kills me, my neck is throbbing, but my leg feels better. That's amazing. It's unbelievable. Since getting shot is not an FDA approved treatment for anything, it means something must have gone wrong in the surgery. Yes, terriblytragically wrong. Enjoy the mistake. He must have nicked something in my peripheral nervous system. If it's alleviating pain, who knows what else it's doing? Get back to the ICU before you rip out your stitches, and I have to chain you to your bed. Why did you try to kill me? I didn�t. Then the gun thing might have been a mistake. If I'd have killed you, it would have been over. I needed you to live. Because I want to see you suffer. Get the needle out of there. He can't breathe. House. The test was negative. Are you sure you want to be doing this? I'm fine. I think Cameron, you got my records? They don't like to release patient's operative notes. And yet you're holding them. And whispering. He's sleeping. Yeah. Killer needs his rest. Otherwise. he's grumpy all day. Hey! Wake up. Watch me save a life almost for sure it's some sort of infection. We've got him on broad spectrum antibiotics, but it's not even slowing the thing down. Unless we figure out what type of infection, we can't treat, and we can't figure out what type because we can't do an LP. Do an LP. See what I did there? Couldn't have done that if you'd killed me. We would have done an LP two days ago if we could have. But that much pressure, something's bound to go-- - we would have done an LP two days ago if the risks hadn't so obviously outweighed the benefits. We just cut a hole in his throat. The equation has changed. Couldn't have put it better myself. pressure with small visible excursions related to respiration and pulse. Well within normal, that's good. No, that's weird. You want to hear a story? I have a rule. People who shoot me forfeit the right-- my wife was sick. None of the doctors could figure out why. Oh, I know this story. She died. So you selected one of her doctors to kill, because that would make everything right again. She lived. You cured her. I'm truly sorry I did that. In the course of investigating her illness, you convinced me that everything was relevant. You needed the truth. I confessed to you that I'd had an affair. But it turns out that it had nothing to do with why she was sick. Genetic predisposition to brain aneurysms. You told her that. You also told her about my affair. And you caught crap, she left you, and now I've got to pay because you couldn't keep your little killer in your pants. She killed herself. What sort of hospital has glass walls? That's my husband. Really? You thought I just liked watching people get needles poked in the back? Nope. I figured a coworker or a sister. Not wife. Why? Don't worry. It's not insulting. At least not to you. You're satisfied by that answer? You're Dr. House, aren't you? You're not going to shoot me, are you? You treated a friend of mine. She told me you only talk to people if you have to. And then you insult them while showing off how insightful you are. Sevens marry sevens. Nines marry nines. Fours marry fours. Maybe there's some wiggle room if there's enough money, or somebody got pregnant. But you've got at least three points on your husband, and your frock says you didn't do it for the money. And your *** say that you haven't had any kids. So you figure my marriage is a mathematical error? Numbers don't lie. We're having trouble finding out what infection your husband has. The most likely culprit is an std. You want to know if I've had an affair with someone closer to my integer. And I have to tell you the truth, or my husband will die. Is your friend single? No. And I've always been faithful. wow. I would've bet money something would go wrong. Let's rotate him back. he's bleeding into his ocular orbit. LP wouldn't do this. Lots of pressure behind. Gotta relieve it. What's going on? What-- what are they doing? I should go. I seem to have torn my stitches. You collapsed in the hall. Tore your stitches. I remember. I was there. How's your gut? It's hurting? You shoot the guy who sold her the gun? She locked herself in the garage, and she started the car. You shoot the guy who sold her the garage door opener? You're an ***. That is a bold position to take, given that I shot you. The shooting just makes you an idiot. You're an *** because you're trying to wrap it in the flag, like you did a good thing. You're an *** and a hypocrite. You don't believe in rules. You do whatever you think is right. That's all I did. You were my role model. Watch out. You�re getting crumbs on the flag. I didn't commit to honor her. I didn't commit to never lie to her. Well, if you'd kept your mouth shut, she'd be alive, and you wouldn't be shot. If you'd kept your pistols in your pants-- it's my fault she's dead. I know it. But why can't you admit that it's maybe just a little bit yours too? That maybe it's not just medical mistakes that screw things up. Here's how life works. You either get to ask for an apology, or you get to shoot people. Not both. infections don't make your eyes pop out. we should get back. You're supposed to be chained to your bed. I'm not done eating. There's got to be some sort of bleeding disorder. This is really stupid. Look, if my stitches pop out again, I got three doctors to save me. Could be some sort of weakness in the lining of the ocular veins. Okay, I�ll be you guys. No way, mate. Too much blood to just be a vein. No way, hizzie. If it was an artery, he'd still be bleeding. Actually, he'd be dead. He could have had a granuloma in his sinuses that bled, which could have been caused by Wegener�s. I think the surgeon would have noticed a giant growth while they were sticking the eyeball back in. Tongue and eyes are sick. What about the nose? It's right in between. Why isn't it sick? So it's not spreading. It's got a common source. Which can only be what? The brain, except the ct was clean. Check the brain's trash, see what it's hiding. The brain doesn't have a lymph system. I know. All its garbage just blows off, gets caught in the snow fence by the side of the road. You're referring to the blood-brain barrier. What else? Biopsy the barrier. Wouldn't it be safer to make a few educated guesses first? Try some relatively safe treatments? Biopsy the barrier. But first, start him on mebendazole in case it's a worm. And levofloxacin in case it's an infection that slipped by the first antibiotic. And azithromycin for stds. I really don't think the wife is the kind to be messing around. If I was married to her, I certainly wouldn't-- House. The patient isn't married. He's a widower. Really, it's more helpful if you do the prescribed rehab yourself. My body is fine. My mind, on the other hand maybe she was a girlfriend. Maybe she was just trying to jerk you around. I spoke to every one of the nurses on that floor. The patient had only had six visitors. Two females, no babes. His mother and his aunt. So they missed someone. They're not security. My posse never saw her or me talking on the other side of the glass. They were a little busy trying to save the guy's life. There's on one possible conclusion. It was a hallucination. What does that look like to you? Point-six? Anesthesia? No. It's got to be six and a smudge. Let's say you� eight. It wouldn't be that uncommon after trauma. After that much blood loss? If my perceptions are compromised, then my judgment is compromised. What if his wife told me that the patient just got bit by a rabid Vietnamese ***? So pull yourself off the case. And the next case? You take two weeks. You recover. What if I don't? What if it wasn't the shooting? The guy who sees connections between everything sees no connection between being shot and minor brain disruptions? What if it was the surgery? What if it was the fact that you tore out your stitches and lost two pints of blood? Why did Gillick give me ketamine during my surgery? Working. We need to talk. Get back to the ICU. Who un-cuffed you? Why would a surgeon administer ketamine? Who showed you your surgical file? How do you know it's mine? Because your patient hasn't had surgery, and you don't care about anybody else. My anesthesia was almost nonexistent, and yet I wasn't awake. For some reason, somebody decided to put me in a dissociative coma instead of just putting me out. There are plenty of reasons to use-- fine. I'll go beat the truth out of my surgeon. Gillick, right? It worked. There's a clinic in Germany. They've been treating chronic pain by inducing comas, and letting the mind basically reboot itself. There's about a 50% chance your pain will come back. Which of course means there is a 50% chance that it won�t. You had no right-- to heal you? You messed with my brain. Why are you so upset? Are you experiencing any neurological symptoms? Dizziness, tremors, hallucinations? No. It's a point of principle. Test was negative. No trash against the fence. Is your leg really better? Don't worry, I�m sure something else is wrong. We did find blood. On which side? The wrong side. First thing that makes sense. The wrong side's the wrong side. It can't make sense. It'd mess with his brain. Wouldn't cause fever. He's been sleeping a lot lately. You worried? I marked a change of meds on his chart. Foreign object. Body wants to get rid of it. It causes the fever. Blood's a foreign object? in the brain lining, it is. Blood dyscrasia means cancer. Find it. All the tests-- - have been negative. What do you do if your trash cans are full? You use your neighbors' trash cans. Except it's still light outside. Your neighbor will see you. So you go out the back way, into an alley, and drop off your trash by their garage. We'll check the lymphatic system in the chest. You got that from trash cans in the alley? The saliva glands from the tongue are connected to the lymphatic system in the lungs. It's the next lymphatic system over. Yeah. Go get lung lymph. How did he know that? I wouldn't have hired him if he wasn't smart. Right. Because you have nothing but respect for him. Maybe he knew the answer because the question wasn't nearly as tricky as you thought. Maybe he's not getting smarter. You're getting dumber. You pretend to buck the system. Pretend to be a rebel. You claim to hate rules. But all you do is substitute your own rules for society�s. And it's a nice, simple rule. Tell the blunt, honest truth in the starkest, darkest way. And what will be will be. What will be should be. And everyone else is a coward. But you're wrong. It's not cowardly to not call someone an idiot. People aren't tactful or polite just because it's nice. They do it because they've got an ounce of humility. Because they know that they will make mistakes, and they know that their actions have consequences. And they know that those consequences are their fault. Why do you want so bad not to be human, House? Oh, he's awake. House, we need to talk to you. How the hell did you know I was awake? Your nostrils flare when you sleep. No, they do not. Fine, I�m lying. Test was negative. You knew? Force of habit. showed no cancer. No reason why he's got a fever of 103, and no reason why his tongue won't fit in his mouth. He's post-op. Chase is getting him up and around. It's important that you're up ASAP after surgery. You think you can urinate? It's getting bigger! What, you're getting aroused? No! Not that part. Oh, god, it hurts. It's not stopping. surgeons found no evidence of a burst artery. The blood had to come from somewhere. You took a shower in it. Trauma? You think someone snuck in here just to kick him in the jewels? And poke out his eye, and swell up his tongue? Keep riding. I got a bet with my physio that I can do 100 klicks by Friday. What about blood from the kidneys? Kidneys drain into the bladder, which drains into the ureter. There's no way it would mess with the ***. Yeah. Basic human anatomy. Therefore, I think it's safe to assume that the problem lies elsewhere. But given that this case doesn't make any kind of sense whatsoever, maybe we should even question the basics. Maybe he's not human. an anatomical defect would seem more likely, but let's not rule that one out. Even more likely, he is human, his anatomy is where it's supposed to be, but he has testicular cancer. we tested for cancer. we tested the lymph system in his chest. surgeons found no growth. surgeons were just trying to put everything back where it was. They weren't doing an inventory. May have been lucky. If you don't catch testicular cancer early, it kills. Probably eroded some vessel. Yeah, I know. The question is why I didn't think of it. Eyes popping out is a rather odd presentation. Sack blowing up, on the other hand if you could think of everything yourself, you wouldn't need a team to annoy. I screwed up some basic anatomy. And I missed connecting a testicular explosion with a testicular problem. You think there's any way I would have done that before Cuddy messed with my brain? She was trying to help you, and it worked. Yeah, I can run like the wind, but I can't think. And seeing as how I�m too old to become a professional athlete, it looks to me as if she screwed me over big time. You don't want a healthy leg. Oh, here we go. If you've got a good life, if you're healthy, you've got no reason to ***. No reason to hate life. Here's the flaw in your argument. If I enjoy hating life, I don't hate life. I enjoy it. I didn't say it was rational. *** testing is 99% accurate, which means there are some people who test positive who live with their own impending doom for months, or years, before finding out everything's okay. Weirdly, most of them don't react with happiness. Or even anger. They get depressed. Not because they wanted to die, but because they've defined themselves by their disease. Suddenly, what made them them isn't real. I don't define myself by my leg. No, you have taken it one step further. The only way you could come to terms with your disability was to somehow make it mean nothing. So you had to redefine everything. You have dismissed anything physical. Anything not coldly, calculatingly intellectual. Why are you protecting her? Because she's done nothing wrong. You're completely comfortable with what she did to me? Yeah, I am. Yeah. You agonize over moral choices. You're not completely comfortable with anything until you've taken days to get your head around every possible side. I've known what she did for six hours. How come you're acting like you've known for days? What do I have? You're not sick. What do I have? You need to calm down. I have my brain! And that's it! We were trying to help you. Yeah, nobody tries to screw up! They just do. You were out of control. You were shooting morphine-- I can make people better! And you two decide to trade that for jogging shoots. If you're suffering from side effects, then we can look at that-- you value the physical so much. Let me put this in terms you can understand. You're unbelievable. Even when you're out of your mind with anger and fear, you still couch it in logical terms. Are you hallucinating? Yeah, I�m hallucinating! No, I mean right now. Are you hallucinating? How did you know I was you were yelling at me. You were calling me Wilson. No. You're losing it, House. I never call Wilson by his name. Oh, yeah, right. The hallucinator is going to tell the hallucinatee what happened. You're not the hallucinatee. Wilson was the hallucinatee. You think maybe you're focusing on the wrong thing here? Cuddy's office was the hallucinatee. The bathroom was the hallucinatee. Bathroom. It figures. What figures? You wet your bed. Damn it. Test was negative. No. AFP and beta HCG say no testicular cancer. So, let's recap. We�ve just ruled out everything. Which doesn't make sense. So the answer has to be something that doesn't make sense. Do a cystoscopy. Make sure he's human. Test was negative. For him being human? Everything was right where it's supposed to be. All the tubes go where they're supposed to go. Most likely scenario is some kind of bacterial prostatitis. Find out if his father hunche his father have trouble peeing? His father have sex with his own mother? If the answers to any of these questions is yes, assume you're right. If the answers are no, assume you're right, but biopsy some prostate lymphs just to be sure. But then we'd have to cut through his stomach. And since he's clearly got a bleeding problem, this kind of surgery might-- he doesn't clearly have anything. How did I get here? What are you talking about? I was in the ICU. And then I was coming down these stairs with you guys. What happened in between? I don't remember how I got here. I'm taking myself off my case. Your patient's in critical care. He�s had a fever unabated for two-- I'm losing my mind. I'm having blackouts. You said you weren't having any-- I lied. If you are doing this to scare me, you made your point. Next time you get shot, I promise to only treat the bullet wounds. I'm off the case. Why did you jump up when I came in? I thought you were going to attack me again. Again? Yeah, you were in my face. You were-- -- no, I wasn�t. You came in here with Wilson and-- that was a hallucination. No, you-- which means this is a hallucination. how can I tell what's real and what's not? Everything looks the same. Sounds the same. Tastes the same. Seems like I'd be the last person you'd want to ask. Why not? You're obviously not here. I'm obviously not here. Which means this is a creation of my mind, which means I'm really just asking myself. Well, if you're talking to yourself, that's a lot of unnecessary explanation. Hey, I�m trying to work this out. That requires give and take, even in my own mind. What was the question? How can I tell what's real? Does it matter? That doesn't sound like something I'd ask. All right. Your concern is at if you act in the real world based on information that's not real, the results are impossible to foresee. With you so far. But information is incapable of harm in and of itself. Ideas are neither good nor bad, but merely as useful as what we do with them. Only actions can cause harm. That sounds like me. So you do nothing. You refrain from taking any actions. Continue to throw out your ideas as you always would, but if they're based on faulty assumptions, your team will point that out. They won't do anything that could hurt him. So I trust my team. Test was negative. No blood in the prostate. No structural abnormalities. If something doesn't make sense, what does that mean? It's not rhetorical. I need your input on everything I ask, no matter how obvious it might seem. It means you're wrong. It means one of your assumptions is wrong. Because if something doesn't make sense, it can't be real. So, what are our assumptions? We don't have any. We�re just guessing on testing. We assume the tests are right. We've already redone them. Twice. Let�s go more basic. What's more basic than the test results? The tests themselves. What does a biopsy consist of? You take a sample. Define sample. It's a small representative piece of whatever you think is the problem. you go down to the shore, you fill a cup of water. It's got no fish in it. Does that mean no fish in the ocean? We can do another biopsy. We could fill another cup of water. We gotta dive in. We gotta see what's actually in there. We can't operate. He�s got a bleeding problem. We assume he's got a bleeding problem. Yeah, because he bled from where he wasn't supposed to bleed, causing parts of his body to blow up. Assuming that crazy assumption is correct, if we operate on him, we'll kill him. What if we could find a way to do this surgery without giving him more than a paper cut? You want to let a robot operate on me? The technology is amazing. It magnifies everything ten times. It�s ten times the accuracy. No way. I want a person. A person will be controlling-- people suck. People have turned you from a guy with a swollen tongue into a guy with one eye, one ball, and a stapled-on face. If you want someone to hold you while you cry yourself to sleep at night, choose warm and soft. If you want someone to write you a poem, pick the sensitive loner. But if all you care about is that something's done right, pick the guy with the metal head. No way. No way, no way. You gotta see this thing in action before you say no way. Come on. House. What are you doing? Nothing. I'm not doing anything. Just throwing out ideas. I think you should put him in a wheelchair, take him down to the O. R. But I may be out of my mind. Relax, Cameron. I'm not going to cut you. I just want to show what this puppy can do. It can make one-millimeter incisions. You know how small that is? It's small even in metric. If I do something that doesn't make sense, even to you, stop me. Delicate, no? House. Does that hurt? Seen enough? No. That wasn't a question. You either do this, or you die. You've wasted your life. Yeah. If only I'd spent more time dedicating myself to finding someone worthy to shoot. If I had killed you, would it have mattered? Not to me. Have you got a pen? You don't care if you live or die? I care because I live. I can't care if I'm dead. I don't want to hear semantics. You anti-semantic ***. Would anybody care that the world lost that wit? Working here. That's all right. You don't have to say anything. Just let me soak into your subconscious. You think that the only truth that matters is the truth that can be measured. Good intentions don't count. What's in your heart doesn't count. Caring doesn't count. But a man's life can be measured by how many tears are shed when he dies. Just because you can't measure them, just because you don't want to measure them, doesn't mean it's not real. That does not make sense. And even if I'm wrong, you're still miserable. Did you really think that your life's purpose was to sacrifice yourself and get nothing in return? No. You believe there's no purpose to anything. Even the lives you save, you dismiss. You turn the one decent thing in your life, and you taint it, strip it of all meaning. You're miserable for nothing. I don't know why you'd want to live. I'm sorry. I know what's wrong. House, get out of here. You�re not sterile. He'll be fine. great. What's he got? How come you guys have never tried to yank me off this case? I'm having hallucinations. Blackouts. But you're always insane, and you're always right. I'm almost always eventually right. You have no way of knowing when "eventually" is. Every time I've had an epiphany on this one, you guys were right on board. No challenges, no need to explain. No offense, but either you guys are getting smarter, or I'm getting dumber. We've worked with you long enough to know-- I know the test results even before you enter the room. We have identical knowledge. How is that possible? You're wrong. If something doesn't make sense, one of your assumptions has to be wrong. Because if something doesn't make sense, it can't be real. But what if the faulty assumption is that it's real? House, you're losing it. I've lost it. Why did you stop me? Because I think you're going to kill him. No, you don't think that. You know it. Because you're in my head. As long as the delusion makes sense, my mind lets it go on. I have to make it not make sense. I have to push it past the point where it can trick my mind. Hey, hey. If this is a nightmare, you're gonna wake up. If it's real, you're killing a man. It's also possible that I may already be dead. But I don't believe in the after life. House, go back to your room. If this is a hallucination, it's a good one. You're pain free, you can walk-- it's not real. Therefore, it's meaningless. I want meaning. Oh, god. Goodbye. - He was shot. - Twice. Once in the abdomen, once in the neck. Hello. -- It's going to be okay. You're gonna be okay. You don't know nothing. Tell Cuddy I want ketamine.