HOUSE, M.D.
1X05: DAMNED IF YOU DO
Original Airdate on FOX: December 14, 2004
Written by Sara B. Cooper
Directed by Greg Yaitanes
Transcript written by Mari
Archived at TWIZ TV.COM with permission from House: Transcripts and More!
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[Opens on the clinic front desk.
Wilson is working on paperwork, House is playing with candies. The desk has
Christmas decorations on it, and “Rudolph the Red-Nosed Reindeer” is playing in
the background.]
House: We are condemned to useless
labor. [House has a giant stack of charts next to him.]
Wilson: Fourth circle of Hell.
Charting goes a lot faster when you eliminate the whole of classic poetry.
[House flicks a candy at him.]
House: Writing down what we
already know to be read by nobody. Pretty sure Dante would agree that
qualifies as useless.
Wilson: You’re over two weeks
behind on your charting. [House flicks another candy; it almost goes down
Cuddy’s shirt.]
House: Oops. I missed.
Cuddy: What are you, eight?
House: Could an eight-year-old do
this? [He makes a face. Wilson smiles.]
Cuddy: You better stop or it’ll
stick that way. You have a patient in Exam Room 1.
House: Yeah, but see, see, I’m off
at twelve and it’s already five of.
Cuddy: She’s been waiting for you
since eleven. [Cuddy walks off.]
House: Melancholy without hope.
Which circle is that?
House walks into the exam room,
sees who’s in there, and makes a “oh no” kind of face. It’s three nuns.]
House: Hi. I’m Dr. House. What
seems to be the problem?
Sr. Eucharist: Show him your
hands, Augustine. [House pops a couple Vicodin. Augustine shows her hands,
which are red, swollen, and covered in hives and sores.
Sr. Pius: It looks like… stigmata.
Sr. Eucharist: Shhhh, Pius!
House: You must be all the talk
around the holy water cooler. You been washing a lot of dishes recently?
Sr. Augustine: I help out in the
kitchen.
House: Anything new in the
kitchen?
Sr. Pius: We just got a donation
of saucepans and pots this week.
Sr. Augustine: I unpacked and
washed them.
House: Should have spent your time
saving souls, it’s easier on the hands. This is contact dermatitis; you’re
allergic to dish soap.
Sr. Eucharist: Nonsense! We’ve
always used that soap. Why is there a problem now?
House: I’ve been a doctor for
years. Why do I have to keep assuring people that I know what I’m doing? A
person can become allergic to substances that they’ve had repeated and
prolonged exposure to. The good news is: free samples. Diphenhydramine. It’s
an antihistamine. It’ll stop the allergic reaction. Take one every eight
hours, it might make you feel a little sleepy. And get some of that
over-the-counter cortisone cream.
Sr. Augustine: Thank you, Doctor.
House: You want some water? [He
hands her the pills.]
Sr. Augustine: I have some tea.
House: Well, you just relax for a
few minutes. That stuff works pretty fast. [He leaves. The other sisters
help Augustine take the medication with her thermos of tea. House to the
clinic main desk and throws the chart down on the pile of other ones.]
Wilson: Still out by twelve.
House: How do you solve a problem
like dermatitis?
Wilson: What?
Sr. Eucharist: Doctor? I want to
thank you for your patience.
Wilson: She talking to you?
House: I don’t know. She’s
certainly looking at me.
Sr. Eucharist: Oh, it’s good to
get a secular diagnosis. The sisters tend to interpret their diagnosis as
divine intervention.
House: And you don’t? Then you’re
wearing an awfully funny hat.
Wilson: Oooh, boy. Excuse me. [He
leaves.]
Sr. Eucharist: If I break my leg,
I believe it happened for a reason. I believe God wanted me to break my leg.
I also believe He wants me to put a cast on it. [House smiles slightly.]
Sr. Pius: Doctor, something’s
wrong!
Cut to Exam Room 1, where
Augustine is having an asthma attack. House grabs his stethoscope.]
House: Lift up your chin. [He
listens to her breathing.] Sister, you’re having an asthma attack. I need you
to relax. [to Eucharist] Roll up her sleeve, please. [He grabs a syringe from
the cabinet.] I’m giving you epinephrine, it’ll open your lungs and help you
breathe. [He sticks the needle in her arm, CGI shot of the bloodstream going
to her lungs, and the airways opening.]
Sr. Eucharist: What happened?
House: Did she take the pill?
Sr. Eucharist: Yes.
House: It’s probably an allergic
reaction.
Sr. Pius: She’s allergic to an
anti-allergy medicine?
House: You figure somebody’s out
to get her? How’re you feeling?
Sr. Augustine: Better.
House: I’ll put you on some
steroids instead.
Sr. Augustine: Is my heart
supposed to be feeling so funny?
House: It’s called adrenaline, it
makes your heart beat fast. [He feels her pulse.] But not this fast. [to the
others] Get a nurse, please. Lie back.
Sr. Pius: Help! Somebody help
us! [House opens Augustine’s shirt and listens to her heartbeat.
House: Somebody get in here! [A
tech comes in.] Call a code and charge up a defibrillator. She’s got no
pulse. [The tech runs out, House starts chest compressions.]
Opening credits.]
Cut to Augustine’s hospital
room. Her cross and Bible are on the table next to her; the two sisters are
praying at her side. Cut to Cuddy’s office.]
Cuddy: You diagnosed the patient
with allergies and prescribed antihistamine, she went into respiratory
distress, and you injected her with epinephrine. Presumably 1 cc.
House: 0.1 cc. That is the
standard dose, that is what I gave her.
Cuddy: People don’t go into
cardiac arrest from 0.1 cc epinephrine.
House: She must have a
pre-existing heart condition that got exacerbated by the epinephrine.
Cuddy: It’s too bad you didn’t
make a notation in the chart.
House: I can make it up right now.
Cuddy: The drawer has syringes
with both dosages, you could have easily reached for the wrong one.
House: But I didn’t.
Cuddy: Everyone makes mistakes.
This is why doctors pay through the nose for malpractice insurance.
House: Relax, they’re not going to
sue. Worse they’d do is whack my hand with a ruler.
Cuddy: And the discipline board?
Are they gonna whack your hand, too?
House: You’re going to report me?
Cuddy: What choice do I have?
House: Uh, how ‘bout not report
me?
Cuddy: I can justify keeping her
here for 24-hour observation. If you haven’t found an underlying cause for the
cardiac arrest by then I will have to notify our attorneys. [House looks at
his watch and walks out.]
Cut to House walking down the
hall with Cameron, Chase and Foreman.]
Cameron: Her hands were red and
swollen, maybe she has a skin infection. Cellulitis? That could manifest with
tachycardia.
Foreman: There’s no history of
fever. Results from the CBC didn’t indicate an infection.
Cameron: The eosinophils were
mildly elevated, sed rate’s up a bit. Could be looking at a systemic allergic
response.
House: It’s not allergic.
Allergies don’t cause cardiac arrest like this. Could be inflammation of the
blood vessels.
Foreman: Vasculitis? That
wouldn’t give you an elevated eosinophil count.
House: Church-Strauss vasculitis
would. Blood vessels of the heart, lungs and skin become inflamed causing the
asthma, rash and heart problems. Covers all her symptoms. [They reach the
diagnostic office.]
Cameron: Need a biopsy to
diagnose.
Chase: Chest CT’d be quicker.
Foreman: The lady just came in
with a rash. [House stops and stares at a bunch of candy canes on the table.]
House: What the hell are those?
Cameron: Candy canes. [Foreman
takes one.]
House: Candy canes? Are
you mocking me?
Cameron: No! It’s Christmas and,
and I, I, I thought –
House: Relax. It’s a joke.
Foreman: Isn’t the prognosis for
Church-Strauss a bit grim?
Cameron: Yeah. Untreated only 33%
of patients survive past a year; treated, five years.
House: Then I’d definitely suggest
treatment.
Foreman: If it was any other
attending doctor, I’d say that he made a mistake and gave her too much
epinephrine.
House: [pouring coffee] Saying
you wouldn’t say it was my mistake is saying it was my mistake.
Foreman: Everyone screws up: your
rule. I think you fit inside the subset of “everyone”.
House: I didn’t screw up.
[Foreman shakes his head.] Order a chest CT and start the sister on
prednisone, 40 mg. TID.
Chase: The sister?
House: Oh, didn’t I mention? The
patient’s a nun. Sister Augustine.
Chase: Aw. I hate nuns.
House: [thinks a little] Who
doesn’t?
Cut to a TV, showing a man and a
women playing in the waves. Sisters Augustine and Pius are watching it
raptly. Foreman, Cameron and Chase walk in.]
Cameron: Sister Augustine? [Pius
hurriedly turns the TV off.]
Augustine: We weren’t watching.
Pius: [holds up remote] We were
trying to see if this was the bed control.
Cameron: Oh, um, this one’s the
bed control [she gives Pius another remote] and that one’s the TV control. I’m
Dr. Cameron, and that’s Dr. Chase and Dr. Foreman.
Augustine: I hadn’t seen
television in over twenty years.
Chase: Do you consider it the work
of the devil, or do you just not get cable where you live? [pause]
Foreman: Um, how’re you feeling,
Sister?
Augustine: I seem to be a little
better; they gave me some medication.
Foreman: Prednisone. It’s a
steroid to help with the inflammation.
Augustine: Has Dr. House figured
out what I have? Will I be okay?
Cameron: We’re not sure what’s
wrong yet. You’ll have a chest CT scan this afternoon that will help with the
diagnosis.
Pius: Dr. House is giving her
medication and he doesn’t know what she has yet?
Augustine: Trust, Sister Pius. It
all happens for a reason.
Cut to the ducklings in the
hallway.]
Foreman: He doesn’t know what he’s
doing. The only problem that woman has is that House grabbed the wrong
syringe.
Cameron: You don’t trust him?
Foreman: I don’t trust a man who
won’t admit he might be wrong. I notice you weren’t so quick to tell her she
has Church-Strauss and only has a couple years to live.
Cameron: I don’t tell patients bad
news unless it’s conclusive.
Foreman: Because you know he might
be wrong.
Cameron: About Church-Strauss, not
about what happened in the clinic.
Foreman: What about you, Chase?
You think he’s infallible, too?
Chase: All I know is, if House
didn’t make a mistake and Sister Augustine has Church-Strauss, he’ll be
self-satisfied and our lives will be good for a few weeks. If House did make a
mistake, he’ll be upset and our lives will be miserable for months.
Foreman: There is that.
Cut to House and Wilson walking
out of the elevator and into the clinic.]
House: If Cuddy thinks I made a
mistake the least she could do is suspend me from clinic duty.
Wilson: She doesn’t confuse making
a mistake with being incompetent.
House: Oh, here we go. Lesson
time. I recognize that confidence is not my short suit. I also recognize that
I am human and capable of error.
Wilson: So you might have screwed
this up?
House: No.
Wilson: So, it’s only a
theoretical capacity for error.
House: Good point. Maybe there
isn’t one. Maybe that’s my error.
Wilson: You know, most people who
think as much of themselves as you do like to talk about themselves.
House: Most people don’t like to
listen, so what’s wrong with you? [He leaves Wilson standing in the clinic.]
Cut to House entering Exam Room
1, which is occupied by… Santa Claus? House makes a point of sniffing the air
as he enters.]
House: Let me guess… inflammatory
bowel.
Santa: Wow, yeah. Is it that bad?
House: Yes. It’s also written on
your chart. Bloody diarrhea, gas, pain… took sulfasalazine, but it didn’t work
–
Santa: No, then I –
House: Next tried steroid enemas,
oral corticosteroids, 5ASAs, 6 mercaptopurine… I’m impressed.
Santa: By my medical history?
House: By how well your last
doctor charted.
Santa: It’s one thing to have to
go to the bathroom every hour, but when the kids sit on my lap, it’s…. The
store sent me home, they’re gonna fire me. Can’t you put me back on 5ASA?
Maybe it’ll work this time?
House: Not likely. I’m giving you
a prescription. It’s cheap, which is good because your insurance company won’t
pay for it. [He gives Santa a prescription, who puts on his glasses to read
it.]
Santa: [tries to read House’s writing]
Cojorius?
House: Cigarettes. One twice a
day, no more, no less. Studies have shown that cigarette smoking is one of the
most effective ways to control inflammatory bowel, plus it’s been established
that you look 30% cooler.
Santa: Are you kidding me?
House: About the looking cooler,
yeah. The rest is true.
Santa: Isn’t it addictive and
dangerous?
House: Pretty much all the drugs I
prescribe are addictive and dangerous. The difference with this one is that
it’s completely legal. [He turns to leave.] Merry Christmas.
Cut to Chase wheeling Augustine
to the CT.]
Augustine: I was talking to the
nurse, Arsenio. Do you know him?
Chase: Not really.
Augustine: He can take pictures
with his phone.
Chase: Cool.
Augustine: That woman from the lab
was interesting, too. She studied astrophysics before becoming a nurse.
Chase: You know the staff better
than I do.
Augustine: Well, I love to hear
about people.
Chase: Yet you live in a
monastery.
Augustine: It’s where I serve our
Lord and the world best.
Chase: Our Lord, maybe. The rest
of the world, on the other hand, would probably get more out of feeding the
homeless or –
Augustine: Healing the sick?
Chase: As an example, yeah.
Augustine: Did you always want to
be a doctor?
Chase: Always. You always want to
be a nun?
Augustine: My parents died when I
was six. I was raised in a foster home run by the Church. When I was
eighteen, I went to the monastery where they let me take my vows. I’ve known
no other life and I haven’t wanted to.
Cut to Augustine going into the
CT.]
Foreman: Okay, Sister, we need to
you lie as still as possible. If you get scared, just let us know.
Augustine: As Jonah said from
inside the whale, “When I had lost all hope, I turned my thoughts to the Lord.”
Foreman: At least she’s got God on
her side.
Cameron: I don’t believe in God.
Foreman: You’re not even a little
agnostic?
Augustine: [from inside the CT] Is
it supposed to smell funny?
Tech: Someone ralphed in there
this afternoon. We cleaned it up, but…
Cameron: It’s normal, Sister.
It’s just a few more minutes. [pause] I believe in a higher order that’s in
control of what happens, but not one anthropomorphic entity called “God” that’s
concerned with the everyday workings of you and me.
Foreman: What else is there to
control but the everyday workings of you and me?
Cameron: It’s always about you,
Foreman.
Foreman: What else are you talking
about? The trees, the fish? Should they be the ones to think it’s all about
them? What about you, Chase? Do you believe in God?
Chase: I believe Sister Augustine
has no vascular pathology, which means no Church-Strauss.
Foreman: Which means House made a
mistake.
Cameron: No, not necessarily. It
could be something else. Thyrotoxicosis or a carcinoid.
Foreman: I don’t get you. You
don’t believe in God, but you’re willing to put complete faith in one man?
Augustine: Please, the smell!
Foreman: Let’s get her out of
there. [Augustine is panicking as they pull her out.]
Cameron: I’m coming, Sister. I
gotcha, I’m coming.
Augustine: Please, please, the
smell, I’m sick –
Cameron: There’s no smell –
Augustine: No, God, no – [she puts
her hands in a praying position, then gestures outward] Oh, it’s Jesus! It’s
Jesus! [Chase rolls his eyes. Augustine starts to laugh and cry.] He’s
coming for me. He’s burning me with his touch!
Foreman: Let’s get her on some
Ativan. [He holds on to Augustine’s arms as she continues to cry.] Smells,
religious visions are symptomatic of temporal lobe swelling. We don’t want her
to –
Augustine: Oh!
Cameron: She’s seizing!
Foreman: Help me get her on her
side. [The three of them maneuver the sister onto her side.]
Chase: Religious visions?
Foreman: Yeah. And next comes…
[he lifts up part of her gown, we see a rash on her leg. Chase and Foreman
share a look.]
Cut to the diagnostic office.]
Foreman: Patient tested positive
for herpetic encephalitis.
House: So what’s that tell us?
Cameron: Her immune system is
severely compromised.
Cuddy: Ooh, I know! Prednisone
compromises the immune system. Isn’t that the medicine you gave her for the
thing she doesn’t have?
House: Yeah, but… hey. I’m think
that’s a trick question.
Cameron: Her immune system is
severely compromised. Two doses of prednisone wouldn’t do that.
Cuddy: Are you hanging your
diagnosis on an adverb?
House: In ten seconds I’m gonna
announce that I gave her the wrong dose in the clinic.
Cuddy: You’re gonna admit
negligence?
House: Unless you leave the room.
If you leave you’ll have to testify. [Cuddy stays put.] Five, four, three,
two…. So, there I was in the clinic, drunk. I open the drawer, close my eyes,
take the first syringe I can find – [the ducklings smile, Cuddy leaves] So,
what are the options for compromised immune system?
Chase: Mixed connective tissue
disease. It’d explain why she was feeling better on the prednisone.
Foreman: Sure, she was feeling
better right up to the moment it almost killed her.
House: On the other hand, it
explains the symptoms. Swollen hands, pulmonary problems, cardiac problems –
it all fits.
Foreman: Except her ANA was
normal.
House: So redraw the blood.
Foreman: But the treatment is
cortical steroids, prednisone, and we can’t go there because of the
encephalitis.
House: Then we’ll treat it with
something that modulates the immune system but doesn’t suppress it. Hypobaric
oxygen chamber.
Foreman: There’s no protocol for
putting a patient in a high-pressure oxygen room to treat autoimmune problems.
House: Oh, you people. Always
with the protocols. [small pause] Prep the nun and discontinue the prednisone.
[He begins to erase the whiteboard and continues to talk to Foreman as the
others leave.] I am both amused and annoyed that you think I should be less
stubborn than you are.
Foreman: You are aware of the
Hippocratic Oath, right?
House: The one that starts: First,
do no harm, then goes on to tell us no abortions, no seductions, and definitely
no cutting of those who labor beneath the stone. Yeah, took a read once,
wasn’t impressed.
Foreman: Hypobaric treatments
could cause oxygen toxicity, lung and eye damage –
House: Every treatment has it’s
dangers –
Foreman: Which is why we treat when
we’re only convinced the patient needs the treatment.
House: I’m convinced. You’re
not. Question is, what are you going to do about it? Hmm?
Cut to Cuddy’s office.]
Cuddy: [on the phone] I have an
opening Thursday at three. Do you have a fourth? Is he any good? [Someone
walks into her office.] Can I call you right back? Okay. [She hangs up.]
What’s up? [We see that it’s Foreman that walked into her office.]
Cut to Chase and Cameron putting
Augustine into the hypobaric chamber.]
Chase: The pressure will force the
oxygen into your system and saturate your blood. It will enhance white cell
activity and reduce the inflammation.
Augustine: And that will help with
this mixed connective tissue disease?
Chase: We’ll be doing about ten
treatments and then we’ll reevaluate.
Augustine: The last treatment with
prednisone cause the seizures, right? How confident is Dr. House about this?
Cameron: That you reacted so
strongly to the prednisone let us know that you had an underlying problem with
your immune system.
Augustine: I guess it was a
blessing… of sorts.
Cut to the hospital chapel.
House is sitting in the chapel watching General Hospital on his portable TV.]
Soap Doc: So, who’s your favorite
reindeer, Nurse [something]?
Soap Nurse: Rudolph.
Soap Doc: I would have thought it
was Vixen.
Soap Nurse: What are you implying?
Soap Doc: Nothing, but I saw you
at the Christmas party with Dr. [fades out. Sr. Eucharist walks in, makes the
sign of the cross, and turns to sit. She sees House in the pew.]
Eucharist: This is a chapel. A
house of prayer.
House: House of prayer, huh. That
explains the good reception. Also why nobody’s ever here.
Eucharist: I need to talk with
you, Dr. House. Sister Augustine believes in things that aren’t real.
House: I thought that was a job
requirement for you people.
Eucharist: She’s been known to lie
to get sympathy. She’s a hypochondriac.
House: [turns off TV] So, you’re
warning me that I may be treating a non-existent ailment
Eucharist: Sore throats, joint
pains… there’s always something wrong, and there’s never a reason for it.
Mother Superior plays right into it. Lets Augustine off work duties, treating
her as fragile, special.
House: That must make you angry.
[eats a piece of chocolate]
Eucharist: It bothers me. It’s
not really in Augustine’s best interests. [She keeps looking at the chocolate
bar.]
House: [offers the chocolate] Want
some?
Eucharist: I shouldn’t. [takes
the bar and sits down next to House]
House: I guess you’ve got to be
good at reading people to be a good infirmarian, huh.
Eucharist: [around a mouthful of
chocolate] Mm hmm.
House: So, we’ve got pride, anger,
envy, gluttony…. That’s four out of seven deadly sins in two minutes. Do you
people keep records of these things? Is there a Cathlympics?
Eucharist: They say you have a
gift.
House: They like to talk.
Eucharist: You hide behind your
intelligence.
House: Yeah, that’s pretty stupid.
Eucharist: And you make jokes
because you’re afraid to take anything seriously. Because if you take things
seriously, they matter, and if they matter –
House: And when things go wrong, I
get hurt. I’m not tough, I’m vulnerable.
Eucharist: I barely know you, and
I don’t know if I’m right. I just hope I am. Because the alternative is, you
really are as miserable as you seem to be. [pause]
House: You know, from the way
you’re looking at me right now, I’d say you just hit number five: lust.
[Eucharist hands House his candy bar and leaves. House pulls out his pocket
TV.]
Soap Nurse: Dr. Brown, I love you,
too.
Cut to Cameron and Chase opening
the hypobaric chamber.]
Chase: How’re you feeling?
Augustine: A little week.
Chase: That’s from the oxygen.
Augustine: My mouth is dry.
Chase: Okay. well, I’ll get you
some of your tea.
Cut to House and Cuddy walking
down a hallway.]
Cuddy: Mixed connective tissue
disease? Her ANA is barely elevated!
House: Well, thanks for checking
up on her. Good to know you’ve got my back.
Cuddy: 0-2 stat is down to 83,
pulmonary problems, breathing problems –
House: Irritation from the oxygen
is typical.
Cuddy: She comes in with a rash
and you put her into cardiac arrest.
House: That well just never runs
dry, does it? If there was no underlying problem, then why is she still having
the rapid heartrate?
Cuddy: Maybe from the herpetic
encephalitis caused by you giving her prednisone!
House: Her reaction is a symptom,
not an error.
Cuddy: There’s always an
explanation, isn’t there?
House: Yes, there is! And if this
one doesn’t work will find another.
Cuddy: But never one involving you
screwing up.
House: One that fits all the
facts. Look, we obviously have a difference of opinion, and that’s fine, but
unfortunately I’ve used up all the time I’ve budgeted today for banging my head
against a wall.
Cuddy: I am going to do you the
biggest favor one doctor can do for another. I am going to stop you from
killing your patient. You’re off the case.
Cut to House, standing in his
office. He gives Foreman a Look, who Looks right back at him. House then
gives him quite an evil grin, and Foreman… well, he’s got nothing on that.]
Cut to the ducklings talking with
Cuddy in her office.]
Cuddy: We’re going to treat the
symptoms.
Cameron: Not the underlying
condition?
Cuddy: There is no underlying
condition. What’s her status?
Chase: The sister’s breathing is
labored.
Cuddy: Pneumonitis from the
hypobaric chamber. Put her on 40% oxygen until her 0-2 stats increase.
Chase: BUN and creatin’s rising,
ALT and AST twice the normal range.
Cuddy: Could be from the
hypertensive episode. Let’s follow them with labs.
Foreman: She still has the rash
and the joint pain she came in with.
Cuddy: Order a non-steroidal
anti-inflammatory.
Cameron: When we were looking at
the differential diagnosis with Dr. House, we were considering –
Cuddy: I don’t need to hear what
Dr. House was considering! All of this woman’s symptoms can be traced to Dr.
House’s considerations. Okay. Let’s just get this patient healthy. I want
her going out the front door, and not the back.
Cut to Cameron, Chase and Foreman
leaving the clinic.]
Foreman: Hey, it’s not like I
betrayed him. Cuddy would have found out about the hypobaric treatments
eventually.
Cameron: You did what you felt you
had to.
Cut to House in the clinic. He’s
looking through the door with the epinephrine syringes.]
Wilson: Can’t get enough of this
place, huh?
House: Came for my stethoscope.
Wilson: So, I shouldn’t read too
much into the fact that you were looking for it in the drawer with the
epinephrine syringes in it?
House: Okay, yeah. I’d like to clear
my reputation.
Wilson: Oh, right. I forgot that
you care about what people think. Prescribing cigarettes for inflammatory
bowel? It could cause lung cancer, you know.
House: [leaving the exam room] You
know why they have ribbons for breast cancer, colorectal cancer, prostate
cancer and not for lung cancer?
Wilson: They ran out of colors?
House: It’s because people blame
lung cancer patients. They smoked, they screwed up, they deserve to die. The
reason people die from lung cancer is guilt. [He enters Cuddy’s office where
the records are kept.]
Wilson: Huh. Well, guilt does a
lot of damage.
House: You said that with great
significance.
Wilson: You’re not here to find
your stethoscope. You’re not here to clear your reputation. You’re here
because you’re having doubts. You might have screwed up.
House: I’m here because, if I’m
right, Cuddy is killing that patient.
Wilson: Okay, but if you’re wrong?
[pause]
House: Then she’s saving her.
Wilson: Fine. You’re going to
have to go through every record of every patient who’s been through this clinic
in the last two days, and you’re gonna have to hope that those records can be
trusted, which, by the way, yours can’t. [Wilson leaves.]
Cut to Chase with Augustine.]
Chase: These pills will help your
kidneys function a little better, Sister. [She takes the pills.] Get your
wrist? [He takes her pulse.]
Augustine: What’s that?
Chase: 104.
Augustine: Is that good?
Chase: It’s fine.
Augustine: You’re a lousy liar,
Dr. Chase. [Chase’s beeper goes off. On it is the message “Call Mom!”
Chase: I have to get this. Excuse
me.
Cut to House’s office. House is
playing with a yo-yo. Chase enters.]
Chase: My mother’s been dead for
10 years.
House: But she’s always with you
in spirit. What do you know about the nun?
Chase: Which one?
House: The cute one. I think she
likes me. The sick one, obviously.
Chase: Her parents died when she
was a child and she’s been with the Church ever since.
House: What’s she lying about?
Chase: Why do you say that?
House: I always say that. And the
old nun says the sick nun is a big fat nun liar. You know nuns, what do you
think?
Chase: I don’t know nuns.
House: You hate nuns. You can’t
hate someone if you don’t know them.
Chase: Know any Nazis? Maybe I
hate them on principle.
House: I have a theory on what
makes good boys “good”. It’s not because of some moral imperative. Good boys
have the fear of God put into them. Catholic Church specializes in that kind
of training, to make good boys afraid of divine retribution so they will do
what their daddies tell them, like, for example, going into medical school when
it’s the last thing they want to do. What do you think?
Chase: I think if she did have a
secret, her boss would know. [He leaves.]
Cut to the monastery. House is
talking to another nun {I’m assuming the Mother Superior.]
House: Did you paint, or put in
new carpets recently?
Nun: No.
House: Any way she could have got
access to drugs?
Nun: Well, we lock all of our
medications in the infirmary, and we don’t keep prescription drugs here. [Nun
is making tea.] Why haven’t you asked Sister Augustine about these things
directly?
House: I’ve found that when you
want to know the truth about someone that someone is probably the last person
you should ask.
Nun: Ah. And have you been
speaking to Sister Eucharist?
House: She ratted out her fellow
sister pretty quickly. If I were you I’d have her repeat a year of nun
school. [Nun chuckles.]
Nun: Becoming a nun doesn’t make
you a saint.
House: Becoming a doctor doesn’t
make you a healer.
Nun: Just because we live in a
monastery and we spend most of our time in prayer doesn’t mean we don’t find
time for drama.
House: So, what is the sick one’s
drama?
Nun: Sister Augustine lived in
Catholic foster care until she came to us. [kettle whistles] Tea?
House: Sure. Do all of you lie?
It’s a good strategy, simpler when you all tell the same lie, but she has not
spent her entire life as a good Catholic. When she had a cardiac arrest I had
to open her blouse to do CPR and I learned two things: nuns can have nice
breasts, and she has a tattoo on her shoulder of a skunk. Now, maybe it’s the
Sacred Skunk of Joseph, but as far as I know, Catholic foster care and
monasteries do not keep tattoo parlors in their refractories.
Nun: We consider that our life
begins when we put on our habits and take our vows. What happens before then –
House: Is irrelevant to you, but
it’s relevant to me.
Nun: Sister Augustine went into
foster care when she was six years old, but she left when she was twelve. She
lived on the streets, she got into drugs. When she was fifteen, she became
pregnant, tried to self-abort. She lost the child, she became ill. We took
her in when she came back. If we had thought it was medically relevant we
would have told you.
House: It’s not. [He takes a sip
of tea, then looks at it.] This tea is delicious. Local herbs?
Cut to Cuddy and the ducklings in
a hallway.]
Cuddy: Any change with medication?
Chase: Yeah, she’s getting worse.
Lung function’s deteriorating, BUN and creatin are continuing to rise. She’s
starting to run a fever and the rash is spreading. At this rate she’s not
going to make Christmas.
Cameron: Maybe House was right.
Maybe there is an underlying condition that explains the symptoms, something we
haven’t considered.
Cuddy: Like what?
Cameron: It could be a metabolic
disorder.
Cuddy: Specifically?
Cameron: Mitogenetic.
Cuddy: Specifically?
Cameron: I’m just saying –
Cuddy: You’re just saying you
think House is right.
Cameron: Might be right.
Cuddy: Of course he might be
right! It might be the Hand of God at work. Don’t say it’s something else
unless you’ve got something concrete to offer. [A teabag is thrown onto
Cuddy’s paperwork, she picks it up and stares at the entering House.] What’s
this, hemlock?
House: “I’m going to do you the
biggest favor one doctor can do another. I’m gonna stop you from killing your
patient.” It’s figwort tea. Great for that little pick-me-up we’re all
looking for in the morning. Opens the lungs, increases the blood pressure,
stimulates the heart. Unfortunately, if you then get injected with even 0.1 cc
of epinephrine: instant cardiac arrest. Still, what the hell, it tastes great.
Cuddy: Sister Augustine –
House: Has been drinking it
religiously, so to speak.
Foreman: Take the cardiac arrest
out of the equation…
House: All the rest of the
symptoms can be explained by a severe long-term allergic reaction.
Foreman: That’s what Cameron said
in the beginning.
House: Yes, she did. Well done.
[Cameron smiles.] But your unwillingness to stick by your diagnosis almost
killed this woman. [No more smiles.] Take a lesson from Foreman: stand up for
what you believe. Okay, let’s go figure out how to save a nun. [He leaves.]
Chase: Damned if you do, damned if
you don’t.
Cut to House and the Ducklings
walking to the diagnostic office.]
House: Because it’s been untreated
for so long, it’s gone from a simple watery eyes, scratchy throat allergy to a
whopping I’m-gonna-kick-your-ass allergy, compromising her immune system,
diminishing her ability to heal and breaking down her organs systems. So,
what’s the source?
Chase: The dish soap.
House: No, symptoms persisted days
after the dishwashing episode. It’s gotta be something she’s been exposed to
here in the hospital as well as the monastery.
Foreman: Well, what about the
tea? It caused her arrhythmia.
House: Could be, but it’s not
definitive.
Chase: We’ll skin test for
allergens.
Cameron: Not yet, she’s too
reactive. She’d test positive for everything. We need to stabilize her,
isolate her from all possible allergens. Give her system a rest.
Chase: Get her in a clean room.
House: Okay. And we’ll gradually
introduce allergens and see how she responds. When she reacts to something
we’ll know that’s what killing her.
Cut to the ducklings helping
Augustine in the clean room.]
Foreman: There you go. No
television, no books.
Augustine: Not even my Bible?
Foreman: I’m afraid not. This
room has filtered air, filtered water… you even have silk sheets. Very
decadent and hypoallergenic. You should be feeling better here. [Foreman and
Cameron leave.]
Chase: We’ll be back to check on
you in a little while.
Augustine: Can the other sisters
come in and pray with me?
Chase: It’d be better if you don’t
have any visitors. Once we isolate what’s causing your allergy, then we can be
a little more lax. [Augustine turns away from the window and starts to cry.] I
can pray with you.
Augustine: I want to die. Why has
He left me?
Chase: I was in seminary school.
They asked us once what our favorite passage was. I chose 1 Peter 1:7. “These
trials only test your faith to see whether or not it is strong and pure. Your
faith is being tested as fire tests gold and purifies it.”
Augustine: “And your faith is far
more precious to the Lord than pure gold; so if your faith remains strong after
being tested, it will bring you much praise and glory and honor on the day of
His return.”
Chase: He hasn’t left you. The
only thing in the way of your knowing if he’s left you is your fear. You have
a choice: faith or fear. That’s the test.
Augustine: Do you think faith
doesn’t mean I won’t die?
Chase: It will affect how you
experience your death, and therefore your life. It’s up to you.
Augustine: Why did you leave
seminary school.
Chase: A test. You passed. I
didn’t.
Cut to Cameron and Foreman
talking to Pius and Eucharist.]
Cameron: We’ll call you if
anything changes.
Eucharist: Will she be all right?
Foreman: As long as she’s not
exposed to anything that will aggravate her allergy, she’ll be fine. [Chase
comes and knocks on the window.]
Chase: Need some help in here!
[Cameron and Foreman start to suit up.] Screw the procedure, she’s in
anaphylactic shock!
Foreman: No way, she’s in the damn
clean room.
Chase: You kidding me? Get in
here! [Cameron and Foreman run in.] 0.1 cc of epi.
Foreman: Gonna have to intubate.
Cameron: I got it. [They insert a
breathing tube.] I’m in. [They start to pump air.] Breathing’s stabilized.
Chase: It’s a clean room!
Cut to House and Wilson looking
through the glass.]
House: How do you get an allergic
reaction in a clean room?
Wilson: Maybe it was the
preservatives in the IV?
House: Checked that.
Wilson: Latex tubing?
House: Checked that. Checked
everything.
Wilson: Well, it could be
mast-cell leukemia. It can cause anaphylaxis.
House: Checked the blood levels.
And it’s not [he mutters a couple of diseases she didn’t have, I couldn’t catch
it].
Wilson: Maybe it’s just divine
will.
House: It’s not my will. [takes a
couple of Vicodin]
Wilson: You do realize if you’re
wrong, about the big picture that is, you’re going to burn, right?
House: What do you want me to do?
Accept it, pack it in?
Wilson: Yeah. I want you to
accept that sometimes patients die against all reason. Sometimes they get
better against all reason.
House: No, they don’t. We just
don’t know the reason.
Wilson: I don’t think the nuns
would agree with you on that.
Cut to House, pacing in his
office. Cameron knocks on his office door and enters.]
Cameron: I just wanted to say that
I know that you did everything you could.
House: I don’t need verification
from you to know that I’m doing my job well. That’s your problem, not mine.
Cameron: I was just being nice.
House: Yeah, well, you don’t need
to always do that. [pause]
Cameron: Merry Christmas. [She
hands House a present. Chase enters.]
Chase: Sister Augustine’s been
extubated.
House: Good.
Chase: She’s requested to check
out against medical advice. She wants to go back to the monastery.
House: Well, talk her out of it.
Chase: I think I may have talked
her into it.
Cut to House entering the clean
room.]
House: Room’s paid up for the rest
of the week. You might as well stick around.
Augustine: This illness is a test
of my faith. If it’s His will to take me, it doesn’t matter where I am. I can
accept that.
House: Does anybody believe
anything you say? You’re not accepting. You’re running away. Just like you
always do. You ran away from the monastery, you get laid, you ran away from
the real world when getting laid didn’t work out so good. Now things aren’t
working out again, so off you go.
Augustine: Why is it so difficult
for you to believe in God?
House: What I have difficulty with
is the whole concept of belief. Faith isn’t based on logic and experience.
Augustine: I experience God on a
daily basis, and the miracle of life all around. The miracle of birth, the
miracle of love. He is always with me.
House: Where is the miracle in
delivering a crack-addicted baby? Hmmm? And watching her mother abandon her
because she needs another score. The miracle of love. You’re twice as likely
to be killed by the person you love than by a stranger.
Augustine: Are you trying to talk
me out of my faith?
House: You can have all the faith
you want in spirits and the afterlife, and heaven and hell, but when it comes
to this world, don’t be an idiot. ‘Cause you can tell me you put your faith in
God to put you through the day, but when it comes time to cross the road, I
know you look both ways.
Augustine: I don’t believe He is
inside me and is going to save me. I believe He is inside me whether I live or
die.
House: Then you might as well
live. You’ve got a better shot betting on me than on Him.
Augustine: When I was 15, I was on
every kind of birth control known to man, and I still got pregnant. I blamed
God. I hated Him for ruining my life, but then I realized something. You
can’t be angry with God and not believe in him at the same time. No one can.
Not even you, Dr. House.
Cut to a hallway. Wilson meets
up with House.]
Wilson: How’d it go?
House: She has God inside her. It
would have been easier to deal with a tumor.
Wilson: Maybe she’s allergic to
God.
Cut to House walking down the
hall with the ducklings in tow.]
House: We looked everywhere for an
allergen that could be causing this reaction except one place: inside her.
Foreman: On her medical history
she didn’t mention any surgery.
House: She had one.
Cameron: Can we get her records?
What hospital was it at?
House: She didn’t have it at a
hospital. Order a full body scan.
Chase: What if she refuses?
House: Tell her I’m looking for a
miracle.
Cut to the imaging center.]
Foreman: No piercings, no
fillings, no surgical pins in the arm, no implants…
Chase: It’s clean as a whistle.
What’s House looking for? [Foreman shakes his head, and then squints at the
screen.]
Foreman: What is that?
Chase: Don’t know.
Foreman: Lock on it. Get a 3D
representation. [The image shows a piece of metal in the form of a cross.]
Cameron: Oh my God!
Cut to House, looking at the
xrays.]
House: The copper cross, a form of
birth control pulled off the market in the 80s.
Foreman: So, she’s allergic to
copper.
House: Rare, but it happens.
Chase: Wouldn’t she know she had
an IUD?
House: She had an abortion. IUD
must have been left in, embedded in the endometrial tissue where it couldn’t be
detected.
Chase: So, all we have to do is
remove the IUD –
cut to Chase talking to
Augustine]
Chase: -- and the symptoms should
subside.
Augustine: I got this IUD when I
was fifteen. It’s been more than twenty years.
Chase: Prolonged exposure to an
allergen with minimal symptoms. But at some point, all it takes is one last
contact to cause a full-blown reaction. It’s like a balloon filled with air.
One last breath, it explodes.
Augustine: The first time I got
the rash was when I was washing the copper cookware.
Chase: And all your subsequent
symptoms came from ingesting food prepared in it.
Augustine: Dr. House found his
miracle.
Chase: I doubt he’ll interpret it
that way.
Augustine: You told me your
favorite passage. Would you like to hear mine? [Chase nods]. “Celebrate and be
glad, for your brother was dead and is alive again.”
Chase: The prodigal son.
Augustine: He’ll be waiting for
you when you’re ready.
Chase: We’ll schedule your surgery
for tomorrow.
Cut to the clinic desk. House is
again throwing candies. Wilson enters and sits next to him, giving him
coffee.]
Wilson: The sixth circle of Hell.
House: Confined in a sweat box
with a bloody nose and all the tissues are soggy.
Wilson: I think that’s the
seventh.
House: Nope, seventh is –
Wilson: God, we must be fun at
parties.
House: I think we both know the
flaw in that theory.
Wilson: How’s the Sister?
House: Kidneys functioning, heart
rate is normal. You know how it is with nuns: you take out their IUDs and they
bounce right back.
Wilson: Great.
House: Told you I didn’t screw up.
Wilson: You screwed up.
House: I gave her 0.1 cc of
epinephrine.
Wilson: Yeah, and if Cuddy hadn’t
taken you off the case, you would have killed her. [small pause] You want to
come over for Christmas dinner?
House: You’re Jewish.
Wilson: Yeah, Hanukkah dinner.
What do you care? It’s food, it’s people.
House: No thanks.
Wilson: Maybe I’ll come to your
place.
House: Your wife doesn’t mind
being alone at Christmas?
Wilson: I’m a doctor, she’s used
to being alone. [House raises his eyebrows.] I don’t want to talk about it.
House: [quickly] Neither do I.
[Cuddy enters.]
Cuddy: You did good with the nun.
Congratulations.
House: Thank you.
Cuddy: Merry Christmas, Dr.
House. Dr. Wilson. [She leaves.]
Wilson: Good night. That was
sweet.
End montage. “Silent Night” is
being played on the piano. Starts with House and Wilson, sitting in House’s
place eating Chinese food, talking and laughing. Cuts to the hospital
Christmas party for the sick kids. Foreman is dressed up as Santa. Cuts to
House, now alone, playing the piano. Cuts to Cameron, in her office with a
Christmas present. Snow is falling in the background. Cuts to Cuddy, who is
tending a patient. Back to House on the piano. Cuts to the hospital Chapel
service. The four nuns we’ve met are present. Chase is watching through the
windows. Final shot of House at the piano.]
[Over and out. –
Marisol]