HOUSE, M.D.
2X18 - SLEEPING DOGS LIE
Original Airdate (FOX): 04/APR/2006
WRITTEN BY SARA HESS
DIRECTED BY GREG YAITANES
TRANSCRIPT PROVIDED BY TWIZ TV.COM
Originally transcribed by KAT_ACLYSM (katt_aclysm@hotmail.com).
POSTED WITH PERMISSION FROM HOUSE: TRANSCRIPTS AND MORE!
==========================
DISCLAIMER:
==========================
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==========================
[Episode opens with
sound of dripping tap. Camera pans in on the exceedingly vexed face of the
Patient of the Week, Hannah. Camera pans up to reveal culprit dripping tap
into sink. Camera whooshes out of kitchen, pans up the stairs of the house,
moving all the way back into the teenager's bedroom. Sound of dripping tap magnifies.][Dramatic flash as the
camera zooms back in on the vexed face of the teenager, and then
there is a rapid transition of time on the clock beside the bed to signify the
passing of many hours. Hannah is awake this entire time, and the camera focuses
on her at short intervals, continuing to show her frustration at
being awake.]
[Hannah sits up in bed,
and all the noises in the house and the nearby area outside seem to
magnify, intensifying her frustration. The dripping tap noise becomes faster,
as does the hissing noise of the radiator, the ticking clock downstairs, and
the noise of a passing car is heard outside, magnified greatly.]
Max: Hannah, you OK?
Hannah: [quietly
panting]
Max: Still can't sleep?
Hannah: [very slightly
shakes her head] I'm fine.
Max: [sighs] Can I do
anything to help you?
Hannah: Just go back to
sleep, I'm going to go get a glass of wine.
Max: I can keep you
company.
Hannah: You have work
in the morning.
Max: Are you sure? You
don't want me to?
Hannah: I'll be right
back. Just sleep.
[Hannah stands, exits
the bedroom. The camera flicks in a mild psychotic fashion.]
---
[Camera focuses on the
alarm clock, now showing that it is 8:00AM. Max wakens from sleep,
discovers that Hannah is not beside her in bed. Max sits up and then walks down
the stairs to investigate.]
Max: Hannah? [Pauses,
reaches the bottom of the stairs, sees Hannah on the floor in the room
adjacent to the one she moves into] Hannah?
[Max moves over to
Hannah. Camera pans in on Hannah to reveal that she is slowly and repeatedly
thumping her head against the wall. Max rushes over to her, crouches down in
front of her. Max raises Hannah's chin up to inspect her. Notices empty pill
bottle on the floor nearby, which camera quickly pans in to reveal the
empty pill's label, "Sleeping Capsules". Max quickly picks up the bottle.]
Max: [desperate tone]
What did you do?
Hannah: I just wanted
to sleep.
Max: I'm calling an
ambulance...
Hannah: [slowly tilts
her face towards the camera, revealing blood on the wall, and a trickle of
blood which is running down her left cheek.]
[Black out.]
----
[Cue to House MD
Opening Sequence with Theme Song "Teardrop" by Massive Attack]
----
[Camera pans up in an
aerial shot on House, to reveal that he is lying on an examination table in
exam room one, a medical journal covering his face. He is fast asleep and
snoring. Sound of the door opening. Then a 'click' as the light switch is turned on.]
Cuddy: [stands in the
doorway for a brief moment, then loudly shuts the door.]
House: [jumps, startled
from sleep, takes the Medical Journal off his face.]
Cuddy: You've seen one
patient in the last two hours.
House: Complicated
case. I'm a night owl - Wilson's an early bird. We're different species.
Cuddy: Move him into
his own cage.
House: Who'll clean the
droppings from mine? [Rolls over, turning his back to her]
Cuddy: [walks to the
other side of the examination bed, hands him the file] Twenty-five year old
female with sleep issues.
House: I'm guessing
she's... what's the medical term? Upset. These 25-year-old females are
usually completely rational. They're rocks. Really. [glances at the file momentarily]
Eh... my theory seems to be supported by the fact that she
swallowed a bottle of sleeping pills. Get her a shrink. And I need some
shut-eye.
Cuddy: She's a little
bit more than upset. She hasn't slept in ten days.
House: She's lying.
Without REM sleep, your neurons stop regenerating - the brains shut down lobe
by lobe. She'd be insane after five days - dead by ten.
Cuddy: Give me a little
credit, I know what gets you off. She took the pills to sleep, not to kill
herself.
House: Clever alibi.
Cuddy: They didn't
work. She stayed awake, even though she downed the whole bottle.
House: [seems
intrigued, takes the file from Cuddy]
Cuddy: And the longest
anyone has ever survived without sleep is eleven days. Which gives you about
22 hours. [exits]
House: [sits up
properly and reads the file]
-------
[Cue to House's office
area.]
Cameron: [slaps a
medical journal down on the table] You stole my article.
Foreman: I wouldn't do
that.
Chase: [gives Foreman a
wary glance]
Cameron: I wrote up the
case where we induced hypothermic cardiac arrest in the terminal cancer
girl.
Foreman: I wrote my
own, I didn't steal yours.
Cameron: You knew I was
writing one, you gave me notes!
House: Got a case. It
can wait, you two finish. [To Chase] Five bucks says someone loses an eye.
Cameron: [snatches the
file from House and begins reading through it]
House: Fine. You're
only putting off the inevitable. Twenty five year old female, hasn't slept
for ten days.
Cameron: I assume the
ER tried giving her some sedatives, we should up the dosage.
Foreman: Sedation isn't
the same as sleep.
Cameron: Thanks for
your insight. For someone who hasn't slept in ten days, sedation is a great
start.
Foreman: Sleep is an
active process. Reboots the system, restores the brain, sedatives don't---
Cameron: [interrupts
him] The brain is being stressed, we need to relieve that. [To House] You've
had my article on your desk for the last four months!
House: I'm a very slow
reader. No fever, no white count, means no infection.
Chase: Schizophrenia?
House: No delusions.
Cameron: You read his!
House: I signed it, I
didn't read it. [pauses] Aside from the sleeping pills, tox-screen was
clean. No cocaine, meth, amphetamines, or diet pills.
Chase: Any medications
she'd had recently are steroids for poison ivy, and ibuprofen for a knee
she hurt skiing.
Cameron: Nothing that
would cause sleep disturbances. When did you get his article?
House: Ahh.. about
three weeks ago. Let's go back to the beginning.
Chase: How far back?
House: Genesis. God
said, let there be light.
Foreman: Sleep is
initially controlled by external light cues.
Chase: And if the brain
can't interpret those cues..
Cameron: Optic-nerve
disease.
House: I'm sensing
another article.
Cameron: I'll go run
the tests.
--------
[Cue to examination
area. Patient is seated on one side of the eye examination equipment,
Cameron on the other.]
Cameron: I'm injecting
a dye which will allow us to look at your retina and your optic nerve.
Hannah: Everything's
kinda blurry.
Cameron: Normal because
of the dye. It's going to be that way the next few hours.
[Foreman opens the
door, enters]
Foreman: Need a hand?
Cameron: No.
Foreman: [amused sigh]
We're never going to work together again?
Cameron: I just don't
see the need to make you feel better by forgiving you.
Foreman: [sighs] I
wasn't asking for forgiveness, I was asking if you needed help.
Cameron: It's
unprofessional to be talking about this in front of a patient. Maybe that doesn't
matter to you, but...
Foreman: It doesn't
matter. She's not listening.
Cameron: [glances at
Hannah] She's asleep.
Foreman: Normal stage
one brain waves.
Cameron: You mean
she's... better?
Hannah: [opens her eyes
again] It's still blurry.
Foreman: You.. fell
asleep.
Hannah: No I didn't.
[Both Cameron and
Foreman look rather stunned]
----------------------------
[Cue to hospital
cafeteria area.]
House: [takes some
vicodin out the pill bottle he had in his pocket and places it inside of a
folded napkin]
Foreman: Negative for
optic nerve disease.
House: But she sleeps.
Foreman: For like 10
seconds. Maximum, one minute. We also checked the ocular pressure. It's
normal.
House: [begins loudly
crushing the vicodin folded inside of the napkin with the back handle of his
cane] And she doesn't know she sleeps.
Foreman: The brain is
often unaware of stage one sleep. CT showed no tumors, no clots, no seizure
disorders.
House: [unfolds the
napkin and sprinkles the crushed vicodin over his food] So.. she sleeps, she
just can't stay asleep.
Foreman: You're...
going somewhere with this?
House: You know what
keeps me awake at night? Monsters in the closet.
Foreman: [laughs]
There's no monster in the closet, we looked.
House: Well, it's
certainly not showing up on the scans. [pauses] Where's Cameron?
Foreman: She felt I
could deliver the news on my own.
House: Oh, this is
going to work out great.
Foreman: [silently
smirks]
House: [wipes his hands
off on the napkin] Come on.
[House and Foreman exit
the cafeteria area]
-------------------------
[Cut to Princeton Plainsboro
Hospital hallways]
House: If you two guys
can't play nice together, I'm taking away your toys. I don't care whose
fault this is.
Cameron: If YOU
hadn't---
House: [interrupts her]
I especially don't care if it's my fault. [pauses] Whatever this woman
has, it's not showing up on our tests, which means she's sick... just not sick
enough for us to see it.
Chase: [amused] You
want us to make her sicker?
House: Yes. I want to
stress her body. Specifically her brain. Keep her awake.
Cameron: But probably
even with the few minutes of sleep she does have, its torture.
House: So is cutting
people with knives. But you can totally get away with that if you have a
doctor coat on.
Foreman: House, those
few seconds of sleep are maybe the only reason she's still alive.
House: The more
symptoms we can force out of her, the more tests we can do, the more tests we do,
the more information we get, the quicker we make a diagnosis. [pauses] See
how much more fun it is when you guys get along? [points to Cameron and
Foreman] You two, take the first four hours.
[House exits into his
office. Cameron, Chase, and Foreman walk in the opposite direction down
the hall]
-----------------------
[Cut to Hannah's
patient room]
Hannah: [is lying in
her bed, her head leaning forward]
Foreman: Hannah?
[silence]
Foreman: [louder]
Hannah.
Hannah: [jolts awake]
Foreman: You fell
asleep.
Hannah: No I didn't.
Cameron: Your brain
doesn't remember, it was just a few seconds.
Max: Is this really necessary?
Foreman: The sooner we
find out what's wrong, the sooner she can get a real night's rest.
Cameron: Hannah?
[pauses, lightly shakes her] Hannah? Hannah.
Foreman: [rolls his
eyes, sighs, moves over, pokes Hannah's thumb with a needle]
Hannah: [jolts awake
once more, wincing in pain] Ow... what did you do that for?
Foreman: You fell
asleep again.
Hannah: No I didn't.
Cameron: We're sorry.
Foreman: We have to do
this.
Cameron: [moves him
away from the patient, then speaks in a lower voice] You don't have to be cruel.
Foreman: [amused sigh]
You know what happens when you're nice. Nothing.
Cameron: That's how you
define nice? Not stealing?
Max: [desperately]
Doctors?
Hannah: [has her head
relaxed and forward once again]
Foreman: She fall
asleep again?
Max: [points to the
area of the bed]
[Foreman and Cameron
become intrigued. Camera is cued to the lower bed, where there is a large
patch of blood on the sheets. The sheet is raised to reveal more bloodstain
on the bed, coming from the underside area of Hannah's lower half]
-------------------------------
[Scene change to
House's office. Area is completely dark, the lights are all off. House is seated at
his desk, leaning back in his chair, his feet up on his table. He is asleep
and snoring.]
[Sound of footsteps
moving up the hallway. Cameron pushes the glass door open, turns on the
lights. House wakes up, wincing at the light.]
Cameron: We've got
rectal bleeding.
House: What, all of
you? [moves his feet off the table and sits in his chair properly] So the
monster is peeking out from under the bed. Which either means she has a
clotting disorder, or she has a tumor in her colon.
Chase: We'll do a
colonoscopy.
House: Who's keeping
her awake now?
Foreman: I figured once
we found another symptom, it really didn't matter.
Cameron:
[sarcastically] Yeah, he's got all the ideas.
House: [stern] Who is
with her?
Chase: Her partner is
donating blood, so she's with the nurse.
House: Probably singing
her lullabies. [pops open his vicodin bottle] I want her awake.
Chase: You have to
sedate a patient to do a colonoscopy.
House: Why? Just
because of the pain? [places the pill in his mouth] If you find a tumor in her
colon, you can knock her out. If you don't - she stays awake.
[Foreman, Cameron and
Chase look rather bothered at this, but exit]
-------------------
[Cut to examination
room, colonoscopy equipment is in the room. Chase is positioned behind
Hannah, whom is lying on her side with her back to him, Cameron is beside him.
Hannah is flinching and making loud pained noises]
Hannah: [groans] It
hurts!
Max: Can't you hurry?
Chase: Trust me, you
don't want me to hurry.
Hannah: [groans louder]
God, you're killing me!
Max: [smiles at her]
Hold my hand.
Cameron: Keep breathing
nice and steady. [pauses] How am I supposed to work with him?
Chase: Maybe.. we
shouldn't be talking about this right now?
Cameron: You think I'm
overreacting?
Chase: [sighs] Um.. I
need you to relax your anus.
Hannah: [continues her
moaning and groaning noises]
Max: We're not here.
We're skiing. It's thanksgiving,
Hannah: You really want
me to think about killing myself on a snowboard?
Max: Come on. You never
fell.
Hannah: [buries her
head in the blankets and makes a loud moan in torment]
Max: You were awesome.
Cameron: Is that what
you told him - I'm hysterical and I need to relax my anus?
Chase: I told him...
how many cases do we work up in a year? They're all weird, he could have
written up any one of them.
[Cue camera to Hannah's
face. A large amount of blood begins coming out of her nose]
Max: She's bleeding.
[Cameron immediately
rushes to her side of the bed to help]
Hannah: I can't
breathe, I can't breathe.
Chase: Hold on.
[Cameron pinches the bridge
of Hannah's nose while Chase continues the colonoscopy.]
[Black out.]
--------------
[Cue to House's office
area.]
Foreman: We prescribed
coagulants to control the bleed, and started transfusing two units
of whole blood.
Cameron: Pathology from
the rectal bleed showed traces of nasal epithelium.
Foreman: So the blood
bleed is just a nosebleed.
Cameron: That much blood
is not a 'just a' anything.
House: When two people
fight this much - you know what it means.
Foreman: It's gotta be
a massive sinus hemorrhage, that was draining down her throat and out the
back.
Cameron: The question
isn't what, it's why.
House: Oh, get a room.
Foreman: Rat poison
mixed with some sort of neurogenic toxin can cause bleeding and sleep
disturbances.
Cameron: Do you have a
specific type of neurogenic toxin in mind, or should we just start running a
thousand different tox-screens?
House: Just pretend I'm
not here. I'll be reading.
Foreman: It also could
be some kind of coagulopathy.
Cameron: Or it could be
us, do you have any idea what it feels like to have a six-foot long hose
shoved into your large intestine?
House: No. But I now
have a much greater respect for whichever basketball player you dated in
college.
Cameron: [sighs] We've
basically been torturing this girl for the last eight hours.
Foreman: We've been
poking her foot, not punching her face.
Cameron: Extreme stress
can cause high blood pressure, which can cause bleeding.
Foreman: Wouldn't keep
her awake for ten days.
House: What if the
poison ivy wasn't poison ivy. She got the rash that was diagnosed as poison ivy
around the same time the insomnia started. Rash plus nosebleed, plus sleep
disturbance equals Wegener's Granulomatosis. Start cortical steroid
treatment.
Foreman: The poison ivy
treatment was steroids.
{House: Much lower
dosage. Get her back on the juice, triple the dose. Get a cianga, and an upper
airway biopsy to confirm the wegener's.}
[Cameron and Foreman
get up to leave the room. Foreman opens the door and motions for Cameron to
go out before him. Cameron gives him a weird glance before exiting, Foreman
then turns and shrugs back at House, who raises his eyebrows in response.]
----------------
[Cut to Exam room one. House
enters.]
Mandarin Woman: [speaks
in Mandarin to her daughter, whom is standing beside her.]
Daughter: She has a... menstrual
problems. They're really bad, the pain keeps her in bed all
day, plus, she's super depressed.
House: [pulls up a
chair with his cane] She said 'super depressed'?
Mandarin Woman:
[continues to speak in Mandarin]
Daughter: She heard
that birth control pills can make her feel better.
House: [sighs] She
wants birth control pills for her PMS.
Daughter: I guess.
House: Judging by the
redness around your mom's nostrils and the tissue she's got conveniently
stashed in her wrist, I'd say her problem is more likely a URI than PMS.
Daughter: URI?
House: Upper
respiratory infection. A cold.
Daughter: I don't think
so...
House: I also think
she's got a problem with SAC.
Daughter: SAC?
House: [winks at her]
Thanks for playing. Stupid American child. If you want the pill, all you have
to do is walk into any health clinic in Jersey alone and ask for it.
Daughter: [sighs]
House: What exactly was
your plan? [clicks his pen and begins writing a prescription] You were
going to exchange the birth control pills for some over the counter
decongestants in the hopes that your mom's cold lasts for another six years?
Daughter: No.
House: [pulls off the
prescription paper and hands it over]
Daughter: That for a
cold?
House: No. That's for
your ovaries. I assume you haven't had a stroke, have you ever had a blood
clot?
Daughter: No.
House: Super. In three
months when you need a refill, take a bus to a free clinic. Don't wait
around hoping for mom to get another sniffle. [stands upright once more, then
leans closer to the Mandarin mother] Not the sharpest chopstick in
the drawer, is she?
Mandarin Woman:
[happily thanks him in Mandarin]
[House exits the exam
room, Cameron is waiting outside the door for him.]
Cameron: Is this just
one of your experiments? You just wanted to see how I'd react to being
screwed over by Foreman?
House: [shuts the exam
room door] Nice idea, but no. This was just good old-fashioned laziness.
Gotta hand it to Foreman though, he knew that you were a suck up and I
don't give a crap. He successfully exploited us both.
Cameron: Right. We're
both victims. A simple heads up, that's all I needed. You know, between your
incredibly witty remarks about anal sex and Cuddy's breasts, you could have
tipped me off.
House: Then I'd have
Foreman pissed at me. And as annoying as you can be, at least I know you're not
going to pop a cap in my ass. Witty, huh?
Cameron: [sighs, starts
to walk away]
House: You on the other
hand, continue to be flabbergasted every time someone actually acts
like a human being. Foreman did what he did because it worked out best that
way for him. That's what everyone does.
Cameron: That is not
the definition of being human. That's the definition of being an ass.
--------------
[Cut to patient's
room.]
Chase: This will numb
you up. [sprays an anesthetic spray at the back of Hannah's throat] And
this will keep your tongue out of the way. [places a ] Don't worry, you
shouldn't feel anything except for a slight plying.
Foreman: So you think I
was out of line?
Chase: That article was
going to sit on House's desk for the next six years.
Foreman: I could have
told her.
Chase: You could have
written it for her too. She knows House as well as any of us. She should have
known she was waiting for him to do something he was never going to do.
Hannah: [her eyes begin
rapidly moving left to right]
Foreman: [watches her]
Chase?
Chase: [also turns his
attention to the female] Hannah? Still with
us?
Max: What's wrong with her eyes?
Foreman: Looks like REM.
Max: What's that?
Chase: Rapid Eye Movements. It's
what your eyes do when you're sleeping.
Max: But she's awake.
Foreman: Hannah. [pause] Hannah
can you hear me?
Hannah: [comes out of her daze]
Yeah of course.
----------------------------------
[Cut to House's office area)
House: Was she sitting up or lying
down?
Chase: Sitting up.
House: Then it wasn't REM.
Cameron: But Chase says her eyes
are moving the exact way.
House: Did you start her on the
steroids?
Chase: Not yet, we were still
doing the---
House: Then she wasn't sleeping.
Chase: How do you know?
{House: Because we haven't done
anything yet. She may be able to sleep with her eyes open, but unless you also
discover that she's got two extra teats in the hooves of her feet, there's
no way she'd be able to retain enough muscle tensity during REM sleep to
sit upright. It's a movement disorder. Which rules out Wegener's. Where's
Foreman?}
Chase: Keeping her awake.
House: Good.
Chase: Rabies could cause muscle
spasms, malaise, anxiety, and wakefulness.
Cameron: I don't think she'd
forget being bitten by a crazed animal.
Chase: She could have been exposed
to an open wound.
House: Did she have a dog?
Cameron: For less than a week. She
had an allergic reaction, so they had to give it away.
Chase: Allergies.
Cameron: Animal allergies seems
unlikely, but its possible that---
House: When?
Cameron When what?
House: When did she get rid of the
dog?
Cameron: About a month ago. Her
girlfriend gave it to her for her birthday.
House: Well then it's not
allergies. She's just leaving her girlfriend.
Cameron: You've... spoke to the
dog?
House: If her birthday was a month
ago, she would still be on steroids for the poison ivy. And those meds
would have suppressed any reaction she might have had to the dog, which means
she lied about being allergic. The dog's a commitment. You pretend to be
allergic, because you don't want to tell your girlfriend that you're not
planning on being around that long. So I think we can move onto options other than
allergies.
Chase: We should still do a
scratch test. If she's allergic to one thing---
House: She is not allergic.
Cameron: Okay. Well, we could either
base the diagnosis on your admittedly keen understanding of lesbian
relationships, or, we could do a scratch test.
House: Do a scratch test.
----------------------
[Cue to patient's room]
Cameron: You still feeling a lot
of blood in your throat?
Hannah: No, it's actually getting
a little better.
Cameron: Good. Maybe things are
just starting to improve on their own. Just a few more. You want some water to
wash out your mouth?
Hannah: No, it's OK.
Max: Come on, that can't taste
good. I'm going to get you a soda. It's OK, isn't it?
Cameron: You and Max have got a
very nice relationship.
Hannah: Yeah.
Cameron: She's very supportive.
Hannah: Uh-huh.
Cameron: When Max got you the dog,
did you lie about having an allergic reaction?
Hannah: No. Why?
Cameron: If you have pre-existing
conditions, it's important we know. But, if you don't, it's just as
important. If I'm wasting my time doing---
Hannah: [speaks over the top of
her] You're not going to tell her, are you?
Cameron: It's none of my business.
Hannah: She's a good person. We've
just been together so long, I... [pauses] I'm tired of her. Sounds terrible,
doesn't it?
Cameron: I guess it happens
sometimes.
Hannah: My back hurts.
Cameron: Hannah, can you turn
over?
Max: What's wrong?
Cameron: I'm not sure.
[Cameron pulls up Hannah's shirt
to reveal a dark red patch of skin)
Hannah: Oh my god.
------------------------
[Cue to House's office.)
Cameron: She has massive internal
bleeding.
Chase: Did she have access to
aspirin?
Cameron: She'd have to take a hell
of a lot.
Chase: Why not? Considering her
current mental state.
House: What about her mental
state?
Cameron: [sighs] You... were right
about her wanting to break up.
House: It just means I was right,
doesn't mean she's suicidal.
Chase: A bottle of pills is what
landed her here in the first place.
House: Sleeping pills. God knows
why she'd want them. What else can cause sleep disorder, and internal
bleeding?
Cameron: Drugs or alcohol can mess
with the sleeping, and compromise the liver.
House: What are you doing here?
Who's keeping her awake?
Foreman: It doesn't matter. Liver
function tests are through the sky. The liver's not compromised, it's
dead. She doesn't need a diagnosis, she needs a new liver.
House: She's not getting a new
liver unless we can figure out what's wrong with her.
Foreman: Test for cirrhosis,
twelve hours. Test for hepatitis, eight, she's not going to last another six.
House: So your advice is we just
give up?
Foreman: My advice is that we
narrow our focus to conditions that we can diagnose, treat and cure in less
than six hours. And there's nothing on that list.
House: The girlfriend donated
blood, right?
Chase: Yeah. So?
House: That means they're the same
type.
Cameron: You can't ask the person
she's about to dump to donate half her liver!
House: Does seem tacky, doesn't
it.
--------------------------
[Cue to patient's room]
House: I'm Doctor House. I'm in
charge of your case.
Max: What's going on? How come no
one is keeping her awake any more?
House: You're in acute liver
failure. We can continue the transfusions and the lactulose. But it's only a
stopgap. There's really nothing we can do to stop the toxins from building up
in your bloodstream. Which means that in a few hours you will lapse into a
coma. And you won't wake up. I'm sorry.
Max: That's it? You're giving up?
You're... not going to try to figure out what's doing this to her?
House: Well even with the right
diagnosis, any treatment is going to take longer than the time she has left.
Max: If it's her liver, can't she
get a transplant?
House: Wouldn't work without a
diagnosis. Whatever killed the first liver will do the same to the second.
Max: But it... but it would give
you move time to make the diagnosis, to get her better.
House: Well, it may give us an
extra day or two, but, no procurement agency is going to let a liver go to a
patient with an undiagnosed pre-existing---
Max: Hannah and I have the same
blood type. Couldn't I be the donor?
House: It is medically possible
for us to take a part of your---
Max: Please, I don't care about
the risks!
House: [To Hannah] You're very
lucky to have such a devoted partner.
---------------
[Cue to House's office area)
House: I just bought us 36 hours.
Differential diagnosis - which monster eats your liver, screws up your
sleep, and causes bleeding?
Cameron: Does Max know Hannah
plans to leave her?
House: Didn't come up, so I guess,
no.
Cameron: If she knew, there's no
way she'd go through with this.
House: And if you didn't have a
pathological need to create a close personal relationship with every dying
person you meet, we would be blissfully ignorant of any ethical dilemmas
and might actually be able to concentrate on the differential.
Chase: Scratch test was negative.
Foreman: It's rare, but any of the
hepatitis viruses can cause sleep disturbances, and liver failure.
Chase: Nope, PCRs were normal.
Cameron: We have an ethical
dilemma.
House: No we don't. Continue.
Chase: What about splenic cancer,
or non-hotchkins lymphoma? She's the right age.
House: It would explain the
bleeding. Maybe the liver failure.
Cameron: We're withholding
information relevant to her decision to risk her life. How is that not an ethical
dilemma?
House: It's not medical
information.
Cameron: Who cares?
House: The AMA.
Foreman: Wilson's disease could
explain the liver, and neurological symptoms. It also causes bleeding
disorders.
Chase: No kaiser-fleischer rings
in her eyes.
House: The rings don't have to be
there if there's neurological symptoms.
Cameron: This is immoral.
House: Look, let's say you're
right. We tell, she changes her mind, our patient dies. How is that moral?
[pauses] What else?
Foreman: Poison mushrooms can
cause liver failure, sleep disturbances, and internal bleeding.
Chase: She's not shrooming, she's
a sports nut.
House: Right. Skiers never party.
Cameron: She's doing this out of
love, and Max doesn't know---
House: It's only moral to save a
person if they love you? That's kind of a selfish way of looking at life. []
I like Wilson's disease, like cancer, love mushrooms.
Foreman: Yeah, but we don't have
the time to test for any of these. Before she can get the transplant, we
need to do about 80 procedures.
{House: So do those tests, and my
tests at the same time. Use the pantalope to look for cancer, and Wilson's
while you endoscope her bile ducts and scrape her stomach for mushroom
spores. One of you CT her liver, While the other two check protein CA125, and
CA19.5. Oh yeah, if anyone says anything to Max, they're fired.}
Cameron: We have to.
House: We have to not. Because
she's not our patient.
Cameron: She's getting surgery,
she's someone's patient.
----------------------
[Cue to hospital hallways.]
House: Need a little help.
Cuddy: Inexplicable rash on a
patient's scrotum you need me to look at?
House: 27 year old female wants to
donate half her liver to her dying girlfriend.
Cuddy: That's very generous. This
the sleepless girl? What's she got?
House: Liver failure.
Cuddy: I suppose I should have
figured that out when you said she needed a new liver.
Cuddy: You don't have a diagnosis.
House: The transplant buys me
time.
Cuddy: Let's just skip the part
where I say this is insane.
House: It was her idea.
Cuddy: If she wants to be an
idiot, it's her call. You don't need me. Have one of your team walk you through
the process.
House: The donor and the donee
sort of have opposing interests, right? Can't really advise them both.
Cuddy: You're concerned about the
ethics of this? What's going on? What do you know?
House: Nothing medically relevant.
Cuddy: But you know something. And
it is relevant.
House: If I can't tell her, I
can't really tell you, can I? And if you're advising her.
Cuddy: I'm assuming this
information is in the medical file.
House: My patient's confidential
file.
Cuddy: This hospital's file.
House: You can either satisfy your
curiousity, or remain ignorant, do nothing ethically wrong and my
patient doesn't die in three hours.
---------------------
[Cue to examination area with
Cuddy and Max]
Cuddy: These tests and the
counseling normally happen over weeks, sometimes months.
Max: It's okay.
Cuddy: The most important part
we're skipping is time. Time for you to change your mind.
Max: I don't want to change my
mind.
Cuddy: Not now, but with time and
perspective, maybe we learn things---
Max: We had the time when we take
the time, but we don't. So can you get this over with?
Cuddy: Either I sign off on this,
or it doesn't happen. So I need you to listen to me. Because there's a
chance that you will die on that operating table.
Max: I just want me and Hannah to
be able to lie in bed together. As old ladies. Compare scars.
Cuddy: I need you to lie on your
side. And hold your knees.
------------------
[Cue to examination area with
Cameron and Hannah)
Cameron: I'm going to check for
vascular abnormalities that can prevent us from doing the transplant. At the
same time, I'm also checking for mushroom spores to see if that's the
underlying---
Hannah: I don't do mushrooms.
Cameron: If you lie about your
love life, maybe you lie about drugs. Open.
[Cameron inserts the endoscopy
equipment into Hannah's throat)
Cameron: Aren't you at all
concerned about what Max is going through right now? Shoving a tube up her rectum.
Then they're going to swab her stomach just like I'm doing. It's going to
hurt just like this hurts, which is nothing at all like the risk she's
taking on the table.
[Cameron removes the endoscopy
equipment from Hannah's throat once again)
Cameron: You don't love her, do
you.
Hannah: I'm not leaving her
because I don't----
Cameron: I'm not talking about the
leaving, I'm talking about this. If you care for her at all, you won't let
her do this blind.
Hannah: You'd really tell?
Cameron: Yeah.
Hannah: You'd die?
--------------------------------------
[Cue to House's office area. The
lights in the room are off. Wilson enters, and drops a medical journal onto
the floor, next to House, whom is sleeping on the floor)
Wilson: I take it you've seen
that?
House: Seen it, digested it,
watched it blow up my entire department.
Wilson: You read Cameron's
version?
House: I didn't read either.
Wilson: It was good.
House: Better than Foreman's?
Wilson: Maybe. He was more
analytical about the diagnostic procedures. She concentrated more on the ethical
dilemmas of informed consent. How any patient can really be informed
without a medical degree.
House: The same old party lines.
Wilson: Foreman should have told
her.
House: Ah, shoulda, woulda,
coulda.
Wilson: If you allow this sort of
thing in your department, you're basically saying it's OK.
House: No, I'm saying that I don't
care what they do as long as my life isn't interrupted by pointless
conversations like this one.
Wilson: They won't trust each
other, and they won't trust you.
House: They shouldn't.
Wilson: Deception like this is
just one step removed from actively sabotaging one other. Then what
would you do?
House: I could be the kindest
gentlest boss in the world, and Foreman still would have done what he did
because that's who he is. We can only hope that Cameron has learned something.
Wilson: Right. Because you're all
about the teaching.
House: Our children are the
future.
--------------------------
[Cue to Hospital hallway]
Foreman: Hey! Cuddy cleared Max
for surgery. She's OK to go.
House: How's our patient?
Foreman: She's also cleared.
House: I don't care about the
prep, what about the diagnostic tests?
Foreman: It looks negative for
Wilson's disease, we'll know for sure in an hour.
Chase: Blood proteins are normal,
it's not---
House: Where's Cameron?
Chase: Taking a sample of the bile
duct.
House: Surgery is supposed to
start in about 15 minutes.
Chase: She had a chance to get one
last---
House: Hannah and Max will be in
the same room.
Foreman: You wanted us to do as
much as we can before---
House: Both awake. With Cameron.
--------------------------
[Cue to Operating Theater area]
Cameron: Maybe we should give
these two a minute before the surgery.
Max: You ready, honey?
Hannah: Max.
Max: It's okay. I'm right here.
Hannah: I need you to know
something.
Max: I know. I love you too.
[House shoves the door open with a
dramatic bang)
Hannah: How should I say this...
House: Good lord.
Max: You can tell me anything.
House: She hasn't slept in eleven
days. Are you trying to torture her?
[House feeds anesthetic into
Hannah's IV line which promptly makes her drift off to sleep)
House: Ding ding, let's go.
-----
House: I told you---
Cameron: I didn't say a word to
Max.
House: This is exactly why you got
screwed with Foreman. You're looking for people to do the right thing.
Cameron: She hasn't slept, her
judgment is compromised due to inactivity in her pre-frontal cortex.
House: Oh, she could have the best
pre-frontal cortex in the history of mankind, but given the choice of
life versus death, those bad bad people are going to choose life.
Cameron: Then why did you sedate
her? If she wasn't going to tell, if she was never going to do the right
thing, why bother knocking her out? [pause] This isn't about them, if she
talks, if she does the decent thing, then you don't get to solve your puzzle,
your game's over, you lose.
House: Yeah. I want to save her.
I'm morally bankrupt.
----------------
[Camera pans over both tables in
the operating theater. The surgery is in progress. Camera pans up to
observation room above the operating theater, where Cameron and Cuddy are
watching.]
Cuddy: How's it going?
Cameron: They're about to remove
Hannah's liver.
[Camera pans back down to the
op-theater)
Surgeon#1: All right. I'm good to
go. We can start removing Max's liver.
Cuddy: You want to let me in on
the big secret between these two?
Cameron: Did you read Foreman's
article?
Cuddy: It was good.
Cameron: He basically stole it
from me.
Cuddy: So?
Cameron: You're on his side?
Cuddy: Sides? No, this isn't dodge
ball.
Cameron: What am I supposed to do?
Just sit back and take it?
Cuddy: No, write another article.
Kick ass until you're sitting behind some big expensive desk and someone
from Johns Hopkins's calls and says 'We're thinking about hiring Eric Foreman
as our head of Neurology'. And you can say whatever you want.
Cameron: [scoffs] Lovely. Revenge
as motive for success.
Cuddy: Ah, it doesn't have to be a
motive. But it sure tastes good.
Surgeon#1: She's in VF, I've got
no pulse.
Surgeon#2: She's arresting.
Surgeon#2: Paddles.
House: Oh! I am so relieved you
two are here. Without you looking at me, they're playing foosball down
there.
Cameron: Max's heart stopped.
House: Your patient is on the other
side. Now get yourself upstairs and figure out what Hannah has or Max
has risked her life for nothing.
Surgeon: Charging... clear. You're
okay.
------------------
[Cue to House's office area.]
Chase: Max's cardiac arrest was
caused by hypoxia from hypoventilation. They restarted her heart and the right
lobe of her liver was successfully transplanted into Hannah.
House: Now, where were we before
we were so rudely interrupted by the liver transplant?
Foreman: {Dopar dicarboxy was
processed normally and the serola plasma and copper levels were normal so no
Wilson's disease.}
Cameron: Gastric content was
negative for spores, so no mushroom toxicity.
House: And the initial tests were
negative for cancer.
Wilson: Which cancer were you
looking for?
House: Any of them.
Cameron: We ran blood tests for
ovarian, lung, and lymphomas.
Wilson: Not going to tell you
much. Her blood was thick after she was given immuno-suppressants. They fight
rejection, they also mess up our ability to get any clear readings.
House: Great battles kick up a lot
of dirt. Obscure the battlefields so the generals can't see what's going
on.
Wilson: So what are your orders,
General House?
House: Sound the retreat.
-----------------------------------
[Cue to Post-op patient room
area.]
Foreman: How are you feeling?
Hannah: [sighs] Is Max OK?
Foreman: She's still unconscious,
but her vitals look good. [sighs] We need to stop all the immuno-suppressant
drugs which are protecting your new liver.
Hannah: [shakes her head] But if
you stop the drugs, I'll die.
Foreman: You're dead anyway if we
don't figure out what caused all of this. By removing any outside
influences, it will help us see what's really going on with your body.
Hannah: So you did this to buy me
a couple of days, and now you're chucking them back? [pause] Will it hurt?
Foreman: As your body begins to go
into acute organ rejection, your liver will begin to swell. It will
pressure on-- [pauses] Yeah, it'll hurt. We can knock you out.
Hannah: Mmm. No. If Max wakes up,
I want to talk to her.
Foreman: [silently nods his head.]
--------------------------------
[Cue to Exam room one. The Mandarin
mother and the daughter have returned.)
House: [Opens the door and moves
inside.)
Mandarin woman: [Speaks in
Mandarin, using a flustered tone as House enters)
Daughter: She's been taking the
decongestants, but she's not getting better, She.. also says...
House: What?
Mandarin woman: [grabs House's
hand and places it on her chest.)
Daughter: Her boobs are bigger.
House: [Promptly yanks his hand
away. Looks intrigued, then places it back where it was.] Wh... how could you
get them mixed up? They come in a little wheel, they don't look anything
like decongestants.
Daughter: Oh god, the cashier put
them both in the same bag, I thought they gave her the right ones.
Mandarin woman: [Asks a question
in Mandarin)
Daughter: [Slowly responds to
her.)
House: No, you gave her the wrong
pills.
Daughter: You speak Mandarin?
House: I can count to ten and ask
to go to the bathroom and [pauses, speaks to the mother in Mandarin)
Mandarin woman: [Looks appalled)
Daughter: I'm not pregnant! We
haven't even done it yet!
Mandarin woman: [begins speaking
to her daughter in a flustered tone)
Daughter: [quickly argues back to
her mother in Mandarin)
House: Okay, I'm going to leave
you two alone now. I'm sure you've got a lot to talk about.
[House picks up his book and
leaves Exam Room one, leaving the mother and the daughter to argue and bicker
with each other.]
-------------------------
[Cue to House's office area.]
Cameron: Fever is 106, she's in
full rejection mode.
House: Is that supposed to
surprise me?
Cameron: Her white count is
normal.
House: Normal is not normal. She's
been on steroids, transplant team gave her a cocktail of
immuno-suppressants, she hasn't slept in over a week. Her white count should be in the tank.
Foreman: Looks like the problem is
some sort of infection. Probably causing hypotension, shock the liver.
Chase: We should start broad
spectrum antibiotics.
House: Yeah, you might want to add
some chicken soup. It's just as useless, but it's got chicken. We need to
know exactly what kind of infection we're dealing with, what kind of
infection causes sleep disturbance, bleeding, movement disorder, organ failure,
and abnormally normal white count.
Chase: What about tularemia?
Cameron: Chest was clear.
Tularemia doesn't cause movement disorders.
Foreman: It would if she developed
meningitis.
Cameron: There is no ulcerations
on the skin. [sighs] The bleeding, it looks more like leptospirosis.
House: Without conjunctivitis and
elevated creatinine?
Forman: What about typhoid, or
some kind of relapsing fever?
Cameron: Makes sense if we were in
the Sudan.
House: You sure she hasn't been
out of the country?
Cameron: She hasn't even been out
of the state in at least a year and neither has Max.
Foreman: Maybe she lied. You
talked to her friends? Neighbors?
Cameron: You don't know? Come on,
if you don't stay up to date on my notes, where's your next article going to
come from?
House: You talked to the dog?
Cameron: We're not as up on foreign
languages as you are.
House: [scoffs] Has the dog been
traveling?
Cameron: It came from a breeder.
House: Where?
Cameron: I don't know. A place
called Blue Barrel Kennels. They only the thing for like, two days.
House: Blue barrel is a kind of
cactus. Do you see many cacti in Jersey?
---------------------
[Cue to post-op patient's room.
House slides the door open and walks inside.]
House: Wanna see a magic trick?
[moves his hand in and pinches Hannah's nose, pretending to steal her
nose. He then shakes out his hand, feigning surprise as her 'nose' disappears]
Oh no, where'd it go, where'd it go? [Raises Hannah's left arm up] Is
it here? [searches it momentarily, then places it down again] How about
here? [raises her right arm and pulls up her sleeve, revealing a large pustule
wound] There it is. Oh, it doesn't look anything like a nose.
Cameron: That wasn't there this
morning.
[House pulls up Hannah's sleeve
completely and nods to Cameron, who turns away to take a syringe out of a
drawer. House then inserts the needle into the pustule and withdraws
completely solid-black fluid from it)
House: Give that to the lab, and
call the CDC.
Chase: And tell them what?
House: That we have a patient with
the plague.
Chase: The... black plague?
House: [nods] Looks that way.
Cameron: The plague is carried by
rodents, not dogs.
House: Where there's dogs, there's
fleas. If they hail from the southwest, then those fleas can't tell the
difference between prairie dogs and puppy dogs. A small percentage of plague
cases present with sleep disturbance. Imagine, an idyllic river of
bacteria. Okay, it's not idyllic for her, but it serves my purposes. The
steroids and the immuno-suppressants acted like a big hunk of dam across the river.
Physics 101, put a dam up in front of a raging river, the river rises. By
stopping the immuno-suppressants, we blew up the dam, and a hundred foot
wall of bacteria flooded her lymph nodes.
Foreman: We better find out where
that dog is now.
House: After you restart the
immuno-suppressants, then fill her up to the eyeballs with streptomycin,
sulfate gentamycin, and tetracycline. Use a garden hose if you've got one. Get
yourselves some prophylactic treatments as well.
Hannah: I've got the plague?
House: Don't worry, it's
treatable. Being a bitch though, nothing we can do about that.
[Hannah glares at him. House
simply exits.]
--------------------
[Cue to hospital hallway, outside
of Hannah's post-op room area.]
Cameron: You weren't in your room.
Max: The surgeon said I'd heal
faster if I walk. Got this far, needed a rest.
Cameron: What you did was crazy,
but it was pretty amazing too.
Max: Yeah. I'm a hero. [watches
Hannah through the glass from her place across the hallway] She's been
planning to leave me.
Cameron: Really?
Max: [nods] She told a friend. The
friend let it slip.
Cameron: You knew, and - you gave
up half your liver anyway?
Max: She can't leave me now.
Cameron: You really want her to
stay out of guilt - that's not going to make any of you happy.
Max: You don't know that. I love
her. I just want her to stay.
---------------------------------
[Cue to House's office area. The
lights are dimmed, Foreman is sitting in a chair and reading. Cameron slowly
approaches him]
Cameron: I don't own House's
cases. You had just as much right as I did to write it up. You should have told
me, but, I should have handled it better too.
Foreman: [settles back in his
chair]
Cameron: If we want
this not to get in the way of our friendship, I think we both have to apologies
and put it behind us.
Foreman: I like you.
Really. We have a good time working together. But ten years from now, we're
not going to be hanging out and having dinners. Maybe we'll exchange
Christmas cards, say hi, give a hug if we're at the same convention. [sighs]
We're not friends. We're colleagues. And I don't have anything to apologize
for.
[Cameron looks rather
shocked as the camera pans out of the office area. The camera shifts into the
next room and focuses on House, whom is fast asleep in his chair.]
------------
End. Roll Credits.