Frritt-Flacc
Dr. Trifulgas, a physician and the main character in Frritt-Flacc, is an eccentric and solitary man. He is cynical about the world, manipulative of others, selective about the cases he chooses to take on, and very good at his job. He might have been the inspiration for a similar character over a century later... but then again, that might have been someone else.
(HOUSE is headed for the exit of the hospital. CUDDY intercepts him at the door.)
HOUSE: You look great today.
CUDDY: Clinic. Two hours. Now.
HOUSE: But it's five o'clock. Five o'clock is time to go home.
CUDDY: You told me you'd do it today, and you're not getting out of it. (thrusts a pile of folders into his arms and strides off)
HOUSE: (hollering after her) But I didn't even make any childish and offensive analogies about your breasts! Doesn't that count for anything?
(HOUSE reluctantly limps into the clinic, shuffling through the folders, and walks into a room. An obese man is sitting on the examining table.)
HOUSE: Mr. Sutton, is it? Can't talk, difficulty breathing... why did you come here instead of the emergency room? (pause) Oh, right! Can't talk. Well, I'm guessing there's a chunk of something lodged in your throat. I'll do the ER a favor and deal with it. Take any medication?
(MR. SUTTON shakes his head.)
HOUSE: Must've been something you ate. Not that that really narrows it down. I would give you the Heimlich but, well, let's just say I'm not Stretch Armstrong.
(MR. SUTTON gives him a disbelieving glare.)
HOUSE: I'll get somebody in here to--
(MR. SUTTON suddenly starts flailing and falls off the table onto the floor.
HOUSE: That's not good. (calls out door) Hey, is there a doctor in the house? I think this guy's in trouble!
(DOCTOR #1 and several NURSES hurry in and begin CPR. The DOCTOR looks down MR. SUTTON'S throat.)
DOCTOR #1: There's nothing in there. We need to intubate. (to House) Do you know what's wrong?
HOUSE: He didn't say.
NURSE: Hurry! I can't feel a pulse!
(DOCTOR #2 arrives with a crash cart and sets to work attempting to revive MR. SUTTON.)
DOCTOR #1: What on earth happened?
HOUSE: Don't look at me, I just got here. You said there's nothing in there?
DOCTOR #2: I think he's gone.
DOCTOR #1: His throat was constricted in a weird way. It almost looked like something strangled him.
HOUSE: Huh.
DOCTOR #2: Time of death, 5:09 PM.
(FOREMAN is looking at the MRI screen.)
FOREMAN: It's an aneurysm, all right. Looks bad. We should get him to surgery soon.
CHASE: Right.
JAMES: (from inside MRI machine) Augh! Oh Christ, it hurts, please help!
(FOREMAN and CHASE hurry to get him out of the machine.)
JAMES: I'm sorry, I'm so sorry, make it stop!
FOREMAN: Ruptured. Blood pressure's dropping, come on.
(CHASE and FOREMAN get JAMES on a gurney and race him to surgery. When they get there, he's stopped making noise.)
CHASE: Somebody restart his heart right now!
(A crash cart arrives, but it's too late for JAMES.)
FOREMAN: Time of death, 10:08 AM.
(HOUSE and WILSON step off the subway, both clearly intoxicated.)
HOUSE: Wilson, don't scream.
WILSON: Why would I scream?
HOUSE: There's a body over there.
WILSON: What?
HOUSE: A body. (points)
WILSON: Oh my god.
(He runs over to the body and kneels down next to it. HOUSE hobbles after him.)
WILSON: He's already stiff.
HOUSE: Yeah, and his head isn't head-shaped anymore. No point in an ambulance.
WILSON: Call the police.
(HOUSE pulls out his cell phone.)
WILSON: He's been gone for hours, but I guess we should call it. Time of death... what time is it?
HOUSE: (checks cell phone) 10:34. Yeah, hi, we found a dead body by the train station. You want it?
WILSON: Time of death, 10:34 PM.
HOUSE: There's something we aren't seeing here. Symptoms?
CHASE: Glossolalia, delirium, extreme anxiety.
CAMERON: But no previous psych history. A totally clean record.
CHASE: No drug use either.
HOUSE: So she says. We won't know for sure until Foreman gets back.
(FOREMAN walks in)
HOUSE: Speak of the burglar. So what has our lovely... (checks chart) Brenda been smoking?
FOREMAN: Her place was clean, House. I talked to her neighbors and no one has ever suspected her of anything. Maybe it is psychological.
CAMERON: If something increased her levels of norephinephrine, that would explain the psych symptoms...
HOUSE: ...but not the glossolalia. No, there is clearly something--
(Their pagers all go off. They run into the room just as the nurses put down the paddles.)
HOUSE: Damn. Time of death, 6:21 PM.
HOUSE: Do you remember injuring your collarbone in the last few years?
PIETRO: Yes, I had an accident at the factory about six months ago. But the pain was not this bad. I could go back to work in only a few days.
HOUSE: Untreated clavicle fracture. Something dislodged the break and now it's pinching a nerve. X-ray to confirm, give him a sling, and send him home.
PIETRO: You are making me leave with this pain?
HOUSE: Don't worry. We'll give you some happy pills, too.
CAMERON: There are other treatments for pinched nerves you can look into. Physical therapy, acupuncture...
HOUSE: Yeah, stabbing yourself with needles should help distract you from that other pain.
(Later, CAMERON looks out the window and sees PIETRO leaving.)
CAMERON: I feel bad tossing him out like that. He should stay until he's healed a little.
HOUSE: He couldn't afford the hotel costs here.
(CAMERON watches PIETRO stop, stand for a moment, and then collapse. She races downstairs and out to the front of the hospital. Several people have gathered around him by the time she arrives. She kneels and feels for a pulse.)
CAMERON: Pietro? Can you hear me? Someone get help!
(Blood dribbles out of his mouth. Two nurses show up with a stretcher.)
CAMERON: I think a shard of his collarbone stabbed his internal jugular vein. Be careful moving him. His pulse is dangerously low, we need to get him to surgery.
(Inside, PIETRO's heart stops. Efforts to revive are fruitless.)
CAMERON: Time of death, 2:19 PM.
HOUSE: You said he used to work as a sailor. Has he ever been to India?
MARY: I don't think so.
HOUSE: Brazil?
MARY: Probably. I know he was on a ship that traveled along the South American coastline for a while. But that was years ago.
CHASE: House, can I speak with you a moment? (in low tones) The lesions around his right ear are getting really bad. It wouldn't take much agitation for it to break off altogether.
HOUSE: Hm. Lesions, body parts falling off... sound familiar to you?
CHASE: Hansen's disease?
HOUSE: That's some kind of fancy medical word for something, isn't it?
CHASE: (sighs) Leprosy.
HOUSE: Get him on promin, dapsone, and rifampicin. (turns to Mary) Ditto her.
MARY: What?
HOUSE: They told you it was syphilis, didn't they? Common mistake. Those injections of penicillin you've been getting aren't going to help. See that patch of red next to her ear there, Chase? (CHASE looks at MARY's left ear.) Better go get some drugs before your ear falls off too. Just your luck, that you and yours are both among the tiny percentage of the population that can even get leprosy.
MARY: Are you suggesting that I've been having sex with Alec?
HOUSE: Your husband seemed to think so. But no, you have not been proven guilty quite yet. Lepers, you see, are people just like ourselves. Some of them are good, some bad, some virgins, some sluts...
(HOUSE and CHASE's pagers go off. CHASE rushes off.)
HOUSE: Hold that thought.
(He follows CHASE down the hall. MARY stares after him, stunned. By the time he gets to ALEC's room, the machines are flatlining. FOREMAN and CAMERON are trying to revive him.)
CHASE: He had a stroke. I don't think they're going to bring him back.
HOUSE: Leprosy doesn't kill people. Not in a hospital.
CHASE: The stroke was probably a coincidence.
HOUSE: Nothing is a coincidence.
FOREMAN: Time of death, 7:13 AM.
CAMERON: (hanging up telephone) He just landed. He's on his way here.
FOREMAN: You're kidding. The Super Bowl is tomorrow.
CAMERON: Are you serious? He is not going to miss being here for his wife right now.
FOREMAN: But he's the quarterback. And it's the Super Bowl. His manager is really letting him come all the way here?
CAMERON: His wife is about to die. I doubt he consulted his manager before he booked the flight.
HOUSE: She won't die if we stop talking about football and start figuring out what's wrong with her.
CHASE: We know what's wrong with her. She has TB and she's resistant to the medications.
HOUSE: The chances of that are way too small for me to accept it. What else could be going on?
FOREMAN: There isn't anything else going on. Sometimes there's just nothing we can do.
HOUSE: That's the kind of attitude that gets people fired from their jobs as diagnosticians.
CAMERON: Foreman's right, House. She's dying. I'm going to go check on her.
HOUSE: You do that. While you're at it, see if she's developed any new symptoms we can use to figure out what's really wrong.
(CAMERON goes to the patient's room. She's straightening the covers when the patient starts crashing. She tries to resuscitate. Several people rush in to help.)
DOCTOR: Her husband is here. Is he--?
CAMERON: (curtly) Yes.
DOCTOR: Whoa.
CAMERON: I doubt he's in the mood to sign autographs. A little help here?
DOCTOR: (looking at patient) I don't think it would do any good.
CAMERON: (after a moment) Time of death, 8:36 AM.
FOREMAN: Pallid complexion, respiratory problems, lack of balance, panic, and seizures. Go.
HOUSE: Sounds like a hallucinogenic overdose to me. Speed or coke, probably. Nice of them to put the diagnosis right at the top of the page here.
FOREMAN: Stoner is the patient's last name, House. Focus.
CHASE: She tested clean. It's not drugs.
(FOREMAN's pager goes off)
FOREMAN: We better figure it out quick.
(They all go to the patient's room.)
HOUSE: (to CAMERON, in the hallway) How come his pager went off? How come my pager didn't go off? Does a demotion come with loss of pager privileges?
(In the room, FOREMAN and CHASE hold down the patient's arms as she's seizing. CAMERON injects an anticonvulsant.)
HOUSE: (waves cane in the air) Ooh! Ooh! Dr. Foreman, sir! I know this one!
FOREMAN: Damn it, House, stop messing around. If you have an idea, spit it out.
HOUSE: Snakebite. Check her legs for the bite mark and get her on antivenom.
(The patient continues seizing violently.)
CHASE: She's choking!
(CAMERON intubates, but the patient stills.)
FOREMAN: She's not breathing.
HOUSE: Right here, see? (points to puncture wound on the patient's foot)
CHASE: Yes, House, you were right. Very good. We're all proud of you. Time of death, 1:28 PM.
(CHASE and CAMERON are walking down the hall together.)
CAMERON: That was extremely unprofessional.
CHASE: Yep. Isn't it nice to be unprofessional once in a while?
CAMERON: Don't count on it happening again.
CHASE: Yeah, that's what you always say.
(A young NURSE dashes up to them.)
NURSE: Dr. Cameron, please come help! I think this patient is bleeding internally and I don't know what to do.
CHASE: Well then, let's go! (as they walk quickly) Are you new here? I don't think we've met. I'm Dr. Chase.
(CAMERON rolls her eyes. The NURSE ignores CHASE.)
NURSE: I think he's been drinking, Dr. Cameron. He's a really nasty guy, and he keeps bullying his wife and daughter into smuggling him rum. He's in here for liver problems. I was changing his medications when he went into shock and his systolic blood pressure dropped all of a sudden.
CAMERON: Don't worry, we'll figure it out.
(They reach the room at the same time as a crash cart. PETER is already unconscious. CAMERON rips open the patient's hospital gown in preparation for resuscitation.)
CAMERON: Definitely internal bleeding. All over the front of the torso, it looks like.
(Resuscitation attempts fail. PETER is unresponsive.)
CHASE: Time of death, 11:03 PM.
(CAMERON is wheeling a bleeding CHARLES down the hall, with HOUSE limping alongside.)
CAMERON: House, not now, this isn't the time.
HOUSE: You don't belong in the ER. Listen, I have a patient with--
CAMERON: Not now, I need to get this patient to the trauma ward.
HOUSE: Aw, it's just a flesh wound. He'll get over it. Arrhythmia--
CAMERON: He's not going to just "get over" six gunshot wounds to the chest.
HOUSE: You're absolutely right, he's not. Look at him, Cameron, he won't even make it to the OR.
(The machines start going off. CAMERON attempts to revive, but CHARLES dies.)
CAMERON: (glaring at HOUSE) Time of death... (pause while she glances at her watch) 7:38 PM.
(HOUSE leads the team into a dark room with a patient on the bed.)
HOUSE: Okay, people, differential diagnosis.
TAUB: Here?
HOUSE: He's in a coma. I don't think we need to worry about him injecting his opinion into the discussion.
KUTNER: (picks up patient's chart) John Turner, sixty-three, diabetic, presented with--
HOUSE: Come on, I need everyone's attention now. This is important. Wilson has been seen consorting with no fewer than eight nurses in the past two days, and we need to figure out what's going on. Don't let me down now, team.
(KUTNER surreptitiously puts down the chart.)
TAUB: I think he's planning a surprise baby shower for the pregnant one.
THIRTEEN: I think he's doing the blonde.
KUTNER: I think he's doing the giggly one behind the blonde's back.
AMBER: I think he's doing all of them.
(The patient's machines start beeping.)
HOUSE: Excellent. Now we just need to--
TAUB: Um, House? This patient needs help.
HOUSE: He's faking. Just wants attention. As I was saying, we need to develop a plan to catch him with one or more of--
(The team ignore him and gather around the patient's bed, trying to revive him, except AMBER.)
HOUSE: Didn't you guys hear me say this was important?
AMBER: We could hide a microphone in his office.
THIRTEEN: Move, let me get to the bed controls.
HOUSE: What if he meets them somewhere else?
KUTNER: Clear!
AMBER: We could follow him in shifts.
TAUB: We're losing him.
HOUSE: Ooh, I like it. Who'd take the night shift?
THIRTEEN: Kutner, stop. He's gone.
AMBER: I'll do it. I'm a night owl anyway.
KUTNER: Time of death, 11:07 AM.
HOUSE: You don't have sleep apnea.
RICHARD: (wheezing) What? I've had terrible sleep apnea my whole life.
HOUSE: Nope. You've got congenital central hypoventilation syndrome, also known as Ondine's curse. Cheated on any nymphs lately?
KUTNER: That's impossible. He's way too old.
HOUSE: There have been documented cases of undiagnosed Ondine's curse in adults.
KUTNER: Are you sure?
HOUSE: I Googled it.
RICHARD: So what is it? What's happening to me?
HOUSE: Did you know that most people don't have to consciously decide to breathe? People with Ondine's curse have no autonomic control of their breathing. Most of us don't even think about it, but you have to cognitively decide to draw in or release a breath of air. That's why every time you fall asleep, you practically die. The BiPAP machine you got for what you thought was sleep apnea kept you alive for a while, but--
(RICHARD starts choking. He grabs his throat and tries to gasp in air.)
HOUSE: Give him a tracheotomy and a ventilator. He'll be fine.
(KUTNER and TAUB rush to perform the tracheotomy. RICHARD doesn't start breathing again.)
KUTNER: House! HOUSE!
TAUB: Time of death, 3:21 PM.
TAUB: Ronald, are you still in there? Stay with us.
RONALD: I can't... my head... my back... ohhh... (goes silent)
TAUB: He's unconscious. I think he fainted from the pain.
FOREMAN: He's got papilledema in both eyes, and his pupils were extremely dilated even before I put the light in his eyes. We need to relieve this intracranial pressure.
THIRTEEN: Heart rate is 43 and slowing.
FOREMAN: Look at the flexion in his arms. He's herniating.
TAUB: And he's not breathing. (reaches for crash cart equipment)
THIRTEEN: And he's going into cardiac arrest.
FOREMAN: There's no way he'll make it.
THIRTEEN: We have to try.
(It doesn't take long for them to give up.)
THIRTEEN: Time of death, 4:23 PM.
THIRTEEN: I'm not this far gone yet, you know.
FOREMAN: I know. And if the world of medicine does its job and figures this thing out, you won't ever be.
THIRTEEN: You're not the world of medicine. It's not your job to rescue me from the big bad Huntington's.
FOREMAN: Yes, it is. I'm a neurologist. I might not be able to rescue you, but it is my job to try.
(THIRTEEN approaches the bed and looks down at its occupant.)
THIRTEEN: What's her name?
FOREMAN: Rose. (pause) She won't be with us much longer.
THIRTEEN: Where's House?
FOREMAN: His office, maybe? Wilson's office? Home? Passed out in front of the strip joint down the street? He's not interested in this case. There's no mystery here. She's just dying.
(The machines start flatlining. THIRTEEN moves toward the patient. FOREMAN holds up a hand to stop her.)
FOREMAN: She's DNR.
(THIRTEEN stills and closes her eyes, taking a deep breath and letting it out.)
FOREMAN: Time of death, 9:11 PM.
(HOUSE is reluctantly attending student rounds.)
SINGH: (to patient) Good morning, Willoughby.
WILLOUGHBY: Morning, doctor.
HOUSE: Willoughby? Seriously? Did your mother want you to become a member of British parliament?
SINGH: (ignoring HOUSE) Patient presented with numbness, lack of control of his left arm, and slurred speech. The symptoms ceased after a few hours.
HOUSE: It's called a transient ischemic attack. It's like a little baby stroke. He's got either plaque in his arteries or a blood clot in his heart. He'll probably have a real grownup stroke soon. Can I go now?
SINGH: That's right, Dr. House. This TIA was caused by dislodged atherosclerotic plaque in the carotid artery. Treatment?
(WILLOUGHBY touches his face with both hands in surprise. One hand begins to drift downwards.)
HOUSE: And there's our grownup stroke!
SINGH: I need to bust the clot. Get me tPA.
(RESIDENT #1 scurries to obey.)
RESIDENT #2: He's unconscious.
(The machines start flatlining.)
SINGH: Time of death, 9:30 AM.
HOUSE: Give me one good reason why I'm not in bed.
CUDDY: The patient has chalk dust in his lungs, and no one can figure out why.
HOUSE: I don't suppose he's a schoolteacher?
CUDDY: No.
HOUSE: Maybe he has pneumonoultramicroscopicsilicovolcanoconiosis.
CUDDY: He's not a miner, either.
HOUSE: I just wanted to use that word. Tell me one more time why I'm awake?
CUDDY: An ambulance brought him to the ER a few hours ago. Someone saw him by the side of the road and called 911. He fell into a coma right after he got here, and I thought perhaps you'd like to try to work out what's wrong with him before he dies.
HOUSE: So what were you doing here in the middle of the night?
CUDDY: Working. Please, take the file and go.
HOUSE: No, I want to hear more about this. Walk with me. Did loverboy kick you out of the house?
CUDDY: Of course not. I had a lot to get done. Listen, this patient is in bad shape. Before he lost consciousness, he told us his name was Joseph, and he said, "They came."
HOUSE: I guess he successfully built it.
(They reach the patient's room. A nurse is hurrying out of it.)
NURSE: You're this guy's attending? Sorry, you're too late.
(They enter. A doctor and another nurse are standing by the bed.)
DOCTOR: I've just given up on him. I don't think there's any way he would have survived the hemorrhaging.
HOUSE: Hemorrhaging? (looks at patient) You didn't tell me his head was smashed in.
CUDDY: (sheepishly) Everything's in the file I gave you.
HOUSE: You shouldn't have woken me up for this. Here's your diagnosis: the guy's got a jigsaw puzzle for a skull. The chalk is completely irrelevant. I'm going back to bed.
(He leaves. CUDDY sighs.)
CUDDY: Have you declared it yet?
DOCTOR: Was just about to.
CUDDY: Time of death, 5:04 AM.
CAMERON: You have to stop this. If it's bacterial, the chemo will kill him.
HOUSE: That's entirely correct, except for the tense. If it were bacterial, the chemo would kill him. Subjunctive.
CAMERON: It could be something we haven't thought of.
HOUSE: It could always be something we haven't thought of. But it's not. It's cancer. You saw those masses on the MRI.
CAMERON: They were barely even there! It could easily have been noise from the machine.
HOUSE: It's cancer. All the symptoms fit.
CAMERON: Logically, it looks like you're right. But I just have a gut feeling about this one. You should understand that, you're the most instinctual doctor I know. If you're wrong, Victor will die.
HOUSE: Sorry about the persecution of the minority here, but the rest of us would like to save the patient's life.
CAMERON: Oh, for...
HOUSE: (singing loudly) When Cameron was in Egypt's land...
(VICTOR reacts badly to chemo, equipment starts beeping, people start rushing around. CAMERON hurries to help.)
HOUSE: (singing softly, in time to beeping) Let my Cameron go.
CAMERON: Time of death, 8:22 PM.
(CHASE is operating. TAUB is watching through the glass. HOUSE comes in.)
HOUSE: How's the anorexic smoker?
TAUB: They're just about done. Didn't we decide he doesn't smoke?
HOUSE: The transplant committee thinks so. That's why they let him have the new lung. I'm not convinced. You don't just randomly get COPD.
(THIRTEEN walks in.)
THIRTEEN: I just talked to Paul's sister. She doesn't speak a whole lot of English, but it sounds like the emphysema was caused by burning charcoal in the house.
TAUB: That would do it.
CHASE: I'm taking him off support now.
(A few moments pass.)
CHASE: Looks like he's okay. Let's get him to post-op.
(Halfway out the door, CHASE stops abruptly.)
CHASE: He's crashing!
(CHASE grabs the paddles.)
CHASE: Charging... clear! Charging...
THIRTEEN: He's already skin and bones. Even if he survives this, losing any weight at all could kill him.
TAUB: Looks like we won't find out.
CHASE: Time of death, 12:17 PM.
(HOUSE is lying in a hospital bed. WILSON, CUDDY, THIRTEEN, FOREMAN, and CHASE are standing around him.)
WILSON: You're kidding. He infected himself? (panic rising in his voice) His last patient died, and he doesn't know why, so he gave himself the same disease? What was he thinking? What do we do?
CUDDY: We find out what it is, and we get him better, and then we kill him ourselves and bury him in an unmarked grave. Foreman, go over the details of the last case.
FOREMAN: It started with mild respiratory problems that got worse as the condition progressed. Cerebral hypoxia led to brain damage, then there was a series of heart attacks, one of which combined with the respiratory distress to cause death.
CUDDY: And House?
THIRTEEN: Everything up until the heart attacks. He's had two since we found him. We think he infected himself last night after we all went home. A janitor saw him on the floor of his office forty-five minutes ago, and it's already progressed to the point where we can't communicate with him. We don't know how it was transmitted, so be careful with his fluids.
(TAUB hurries in, holding up a piece of paper.)
TAUB: I found a note on his desk. All it says is, "If you manage to keep me alive long enough for the pulmonary edema to set in, I was right."
CHASE: That's it? Nothing else?
(TAUB hands CHASE the note.)
FOREMAN: Why would he do this? How is it solving the case if he dies too, without telling anyone what killed him?
WILSON: He's never wanted publicity or credit for his work. He doesn't care whether his diagnoses are disseminated so they can be used to cure other people. He just wants to figure out the puzzles. I guess that's enough for him.
THIRTEEN: But he won't know. He won't be aware enough to--
(HOUSE coughs weakly and draws a rasping breath.)
FOREMAN: (looking in his mouth) Pink sputum.
WILSON: Pulmonary edema. He was right.
(The machines go off.)
CUDDY: Intubate!
FOREMAN: Paddles!
(They all try desperately to stabilize him. TAUB is the first to step back.)
TAUB: He's been flatlining for four minutes. He's not coming back.
(One by one, the rest of the team stop trying to resuscitate. Finally, only WILSON is still at it.)
CUDDY: Wilson.
WILSON: No! He's not suicidal, he wouldn't have done this if he didn't know we could save him!
CUDDY: Time of death.
(WILSON ignores her and continues trying to revive HOUSE. The team watches in silence.)
CUDDY: Wilson, time of death.
(WILSON's breath catches and he starts crying. Finally, he stops.)
WILSON: Time... time of death, 6:27 AM.
[Note: producers have refused to confirm or deny rumors that House will be brought back next season by popular demand.]
HOUSE: You look great today.
CUDDY: Clinic. Two hours. Now.
HOUSE: But it's five o'clock. Five o'clock is time to go home.
CUDDY: You told me you'd do it today, and you're not getting out of it. (thrusts a pile of folders into his arms and strides off)
HOUSE: (hollering after her) But I didn't even make any childish and offensive analogies about your breasts! Doesn't that count for anything?
(HOUSE reluctantly limps into the clinic, shuffling through the folders, and walks into a room. An obese man is sitting on the examining table.)
HOUSE: Mr. Sutton, is it? Can't talk, difficulty breathing... why did you come here instead of the emergency room? (pause) Oh, right! Can't talk. Well, I'm guessing there's a chunk of something lodged in your throat. I'll do the ER a favor and deal with it. Take any medication?
(MR. SUTTON shakes his head.)
HOUSE: Must've been something you ate. Not that that really narrows it down. I would give you the Heimlich but, well, let's just say I'm not Stretch Armstrong.
(MR. SUTTON gives him a disbelieving glare.)
HOUSE: I'll get somebody in here to--
(MR. SUTTON suddenly starts flailing and falls off the table onto the floor.
HOUSE: That's not good. (calls out door) Hey, is there a doctor in the house? I think this guy's in trouble!
(DOCTOR #1 and several NURSES hurry in and begin CPR. The DOCTOR looks down MR. SUTTON'S throat.)
DOCTOR #1: There's nothing in there. We need to intubate. (to House) Do you know what's wrong?
HOUSE: He didn't say.
NURSE: Hurry! I can't feel a pulse!
(DOCTOR #2 arrives with a crash cart and sets to work attempting to revive MR. SUTTON.)
DOCTOR #1: What on earth happened?
HOUSE: Don't look at me, I just got here. You said there's nothing in there?
DOCTOR #2: I think he's gone.
DOCTOR #1: His throat was constricted in a weird way. It almost looked like something strangled him.
HOUSE: Huh.
DOCTOR #2: Time of death, 5:09 PM.
(FOREMAN is looking at the MRI screen.)
FOREMAN: It's an aneurysm, all right. Looks bad. We should get him to surgery soon.
CHASE: Right.
JAMES: (from inside MRI machine) Augh! Oh Christ, it hurts, please help!
(FOREMAN and CHASE hurry to get him out of the machine.)
JAMES: I'm sorry, I'm so sorry, make it stop!
FOREMAN: Ruptured. Blood pressure's dropping, come on.
(CHASE and FOREMAN get JAMES on a gurney and race him to surgery. When they get there, he's stopped making noise.)
CHASE: Somebody restart his heart right now!
(A crash cart arrives, but it's too late for JAMES.)
FOREMAN: Time of death, 10:08 AM.
(HOUSE and WILSON step off the subway, both clearly intoxicated.)
HOUSE: Wilson, don't scream.
WILSON: Why would I scream?
HOUSE: There's a body over there.
WILSON: What?
HOUSE: A body. (points)
WILSON: Oh my god.
(He runs over to the body and kneels down next to it. HOUSE hobbles after him.)
WILSON: He's already stiff.
HOUSE: Yeah, and his head isn't head-shaped anymore. No point in an ambulance.
WILSON: Call the police.
(HOUSE pulls out his cell phone.)
WILSON: He's been gone for hours, but I guess we should call it. Time of death... what time is it?
HOUSE: (checks cell phone) 10:34. Yeah, hi, we found a dead body by the train station. You want it?
WILSON: Time of death, 10:34 PM.
HOUSE: There's something we aren't seeing here. Symptoms?
CHASE: Glossolalia, delirium, extreme anxiety.
CAMERON: But no previous psych history. A totally clean record.
CHASE: No drug use either.
HOUSE: So she says. We won't know for sure until Foreman gets back.
(FOREMAN walks in)
HOUSE: Speak of the burglar. So what has our lovely... (checks chart) Brenda been smoking?
FOREMAN: Her place was clean, House. I talked to her neighbors and no one has ever suspected her of anything. Maybe it is psychological.
CAMERON: If something increased her levels of norephinephrine, that would explain the psych symptoms...
HOUSE: ...but not the glossolalia. No, there is clearly something--
(Their pagers all go off. They run into the room just as the nurses put down the paddles.)
HOUSE: Damn. Time of death, 6:21 PM.
HOUSE: Do you remember injuring your collarbone in the last few years?
PIETRO: Yes, I had an accident at the factory about six months ago. But the pain was not this bad. I could go back to work in only a few days.
HOUSE: Untreated clavicle fracture. Something dislodged the break and now it's pinching a nerve. X-ray to confirm, give him a sling, and send him home.
PIETRO: You are making me leave with this pain?
HOUSE: Don't worry. We'll give you some happy pills, too.
CAMERON: There are other treatments for pinched nerves you can look into. Physical therapy, acupuncture...
HOUSE: Yeah, stabbing yourself with needles should help distract you from that other pain.
(Later, CAMERON looks out the window and sees PIETRO leaving.)
CAMERON: I feel bad tossing him out like that. He should stay until he's healed a little.
HOUSE: He couldn't afford the hotel costs here.
(CAMERON watches PIETRO stop, stand for a moment, and then collapse. She races downstairs and out to the front of the hospital. Several people have gathered around him by the time she arrives. She kneels and feels for a pulse.)
CAMERON: Pietro? Can you hear me? Someone get help!
(Blood dribbles out of his mouth. Two nurses show up with a stretcher.)
CAMERON: I think a shard of his collarbone stabbed his internal jugular vein. Be careful moving him. His pulse is dangerously low, we need to get him to surgery.
(Inside, PIETRO's heart stops. Efforts to revive are fruitless.)
CAMERON: Time of death, 2:19 PM.
HOUSE: You said he used to work as a sailor. Has he ever been to India?
MARY: I don't think so.
HOUSE: Brazil?
MARY: Probably. I know he was on a ship that traveled along the South American coastline for a while. But that was years ago.
CHASE: House, can I speak with you a moment? (in low tones) The lesions around his right ear are getting really bad. It wouldn't take much agitation for it to break off altogether.
HOUSE: Hm. Lesions, body parts falling off... sound familiar to you?
CHASE: Hansen's disease?
HOUSE: That's some kind of fancy medical word for something, isn't it?
CHASE: (sighs) Leprosy.
HOUSE: Get him on promin, dapsone, and rifampicin. (turns to Mary) Ditto her.
MARY: What?
HOUSE: They told you it was syphilis, didn't they? Common mistake. Those injections of penicillin you've been getting aren't going to help. See that patch of red next to her ear there, Chase? (CHASE looks at MARY's left ear.) Better go get some drugs before your ear falls off too. Just your luck, that you and yours are both among the tiny percentage of the population that can even get leprosy.
MARY: Are you suggesting that I've been having sex with Alec?
HOUSE: Your husband seemed to think so. But no, you have not been proven guilty quite yet. Lepers, you see, are people just like ourselves. Some of them are good, some bad, some virgins, some sluts...
(HOUSE and CHASE's pagers go off. CHASE rushes off.)
HOUSE: Hold that thought.
(He follows CHASE down the hall. MARY stares after him, stunned. By the time he gets to ALEC's room, the machines are flatlining. FOREMAN and CAMERON are trying to revive him.)
CHASE: He had a stroke. I don't think they're going to bring him back.
HOUSE: Leprosy doesn't kill people. Not in a hospital.
CHASE: The stroke was probably a coincidence.
HOUSE: Nothing is a coincidence.
FOREMAN: Time of death, 7:13 AM.
CAMERON: (hanging up telephone) He just landed. He's on his way here.
FOREMAN: You're kidding. The Super Bowl is tomorrow.
CAMERON: Are you serious? He is not going to miss being here for his wife right now.
FOREMAN: But he's the quarterback. And it's the Super Bowl. His manager is really letting him come all the way here?
CAMERON: His wife is about to die. I doubt he consulted his manager before he booked the flight.
HOUSE: She won't die if we stop talking about football and start figuring out what's wrong with her.
CHASE: We know what's wrong with her. She has TB and she's resistant to the medications.
HOUSE: The chances of that are way too small for me to accept it. What else could be going on?
FOREMAN: There isn't anything else going on. Sometimes there's just nothing we can do.
HOUSE: That's the kind of attitude that gets people fired from their jobs as diagnosticians.
CAMERON: Foreman's right, House. She's dying. I'm going to go check on her.
HOUSE: You do that. While you're at it, see if she's developed any new symptoms we can use to figure out what's really wrong.
(CAMERON goes to the patient's room. She's straightening the covers when the patient starts crashing. She tries to resuscitate. Several people rush in to help.)
DOCTOR: Her husband is here. Is he--?
CAMERON: (curtly) Yes.
DOCTOR: Whoa.
CAMERON: I doubt he's in the mood to sign autographs. A little help here?
DOCTOR: (looking at patient) I don't think it would do any good.
CAMERON: (after a moment) Time of death, 8:36 AM.
FOREMAN: Pallid complexion, respiratory problems, lack of balance, panic, and seizures. Go.
HOUSE: Sounds like a hallucinogenic overdose to me. Speed or coke, probably. Nice of them to put the diagnosis right at the top of the page here.
FOREMAN: Stoner is the patient's last name, House. Focus.
CHASE: She tested clean. It's not drugs.
(FOREMAN's pager goes off)
FOREMAN: We better figure it out quick.
(They all go to the patient's room.)
HOUSE: (to CAMERON, in the hallway) How come his pager went off? How come my pager didn't go off? Does a demotion come with loss of pager privileges?
(In the room, FOREMAN and CHASE hold down the patient's arms as she's seizing. CAMERON injects an anticonvulsant.)
HOUSE: (waves cane in the air) Ooh! Ooh! Dr. Foreman, sir! I know this one!
FOREMAN: Damn it, House, stop messing around. If you have an idea, spit it out.
HOUSE: Snakebite. Check her legs for the bite mark and get her on antivenom.
(The patient continues seizing violently.)
CHASE: She's choking!
(CAMERON intubates, but the patient stills.)
FOREMAN: She's not breathing.
HOUSE: Right here, see? (points to puncture wound on the patient's foot)
CHASE: Yes, House, you were right. Very good. We're all proud of you. Time of death, 1:28 PM.
(CHASE and CAMERON are walking down the hall together.)
CAMERON: That was extremely unprofessional.
CHASE: Yep. Isn't it nice to be unprofessional once in a while?
CAMERON: Don't count on it happening again.
CHASE: Yeah, that's what you always say.
(A young NURSE dashes up to them.)
NURSE: Dr. Cameron, please come help! I think this patient is bleeding internally and I don't know what to do.
CHASE: Well then, let's go! (as they walk quickly) Are you new here? I don't think we've met. I'm Dr. Chase.
(CAMERON rolls her eyes. The NURSE ignores CHASE.)
NURSE: I think he's been drinking, Dr. Cameron. He's a really nasty guy, and he keeps bullying his wife and daughter into smuggling him rum. He's in here for liver problems. I was changing his medications when he went into shock and his systolic blood pressure dropped all of a sudden.
CAMERON: Don't worry, we'll figure it out.
(They reach the room at the same time as a crash cart. PETER is already unconscious. CAMERON rips open the patient's hospital gown in preparation for resuscitation.)
CAMERON: Definitely internal bleeding. All over the front of the torso, it looks like.
(Resuscitation attempts fail. PETER is unresponsive.)
CHASE: Time of death, 11:03 PM.
(CAMERON is wheeling a bleeding CHARLES down the hall, with HOUSE limping alongside.)
CAMERON: House, not now, this isn't the time.
HOUSE: You don't belong in the ER. Listen, I have a patient with--
CAMERON: Not now, I need to get this patient to the trauma ward.
HOUSE: Aw, it's just a flesh wound. He'll get over it. Arrhythmia--
CAMERON: He's not going to just "get over" six gunshot wounds to the chest.
HOUSE: You're absolutely right, he's not. Look at him, Cameron, he won't even make it to the OR.
(The machines start going off. CAMERON attempts to revive, but CHARLES dies.)
CAMERON: (glaring at HOUSE) Time of death... (pause while she glances at her watch) 7:38 PM.
(HOUSE leads the team into a dark room with a patient on the bed.)
HOUSE: Okay, people, differential diagnosis.
TAUB: Here?
HOUSE: He's in a coma. I don't think we need to worry about him injecting his opinion into the discussion.
KUTNER: (picks up patient's chart) John Turner, sixty-three, diabetic, presented with--
HOUSE: Come on, I need everyone's attention now. This is important. Wilson has been seen consorting with no fewer than eight nurses in the past two days, and we need to figure out what's going on. Don't let me down now, team.
(KUTNER surreptitiously puts down the chart.)
TAUB: I think he's planning a surprise baby shower for the pregnant one.
THIRTEEN: I think he's doing the blonde.
KUTNER: I think he's doing the giggly one behind the blonde's back.
AMBER: I think he's doing all of them.
(The patient's machines start beeping.)
HOUSE: Excellent. Now we just need to--
TAUB: Um, House? This patient needs help.
HOUSE: He's faking. Just wants attention. As I was saying, we need to develop a plan to catch him with one or more of--
(The team ignore him and gather around the patient's bed, trying to revive him, except AMBER.)
HOUSE: Didn't you guys hear me say this was important?
AMBER: We could hide a microphone in his office.
THIRTEEN: Move, let me get to the bed controls.
HOUSE: What if he meets them somewhere else?
KUTNER: Clear!
AMBER: We could follow him in shifts.
TAUB: We're losing him.
HOUSE: Ooh, I like it. Who'd take the night shift?
THIRTEEN: Kutner, stop. He's gone.
AMBER: I'll do it. I'm a night owl anyway.
KUTNER: Time of death, 11:07 AM.
HOUSE: You don't have sleep apnea.
RICHARD: (wheezing) What? I've had terrible sleep apnea my whole life.
HOUSE: Nope. You've got congenital central hypoventilation syndrome, also known as Ondine's curse. Cheated on any nymphs lately?
KUTNER: That's impossible. He's way too old.
HOUSE: There have been documented cases of undiagnosed Ondine's curse in adults.
KUTNER: Are you sure?
HOUSE: I Googled it.
RICHARD: So what is it? What's happening to me?
HOUSE: Did you know that most people don't have to consciously decide to breathe? People with Ondine's curse have no autonomic control of their breathing. Most of us don't even think about it, but you have to cognitively decide to draw in or release a breath of air. That's why every time you fall asleep, you practically die. The BiPAP machine you got for what you thought was sleep apnea kept you alive for a while, but--
(RICHARD starts choking. He grabs his throat and tries to gasp in air.)
HOUSE: Give him a tracheotomy and a ventilator. He'll be fine.
(KUTNER and TAUB rush to perform the tracheotomy. RICHARD doesn't start breathing again.)
KUTNER: House! HOUSE!
TAUB: Time of death, 3:21 PM.
TAUB: Ronald, are you still in there? Stay with us.
RONALD: I can't... my head... my back... ohhh... (goes silent)
TAUB: He's unconscious. I think he fainted from the pain.
FOREMAN: He's got papilledema in both eyes, and his pupils were extremely dilated even before I put the light in his eyes. We need to relieve this intracranial pressure.
THIRTEEN: Heart rate is 43 and slowing.
FOREMAN: Look at the flexion in his arms. He's herniating.
TAUB: And he's not breathing. (reaches for crash cart equipment)
THIRTEEN: And he's going into cardiac arrest.
FOREMAN: There's no way he'll make it.
THIRTEEN: We have to try.
(It doesn't take long for them to give up.)
THIRTEEN: Time of death, 4:23 PM.
THIRTEEN: I'm not this far gone yet, you know.
FOREMAN: I know. And if the world of medicine does its job and figures this thing out, you won't ever be.
THIRTEEN: You're not the world of medicine. It's not your job to rescue me from the big bad Huntington's.
FOREMAN: Yes, it is. I'm a neurologist. I might not be able to rescue you, but it is my job to try.
(THIRTEEN approaches the bed and looks down at its occupant.)
THIRTEEN: What's her name?
FOREMAN: Rose. (pause) She won't be with us much longer.
THIRTEEN: Where's House?
FOREMAN: His office, maybe? Wilson's office? Home? Passed out in front of the strip joint down the street? He's not interested in this case. There's no mystery here. She's just dying.
(The machines start flatlining. THIRTEEN moves toward the patient. FOREMAN holds up a hand to stop her.)
FOREMAN: She's DNR.
(THIRTEEN stills and closes her eyes, taking a deep breath and letting it out.)
FOREMAN: Time of death, 9:11 PM.
(HOUSE is reluctantly attending student rounds.)
SINGH: (to patient) Good morning, Willoughby.
WILLOUGHBY: Morning, doctor.
HOUSE: Willoughby? Seriously? Did your mother want you to become a member of British parliament?
SINGH: (ignoring HOUSE) Patient presented with numbness, lack of control of his left arm, and slurred speech. The symptoms ceased after a few hours.
HOUSE: It's called a transient ischemic attack. It's like a little baby stroke. He's got either plaque in his arteries or a blood clot in his heart. He'll probably have a real grownup stroke soon. Can I go now?
SINGH: That's right, Dr. House. This TIA was caused by dislodged atherosclerotic plaque in the carotid artery. Treatment?
(WILLOUGHBY touches his face with both hands in surprise. One hand begins to drift downwards.)
HOUSE: And there's our grownup stroke!
SINGH: I need to bust the clot. Get me tPA.
(RESIDENT #1 scurries to obey.)
RESIDENT #2: He's unconscious.
(The machines start flatlining.)
SINGH: Time of death, 9:30 AM.
HOUSE: Give me one good reason why I'm not in bed.
CUDDY: The patient has chalk dust in his lungs, and no one can figure out why.
HOUSE: I don't suppose he's a schoolteacher?
CUDDY: No.
HOUSE: Maybe he has pneumonoultramicroscopicsilicovolcanoconiosis.
CUDDY: He's not a miner, either.
HOUSE: I just wanted to use that word. Tell me one more time why I'm awake?
CUDDY: An ambulance brought him to the ER a few hours ago. Someone saw him by the side of the road and called 911. He fell into a coma right after he got here, and I thought perhaps you'd like to try to work out what's wrong with him before he dies.
HOUSE: So what were you doing here in the middle of the night?
CUDDY: Working. Please, take the file and go.
HOUSE: No, I want to hear more about this. Walk with me. Did loverboy kick you out of the house?
CUDDY: Of course not. I had a lot to get done. Listen, this patient is in bad shape. Before he lost consciousness, he told us his name was Joseph, and he said, "They came."
HOUSE: I guess he successfully built it.
(They reach the patient's room. A nurse is hurrying out of it.)
NURSE: You're this guy's attending? Sorry, you're too late.
(They enter. A doctor and another nurse are standing by the bed.)
DOCTOR: I've just given up on him. I don't think there's any way he would have survived the hemorrhaging.
HOUSE: Hemorrhaging? (looks at patient) You didn't tell me his head was smashed in.
CUDDY: (sheepishly) Everything's in the file I gave you.
HOUSE: You shouldn't have woken me up for this. Here's your diagnosis: the guy's got a jigsaw puzzle for a skull. The chalk is completely irrelevant. I'm going back to bed.
(He leaves. CUDDY sighs.)
CUDDY: Have you declared it yet?
DOCTOR: Was just about to.
CUDDY: Time of death, 5:04 AM.
CAMERON: You have to stop this. If it's bacterial, the chemo will kill him.
HOUSE: That's entirely correct, except for the tense. If it were bacterial, the chemo would kill him. Subjunctive.
CAMERON: It could be something we haven't thought of.
HOUSE: It could always be something we haven't thought of. But it's not. It's cancer. You saw those masses on the MRI.
CAMERON: They were barely even there! It could easily have been noise from the machine.
HOUSE: It's cancer. All the symptoms fit.
CAMERON: Logically, it looks like you're right. But I just have a gut feeling about this one. You should understand that, you're the most instinctual doctor I know. If you're wrong, Victor will die.
HOUSE: Sorry about the persecution of the minority here, but the rest of us would like to save the patient's life.
CAMERON: Oh, for...
HOUSE: (singing loudly) When Cameron was in Egypt's land...
(VICTOR reacts badly to chemo, equipment starts beeping, people start rushing around. CAMERON hurries to help.)
HOUSE: (singing softly, in time to beeping) Let my Cameron go.
CAMERON: Time of death, 8:22 PM.
(CHASE is operating. TAUB is watching through the glass. HOUSE comes in.)
HOUSE: How's the anorexic smoker?
TAUB: They're just about done. Didn't we decide he doesn't smoke?
HOUSE: The transplant committee thinks so. That's why they let him have the new lung. I'm not convinced. You don't just randomly get COPD.
(THIRTEEN walks in.)
THIRTEEN: I just talked to Paul's sister. She doesn't speak a whole lot of English, but it sounds like the emphysema was caused by burning charcoal in the house.
TAUB: That would do it.
CHASE: I'm taking him off support now.
(A few moments pass.)
CHASE: Looks like he's okay. Let's get him to post-op.
(Halfway out the door, CHASE stops abruptly.)
CHASE: He's crashing!
(CHASE grabs the paddles.)
CHASE: Charging... clear! Charging...
THIRTEEN: He's already skin and bones. Even if he survives this, losing any weight at all could kill him.
TAUB: Looks like we won't find out.
CHASE: Time of death, 12:17 PM.
(HOUSE is lying in a hospital bed. WILSON, CUDDY, THIRTEEN, FOREMAN, and CHASE are standing around him.)
WILSON: You're kidding. He infected himself? (panic rising in his voice) His last patient died, and he doesn't know why, so he gave himself the same disease? What was he thinking? What do we do?
CUDDY: We find out what it is, and we get him better, and then we kill him ourselves and bury him in an unmarked grave. Foreman, go over the details of the last case.
FOREMAN: It started with mild respiratory problems that got worse as the condition progressed. Cerebral hypoxia led to brain damage, then there was a series of heart attacks, one of which combined with the respiratory distress to cause death.
CUDDY: And House?
THIRTEEN: Everything up until the heart attacks. He's had two since we found him. We think he infected himself last night after we all went home. A janitor saw him on the floor of his office forty-five minutes ago, and it's already progressed to the point where we can't communicate with him. We don't know how it was transmitted, so be careful with his fluids.
(TAUB hurries in, holding up a piece of paper.)
TAUB: I found a note on his desk. All it says is, "If you manage to keep me alive long enough for the pulmonary edema to set in, I was right."
CHASE: That's it? Nothing else?
(TAUB hands CHASE the note.)
FOREMAN: Why would he do this? How is it solving the case if he dies too, without telling anyone what killed him?
WILSON: He's never wanted publicity or credit for his work. He doesn't care whether his diagnoses are disseminated so they can be used to cure other people. He just wants to figure out the puzzles. I guess that's enough for him.
THIRTEEN: But he won't know. He won't be aware enough to--
(HOUSE coughs weakly and draws a rasping breath.)
FOREMAN: (looking in his mouth) Pink sputum.
WILSON: Pulmonary edema. He was right.
(The machines go off.)
CUDDY: Intubate!
FOREMAN: Paddles!
(They all try desperately to stabilize him. TAUB is the first to step back.)
TAUB: He's been flatlining for four minutes. He's not coming back.
(One by one, the rest of the team stop trying to resuscitate. Finally, only WILSON is still at it.)
CUDDY: Wilson.
WILSON: No! He's not suicidal, he wouldn't have done this if he didn't know we could save him!
CUDDY: Time of death.
(WILSON ignores her and continues trying to revive HOUSE. The team watches in silence.)
CUDDY: Wilson, time of death.
(WILSON's breath catches and he starts crying. Finally, he stops.)
WILSON: Time... time of death, 6:27 AM.
[Note: producers have refused to confirm or deny rumors that House will be brought back next season by popular demand.]