[Rebecca riding bus and then running into a school. Meets up with Melanie]
Melanie: Why are you late?
Rebecca: You’re not going to like the answer.
Melanie: I already know the answer.
Rebecca: I missed the bus.
Melanie: I don’t doubt it, no bus stops near Brad’s. You spent the night, the alarm didn’t work. Or maybe it did.
Rebecca: I didn’t sleep with him.
Melanie: Girl, there’s...[Interrupted]
Rebecca: I missed the bus!
Melanie: There’s something either very wrong with you, or there’s something very wrong with him.
Rebecca: There’s nothing wrong with him.
Melanie: Please tell me you know that for a fact.
Rebecca: Melanie, I gotta go.
Melanie: You’re lying aren’t you?
Rebecca: I wouldn’t lie to you. [Turns to class of 5 year olds] Good morning guys!
Class: Good morning Miss Rebecca!
Rebecca: Everybody’s in their seats?
Rebecca: Ok, Sidney, why don’t you tell us what you did this weekend. Come on, Sidney, we know you’re not shy.
Sidney: How come we always have to tell you what we did, and you never tell us what you did?
Rebecca: Ok, I had a really great weekend, but you can’t tell Miss Melanie, ok?
Sidney: What did you do?
Rebecca: I made a new friend. It’s so much fun to make new friends, isn’t it?
Class: Yeah, Yes, etc.
Girl 2: Did you tell you mom and dad about your new friend?
Rebecca: Absolutely! You should never keep anything from your parents. And I told them [gibberish]
Class [more giggles]
Class: [Laughs and giggles]
[Rebecca goes to the board and starts writing]
Class: C, A, T, H
Boy: We know that word, “the.”
[Rebecca collapses, on the board the words “call the nurse” are written]
(Evil commercials…bane of my existence!)
[House and Wilson are walking through the hallway. All you can see is their hands and legs, showing that House is using a cane and limping. Wilson is the only one of the two wearing a lab coat.]
Wilson: 29 year old female, first seizure one month ago, lost the ability to speak. Babbled like a baby. Present deterioration of mental status.
House: See that? They all assume I’m a patient because of this cane.
Wilson: So put on a white coat like the rest of us.
House: I don’t want them to think I’m a doctor.
Wilson: You see where the administration might have a problem with that attitude.
House: People don’t want a sick doctor.
Wilson: Fair enough. I don’t like healthy patients. The 29 year old female…
House: The one who can’t talk, I liked that part.
Wilson: She’s my cousin.
House: And your cousin doesn’t like the diagnosis. I wouldn’t either. Brain tumor, she’s gonna die, boring.
Wilson: No wonder you’re such a renowned diagnostician. You don’t need to actually know anything to figure out what’s wrong.
House: You’re the oncologist; I’m just a lowly infectious disease guy.
Wilson: Hah, yes, just a simple country doctor. Brain tumors at her age are highly unlikely.
House: She’s 29. Whatever she’s got is highly unlikely.
Wilson: Protein markers for the three most prevalent brain cancers came up negative.
House: That’s an HMO lab; you might as well have sent it to a high school kid with a chemistry set.
Wilson: No family history.
House: I thought your uncle died of cancer.
Wilson: Other side. No environmental factors.
House: That you know of.
Wilson: And she’s not responding to radiation treatment.
House: None of which is even close to dispositive. All it does is raise one question. Your cousin goes to an HMO?
Wilson: Come on! Why leave all the fun for the coroner? What’s the point of putting together a team if you’re not going to use them? You’ve got three overqualified doctors working for you. Getting bored.
[Cut to Rebecca, into the nose, and up the blood stream. Cut to House looking through an MRI of Rebecca’s head.]
Foreman: It’s a lesion.
House: And the big green thing in the middle of the bigger blue thing on a map is an island. I was hoping for something a bit more creative.
Foreman: Shouldn’t we be speaking to the patient before we start diagnosing?
House: Is she a doctor?
Foreman: No, but…
House: Everybody lies.
Cameron: Dr. House doesn’t like dealing with patients.
Foreman: Isn’t treating patients why we became doctors?
House: No, treating illnesses is why we became doctors, treating patients is what makes most doctors miserable.
Foreman: So you’re trying to eliminate the humanity from the practice of medicine.
House: If we don’t talk to them they can’t lie to us, and we can’t lie to them. Humanity is overrated. I don’t think it’s a tumor.
Foreman: First year of medical school if you hear hoof beats you think “horses” not “zebras”.
House: Are you in first year of medical school? No. First of all, there’s nothing on the CAT scan. Second of all, if this is a horse then the kindly family doctor in Trenton makes the obvious diagnosis and it never gets near this office. Differential diagnosis, people: if it’s not a tumor what are the suspects? Why couldn’t she talk?
Chase: Aneurysm, stroke, or some other ischemic syndrome.
House: Get her a contrast MRI.
Cameron: Creutzfeld-Jakob disease.
Chase: Mad cow?
House: Mad zebra.
Foreman: Wernickie's encephalopathy?
House: No, blood thiamine level was normal.
Foreman: Lab in Trenton could have screwed up the blood test. I assume it’s a corollary if people lie, that people screw up.
House: Re-draw the blood tests. And get her scheduled for that contrast MRI ASAP. Let’s find out what kind of zebra we’re dealing with here.
[Cut to House standing at the elevator, he sees Cuddy and presses the down button twice]
Cuddy: I was expecting you in my office 20 minutes ago.
House: Really? Well, that’s odd, because I had no intention of being in your office 20 minutes ago.
Cuddy: You think we have nothing to talk about?
House: No, just that I can’t think of anything that I’d be interested in.
Cuddy: I sign your paychecks.
House: I have tenure. Are you going to grab my cane now, stop me from leaving?
Cuddy: That would be juvenile.
[Both enter the elevator]
Cuddy: I can still fire you if you’re not doing your job.
House: I’m here from 9 to 5.
Cuddy: Your billings are practically nonexistent.
House: Rough year.
Cuddy: You ignore requests for consults.
House: I call back. Sometimes I misdial.
Cuddy: You’re 6 years behind on your obligation to this clinic.
House: See, I was right, this doesn’t interest me.
Cuddy: 6 years, times 3 weeks; you owe me better than 4 months.
House: It’s 5:00. I’m going home.
Cuddy: To what?
Cuddy: Look, Dr. House, the only reason that I don’t fire you is because your reputation still worth something to this hospital.
House: Excellent, we have a point of agreement. You aren’t going to fire me.
Cuddy: Your reputation won’t last up if you don’t do your job. The clinic is part of your job. I want you to do your job.
House: Well, like the philosopher Jagger once said, “You can’t always get what you want.”
[Scene of hospital from above, cut to hallway, Rebecca in wheelchair with Cameron, Chase, and Foreman around.]
Rebecca: You’re not my doctor. Are you Dr. House?
Chase: Thankfully no. I’m Dr. Chase.
Cameron: Dr. House is the head of diagnostic medicine. He’s very busy, but he has taken a keen interest in your case.
[Cut to MRI room, Rebecca is on the table]
Foreman: We inject gadolinium into a vein. It distributes itself throughout your brain and acts as a contrast material for the magnetic resonance imagery.
Cameron: Basically, whatever’s in your head, lights up like a Christmas tree.
Foreman: It might make you feel a little light-headed.
Nurse: Dr. Cameron. I’m sorry I have to stop you, there’s a problem.
[Cut to House, busting into Cuddy’s office]
House: You pulled my authorization.
Cuddy: Yes, why are you yelling?
House: No MRIs, no imaging studies, no labs.
Cuddy: You also can’t make long distance phone calls.
House: If you’re gonna fire me at least have the guts to face me.
Cuddy: Or photocopies; you’re still yelling.
House: I’m ANGRY! You’re risking a patient’s life.
Cuddy: I assume those are two separate points.
House: You showed me disrespect, you embarrassed me and as long as I’m still work here you have…[interrupted]
Cuddy: Is your yelling designed to scare me because I’m not sure what I’m supposed to be scared of. More yelling? That’s not scary. That you’re gonna hurt me? That’s scary, but I’m pretty sure I can outrun ya.
Cuddy: Oh, I looked into that philosopher you quoted, Jagger, and you’re right, “You can’t always get what you want,” but as it turns out “if you try sometimes you get what you need.”
House: So, because you want me to treat patients, you aren’t letting me treat patients.
Cuddy: I need you to do your job.
[House comes out of Cuddy’s office; Wilson and the ducklings are there]
House: Do the MRI, she folded. [Ducklings leave, House turns to Wilson] I’ve gotta do four hours a week in this clinic until I make up the time I’ve missed. 2054. I’ll be caught up in 2054. [He walks into the clinic] You better love this cousin a whole lot.
[Cut back to MRI room Rebecca is back on the table. She is pushed into the machine.]
Cameron: All right Rebecca, [over intercom] we know you may feel a little claustrophobic in there, but we need you to remain still.
Chase: [over intercom] Ok, we’re gonna begin.
[Machine starts up and makes weird sounds]
Rebecca: I don’t feel so good.
Chase: It’s all right. Just try to relax.
[Rebecca starts choking. Cool shot of inside her throat. You can see that it closes up]
Cameron: Rebecca? [over intercom] Rebecca? [back in booth] Rebecca! Get her out of there.
Chase: Ah she probably fell asleep; she’s exhausted.
Cameron: She was claustrophobic 30 seconds ago, she’s not sleeping. We gotta get her out of there!
Chase: It’ll just be another minute.
Cameron: She’s having an allergic reaction to gadolinium. She’ll be dead in two minutes.
Foreman: Hold her neck.
Cameron: Oh, she’s ashen.
Foreman: She’s not breathing. Epi point five.
Cameron: Come on, I can’t ventilate.
Foreman: Too much edema, where’s the surgical airway kit?
Chase: Yep, coming.
[Cool cutting into Rebecca’s neck sounds, and real colored blood for a change. They get her bagged.]
Chase: Good call.
(And we’re back to commercials…blah…)
[Cut into hospital room, next day. Rebecca has a ventilator hooked up to her, and the ducklings are present]
Chase: We’ll get that tube out of your throat later today.
Cameron: Just get some rest for now.
[They leave to hallway, House is there.]
House: Told you, can’t trust people.
Cameron: She probably knew she was allergic to gadolinium, figured it was an easy way to get someone to cut a hole in her throat.
House: Can’t get a picture, gonna have to get a thousand words.
Foreman: You actually want me to talk to the patient? Get a history?
House: We need to know if there’s some genetic or environmental causes triggering an inflammatory response.
Foreman: I thought everybody lied?
House: Truth begins in lies. Think about it.
Foreman: That doesn’t mean anything,does it?
[House walks away]
[House enters the clinic…dun dun dun!]
House: 12:52 PM Dr. House checks in, please write that down. Do you have cable TV here somewhere? General Hospital starts in 8 minutes.
Cuddy: No TV, but we’ve got patients.
House: Can’t you give out the aspirin yourself? I’ll do paperwork.
Cuddy: I made sure your first case was an interesting one.
House: Cough just won’t go away, runny nose looks a funny color.
Cuddy: Patient admitted complaining of back spasms.
House: I think I read about something like that in the New England Journal of Medicine.
Cuddy: Patient is orange.
House: The color?
Cuddy: No, the fruit.
House: You mean yellow; it’s jaundice.
Cuddy: I mean orange.
House: Well, how orange?
Cuddy: Exam room 1.
[Cut to House in exam room 1 with Orange Guy]
Orange Guy: I was playing golf and my cleat got stuck. I mean, it hurt a little but I kept playing. The next morning I could barely stand up. Well, you’re smiling so I take it that means this isn’t serious.
[House takes out his pills]
Orange Guy: What’s that? What are you doing?
Orange Guy: Oh, for you, for your leg.
House: No, ‘cause they’re yummy. You want one? It’ll make your back feel better.
[Guy nods and House gives him a painkiller]
House: Unfortunately, you have a deeper problem. Your wife is having an affair.
Orange Guy: What?!
House: You’re orange, you moron! It’s one thing for you not to notice, but if your wife hasn’t picked up on the fact that her husband has changed color, she’s just not paying attention. By the way, do you consume just a ridiculous amount of carrots and mega-dose vitamins?
House: The carrots turn you yellow, the niacin turns you red. Get some finger-paints and do the math. And get a good lawyer.
[House leaves the room]
[Cut to House in another exam room, this time with a little boy]
House: Deep breath.
Little boy: It’s cold.
House: Has he been using his inhaler?
Mother: Not in the past few days. He’s, um, only ten. I worry about children taking such strong medicine so frequently.
Little boy: What happened to your leg?
[After saying this the little boy starts to wheeze a little, and continues throughout the entire time that House is talking.]
House: Your doctor probably was concerned about the strength of the medicine, too. She probably weighed that danger against the danger of not breathing. Oxygen is so important during those prepubescent years, don’t you think? Ok, I’m gonna assume that no body’s ever told you what asthma is, or if they have, you had other things on your mind. A stimulant triggers cells in your child’s airways to release substances that inflame the air passages and cause them to contract. Mucus production increases, cell-lining starts to shed. But the steroids, the steroids…stop the inflammation. The more often this happens…[trails off and starts to leave the room]
Mother: What? “The more often this happens…”what?”
House: Forget it. If you don’t trust steroids, you shouldn’t trust doctors.
[Cut to Rebecca’s room]
Rebecca: My mother passed away three years ago. She had a heart attack, and my father broke his back doing construction.
[Cameron’s pager goes off]
Cameron: It’s House, it’s urgent. I’m sorry.
[They go outside the room and see House waiting for them there]
Cameron: You couldn’t have knocked?
House: Steroids. Give her steroids, high doses of prednisone.
Foreman: You’re looking for support for a diagnosis of cerebral vasculitus.
Cameron: Inflammation of the blood vessels in the brain is awfully rare. Especially for someone her age.
House: So is a tumor. Her SED rate was elevated.
Cameron: That could mean anything, or nothing.
House: Yeah, I know. I have no reason to think that it’s vasculitus except that it could be.
If the blood vessels were inflamed that’s gonna look exactly like what we saw on the MRI from Trenton County, and the pressure’s gonna cause neurological symptoms.
Cameron: You can’t diagnose that without a biopsy.
House: Yes, we can, we treat it. If she gets better we know that we’re right.
Cameron: And if we’re wrong?
House: We learn something else.
[Cut to overview of hospital, and then back into Rebecca’s room]
Rebecca: Why steroids?
Chase: Just part of your treatment. You haven’t had many visitors. No boyfriend?
Rebecca: Three dates. I wouldn’t have stood by him if her were vomiting all day.
Chase: Well, what abut work? You must have friends from work.
Rebecca: Pretty much everybody I like is 5 years old. A nurse said you’re stopping my radiation.
Chase: We’re just trying some alternative medications. So, where’s your family from then?
Rebecca: Steroids aren’t an alternative to radiation.
Chase: The tests weren’t really conclusive.
Cameron: We’re treating you for vasculitus, it’s the inflammation of blood vessels in the brain.
Rebecca: It’s not a tumor? I don’t have a tumor?
[Cut to hallway with Cameron and Chase]
Chase: You should have told her the truth. It’s a long shot guess.
Cameron: [to nurse] Thank you. [To Chase] If House is right, no harm, if he’s wrong we’ve given a dying woman a couple days hope.
Chase: False hope.
Cameron: If there was any other type available I would have given her that.
[Cut to classroom where Foreman is smelling the floor]
Sidney: Why are you smelling Billy’s pants?
Foreman: I’m not.
Sidney: Looked like you were.
Foreman: I was smelling the floor.
Foreman: Do you have any pets in this class?
Sidney: No, but we used to have a gerbil, but Carly L. dropped a book on it.
Sidney: Do you need to smell it?
Foreman: No, I’m smelling for mold. I don’t need to smell it.
Sidney: You can smell our parrot.
Foreman: You said you didn’t have any pets in this class.
Sidney: A parrot is a bird.
[Cut to House and Foreman eating lunch with some Soap on the TV that has House’s attention more than Foreman does]
Foreman: Parrots are the primary source of psitticosis.
House: It’s not the parrot.
Foreman: Psitticosis can lead to nerve problems and neurological complications.
House: How many kids were there in the class?
House: How many are home sick?
Foreman: None, but…
House: None, but you think that 5 year olds are more serious about bird hygiene than their teacher. You’ve been through her home?
Foreman: She lives in Trenton. I can go up to her room tomorrow morning and ask her for the key.
House: Would the police call for permission before dropping by to check out a crime scene?
Foreman: It’s not a crime scene.
House: Far as I know she’s running a Meth Lab out of her basement.
Foreman: She’s a kindergarten teacher!
House: And if I was a Kindergarten student I would trust her implicitly. [Sigh] Ok, I’ll give you a for instance. The lady back there, who made your egg-salad sandwich. Her eyes look glassy, did you notice that? Now hospital policy is to stay home if you’re sick, but if you’re making $8.00 an hour, then ya kinda need the $8.00 an hour right? The sign in the bathroom says that employees must wash after using the facilities, but I figure that somebody who wipes snot on a sleeve isn’t hyper concerned about sanitary conditions. So what do ya think? Should I trust her? I want you to check the patient’s home for contaminants, garbage, medication…[interrupted]
Foreman: Whoa, oh, I can’t just break into someone’s house.
House: Isn’t that how you got into the Felker’s home? [pause] Yeah, I know, court records are sealed, you were 16, it was a stupid mistake, but your old gym teacher has a big mouth. You should write a thank you note.
Foreman: I should thank him?
House: Well, I needed somebody around here with street smarts. Ok? Knows when you’re being conned, knows how to con.
Foreman: I should sue you!
House: I’m pretty sure you can’t sue somebody for wrongful hiring.
Foreman: But I’m pretty sure I can sue if you fire me for not breaking into some lady’s house.
[Foreman eats the rest of the sandwich]
[Cut to House sitting and reading “Spring’s hottest people’ Magazine, Cuddy walks in]
House: I’m doing research. People are fascinating aren’t they?
Cuddy: Why are you giving Adler steroids?
House: Well, she’s my patient that’s what you do with patients. You give them medicine.
Cuddy: You don’t prescribe medicine based on guesses. At least we don’t since Tuskeegee and Mengele.
House: You’re comparing me to a Nazi? Nice.
Cuddy: I’m stopping the treatment.
House: She’s my patient.
Cuddy: It’s my hospital.
House: I did not get her sick, she is not an experiment, I have a legitimate theory about what’s wrong with her.
Cuddy: With no proof.
House: There’s never any proof. 5 different doctors come up with 5 different diagnoses based on the same evidence.
Cuddy: You don’t have any evidence. And nobody knows anything huh? Then how is it that you always assume you’re right?
House: I don’t, I just find it hard to operate on the opposite assumption. And why are you so afraid of making a mistake?
Cuddy: Because I’m a doctor. Because when we make mistakes people die.
[She walks off up the stairs]
House: Come on.
[House thinks about going up the stairs, but decides against it]
House: People used to have more respect for cripples you know! [Turns to a guy in a wheelchair] They didn’t really.
[Cut to Cuddy entering Rebecca’s room. Rebecca is eating voraciously.]
Cuddy; So, how ya feeling?
Rebecca: Much better, thanks. Are you Dr. House? I thought he was a he, but…?
Cuddy: No. Don’t eat too much too fast.
Rebecca: Thank him for me.
[Cuddy exits the room, and House is standing there, Cuddy is a bit surprised by him standing there.]
House: Should I discontinue the treatment, boss?
Cuddy: You got lucky.
[She walks off]
House: Cool, huh?
[Cut to the outside of the hospital, and back into Rebecca’s room, it’s now night and Wilson is there]
Wilson: Ok, once again.
[Rebecca takes a deep breath]
Rebecca: Am I ever gonna meet Dr. House?
Wilson: [scoffs] Well, you might run into him at the movies or on the bus.
Rebecca: Is he a good man?
Wilson: He’s a good doctor.
Rebecca: Can you be one without the other? Don’t you have to care about people?
Wilson: Caring’s a good motivator. He’s found something else. [Has Rebecca grab his hands] Feel this?
Wilson: How about this?
Wilson: Ok squeeze. [Pause] Harder. All right.
Rebecca: He’s your friend, huh?
Rebecca: Does he care about you?
Wilson: I think so.
Rebecca: You don’t know?
Wilson: As Dr. House likes to say, “Everybody lies.”
Rebecca: It’s not what people say, it’s what they do.
Wilson: [Pause] Yes, he cares about me.
Rebecca: I can’t see. [Pause] I can’t see.
[She starts having a seizure and monitors go crazy]
Wilson: A little help in here!
[Flat line on the heart monitor]
(Commercial, again, evil!)
[Cut back to Rebecca’s room, daytime, she has an oxygen mask on. Foreman is there]
Foreman: Your chest will be sore for a while. We needed to shock you to get your heart going. Ok. [He lays a bunch of cards with pictures on them in front of Rebecca] Can you arrange these to tell a story?
[cut to pictures and then to House’s office]
Foreman: She couldn’t put them in order.
Chase: Could the damage have been caused by a lack of oxygen during her seizure?
Foreman: No, I gave her the same test 5 minutes later and she did just fine. The altered mental status is intermittent, just like the verbal skills.
Cameron: So, what now?
Foreman: Given the latest symptoms it’s clearly growing deeper into the brain stem. Soon she won’t be able to walk, she’ll go blind permanently, and then the respiratory center will fail.
House: How long do we have?
Foreman: If it’s a tumor we’re talking a month, maybe two, if it’s infectious a few weeks, if it’s vascular that’ll probably be fastest of all, maybe a week.
House: We’re gonna stop all treatment.
[House gets up and walks over to the drinks.]
Foreman: I still think it’s a tumor. I think we should go back to the radiation.
Chase: She didn’t respond to the radiation.
Foreman: Well, maybe we didn’t see the effects until we started steroids.
House: No, it’s not a tumor. The steroids did something, I just don’t know what.
Foreman: So we’re just gonna do nothing? We’re just gonna watch her die?
House: Yeah, we’re gonna watch her die. Specifically we’re gonna watch how fast she’s dying. You just told us, each diagnosis has its own timeframe. When we see how fast it’s killing her we’ll know what it is.
Cameron: And by then maybe there’s nothing we can do about it.
Foreman: There’s go to be something we can do, something better than watching her die.
House: Well, I got nothing. How ‘bout you?
[Cut to hallway, Foreman and Cameron exit the office]
Foreman: b*st*rd. [Turns to Cameron] Oh, Cameron, I need you for a couple of hours.
Cameron: What’s up?
Foreman: When you break into someone’s house; it’s always better to have a white chick with you.
Cameron: Adler’s house? Why don’t we just ask her for a key?
Foreman: For all we know she could be running a meth lab out of her basement.
[Cut to clinic and House is with a patient, a guy]
Guy: I’m tired a lot.
House: Any other reason you think you may have Chronic Fatigue Syndrome?
Guy: It’s kinda the definition isn’t it?
House: It’s kinda the definition of getting older.
Guy: I had a couple headaches last month, mild fever, sometimes I can’t sleep, and I have trouble concentrating.
House: Apparently not while researching this stuff on the internet.
Guy: I was thinking it also might be fibromyalgia.
House: [Looks contemplative, and then serious] Excellent diagnosis [sarcastic]!
Guy: Is there anything for that?
House: [heavy sigh] Ya know, I think there just might be.
[House goes out of the room, and to the dispensary.]
House: I need 36 Vicodin, and change for a dollar.
Nurse: (jumbled, I can’t tell)
[House gets his change and goes to a candy machine. He gets white candies out of the machine, and goes back to the counter. There he takes the Vicodin and slips them into his pocket, exchanging them for the candy.]
House: Exam room 2. [Places the bottle back on the counter.]
[Cut to Cameron and Foreman in Rebecca’s house]
Cameron: House doesn’t believe in pretense. Figures life’s too short and too painful. So he just says what he thinks.
Foreman: Nothing interesting in the garbage. “I say what I think” is just another way of saying “I’m an ass.”
Cameron: Well, if you wanted to be judged on your medical prowess only, maybe you shouldn’t have broken into someone’s home.
Foreman: I was 16! Don’t know about ticks, but her dog’s definitely got fleas.
Cameron: I managed to make it to 17 without a criminal record.
[Foreman is in the fridge, and takes out some ham and mustard]
Foreman: Yeah? Well you obviously didn’t grow up in my neighborhood.
Cameron: That’s right. You stole a loaf of bread to feed your starving family right? You always eat during break-ins?
Foreman: Am I supposed to respect their food more than I respect their DVD players? You want some?
Foreman: You gonna go hungry until she dies?
Foreman: You know what, after centuries of oppression, decades of civil rights marches, and more significantly living like a monk, never getting less than a 4.0 GPA, you don’t think it’s kind of disgusting I get one of the top jobs in the country because I’m a delinquent? We’ll eat, then we’ll tear up the carpet.
Cameron: You went to Hopkins right?
Cameron: So, you went to a better school than I did, got better grades than I did.
Foreman: So how’d you get the job? Did you stab a guy in a bar fight?
[Off Cameron’s face, a little disturbed]
[Cut to the hospital exterior, daytime, then into House’s office again]
House: It’s not a tumor; she’s getting worse too fast. She can’t stand up.
Wilson: No toxins, no medication?
Foreman: Nothing that would explain these symptoms.
Wilson: Family history of neurological problems?
Foreman: Not that I could tell from her underwear drawer.
House: You said nothing that would explain these symptoms. What did you find that doesn’t explain these symptoms?
Foreman: Dr. Wilson convinced you to treat this patient under false pretenses. Adler’s not his cousin.
Wilson: That’s ridiculous. You can ask her yourself. Can we get back to… [interrupted]
Foreman: She’s not Jewish!
Wilson: Rachel Adler’s not Jewish?
Foreman: I had ham at her apartment!
Wilson: [chuckles] Dr. Foreman, a lot of Jews have non-Jewish relatives, and most of us don’t keep kosher. I can see getting through high school without learning a thing about Jews, but medical school…
Foreman: Ok, maybe she’s Jewish, but she’s definitely not your cousin.
Wilson: Really? This guy’s…he…
Foreman: You don’t even know her name! You called her Rachel; her name is Rebecca!
Wilson: Yes, yes, her name is Rebecca. I call her Rachel.
[While this is going on House is very quiet and you can almost see that he is putting things together}
House: You idiot!
House: Not you, him! You said you didn’t find anything.
Foreman: Everything I found was in [interrupted]
House: You found ham.
House: Where there’s ham there’s pork, where there’s pork there’s neurocysticercosis.
Chase: Tapeworm?! You think she’s got a worm in her brain?
House: It fits. Could have been living there for years, it never occurred to me [interrupted]
Cameron: Millions of people eat ham every day. It’s quite a leap to think that she’s got a tapeworm.
House: OK, Mr. Neurologist. What happens when you give steroids to a person who has a tapeworm?
Foreman: They, they get a little better and then they get worse.
Wilson: Just like Rebecca Adler did.
[Cut out and then in again, House has a book and lays it on the table, open to a page on tapeworms]
House: In a typical case if you don’t cook pork well enough you ingest live tapeworm larvae. They got these little hooks they grab onto your bowel, they live, they grow up, they reproduce.
Chase: Reproduce? There’s only got one lesion, and it’s nowhere near her bowel.
House: That’s because this is not a typical case. Tapeworm can produce 20 to 30,000 eggs a day. Guess where they go.
House: Not all of them. Unlike the larvae, the egg can pass right through the walls of the intestines and into the blood stream. And where does the blood stream go?
House: As long as it’s healthy the immune system doesn’t even know it’s there. The worm builds a wall, uses secretions to shut down the body’s immune response and control fluid flow. It’s really kinda beautiful.
Foreman: As long as it’s healthy, so what do we do? Call a vet and nurse the little guy back to health?
House: It’s too late for that. It’s dying, and as it dies this parasite loses the ability to control of the host’s defenses. The immune system wakes up and attacks the worm and everything starts to swell, and that is very bad for the brain.
Wilson: It could still be a hundred other things. The eosinophil count was normal.
Chase: It’s only abnormal in 30% of cases.
Wilson: Proving nothing.
House: No, no, no, no, you see, it fits, it’s perfect! It explains everything.
Wilson: But it proves nothing.
House: I can prove it by treating it.
Wilson: No, you can’t. I was just with her, she doesn’t want any more treatments, she doesn’t want any more experiments, she wants to go home and die.
(Commercials! Gah! I wish commercials would go home and die!)
[Cut back into Rebecca’s room, it’s nighttime and House enters]
House: [To nurse] Will you excuse us, please?
House: I’m Dr. House.
Rebecca: It’s good to meet you.
House: You’re being an idiot. Ahem. [Pause] You have a tapeworm in your brain, it’s not pleasant, but if we don’t do anything you’ll be dead by the weekend.
Rebecca: Have you actually seen the worm?
House: When you’re all better I’ll show you my diplomas.
Rebecca: You were sure I had vasculitus too. Now I can’t walk and I’m wearing a
diaper. What’s this treatment gonna do for me?
House: I’m not talking about a treatment; I’m talking about a cure. But because I might be wrong, you want to die.
Rebecca: What made you a cripple?
House: I had an infarction.
Rebecca: A heart attack?
House: It’s what happens when the blood flow is obstructed. If it’s in the heart it’s a heart attack. If it’s in the lungs it’s a pulmonary embolism. If it’s in the brain it’s a stroke. I had it in my thigh muscles.
Rebecca: Wasn’t there something they could do?
House: There was plenty they could do, if they made the right diagnosis, but the only symptom was pain. Not may people get to experience muscle death.
Rebecca: Did you think you were dying?
House: I hoped I was dying.
Rebecca: So you hide in your office, refuse to see patients because you don’t like the way people look at you. You feel cheated by life so now you’re gonna get even with the world. You want me to fight this. Why? What makes you think I’m so much better than you?
House: When you’re scared, you’ll turn into me.
Rebecca: I just want to die with a little dignity.
House: There’s no such thing! Our bodies break down, sometimes when we’re 90, sometimes before we’re even born, but it always happens and there’s never any dignity in it. I don’t care if you can walk, see, wipe your own ass. It’s always ugly, always. [Pause] You can live with dignity, we can’t die with it.
[Cut to hallway, outside the room, looks like daytime, but it could be the lights in the hospital.]
House: No treatment.
Foreman: Maybe we can get a court order, override her wishes. Claim she doesn’t have the capacity to make this decision.
House: But she does.
Cameron: But we could claim that the illness made her mentally incompetent.
Foreman: Pretty common result.
House: That didn’t happen here.
Wilson: He’s not gonna do it. She’s not just a file to him anymore. He respects her.
Cameron: So because you respect her, you’re going to let her die?
House: I solved the case, my work is done.
[House starts to walk away]
House: Patients always want proof, we’re not making cars here, we don’t give guarantees.
[House continues walking, Off Chase]
Chase: I think we can prove it’s a worm. It’s noninvasive, it’s safe. I’m not completely sure but…[interrupted]
House: Yeah, yeah, yeah what’s the damn idea?
Chase: Have you ever seen a worm under an x-ray, a regular old no contrast 100-year-old technology x-ray? They light up like shotgun pellets. Just like on a contrast MRI.
Foreman: Which is the same thing as a CT scan, which we did, which proved nothing.
House: Worm cysts is the same density as the cerebrospinal fluid, we’re not going to see anything in her head, but Chase is right, he’s right, we should x-ray her, but we don’t x-ray her brain, we x-ray her leg, worms love thigh muscle. If she’s got one in her head I guarantee you there’s one in her leg.
[Cut to x-ray table, Rebecca is on it, and they focus on her leg, x-ray is taken.]
Chase: Hold still, Rebecca.
[…And the worm shows up. Cut to Rebecca’s hospital room, day.]
Chase: This here is a worm larva. [Chase pointing to x-ray of her leg]
Rebecca: So, if it’s in my leg, it’s in my brain?
Chase: Are you looking for a guarantee? It’s there, probably been there 6 to 10 years.
Rebecca: Could I have more?
Chase: Probably. It’s good news.
Rebecca: What do we do now?
Chase: Now we get you better. Albendazole.
[Hands her a cup with two pills in it.]
Rebecca: Two pills?
Chase: Yeah, every day for at least a month with a meal.
Rebecca: Two pills?
Chase: Yeah, possible side effects include abdominal pain, nausea, headache, dizziness, fever, and hair loss. We’ll probably make you keep taking the pills even if you get every one of those.
[Rebecca smirks, and then downs the pills]
[Cut to House’s office, day. Cameron’s there waiting as House enters.]
Cameron: Why did you hire me?
House: Does it matter?
Cameron: Kinda hard to work for a guy who doesn’t respect you.
Cameron: Is that rhetorical?
House: No, it just seems that way because you can’t think of an answer. Does it make a difference why I think I’m a jerk? The only thing that matters is what you think. Can you do the job?
Cameron: You hired a black guy because he had a juvenile record.
House: No, it wasn’t a racial thing, I didn’t see a black guy. I just saw a doctor…with a juvenile record. I hired Chase ‘cause his dad made a phone call. I hired you because you are extremely pretty.
Cameron: You hired me to get into my pants?!
House: I can’t believe that that would shock you. It’s also not what I said. No, I hired you because you look good; it’s like having a nice piece of art in the lobby.
Cameron: I was in the top of my class.
House: But not THE top.
Cameron: I did an internship at the Mayo Clinic.
House: Yes, you were a very good applicant.
Cameron: But not the best?
House: Would that upset you, really, to think that you were hired because of some genetic gift of beauty not some genetic gift of intelligence?
Cameron: I worked very hard to get where I am.
House: But you didn’t have to. People choose the paths that gain them the greatest rewards for the least amount of effort. That’s a law of nature, and you defied it. That’s why I hired you. You could have married rich, could have been a model, you could have just shown up and people would have given you stuff. Lots of stuff, but you didn’t, you worked your stunning little ass off.
Cameron: Am I supposed to be flattered?
House: Gorgeous women do not go to medical school. Unless they’re as damaged as they are beautiful. Were you abused by a family member?
House: Sexually assaulted?
House: But you are damaged, aren’t you?
[Cameron hesitates, and in that moment her pager goes off]
Cameron: I have to go.
[She leaves, cut to orange guy (not so orange now) in with Cuddy]
Orange guy: I followed her. I couldn’t stop thinking about what that doctor said.
Cuddy: I told you not to listen to him, he’s an idiot.
Orange guy: I was ORANGE.
Cuddy: I don’t want to know what you found out.
Orange guy: You don’t care?
Cuddy: I’m your doctor, you’ve been good to me and good to this hospital, of course I care, but I don’t see how this conversation can end well for me. Either your wife is having an affair, or she’s not having an affair and you have come here because you rightly think I should fire him, but I can’t even if it cost me your money, the son of a bitch is the best doctor we have.
[Cut to his finger, now missing his ring]
[Cut to Rebecca’s room, Chase enters]
Chase: Feeling any better?
Rebecca: I can’t complain.
Chase: As you know the hospital has certain rules, and as you also know we tend to ignore them, but I think this one’s gonna be a little obvious unless we get your help.
[Cameron enters with Rebecca’s class]
Cameron: If anyone asks, you have 11 daughters and 5 sons.
Rebecca: Hi, you guys!
Rebecca: Come here!
[They gather around her bed and present her with a card.]
Rebecca: It’s so good to see you guys! I missed you! Is this for me?
[Rebecca opens it and inside it says “Miss Rebecca we’re glad you’re not dead”]
Rebecca: Oh, I love you guys. [To Chase and Cameron] I wanted to thank Dr. House, but he never visited again.
Cameron: He cured you, you didn’t cure him.
Rebecca: [Talking to class] Ok, I want a hug and a kiss from every single one of you. Get up here right now!
Class: [Giggles, and laughs]
[They get up on the bed with Rebecca]
[Cut to House watching General Hospital (I assume)]
Female Dr. on mini TV: There.
Male Dr on mini TV: Hold on.
Female Dr. on mini TV: She’s converted.
House: You said she was your cousin. Why would you lie?
Wilson: It got you to take the case.
House: You lied to a friend to save a stranger, you don’t think that’s screwed up?
Wilson: You’ve never lied to me?
House: I NEVER lie.
Wilson: Oh, really.
Male Dr on mini TV: Why do we do this?
Female Dr. on mini TV: Because we’re doctors, when we make mistakes people die.
[House gets a great little smirk here, re: Cuddy using the same line earlier]
[Knock on the door]
Nurse: Dr. House? You have a patient.
[Nurse pulls the blinds away to reveal the guy that House gave the candy pills to.]
Nurse: He says he needs a refill.
House: Got change for a dollar?
[Cut to outside the hospital and aerial view of the campus.]
Singing: “No, you can’t always get what you want.” “You can’t always get what you want.”