05x23 - Under My Skin

[bunniefuu]

[Open on the overhead grid at a theater. Philip Glass’s Company: II is playing. Cut to a line of feet, in toe shoes. Cuts between the dancers on stage, the orchestra and backstage. Jeremy and Penelope dance together. He dips her and grabs his back as he straightens up.]

Jeremy: [holding his back] It’s way too fast.

Penelope: Felt good.

Choreographer: [with a group in the seats] If we could clear the stage quickly, please.

Jeremy: [to the conductor] Maury, it’s too fast.

Maury: It’s exactly the same.

Jeremy: Then slow it down.

Choreographer: [coming down the aisle] Everything all right, Jeremy?

Jeremy: Sure. Ready when you are.

Choreographer: From the allegro, please.

Woman: What’s his problem?

Choreographer: His back’s not 100%.

Female Staff Member: He can’t talk to the conductor like that.

Choreographer: No, he can’t. [looks at Penelope, dancing] She could.

Penelope: [to Jeremy, sotto voce] You okay with the lift?

Jeremy: Fine, unless you mess up the timing.

Penelope: My timing is perfect.

Jeremy: It was last night.

Female Staff Member: [as Penelope dances toward Jeremy] Moment of truth.

[Penelope dances across the stage. Jeremy holds her in a one-armed lift. As he begins to turn, he cries out and falls to the floor, dropping Penelope.]

Jeremy: Ahhhhhh!

Male Staff Member: Damn it!

[Cut to Penelope, on floor, gasping in pain; Jeremy grabbing his back in pain, choreographer running down the aisle.]

Manager: Penelope, are you all right?

[She is gasping. CGI of her heart. Jeremy goes to her.]

Jeremy: She can’t breathe. Call a doctor.

[Opening Credits]

[Cut to House’s living room. He is on the couch, in a bathrobe, eating cereal and watching a show about elephants on TV. There is a plinking noise. Amber is playing Yankee Doodle Dandy on the ukulele, badly.]

Amber: Are you going to ignore me all day, again? I help you.

House: You tried to k*ll Chase.

Amber: Doing what you wanted. That’s all, boss. [She stands between him and the TV] I exist.

House: No, you don’t. I acknowledge my subconscious exists. Now go away.

[There’s loud knocking on the door.]

Amber: Saying it is one thing, living it is another. You’re not rational. [He gives her a look as he heads to the door] Not completely.

Foreman: [in the hall when House opens his door] Put the phone on the receiver, send the hookers home and get dressed. We’ve got a case.

House: I’m taking a personal day.

Foreman: Twenty-one year old star of the New York Ballet collapsed on stage.

House: I love ballet but, as someone may have mentioned, I’m taking a personal day.

Foreman: Cuddy said get your ass in or you’re fired.

House; She’s not gonna fire me.

Amber: She’s not gonna fire you? If you don’t go to work?

Foreman: Okay. [he leaves]

Amber: How long do you figure until I just… disappear?

House: [following Foreman into the vestibule] Hold on.

[Cut to Diagnostics Office. The fellows are sitting around the table. House is pacing.]

Thirteen: No tumors or punctures in the lungs. No bruising. No sign of trauma. No STDs.

Taub: And supplemental oxygen’s only gotten her saturation level to 60. Lungs keep collapsing despite a chest tube.

Foreman: ER ruled out the obvious. White count and temp are normal so no pneumonia.

Amber: Coffee’s burnt. Thirteen’s wearing cherry-flavored lip gloss. Foreman’s staring at you. Any of that helpful?

Foreman: House?

House: STD?

Foreman: We just said the tests were negative. You think we should…

House: No.

Amber: She’s a dancer. What about dehydration?

House: What about a pulmonary contusion?

Thirteen: CT showed no inflammation on the lungs.

Amber: What about dehydration?

House: B.U.N. and creatinine are elevated but within range…

Amber: Hey. I’m just the irrational part of your brain but elevated means high, right? Dehydration could hide an infection.

House: Dehydration could hide an infection. Go treat her for the obvious. IV fluids and antibiotics for the pneumonia.

[The fellows leave.]

Amber: We’re like Magic and Kareem. [She puts up a hand for a high-five and House walks past her.]

[Cut to Wilson’s office]

Wilson: Mr. Pietramala, you have kidney cancer.

Pietramala: Wow. Is that a bad one? I mean, they’re all bad, but…

[House enters]

Wilson: The door was closed for a reason.

House: Well, now it’s open for a reason. We need to talk.

Pietramala: He just told me I have kidney cancer.

House: Then you’ll obviously need a moment to process.

Wilson: House…

House: I’m hallucinating.

Wilson: I’m… I’ll be right back. [He follows House into the hall. House closes the office door.]

House: I need you to sit in on my differentials, double-check everything I do.

Wilson: You can’t treat patients.

House: It’s gotta be sleep apnea. I get a good night’s sleep and I still feel exhausted. Lack of delta sleep can lead to hallucinations.

Wilson: Do you have any other neurological symptoms?

House: I don’t think so.

Wilson: Aphasia?

House: No.

Wilson: Memory loss?

House: Nope.

Wilson: Irritability?

House: Yeah! That one!

Amber: Don’t deflect. He cares about you. You care about him. Tell him you…

Wilson: [at the same time] You shouldn’t be practicing. At least…

House: Enough! [Both Amber and Wilson stop talking.] Don’t give me the look. I told you I was hallucinating.

Wilson: [looking behind himself] Who were you talking to?

House: Someone who’s not actually here. Beyond that seems irrelevant.

Wilson: Your mind made a choice. It means something.

Amber: You know he’s just going to keep asking.

House: Kutner.

Amber: Good choice. He feels bad.

House: You gonna help me or not?

Wilson: Yeah. [He goes back into his office.]

[Cut to Cameron’s home. She and Chase are having dinner.]

Chase: I could eat from this place seven days a week.

Cameron: We practically do.

Chase: [clearing the table] You can order tomorrow night. Do you want some wine?

Cameron: No, thanks. [pause] I have my husband’s sperm.

Chase: Your dead husband’s?

Cameron: We froze it when he got diagnosed.

Chase: And you kept it? All this time?

Cameron: I used to think if I didn’t find anyone, then…

Chase: You found someone.

Cameron: I know. But…

Chase: What if it goes wrong? What if I turn out to be a radical anarchist with a secret family and that I age backwards?

Cameron: Nobody plans on getting divorced. I didn’t plan on my husband dying, but he did.

Chase: So you’re saying you want a prenup, in liquid form.

[Cut to sleep lab. House is in bed and taking off his watch.]

Wilson: What if it’s not sleep apnea? Trauma from your motorcycle accident? Vicodin abuse? You need to be admitted.

Amber: [Sitting on the foot of the bed] I know you’re wrong about sleep apnea which means you know you’re wrong about sleep apnea. You’re scared. Tell him you’re scared.

House: [to Wilson] Can’t sleep with you here.

[Wilson sighs and leaves.]

[Cut to House’s office the next morning. Wilson stands as House enters.]

Wilson: Did it work?

House: Do you see someone standing beside me?

Wilson: No.

House: Then, no. [Amber is standing next to him.]

Amber: So, what’s next on your list of things it’s not.

Foreman: [entering] Patient’s not responding to the antibiotics. Still can’t breathe.

House: So run a test to confirm it’s pneumonia.

Foreman: We can’t do a bronc because her lungs are still collapsed.

House: Trans-tracheal aspiration.

Foreman: That’s basically water boarding.

Wilson: It is pretty radical.

Amber: It’s a great idea!

House: Regular radical, me radical or me out of my mind radical?

Wilson: Somewhere between regular and you.

House: So what’s the problem?

Foreman: Everything okay?

House: No. Our patient can’t breathe. Either do the test or come up with a better one. [Foreman leaves. House hands Wilson a list on the back of an envelope] So, we’re down to infection, trauma, MS, schizophrenia, pills.

Wilson: Schizophrenia usually manifests younger.

House: That’s why it’s further down the list. We can confirm an infection with a simple blood test.

Amber: An infection can be treated. Cured. Means you still got a job. Means you still got a life. Doesn’t make it a better idea, just a nicer one. This the rational you talking?

House: [handing a blood drawing kit to Wilson] Can’t do this on my own.

[Cut to Penelope’s room. Jeremy is holding her hand.]

Foreman: When we inject the water it’s going to feel like you’re drowning, but it will be over in a few seconds.

Penelope: Then it will be better?

Taub: A little.

Foreman: [to Taub who has moved to the head of the bed] Hold her shoulders down a little. [He swabs her throat with povidone.] Ready? [He starts the tracheotomy] You’re doing great. Here comes the liquid. [She starts to cough and sit up.] Taub.

Taub: I slipped. Oh, no.

Jeremy: What?

Taub: Her skin came off.

[Penelope starts to cry]

[Cut to burn unit. Taub is draping a sheet of artificial skin on Penelope.]

[Cut to room where House and Foreman are watching the procedure on TV. Jeremy is near a TV showing the procedure]

Foreman: Her skin is sloughing off faster than we can replace it with the artificial skin.

Thirteen: Could be autoimmune.

Foreman: The ANA was negative.

House: Focus on the lungs.

Foreman: You want us to ignore the fact that she’s lost 80% of her skin?

House: We know it’s not lung cancer. It could be a liver tumor, eats through to the lungs. Get an ultrasound of her liver. If you find masses, get a biopsy.

Foreman: We can’t just ignore the skin. It’s obviously the most significant and dangerous symptom right now.

House: I don’t think it is a symptom. I think we caused it.

Thirteen: By doing what?

House: I prescribed antibiotics.

Foreman: Toxic epidermal necrolysis. That’s a one in a million reaction.

House: Yeah, well, maybe this is the one. Get swabs of her old skin to confirm.

[Cut to the Clinic. House raps on the door with his cane to get Wilson’s attention.]

House: Where the hell were you?

Wilson: I do have a practice.

House: Ballerina has toxic epidermal necrolysis.

Wilson: Are you sure?

House: About to be.

Wilson: I’m sorry.

House: I feel guilty.

Wilson: You didn’t do anything wrong. You prescribed antibiotics. Any other doctor would have done the exact same thing.

Amber: Any other doctor? Words can hurt, you know.

House: I have no reason to feel guilty. It doesn’t make any sense. Unless there’s something wrong in the limbic area of my brain.

Wilson: Guilt as a symptom?

House: It’s consistent with MS. And, since the blood tests were negative… I have to apologize. If I feel better then you’re right, I was feeling an emotion. If I feel nothing, it means my limbic brain is sh*t.

[House leaves, followed by Amber.]

[Cut to isolation room. Penelope is a bloody mess. Jeremy, gowned and masked, is holding her hand. House enters, also gowned and masked, without his cane.]

House: I’m Doctor House. Anyone explain to you your status?

Penelope: They found a mass in my liver. Cancer.

Jeremy: They said that they think they can treat it and that the skin is starting to take.

Penelope: I’ll be able to dance again.

Amber: [sitting next to House] She’s half dead and she’s wondering if she’ll ever plie again? Healthy priorities. Let the mocking begin.

House: I’m sorry. I treated you for an infection before confirming that you had one. That’s why you lost your skin. I know you’re in pain. I know that I caused it. I’m sorry.

Amber: Very nice. [She pats him comfortingly on the leg]

Jeremy: Thank you?

House: [thinks then shakes his head] Nothing.

[He leaves, tossing his gown in a hamper and grabbing his cane]

[Cut to hall where House joins Amber. She does a little fifth position ballet movement]

Amber: Maybe you didn’t mean it.

House: I meant it. Did you do a liver biopsy to confirm?

Foreman: [in the hall with Wilson] Couldn’t. The artificial skin was too thin. She’d bleed out. Why were you talking to the patient?

House: I think skinless women are hot. Do a trans-jugular liver biopsy. If she bleeds, at least it stays in her veins. [He looks at Wilson]

Foreman: Did you just check with Wilson again?

House: No. [Foreman leaves] I felt nothing. It’s MS.

Wilson: Apologies aren’t supposed to make you feel better. They’re supposed to make the other person feel better.

House: In order to make you feel better.

[They walk down the hall, followed by Amber]

Wilson: Fine. You want to do an LP to confirm or is guilt enough to start filling prescriptions.

[Cut to treatment room where Penelope is getting the trans-jugular biopsy]

Foreman: Last mass about a centimeter to your right. [A machine beeps]

Chase: Problem?

Foreman: A short burst of flutter. We’re almost done.

Chase: Entering the right hepatic vein. Cameron kept her dead husband’s sperm.

Foreman: She doesn’t like yours?

Chase: She likes his better. Or at least she wants to hang on to it in case mine is… unfaithful or something.

Foreman: Wow.

Chase: Advancing two centimeters.

Foreman: You gotta let her do it. If you don’t, you’ll be stuck with her forever.

Chase: I want to be stuck with her forever.

Foreman: She married a dying guy. She has issues. You cannot leave her ever, for any reason because then you’re not just the guy who left her; you’re the guy who k*lled her kids. [A machine starts beeping rapidly] That’s not a good rhythm. Get out.

Chase: Narrow complex tachycardia. She’s gonna crash.

[Cut to Diagnostics Office]

Taub: Liver biopsy was negative for cancer but the procedure sent her heart into a-fib.

Thirteen: We don’t know it was the biopsy that caused the heart problem. Maybe the heart caused the lungs to collapse.

Foreman: Why is Wilson here?

House: You were looking for cancer. I thought it would be helpful for [he gestures toward Wilson]

Foreman: We didn’t find cancer.

House: Yes. Which you reported to me five seconds ago. Thought I’d let him finish his hors d’oeuvres before getting the bouncer to take care of him.

Taub: Until we regulate the heart we can’t get meaningful pictures so we can’t tell…

Wilson: Metoprolol can correct irregular heart…

Foreman: Tried it. Didn’t work. Is Cuddy making him oversee?

House: No!

[Amber picks up an X-acto Kn*fe from House’s desk]

Taub: Heart’s too irregular for MRI. Other scans wouldn’t …

Foreman: Then you’re making him oversee your choices. You don’t trust yourself. Why?

House: Wilson. Get out.

Wilson: Are you sure?

House: Do I need your approval to throw you out? [Wilson leaves] You happy now?

Taub: There’s only times her heart’s going to be still for our pictures and that’s when she’s dead.

Amber: It’s not MS. Severe mental illness and Vicodin are all that’s left. Mental illness means you can no longer practice medicine. Vicodin means detox, which means pain for the rest of your life. Which means you can no longer practice medicine.

[She plunges the Kn*fe deeply into her arm and cuts up toward her elbow. The wound is several inches long and bleeds profusely.]

House: Are you saying we should k*ll her?

Taub: No.

House: If we stopped her heart we could get our pictures and then restart it.

Thirteen: What if we can’t restart it?

House: Then she stays dead.

Taub: We restart hearts all the time.

Thirteen: It’ll take four minutes to MRI her entire heart.

Foreman: And we only have three minutes until there’s brain damage. Sure about this?

House: Yeah.

[Cut to a nurses’ station where Wilson is charting]

House: We’re gonna stop her heart so I can MRI it. I think it was her idea. Pneumonia was her idea and almost k*lled my patient.

Wilson: Her?

Amber: Ooops.

House: Kutner was secretly a woman. That’s why he k*lled himself. [Wilson waits] It’s Amber.

Wilson: Your subconscious picked my dead girlfriend?

House: Yeah. The irrational part of my brain works like the rational part of yours. How about that.

Wilson: It raises questions.

Amber: It answers questions.

House: Who cares? I’ve got competing ideas. They can’t both be right.

Amber: Everybody gets competing ideas. Everybody has doubts.

House: So is it regular radical, me radical or me out of my mind radical?

Wilson: It’s on the upper end of you radical. Do you have any alternative?

House: Nothing that anyone in my head has come up with.

Wilson: Then you’re as safe as you can be.

House: Great. [starts to leave, turns back] You get the LP results back?

Wilson: Yeah. It’s a big shock. You don’t have MS. But while I had your blood sample, I checked your Vicodin levels. Way too high.

House: I need the pills.

Amber: Not an argument. He knows that’s not an argument.

House: It could still be schizophrenia.

Wilson: House, if you’re on anti-psych meds, you’re not going to be able to practice.

House: I know.

Wilson: You’d prefer electroshock therapy to rehab?

House: I’d prefer something that could actually work.

Wilson: You’re rationalizing.

Amber: No kidding.

Wilson: I know that you’re afraid of the pain, but electoshock?

House: Don’t give me the cancer voice, that overly earnest tone.

Wilson: Heart att*ck, stroke, seizure, death or worse.

House: Worse? Double-death?

Wilson: You live but you damage the only thing you care about. Your rational mind. [House lets this sink in, then nods] I’ll make some calls.

[Cut to MRI room]

Penelope: I’ll actually be dead?

Chase: Just your heart. Just for a little while.

Penelope: Hopefully.

[Chase zaps her with the defibrillator paddles, starts the MRI and joins Thirteen, Taub and Foreman in the control room]

[Cut to House’s office. He is talking on the phone with Wilson who is in the cafeteria.]

House: I have an idea.

Wilson: Stop having ideas.

House: Insulin shock.

Wilson: Yes. That’s marginally less dangerous than ECT. Puts you in a coma, could cause…

House: Could work.

Wilson: If you had psychosis, which you don’t.

House: I’ve had no diarrhea, no sweating, no vomiting. None of the symptoms of Vicodin overdose.

Wilson: Yeah, except the “I see dead people” thing.

House: I’ve been popping pills for years. I’ve only been seeing things for days. Something changed.

Wilson: Vicodin addiction is still more likely.

House: So, we’re no longer dealing in absolutes.

Wilson: House, I’ll be up in five minutes. Then we can talk about how you’d rather be in a coma than in rehab.

House: Actually, if you could be up here in two, that’d be really helpful.

Wilson: Why?

House: Because I’m about to put myself into insulin shock.

[Wilson grabs the edge of the table and propels himself out of the booth.]

[Inter-cut between MRI room and House’s office]

Thirteen: Left atrium is fine.

Taub: Left coronary artery also fine. We’re almost at three minutes.

[The clock shows 8 seconds remain.]

Foreman: Keep going.

Chase: Chordae tendineae clear.

Thirteen: Right atrium is fine.

Chase: I got to start her back up.

Thirteen: We have some time.

Chase: We’re over.

Taub: Right coronary artery is fine.

Thirteen: The three-minute threshold is a guideline.

Chase: She might have less. We have to stop.

Foreman: What’s that by the aorta?

Taub: I don’t see anything.

Chase: I’m restarting her heart.

Foreman: That’s a shadow. Two centimeters…

[Chase interrupts the scan and gets Penelope out.]

[Cut to House’s office. Amber is sitting on the floor]

House: You’re only scared because you know this is going to work. [He injects the insulin in his left forearm]

[Cut to MRI. Chase shocks Penelope. It’s 19 seconds past the 3-minute mark.]

Thirteen: We’re over three minutes.

[Chase shocks her again]

[Cut to House, withdrawing the needle. He stares at Amber who gets blurry, as does the rest of the room]

[Cut to Chase, shocking Penelope for the third and forth time.]

[Cut to House, smiling. Amber stands and quickly recedes past the desk. She disappears through the wall.]

House: Yes. [He begins to seize.]

[Cut to Penelope, awake]

[Cut to House, falling off his chair onto the floor, convulsing. Wilson runs to him]

Wilson: I need glucose in here!

[Cut to House lying on a gurney. Wilson is pacing. House wakes up and looks around.]

Wilson: You could have d*ed. [House pushes the curtain between cubicles aside and looks in.]

House: It worked. Where are my pants?

Wilson: Are you sure? [Picks up House’s jeans]

House: She’s been everywhere I’ve been for days. [House sits on the edge of the gurney with his (scarless) right thigh showing. He pulls on his pants while Wilson tosses his jeans on the gurney.] She’s not here, ergo…

Wilson: This was not the next rational step.

House: Now who’s being biased? You wanted me to detox as much as I wanted… [stops dressing] Forgot how to do my zipper.

Wilson: Any other neurological deficit?

House: You don’t seem to annoy me as usual. I’m not sure that’s a deficit. [zips pants] And, I’m all better.

[Wilson puts his hands on House’s shoulders and pushes him firmly back down. He takes out a flashlight and checks House’s eyes.]

Wilson: Is she really gone?

House: Absolutely. I can feel myself repressing all kinds of icky things. I check out, don’t I? [Wilson shrugs as House’s beeper goes off. He checks it] Damn.

[Cut to light board room. The walls are covered with x-rays]

Chase: He didn’t see anything. He saw an artifact on the monitor.

Foreman: It was a shadow on her heart.

Chase: She’d already been technically dead for three minutes. I thought keeping her alive took precedence over prolonging the photo op.

House: Any brain damage?

Thirteen: No. And all tests indicate that…

House: Obviously had more time.

Chase: [giving up] Best of luck. [He leaves]

House: I assume we can’t k*ll her again and take more pictures.

Foreman: Uhhh. You’ll wanna check with Wilson?

House: Good one.

Taub: It’s something. A lesion.

Thirteen: Tumor? Scar tissue?

Foreman: Could be an abscess infection. Explains why it’s invisible in the blood. It’s doing its damage behind closed doors, sealed off.

House: See, the problem with speculation is you make a speck out of you and some guy named “Lation” which really doesn’t affect me at all.

Taub: We have to guess. It’s all we’ve got. We can’t do a biopsy. The last time we went into her heart she had a major cardiac event.

House: Which just leaves…

[He leaves, followed by the fellows.]

[Cut to observation room over the isolation unit. Jeremy is holding Penelope’s hand.]

Taub: What are you looking for?

House: I don’t know yet.

Thirteen: The picture doesn’t change. She lies there in pain. He sits there, worried.

House: Nothing changes. [pause] I just had an epiphany. All by myself. Popped into my head out of nothing.

Taub: Care to share?

House: He’s too devoted.

Foreman: Too devoted? You think he feels guilty?

House: Right. I’m being cynical. People can care because they care, not because they cheated. Theoretically true. But gonorrhea fits better.

Thirteen: No. No STDs. We tested her.

House: Tested her blood.

Taub: That is the test.

House: That’s not where her problem is. Gonorrhea disseminated to her heart. Got walled off in an abscess, it’d be invisible.

Foreman: And it would look like a shadow.

House: No need to test her again when we can check Prince Charming. Once you confirm, cut the abscess out of her heart.

[Cut to a restaurant. House is sitting at a window seat.]

Molly: Here are your onion rings, extra well done.

House: Thank you, Molly. And another beer when you get the chance. I’m celebrating.

Molly: Alone?

House: Thank goodness. [MMMBop is heard. House pulls out his cell phone.] Don’t tell me, I was right.

Foreman: [at House’s desk] Yep. Boyfriend has gonorrhea.

House: And everyone’s a winner.

Foreman: He’s not too happy about it. He insists he’s never cheated, must have gotten it from her.

House: Don’t think so.

Foreman: Timing would fit. He’s got no symptoms and she’s dying.

House: Lying would fit too.

Foreman: He’s not hanging out in her room anymore. [House thinks] What does it matter? You were right. We’re prepping her for surgery.

House: I saw guilt in him. If he’s not actually guilty, then I wasn’t right. I was lucky.

Foreman: House, you made a brilliant deduction about her heart.

House: And if I was just lucky…

[House hears humming. He turns. Amber is by the microphone on the restaurant’s bandstand. She starts singing. One. Word. At. A. Time]

Amber: Enjoy yourself, it’s later than you think. Enjoy yourself, while you’re still in the pink. The years go by [laughs] as quickly as a wink. Enjoy yourself. Enjoy yourself. It’s later than you think. [Laughs]

[House looks terrified. His hand lowers to the table and he stares at Amber. During the last two “enjoy yourself”s, he picks up the phone again and talks over Amber’s singing.]

House: Wilson. Come get me.

[Cut to Wilson’s car. It’s raining and House is staring out the window.]

Wilson: I know a nice facility outside Philly. I went to undergrad with one of the directors.

House: Thanks.

[Amber, in the back seat, smiles.]

[Cut to House’s bedroom. He’s taking clothes out of his bureau.]

House: How many shirts do I need?

Wilson: They said three. They have laundry.

Amber: Like living with Mom again. Delightful.

[MMMBop is heard. Wilson takes House’s phone from the dresser.]

House: It’s probably Foreman.

Wilson: He’s unavailable.

Foreman: [in Penelope’s room] Tell him the infection’s made her septic. We can’t remove the abscess until we get her BP up and it’s not responding to fluids, it’s not…

Wilson: He’s off the case. [He closes the phone.]

House: Patient okay?

Wilson: Yeah.

Amber: He’s lying.

House: Why don’t I feel scared?

Wilson: I’d say you’re unaware of what you’re feeling at this moment.

House: I feel like crap. My life if falling apart, but I don’t feel scared. Not of the rehab, anyway.

Amber: We’ve always been able to find a way to cheat.

House: It won’t work.

Wilson: You want it to work this time.

Amber: Do we?

Wilson: House, it’s your only option.

House: What do I do if my only option won’t work?

Wilson: You don’t give up.

House: Hmm. It’s either that or electroshock every six hours. Good night, Wilson.

[Cut to the observation room]

Taub: What if we put her on a heart-lung machine?

Thirteen: She’s septic. We don’t need a heart-lung machine. We need a blood-vessel-holder-together machine.

Foreman: We could try high-dose dopamine. It’s a vasoconstrictor. It’ll close the blood vessels so she won’t bleed out.

Taub: Her heart can’t take that much dopamine. It’ll explode.

Foreman: And, if we don’t use the dopamine, it’ll implode.

Thirteen: Is House really done?

Foreman: It sounded that way.

Thirteen: Dopamine it is.

[Cut to Cuddy’s office. She’s getting ready to leave for the day. House enters, walks to her desk and stands there, silently.]

Cuddy: It’s late and I’m tired. Can we get to the talking part of this conversation?

House: I quit.

Cuddy: Great. My nanny is off the clock at 7:30 so your week off, bigger desk, tighter nurses’ uniforms or whatever other stupid thing you’re about to demand is going to have to wait until…

House: You can go suckle the little bastard child who makes you feel good about yourself.

Cuddy: [very hurt] Screw you. [She walks to the door.]

Amber: Don’t do this.

House: I’m hallucinating.

Cuddy: [stops] From the Vicodin?

House: Ruled out everything else.

Cuddy: We can, uh, admit you through the ER under a pseudonym. No one has to…

House: I’ll cheat, scam, find some way to keep using.

Cuddy: These people know what they’re doing.

House: These people don’t know me. You do.

Amber: She’s not your keeper. She has no responsibility for you.

House: I need you.

Cuddy: Let me call my baby sitter.

[Cut to OR. Chase is operating. Foreman, Taub and Thirteen are in the observation balcony.]

Taub: Blood pressure is 90 over 60.

Foreman: We know.

Taub: I’m just saying it’s still 90 over 60. It’s holding.

Chase: Abscess is intact. It doesn’t look like any of the surrounding tissue is affected. She’s gonna be fine.

Nurse: Doctor!

[She peels back the drape over Penelope’s hand. He looks and lifts the drape over the other hand. Her fingers are a black/copper/gray color. Her toes look the same.]

Chase: We’ve got a problem.

[Cut to House’s living room. He’s on the couch, vomiting into the trash can.]

Cuddy: Lie down. I’ll get you some tea.

House: Yeah. That’ll be better. [He watches her leave then leans across the couch to open a decorative box on the end table.]

Amber: You really think she hasn’t searched this place for your secret stash?

[He feels inside the box, anyway, as Cuddy returns.]

Cuddy: I already did this room and the bathroom and your bedroom. Where should I look, in the kitchen?

House: [His eyes are watering. He’s shivering. His hand has a major tremor. He can barely speak.] Coffee cup. On the top shelf.

Cuddy: That was a test. I already did the kitchen.

Amber: Nicely played. She’ll think you’ve come clean and given her everything. [House nods]

House: There’s more.

Amber: Don’t. You’re hurting already. It’ll only get worse.

Cuddy: House, you should tell me where it is now because you won’t have the will to tell me in two hours.

House: My shoes in the closet.

Amber: It’s like I don’t even know who you are anymore.

[House continues to shake. He throws his head back on the couch with a groan.]

Cuddy: Okay. Hold my hand.

[Cut to recovery room. Penelope wakes up.]

Penelope: Am I okay?

Chase: We were able to successfully remove the abscess from your heart but the dopamine caused the blood vessels in your hands and feet to clamp shut. We need to amputate or the gangrene will spread. You’ll die.

Penelope: My feet?

Chase: And your hands. I’m sorry.

Penelope: No. I’m a dancer.

Chase: The tissue can’t be saved.

Penelope: No.

[Chase looks up at the observation deck where the fellows are.]

[Cut to Diagnostics Office. House’s desk is noticeably empty.]

Taub: We know what House would do.

Chase: House would have never woken her up to ask for consent. If you can’t live with the answer, don’t ask the question.

Thirteen: You’re saying we should accept her decision.

Chase: Bold idea, I know.

Thirteen: Maybe we can get the boyfriend to convince her to do it.

Chase: Yeah. Boyfriends get everything they want.

Foreman: Forget it. The boyfriend doesn’t want to talk to her at all. [He stands.]

Taub: Where are you going?

Foreman: Home. The case is over.

Taub: No, it’s not. Not until we come up with something that might work. It’s a shame that she might die because House has some personal crap to work through.

Chase: Technically, if she dies it’s because House has some personal crap to work through and we weren’t smart enough to get the answer without him.

[Chase pushed the right button. Foreman sits back down.]

[Cut to House’s bathroom. He’s sitting on the floor, curled around the toilet. Cuddy is sitting, watching him.]

House: False alarm.

Cuddy: Drink this. [Hands him a glass.]

House: That’s your advice? Drink this?

Cuddy: It’s ginger. It’ll ease the nausea.

House: You know what would calm the nausea? Vicodin. Marijuana. A coma. [He sees a lone Vicodin on the floor, past the bath mat.]

Amber: Now, don’t pretend you didn’t see it. I saw it, which means you saw it. Send her away.

[He swallows some of the ginger.]

House: Too bitter. I already have enough bitter.

Cuddy: I’ll add some honey. [She leaves]

Amber: You’re pathetic. If you want the pill, just send her home. But you can’t because that would mean admitting defeat to her.

[House stretches out his bad leg and starts crawling toward the pill.]

Amber (continues): Now this is interesting. If you take the pill, you don’t deserve her. If you secretly take the pill, you don’t deserve anyone.

[House reaches for the pill just as Cuddy returns.[

Cuddy: No!

[She puts down the glass, runs over and grabs the pill.]

House: No! No!

[Cuddy tosses the pill in the toilet and flushes it. House slides back and sticks his hands in, trying to retrieve it. She strokes his arm.]

[Cut to OR. A syringe of something is being used on Penelope.]

Chase: This isn’t going to work.

Taub: It might work. That’s all we’re going for. Vasodilators can…

Chase: Big jump from reopening to reanimating. I’m out of the ulnar. I’m not seeing any clearing. This won’t work.

Taub: This probably won’t work.

Chase: Radial artery’s really tight.

Taub: Don’t go too fast. If it clots, she loses the hand.

Chase: If it clots, she’s dead. [He looks at the monitor] I can’t believe it.

Taub: What?

Chase: It might be working.

[Cut to House’s apartment at dawn. He’s lying on the couch. Cuddy is curled on the chair with a blanket, a cup of tea and a fishing magazine.]

House: Can you stop? The breathing.

Cuddy: Air goes in. Air goes out.

House: Then use your nose.

Cuddy: You’re supposed to feel like crap. You’re doing great.

House: And after?

Cuddy: You come back to work.

House: And what if I can’t?

Cuddy: Opioid dependency can make you think you have more pain than you really have. You’re going to be okay.

House: You’re telling me what I want to hear. With no evidence.

Cuddy: I’m telling you what I believe to be true.

House: With no evidence.

Cuddy: You’re hardly the most unbiased observer.

House: Neither are you. [Cuddy looks surprised.] I’m your hospital’s biggest asset.

Cuddy: Is that why you think I’m here?

House: That’s why you’re here. That’s why you’re lying to me about…

Cuddy: I haven’t lied to you in 20 years.

House: Sure you have. [He props himself up, interested in the puzzle] Which means that you just said that because you want to tell me what you lied to me about twenty years ago.

Cuddy: You’re an ass.

House: Am I wrong?

Cuddy: I wasn’t in your endocrinology class.

House: You sat next to me. I cheated off you in the midterm.

Cuddy: I audited your endocrinology class.

House: Why would you…?

Cuddy: Because I thought you were an interesting lunatic, even then. I’m not here protecting hospital property.

[House thinks for a minute.]

House: We’re alone.

Cuddy: We’ve been alone all night.

House: No, I mean Amber. She’s gone.

[Cut to Penelope’s room. She looks at her hands. Taub enters.]

Penelope: Where’s Jeremy?

Taub: He left. [pause] You okay?

[She nods.]

[Cut to Cameron’s apartment. Chase is on the couch.]

Chase: The surgery worked.

Cameron: Congratulations.

Chase: I can’t do it. You have doubts.

Cameron: And you don’t?

Chase: No.

Cameron: Well, that’s… naïve. I want to spend the rest of my life with you. I love you. That’s how I feel right now. But I don’t… know.

Chase: I’ll wait until you do. [He stands]

Cameron: I can’t know. No one knows.

Chase: I do. [He leaves]

[Cut to House’s apartment. Cuddy is putting on her jacket.]

Cuddy: I’ll see you in later? I have some papers to push for you.

House: Thank you.

Cuddy: [starts to open the door] You want to kiss me, don’t you?

House: I always want to kiss you.

[She leans over and gives him a chaste kiss on the lips. They look at each other for a couple of seconds then he pushes the door closed and they grab each other. Then they’re against the wall, kissing, groping and pulling Cuddy’s jacket off.]

The End