08x11 - Nobody's Fault

[bunniefuu]

Taub: [voice] Pressure. I need pressure.

Adams: [voice] Get me sutures on a Kelly.

Taub: [voice] Need an epi.

Adams: [voice] Get O.R. ten unpacked. Alert trauma.

[Cut to House in a dark, silent bathroom. He stares at himself in the mirror for several seconds then turns on the tap. He cups his hands, fills them with water and splashes his face. He dries it with a paper towel.]

[Cut to House slowly walking down a deserted hall. One wall is lined with old-fashioned sash windows. Only his legs and cane are visible, viewed from the back, until he reaches the end of the hall.]

[Cut to House opening a door. He looks around, closes the door behind him and approaches a table. He sits at the only chair on the side near the door. An impressive man, about House’s age, sits on the only chair on the other side. He makes sure House sees him turn on a small recorder.]

Cofield: Let the record show that we are officially convening a disciplinary hearing regarding the events of February 3, 2012 in patient room 209. Dr. House, this recording will be transcribed and published along with all supporting documentation and rulings. Do you have any questions before we get started?

House: Yeah. Who the hell are you?

Cofield: I'm Walter Cofield, Chief of Neurology, Mercy Hospital. I'll be deciding your fate today.


**


House: Cofield. [thinks] You were the Residency Director at Hopkins before you moved to Mercy, which means it's safe to assume that you trained Foreman. Which means it's also safe to assume that he trusts you.

Cofield: This hearing isn't about me, Dr. House. I know you'd like to make it about me, because then it wouldn't be about you.

House: It's interesting that he'd pick the old mentor to judge the new one.

Cofield: Interesting, but not relevant. The facts of this case, on the other hand—

House: [interrupting] The facts are in the file. If you have trouble reading my handwriting, give me a call. I'm going back to work.

[House stands, reaches the door and opens it.]

Cofield: If I just consider the file, the facts aren't in your favor. The facts say you should be suspended, which, from what I understand, would mean a revocation of your parole.

[House closes the door and returns to his seat. There’s a long pause before House starts talking. As he does, the scene shifts to a man jogging on a snow-covered, tree-lined road. His legs give way and he ends up splayed on the ice.]

House: The patient was a 32-year-old high school chemistry teacher. He collapsed while out jogging. He was paralyzed in all four extremities despite the fact that the scans…

[Cut to Foreman’s office.]

Foreman: Show no sign of stroke or structural lesions.

House: Put out an APB for a car with a man-shaped dent in the grill?

Foreman: No broken bones, no signs of trauma.

House: Transverse myelitis. Boring.

Foreman: No enhancement on the MRI. I just don't know what to do. [pleading] Please. You have to help me solve this thing.

[As a heavenly choir intones, House reaches over and takes the file which he tucks under one arm. He raises his cane heaven-ward in his other hand and stands very tall as a ray of light shines on him from above.]

[Cut to the conference room. Cofield smirks.]

House: A little poetic license. [He takes some Vicodin.]

Cofield: What are you doing?

House: Taking my Vic-amins.

Cofield: Those are Vicodin? Did you have surgery recently?

House: About a decade ago. My leg is no good at judging time.

Cofield: Were you taking Vicodin during this case?

House: Uhh… Yes. [takes another] And during about nine years of previous cases. [He tosses the empty pill bottle in a trash can.] My process is proven. Good things usually happen. Bad things sometimes happen.

Cofield: And when bad things happen, we should figure out what went wrong, so we can learn from it and correct it.

House: So that we can assign blame instead of recognizing that bad things sometimes happen. It was nobody's fault.

Cofield: And then what happened?

[Cut to Diagnostics. House is flipping copies of the file on the table.]

House: Those who can, do. Those who can't, teach. Those who can't teach, teach gym. Those who can't move their arms or legs teach us to laugh at others.

**

Cofield: House actually presented the case in that way, or are you just trying to make him look bad?

[Pan to Adams who is in the interviewee chair. Note that, while it seems that Cofield interviewed each team member in two sessions, we see those sessions merged based on the patient’s time line. In this round, the camera pans from Cofield to the other person and back, without editing cuts. In some cases the camera moves a full 360º around the table before returning to Cofield’s face. After this, while the camera will still circle Cofield during several rounds of interviews, there will be a cut to the other person.]

Adams: Why would I be trying to make him look bad?

Cofield: Could be your not-so-subtle way of implying this was House's fault. [She rolls her eyes.] Given what's happened, it's understandable that your opinion would color your testimony, but I just want to know what you said, what you did, and what you were thinking at the time.

Adams: I don't think it was his fault.

Cofield: Just tell me your initial theory.

Taub: I thought the patient had a liver problem. Hepatic encephalopathy explained why he passed out, why he couldn't move his limbs.

Cofield: But that's not the idea House went with.

Park: He thought Taub's idea was stupid.

Cofield: And what about your idea?

Park: He thought that was stupid too.

Cofield: [slight laugh] No, I meant, what was it?

Park: Oh. I thought the patient had normal pressure hydrocephalus.

Cofield: And why did House think that was stupid?

House: Oh, come on. Unless you're an idiot, you know why I thought Park was an idiot.

Cofield: [looks at patient file] The patient had low opening pressure on his LP.

House: That's what I said.

[Cut to Diagnostics. House paces.]

House: No, you idiot. The patient had low opening pressure on his LP. Try unsquinting your eyes and reading the labs next time.

[Cut to the conference room.]

Cofield: Are you intentionally trying to get me to dislike you?

House: That wasn't me. The chair squeaked.

Cofield: You're testifying, for the record, that you actually used the phrasing "unsquint your eyes"? It's not the place to exorcise your guilt just b—

House: I actually used the phrasing [enunciating clearly into the recorder] "unsquint your eyes."

[Cut to Diagnostics.]

Chase: [batting a copy of the file away before it hits Park in the face] He's hypokalemic. Could indicate a problem with his heart, which would…

Adams: EKG was normal.

House: But Chase, a doctor who actually takes the time to read the lab reports, has a point. The guy's potassium is off. Could be thyrotoxic paralysis. Start him on…

[Cut to the conference room.]

House: …steroids, PTU, and beta blockers.

Cofield: Mm-hmm. And how did these orange smudges get on the patient files?

House: Seriously? That's your follow-up? I eat a lot of Cheetos, I forget to wash my hands. Is my snacking really relevant to this case?

Cofield: Might be, if these were actually Cheetos stains. What are they?

Chase: Seriously, House?

House: You're blaming me? You used Adams' shampoo.

[Chase looks at Adams.]

Adams: [calmly] I didn't do it.

[Chase rubs his head then starts flipping through the patient file. It was his copy that Cofield was looking at.]

[Cut to the conference room.]

House: It was a harmless prank. My team is made up of Type A personalities. They need something to break the tension every once in a while.

Cofield: So this was a team-building exercise?

Adams: Is that what he called it?

Cofield: That's what he implied.

Adams: House prefers chaos over cohesion. He believes that disagreement and mistrust lead to better ideas. He's not wrong.

Cofield: As opposed to being right? [pause] So you treated with steroids. And then what happened?

Adams: They worked. Our patient woke up.

**

Emily: Bill? Can you hear me?

Bill: Yeah. I'm thirsty.

Adams: [checking his eyes] That's normal. You've been in a coma for several hours. Can you tell me your name?

Bill: Uh, Bill. Bill Koppelman. Can you tell me what happened to me?

Taub: We're treating you for an overactive thyroid. We think that's why you passed out and couldn't move.

Adams: Can you wiggle your fingers for me?

[Two teenage girls appear in the doorway. Madison, on the left, carries a bunch of helium balloons and a card. Jordan, on the right, has a vase of roses and daisies.]

Jordan: Is he going to be okay?

Taub: Excuse me, but only family members are allowed.

Bill: It's okay. They're my students.

Jordan: Everyone back at school is so worried about you.

Madison: Is he sick because of the expl*si*n?

Taub & Adams: What expl*si*n?

[Cut to the conference room.]

Cofield: What expl*si*n?

Taub: A chemistry demonstration he was doing for his class went wrong.

Cofield: Why was it not already in the patient history?

Taub: Because the patient was unconscious.

Cofield: But I'm assuming Dr. House spoke to the wife.

Taub: The wife didn't know about the expl*si*n. And I was the one who questioned her, so, if there was an oversight, it was mine.

Cofield: Does Dr. House not attach importance to patient histories?

Taub: No, he thinks they're crucial. He just doesn't think being in the same room as the patient is crucial. House thinks avoiding patients allows him to stay as objective as possible. [pause] He's not wrong.

Cofield: Sounds like a very diplomatic way of saying he's lazy.

House: That's also true. Either way, I'm covered. If you want an accurate patient history, don't ever talk to the patient. Everybody lies. Except me. To you. Would never do that.

Cofield: Okay. Say you're right. If you had actually been in the room, questioning the patient, you could read body language, you could ask follow-up questions, warn him of the costs of lying to you.

House: Don't forget the thumbscrews.

Cofield: Can you dispute the possibility that, had you visited the patient sooner, maybe talked to the wife, been directed to one of the students, that this case might have ended very differently?

[House looks uncomfortable but doesn’t answer.]

[Cut to room 209.]

Bill: It wasn't exactly an expl*si*n. It was a controlled reaction that went a little haywire.

Jordan: It was too an expl*si*n. Simon Harris filmed the whole thing on his camera phone and posted it on YouTube.

Madison: It got, like, over 75,000 hits already.

Emily: Looks like you've gone viral, hon.

[He coughs, sits up and coughs blood onto the blanket.]

[Cut to the conference room.]

House: He had a loss of consciousness, temporary paralysis… But when I was told the patient coughed up blood, then things really started to get interesting.

Cofield: Your patient was doubled over in pain and coughing up blood, and you found that interesting?

House: Why, is that bad?

Cofield: It's interesting.

[Cut to room 209. Bill and Adams are looking at the YouTube video. Emily stands by the bed.]

Bill: I do this demonstration every year. I usually have a student aide help me set it up, and apparently this year he added extra hydrofluoric acid, which is why it exploded.

[On the computer, Bill adds something to a beaker. The resulting expl*si*n hurls him back against the wall.]

[Cut to the conference room.]

Adams: The student aide was just trying to make a viral video, not hurt anyone. Ended up doing both. So we figured the patient inhaled the extra large dose of hydrofluoric acid and…

[Cut to Diagnostics.]

Adams: …b*rned his lungs, which is why he coughed up blood.

Taub: If only burnt lungs explained the passing out and paralysis.

Park: The expl*si*n does. Check out the video again. He smacked his head against the wall. If that caused swelling in his brainstem, that would have led to eventual loss of consciousness and paralysis.

[Cut to the conference room.]

Park: So we discussed it a little longer, and House decided to treat with heparin.

Cofield: I wouldn't mind a couple more details.

Park: It was aerosolized heparin.

Cofield: You skipped over the actual DDX, and now you're averting your eyes. I'm growing more and more curious by the moment.

[Cut to Diagnostics.]

Park: He smacked his head against the wall. If that caused swelling in his brainstem, that would have led to eventual loss of consciousness and paralysis.

House: [muffled] Nobody move.

Taub: Aagh!

[House is wearing an industrial gas mask. He’s holding a smoking jar.]

[Cut to the conference room.]

Cofield: He… he had on a what?

Park: Gas mask. [long pause] The stink b*mb was Chase's. He was getting revenge for the orange hair and rigged it in House's office. But House found it.

Cofield: Mm-hmm.

[Cut to Diagnostics.]

House: You can leave when I have an answer.

Chase: [through his lab coat sleeve, which he is holding to his nose and mouth] It might help if we knew the question.

House: How do we treat chemical burns inside the lungs?

Adams: [speaking quickly with the front of her blouse pulled up over her nose] Maybe we can use a bronchoalveolar lavage to wash 'em out with water.

House: Sorry. My fault. Should have clarified. How do we treat chemical burns inside the lungs without k*lling the patient?

Park: [hands cupped over her mouth and nose] Silver sulfadiazine works well on chemical burns.

House: Burn cream would drown him faster than water. [waves stink b*mb] Well?

Taub: [temporarily parting the lapels of his lab coat and sticking his head up] Aerosolized heparin.

House: Me likey.

Park: But that's only experimental. It's never actually been used before.

House: Not true.

[Cut to the conference room.]

House: Been used in sheep.

Cofield: Uh-huh.

House: The guy was going downhill fast. We needed a treatment that was a… slope changer.

Cofield: So you busted out the sulfur dioxide stink b*mb?

House: It was a team-building exercise.
Cofield: No. It was manipulation. You were pressuring your team into coming up with unsafe medical ideas just to get out of that room.

House: You say pressure, I say inspire. The usual safe ideas were not gonna work. Aerosolized heparin might.

Cofield: And everyone else just went along with this?

Park: No. I told House I thought it was a mistake.

Cofield: And those were your exact words?

Park: I think I might have said insane.

Cofield: You thought it was insane, and yet you let it happen.

Park: No, I…

Cofield: If you disagree with Dr. House on patient safety, doctor, it is your duty to speak up. Otherwise, you are equally to blame.

Park: I did speak up. I tried.

Cofield: And you failed.

Park: And that's why I went to Dr. Foreman.

[He nods slightly]

[Cut to Foreman’s office.]

Park: The heparin could cause the patient to bleed into his lungs even faster.

Foreman: It is crazy, but House doesn't do crazy just for crazy's sake. If he thinks this is the only way to help your patient…

[He cuts off the discussion by walking out on her.]

[Pan to the side of the office Cuddy’s desk used to occupy. It’s much darker and Cofield and Foreman are looking out the window at the snow.]

Cofield: You did not tell me you were involved in this case when you asked me to do this.

Foreman: I wasn't. The heparin decision didn't have anything to do with the outcome.

Cofield: If signing off on everything House does is a pattern, it affects the way House behaves, it affects the way House's team reacts to the way House behaves.

Foreman: House… is brilliant. I give him the benefit of the doubt most of the time because I've seen what he can do.

Cofield: Getting House out of prison is the biggest decision you've made as Dean of Medicine, right? And if he's suspended as a result of this hearing, he violates his parole and he goes back. And that probably leaves you as former Dean of Medicine.

Foreman: I suppose so.

Cofield: You didn't choose me to oversee this because you thought I could be objective. You chose me because you thought I'd have your back and I'd think twice about making a decision that would get you fired. [pause] Eric. I'm sorry. But if your get-House-out-of-jail-free experiment blows up in your face, it's not my job to get you out of it.

[Cut to the conference room. None of the main lights are on but the spots over the bookcases lining the wall are. It’s a little brighter.]

Cofield: After you'd administered the heparin, I see there was a discharge order on the chart, and yet the patient never left.

Adams: House ordered a therapeutic bath first to wash off any residual chemicals from the blast. But we wound up finding something.

[Cut to treatment room. Bill is in a stainless tub, being rinsed off by an attendant.]

Adams: You have a bit of a rash. Can you raise both your arms? I just need to see how far it goes.

Bill: [hands over his head] You told me it was going to be okay. And now there's still something wrong with me.

Park: It probably doesn't mean anything, but we want to make sure.

Bill: Of course you do. I got to get out of here, okay?

[He keeps starting to stand up.]

Adams: Ju-just relax.

Bill: Please just let me get out of here.

Adams: It'll just take a minute. We just need to get a good look at the rash.

[Cut to the conference room.]

Park: The rash? That was nothing. Just some irritation from lying in bed all day. The problem was the patient's brain. He freaked out.

[Cut to the treatment room. Bill is trying to stand up. The attendant holds him down.]

Bill: I got to… I got to get out. I got to get out of here.

[Cut to the conference room. The panning around the table is back, but this time there are cuts to the team members after the pans to Cofield.]

Adams: "Freak out" is a little strong. In my opinion at the time, it was the rash that was gonna k*ll him. Invasive strep.

Cofield: Reasonable theory, supported by the evidence.

Park: The evidence pointed to psychosis. We caused it by giving him steroids when he first came in.

Cofield: What'd you think?

Taub: I thought Park and Adams were both right but that their conclusions were both wrong. The neuro symptoms and the rash were both signs of an underlying disease. Together with the lung, it added up to Wegener's.

Cofield: How does Dr. House handle it when three smart doctors come up with three different but equally valid ideas?

House: I run a diagnostic trial.

[Cut to Diagnostics.]

House: Start the patient on high-dose steroids. Multiple birds, single stone. If Taub is right, then he will walk out of here cured. If Adams is right, he'll spike a fever, get hypotensive, we can treat it. He can walk out of here cured. If Park is right, he goes all cuckoo's nest on us, we can cross "brain" off the list…

[Cut to the conference room.]

House: …diagnose him, and he can walk out of here cured.

Cofield: Are you trying to make this easy for me? By your own admission, if you give the patient steroids, two of the three outcomes are gonna make him worse.

House: What was making the patient worse was not having a diagnosis. This was the fastest way to get it. It was a perfect diagnostic moment.

Cofield: In light of what happened, you still think it was the perfect diagnostic moment?

House: Yes. My theory accounted for all the medical outcomes. [Cofield raises one eyebrow.] It did not account for the disobedience of my own team.

[Cut to room 209. Chase is there with a cart. He takes off his lab coat.]

Adams: What are you doing?

Chase: I think you're right about the strep. [tucks his tie into his shirt] Can't hurt to biopsy the rash while we're waiting.

Adams: Thanks.

[Cut to the conference room. Cofield has taken off his jacket.]

Adams: At the time, it seemed like a good idea.

Cofield: I know this is hard, but please tell me exactly what happened next.

[Cut to room 209. The kit is open. Chase removes supplies.]

Chase: Draw up a little anesthetic.

Adams: Two CCS Lidocaine.

[She inverts the bottle and inserts needle. As Chase puts on his gloves, Bill throws off the bed clothes violently.]

Bill: Get away from me.

[He smacks Adam’s hand, causing her to drop the bottle and cringe against the wall. Chase climbs over the bed to grab Bill from behind. Bill tries to shake him off by slamming forward into the bedside table then back against the windowed wall. By this time Adams is right to be cowering in a corner — it is getting very violent. Bill turns around to hit at Chase: Chase tries to grab him in a bear hug then throws Bill into the windows. Several of the vertical blinds slats fall and drape over them.]

Chase: You're in a hospital. Calm down.

[They lunge around the room, smashing into the wheeled bed-table. Adams pulls it away.]

Adams: [shouting] Code grey!

[Cut to the conference room.]

Cofield: So your position is that your team's disobedience caused this?

House: That's not what I said.

Cofield: You said you didn't anticipate their defiance. You implied that all would have been fine otherwise. So who do you blame, Dr. Adams or Dr. Chase? Or both?

House: I don't blame either one.

Cofield: So who do you blame, Dr. House?

[Cut to the hallway outside room 209. Taub is at the nurses’ station. He runs in as Chase and Bill hit the table. Adams tries to pull him off Chase.]

Adams: Code grey!

[Taub opens the cart and starts searching for something. A male nurse rushes in. Chase is still wrestling with Bill, who is making “arg” sounds.]

Adams: Get haloperidol.

[Taub finds it. Two more male nurses rush in and help hold Bill.]

Taub: Got it.

[He injects Bill in the leg. The nurses pull Bill toward the bed. Chase stands up and starts to catch his breath. Bill sinks to the floor, unconscious.]

Bill: Ah… ah…

[Adams’ gloves are covered with blood. She takes a deep breath then looks at Chase.]

Adams: Oh, my God, Chase.

[Chase looks down. A scalpel is sticking out of his chest. Taub looks. Chase looks up at them and the scalpel falls to the floor. As Adams starts toward him, Chase collapses onto the floor, face first.]

Taub: Prep the O.R. and get a gurney. Start an I.V.

[They turn him over. Adams rips his shirt, straddles him and sticks her finger in the hole in his chest.]

Adams: Come on. The bleeder's got to be in here. [Some blood spurts on her face as she feels around.] Got it.

Taub: Which artery?

Adams: It's his heart.

[Cut to the conference room.]

Adams: Fortunately, only the Kn*fe tip reached the cardiac muscle. Made a laceration in the left ventricle about the size of the tip of my index finger. At that moment, he could only stay alive as long as my finger plugged the hole. [Her voice shakes.] It could have been me on the floor. It should have been me. It was my theory. I held the needle in front of the patient that set off his paranoia. If you're looking for someone to blame… blame me.

Cofield: Please continue.

[Cut to a hallway. Chase is being wheeled to the O.R. at top speed. He has a mask on and Taub is pumping a bag to keep him breathing. Adams is still on top of him, plugging the hole with her finger.]

Adams: Getting some ectopy.

Nurse: Coming through.

Park: Good carotid pulse.

Adams: Regular?

Park: No.

Adams: Got a PVC.

Nurse: Got to move it, people.

[Cut to the conference room.]

House: My diagnostic test worked. It proved the patient had a steroid-induced psychosis.

Cofield: And that's what you took away from this situation?

House: The brain was not a symptom of an underlying disease.

Cofield: Your colleague was stabbed. Are you telling me you didn't care?

[Cut to the O.R. House has scrubbed and he opens the door with his hip, arms held high. Someone immediately puts a gown on him.]

House: How bad is it?

Taub: Bad. Patch. [Chase, on the table, isn’t visible. Only his open chest is.] Ready?

Adams: I can't take my finger out. He'll bleed. I don't think he can take it.

House: Oxygenation's at 100%. He's as ready as he's gonna be.

Taub: We got to go for it.

Adams: On my count.

[sh*t of Chase’s exposed heart with Adam’s finger in place. Taub holds an instrument with some gauze or something at the ready.]

Adams: One, two, three.

[She removes her finger and everyone goes to work, repairing the hole.]

Taub: Suture. [It’s passed to him.] Got it.

Park: BP is stable.

Taub: Patch is holding.

House: What was his heart rate?

Park: He doesn't have one. He's on bypass.

House: Not Chase. The patient.

Adams: [in disbelief] You're DDX-ing?

House: Park, come with me. Taub's got this.

Park: My friend is here because you didn't listen to me.

House: I did listen to you. Chase didn't listen to me. At this point, being here makes you feel better. You're not helping Chase or our patient. [She turns back to the table.] Fine.

[He pushes open the doors, removing his gown as he goes.]

[Cut to the conference room.]

Cofield: So he just walked out?

Taub: There really was nothing for him to do.

Cofield: Speaks to a certain callousness on Dr. House's part, don't you think?

Taub: Who cares if House was callous? Are you gonna punish callousness?

Cofield: Hmm. But you agree that empathy is a useful quality for doctors?

Taub: House is not the problem.

Cofield: Your friend got stabbed. He may die from those wounds. If you had been in that room, maybe that could have been you.

Taub: I wouldn't have been in the room.

Cofield: Implicitly, you just said that Chase was at fault.

Taub: [long pause] We all knew a psychotic episode was one of the three possible outcomes. And Chase brought a scalpel in there. He endangered Dr. Adams, he endangered himself, and he endangered the patient.

Caufield: Thank you.

[Cut to room 209. All that’s in focus is Chase’s lab coat with his hospital ID. The door slides open. House enters and stops when he sees the coat. Then he begins to look around. He walks carefully through the debris. On the far side of the bed, he finds the EKG machine. He kneels down and picks up the final printout. A large portion of the paper is bloodstained. He reads it carefully, marking his place with his thumb.]

[Cut to the recovery room or PACU (post-anesthesia care unit.) House enters. The team is sitting by Chase’s bed at the end of the ward.]

House: Lungs, rash, now excessive RR variability. Go.

[No one answers him. Finally Taub speaks up.]

Taub: It's a hospital. There are lots of doctors who can take care of him.

House: And your thinking is that only you guys are qualified to sit in this room, doing nothing? If you're motivated by caring, just bear in mind he's a dedicated chemistry teacher with a pretty wife and adoring students, baby on the way.

Adams: She's not pregnant.

House: Would it make a difference? 'Cause I could knock her up. Autonomic dysregulation.

Adams: Shut up.

Chase: [groggy] Could you guys keep it down?

[House’s expression is indescribable.]

Taub: You made it, bud.

Adams: You're in the PACU. Been in surgery. The anesthesia's just wearing off.

Chase: Did I have an epidural?

Taub: Uh… no.

Chase: 'Cause I can't feel my legs.

[They all look at each other, worried.]

**

[Cut to the Chase’s room. It’s night and the only light is above the headboard. Chase is alone when the door slides open.]

Cofield: Dr. Chase? Robert?

Chase: Yeah.

Cofield: I'm Walter Cofield. I'm a neurologist over at…

Chase: [taking off his oxygen mask] I know who you are.

Cofield: Good. [pause] Think you're up for answering a couple questions?

Chase: Well, it's not like I can get up and run away. Wasn't my best joke.

Cofield: I'm smiling because, for the last 12 hours, I've been picturing you with orange hair.

Chase: I dyed it back.

[After a moment, Cofield takes the recorder from his jacket pocket. He makes sure Chase sees him turn it on before he places it on the bed.]

Cofield: Were you angry with Dr. House?

Chase: It was a prank. It wasn't uncommon.

Cofield: So I've heard. That doesn't mean you couldn't get angry. Might actually contribute to that reaction.

Chase: May I ask why that matters? Are you trying to prove that I was distracted, that my judgment was compromised?

Cofield: Who do you think was at fault for what happened to you, Dr. Chase?

Chase: Again, why does it matter?

Cofield: You're a smart doctor. You know what happened here better than anyone, and you've worked with Dr. House longer than anyone. And I suspect that you've spent every minute since this has happened trying to answer that very question.

Chase: I don't think it was anyone's fault. I was angry, but I wasn't distracted. And I think that, if there's any chance I'm gonna walk again, it's because Dr. House is a genius.

[Cut to the PACU, earlier in the evening. The team is DDXing Chase.]

House: How about warmth? Can you feel the sheets on your skin?

Chase: I just said I don't feel anything. Objectivity, House. [The team looks stumped. House looks scared.] What about posttraumatic syringomyelia? Syrinx formed in the subarachnoid space, blocking the flow of cerebrospinal fluid.

[House turns away to think.]

Adams: That'd mean the damage was permanent.

House: No. [turns back] Forget the nerves.

Taub: House, if it's total paralysis, he must have…

House: Not necessarily. Think arteries. Blood flow to his spinal column is cut off. It's a clot in the radicular artery.

Chase: That could be fixable.

House: Prep a room for an embolectomy. Let's get that thing out of there before it does any more damage.

Chase: And if it's not a clot?

House: Then you can ask Foreman if hospital insurance covers ramp-vans.

[Cut to treatment room. Taub is performing the embolectomy. Park is watching the monitor, guiding him. Adams is taking notes.]

Park: You're through the aorta.

Chase: There.

Adams: Sensory level is at L5. It must be the descending branch.

Chase: Can I see the monitor?

Park: Stop there. sh**t the dye.

Chase: There it is.

Taub: Don't get too excited. We still got to get it out. Still could have done permanent damage.

[Door slides open. House enters, ungowned.]

House: Patient does not have autonomic dysregulation. There's blood in his urine bag. Kidneys are failing.

Adams: House, not now.

House: Got to be now. Foreman is transferring our guy to Princeton general as soon as there's a bed available. Says the doctors here can no longer be objective since the stabbing.

Cofield: In the middle of a procedure that could basically save your life, House is actually trying to drag people away? How do you work with a guy like that?

Chase: He wasn't trying to pull anybody away. Everyone had already refused to work on that case. He knew the answer. He wanted to check on me. But he needed an excuse. Otherwise, he could be accused of caring.

Cofield: So your testimony is that Dr. House's complete lack of concern is evidence of his deep concern? [Chase nods slightly. Cofield shifts and considers this.] Did you just do that?

Chase: What?

[Cofield goes to the foot of the bed and pulls the blanket off Chase’s foot.]

Cofield: Wiggle your toes.

[Two of the toes on Chase’s left foot move. Cofield gets a plexor out of the bedside table. He holds the rubber head, usually used for testing reflexes, and runs the handle along Chase’s instep.]

Cofield: Do you feel that? [Chase nods several times.] Congratulations. It was the clot. Short occlusion time of the artery, when the swelling goes down, you should… gain back at least some of the function. [Chase’s head drops back on the pillows and he breathes deeply.] One more thing. Sorry. You knew that your patient was at risk for a psychotic break when you brought a scalpel within his reach. Why did you ignore that risk?

Chase: I thought I was right about the rash. I would do it again.

Cofield: I thought so. [He picks up the recorder and puts it in his pocket.]

Chase: What, that's it? "I thought so"? What the hell does that mean?

Cofield: You brazenly defied your boss. Now that happened either because Dr. House has established that that's okay in his world, or his prank w*r distracted you, or House makes medicine a game, and you just wanted to b*at him. Whatever the reason, it boils down to the fact that you may never walk again because House created an atmosphere that promotes recklessness.

[Cut to the conference room. It’s dark outside and, bless my Lord, it is a hell of a theatrical effect going on out there, in the form of rain. Three green-shaded table lamps and four large ceiling fixtures have been turned on. Combined they give off about as much light as the typical 40-watt bulb. Cofield and House are practically silhouettes.]

Cofield: This will be our last round of questions. I've spoken with Dr. Chase. You know he regained movement.

House: No.

[Cofield stares at him then turns off the recorder.]

Cofield: Are you really this indifferent to the fact that Dr. Chase is hurt?

House: We're going off the record because this is irrelevant, or are you gonna hit me?

Cofield: Why don't you go tell the guy you're sorry…

House: I didn't do anything wrong.

Cofield: It's not an admission of guilt. He's your friend, and he's not well.

House: He's a coworker.

Cofield: Coworker whom you've known for almost ten years who nearly d*ed and who's still scared he may not walk.

House: Are you going to have me fired for bad manners?

[He turns in his seat, lifts his right leg onto the table and crosses his left leg over it.]

Cofield: Just trying to understand you. Why a man in your position, with your abilities, is incapable of shaking the impulse to act like an ass.

House: [pulling a Vicodin bottle from his pocket] Could we go back on the record and get this over with?

[He shakes the bottle as Cofield turns the recorder on.]

Cofield: Put the Vicodin away, Dr. House.

House: My leg hurts.

[He opens the bottle. There’s a loud POP and Vicodin fly everywhere like confetti. House gives a short laugh.]

Cofield: [brushing Vicodin off his papers] Is that supposed to be funny?

[Long pause then House gets his epiphany.]

House: Two explosions.

[He gets up and leaves.]

Cofield: We're not done here.

[The door closes.]

[END OF ACT FIVE]


[ACT SIX]

[Cut to the ambulance bay. A bed at Princeton General must have opened up. Emily watches as they load Bill in.]

House: Hey, hold on.

EMT 1: Close it up.

House: Take him out of there.

[They close the ambulance doors.]

EMT 1: Dr. Foreman said you'd try this. Said to tell you he's no longer your patient.

EMT 2: Let's go! [Bangs on the side of the ambulance to let the driver know they’re ready.]

House: Hey!

[The ambulance leaves with sirens blaring. Emily turns and walks past him on her way to the elevator. House follows.]

House: Wait. [catching up with her] Wait.

Emily: I have to get to my car. I don’t… I n—

House: Your husband has a tumor in his lymph nodes.

Emily: You've been wrong every time.

House: Yeah, well, not this time. [sh*t of the expl*si*n followed by CGI of the lymph node activity.] The expl*si*n in the classroom caused the cancer cells to break open. It's called tumor lysis syndrome. His body's flooded with an excess of phosphates, potassium, acids, all kinds of cancerous junk. It explains the paralysis, the bleeding, the heart and kidney issues, everything.

Emily: What about the psychotic break?

House: Turns out we caused that. [The elevator arrives. She gets in.] This is treatable. Okay? [He holds the elevator door open.] You have to tell the new doctors that he needs total body radiation and plasmapheresis.

Emily: Move your cane, please.

[Cut to Foreman coming out of the conference room. He meets House in the hallway.]

House: Where's Cofield?

Foreman: He said you walked out.

House: Well, I'm walking back. I'm not done testifying.

Foreman: Apparently you were. Said he'd have his decision tomorrow.

[Cut to Chase lying, sleepless in his bed.]

[Cut to Foreman, sitting in the dark in his office.]

[Cut to Cofield, writing at his kitchen table. There’s an empty wine glass next to him and open Chinese food cartons nearby. He stops writing to think.]

[Cut to Chase’s room. House stands in the doorway, watching him. Chase is facing him but House might not realize he’s awake. Neither of them says anything, then House turns and leaves.]

[Cut to the conference room the next morning. It’s daytime so the lights are turned off but it’s still raining and the room is as dark as ever. House is the first to arrive. He starts to close the door but, thanks to editing, it is Foreman who finishes closing the door. House is staring out the window.]

[Foreman walks toward the table and away from House. Cut to Foreman standing by the wall behind the table as Taub puts a chair next to House who is already seated. As he sits, Adams takes a seat on House’s other side. Park stands near Foreman. The door opens. Cofield enters and puts his briefcase on the table. The team watches, somberly. Cofield takes out the papers he needs, puts his briefcase on the floor and very deliberately turns on the recorder before sitting down.]

Cofield: This case is a fiasco. Didn't sleep last night. [pause] Dr. House is obviously brilliant…

House: Well, I think we've heard enough.

Cofield: But Dr. House is also a fiasco. If I were to exonerate him, condone his completely reckless, immature, almost misanthropic behavior, I would essentially be sending a message to all the other doctors in this hospital that it's okay to act that way and… it… is—

[He breaks off as Emily walks in, followed by a staff member.]

Emily: Sorry.

Cofield: We're in the middle of something.

Emily: I know. I came to speak with Dr. House. And when they told me he was in here, I thought I should say something. I mean… he wasn't the nicest doctor I've ever met.

House: Well, I think we've heard enough.

Emily: But he was right. They found the tumor. They are removing it, and they are starting plasmapheresis. They expect a full recovery. He saved my husband's life. [pause] Well… I guess that's it. Thanks again. [leaves]

Cofield: As I was saying, Dr. House's process is dangerous, inappropriate. But he is effective. I've decided that I would be doing this hospital a disservice if I did anything to change that process. [House stares at him.] Congratulations, Dr. House. This unfortunate stabbing incident is officially nobody's fault.

[The others in the room start breathing easier. Cofield stands and prepares to go. Foreman heads for the door, followed by Park. House hasn’t moved.]

House: Coward.

Cofield: Excuse me?

House: You've got, like, 20 pages of notes there. You were expecting to bore us for at least half an hour. [He stands and snatches Cofield’s folder] You got my parole form in here. You were gonna send me back to prison.

Foreman: House, stop.

House: Good things usually happen; Bad things sometimes happen. The fact that that would-be widow came in just in time to sob all over your soft, mushy heart and the fact that her husband's gonna live does not change whether or not I did the right thing.

[Cofield is impassive. House turns and storms out, not closing the door behind him. Everyone is uncomfortably silent. Cofield raises his eyebrows a millimeter.]

[Cut to House striding down the hall, about three times as fast as his initial walk to the conference room the day before.]

[Cut to Rehab. Chase, gasping from the effort and pain, is learning to walk again, assisted by a therapist. He’s wearing sneakers, sweatpants and a hospital robe. An enormous white bandage on his chest is visible at the top of the robe. House enters.]

House: How'd you get the f*ring wire into the Vicodin bottle without me noticing?

[Chase nods to the therapist who moves away. He stands, holding onto the rails.]

Chase: Why'd I even have to? What was the point of the orange hair?

House: Your hair smelled like Adams. And since there's no way that you're doing her without me knowing, it means you were just doing her shampoo. Which means you were out late drinking with some new girl or, because there is no new girl, you were trying to make up time by showering at the hospital because you're too lazy to buy your own shampoo. So I found a way to let you know to not be late.

Chase: You couldn't just ask me to stop being late?

House: What fun would that be?

Chase: None of this is fun, House.

[He starts to walk again. The therapist comes back over.]

House: They decided that your being stabbed… was nobody's fault. [long pause. Chase is listening.] They're wrong. I'm sorry.

Chase: Anything else? I'm kind of busy.

House: No. That was it.

Chase: [to the therapist] I've got it.