Épisode Une mère à charge S01E06 - House Saison 1

[ Lucy and Luke sitting with social worker ]

VOICE:  Cat got your tongue?  Nah, you killed the cat.  Cut off its head.

SOCIAL WORKER:  …need to take a look at this.

LUKE:  Mom?  Mom.  Mom!  It’s OK.

SOCIAL WORKER:  Just a couple of questions before I can authorize extending her disability benefits…

LUCY:  I don’t like her.  She’s fat.

SOCIAL WORKER:  I could lose a little weight.

[ Lucy gasps at sudden pain in leg CGI shot of blood clot in her leg]

LUKE:  You all right?

SOCIAL WORKER:  Actually, before she signs….

LUCY:  I killed the cat, lots of blood.

LUKE:  [ to social worker ]  It’s OK.

SOCIAL WORKER:  I have a couple of questions about some of these dates.  The first diagnosis…

LUKE:  Schizophrenia.  Dr. Walters, May 11th, last year.  The letter’s in the medical file.

SOCIAL WORKER:  And April 6th?  That was the last day she worked, and she received unemployment benefits for that week.

[ view inside Lucy’ bloodstream, a blood clot floating around ]

LUKE:  We fixed that, I know we did, we returned the money.  [ handing over paper ] That’s the canceled check.  Not the real one, you know, it’s a copy.

SOCIAL WORKER:  And you’re the dependent?

LUKE:  No, that’s my little brother.  I’m eighteen.  Just helpin’ out.

SOCIAL WORKER:  You’re all set.  Just need a signature.

VOICE:  [ from glass frog on desk ] Hey!  I’m talking to you.  The cat’s first.  Now it’s your turn, Lucy.

LUCY: Shhhhh. Shut up, shut up, shut up!

LUKE:  It’s OK, she just, she just needs a little water, is all…

SOCIAL WORKER:  I’ll go get it.  [ gets up and walks away ]

LUKE:  [ taking out a nip bottle of vodka; Lucy swigs at it ]  Just hold on, OK, just… when she comes back, sign it and we’re gonna be done. We need this, OK?  Please?  OK?

LUCY:  The voices…

LUKE:  The voices aren’t real.

[ Lucy clutches at pain in chest; blood clot gets stuck; she falls to floor ]

LUKE:  Mom?  Mom!  Mom!!  Mom!!

[Aerial view of Princeton-Plainview Teaching Hospital ]

ER VOICE-OVER:  Thirty-eight year old Caucasian woman, status post-respiratory arrest in the field, intubated, oxygenating poorly.

[ ER waiting room; Luke is pacing ]

P.A.:  Dr. Gregory House, please call Dr. Cuddy at extension 3731.

[ House puts down newspaper and frowns up at P.A. from his seat, returns to paper ]

LUKE:  [ to House ]  This is a good hospital?

HOUSE:  Depends what you mean by “good.”  I like these chairs.  [ back to paper ]

[ Luke sees ER doc and goes over to him ]

LUKE:  How is she?

ER DOC:  Stable.  OK.  Your mom had a small pulmonary embolism; blood clot that got stuck in her lungs, blocked the oxygen.

LUKE:  [ taking notebook out… ]  But the pain started in her leg.

ER DOC:  Where the clot started.  Her calf.  It’s called a deep vein thrombosis.  Basically a bigger clot.

LUKE:  It never hurt there before.  I would have noticed.

ER DOC:  Piece of that broke off, went up the vein, through the heart, blocked the blood flow to her lungs.  No blood flow, no oxygen.

LUKE:  [scribbling]  OK…

ER DOC:  Is your dad here?  I have some things I need to talk to him about.

LUKE:  Uh, my dad’s running a little late. He’s dead.  Just talk to me – I take care of her.

ER DOC:  All right.  Your mom’s blood alcohol was .12.  Ten thirty in the morning.

LUKE:  I gave it to her.  Two ounces of vodka.  It cools her out.  But that’s the first since Monday.  That was three days ago.  I’ve been real careful.  [Doc looks at him; Luke sighs] She hears voices.

ER DOC:  She’s schizophrenic?  Explains the DVT.  The alcohol makes her pass out, she’s immobile for long periods of time…

LUKE:  That doesn’t happen.  She’s not an alcoholic.

ER DOC:  She only drinks when you give it to her.  We put her on blood thinners.  You can probably take her home tomorrow.

LUKE:  It’s not the alcohol, it’s gotta be something else.

HOUSE:  [rattling paper]  Of COURSE it’s the alcohol.  [Both turn to look at him]  Hello!  [House gets up and walks over to them] This guy’s a professional doctor.  Plays golf and everything, I bet.  He’s not gonna tell you your mom’s an alcoholic without proof.  I’m sure he scoped for varices , checked her esophagus, ran all kinds of blood tests.  Doctors like this, they don’t make assumptions, they do the work!

ER DOC:  I’d be happy to refer you the case, Dr. House.  You seem so interested.

HOUSE:  What case?  It’s over.  You’re sending her home.  [ to Luke ]  How old is she?

LUKE:  You’re a doctor?

HOUSE:  Own my own stethoscope.  Did I ask you how old she was?  I forget.

[ House’s office, House at the whiteboard with marker and Luke’s notes, ducklings sitting around the table ]

HOUSE:  Thirty eight year old woman with no previous symptoms or history presents with deep vein thrombosis -- how did she get it?

FOREMAN:  Oral contraceptives, smoking, diabetes, obesity, and what’s the point here?  A DVT’s a DVT.  Put her on IV heparin to prevent future clots.  What’s the big mystery?

HOUSE:  Fine.  You’re all sleeping.  You need a clue. [ circles “38yo” on whiteboard ]  She’s 38 years old!  She’s 20 years too young to get a deep vein thrombosis!

FOREMAN:  I treated a 12 year old girl once, soccer player, she got kicked in the leg…

HOUSE:  There was no trauma, none of the risk factors.

CAMERON:  You took a history?

HOUSE:  I… have some notes.  They’re not mine, but they’re reliable, I think, for purposes of this discussion.  As for the immobility, well, she’s real active right now, of course – paranoia keeps her limber.

FOREMAN:  Paranoia?

HOUSE:  Oh yeah – she’s schizophrenic.  And her kid wrote this [ hefting notebook ], so it might be a little biased.  Having to take care of his nutso mom and all.  You think there’s a connection?  Do we include schizophrenia in the differential for DVT?

FOREMAN:  Well…

HOUSE:  The answer is no.  Abnormal dopaminergic pathways in the brain do not cause blood clots.  Schizophrenia is not the cause of DVT.

[ House and Wilson entering Cuyler Wing ]

HOUSE:  On the other hand, we don’t really know anything about schizophrenia, so maybe it is connected.

WILSON:  Well, the schizophrenia explains one mystery  – why you’re so fascinated by a woman with a bump in her leg. Like Picasso deciding to whitewash a fence.

HOUSE:  Thanks.  I’m more of a Leroy Neiman man.  And it is only about the DVT.  She’s 38 years old, she should be…

WILSON:  Right.  Solve this one and you’re on your way to Stockholm. [ they reach the nurse’s station, where Wilson fiddles with paperwork ]

HOUSE:  We don’t even know how to treat it!  Come on!  Fumigation of the vagina?

WILSON:  A little louder -- I don’t think everyone heard you. [ walking down the hall ]

HOUSE:  Two thousand years ago, that’s how Galen treated schizophrenics – the Marcus Welby of ancient Greece.

WILSON:  Oh!  Clearly you’re not interested.

HOUSE:   I’m interested.  I’m interested in how voices in the head could be caused by malposition of the uterus.

WILSON:  There’s a better place for it?

HOUSE:  And now what have we got?  We’ve got lobotomies, rubber rooms, electric shock – my – Galen was so primitive.

WILSON:  [ stopping while House walks ahead ]  Where are you going?

HOUSE:  Going to see the patient.  That all-important human connection.  Thought I’d give it a whirl.

WILSON:  You won’t talk to patients because they lie, but give you patient with no concept of reality…  [ catches up ]

HOUSE:  If it wasn’t for Socrates, that raving untreated schizophrenic, we wouldn’t have the Socratic method – the best way of teaching everything, apart from juggling chainsaws.  Without Isaac Newton, we’d be floating on the ceiling.

WILSON:  Dodging chainsaws, no doubt.

HOUSE:  And that guitar player in that English band – he was great.  [ stopping at Lucy’s room ]  You think I’m interested because of the schizophrenia.

WILSON:  Yeah.  I’m pretty sure.

HOUSE:  Galen was pretty sure about the fumigation thing.  [ sliding door open and closed ]  Pink Floyd.

[ inside Lucy’s room ]

LUKE: Mom, this is Dr…

HOUSE:  Gregory House – nice to meet you.  [ to Luke ]  Be all right if we spoke alone for awhile?

LUKE:  Well, you’re gonna need me to…

HOUSE:  [ hefting notes ]  Got your case notes… doctor.  There’s a cafeteria downstairs.  [ holding out bill ]  Get yourself whatever you want as long as there’s enough left over for a reuben sandwich, dry, no fries, hold the pickles.  Should run you about $5.80 with tax.  [ Luke takes money; House pulls pager off his belt and hands it to the kid ]  I’ll page you when we’re done.  [ Luke leaves; House goes over and sits at Lucy’s bedside ]

LUCY:  [ shaking head ]  No… pickles.

HOUSE:  Nice kid.  How much do you really drink?

[ she looks at him ]

[ outside Lucy’s room ]

FOREMAN:  He’s really talking to a patient?

CHASE:  I don’t know who I am anymore.

FOREMAN:  It’s a blood clot.  What’s so fascinating about that?

CHASE:  He likes crazy people.  Likes the way they think.

FOREMAN:  They think… badly.  That’s the definition of crazy.  Why would he like…

CHASE:  They’re not boring.  He likes that.

[Back in the room]

HOUSE:  And the meds…

LUCY:  [ twitching ]  Baseball!  I like baseball.

HOUSE:  Very nice.

LUCY:  Very sad.  My boy and me – we went to see a game.

HOUSE:  Not “Mets” – meds – medicine.  You take what he tells you to take.

LUCY:  No one believes me.

HOUSE:  I do.

[Outside the room]

FOREMAN:  I thought he liked rationality.

WILSON:  He likes puzzles.

FOREMAN:  Patients are puzzles?

WILSON:  You don’t think so?

FOREMAN:  I think they’re people.

WILSON:  Yeah.  Well, he hates them, and he’s fascinated by them.  Tell me you can’t relate to that symptom.  [ walks away ]

[ Lucy is laughing and smoothing out the blankets over her legs ]

HOUSE:  You told Luke it never hurt before.

LUCY:  Just rough – they didn’t hurt. 

HOUSE: Didn’t?

LUCY: Don’t lie to him, Limpie.  Lively Lucy never lies to Lucas.  Look what I do to him.

[ House joins other docs ]

WILSON:  Learn anything from the “human connection”?

HOUSE:  Yeah.  The Mets suck.  Also, for the last two months, she hasn’t shaved her legs.  Because of the tremors… she cuts herself.

CHASE:  The tremors aren’t new – she must always cut herself.

HOUSE:  Exactly.  Something changed in the last two months.  I’m thinking the amount of blood when she cut herself.  So let’s start with some bloodwork.  Collect and send for  clotting studies, PT, PTT, factor 5, protein, CNS, the whole shebang.

WILSON:  [ walking away ]  Good luck.

LUKE:  [ coming up to them, sandwich in hand ]  No pickles, and it’s cold now.

CAMERON:  If it’s a reuben, that’s the way he likes it.

HOUSE:  Everyone, this is Luke.

CAMERON:  [ standing up to shake hands ]  Allison Cameron, it’s nice to…

HOUSE:  Yeah, yeah, yeah, save it, we’re busy.  Luke, give us another half hour with your mom.  We need to do some tests.  [ Luke walks away ]  Nice kid.  Take her off the psych meds, that way we’ll know what’s what on the physical side, and who knows, we might get more out of her.  [ guys walk away, House is opening up the wrapper, munching into the sandwich; Cameron is hanging back with him ]  Don’t worry – no pickles.

CAMERON:  Happy birthday.

HOUSE:  [ chewing ]  OK… whose?

CAMERON:  I was going through your mail, and it was on a form.  Happy birthday.

HOUSE:  Oh.

[ Cameron walks away; House is still taken aback ]

[ Lucy’s room – Foreman is setting up to draw blood, and Lucy’s not happy ]

LUCY:  No, no blood, not mine!

FOREMAN:  For the test, Dr. House said…  [ Lucy spits in his face; one aide presses call button for help ]

LUCY:  You’re gonna steal it, sell it, no, no blood, no, no blood, no, no blood, no!  [ nurses and aides come in to hold thrashing patient ]

FOREMAN:  Haldol, 5 milligrams, stat.

LUCY:  No no no no no no …!

[ she fades out as the Haldol kicks in ]

[ clinic exam room; shot on matching bracelets]

HOUSE:  [ entering exam room ]  Well, good news, the lab says it’s not strep, so we’re done.

MOM:  Wait a second…

HOUSE:  No, really, not strep.  Boys in the lab, sure, they’re hard drinkers, but they’re pros, you know.  Plus, your kid actually has none of the symptoms of strep, I just figured it was quicker running the test than arguing with you.  My point is – go!

MOM:  I just wanted to ask your opinion, doctor.  She’s having a birthday party next week and she’s upset that I’m getting a sugarless cake.

DAUGHTER:  The other kids hate it!

HOUSE:  This is why you’re here.

MOM:  Sugar is the leading cause of obesity in America.

HOUSE:  You want a doctor to scare her about the dangers of sugar.

MOM:  She needs to get her weight under control.

HOUSE:  [ closes door ]  Well, you know… [ comes over to girl ]  I feel sorry for those other kids, Wendy, who don’t have a mom like yours – a mom who knows that sugar causes heart disease, appendicitis, and athlete’s foot.

MOM:  That’s not fair.

HOUSE:  Oh, yes it is.  No, I get it.  You want her to slim down a little, so she can wear pretty clothes like yours. Love the bracelets.  Hey!  What about matching outfits?  You could be twins!  She can’t be your daughter, it’s impossible, you look way too young!  [  leaving ]  Happy birthday.  Get the kid a damned ice cream cake.

[ Luke waiting in hall for House ]

LUKE:  You drugged her.

HOUSE:  Actually, I didn’t.  I’ve taken her off all medications.

LUKE:  Your guy, Foreman, gave her Haldol.

HOUSE:  We needed blood for some tests.  I assume that was the only way to get it.

LUKE:  He knocked her out.

HOUSE:  Look – I have a cane, and I know how to use it.

LUKE:  I hired you.  You work for me.

HOUSE:  OK, can I go now?  Boss? [ walks away ]

LUKE:  [ calling after him ]  The Haldol changes her.  She says it makes her soul numb.  Don’t give it to her.

[ Luke in Lucy’s room ]

LUKE: [ reading ]  “If there be rags enough, he will know her name and be well pleased remembering it.”  [ Lucy coughing ]  You OK?

LUCY:  “Old… days…”

LUKE:  “For in the old days, though she had young men’s praise and old men’s blame, among the poor, both old and young gave her praise.”  [ Lucy coughs again and blood spatters on page; Luke turns as she begins to vomit up lots of blood ]

LUKE:  [ running for the door ]  Help!  Somebody, help!

[ shot of Lucy asleep ]

[ House’s office, he’s chewing out Foreman ]

HOUSE:  So, when I said, “no psych meds,” I’m just curious – which word didn’t you understand?

FOREMAN:  The Haldol had nothing to do with the bleed.  You know that.  I used it purely as a chemical restraint.

HOUSE:  Oh, great, well, that’s good to hear.  So she won’t experience any of those pesky little side effects you get when your motives AREN’T pure.

FOREMAN:  Those side effects are so rare!

HOUSE:  Passing out, increased confusion, depression, that’s not gonna happen.  That’s not gonna screw up our diagnosis, ‘cause you just used it to restrain her.  I’m so relieved!

FOREMAN:  She spit in my face! 

HOUSE:  It must have been so frightening for you.

FOREMAN:  What was I supposed to do?  Tie her down?

HOUSE:  Yeah!  Anything but give her drugs – that’s basically my point!

[ Cameron is sitting at a table outside House’s office as Chase comes in with a folder ]

CHASE:  The clotting studies.  Pretty fast – you promise to date the entire lab?

CAMERON:  No – I save that for emergencies.  I told them she bled out two units and if it happened again, she’d die.

CHASE:  If it’d happened at home, she would have died.  That ER doc, he was gonna send her home.

HOUSE:  It turns out your best judgment is not good enough.  Here’s an idea – next time, use mine.

CAMERON:  I think they’re choosing a movie.

[ House and Foreman come out ]

HOUSE:  Why did the patient bleed out?

CAMERON:  The clotting studies so far are normal.

HOUSE:  Well, cover your ears if you don’t want me to spoil the ending.  Everything was normal, except for prolonged PT time, which means what?

FOREMAN:  Usually it means, whoever drew the blood didn’t do it right.

HOUSE:  Oh, that’s right – ‘cause… you drew the blood.  But you were precise, because you knew the tube was purely for the PT study.

FOREMAN:  That’s right.

HOUSE:  And I’m right with you.  I trust this result.  For two reasons, a) because you are a good doctor, and b) because five milligrams of IV Haldol makes for a spectacularly cooperative patient.  The prolonged PT time makes me think she’s got a vitamin K deficiency.

CAMERON:  Vitamin K would explain the bleed but not the clot.

HOUSE:  Without vitamin K, protein C doesn’t work.  Without protein C, she clots.  Clotting and thinning, all at the same time.

CAMERON:  What about another drug interacting with heparin, an antibiotic like ampicillin?  That would …

HOUSE:  Clever, but she’s not on ampicillin.

CAMERON:  [ looking at notes ]  Two months ago, she complained of a sore throat. And he got her ampicillin.

HOUSE:  Which she refused to take.

CAMERON:  He just said she didn’t take it.  What is it, everybody lies, except for schizophrenics and their children?

CHASE:  It’s more likely than malnourishment.  Why not scurvy or the plague?

HOUSE:  Gee, I wish my idea was as cool and with it as yours.  What is yours, by the way?  Do you have one?

CHASE:  Alcohol.  Simple.  It causes immobility, which explains the DVT.  It also causes cirrhosis which explains the bleed and the prolonged PT time.  Let’s ultrasound the liver.

HOUSE:  Three theories.  Check out her place for ampicillin and diet, then ultrasound her liver.  Let’s find out who’s right before she bleeds to death.

[ ducklings walk away ]

[ Chase and Foreman enter building, up stairs to apartment ]

CHASE:  101.  [ pulls credit card out of his wallet to open door, struggles to open the door with it ]

FOREMAN:  So House says the kid’s sensitive.  Thinks he takes good care of her.  If we don’t find anything, why let him know we did it in the first place?  What’s the point?  Why not just make old Foreman [ pulling a key out of his pocket ] lift the key from the kid’s backpack?  [ Chase takes it and they go in ]

CHASE:  Looks like Luke sleeps in the living room.

[ Foreman checks bathroom; Chase checks bureau drawers labeled with days of the week]

FOREMAN:  Nothing in there.  He lays out her clothes?

CHASE:  Enough organization, enough lists, you think you can control the uncontrollable.  Fix her meds, fix her clothes, maybe you can even fix her.

FOREMAN:  Pick that up on your psych rotation?

[ Chase picks up a picture of Lucy and son ]

FOREMAN:  [ finding strongbox ]  Trifluo perazine, Thorazine, Foziril – whew, they tried everything.  The ampicillin -- [ shakes bottle ] never touched it.  There goes Cameron’s theory.

CHASE:  Oh, God, I hope it’s not a vitamin K deficiency.

[ they go into the kitchen – empty fridge, freezer full of frozen burger dinners ]

CHASE:  [ groans ]  Damn.

FOREMAN:  Breakfast, lunch and dinner.  House was right.

[ microwave beeps; House takes out burger, goes to sit at table with Luke ]

LUKE:  That’s the only thing she’ll eat.

HOUSE:  Ah.  Problem is, you can’t actually live on this stuff.

LUKE:  I checked it out, I looked on the box, all the nutritional values were solid.

There’s plenty of protein, and calories…

HOUSE:  Yeah, vitamin A and C, but no K.  That’s why your mom got sick.

LUKE:  So, what’s the plan?

HOUSE:  Load her up with vitamin K. 

LUKE:  That’s it?

HOUSE:  If it all checks out, you can take her home in a couple of days.  Oh God, you’re upset about something.  You’re gonna open to me now, aren’t you?

LUKE:  It’s all my fault.

HOUSE:  Here we go….  OK, I’m gonna say this once. You have done a very good job taking care of your mother.  If this was all she’d eat, then what else could you do?  Gosh, just being a kid is a full-time job…

LUKE:  Shut up!  I’m 18, I should be able to take care of my mom!  I almost killed her.

HOUSE:  Good example, just the time it takes to express those ridiculous self-centered teenage ideas… I don’t envy your schedule.  [ chomps ]  No pickles.

LUKE:  My mom doesn’t like them either.

HOUSE:  Smart woman.

LUKE:  Before she got sick, I didn’t like how bossy she was, always telling me what to do, the right way to do it.  Never thought I’d miss that.  [ lifting backpack, wrist pain ]  Ah…

HOUSE:  You should get that looked at.

  

[ Foreman and Chase walking down hall ]

CHASE:  I still don’t buy a vitamin K deficiency.

FOREMAN:  House was right.  That usually makes you happy.  Less work for us.

CHASE:  The kid feeds his mum a steady diet of booze and the problem is too many burgers?

FOREMAN:  The kid’s in a tough situation – you do what you’ve gotta do to survive.

CHASE:  Feeding alcohol to an alcoholic is not a survival technique.

FOREMAN:  Where I come from, if it works…

CHASE:  Yeah, right.  I’m rich, I couldn’t possibly understand what this kid is going through.  Just because you’re drinking pricier stuff doesn’t mean you don’t have a problem.

FOREMAN:  You’ve seen someone stagger down that road?

CHASE:  No way vitamin K’s the whole story.

[ House and Luke in House’s office ]

HOUSE:  [ putting up x-ray on lightbox ]  It’s not broken.  [ pointing ]  See this right here?  It’s the epiphyseal plate, otherwise known as the growth plate. 

LUKE:  What’s wrong with it?

HOUSE:  Amazing thing, this bone.  If you know how to read it, it can tell you how old someone really is, exactly how old.

LUKE: Great.

HOUSE:  Not even fifteen.  Almost, though.  Two weeks away, maybe a month.

LUKE:  Last week.  I was fifteen last week.

HOUSE:  [ walking over to his desk and sitting down ]  Happy birthday to both of us.  If you’re gonna lie though, go big, go 21.  That way you won’t need your crazy mom to help you buy vodka.

LUKE:  Great.  Thanks for the tip.  [ takes out notebook ]  Now, when I bring my mom home, is there anything I need to know about taking care of her?

HOUSE:  I suppose your biggest worry isn’t the booze. You’re 15, basically no mom.  Child Welfare let kids get away with that, well, they wouldn’t need those nice foster homes, and that would make them sad.

LUKE:  They’d put her someplace too.  My life is working.

HOUSE:  Not the word I’d use.  Most 15 year old kids are doing what they’re supposed to be doing, you know, they’re huffing glue, catching crabs…

LUKE:  If you turn me in, I’ll sue you.  That’s privileged information.

HOUSE:  Oh, relax.  It’s not even your x-ray.

[ Luke is taken aback; House makes a face at him ]

[ Lucy’s room, Chase doing ultrasound of liver; Cameron comes up to him ]

CAMERON:  She’s awfully calm.

CHASE:  House write new orders?

[ Cameron checks drug vial ]

CAMERON:  There’s a little bit of scarring, not much, not enough to con…

CHASE:  It’s cirrhosis.  But she doesn’t drink!

CAMERON:  Congratulations, you win.

[ both goggle at the screen ]

CAMERON:  Actually… no one wins.

CHASE:  A tumor.  Cystic?

CAMERON:  Solid mass.  Cancer.

[ Wilson in House’s office, looking at ultrasound ]

WILSON:  The vitamin K caused the DVT, and aggravated the liver.  But the tumor’s the real reason for the bleed.  The tumor’s the problem.

[ in Lucy’s room ]

WILSON:  Mrs. Palmeiro, I’m Dr Wilson.  I’m afraid I have some bad news from your ultrasound. You have cancer.

[ As he continues, Luke puts down notebook, walks away from her bedside, overwhelmed.  Lucy watches his reaction. ]

[ House and ducklings in House’s conference room ]

FOREMAN:  It’s big.  Five point eight centimeters.

CHASE:  We do nothing, she dies from liver failure within 60 days.

CAMERON:  She needs a transplant.

HOUSE:  [Sarcastically] That’s gonna happen.

CAMERON:  She’s a 38 years old, she’s a mother...

HOUSE:  She’s a schizophrenic mother, with no money, on the public dole, in fact, who knocks back vodka every time a breeze blows her way.

[ Wilson walks in ]

FOREMAN:  Mickey Mantle had a whole bar named after him.  He got a transplant.

HOUSE:  Yeah, well, Lucy can’t switch-hit.  Plan B.  Surgery to resect the tumor.

CHASE:  Joe Bergen does the knife thing --  laser cauterizes while it cuts, saves more liver.

WILSON:  The tumor’s way too big.  He won’t even consider it.

FOREMAN:  Not a big risk taker, Bergen.  He won’t even drink milk on its expiration date.

WILSON:  He has no discretion.  Five point eight centimeters is past the surgical guidelines.

HOUSE:  Would he do it at 4.6?

CAMERON:  Why don’t we just say it’s zero, then we don’t need him at all.  Tumors grow, they don’t shrink.

HOUSE:  This one does.

[ Wilson and Cameron in Lucy’s room, Cameron with ultrasound and Wilson with honking great big syringe to inject the tumor ]

WILSON:  Ninety five percent ethanol.  The ethanol dehydrates the tumor cells, literally sucks them dry. Shrinks the tumor temporarily.

CAMERON:  How temporarily?

WILSON:  Well, if we’re lucky, just long enough to fool the surgeon.

[ House walks into the clinic as Cuddy comes out of her office ]

CUDDY:  Good morning, Dr. House!

HOUSE:  Good morning, Dr. Cuddy!  Love that outfit.  Says, I’m professional, but I’m still a woman.  Actually, it sorta yells the second part.

CUDDY:  Yeah, and your big cane is real subtle too.

HOUSE:  Gotta go.  [ walks away ]  Those running noses aren’t just gonna start walking on their own.

CUDDY:  The clinic can wait.

HOUSE:  [ stops ]  How long?  Maybe we could catch a movie.

CUDDY:  You should know by now my doctors have no secrets from me.

HOUSE:  I don’t believe it.  Who came running to Mommy?

CUDDY:  It doesn’t matter who.  The point is, I know exactly what you did.

HOUSE:  [ realizes she’s bluffing ]  You have no idea what I’m talking about.

CUDDY:  [ walking over to him ]  Somebody knows about a bad thing you did – that’s a big field.  But somebody you think might have told me, that narrows it down quite a bit.  Someone who views me as a maternal authority figure. A young person, perhaps…  How am I doing?  You think I’m gonna get there?  Presumably hospital business.  How many patients…

HOUSE:  It’s Cameron.  She… found out about my birthday.  I thought she told you, and I’d have to stand here and smile while you gave me a sweatshirt or a fruit basket, you know, made me feel that deep sense of belonging.

CUDDY:  Actually, I was just gonna remind you, you owe me six clinic hours this week.

HOUSE:  Oops.  [ walks away; Cuddy walks over and picks up phone ]

CUDDY:  Hi, this is Dr. Cuddy.  I need all the charts on Dr. House’s current patients. [ throws birthday card in wastebasket ]

[ Clinic exam room ]

PATIENT:  Hiccups.  I’ve tried everything.

HOUSE:  Um hmm.  [ reading from chart ]  Pulling the tongue, icepacks on the throat, hitting yourself… the groin pinch.  Well, you’ve certainly covered all the normal medical bases.  Uh, how are you hitting yourself, though?  Is it open hand or fist?

PATIENT:  Open hand.

HOUSE:  Well, that’s how they teach it at Harvard Med.  How hard though?

[ Cuddy comes in; patient slaps himself ]

HOUSE: I’m sorry, I missed that.  Could… could you do that again?  [ patient slaps himself again ]  That’s… that’s very good.  [ to Cuddy ]  Hiccups.

CUDDY:  I need to speak with you.  NOW.

HOUSE:  Mmhhmmm, I need to go peepee.  [ to patient ]  Dial it up a notch and repeat.  I’ll be back.  [ he leaves, Cuddy follows, patient slaps himself again ]

[ House is washing his face in the men’s room as Cuddy walks in ]

HOUSE:  Ooh, girl in the boys’ bathroom.  Very dramatic.  Must be very important what you have to say to me.  [ dries hands and face on paper towel ]

CUDDY:  Yesterday your patient’s tumor was 5.8 centimeters.  Today it’s 4.6.  How did that happen?

HOUSE:  At a guess, I’d say “Dr. House must be really really good – why am I wasting him on hiccups?”  I wash before and after.  [ walks over to urinal ]

CUDDY:  You also requisitioned 20cc of ethanol -- what patient was that for? Or are you planning a party?

HOUSE:  [ over his shoulder ]  Do me a favor…?

[ Cuddy turns on water faucet ]

HOUSE: I was gonna say “leave,” but that works.

CUDDY:  You shrunk the tumor!

HOUSE:  Only way to get the guy to do the surgery…

CUDDY:  Fraud!  Fraud was the only way.  There is a reason that we have these guidelines.

HOUSE:  I know – to save lives.  Specifically doctors’ lives, and not just their lives but their lifestyles.  Wouldn’t wanna operate on anyone really sick – they might die and spoil our stats.

CUDDY:  Bergen has a right to know what he is operating on.

HOUSE:  True.  I got all focused on her right to live, and forgot.  You do what you think is right.

[ Cameron walks into House’s office as he’s typing away on his computer; he notices her and stops ]

CAMERON:  You really didn’t know.

HOUSE:  No.  I didn’t.  And frankly I’m angry.  Which I’m guessing is the correct response.  ‘Course I’ll know better once you tell me what you’re talking about.

CAMERON:  Your birthday.

HOUSE:  Oh.  Anger was a bad guess.  Well, normally I’d put on a festive hat and celebrate the fact that the earth has circled the sun one more time.  I really didn’t think it was gonna make it this year, but darnit, if it wasn’t the Little Planet That Could all over again.

CAMERON:  It’s a birthday.  It’s an excuse to be happy. You think that’s lame?

HOUSE:  Why are you here? To buy me a pony?

CAMERON:  I’m just waiting for the surgery.

HOUSE:  Yeah well, go scrub in.

[ operating room ]

BERGEN:  All right, done.  Close her up.  [ Bergen and Cameron begin stripping off gloves and masks ]  That tumor didn’t just walk itself into a bar and order up a double shot of ethanol.  Someone shrunk it down.

CAMERON:  I’m sorry.  It was very, very wrong.

BERGEN:  House is lucky I didn’t just close her up.  He tries again, that’s what happens.

CAMERON:  I’ll pass it on.

[ shot of Lucy asleep, panning over to Chase and Luke ]

CHASE:  It looks like the surgeon got it all, but she’s gonna have to have some chemotherapy.

LUKE:  [ taking notes ]  What kind is it?

CHASE:  Luke, stop writing. [ he sits down at the table with Luke ]  If you stop for a second, it’s not all gonna fall apart.  Give yourself a break once in a while.  The fact is, your mum’s gonna have an extra drink every now and then.

LUKE:  No.  No, she won’t, she doesn’t.

CHASE:  Fine.  There are some things you just can’t fix, that’s all I’m saying.

LUKE:  That’s how you’d handle it, something like this?  You’d just give up?

CHASE:  No.  I’d do it just like you.  It’s an infusion.  [ hands him a pamphlet ]  She’s gonna have a drain in her abdomen, you’re gonna have to check for possible infections.

WYETH:  [ entering room, with a guy ]  Lucas Palmeiro?  Trina Wyeth, Child Services, State of New Jersey.

CHASE:  [ standing up ]  Can I help you?  This is a private room.

WYETH:  He’s only 15 years old, a minor, he’s in a tough living situation -- we’re just here to help.

LUKE:  I don’t need your help.

CHASE: 15?

WYETH:  Lucas, you’re gonna have to come with us. Right Now.

CHASE:  Where are you taking him?

WYETH:  Until the determination had been made he’ll be housed at Children’s Services.

LUKE:  I don’t wanna be housed, I live with my mom.

WYETH:  Not for the next few days.  [ Luke stands up, goes over to Lucy’s bed ]  Come on, let’s not make this difficult, huh?

LUKE:  Mom?  Mom?  I love you.

[ she wakes and turns to him ]

LUCY:  The Mets lost.  You remember?

LUKE:  Yeah.  I remember.

LUCY:  I love you.  [ closes her eyes;  Luke picks up backpack and walks out, crying, tears streaming down his face ]

WILSON:  Cuddy didn’t say anything about pushing Bergen to finish the surgery?

HOUSE:  Not a word.  Some kind of mind game. She’s waiting for me to crack.

WILSON:  Well, either that, or she’s just being nice.

HOUSE:  Yeah, well…  [ Luke storms past them, followed by Child Services reps ]

LUKE:  You said you wouldn’t call – you’re a real bastard, you know?

HOUSE:  [ staring after them ]  Yeah.  I get that a lot.  I don’t think Mom’s crazy. [ reading to Lucy ]  “For in the old days, though she had young men’s praise and old men’s blame, among the poor, both old and young gave her praise.”  [ he snaps the book shut and she wakes up ] You called Social Services.  It was you.

LUCY:  No, no.  No.

HOUSE:  It’s OK, it’s OK, I get it.  He’ll have an easier time dealing with the system.  Sure, he won’t be with his real mother, but his real mother’s sick.  Someone needs to take care of him.

LUCY:  I’m not gonna live here.

HOUSE:  What would his future have been?  Taking you to chemo and back on the bus… and even if the cancer’s in complete remission, he’ll still have a mother who hears voices.

LUCY:  Talk no more, talk… no more.

HOUSE:  “Look what I do to him, limpie.”  You said that.  I checked the phone records – only one call from this room. Smart – they charge you two bucks a call.  It was to Social Services of the State of New Jersey.  You’re his mother, couldn’t do it to him anymore. Good for you.

[ House and Wilson coming out of House’s office and walking down the hall ]

WILSON:  Schizophrenics can make rational decisions.

HOUSE:  On the small stuff, yeah, when to sleep, what to drink, no lemonade but I’ll take some hemlock if you’ve got it.

WILSON:  Your man Socrates.

HOUSE:  But giving up your son, because it’s better for him – it’s so sane, so rational.  Self-sacrifice is not a symptom of schizophrenia… it excludes the diagnosis.

WILSON:  She’s not schizophrenic?

HOUSE:  She’s 36 years old when she first presents…

WILSON:  It’s a little late, but within the parameters.

HOUSE:  The internist sends her to a shrink, one shrink sends her to the next, she tells them all she’s not crazy, the drugs don’t work and why would they if she’s not a head case?  She got clearer when I took her off the psych meds. [ pauses at his office door ] You think I’M crazy.

WILSON:  Well, yeah, but that’s not the problem.  Didn’t we just leave your office?

HOUSE:  I like to walk.

[ Sounds of piano coming from 3rd floor apartment; House is playing something classical.  He finishes that piece, taps out “happy birthday to you, happy birthday to you.”  Takes a drink from a glass on top of the piano – scotch? Or whiskey?  Looks over at Luke’s notebook, limps over to pick it up, sits back on piano stool and pages through it. ]

HOUSE:  [ picking up telephone ]  Is that Dr. Jeffrey Walters?  Hi.  My name is Greg House, I’m a doctor…  oh, is that the time?  Yeah, I’m sorry, my watch must have stopped.  Listen, you treated a patient about eighteen months ago, a woman named Lucille Palmeiro, I wondered if you recalled running any tests… [ fades as Walters hangs up on him ]  …at all.  [ tries again, using a terrible English accent! ]  Oh, how terribly foolish of me, doctor, is it that late?  Yes, I’m calling from London, you see, must have got my times mixed up so…  [ another hangup ]

[ he looks at the notebook, gathers stuff up and leaves ]

[ House and ducklings in his office; he’s pacing, and they have all obviously been woken up in the middle of the night ]

HOUSE:  I have a headache.  It’s my only symptom.  I go to see three doctors.  The neurologist tells me it’s an aneurysm, the immunologist says I got hay fever, the intensivist… can’t be bothered, sends me to a shrink, who tells me that I’m punishing myself ‘cause I wanna sleep with my mommy.

FOREMAN:  Maybe you’re just not getting enough sleep.

HOUSE:  Pick your specialist, you pick your disease.  If it’s not schizophrenia, what else presents with psych symptoms?

CAMERON:  Prophyria.

CHASE:  The madness of King George.

CAMERON:  What about that copper thing?  What’s it called?  It’s genetic – the body accumulates too much copper.

CHASE:  Oh, uh, Wilson’s disease?

HOUSE:  Very rare.  Nice.  I like it.

FOREMAN:  If any of us did this, you’d fire us.

HOUSE:  Well, that’s funny, I thought I encouraged you to question…

FOREMAN:  You’re not questioning, you’re hoping, you want it to be Wilson’s, boom! Give her a couple of drugs, she’s OK!

HOUSE:  July 17, an appointment with a Dr. Carne.

CAMERON:  She didn’t keep it.  She never kept another appointment with a shrink he made after that.

HOUSE:  Carne is not a shrink.  I looked him up, he’s an ophthalmologist.  Now why would she want her eyes checked?

CAMERON:  Wilson’s presents with cataracts, I think.

HOUSE:  Yes, it does.  It also causes slight cirrhosis, which Dr. Chase so eagerly attributed to alcohol.  [ looks at them all ]  So what are we still doing here???

[ Lucy’s room ]

HOUSE:  Lucy!  [ she snaps awake ]  I don’t think you’re crazy.

LUCY:  Neither do I, [ they sit her up in bed ] but I’m crazy…

HOUSE:  Come on.  [ they get her up, move an eye scope around to the side of her bed ]

CHASE: Put your hands on the bar, and your chin in here. Thank you.

FOREMAN:  [ at the controls ]  You’re gonna see a bright light, OK?  Your body might be accumulating too much copper.  If it is, this should help us see something called Kaiser-Fleischer rings, copper-colored circles around your corneas.  [ he twiddles knobs, brings view into focus – it shows a copper ring around the cornea ]  I guess we should start treating her for Wilson’s.

HOUSE:  It’s what I’d do.

[ Lucy, twitching in bed ]

LUCY:  [ voiceover]  “I will talk no more of books, or the long war, but walk by the dry thorn until I have found some beggar sheltering from the wind and there, manage the talk until her name come round… [ camera begins to spin around the room ] …and be well pleased remembering it.”

[ camera shows Lucy, dressed, wearing reading glasses, reading from the Yeats book ]

[ still voiceover ] “For in the old days, though she had young men’s praise and old men’s blame, among the poor, both old and young gave her praise.”  [ takes off glasses, sighs ]

CHASE:  [ coming in ]  Hi, Mrs. Palmeiro, ready to go home?

LUCY:  Almost.

[ Luke comes in, they hug ]

LUKE:  Mom? How are you?

LUCY:  I’m good.  [ they hug again ]  Oh, oh, oh, you really need a haircut. [ both laugh and hug, tears falling; Chase leaves, thoughtful ]

[ Luke pushes her in a wheelchair, an aide alongside, to elevator; door opens; Luke stops when he sees House and Wilson in elevator ]

LUCY:  Dr. House!  Luke, you’re making Dr. House wait!

HOUSE:  That’s OK, we’re just here for the music.

LUCY:  Luke, come on. [ they all get in, the door closes ]  I’m being discharged.

HOUSE:  I heard a rumor.

LUCY:  Thank God I had cancer, huh?  It’s terrible having everybody think you’re nuts…

HOUSE:  Really?

LUCY:  I called to thank you, did you get my message?

HOUSE:  Yes.  You’re welcome.

LUKE:  [ resentful ]  I’m never thanking you.  You turned me in.  I told you we were doing OK, it was none of your business.  [ Lucy looks uncomfortable ]

HOUSE:  Look.  I don’t care how you were living.  I just wanted you out of MY life.  That’s why I had Dr. Cuddy call Social Services. 

[ House looks at Wilson, then at Luke, Lucy stares straight ahead.  The door opens, they wheel out.  House and Wilson stand watching them go. ]

WILSON:  You OK?

HOUSE:  You were right.  It wasn’t the DVT.  It was the schizophrenia.

WILSON:  I know.

HOUSE:  She’s not nearly as interesting any more.

WILSON:  Isn’t it your birthday around now?

[ House closes his eyes, wincing ]