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#114 : Changement de direction

Episode Changement de direction
Edward Vogler, un riche entrepreneur, est élu à la tête du conseil d'administration de l'hôpital. Il a l'intention de transformer l'établissement en centre de recherche spécialisé dans les maladies incurables. Pour mener son projet à bien, Vogler veut sacrifier le service du docteur House, jugé trop peu rentable.

Captures de l'épisode


Réalisateur : Randall Zisk

Scénariste : Lawrence Kaplow

Acteurs principaux : Hugh Laurie (Dr Gregory House), Robert Sean Leonard (Dr James Wilson), Omar Epps (Dr Eric Foreman), Jennifer Morrison (Dr Allison Cameron), Lisa Edelstein (Dr Lisa Cuddy), Jesse Spencer (Dr Robert Chase)

Acteurs secondaires : Ron Perkins (Dr. Simpson), Chi McBride (Edward Vogler), Sheila Cavalette (Anesthesiologist), Joshua Miller (Ricky), Andrew Borba (Mr. Van Der Meer), Sunny Mabrey (Jenny), David Joyner (Cardiac Surgeon #2), David Castellani (Boardmember #2), Vivian Bang (Robin), Sarah Clarke (Carly Forlano), Dar Dixon (Don)


3.89 - 9 votes

Titre VO

Titre VF
Changement de direction

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Première diffusion en France

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House à son bureau.

House à son bureau.


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France (redif)
Lundi 25.09.2017 à 15:05

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Vendredi 22.09.2017 à 16:00

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Mardi 19.09.2017 à 17:40

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(Dans la salle de repos) Chase : Quelqu'un a eu des échos sur le nouveau boss ?
Foreman : Oui, il a pris ta place de parking !

* * *

Cuddy : J'aimerais vous voir porter une blouse.
House : Moi j'aimerais deux jours de folie sexuelle avec une super nana plus jeune que vous ! Nettement plus jeune !
Cuddy : Portez la blouse.
House : Mais elle mord ! Il y a eu distribution de fessées ce matin ?

[We open on a flyover of New York City (the Chrysler building, etc.).  Cut to a business office, where a phone is ringing, and several businesswomen are looking through papers.]

Carly: Where are those projections?

Robin: 3, 6, and 9 are in your folders.

Carly: Can I have some more –

Robin: Tea’s at your seat.  [She runs to pick up the phone.]

Carly: Excellent.

Robin: [on the phone] Hello?  Oh, hold on.  [She hangs up and runs after Carly.]  Ben Federman again.  Another pre-call.  [Carly presses the speaker phone.]

Carly: We did the pre-call.  This is the post-pre-call-call?

Ben: Board’s gonna want some specifics for the push into the Asian market.

Carly: Ben, there are no specifics about Asia.  We came up with that as a Hail
Mary at three in the morning to placate the board about International!

Ben: Carly, I’m just giving you a heads-up about Asia. [Carly picks up the receiver.]

Carly: There is no Asia.

[Cut to Carly, in the board room, standing by a BIG map of Asia.]

Carly: Let’s talk about Asia.  We’re in the preliminary stages of forming a strategic alliance with Credit Lyonnais.  Within three months you won’t be able to walk four feet in Kyung Hong, South Korea, without seeing one of our beautiful models smiling at you from billboards and drugstore windows inviting you in.

Boardmember: That’s incredible news, Carly.  We’d hoped to hear something about Asia, but had no idea plans were so far along.  [The rest of the board also looks very excited.]

Carly: Well, you know Asia.  Nothing’s done until it’s done.  [The board laughs.  Carly is sweating, and when she sets down her teacup, we see that her hand is shaking.]

Boardmember: Carly, I was wondering, could you walk us through what you were thinking for other Asian territories?

Carly: Absolutely.  India has over half a billion women.  In terms of spending power it’s the single largest potential market in the world.  [She grabs her leg.  CG shot of the leg muscles, which are straining.] Um, we have retained a local firm to ensure that cultural differences are respected, um, however, I can’t go into the specifics of my plan with you until tomorrow; right now I have a meeting and I need the room. [She grabs her Blackberry.]

Boardmember #2: We were just getting started.

Carly: [typing under the table] I know, and I do apologize.  It’s last minute, but the meeting is with three State Department officials to smooth the way for China. [She has typed “I need help.” into her Blackberry.]

Boardmember: China?  This is just incredible.

Carly: We’ll be in touch.

Boardmember: Thank you. [They all get up to leave, except Carly.  Robin leans in behind Carly.]

Robin: What is it?

Carly: I need a doctor.  I can’t move my leg!

[Quick cut to Carly, lying in a bed at PPTH, before House walks into the Diagnostic offices.]

House: 32-year-old female, paralysis and severe pain in her right quad.  Go.

Foreman: How’d she get to you?

House: She’s the CEO of Sonyo Cosmetics.  Three assistants and fifteen VPs checked out who should be treating her.  Who da man?  I da man.  I always suspected.

Cameron: Dr. House, I know the chances are very slim, but I’m sure you recognize that she may have what you had: a clot in her thigh.

Chase: [coughs] A bit of a long shot.

Foreman: What about a disc herniation?

Cameron: I don’t know, Eric.  If her disc were herniated, she’d present with pain elsewhere, wouldn’t she? [At this point, Foreman is looking at Cameron like she’s an alien, Chase is looking at her like she’s something on the bottom of his shoe, and House is looking at the whole thing with mild interest.]

Foreman: Yeah, I suppose.

Cameron: You’re right, a clot’s also the most deadly, right, Robert?

Chase: True.  The clot breaks off, she could stroke and die.  [looks at House questioningly]

Cameron: Dr. House, I believe that they’re right, and –

House: Stop talking.

Cameron: What?

House: You read one of those negotiating books, didn’t you?  “Getting to Yes: Fifty Ways to Win an Argument.”  “The Hitchhiker’s Guide to Being a Pal.”  In five seconds you just manipulated these two into agreeing with your point of view. [Chase and Foreman look defensive.]  Fellas, this is known as “soft positional bargaining.”  It’s not gonna work.

Cameron: Dr. House, are you saying that she doesn’t have a clot or are you saying that if she does have a clot she doesn’t need blood thinners and an angiogram?

House: Chase, put her on blood thinners, do an angiogram. [Cameron looks triumphant.] When that comes back negative, MRI the spine.  If that’s clean, cut her open and biopsy the leg.

Cameron: Excellent suggestion.

House: Read less, more TV.

[Cut to a conference room in the hospital.  Cuddy is talking to the board of directors.]

Cuddy: It’s rare for an individual to make a donation significant enough to impact an organization as large and unwieldy as a hospital.  This donation does come with one string: that he be made Chairman of the Board.  I think that’s a reasonable request. [Shot of Wilson, who is on the Board?  Whoa.]  I think he should have the right to know what it is we do with his $100 million.  Please welcome our new Chairman of the Board, Edward Vogler. [All the board members clap, Vogler stands.]

Vogler: Thank you, thank you.  When I was eighteen, my dad loaned me $20, 000 for a college tuition which he would have known was a mistake had he known that I wasn’t actually in college. [board chuckles]  I took his money and invested in a friend who had a little business, and when my dad found out what I had done with his money, he and I didn’t talk much after that.  But my friend’s business took off, and I used the profits from that to buy another company, and another, and I must have been pretty good at it, had a good eye, because before I knew it people were making offers for my company.  And, uh, about a year ago I went public and overnight I was worth a billion dollars.  So I went to see my dad. [Board chuckles, Cuddy looks to Wilson, who sort of smiles] I’ll admit, I wanted a little payback, you know, kind of shove the wind in his face, so I went upstate and sat in the kitchen I grew up in and, uh, he had no reaction.  It wasn’t his fault, he didn’t even know who I was.  Because his Alzheimer’s had taken a turn for the worse, despite the best drugs and care out there, and that is why I’m here.  What if my contribution to this hospital is the difference between no cure and a cure for cancer?  The difference between a man not recognizing his wife of 35 years and being able to look at her and say, “Good morning, honey.  I love you.” [Wilson now looks pensive and a little sad.  (Hey, we keep coming back to Wilson and he doesn’t say anything… something must be important here!)]  If there’s a disease out there killing people, I am writing you a blank check to fight back.  [big smile] So, things are going to change, a lot. [more board clapping.  Strangely enough, Wilson is the last one to start clapping, and it’s very subdued.  Hmmm…]

[Cut to the x-ray room, where Carly is on the table and still punching messages into her Blackberry.]

Chase: I’m gonna have to ask you for the cell phone?

Carly: Do what you need to do, I’m okay.

Chase: Pretty sure my x-ray machine can take your phone in a fight.  It’ll fry it.

Carly: [handing it over] Fine.

Jenny [the radiologist]: How old is she?

Chase: 32.

Jenny: Wow.  She’s already the CEO of a public company.

Chase: She’s a workaholic.  Okay Carly, hold still.  The x-ray machine is gonna pass over your leg.

Carly: Okay.

Jenny: What’d you do with your time off?

Chase: Snowboarding in Stadt.

Jenny: Switzerland!

Chase: Do you ski or board?  You can come with, if you like.

Jenny: Maybe we should start with a drink before we go ‘round the world.

Chase: Oh, you want to have a drink with me? [She hits him.]  Oooh, very aggressive!  I like that. [The x-ray commences.]

[Cut to Vogler and Cuddy walking in the hallway.]

Vogler: I want to run this place like a business.

Cuddy: What, you want to put more vending machines in the hallway?  Maybe a roulette wheel?

Vogler: Nice one.  But I’m serious.  The product that you’re selling is good health, it shouldn’t be a tough sell.  You don’t want to sell, it means people don’t care about your product.  You care if people are healthy, or are you too proud for that?
[Cuddy looks insulted, but Vogler looks over her and sees…]
Who’s that? [A yo-yo, being played with by one Dr. House.]

Cuddy: That’s, uh, just one of our doctors.

Vogler: Aren’t doctors supposed to wear lab coats. [House lifts his head slightly to eavesdrop.]

Cuddy: He’s… different.

Vogler: Everyone’s buddy.

Cuddy: No, not exactly.

Vogler: Then why does he get away with it?

Cuddy: It’s just a coat.  He’s very good.

Vogler: Hmm.  [He walks off.]

[Cut to House in the clinic, giving a strep test to a young boy.]

House: Say “ah”.

Ricky: Ah.

House: No, really belt it out, like you’re gonna throw up.

Rick: Ah! [He coughs in House’s face.]

House: Perfect. Okay, that’s it.  We should know in a couple of days what’s growing in your son’s throat. [The dad doesn’t say anything in response.]  Hello?

Ricky: He can’t talk.

House: Excuse me?

Ricky: He had knee surgery.

House: Right…

Ricky: About a year ago, and then he couldn’t talk.

House: Right, yeah, well, that happens.  You know, it’s very dangerous operating so close to the vocal chords.  Okay, well, we’ll send your kid’s culture to the lab and somebody will call you.  [As he’s leaving] BOO!

Ricky: AAH! [The dad looks frightened, but doesn’t say anything.]

House: Just wanted to see if your dad, uh, sorry. [He leaves.]

[Cut to Cuddy and House getting out of the elevator.]

Cuddy: I need you to wear your lab coat.

House: I need two days of outrageous sex with someone obscenely younger than you.  Like half your age.

Cuddy: Wear the coat.

House: Man oh man.  Someone got spanked real good this morning.

Cuddy: Guy gives $100 million to cure cancer, pretty small concession to wear a lab coat.

House: Cure cancer.  Is the hospital getting out of the dull business of treating patients?

Cuddy: You know that’s not what he’s doing.

House: I know exactly what he’s doing.  He’s using us to run clinical trials.

Cuddy: Oh, shame on him!  Saving lives like that!

House: [entering his office] It’s unethical. [Cuddy follows.]  Oh, are you coming in, too?  I thought I had you convinced.

Cuddy: Clinical trials save thousands of lives.

House: He’s using patients as guinea pigs.

Cuddy: Pharmaceutical companies do that every day.

House:  Are we a pharmaceutical company?  We’re gonna wind up pressuring desperate patients into choices that are bad for them, good for us.  You’re gonna compromise patient care.

Cuddy: Who the hell am I talking to?  Suddenly ethical lapses are a major concern for you?

House: What’s interesting is it suddenly doesn’t bother you.

Cuddy: So, if you ignore ethics to save one person it’s admirable, but if you do it to save a thousand you’re a bastard.  All he’s done is taken your game and gone pro.

House: He’s not going to kill a few patients.  He’s going to kill this hospital.

Cuddy: It took him three seconds to size you up, and surprise?  He doesn’t like you.  Wear the damn coat.

[Cut to Foreman entering Carly’s room.  Carly’s curled up on her side.]

Foreman: Hello.  I’m Dr. Foreman, I work with Dr. House.  Our initial tests say you’re fine.  We think you may have had a clot but it resolved on its own, so we’re gonna keep you overnight to be safe and you can go back home tomorrow.  Or, back to work.  Hey, you okay.  [Carly whimpers in pain, clutching her leg.  Foreman runs to the other side of the bed.  Then she SCREAMS in pain.] [to the nurse]  Get in here!  I need a line in her, IV morphine, stat!

[Cut to House entering the Diagnostic offices.]

Chase: Get any read on the new Chairman of the Board?

Foreman: Yeah, he took your parking space.

Cameron: It’s not necessarily bad news.

Foreman: Do you ever watch “Gilligan’s Island” reruns and really, really think they’re gonna get off the island this time?

Cameron: We should introduce ourselves.  It couldn’t hurt.

House: [getting coffee] Make him a bundt cake.  Patient hit a ten on the pain scale.  What would explain that?

Chase: There was no clot in her leg, the angio was totally clean.

House: What about the muscle biopsy?

Chase: No neurogenic or myopathic abnormalities.

Foreman: She’s also negative for trichinosis, no toxoplasmosis or polyarteritis nodosa.

Cameron: Robert, what was her sedimentation rate?

Chase: Normal, Allison, therefore no inflammation, no immunologic response.

Cameron: Do you mind sharing that number with me? [Foreman and Chase try to stop from smiling.]

Chase: Fifteen, Allison.

Cameron: Are you mocking me?

Foreman: Duh, Allison.

Cameron: I’m just suggesting we look outside the box.  What if her sed rate is elevated?

Chase: Well, let’s go further outside the box.  Let’s say the angio revealed a clot, and let’s say we treated that clot, and now she’s all better, and personally thanked me by performing –

Cameron: My Aunt Elisa lives in Philiadelphia.

House: Oh, it’s storytime!  Let me get my baba.

Cameron: Her normal temperature is 96.2, not 98.6 like you and me.  If her temperature were 98.6, she’d have a fever.  I’m just wondering if you think we could apply the same logic to Carly’s sed rate.

House: That’s absurd.  I love it.

Cameron: If 15 is high for Carly, then she has inflammation.

House: Which could, in turn, mean cancer.  I’ll talk to Wilson.  Next time, skip Aunt Elisa.

[Cut to House and Wilson in the hallway.]

Wilson: You’re probably talking about a primary bone cancer.  Can be tricky to detect, you’ll need a bone scan –

House: That’s why I’m talking to an oncologist.

Wilson: Sure, I’ve nothing better to do besides departmental meetings and budget reports… new Chairman of the Board, you know.

House: Oh!  I hadn’t heard.

Wilson: Right.  Clinical trials…

House: Completely unethical.

Wilson: And a very bad omen for you.  There’s not much money in curing African sleeping sickness.

House: No, I have seen every scary movie ever made.  Six-year-old twins in front of an elevator of blood, boys’ choirs: those are bad omens.  This is much more mundane: a billionaire wants to get laid.

Wilson: Billionaires buy movie studios to get laid.  They buy hospitals to get respect.

House: And the reason you want respect?

Wilson: To… get laid.

House: Okay then.  You’ve just gotta think like a billionaire. [Wilson smiles.]  Let’s see, big scary changes, and then, “Oh, Dr. Cameron, we should have dinner to discuss your future on my G-5 private jet.”

Wilson: Oh, come on.  You know how good you have it here.

House: Yes, I’m the big poobah, the big cheese, the go-to guy.

Wilson: You do the cases you want to do, when you want to do them.  You’re not going to get that anywhere else.

House: Relax, I’ve been through three regime changes in this hospital.  Every time, same story.

Wilson: Just keep your head down, that’s all I’m saying.  And put on your coat.

House: It itches.  [Wilson sighs and leaves.  House calls after him.]  So, are you going to do this bone scan for me or what?

Wilson: Yes.  [House throws a Vicodin up in the air and catches it in his mouth.]

[Cut to House sleeping his yo-yo, waiting for Dr. Simpson.]

House: Dr. Simpson!  Did you hear?  New management.  I’m thinking about switching to orthopedics.  How much do you guys get for massage now, without the happy ending?

Simpson: Dr. House, what do you want?

House: You remember a guy named Van Der Meer?  Not a big talker.  You fixed his ACL.

Simpson: Well, not according to my medical malpractice premiums.

House: Didn’t get hypertensive during surgery?  No strokes?  Maybe some connectivity loss?

Simpson: What, you’re going to get involved now?

House: I’m not involved.  Guy brought his son into the clinic.

Simpson: I didn’t touch the son.  I’m not taking any responsibility there.

House: The son’s fine.  Can’t shut him up.  The dad show any signs of cortical disease?  Wernicke’s?

Simpson: No.  Nothing.  And that’s why we settled; because we couldn’t find
anything.  The guy got over a million dollars, don’t tell me he’s complaining.

House: He’s not saying “boo”.

[Cut to Robin and Carly, conducting business in a hospital room.]

Robin: Your father wants to know when you’ll be back from your trip.

Carly: Email back.  It’s “taking longer than I thought.”  He doesn’t need to see me like this.

Robin: What about your brother?

Carly: No.  [Wilson enters.]

Wilson: Hello.  I’m Dr. Wilson.  I was –

Carly: Robin, I’m going to need a minute.

Robin: Oh. [Robin collects all of the papers off of Carly’s bed and hurries out.]

Carly: [as she leaves] Thank you. [to Wilson, as he shuts the door]  There are two Dr. Wilsons in the hospital.  One in ophthalmology and one in cancer. [Wilson sits.]  My eyes are fine, so you’re here to tell me I have cancer.

Wilson: There’s no cancer in your bone.

Carly: You’re not smiling.

Wilson: There’s something called referred pain.  You could have cancer in one part of your body that presents in another.  Given your age and your family history, I’m thinking your colon.

Carly: [to herself] Great. [to Wilson] I was at Columbia when my mom died.  Now there’s a blast.  Cleaning up her vomit and running to my econ final.  Look, if I’m a short-timer give me drugs, I’ll go back to work, I’ll die there.

Wilson: Whoa.  There’s a quick test to see if you even have it, a colonoscopy. 

Carly: I know how you do that test. [She shakes her head.]

Wilson: If you have colon cancer, we can treat it, it’s early.

Carly: That’s what they told my mom.  She was dead six months later.

Wilson: You’re a smart person about to make a very bad decision.  You know, cancer treatment’s come a long way in twelve years, but if you don’t do this now –

Carly: I don’t want to be looked at!

Wilson: There is another way.  We could do a virtual colonoscopy.  Basically, we do a CT scan of your colon.  It’s non-evasive, but it’s very expensive.  I assume that’s not a problem.  [Carly looks at him.]  Say yes.

[Cut to the clinic.  House enters a room with Dad Van Der Meer.]

House: Mr. Van Der Meer. [Dad is typing on his laptop.]  What? [Dad types “wHats werong gwith ricky”] Relax, Ricky’s going to be just “finkf”.  Strep throat, here’s a prescription for an antibiotic.  He should be all better in a few days.  Although,
[House turns around wielding a needle] this might sting a little.  [He approaches the dad, who looks frightened.  House looks up to the ceiling, and when the dad looks up, House injects him in the neck.]  I want to see you again real soon. [Evil smile!]

[Cut to Wilson and House walking in a hallway.]

Wilson: Virtual colonoscopy was clean.  No colon cancer.

House: What happened to a regular old-fashioned colonoscopy?

Wilson: She was uncomfortable doing any more tests!  I had to convince her to do that one!

House: Do you get that often?  Women would rather die than get naked with you?

Wilson: She’s scared.

House: But not of tests.  Just embarrassing ones.

Wilson: Yeah.

[Cut to House, entering his office.  Chase is sitting in his chair, which he vacates.]

House: It’s not an inflammatory process, it’s not a clot because Chase’s angio says so, and it’s not cancer because her toosh is perfect.  Anybody else got an Aunt Elisa with weird stuff? [He looks at the angiogram.]

Cameron: Maybe it’s worth looking into –

House: I thought you said Carly’s angio was clean.

Chase: It was clean.  [House puts the scans up on his light board.]

House: You guys see the problem here?  [Foreman gets up to get a closer look.]

Foreman: There’s no indication of any abnormalities.  No lesions, no spurs, no masses –

House: Her toes are screwed up.  They’re backwards.  Do you guys know how much surgery it’s going to take to swap them back?

Chase: What are you talking about?

House: Either she literally has two left feet or you angio-ed the wrong leg.

Chase: [gets up to look] That’s impossible.  It can’t be the wrong –

House: Or maybe it was Jenny!  How come some resident signed this radiology form?  Were you even in the room?

Chase: I’ll redo her angio straight away –

House: You’ll do nothing!  Foreman, you do the angiogram.  [Foreman leaves.]

Chase: I can’t believe I did that.

[Cut to Foreman performing the angiogram.]

Carly: Why do we have to redo the angiogram?

Foreman: There was a shadow on the first test.

Carly: A shadow?  A shadow means there could be a blood clot, right?  I read Colin’s current therapy.

Foreman: Real page turner.  No, it’s not that kind of shadow.

Carly: My chest hurts.

Foreman: It’s from the tracer I injected.  Might also get a little nauseous, or have a metallic taste, all normal.

Carly: I’m a runner.  I shouldn’t feel like this.

Foreman: Carly, I’m looking at your vitals right now, and –

Carly: I can’t breathe. [She starts to choke.]

Foreman: Carly?

Carly: My chest… [Foreman grabs his stethoscope and listens to her lungs.]  My chest.  [CG shot of fluid filling her lungs.]

Foreman: Respiratory arrest, call the code.

Tech: What’ve you got?

Foreman: She’s drowning.  [Carly starts to flail.]

[Cut to House, looking at the white board in his office.]

[Cut to Foreman, draining Carly’s lungs, as Cameron talks to House in his office.]

Cameron: Foreman did a thoracentesis to drain the fluid from her lungs.  They sent the fluid to the lab, it’ll be back in a few hours.  You’ll be happy to know that Chase’s mistake didn’t cost her.  Angio revealed no clot.

House: I’m thrilled.  [Cameron leaves.  House is still staring at the white board.  While thinking, he twirls his cane, throws his ball…. He ends up erasing the board with Carly’s physical symptoms, and starts to write her psych symptoms.]

[Cut to Carly, sleeping.  House comes over to her bed, and lifts the sheet over her right thigh, revealing a series of scar marks from cutting.]

[Cut to Wilson, reviewing charts outside.  House comes up to him and taps his cane on the table.]

Wilson: Okay, see, now you’re just being stubborn.  It’s cold, perfectly good excuse to wear your lab coat.

House: Carly needs a heart transplant.

Wilson: Thoracentesis revealed a transudate?

House: Haven’t gotten it back yet.

Wilson: Her MUGA scan, what was the ejection fracture?  Maybe you could treat it, surgically.

House: Haven’t done the MUGA.

Wilson: How do you know she needs a heart transplant?

House: I got my aura read today.  It said someone close to me had a broken heart.

Wilson: Since when do I need the secret pass code to talk to you?

House: I can’t tell you anything.  Professional responsibility.

Wilson: Like that matters to you.

House: Not my professional responsibility, yours.  New regime, you gotta keep your head down, too.

Wilson: Now, that’s good thinking, because I was going to go right to Cuddy and rat you out as soon as you were done talking.

House: I’m not saying you want to, I’m saying you’d be obligated to.

Wilson: Because of my position on the Board? [House looks at him.]  Because of my position on the transplant committee? [House says nothing.]  Hey, you brought this up for a reason.  You need to talk to me.

House: I can’t.

Wilson: You sure you’re doing the right thing?

House: I’ve come up with a few really great rationalizations.  [Chase and Cameron walk up.]

Chase: Sorry to interrupt.  We have a problem.

Cameron: Thoracentesis revealed a transudate.  [Wilson looks, well, amazed.]  We did an echo.  She’s in severe congestive heart failure.  She needs a heart transplant.  We’ll get her on the list immediately –

House: She’s already on the list.

[Cut to Cuddy’s office.  Vogler knocks on the door.]

Cuddy: Come in.

Vogler: Thanks.  What is a “Department of Diagnostic Medicine”?

Cuddy: That’s Dr. House’s department.  They deal with cases that other doctors
can’t figure out.

Vogler: It’s a financial black hole. [He sits.]  Department costs us $3 million a year, treat one patient a week.

Cuddy: He saves one patient per week.

Vogler: What about everyone else?  His department’s not going to find the cure
for breast cancer.

Cuddy: Uh, maybe not, but –

Vogler: Are you sleeping with House?

Cuddy: [a bit shocked] What?  No.

Vogler: But you did, right?  A long time ago?

Cuddy: That’s an incredibly inappropriate question.

Vogler: If your judgment is compromised by prior or current relationship, that is my business.

Cuddy: I respect him, that is all you need to know.

Vogler: He’s still not wearing a coat.

Cuddy: Well, I told him –

Vogler: I’m sure you did.  And yet, he’s not wearing it.  I’m just wondering if that’s a reflection on him, or on you. [Cuddy gives a non-smile.]

[Cut to Carly’s room.  House walks in.]

Carly: You’re Dr. House.  I found a picture of you online at a conference –

House: You need a heart transplant.

Carly: I run, I work out, I –

House: You cut yourself.  Probably highly ritualized.  You play the same Sarah MacLaughlin song over and over while you do it, probably works better than anti-depressants.

Carly: I don’t understand how that has to –

House: You’re a high-powered bulimic.  You make yourself throw up.  You have to find the most efficient way to vomit without revealing the tell-tale signs of bulimia, which is all, eugh.  Very unseemly, for a CEO.  So, you found a common antidote for accidental poisoning to do the job: ipecac.  Which is great, if your kid’s just swallowed a bottle of aspirin, but really, really bad if it’s a habit.  It causes muscle damage.  It caused the pain in your leg.  And it destroyed your heart.  How often do you do it?

Carly: Three times a week.

House: In about an hour, there’s going to be an emergency meeting of the transplant committee to discuss where you fall on the list should a new heart become available.  Problem is, I am required to tell the committee of your bulimia, it’s a major psychiatric condition.  Ranks right up there with suicidal, makes you a very bad risk.

Carly: So you’re here to tell me I have just a few hours to live?

House: Unless I lie to the committee.  But if they find out, I lose my medical license.  This would be a very good time to offer me a bribe.  How much is your life worth, how much is my job worth –

Carly: Why are you here doing this to me?  What do you want?

House: I want to know what’s right.

Carly: Am I worth it?  You think I’m pathetic.  Has a good job, everything in the world, but she just doesn’t like the way that she looks –

House: Oh, stop hiding! [Carly looks taken aback at his yelling.] I’m asking you if you want to live or die, you can’t even say that!

Carly: What do you want me to do?  Cry?

House: Yes!  I want you to tell me that your life is important to you, because I don’t know! Because that’s what’s on the table right now: your life.  [He turns to leave; Carly grabs his arm.]

Carly: [crying] I don’t want to die.  I don’t.

[Cut to House, sitting in front of the transplant committee.]

House: This 32-year-old female was admitted by my staff because of paralysis and pain in her right thigh.  Patient rapidly deteriorated and now has severe congestive heart failure.  Pressers and vasodilators have not improved her conditions whatsoever.  Pulmonary function tests show an FVC of over 3 liters with EDD-1 of at least 90% of predicted.  And preserved FEB/FEC ratio and preserved DLCO as well. [Ed note: These were rattled off so fast, I have no clue if the acronyms are right.]  Her MUGA had an ejection fraction of 19% with no focal wall or motion abnormalities.  Heart catheterization revealed clean left, right and circumflex arteries, and subsequent biopsy revealed irreversible cardial myopathy.  [wrapping up]  Which is why we’re here.

Cuddy: Uh, Dr. House, I’m confused by your time and date stamps.  It appears that you put Carly on the transplant list before you did these tests.

House: I had a hunch.

Cuddy: You don’t have hunches.  You know.

House: Look, if the tests had come back differently, obviously I would have taken her off the lists, but on the long shot… [Vogler walks in and takes a seat on the sidelines] On the long shot I was right, I didn’t want to waste time.

Cuddy: Is there any exclusion criteria we should know about?

House: CAT scan revealed no tumors and Dr. Wilson found no trace of cancer.

Cuddy: What about any other criteria?

House: No atherosclerotic vascular disease –

Cuddy: Are there any –

House: No pneumonia, no bacteriemia, no Hep-B or C or any other letters.

Cuddy: Substance abuse?  Any history of –

House: No alcohol, no drugs.

Cuddy: Any psychiatric conditions, history of depression –

House: She’s a little blue, but turns out she needs a heart transplant.  [Cuddy glances at Vogler, who gives her a pointed look.]

Cuddy: Dr. House, if you subvert or mislead this committee, you will be subject to disciplinary action.

House: Dr. Cuddy, do you have any reason to think that I would lie?

Cuddy: I simply want you to answer the question!  Is there anything on the recipient exclusion criteria that would disqualify your patient from getting a heart?

House: [looks at Wilson and Vogler before answering] No.

[Cut to House looking through his office window.  It’s raining ouside.  Wilson walks in.]

House: Beautiful organ donor weather.

Wilson: [in his best “hands-on-hips” confrontation voice] You lied, didn’t you?

House: I never lie.

Wilson: Big mistake.

House: Then you should have voted against putting her on the list.

Wilson: You’re my friend.

House: Oh, jeez.  Have some backbone.  If you think I’m wrong, do something.

Wilson: Wait, you’re getting mad at me for sticking up for you?

House: You value our friendship more than your ethical responsibilities.

Wilson: Our friendship is an ethical responsibility. [House’s beeper beeps.]  What is it?

House: My patient’s getting a heart.

[Cut to the OR, and the surgeon making the first cut for the transplant.  Shot of the bonesaw.]

[Cut to the Ducklings in the Diagnostic office.  Chase is staring out at the rain.]

Cameron: He’s not gonna fire you.

Foreman: I’d fire you.  Bye bye.

Chase: If I screw up, the patient dies… I’ll never get another job.

Foreman: So go stick your head between your legs and lick your wounds in Stadt.

Chase: Well, I like it here. You guys don’t think it’s weird House knew the patient needed a heart transplant before we did any heart tests?

Cameron: That’s House.  He knows things.

Chase: But usually, he’s putting it in our face, telling us how cleverly he figured it out.  This time, nothing.  Just “I had a hunch.”

Foreman: It is weird.

[Cut to Chase, looking through Carly’s hospital room.  He goes through her magazines, her purse… and he finds the bottle of ipecac.]

[Cut to the OR.  Carly’s heart is now exposed.]

Surgeon:  Okay, ready for the donor heart.  [They inject her heart and we hear the monitors flatlining.]

[Cut to House’s office, inhabited by Cameron.  House walks in.]

Cameron: They just stopped Carly’s heart.  And your dumb patient –

House: They’re all – oh, the guy who can’t talk.

Cameron: Mr. Van Der Meer, he scheduled an appointment to see you.

House: Oooh, goody.

Cameron: I wanted you to know Chase is worried you’re going to fire him.

House: It’s bad enough that screw-ups cost lives.  Now we’ve got Vogler, screw-ups cost jobs.  I want Chase scared.  I want him doing everything he can to protect his job.

Cameron: Dr. House, if you were in his position wouldn’t you be more likely to perform well if you were reassured and –

House: Oh, will you stop it with the book!  Why are you doing this?

Cameron: I’m not doing anything.

House: You’re manipulating everyone.

Cameron: People… dismiss me.  Because I’m a woman, because I’m pretty, because I’m not aggressive.  My opinions shouldn’t be rejected just because people don’t like me.

House: They like you.  Everyone likes you.  [He starts to walk away.]

Cameron: Do you? [dramatic pause.  House stares at Cameron blankly.]  I have to know.

House: No.

Cameron: [quietly] Okay.  [She walks away.]

[Cut to the surgeon leaving the OR wing.  House and Robin are waiting for him in the  waiting area, House playing on his Game Boy.]

House: [looking at his watch] 5 hours, 23 minutes, that’s fast.

Robin: Is that good or bad?

House: It depends.  Either surgery went really well, or it ended really abruptly.

Surgeon: Textbook.  She’ll outlive us all.

House: Thank you.

[Cut to the clinic exam room, and Mr. Van Der Meer {or Dad, as we’re calling him).]

House: So, sing for me. [Dad looks at House, and then grabs his laptop.] Oh, no, no, no, no… come on, look.  When you had your surgery, you were intubated.  Surgeon stuck a tube down your throat.  Now, it never happens, and it’s never caught, but it happens.  Your vocal chords were paralyzed.  I treated the spastic dysphonia with Botox.  Ironically, a substance that tightens every other corner of your face actually loosens the tongue.  I have healed you.  You can talk.  [Dad shakes his head.]  Oh, well. [House goes to leave, and as he does…] BOOOO! [Dad grasps his laptop in fear, but no scream.]  Okay, you don’t have to say anything, it can be our little secret.  If you can talk, blink twice. [Dad stares at House.]  But you’re not going to, because you think you won’t be entitled to the money you won in the settlement with Simpson.  Yesterday I would have said you’d have to give the money back.  Today… hospital’s come into a lot of money, mum’s the word.  [Dad blinks twice, and House smiles.  Dad smiles back, and all is cheery in Exam Room one.]

[Cut to Carly’s room.  House is sitting by her bed, and pokes her awake.]

House: Hey.

Carly: Hey.

House: I know the cardiologist has given you some guidelines, schedule of medications, and a strict diet: just what someone with an eating disorder needs.  So, I thought I’d get you started.  [He grabs a Styrofoam take-out container.]  Fried chicken from the Carnegie Deli.

Carly: You’re kidding.

House: Yeah.  Actually, I got it downstairs.  [Carly laughs a bit.]

Carly: Why did you fight for me?  You risked so much, and you hardly know me.

House: You’re my patient.  Don’t screw it up.  [Carly nods, and House leaves.]

[Cut to House’s office.  The Who’s “Baba O’Riley” is playing through his iPod stereo, and House is playing air synthesizer on his desk, totally rocking out.  Cut to Vogler walking (stalking?) down the hallway.  He starts to air play the piano part, and Vogler walks in his office.]

House: [over the music] Love this part! [switches to air drums, and… Vogler turns off his music] Okay.  He ruined it.

Vogler: Just wanted to stop by and introduce myself.  I’m Edward Vogler, new
Chairman of the Board.  In a way, I guess that makes me your boss.

House: I am sorry about the lab coat thing.  The dry cleaners destroyed it. [Vogler laughs and sits.]

Vogler: That was my very first heart transplant meeting, very exciting.

House: Trust me.  Six Flags, way more exciting.

Vogler: Patient’s very lucky to have such a passionate doctor who stands up for what he believes in.

House: Sweet of you to say.

Vogler: Yeah.  ‘Fraid you’ve been duped, though.  [He pulls out the bottle of ipecac from his pocket.]  The nurse found this in the patient’s purse.

House: Oh, my.  If only I’d known.

Vogler: Tough being a doctor.  You’ve got all that power.  The power to play God.

House: Yes, I don’t envy the transplant committee their responsibility.  They basically would have been forced to kill that poor girl.  I’m not sure I could have done that.

Vogler: This is not a game to me, Dr. House.

House: No.  This is actually more like we’re dancing right now, so let’s get to the point.  You don’t like me.  I’m pretty sure I’m not going to like you.  It’s nothing personal, I don’t like anybody.  But none of that really matters, does it, because you’ve got money, and I’ve got tenure.  You need full board approval to get rid of me.  I’ve got Cuddy.

Vogler: Right.

House: And Wilson.  So, as long as we’re stuck with each other, we might as well ignore each other.  [He turns on the iPod and out comes “Hava Nagila”.  The music is quickly turned off.]  That wasn’t nearly as dramatic as I was hoping.

Vogler: [smiles as he rises]  I looked into that tenure thing, and you’re right.  It’s actually easier for me to get rid of a board member like Cuddy or Wilson than to get rid of a doctor.  That’s interesting, isn’t it?  [House is left with something to think about.]

[Cut to House leaving the hospital through the main lobby, The Who blaring once again.]

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