Épisode Sacrifices S01E18 - House Saison 1

[Opens on a car driving down a town/city road at night.  Naomi Randolph, a pregnant woman, is driving her husband Sean home from a party.]

Sean: Did I say anything stupid?  [Naomi smiles.]  I had two drinks!  [Naomi looks at him.]  Three!  [She looks at him again.]  Okay, there was that last one.

Naomi:  That’s okay, some day you’ll be pregnant and you can return the favor.

Sean: I feel like such an idiot sometimes.

Naomi: Oh!

Sean: You know, when the baby comes –

Naomi: You know what?  You are going to be so great.  You are.  [He gives her a kiss on the cheek, and CGI time!  We see the neurons of her brain going off like fireworks, Naomi’s head lolls back, and the car swerves to the other side of the road.]

Sean: Hey!  [Sean grabs the wheel and pulls the car over to a parking space.  Naomi wakes up.]

Naomi: Oh.

Sean: You all right?

Naomi: Uh, uh huh.  [Sirens are heard behind them.]  Oh, no.  [The officer walks up.]

Officer: You know why I pulled you over?

Naomi: I - I’m so sorry, Officer, I must have, uh, dozed off.

Officer: Have you been drinking?

Naomi: No.

Sean: Of course she hasn’t.

Officer: Somebody has.

Sean: I’ve been drinking.  [to Naomi]  You all right?

Naomi: I, I’m not, I, uh –

Officer: How far along are you?

Naomi: Uh, almost, um –

Officer: Ma’am, step out of the vehicle.  [Naomi gets out of the car.]  Ma’am, walk to the rear of the car.  [Naomi starts to do so, looking very dazed.]

Sean: Naomi, are you… Naomi?  [Sean gets out of the car.]  Naomi –

Officer: Sir, remain in the car!

Sean: Hey, listen, she’s not drunk, all right?

Officer: I will arrest you, sir.

Sean: She’s sick!

Officer: [into com] Badge 302, could you roll me another unit?

Sean: She’s not looking –

Officer: Get back in the car. [Officer pushes Sean against the car; at that moment, Naomi collapses.]

Sean: Naomi!  [He rushes to her.]  Call an ambulance!

 

[Cut to Foreman looking at an MRI of Naomi’s brain.]

Foreman: Well, the good news is, it doesn’t look like a stroke.  No bleeds, no clots.

Sean: Thank God.

Naomi: It sounds like there’s bad news.

Foreman: We got your blood work back.  Some things are a little off.  Your liver and kidneys aren’t working so well.

Sean: Why, what would cause that?

Naomi: It’s preeclampsia, isn’t it?  I’m gonna miscarry, aren’t I?

Foreman: Preeclampsia is a possibility, but let’s not get ahead of ourselves.

Naomi: I’ve miscarried three times, I’m 39, we had to use in vitro, you’ve gotta make sure that the baby’s okay –

Sean: Let’s make sure that you’re okay, first.

Foreman: How about we take care of both of you at the same time.  The nurse will be in soon to draw some blood; I’d like to run some more tests.

Naomi: Thank you, Doctor.

Sean: Thank you.

[Foreman leaves, and walks up to Chase, who is at the desk.]

Chase: Where is everybody?

Foreman:  No one’s in the office?

Chase: No, haven’t heard from Cameron all day.  You seen House?

Foreman: Heh.  Look for a shallow grave with Vogler standing over it.

[Cut to House at his desk.  Vogler is sitting across from him.  Both look very solemn.]

House: You have a Stage 4 cancer.  It’s metastasized to your liver.  [Vogler looks shocked.]  There’s a new drug called 8C 12 that’s shown promise in Phase 2 trials.  It’s your best shot.

Vogler: Thank you, Doctor.  You’ve been so good to me.

House: Well, I did publicly bash your company’s drug.

Vogler: When I think about how I treated you…

House: Oh, hey, come on.  [House gets up and walks to behind Vogler, sans cane and limp.  He rests his hands on Vogler’s shoulders.]  There, there, there.  [Vogler sniffles.]

Vogler: So, um, there is some hope?

House: Always.  But just in case, I special-order an extra jumbo-size coffin.

Vogler: Hey!

House: Don’t thank me.  It’s just who I am.

Foreman’s voice: Hey!

[Cut to a clinic room.  House wakes up; he was sleeping on one of the clinic beds.]

Foreman: Up and at ‘em, big guy.  [House blinks and rubs his eyes.]

House: Sorry, up late.  Internet porn.

Chase: How come you’re not in your office?

House: Because there is a computer in my office.  If I log on, romance will ensue.  My wrist might fall off.

Foreman: Hiding because Vogler’s looking for you.  That’s just pathetic.

House: I don’t like loud, angry giants threatening me with violence.  How is that pathetic?

Chase: You think you can avoid firing one of us by hiding out here?  He’ll find you sooner or later.

House: [getting a drink] I’m okay with later.

Foreman: [holds out chart] 39-year-old female, 28 weeks pregnant, G 4, P 0.

House: Three miscarriages?  Gimme.  [takes the file]

Foreman: Altered mental status and complete loss of coordination.

House: Tox screen?

Foreman: Negative for alcohol and drugs.  She was on oxybutynin.

House: For incontinence. 

Foreman: We took her off, but no change.  BUN, creatinine are up, LFT slightly elevated.

Chase: Preeclampsia.  Call the OB-GYN service and rub some prayer beads.

Foreman: BP’s normal; no preeclampsia in other pregnancies.

Chase: Because she didn’t carry long enough.

Foreman: The three miscarriages make me think it’s an underlying physiology.

House: Pregnancy-related autoimmunity.  Too bad that Cameron quit, I could use an immunologist right now.  We’ll see if you’re right; check the blood.

Foreman: Cameron quit?

House: Last night.  And do an MRA for vasculitis, too.

Foreman: There is no way she quit!  She got fired because you couldn’t swallow your pride!

House: An ultrasound?  Excellent thought!  And put her on magnesium, too, in case it is preeclampsia.  [He takes a Vicodin.]

Chase: Sure.  [He leaves, and Foreman follows him out.]

[Cut to Chase and Foreman standing in the elevator.]

Foreman: Here, pussy, pussy, pussy.

Chase: I didn’t do anything.

Foreman: Exactly my point.

Chase: You wanted me to yell at him?  [They walk out, still talking.]  What the hell would that have achieved?  What, is he going to jump into his time machine and fix everything?

Foreman: When a dog dumps on the floor, do you pat its head and call it a genius?  No, you smack it in the nose with a newspaper!

Chase: Dogs can learn things, House can’t.

Foreman: Coward.

Chase: Child.  [They both plaster smiles on their faces as they reach Naomi’s room and open the door.]

Foreman: Hey, there!  I brought my colleague along to help out.

Chase: Hi, I’m Dr. Chase.

Naomi: Hi.

[Cut to Chase performing the ultrasound on Naomi.  Everything looks good on the screen.]

Chase: Well, ultrasound looks good.  No sign of fetal distress.

Naomi: So it’s not preeclampsia?

Chase: Well, it still could be, but it hasn’t progressed, at least.  We’re gonna put you on bed rest and monitor the baby.

Naomi: Okay. [She takes some food from her tray and eats it.]

Chase: We’ll give you some potassium and magnesium as well.  So, we should keep the fluids running for now and check her again in an hour unless there are signs of fetal distress or – [Naomi begins to choke.]

Sean: Honey?  Wha – uh, she’s choking!

Foreman: Lean forward.

Sean: What is, is she all right?

Foreman: It’s probably just some muscle weakness.  [They put Naomi on her back, and Foreman starts to remove the offending food with tweezers.]

Sean: What do you mean, probably?

Foreman: Naomi, open up.

Chase: People choke, it could be nothing.  [Foreman gets the piece of pear that was lodged in Naomi’s throat.]  You all right?

Naomi:  I can’t, I can’t, I can’t even swallow.

[Cut to the clinic, where House is looking at a baby.  Her parents, Rachel and Joel, are standing close by.]

Joel: She gets sick a lot but this, this cold got really bad all of a sudden.  And the fever… [to the baby]  Shhhh, it’s okay.

House: It’s not a cold.  [hands the baby back to Rachel]  It’s pneumonia.

Rachel: Pneumonia?

House: Relax, pneumonia’s her second-biggest problem.  She has gone from the twenty-fifth weight percentile to the third in one month.  Now, I’m not a baby expert but I’m pretty sure they’re not supposed to shrink.

Rachel: Well, there’s this diet we put her on when we stopped breastfeeding –

Joel: But it’s healthy, raw food.  We’re vegans.  Almond milk, tofu, vegetables…

House: Raw food.  If only her ancestors had mastered the secret of fire.  Babies need fat, proteins, calories.  Less important: sprouts and hemp.  Starving babies is bad, and illegal in many cultures.  I’m having her admitted.

Rachel: Is she gonna be all right?

House: Antibiotics for the pneumonia, IV feeding to get the weight up.  Don’t worry, it’s a vegan IV.

[Cut to Naomi in the MRI machine.]

Chase: Don’t see any signs of vasculitis.  Odd, since you’re always right about everything.

Foreman: Could be a different auto-immunity.  Or you could bite me.

Naomi: Oh, no.

Chase: Naomi, you okay?

Naomi: I’m getting cramps.  [Foreman and Chase rush out to her.]

Foreman: Strong?

Naomi:  Yeah.  Feels like my miscarriage. 

Chase: It’s preterm labor.

Naomi: He’s too little, he won’t survive!

Foreman: She’s on magnesium already.

Chase: Fuse interbutoline, then.  We’re going to give you some medicine, okay?  Try to stop your labor.

Naomi: Okay.  [They inject her with the medication.]

[Cut to House, peeking into his office.  Seeing no Vogler, he walks in and looks at the papers on his desk.  He turns to leave, and…]

House: Whoa!  [Vogler is standing right in front of him, and he doesn’t look happy.]  There you are, I’ve been looking everywhere for you.  Uh, listen, you said I had to cut one of my people if I didn’t give that speech about your drug, and in fairness to your point of view, my speech really wasn’t the one you had in mind, so I’ve cut Cameron.  Now we’re all squared away, right?

Vogler: In the morning, I expect you in my office with your letter of resignation and plans for a public apology, otherwise I’ll destroy you.  [House looks a little shocked as Vogler walks off.]

House: So that’s a ‘no’ on us being squared away.

[Cut to House, Foreman and Chase in the Diagnostic office.]

Chase: She might make it to full term.  Contractions are less frequent and not well organized.

Foreman: [to House, who is rummaging through the cabinets] Great to see you back in the office.  I guess Vogler found you?

House: Yeah, we had a nice little chat.  I really should have kept Cameron.  She knew where to find the sugar.

Chase: It’s what I said.  Preeclampsia.  A little stress from the MRA, she pops straight into labor.

House: Ah ha!  [He shakes a packet of sugar triumphantly.]

Foreman: What about the myasthenia?

Chase: Come on, she didn’t seem that weak.

Foreman: She choked, she couldn’t even swallow.

House: What did she choke on?

Foreman: Her food.  The muscle weakness isn’t a symptom of preeclampsia.

House: What kind of food?

Foreman: A little bit of cooked pear, it doesn’t matter!  It shows weakness.

House: She choked on soft, wet pear.  Did she forget to take the bones out?  That’s way past muscle weakness.  Did you do an upper endoscopy?

Chase: You think there’s something obstructing her esophagus?  [Wilson enters.]

Wilson: We’ve gotta talk.

House:  Oooh.  We’ve gotta talk.  [as he leaves]  And check her eyelids.

Foreman: Check her eyelids?

[Cut to House and Wilson walking down the hallway.]

Wilson: Special board meeting today, only one item on the agenda: you.

House: Well, enjoy the bagels.  I’m untouchable.

Wilson: Huh.  Right.

House: Any vote to revoke my tenure has to be unanimous. I’ve got you and maybe even Cuddy.

Wilson: Oh, well that settles it.  Mr. Ruthless Corporate Raider will be stymied, go home, curl up on the floor of his shower and weep.

House: What can he do?  I’ve got a contract.

Wilson: Does it say how much your team gets paid?  Where your parking space is?  If your car should be filled with horse manure?  Vogler’s smart; he’s got some plan to get you.

House: Does it involve candy?  Because I’m a sucker for chocolates.  [Wilson gives him a look and walks away, House takes a Vicodin or two.]

[Cut to House checking in on the Kaplan baby.]

House: She’s doing better.

Rachel: Oh, thank God.

House: Technically, Alexander Fleming.  He developed antibiotics.  Pneumonia’s under control, and from now on, what say you stick with human food.

Joel: Absolutely, swear to God.

House: This time, that’s your guy. [House stars to leave, but is blocked by a bunch of people entering the room, including police officers.]

Ms. Friedman: Rachel and Joel Kaplan?

Rachel: Yes?

Officer: You’re under arrest.  You have the right to remain silent…

Joel: What did we do?

Ms. Friedman: You’re being charged with child endangerment.

Rachel: What?  How?  We –

Ms. Friedman: Starving your kid.  I’m from Social Services, we’re taking responsibility for your baby.  [They all leave, leaving House standing there.]

[Cut to Cuddy’s office, where House storms in, quite upset.]

House: This is how Vogler’s gonna destroy me?

Cuddy: What did he do, grease your cane?

House: He had my patients arrested.

Cuddy: He didn’t, I did. The nurses were concerned and they called me.  There was evidence of abuse; you took a big legal risk by not calling Social Services.

House: Those parents were not abusive, they’re idiots.

Cuddy: Oh, well that’s certainly a relief.

House: It was my call.

Cuddy: You made the wrong one.

House: You know, there’s a new biography of Quisling, I think you might like it.

Cuddy: Sure.  No idea who that is.

House: Uh, Norwegian guy, World War II, traitor.  The fact that I have to explain this kind of takes the edge off my flow.

Cuddy: I was protecting you.

House: From what?  Cops aren’t gonna bust me.  Disiplinary committee maybe gives me a slap on the wrist.

Cuddy: And Vogler has an excuse to get rid of you.

House: If I don’t give him one, he makes one up.

Cuddy: Vogler’s just one vote; he’s gotta convince the other eleven of us. I’m just trying to stop you from making that extra easy. [House leaves.]

[Cut to Foreman and Chase examining Naomi.]

Foreman: Sean, do your wife’s eyelids look any different than usual?

Sean: Um, maybe one is drooping a little bit, but you know, she’s tired, so…

Chase: Naomi, can you open your mouth for me and tilt your head back?  This is gonna be a little uncomfortable.  [He inserts the scope into her throat, and we see that there is a lump in her throat.]  Yeah, there’s swelling, indenting the esophagus.

Sean: Is that why she choked?

Foreman: We’ll need to do an x-ray.

Naomi: What?  No, the baby – you said no x-rays.

Foreman: It’s important. 

[Cut to Wilson looking at the x-rays.]

Wilson: Three centimeter mass in her right upper lobe.

Foreman: Maybe it’s a granuloma.

House: No.  There’s no calcification.

[Cut to Wilson talking to Naomi and Sean.]

Wilson: It’s small-cell lung cancer.  The tumor’s starting to press against your esophagus.  It hasn’t metastasized, but it has spread to other parts of your lungs so we can’t operate.

Sean: Wait, that doesn’t make sense.  She had kidney failure and brain problems…

Wilson: Some cancer patients get what are called paraneoplastic syndromes.  You were making antibodies to fight the tumor.  It attacked other cells: your brain first, then your liver, kidneys… even the nerves that control your eyelids.  That’s called Lambert-Eaton syndrome, it told us the tumor was in the lungs.

Naomi: How bad is it?

Wilson: Small-cell is the most aggressive kind of lung cancer.  The five-year survival rate is only about ten to fifteen percent, which is why we need to start you on chemo and radiation right away.

Naomi: Not radiation, what about the baby?

Wilson: You’ll need a C-section before you can start the treatment; I can get you in first thing tomorrow morning.

Naomi: What are the chances my baby will survive?

Wilson: Pretty good.  Twenty-eight weeks, so about eighty percent.

Naomi: No, wait, that’s one in five chance he’ll die?

Wilson: I really wouldn’t advise waiting.

Sean: Naomi, you’ve got to start this treatment right away –

Naomi: What happens if I wait?

Wilson: Twenty-nine weeks, survival rate is closer to ninety percent.

Naomi: I’m not doing the radiation.

Sean: You’ll die –

Naomi: Listen, you know the chances, they’re nothing, but a few more weeks will save the baby.

Sean: Listen, you’re depressed right now, and you’re not thinking right.

Naomi: Sweetie –

Sean: [to Wilson] Could you just, tell her, please?

Wilson: This cancer moves quick.  The median survival’s two to four months.  If you postpone, even for a week…

Naomi: I’m sorry, honey. [Sean looks broken.]

[Cut to the board room, where everyone is gathered, sans Wilson.]

Vogler: As most of you know, Gregory House recently gave a speech about me. [Wilson enters.] I’d like to return the favor.

Wilson: [sitting] Sorry.

Vogler: Dr. Wilson.  I was hoping you were going to miss this one.  A man is the sum of his actions.  Here are a few of Dr. House’s.  He violated a DNR and was charged with assault.  He brought a termite into the OR and spat on a surgeon.  He accepted a Corvette from a patient who was a known member of the New Jersey mafia.

Dr. Simpson: Ed, look –

Vogler: Edward.

Dr. Simpson: Edward.  You look at anyone’s career, you can find things that are –

Vogler: These are the last three months.  He’s personally had more complaints filed against him than any department in this hospital.

Wilson: Okay, he’s screwed up.  He’s miserable, and he should probably reread the Ethics Code, but it works for him.  He’s saved hundreds of lives.

Vogler: He is a drug addict who flaunts his addiction and refuses to get treatment.  He is a disgrace and an embarrassment to this hospital.  I’d go on, but it gets kinda mean, so I’m gonna keep this simple.  House goes, or I go.

Cuddy: You shouldn’t personalize this.

Vogler: And by I, I mean my $100 million.  How’s that for personalizing?

Cuddy: You gave us that money for a reason.  Are you really willing to throw it all away because of one doctor?

Vogler: Gregory House is a symbol of everything wrong with the healthcare industry.  Waste, insubordination, doctors preening like they’re kings and the hospital their own private fiefdom.  Healthcare is a business, I’m gonna run it like one.  I hereby move to revoke the tenure of Dr. Gregory House and terminate his employment at this hospital, effective immediately.

Female Doctor: Don’t you think we should discuss this –

Vogler: We just did.

Cuddy: We need time.

Vogler: The vote is on the table.  All in favor?  [There is silence in the boardroom.  Awkward pauses ensue, until one doctor on Vogler’s right raises his hand.  All of the rest of the hands in the room quickly go up, except for Cuddy’s and Wilson’s.  Cuddy stares at Vogler, who stares back, and she sighs and raises her hand, which leaves…] Dr. Wilson?

Wilson: Opposed?

Vogler: The motion is defeated.  Dr. Wilson, would you mind leaving the room, please?

Wilson: Excuse me?

Vogler: We’re gonna take another vote.

Wilson: Well, first of all, you can’t void my vote by making me stand in the hallway.  And second, you should check the by-laws.  You need notice and at least one business day before you can reconsider any matter.

Vogler: We’re voting on a different matter which you are… conflicted out of.

Wilson: How can I be conflicted?

Vogler: This vote is whether to dismiss Dr. James Wilson.  [Wilson, a little annoyed, leaves.]

[Cut to House, Foreman and Chase in House’s office.]

Chase: Naomi is refusing to have the C-section.  Her odds aren’t good enough.

House: They do suck.  Where’s Wilson?

Foreman: Paged him twice.

Chase: She does this, she knows she’s gonna die.

Foreman: She’s saving her child.  Cameron would point out that people are capable of sacrifice.

House: Cameron isn’t here.

Foreman: Perhaps proving her point.

House: You think this woman is making a rational decision?

Foreman: I think people can overcome their baser drives.

House: Pretty damn rarely.  And not this time, this is purely biological.  In evolutionary terms, the needs of the next generation are more important.

Chase: You’re saying she’s making the right call?

House: Darwin is, I’m not.  The next generation is not my patient.  We have to raise the odds for Mommy.  And where the hell is Wilson?  He’s the oncologist.  [He leaves.]

Foreman: Good plan, cure cancer.  Surprised no one ever thought of that before.

[Cut to House leaving his office.  Joel and Rachel run up to him.]

Rachel: [to Joel] There he is.  Dr. House!

House: You guys bust out?

Joel: We made bail.  They won’t let us in our baby’s room.

House: Weird.  You’d think they’d let you take her home while they figured out if you tried to kill her.

Joel: We’re good parents, we fed her whenever she was hungry.

Rachel: Big meals.  We had no idea that diet was so bad for her.

Joel: The nutritionist said it had everything she needed!

House: The kid who stacks the free-range grapefruit in your health food store is not a nutritionist.

Rachel: But my uncle is.  He went to college and everything.  [House looks at them, and then picks up the phone at the desk.]

House: Foreman, I need a CT scan on…

Joel: Olive Kaplan.

House: Seriously?  [Joel nods proudly.]  Olive Kaplan.  Check for abscesses or occult infections. [He hangs up; to the Kaplans] Bu-bye.

[Cut to House, walking into Wilson’s office.]

House: Listen, Vogler’s all about clinical trials, the hospital’s chock full of them.  There’s got to be something for small-cell lung cancer.  [House notices that Wilson is packing his stuff in boxes.]  What are you doing?

Wilson: I got sacked.

House: Did you make a pass at Cuddy?  Told you, she only has thighs for me.

Wilson: I voted to keep you.

House: So he’s getting rid of every board member who votes to keep me around?

Wilson: Yeah, every one of us.

House: Just you? 

Wilson: Yeah.

House: But you’re only off the board, right?  They couldn’t have got unanimous approval for you.

Wilson: Brown from Oncology voted no, so did Cuddy, Taylor and Peevey.

House: Eh, so you’re off the board, big deal.  Frees up Wednesday nights for bowling.  You’re still a doctor –

Wilson: Yeah, getting dumped looks great in Who’s Who.  Vogler gave me the option of resigning, and I took it.

House: Big of him.

Wilson: I’ve got no kids, my marriage sucks; I’ve only got two things that work for me: this job and this stupid, screwed-up friendship, and neither mattered enough to you to give one lousy speech.

House: [quietly] They mattered.  If I could do it all again –

Wilson: You’d do the same thing.  Well, you’ll be gone soon, too.

House: Those clinical trials?

Wilson: I’ll make some calls. [takes the chart]

House: Thanks.

[Cut to Cuddy, doing a prostate exam on a patient in the clinic.]

Cuddy: It’s not cancer.

Patient: It’s not gonna kill me?

Cuddy: It’s hemorrhoids.

Patient: But all that blood… that can’t be right?

Cuddy: Looks worse than it is. [House walks in.]

House: Nice job of protecting me.

Cuddy: Can this wait?

House: His ass can wait.  You saved my job by sacking Wilson?

Cuddy: What did you think would happen when you made that speech?  You think he would just pout for a little while and we’d all forgive you?  You don’t spit on the man who signs your paycheck.  First Cameron, then Wilson – you’re next. [to patient]  Pull your pants up.

House: So it’s about the money.

Cuddy: Of course it’s about the money.  The money Vogler gave, he could have bought a few jets, maybe a baseball team, or just stuck it in Chase Manhattan and collected interested.  But he gave it to us to buy equipment, to do research!  You are a great doctor, House, but you are not worth $100 million.

[Cut to House talking to Dr. Prather, the oncologist running the trial.]

House: We’ve sequenced the DNA of the tumor cells.  P53 gene mutation and codon 55.  She’s perfect for your trial.

Prather: She’s pretty far advanced.

House: Well, you want easy cases, you picked the wrong speciality.

Prather: Otherwise in good health?

House: Excellent.

Prather: When can she start?

House: Middle of next week.

Prather: Cancer’s already stage 3, it’d be a waste of time.

House: She can start in two days.

[Cut to House walking to Naomi’s room with Foreman and Chase.]

Foreman: She can’t start in two days!  She’s pregnant!

House: She won’t be in two days.  I’ve scheduled a C-section.

Chase: She’d still have to wait a month.  You can’t take part in an trials until 30 days after major sugery.

House: Well, it’s definitely surgery, but major?

Foreman: It’s not your call.

House: Again, a question of interpretation.

Chase: You’re scamming a doctor, now?  Come on, Vogler’s looking for any excuse to can you.

House: Oh, I think he’s got a big bag of those already.

Foreman: These regulations aren’t just here to annoy you, okay?  Doing this is dangerous to the patient.

House: Well, I’ll be sure to let her know that.  Care to join me?

[Cut to House talking to Naomi and Sean.]

House: Angiogenesis inhibitors prevent the tumors from creating blood vessels.  Without blood, the tumor starves.

Sean: That sounds great –

Naomi: What about the baby?

House: The treatment would be fatal to the baby.  I’ve scheduled a C-section for later this afternoon.  It’s in the trial phase right now, but so far complete remission in more than thirty percent of subjects.

Naomi: I told Dr. Foreman I didn’t want a C-section.

House: When your chances of living were less than a third of what they are now.

Naomi: Well, the baby’s premature, that –

House: Our pediatrics department has the best neonatal ICU in the state.

Naomi: No, his lungs, his brain, he’s not ready.

Sean: And he could be fine!

Naomi: You don’t know what it’s like, raising a sick child! [House looks up, interested.]

Sean: His odds are much better than yours are.  You have to let them at least try this.  [to House] Talk to her.

House: Okay.  Leave the room.  [Sean does so.]  How long have you been taking oxybutynin?

Naomi: Uh, since I was about twenty.

House: Incontinence is pretty uncommon in a woman of your age.  It’s even more bizarre in a woman in her twenties.

Naomi: I guess I haven’t had the best luck when it comes to my health.

House: Seems that way.  You said to your husband, “You don’t know what it’s like, raising a sick child.”  You didn’t say, “You don’t know what it would be like.”  This is not your first child, is it?  And he doesn’t know.

Naomi: I was eighteen.  Got pregnant, got married.  I had the most beautiful little girl, Grace.  She had infantile Alexander’s disease.

House: I’m sorry.

Naomi: For two years we watched her die.  My husband was, uh, my first husband was a, a great guy, but after that I couldn’t even look at him without thinking of her.  I left him, I left my job, I left everthing –

House: Very moving story.  Explains why you’re being so selfish.

Naomi: I’m willing to die to protect my husband.

House: Because it’s what you want.  Your husband wants you to live.

Naomi: Well, he doesn’t understand…

House: Oh, who the hell does?  Tragedies happen.  You think that turning yourself into a disposable incubator for a few weeks is going to protect your baby from all the crap in this world, go ahead, die happy.  I got no problems with people killing themselves, but don’t think it makes you a hero.

Naomi: [crying] Okay.

House: You’re scheduled for 4 P.M.

[Cut to the OR.  Dr. Lim is getting ready for the surgery, but a nurse has a

phone up to his ear.]

Lim: Yes, this is Dr. Lim.  [The nurses are talking about various happenings, and the anesthesiologist begins to put Naomi under.]

Anesthesiologist: Count down from ten.

Naomi: Okay.  Ten… nine… eight…

Sean: That seemed kind of fast, is she all right?

Anesthesiologist: She’s fine.

Lim: Wake her up.  That was Vogler; surgery’s off.

[Cut to Vogler, walking down the stairs into the lobby.  House comes out of the elevator and starts YELLING.]

House: HEY!  You’re killing her!

Vogler: Really?  See, I thought you were the one trying to ram her into a drug trial five minutes after surgery –

House: She knows the risks, she was fully informed –

Vogler: Well, the guy running the study sure wasn’t.

House: Not his life, not his call!

Vogler: His study, his call!  [Cuddy comes out of the clinic to watch.]

House: Right, so she kicks off, his number look bad.

Vogler: The numbers look bad, the study looks bad!

House: Which would cost you money!

Vogler: And keep a life-saving protocol off the market!

House: One person, one blip in the data!

Vogler: You ever heard of the FDA?  They eat blips for breakfast!  One person should never endanger thousands!

House: Well, thank God you were here to save all those lives! [Vogler pauses, breathes, laughs, and shakes a finger at House.]

Vogler: The board’s meeting again this evening.  Why don’t you settle down?  Play some Game Boy.  Why don’t you watch your soap?  I hear they’re firing the handsome doctor today, boy, that should be a good one.  [He walks off.  House glares at Cuddy before he leaves.]

[Cut to Foreman and Chase in Naomi’s room.]

Sean: If we had the C-section anyway, we could still do the experimental treatment, right?  We’d just have to wait thirty days.

Chase: Assuming the doctor running the trial isn’t too pissed off to let her in, yeah.

Naomi: And assuming I’m even healthy enough to – [She gasps, grabs Foreman, and the monitors all start to beep.]

Sean: Honey?  Are you okay?

Chase: Stats are dropping.  Down to the 80s.  Stay with us, Naomi.

Sean: What’s going on?

Chase: We need you to leave the room. [CGI shot of a blood clot getting stuck in her lungs.]

Foreman: [to a nurse running in] Respiratory distress.

Sean: Could you just tell me what’s going on?

Chase: We’re trying to find out.  [Sean is escorted from the room.  Foreman is doing a quick ultrasound on the baby and Naomi’s lungs, while Chase looks down Naomi’s airway.]

Foreman: Still kicking.

Chase: Flash pulmonary edema?

Foreman: Lungs are clear.  There it is.

Chase: Pulmonary embolus.

Foreman: Gotta get her to an OR.

[Cut to Foreman and Chase running with a bunch of nurses and techs to

the OR.  Sean is rushing after them.]

Sean: What happened?

Foreman: [breaking off from the group to talk to Sean] It’s an embolism.  A blood clot.  It’s fairly common with lung cancer.  It’s not a [something] embolism, so blood’s still trickling through.  We’ve been able to get Naomi breathing a little, but we need to remove the clot, and we need you to approve the treatment.

Sean: Yeah, whatever you have to do, just do it!

Foreman: It’s not that simple, okay.  The best course for the baby would be an immediate C-section.  The longer we postpone, the greater chance it’ll have brain damage from lack of oxygen.

Sean: Fine, whatever, just do it!

Foreman: Here’s the problem.  The C-section would be very, very dangerous for Naomi.

Sean: Dangerous, like…

Foreman: In her current condition, there’s a real chance she wouldn’t survive.  I’m sorry. Look, your wife’s unconscious, we need you to make a decision.

Sean: I just want her to live.  No C-section.  [Foreman nods and runs to the OR, leaving Sean standing in the hallway.]

[Cut to the OR.]

Foreman: Stats are still way down.  We’ve got to push the streptokinase.

Chase: Too risky.  Even if it dissolves the clot, she could still bleed out anyway.

Foreman: She’s hemodynamically compromised.

Chase: It’s not good for the baby.

Foreman: Dad doesn’t care.

Chase: [inserting a needle] Embolcine 250,000 units.  [The monitors start to beep.]

Foreman: BP’s dropping.  Pressers!

Chase: We don’t have time.  We’ve gotta suck it out.

Foreman: Systolic BP’s 80.  [Chase gets the clot out.]  BP’s stabilizing, O2 stats rising. [House enters the OR, in scrubs and minus his cane.]

House: Did you get the clot?

Chase: I think so.  She’s stabilized.

House: How long was her oxygen at that level?

Chase: Ten minutes?

House: Brain function compromised? [The monitors go off again.]

Chase: BP’s dropping.  Up the dopamine.  She’s not responding.  How much?

Foreman: She’s up to 30 micrograms!

Chase: Is she septic?  [House lifts the robe on her stomach to reveal a expanding purplish bruise.]

House: She’s bleeding into her abdomen.

Foreman: We won’t be able to stop it.  I’ll go talk to the husband.

House: No, you stay here. [leaving] Keep her as stable as you can for as long as you can.  [He leaves the OR to find Sean pacing outside of it.]  She had trauma during the procedure.  She’s bleeding into her abdomen.  There’s nothing we can do; I’m sorry.

Sean: Um, no.

House: I need you to okay the C-section.

Sean: Yeah, that’s gonna kill her, right?

House: It probably will.

Sean: I can’t do that.

House: She’s dying either way. [Sean drops his coffee cup.]

Sean: I’m sorry, I’m – [House grabs his arms.]

House: Stay with me, Sean.  I need your okay on this.

Sean: She makes the decisions, and I’m –

House: Right, and that’s gonna be tough from now on, but this decision is easy.  You know what she’d want.

Sean: I can’t do it.

House: You make this call, only two things change.  One: yeah, you feel guilty for killing your wife.  Two: your baby lives.  Naomi’s baby lives.

Sean: [sobbing] Okay, okay.  [House reenters the OR, Sean sits in one of the chairs outside of it.]

[Cut to the OR, where the C-section is underway.]

Lim: He’s out; umbilical cord’s clamped.

Chase: No respiration.

Foreman: His lungs aren’t opening up.

Chase: They aren’t mature.  [Chase and Foreman work on the baby.]

Foreman: Come on, take a breath.  You know you can do it.  [The monitors beep.  Chase continues to work on the baby while Foreman walks over to Naomi.]  What’ve you got?

Lim: Looks like v-fib.

Foreman: Pulse?

Lim: No.  Paddles!

Chase: [rubbing the baby’s chest] Come on, come on.

Lim: Clear!  [A shock.]

Foreman: Nothing.

Lim: Charging.

Chase: Come on, open up.

Foreman: [to Chase] How’s he doing?

Chase: He’s still not breathing; we’ve got to intubate.  [He goes to get the equipment.]

Lim: Clear! [Another shock.  Nothing happens to Naomi, but the baby starts to cry.  As Naomi is shocked again, Chase tends to the now-breathing baby.]

[Cut to House sitting in the hallway.]

Cuddy: [to person she was walking with] Thank you. [to House] I’m late for the board meeting. [House gets up to walk with her.]

House: We need to talk.

Cuddy: I don’t want to hear it.

House: It’s about a patient.

Cuddy: The pregnant woman?  She wasn’t qualified for that trial and I’m not going to apologize –

House: I’m not talking about her.  At this point I think it’s best that I concentrate on patients who are still alive.  [Cuddy looks surprised.]  Pulmonary embolism.  She bled out.  Saved her son.  [He hands Cuddy some films.]  This is Olive Kaplan’s CT scan, the incredible shrinking baby.  [Cuddy looks at it.]

Cuddy: Her thymus gland –

House: DiGeorge Syndrome.  It’s genetic, can cause the gland to wither to nothing.

Cuddy: This is why she couldn’t gain weight.

House: Yeah.

Cuddy: I’ll call the police and Social Services and have all the charges withdrawn.

House: I’ve sent a test down to confirm; when it comes back you should start Olive on immunoglobulin replacement.

Cuddy: You’re not going to do it?

House: I assume I won’t be here.

[Cut to Sean, standing by the bed of his wife.  Foreman walks in.]

Foreman: Your boy’s doing good.  [Sean nods, and bends over to kiss Naomi.]

[Cut to the board meeting.]

Vogler: It’s the same motion as yesterday, people, same reasons.  All those in favor of dismissing Gregory House raise a hand.  [Everyone raises a hand except Cuddy.]  Dr. Cuddy, you realize this is going to happen.

Cuddy: I can’t do it.

Vogler: You can’t abstain.

Cuddy: I’m not abstaining, I’m voting no.

Vogler: You’ve changed your mind since yesterday?  What did he do, buy you dinner and roses?  Threaten to drown your dog?

Cuddy: He did his job.

Vogler: Right.  He saved another life.

Cuddy: Maybe.

Vogler: Good for him.  It’s great.  It’s not the point.

Cuddy: It’s what we do.

Vogler: And you could do it a lot better if you didn’t have to worry about some madman running around the hospital accountable to no one!

Cuddy: But that’s not the choice you’re giving us.

Vogler: House won’t listen to anyone –

Cuddy: And you’re not accountable to anybody, either!  Because you think you own us.

Vogler: I move for the immediate dismissal of Dr. Lisa Cuddy.

Dr. Simpson: She’s upset, we all are.  Why would you risk your career to save him? [Cuddy gives him an incredulous look.]

Cuddy: If you think House deserves to go, if you think I deserve to go, Wilson deserved to go, then vote yes.  But if you’re doing this because you are afraid of losing his money, then he’s right!  He does own you. [She stands to leave.]  You have a choice.  Maybe the last real one you’ll have here.  [She leaves.  Everyone looks at Vogler, and…]

[Cut to Wilson, popping the cork on a champagne bottle in House’s office!  Yay!  He, House, Foreman and Chase are drinking and throwing a Nerf football around.]

House: Cuddy is a genius, [Ball to Foreman] convincing four people to give up a fortune to save our sorry asses.  [Cuddy walks in.]  Dr. Cuddy! [He raises his glass.] The man of the hour.  [Foreman throws the ball to her, which she catches.  There are shouts of “Hey, hey!” and the like.]

Cuddy: What are you doing?

House: We’re drinking.  I would have thought that was pretty obvious.  [Ball is  thrown to Chase, Cuddy picks up a glass.]

Cuddy: Well, to the great champion.  Saved you, saved Wilson, saved the whole team.  [She drinks the entire glass in one go.]  Of course, none of them would have needed saving if you could actually get along with another human being.

House: Well, thank you, Miss Buzzkill.

Cuddy: Well, you only cost us $100 million.  Could have saved some lives, could have made a few jobs, helped a few people.  Yippee.

House: You voted to get rid of him.

Cuddy: The lesser of two evils.  You should be mourning.  I know I am.

[Closing montage.  Clips of Sean holding his new baby and crying, Foreman watching through the glass wall; Joel and Rachel with Olive in her hospital room; Wilson unpacking his office; Chase turning off the lights and leaving Diagnostics, passing House in his office, who is working on a case and looking at CT scans.  And good night!]