Épisode Casse-tête S02E12 - House Saison 2

(Scenes opens on a track running through the forest, Adam (son) and Doug (father) are riding on the family ATV, whooping as they go.)

Doug: All right, hold on. I got the turn up here.

[Adam whoops in delight.]

Adam: Wow! How cool was that?

Doug: That was WAY cool!

[They get off the bike.]

Adam: My turn!

Doug: No sorry, it's not allowed. We just signed 15 pages of forms saying you gotta ride on the back of that thing.

Adam: I don't see any lawyers around.

Doug: You know that's not the point.

Adam: No, you just want to keep all the fun to yourself. [He crosses his arms over his chest.] Come on, dad!

Doug: You go over 15; we're pulling over, all right? I mean it!

Adam: You're the best!

Doug: Alright, get on there. Put on your goggles. [He sits behind his son on the ATV, Adam is very excited.]

Adam: Ready?

Doug: You got the clutch it? Alright, that's my boy!

[They speed down the track, Adam is whooping and suddenly his eyes are going funny, he looks like he's having some kind of fit and can no longer control himself physically. He accelerates on the ATV and doesn't seem to know himself anymore.]

Doug: Adam! You're going to go too fast slow it down! I mean it! You're going too fast! Slow down!! Adam!!! [They go around a curve and Doug falls off the back, Adam speeds on ahead.] ADAM!! Let go of the throttle!

[Adam drives the ATV on ahead over into a pit where the ATV bursts into flames and Adam catches on fire as well.]

Doug: ADAM! ADAM! NO!!!

(Scene opens on the helipad of the hospital on the rooftop; Adam's body is wrapped in metallic foil on a stretcher and being wheeled into the hospital by paramedics.)

Doctor: What've you got?

Paramedic: 16-yr-old, status burnt. ATV crashed, 40% of burns on his body.

Doctor: Nasal tracheal intervention. Start a bag of lactated ringers wide open.

Doug: Will he be ok?

Doctor: [Putting on scrubs.] We'll be with you when we can. Get him out!

Doug: Wait, wait, wait...

[Doug is pushed out of the room as the doctors and nurses prepare to take Adam out of the protective foil.]

Nurse: I'll start fluids. Let's go get him hooked up. [Doug watches worriedly from outside.]

Doctor: Watch the line.

(Scene cuts to House reading an Indian medical journal in the observation deck above an empty operating theatre.)

[House makes a derisive noise and picks up what looks like a dictionary to probably translate what he just read.]

House: Deia rei marki. Deia rei marki! [Pronouncing something out of the book, Foreman enters.]

Foreman: Been looking for you.

House: Been avoiding you. Burn unit can handle it.

Foreman: If they could handle it, they wouldn't be asking for you. [Foreman takes out his mobile phone to check something; then he tosses the patient's file into House's lap. House rolls his eyes.] Is that a Journal?

House: Friend wrote an article.

Foreman: In Hindi?

House: They have a cutting edge neuroscience program in India. Says so right on the cover [He hands it over to Foreman and looks at the file.] Kid's heart rate's a mess. [He gets up.]

Foreman: Tachycardia can be explained by the burn.

House: I assume the burn unit knew that.

[They're walking down the corridor and are joined by Chase and Cameron running in.]

House: His potassium's low.

Foreman: Which can also be explained by the burn.

House: Except I'm sure the burn unit's pumping him with fluids, which means his potassium should be going up, not down.

Foreman: Could be amphetamines.

House: Or a bacteria lunching on his heart; or cardiomyopathy or some other very bad thing. He needs an EKG.

[They walk up the steps to a small observatory platform and look into the next room where Adam is sedated though you can see all the burns all over his chest and torso. It isn't a pretty sight.]

House: Eww. 'Kay, no skin, no EKG.

Chase: Is he even going to survive the burn?

House: What have you got a date or something? [He draws a deep breath.] 40% of his body, if the burns unit can prevent an infection, his body will regenerate maybe 10%, surgeons will do 20 or so grafts, 6 months in this room he'll end up with a series of nasty scars, maybe some pain but he'll live. [Some nurses in scrubs are washing Adam's burns and scrubbing away the burnt flesh.] Unless his heart shuts down because we can't figure out what's causing the low potassium and tachycardia. We need help from a Belgian doc named Eindhoven.

Chase: He's dead.

House: While he was alive he invented a little ditty called the galvanometer.

Foreman: Where do we get one?

House: Go to an electronics store that's been open since before nineteen-o-five. There's a good chance they got one in the corner of the basement.

[Scene cuts to Cuddy in her office, nurse Brenda interrupts.]

Brenda: We need an audio visual set up for the lecture hall.

Cuddy: What for?

Brenda: For the lecture.

Cuddy: What lecture?

Brenda: Dr. Weber's lecture.

Cuddy: Who is Dr. Weber?

Brenda: A neurologist, I think. The memo was from you.

Cuddy: [She looks immediately suspicious and takes a look at the memo.] Where is my assistant?

Brenda: She left.

Cuddy: When?

Brenda: Wednesday.

Cuddy: Seriously?

Brenda: The temp agency sent someone, but she got lost.

Cuddy: Well, when she gets here, fire her.

[Scene cuts to House in a coma patient's room -- the same one as from Acceptance and TB or not TB methinks -- performing some kind of test. He's giving the guy in a coma something and checking the results on a screen that's flashing with lots of blue and red lights.]

House: [Seemingly pleased with the results.] Oh yeah!

Cuddy: [Walks in.] Did you issue this memo?

House: Look at that.

Cuddy: [Has no idea what she's meant to see.] Congratulations, the patient that has been in a coma for 2 years and counting is still in a coma. This is not my signature; I don't know anything about this guy. I'm supposed to introduce him, have lunch? [Lots of red lights on the screen now.] The coma patient has a migraine?

House: Oh no, no, no, no, no I gave him medication to prevent a migraine.

Cuddy: That's a migraine, increased flow velocity in his cerebral arteries.

House: I did subsequently give him nitroglycerine which could possibly--

Cuddy: You induced a migraine headache in a coma patient?!

House: Gave him a little headache, similar to the one you're giving me now.

Cuddy: Have you even read an ethical guideline?

House: Well if you are to try out a new migraine prevention medication on someone who can actually feel pain...

Cuddy: Did you sign this?

House: Errr... yeah. [Grabs his cane.] We can talk later about the appropriate discipline. [Gives a low sexy growl and then limps out.]

(Cut to Adam's body wrapped up protectively, he's still sedated.)

Cameron: Because of the burn, we can't perform any of our normal tests to see what's wrong, so we're going to try a galvanometer.

[Chase and Foreman are attaching the galvanometer to Adam, attaching wires to his ankles and wrists with his feet and hands dipped in bowls of water.]

Cameron: It picks up a pulse in the wrists and the ankles. Hopefully it'll tell us whether his heart rhythm is abnormal.

[Cameron is in the observation deck above with the parents.]

Doug: What have I done to him? I...

Emily: It was an accident! So... he's got all these burns and err... and now there's something wrong with his heart?

Cameron: We're trying to figure out if the two were somehow connected. Had he been sick lately?

Emily: [They both shake their heads.] No, nothing.

Cameron: Anything unusual with his behavior, had he been tired a lot?

Emily: Nothing.

Doug: He was great, he was happy, he was just having a great time and then...

Cameron: If he was experimenting with amphetamines or cocaine..?

Emily: No. We gave him some pot about a year ago to try--

Doug: It was just once. We thought if we took the mystery out of drugs and alcohol, the less he'd experiment.

Cameron: We'll know more after the test.

Doug: It looks like they're going to electrocute him [Panics quietly.]

[In the room below.]

Foreman: Plug it in.

Chase: You plug it in.

Foreman: Fine, give me the cord. [He plugs it in, the galvanometer starts drawing the heart waves on to the paper.] Works. Prominent U waves.

Chase: And a bit of T wave. No ischemia.

Foreman: Q wave normal. [Looks again.] That's not good.

[Adam suddenly starts to have a seizure.]

Foreman: Chase! Turn it off! Turn it off!

Doug: What's happening?

Emily: What is that?

Chase: [Into the intercom.] Anesthetist get in here.

[Emily and Doug keep shouting as Cameron leaves the observation deck. Adam continues with his seizure.]

(Cut to the Ducklings in front of the whiteboard in the conference room.)

House: [Walking in.] Who electrocuted my patient?

Foreman: He had a seizure.

Cameron: He wasn't electrocuted.

House: [Searching through some books on his shelves.] What does the seizure tell us? [Turns around to see Chase leaning against the desk.] Move.

Cameron: What are you looking for?

House: Same as you - love, acceptance, solid return on investment. [Searching the papers on the desk.] Differential diagnosis, go.

Chase: Could be epilepsy or seizure disorder?

Cameron: Not with the tachycardia. It could be a virus in his brain.

Chase: Your specificity is impressive. Adrenoleukodystrophy.

Foreman: Could be MS, seizures could be caused by plaques and lesions on the brain.

House: [Finally finds the file he was looking for on another table and picks it up.] Well let's find out which, get an MRI. [Walks out.]

Foreman: No nuclear imaging. [House walks back.] He wouldn't survive the move to radiology. MRI and CT scan are both out.

House: [Big sigh.] Ok. Lumbar puncture will tell us if his proteins are elevated and at least we can exclude MS. [Walks out again.]

Chase: Can't do a lumbar puncture either. [House walks back in again.]

House: You're cramping my exits. Don't tell me, no skin on his spine.

Chase: We'd be inserting a needle into an area that's teeming with bacteria. If he doesn't have a brain infection already, we'd give him one for sure.

Cameron: There's no other way to look at a brain.

House: Transcranial doppler sonography.

Foreman: She said brain, not pregnant woman's uterus. They do sound alike.

House: I used one to look at a brain this morning.

Foreman: Why didn't you take the patient to radiology, get an MRI?

House: [Looks behind to check if anyone's listening in.] Obviously I was doing something illegal and using nuclear imaging would have raised questions.

Foreman: You're not going to get a diagnosis of MS from a sonogram!

House: Not definitively, but patients with MS have more reactive neurons in their occipital cortex. [He walks out yet again, but quickly peers back in.] Ok then.

(Cut to Cuddy speaking in front of people at the lecture theatre.)

Cuddy: Thank you for all coming to today's lecture by Dr. Phillip Weber. Who is our guest today at our hospital to talk about... [She obviously doesn't know.] Headaches. Dr. Weber is at the Weber Center for Pain. That makes sense. [Mutters as though she is trying to remember something.] Weber, Weber. Erm, so please welcome Dr. Weber.

[The audience claps, camera pans to House sitting alone wearing his trucker cap from Sports Medicine, a green jacket, and sunglasses.]

Weber: Thank you Dr... [Pretends to check his file.] Cuddy. [The audience laughs. Cuddy pretends to smile but spares House a glare before exiting the lecture theatre.] I suppose I should tell you err... a little bit more about myself.

[Wilson enters the hall and sits down next to House; he stares at House's strange outfit.]

Weber: I went to school in Virginia. [You can hear him in the background.]

Wilson: You've never been to one of these things in your life, who is this guy?

House: [He shrugs.] No idea.

Wilson: What's with the outfit?

House: Sudden chills, and light sensitivity. Inexplicable.

Weber: I received my medical degree at Johns Hopkins University, where I studied under Brightman and Gilmar.

Wilson: [Looks thoughtful.] Hmm! He must be good. You went to Hopkins and studied under Brightman and Gilmar.

House: Shhh...

Weber: This helped me to win the Doyle internship at the Mayo Clinic.

Wilson: You were supposed to get the Doyle internship. [He looks between House and Weber, suddenly realizing.] This guy's von Lieberman?! The guy got you thrown out for cheating?

House: The Dean threw me out. Von Lieberman just ratted on me.

Wilson: This guy's name is Weber, not von Lieberman.

House: I call him Weber von Lieberman. Way eviler. Shh.

Weber: --and the receptors have improved the acute treatment of migraines. To this point, the prevention of-- [He continues in the background.]

Wilson: So what's the plan? You going to wait 'til he bends over then make a fart sound?

House: I'm not here about the past, he's a bad scientist.

Wilson: Well you cheated off him, how bad can he be?

House: He got the answer wrong.

(Foreman and Chase and a male nurse are preparing Adam for the sonogram. The male nurse is opening up Adam's eyes with metal propping-things to keep his eyes open. The parents and Cameron are watching from the observation deck.)

Doug: Are they trying to wake him up? They can't do that, right? He'd be in too much pain.

Cameron: Don't worry, he's still under, but the brain never completely sleeps, it's always working; controlling your heart rate, breathing, temperature.

[Chase holds up cards with pictures on them in front of Adam's eyes, Foreman checks the effects on a screen and shakes his head.]

Cameron: The eyes respond to visual stimuli, blood flow increases in certain areas in the brain and we contract that with the sonogram. With MS, blood vessels are more reactive so flow is faster. If Adam has an infection, they'd be swelling which would constrict the arteries, and the flow would be slower.

Foreman: [Looks concerned.] Chase. Near the subarachnoid space. [Chase looks at the screen in alarm.]

(Cut to Weber's lecture.)

Weber: [Writing on the whiteboard.] Data from control subjects were analyzed in a two-way ANOVA with status and side as within subject factors.]

Wilson: Uhh... you stalked this guy for 20 years just for this shot to humiliate him?

House: Shh! I'm trying to learn.

Weber: --vessels without significant rebound. [He continues in the background.]

House: He doesn't even know what that means.

Wilson: You're going to interrupt him, aren't you?

House: If I have a question.

Wilson: And what's that going to accomplish?

House: Why can't you just enjoy this? Why can't you just be happy for me?

Wilson: You have got to find less debilitating outlets than humiliating people! I... hear bowling is more fun than stalking.

House: But I'm better at this.

Weber: If P is less than point zero... [The door to the lecture theatre opens; Foreman quickly spots House and crouches in the row next to him.]

Wilson: Blow a ton of money on a plasma TV.

Foreman: We found a subarachnoid bleed.

House: Bleed in the head isn't causing seizures.

Wilson: It could be. 10% would damage the cerebral cortex and have seizure.

Foreman: Or bacterial meningitis.

Wilson: Viral encephalitis?

Foreman: There's no way to tell without--

House: [Slightly too loud.] Shut up!

Weber: [Stops and turns around.] Excuse me?

House: Not you.

Weber: You know if my lecture is interrupting your meeting I can wait.

House: Bahatchat kria. [Wilson furrows his eyebrows in confusion.] As your people say in India, 'preciate it. [To Foreman.] We'll figure out why later. And fix the bleed or he dies. Talk to you in a couple of hours [Foreman leaves, to Weber.] Terimaki [He puts his hands together and nods his head in a gesture that clearly is supposed to mean thank you. The expression of confusion on Wilson's face is priceless.]

(Cut back to Adam.)

[Chase is inserting a wire into Adam's femoral artery, Foreman is controlling the sonogram.]

Chase: I'm in the subarachnoid space.

Foreman: Can you get it?

Chase: Think so. [After a moment.] Put the probe back where I can see the wire!

Foreman: We're looking for the bleed--

Chase: Look when I get there! I'm flying blind without a contrast CT here!

(Cut back to Weber's lecture.)

Weber: And with a P value of less than point zero zero one, we have strong statistical evidence that this drug prevents migraine headaches without daily administration.

House: Err... excuse me doctor.

Wilson: [Mutters to House.] He knows his field better than you do.

House: It's always been my understanding that err, unless you follow a daily regimen, no drug can prevent a migraine.

Weber: That's why they call it a breakthrough.

House: That's why YOU call it a breakthrough.

Weber: No, the... err pharmaceutical company sponsoring my clinical trials also hails it as a breakthrough.

House: I'm sure your wife and lawyer do too. Is there anybody who doesn't stand to make a fortune from it calling a breakthrough?

Weber: Who are you?

Wilson: [Mutters to House.] Just a lunatic who desperately needs a hobby.

House: And how exactly did these studies work? You give this drug to a bunch of people and if they don't get a migraine you go "voila, my drug works"? [He points to a lady sitting a few rows below him.] Erm, excuse me miss, uh do you have cancer? [She frowns in disbelief and shakes her head; House looks back up at Weber.] Wow! [He points to the bottle she's been drinking from.] Mango juice prevents cancer!

Weber: Uh, perhaps I should have taken my medication before this lecture.

[House gives an incredibly loud and high-pitched fake laugh.]

Weber: We had a very specific control group. Chronic migraine sufferers, I don't have time to go through all the math right now but the incidence was dramatically--

House: Sure, in India. Two plus two equals five there, right?

Weber: Do I know you?

House: I know your math skills. They blow.

Wilson: [Mutters.] Touch

Weber: You sound very familiar.

House: Why did you publish it in an obscure journal in India? Why not publish it in really, really cool head cases of South Philly?

Weber: Neuroscience New Delhi is a respected journal.

House: Yeah. The guy running Slurp 'N' Gulp tells me its one of the best.

Wilson: [Mutters to House.] Get a hooker. Anything.

House: See I'm thinking that publishing studies is probably the easiest way to get a pharmaceutical company to give you a reach around. And choosing a journal that no one can actually read well that's... that's shrewd. [Wilson is going facepalm beside him.]

Weber: [Has been walking up the steps closer and closer to House.] I know I know you.

House: Sure you do. Dick.

Weber: The name's Phillip.

House: Oh, my bad. Something to do with your face. I always think your name is Dick.

Weber: [Realizes.] House?!

House: Here.

Weber: Medical school was 20 years ago, give it a rest, grow up.

House: Yeah, you were always the grown-up. Do the responsible thing. Tattletale!

Weber: You cheated!

House: I cheated then, you're cheating now! Your drug doesn't work.

Weber: Oh yes, you would like to believe that because it plays right in to your fantasy.

House: I tested it.

Weber: Oh really? What were your parameters? Where's your study?

House: [Quickly looks over at Wilson.] Room 2134.

Weber: One patient?

Wilson: [Blurts out as it clicks.] The coma patient? [House gives Wilson a look.]

Weber: You haven't changed a bit. You took shortcuts in Med school, you're taking shortcuts now. You cannot test this on an abnormal brain.

House: That's so close-minded. He's not abnormal, he's... special.

Weber: Cerebral cortex atrophies in coma patients. You need live conscious people. You don't know everything, House.

(Cut to Chase and Foreman in the room with the hyperbaric chamber, Adam is inside.)

Foreman: Something that disrupts brain function. Plaques are perfect, interrupt neuron communication.

Chase: MS?

Foreman: No. MS is complicated, I think this is more basic. It's just tachycardia and seizures. How much longer the burn unit guys gonna keep him in that thing?

Cameron: [Enters with scrubs on.] Lecture's over, let's go. House wants to-- [She peers into the hyperbaric chamber and can see Adam's eyelids flicking open and close.] Adam's waking up.

Foreman: [Into the intercom.] Get the anesthesiologist in here now!

Cameron: He's in pain.

Foreman: [Looks in through the other window in the chamber.] That's not pain. [Back into the intercom.] Need some help in here.

[In the chamber, Adam's gasping, his body is arching slightly and his eyelids are still flickering.]

(Cut to House in his office.)

[He ties a band around his upper arm and takes out a needle with which he injects some of Weber's miraculous migraine medicine into his own bloodstream. He reaches for the next bottle - nitroglycerin (which causes severe migraines) and he injects a measure of that into himself too. Loosening the band around his arm and taking it off, he sits back in his chair as Cameron enters the office.]

Cameron: Adam had an orgasm.

House: What? You mean while he was se-- [He suddenly gasps in the middle of the word and slams his hand down hard on to the table. Cameron jumps a little in surprise. House's expression could really either be interpreted as immense pleasure of the orgasmic variety, or immense pain.]

Cameron: What's wrong?

House: I'm having a migraine.

Cameron: Are you ok?

House: Hah. Yes. I was right. [A strong burst of pain hits him hard and he groans before pushing his clenched fists against his forehead.]

(Cut to later, House in his office, all the blinds have been pulled to cover the place in darkness.)

[Foreman is there using another needle to inject House with help for his migraine.]

Foreman: It'll knock you out for a couple of hours.

House: [Weakly.] No, I got work to do. Just give me sumatriptan for the pain and Verapamil so it doesn't recur. I heard the patient had fun in the hyperbaric chamber.

Foreman: Yeah.

House: Gotta schedule me some time in there.

Foreman: [Takes the bottle of Weber's cure from House's hand.] Weber's meds aren't even legal in the US.

House: It's legal in India. I was disoriented.

[Foreman finishes with the injections and House tries to stand up.]

Foreman: Err... moving around is a bad idea. Hey if you feel chest pain you need to let me know. Verapamil can cause congestive heart failure.

House: Nothing can hurt my heart.

[He enters into the conference room, Chase and Cameron immediately get up to switch off the lights and draw the blinds for House.]

Foreman: Hey you're going to feel some dizziness, definitely going to be constipated.

House: Differential diagnosis for getting off. [Sits himself down on a chair at the big table.]

Cameron: Is he going to be ok?

Foreman: No, something's seriously wrong with him. [He draws a circle on the side of his forehead in the almost-universal gesture of a crazy person.]

House: [Pushes the chair aside and lies down on the floor under the table.] Different diagnosis for ejaculation. [He takes a huge book off the table top and uses it as a pillow.] Don't make me say that again.

Foreman: We're not stalling you, we just don't know. [The Ducklings all take seats around where their mentor lies.]

House: Then guess.

Cameron: Could pain medication cause an orgasm?

House: I wish.

Chase: Maybe pain caused the orgasm. You get a tattoo; the brain releases endorphins which create pleasure.

Cameron: Most people don't orgasm from a needle prick.

House: Actually Chase has a point; the brain is like a huge train station. If the switches get-- [Looks like the pain is back full swing, he gasps.] -- you're the neurologist, talk for me.

Foreman: If sensory information got misinterpreted by the medial forebrain bundle, it's possible for bad to feel good and good to feel bad.

House: He's a lucky kid. Let's not fix him until the burns heal.

Chase: So what attacks the medial forebrain bundle?

Foreman: Infected neuropathies, vasculitic neuropathies

Cameron: Crab's disease, metachromatic leukodystrophy.

House: All very bad things. No way to look for any of them in his condition.

Cameron: Could be an infection.

Foreman: I said infection about 8 seconds ago.

Cameron: You listed some brain infections, but what if it's just a regular old infection festering in the burned skin?

Foreman: Pus on his arm isn't causing problems in the forebrain.

Cameron: He's on 20 different medications to manage his pain and his heart, how often he urinates. His brain is like a waiter that's got too many--

House: Heyy! I do the metaphors.

Cameron: [Sighs.] The brain is stressed. An infection's elsewhere could put it over the edge.

Foreman: So we just wait for his burns to heal to see if you're right? If you're wrong, he doesn't have that kind of time.

House: Dominic Larrey.

Chase: He another dead doctor?

House: He was Napoleon's Surgeon in Chief. Cleaned a lot of battle wounds.

Foreman: By amputating legs.

House: And with bugs.

(Cut to maggots being placed on Adam's chest all over his burns. Um. Ew.)

Cameron: Maggots are implanted directly into Adam's burns.

Doug: Maggots... they eat dead people, I...

Cameron: Maggots eat dead flesh, only dead flesh, so they're perfectly suited to clean wounds. They also kill the bacteria that thrive in injured tissues.

[Parents are looking fairly disgusted at the maggots crawling all over their son.]

(Cut to House sitting in his office looking very haggard. He looks at his red coffee mug across the room and slowly gets up and limps along with his cane to try and get it.)

[Wilson enters the office with a rather loud clanging of the blinds in place.]

House: Ohh! [He grimaces.]

Wilson: [Standing there with hands on his hips.] Dr. Jekyll I presume, they found a half-eaten sheep in the zoo, police wanna ask you a few questions.

House: [Points at the mug.] Need something to wash it down.

Wilson: Coffee? Bad idea. [He raises his voice deliberately so the volume almost sounds like shouting - obviously he's trying to torture poor House with his migraine.] You're better off with water.

House: Coffee's closer.

Wilson: [Grabs the mug before House and dashes off into the conference room.] Fool-proof plan by the way. Either his meds would work and you'd be in psychic pain because von Evil is going to be rich. Or they wouldn't, and you got to be in agony all day. [Wilson pours a glass of water for House, but takes all the teaspoons on the counter and dumps them into the sink deliberately with a LOUD clang. House grimaces again.] Perfect lose-lose situation. Very you.

House: I had to prove--

Wilson: You proved nothing. [He hands House the glass of water.]

House: Right. This isn't a migraine.

Wilson: Yeah. Dear New England Journal of Medicine, I took this guy's drug and still got a headache thus scientifically proving that my archenemy is an idiot. You just wanted the pain.

House: The meds are supposed to prevent migraine.

Wilson: You get distracted by pain, leaves less room for the things you don't want to think about, like the Flyers sucking or the price of gas or... ohh, the fact that you pushed the love of your life out of your life.

House: God I wish the pain, [Turns his head to give Wilson a pointed look.] would go away.

Wilson: Next time you need to get your mind off her, stick a needle into your eye. It's less annoying to the rest of us when you can still walk. [Wilson walks out; House grimaces once again at the sound of the blinds.]

(Cut to the next morning, House is lying asleep on the floor.)

Cameron: Did you sleep here?

House: [Suddenly wakes up and looks at the Ducklings all looking worriedly at him.] Lower.

Cameron: [Whispers.] Do you want a pillow?

House: Not softer, lower. Frequency of your voice is grating.

Foreman: You should have been better by now.

House: I'm super. Patient?

Cameron: The maggots did great for the burn [Sighs.] but the brainwaves are still all over the map.

House: Which means your regular old infection isn't causing his brain dysfunction, which means there's an underlying condition which means we gotta get inside his head. Do a lumbar puncture.

Chase: We've already established that we can't get a lumbar puncture.

House: C2, C3.

Foreman: No, no, NO way. I only saw a cervical tap once and that guy got paralyzed.

House: Ask the parents if they prefer to have their son in a wheelchair, or dead.

(Cut to Foreman talking to the parents)

Foreman: Something's causing his brain to lose control. Eventually it'll shut off. We need to do a lumbar puncture to get some of the fluid in his spine so we can test it.

Emily: You need us to sign a consent?

Foreman: I have to warn you, there's a serious risk of paralysis, or death.

Doug: Are you saying we shouldn't do this?

Foreman: You have to do this.

Emily: Then why are you telling us what can go wrong?

Foreman: I just think you should know.

Emily: Either you're cruel or this is a way for you to cover your ass incase you cripple our son!

Doug: This isn't his fault.

Emily: No it's not; it's yours, that's what you keep telling me! My son is lying in there half-dead I am just trying to find a way to get through this. [She signs the form quickly.]

Doug: I'm sorry.

Emily: Yeah, I know. [She walks off.]

(Cut to Adam, the last of the maggots are removed and they turn him on his side. Foreman starts to perform the cervical tap.)

Foreman: Needle. [Chase passes it to him.]

[Foreman tries to push it in but it won't go through.]

Foreman: It's not going in.

Chase: Don't force it.

Foreman: I'm going one space higher.

Chase: It's too close to his brain stem, it'll herniate. [Foreman looks determined.] You're going to paralyze him!

Foreman: Not helping! [The monitors start beeping.]

Chase: His blood pressure's spiking, stop!

Foreman: I'm getting it.

Chase: He's 180 over 120, he's going to stroke!

Foreman: I'm in the space, give me the vial. [Chase quickly does so and they collect the spinal fluid. The monitors stop beeping erratically.]

(Cut to House sitting alone on the balcony, a blanket covering the lower half of his body. He looks tired and haggard.)

[Foreman walks out to join him.]

Foreman: He doesn't have MS or an infection.

House: His proteins aren't elevated?

Foreman: Wrong protein. IGM, not IGG. Elevation was probably caused by the bleed.

House: What if there was tingling in his extremities prior to the crash?

Foreman: How can you still be on MS?

House: I gotta be on something. Something's interrupting his neurons chitchat, like lesions.

Foreman: We can't scan for them, the only test we can do, we just did and it was negative. He has no tingling, no numbness. And you read his history; parents didn't say anything about--

House: What about Adam?

Foreman: We can't look into his brain but you want us to read his mind?

House: Good point.

(Cut to some doctors/nurses taking care of Adam, House walks in with scrubs on.)

House: Yeah, you can finish the sponge bath in a minute.

Anesthesiologist: They're just re-doing his dressings. He's out. He's fine.

[Some of the little doctors move out of the room.]

House: I didn't page you to put him out; I paged you to wake him up. Why are these lights so damn bright?

[One of the little doctors switches off some of the lights and leaves House and the Anesthesiologist together with Adam.]

House: Thank you. Come on, I need to talk to him.

Anesthesiologist: House, you can't wake up a burn victim to play 20 questions. It's torture.

House: He won't remember.

Anesthesiologist: He's going to be in extraordinary pain!

House: God you're good, you're putting me to sleep! I know he's going to be in pain, I know you disapprove, I'm his attending. Wake him up.

[The Anesthesiologist looks pissed but reluctantly injects something to wake Adam up. Adam's eyes slowly flicker open. He looks overwhelmed with pain.]

Adam: Oh my god!

House: I'm Doctor House.

Adam: It hurts!

House: It's going to get a lot worse so answer fast. Before the accident did you experience any numbness or tingling in your fingers? [Adam looks down at the burns on his chest, he's panicking and scared and in a LOT of pain.] You got burned, it's healing. I need an answer!

Adam: It really hurts!

House: Any tingling in your arms or legs?

Adam: Can you do something? I can't..!

House: Adam! You gotta listen to me! Did you feel anything?

Adam: [Screams in pain.] Pissed my pants and... then... I don't remember. [He screams again very loudly, they inject something to sedate him again.]

(Cut to House walking out into the corridors still with scrubs on. Cameron is waiting for him.)

Cameron: Is he ok?

House: Get everyone in my office. [He limps past her.]

Cameron: Where are you going?

House: Kid's screaming gave me a headache. Gotta take an aspirin.

(Cut to the SHOWER SCENE)

[House is naked under the shower; we see him very wet and relaxing under the shower spray as the music starts. The shower goes off and he pulls the towel from the top of the door and opens the door. He steps out and wraps the towel around his waist, then limps to sit down on the bench in the locker room. He hunches over and rests his arms on his knees then stares down at the floor. A droplet of water from his face drops to the floor and turns a bright blue color. This then proceeds to turn red and look very psychedelic and has 3D bubbling things.]

Cameron: House, you ok? We've been waiting for you.

House: [He slowly looks up at her.] I'm hallucinating.

Cameron: [She puts her stuff down hurriedly.] Hallucinations with migraines are pretty uncommon. [She checks his pupils.] What did you see?

House: I saw music.

Cameron: Sensory deception makes no sense.

House: Shhh... [We see Cameron through House's eyes, she's all blurred up. We also hear her from House's ears and she echoes badly.]

Cameron: You took something. The kid's fighting for his life!

[House looks very high and doesn't seem to really care at all. She walks out in a huff, House lies back against the wall in his high state as the music swells. Get miles away by Gomez.]

(Cut to Cameron in the conference room, Foreman and Chase walk in.)

Foreman: Hey, you find him?

Cameron: He was hallucinating in the locker room.

Foreman: He ok?

Cameron: He's feeling no pain, he is high.

Chase: Vicodin high?

Cameron: Past that. He's seeing sounds. Took something.

[Suddenly, House walks in. He looks alert and completely out of pain as well as definitely not being high either.]

House: Why's it so dark in here? Beautiful day outside, open the shades, let the sun shine in.

Cameron: Its night time.

House: It's still Tuesday, right?

Foreman: You look better.

House: I took something.

Foreman: Mind if I ask what?

House: Err... a little of this, little of that. And I was wrong with our patient, he's depressed.

Cameron: He told you that when you woke him up?

House: Nope. Told me he pissed his pants and he blacked out.

Foreman: That's not diagnostic of depression. Lack of appetite, isolating yourself--

House: Uncontrollable urination and blacking out are good predictors of what?

Cameron: Seizure.

House: Which means the seizure he had when you tested his heart was at least a second seizure.

Foreman: So what? Depression and seizures aren't correlated.

House: No, but you know what is? Depression and anti-depression medicine.

Chase: Tox screen was clean.

House: Yeah, but you know how much crap he's got in his system from dealing with those burns, the guy could have the Spanish Armada floating through his bloodstream and we wouldn't know about it. Until they started firing cannons.

Foreman: Antidepressants have been known to cause seizures in kids but not orgasms. This is a brain in trouble.

House: This is a brain with too much serotonin.

Cameron: Serotonin affects mood, appetite, it doesn't cause a brain to shut down.

House: Antidepressants fake brains into thinking they have more serotonin than they actually do. Every 10 million or so cases, sets off a chain reaction; produces too much, enough to fry itself.

Foreman: If Adam has Serotonin Storm, it's deadly.

Chase: But treatable. Cyproheptadine.

Cameron: Unless he doesn't have Serotonin Storm, he could just as easily have too much dopamine as serotonin, but if it's dopamine the cyproheptadine will kill him.

[House is about walk out of the office.]

Chase: Where are you going?

House: Going to talk to the kid again, seems nice.

Cameron: You can't.

House: Why? Did he say he doesn't like me?

Cameron: Anesthesiologist told the parents what you did.

House: Everyone's a tattletale. [He switches off the lights in the office and leaves.]

(House walks up to the parents sitting together on a couch.)

House: Is your son depressed?

Emily: No, who are you?

House: I'm doctor House.

Emily: Oh you're the idiot who thought that--

Doug: I heard him screaming all the way down the hallway!

House: If I didn't wake him, I wouldn't have learned what caused the crash. We think he had a seizure.

Doug: [Long pause.] This wasn't my fault?

House: Well if he hadn't had the brain problem, he wouldn't have the burns. On the other hand, if you hadn't put him on the ATV, he also wouldn't have the burns. You can debate your personal responsibility after I leave. I need to wake him up again. I need to know if he's taking antidepressants.

Emily: He's not.

Doug: He's the happiest kid I know.

House: But you don't know, do you?

Doug: He's my son.

House: Hmm... that's sorta my point. At sixteen, they'll tell anyone anything, except their parents.

Emily: Adam talks to us about everything.

House: Yeah, I know about the pot and the cocaine.

Emily: There was never... cocaine! What...

House: You sure? Are you having him followed?

Emily: He told us when he got drunk at a party; he told us when he started having sex--

House: Sixteen. Way to go.

Emily: He told us when he cheated on a math test; he told us when his girlfriend cheated on him! He doesn't hide anything from us.

House: But if he was depressed...

Emily: He'd tell us. We don't judge, he's not depressed, we're sure.

House: Bet-his-life-on-it sure? Just hypothetically.

Doug: Yeah.

House: Okay.

(Cut to House walking back to the Ducklings in the conference room.)

House: Kid's happy; happy, happy, happy.

Cameron: Then we're back to where we started. Seizure disorders.

House: Seizure disorders aren't causing orgasms.

Chase: Vascular malformations?

House: Would have seen it on the sonogram.

Foreman: Hepatic encephalopathy?

House: [Shakes his head.] Liver enzyme tests were normal. [He looks like he's thought of something and gets up to go out again.]

Cameron: Where are you going?

House: To take a leak.

(Cut to Adam's room, House has scrubbed in and is washing his hands in the prep room.)

[The parents anxiously walk in.]

Doug: What are you doing?

House: Can't come in here, you're not sterile.

Emily: Don't touch our son, we told you!

House: Seriously, millions of bacteria, microbes on you. He'll die of sepsis.

Emily: If you go in there...

[House tauntingly steps into the room backwards while the parents watch him; Doug quickly runs off and runs back down the corridor with Foreman.]

Doug: I think he's going to wake him up again!

Foreman: I know he is. [He rushes into the prep room and quickly tries to wash his hands.] House! You can't do this!

House: Oh if I had a nickel for every time I've heard that. Relax. Are they going to sue us? If I'm right, I save his life. If I'm wrong, he's dead no matter what I do. Either way, how much have I really hurt them? [House has loaded up a syringe with whatever it is he plans to inject Adam with.]

Emily: [From outside the room.] Leave him alone!

[Foreman runs in and places himself next to the kid, desperately trying to stop House.]

House: You're not sterile; do you want to kill the kid?

Foreman: Give me the syringe.

House: [Prepares to use the syringe.] No pain, no gain.

Foreman: Hey! [He grabs House's arm.] You gotta stop this!

House: [Has paused by that point and is inspecting something on Adam's wrist.] They're right, he's not depressed.

Foreman: Yeah sure, I'm not letting you go until you give me that syringe.

House: What's that on his wrist?

Foreman: [He looks down at it - it's a circular burn mark on Adam's wrist in the middle of what is otherwise unblemished skin.] A burn.

House: Why on his wrist?

Foreman: Why not on his wrist?

House: His back, his torso, everything's a mess, forearms are clean. Except right there.

Foreman: So what?

House: It's a perfect circle.

Foreman: So a drop of burning gasoline fell on his wrist, a screw from the ATV [He manages to finally get the syringe from House.]

House: Maybe. [He inspects Adam's fingers and finds a yellow nicotine stain on the side of Adam's middle finger.]

(Cut to House walking out of Adam's room - he doesn't have his cane and is grabbing his leg as he limps.)

Emily: Why are you torturing him?

House: Does your son smoke?

Doug: I'd kill him.

House: [Smiles.] So, he talks to you about sex, crack, anything except cigarettes. He has a cigarette burn on his wrist, also a fading nicotine stain between two fingers. Bad news, your son has a filthy, unhealthy habit. Good news, he's trying to quit. Bad news, the quitting is killing him. Good news, I can cure him. Bad news... nope, that's the end of it.

Emily: Quitting smoking can kill?

House: No-smoke meds are antidepressants. Crappy ones you can get over the internet are loaded with whatever antidepressants they can get cheap. [Foreman walks out and hands House his cane.] Since mommy and daddy obviously didn't take him to a pediatrician. Sorry I was wrong about him being depressed. [To Foreman.] Treat him.

(Cut to House playing with the ball as he sits in his chair in the office staring out the window.)

Cuddy: [Walking in.] Hey, did you drop acid?

House: [Swivels his chair around.] Why would I do that?

Cuddy: To annoy me, or maybe because you're miserable, or... because you... want to self-destruct. Pick one.

House: How about because LSD acts on serotonin receptors in the brain which can stop a migraine in its tracks? I'm just saying that's also a possibility. How did you know about it?

Cuddy: Cameron is worried about you. I told her that LSD lasts up to 12 hours; if you were functional she must be wrong.

House: Well, either that or I also took a whole bunch of antidepressants which short-circuited the LSD. I'm just saying that would also explain it.

[Weber suddenly bursts into House's office angrily.]

Weber: Thank you for ruining my clinical trials. Pharmaceutical company is shutting me down.

House: You're kidding, really?

Weber: How could that surprise you? You sent them an email complaining about my math, telling them about your stunt.

House: I didn't know people actually read emails. The delete button is so conveniently located--

Weber: So what's next? You going to follow me my whole life? Torture me?

House: Why would I do that?

Weber: You waited 20 years to do this. What's next? Break up my marriage?

House: No. We're even.

Weber: Right. [He starts to walk out, then stops and looks at Cuddy.] Oh thanks, for setting me up. [He walks out, Cuddy gives House a disbelieving look.]

House: An eye for an eye, LSD and antidepressants. Everything in balance. [He starts tossing the ball into the air and then catching it.] Buddhists call it karma and Christians call it the golden rule, Jews call it... [Cuddy gives inquiring look.] I don't know. Rabbi Hillel said something poignant. Universe always settles the score.

Cuddy: Does it?

House: No, but it should.

(Cut to Adam on his bed looking much better, parents standing outside the room looking in.)

Doug: Do you think you'll ever be able to look at him and not blame me?

Emily: Yeah. Will you?

[Adam opens his eyes and turns over to look at them. They all smile at each other.]

(Cut to House sitting alone in his home. its night time, he's fiddling with his cane.)

[There's a knock at the door. House finishes his drink (scotch or whiskey) and gets up. He hesitates a moment at the door before opening it. We see from the back that the person standing at the door has long black hair.]

Stranger at the door: I'm Paula.

House: Hey Paula.

[We now see Paula who is a beautiful young lady.]

Paula: How you doing? You work over at the college? Or are you full-time over at the--

House: I'm looking for a distraction. You don't need to talk to do that, do you?

[Paula smiles, shakes her head and walks in; House closes the door behind her.]