(Scene opens on snow falling outside the hospital then moves into the hospital to show all the fancy Christmas decorations, "'Zat You Santa Claus?" by Louis Armstrong plays in the background. House walks in through the front doors past the busy lobby, scene quickly moves to House walking into his office. Wilson is waiting inside next to House's desk and he turns around to face House. House looks surprised and he quickly looks to his armchair in the corner and notices Tritter seated there.)
Tritter: Merry Christmas.
House: And a happy go to hell. [To Wilson] What is he doing here? Is he with you?
Wilson: Detective Tritter and I... we worked out a deal. [He moves away so House can set his stuff down on his chair]
House: Already got a lawyer, get out of my office.
Wilson: I told him I didn't write those prescriptions. [House freezes while taking off his coat]
Tritter: I spoke with the DA, he agreed to two months in a rehab facility in exchange for a guilty plea.
House: Get out of my office.
Wilson: [surprised at House's reaction] No jail time.
House: Right, so I should get locked up in some place I don't belong in order to avoid getting locked up in some other place I don't belong.
Tritter: I got you on forgery, fraud and on drugs--
Wilson: No sanctions to the medical board.
House: Um hmm, and you get your car back and your bank accounts and your precious tumour-ridden patients.
Wilson: I did this to help you.
House: Next Christmas, buy me a sweater.
Wilson: You punched out an employee; you nearly cut a little girl in half because you were too strung out--
House: I was in pain! You need to believe that I've got a problem so that your betrayal has the illusion of nobility, but you just selfishly-- [Wilson is frozen in shock]
Tritter: Knock it off. [He gets up off the seat and approaches House] Look, I don't care why Doctor Wilson is doing this, and right now it makes no difference to you either, you need to deal with the reality of your current situation. You want to stand on principle, you end up in a cell, and you end up never practicing medicine again. So you got two choices - your principles, or your life.
House: [still glaring at Wilson] Get out of my office. [Tritter shakes his head and Wilson looks disappointed]
Tritter: The DA put a clock on the deal. You got three days to decide.
(Scene opens on the lobby, Wilson is running to catch up with House)
Wilson: House! Just give me a minute. You're afraid of the pain.
House: You're not? [He holds up the cane threateningly]
Wilson: [holds up a hand and gives House a look] You can still have pain meds in rehab - tramadol, gabapentin--
House: Those don't work. [He turns around to face Wilson]
Wilson: They will once you're weaned off the vicodin.
House: [points to one of the decorations in the lobby] Look, there's Jesus, go tell the Romans. [He walks into the clinic]
Wilson: Fine, run to Cuddy. You don't think she's going to support me on this?
(In the clinic, Cuddy is examining Abigail, a 15-yr-old dwarf girl.)
Cuddy: Well the stitches are healing nicely, there's no sign of infection.
House: [bursts in through the door. Cuddy, Abigail and Maddy (the mother) are startled] Woah. Sorry. Just need her for a tiny moment. Small favour. [Cuddy gives him a look] Pills.
Maddy: Who's the wit?
Cuddy: Doctor. Don't worry, I'll be firing him soon. Wait in my office.
House: Incision looks just big enough for chest tube. Collapsed lung? Someone mistake you for a pi?
Maddy: Delightful, usually we just get the elf jokes this time of year.
House: No trauma. [Looks at her forearm to find a clear patch of skin where a circle has been marked out in black] Negative PPD. What flavoured dwarfs are you guys?
Maddy: My daughter and I both have cartilage hair hypoplasia; think you can make a pun out of that?
House: Yes, but I don't want to be insensitive. [Turns to Cuddy and indicates at Maddy] She's got a bit of a short fuse hasn't she?
Cuddy: It's a bleb, wait in my office.
House: Bleb's not a diagnosis, it's an evasion.
Cuddy: We'll schedule an MRI to make sure, but a certain number of these cases are idiopathic.
House: Let me translate that into Tolkien for you guys - means Doctor Cuddy's got no idea why your daughter's lung suddenly popped like a balloon.
Maddy: You think you do?
House: Give me her chart, and my pills.
(House enters his office, this time the Ducklings are waiting in the conference room)
House: Santa needs us. [He throws the chart at Chase who looks up and we see a dark bruise on his jaw where House punched him] Did you get that looked at?
Chase: I'm fine.
House: Great. I just admitted a cartilage hair hypoplasia dwarf, 15-yrs-old--
Cameron: What are you going to do?
House: I thought I'd get your theories, mock them, then embrace my own. The usual.
Foreman: Wilson told us he ratted.
House: Your choice of verb I take it?
Foreman: It's appropriate, he betrayed you. And you should take the deal.
House: Unexplained lung collapse and anaemia. Cuddy thinks it's idiopathic - Cuddy and "idiop" being the relevant parts of that sentence.
Chase: Can't be TB since Cuddy already ruled it out. [He hands the case down to Foreman]
House: Then you'd be just as big an idiop as her. Don't you people know your dwarfs?
Chase: There are over 200 varieties of dwarfism, each with different medical complications; you can't expect us to be intimately familiar with all of them.
House: The sick dwarfs sure expect you to.
Cameron: Cartilage hair hypoplasia - they have compromised immune systems.
House: Gold star for Cameron, for extra credit explain to the special needs section of the class why our patient's negative TB test is irrelevant.
Cameron: A PPD involves planting a fragment of TB under the skin to see if the immune system recognises it, because of her compromised immune system, our patient could have TB but not recognise it.
House: The little people love you. [Gets up] Let's go see a dwarf about a gallium scan.
(Cameron and House are in Abigail's room talking to her and her mom.)
Cameron: Gallium is a radioactive isotope, travels through your veins allowing us to see any bright spots that might indicate infection.
Maddy: [notices House scrutinising and comparing her with his cane behind her back] I'm 4' 1". That's 1.5 canes in metric.
House: You don't look a day over 4 feet. I saw in the file that her dad was normal size.
Maddy: It's average-sized.
House: Compared to you I'm sure he was huge. Did he have a fetish or did he just fall in love with your long-legged soul?
Maddy: He grew up in the circus, said I reminded him of home. Seems like you're the one with the fetish.
House: Certainly curious about the logistics. Did you stand on a table?
Cameron: [turning around] House!
Maddy: [also turning around to face House directly] Pretty much he laid flat and spinned me. [House smiles]
Abigail: Mom.
Cameron: So Abigail, you wanna hop up on the table for me?
Abigail: [looks at the table that's almost her height] That's gonna be tough.
Cameron: Oh, I'm sorry. Erm let me give you a boost [she's about to help lift Abigail]
Maddy: Stop lifting her like she's 5, just bring over a stool and let her climb up herself.
Abigail: Mom, it's ok.
Cameron: I'm just trying to be helpful. [She does slide over a stool and Abigail climbs on to the table]
House: She also hates Jews.
Maddy: I've dealt with worse. Being different, you get used to people's idiocy. [She throws that word behind her shoulder and Cameron glances over for a moment insulted] Still beats the hell out of actually being an idiot. [House breaks into a smile again at her words] What?
House: Care to go for a spin?
[Both Cameron and Abigail look over in shock. Maddy looks speculative for a moment before turning her back to House with a smirk on her face]
(Wilson is in Cuddy's office talking to her.)
Cuddy: What the hell were you thinking? You didn't think ratting out this hospital's best doctor merited checking with your boss first?
Wilson: I didn't rat him out, I got him a deal.
Cuddy: Which he'll never take.
Wilson: He will if we--
Cuddy: How long have you known House? Did you think he'd suddenly become reasonable?
Wilson: I made the deal, it's done, you can either keep yelling at me or you can help me avoid a complete disaster.
Cuddy: There already is going to be a complete disaster. He's not going to take the deal, he's going to go to jail because he's a child, he's too stubborn!
Wilson: When a child misbehaves, what do you do? You take away something he loves.
Cuddy: We can't take away his vicodin. Not only will he be in pain, he'll start to detox.
Wilson: And we tell him the only way to get the pills back is to take the deal.
Cuddy: He won't be able to function.
Wilson: That's the point.
Cuddy: You going to explain that to his patient?
Wilson: What choice do we have?
(Cameron and House look at the results of the gallium scan in the conference room)
Cameron: Gallium scan shows no bright spots of any kind, means it's not TB or any other infection.
House: There are no bright spots because the whole thing is too bright. Except for the liver.
Cameron: That type could have overexposed the image a bit but its nothing. Her liver looks fine.
Foreman: Could be lung cancer. Tumour causes structural damage, lung caves in on itself, also explains the anaemia.
House: Doesn't explain the liver problem though.
Cameron: Her lung collapsed, there is no liver problem.
House: Did you guys look at the liver on this thing?
Foreman: There's no liver problem.
House: Seriously, look at the liver.
Chase: There's nothing there.
House: Why not?
Chase: Because there's nothing wrong?
House: Every organ in the scan is lit up like a hundred watt bulb except for her liver which is hovering around 60 watts. And not one of them good 60 watte-ers but an energy-saving--
Foreman: You saying her liver's shutting down because the lighting is off? You just don't want a cancer diagnosis because then you'd have to deal with Wilson.
House: Lung cancer is a lame diagnosis. Avoiding Wilson is an added bonus.
[Cuddy enters the office]
Cuddy: House, we need to talk.
House: Not taking the deal. Glad we talked. Ultrasound her liver. [The ducklings make to take off]
Cuddy: Sit down.
House: Stand up. [Looks to Cuddy] Your turn.
Cuddy: House, you're off the case. Your treatment privileges are suspended until you accept Tritter's deal.
House: Well I'm obviously not going to take the deal just so I can have the fun of treating a dwarf so I assume there's more to this threat.
Cuddy: I'm also cutting off your vicodin.
House: That could work.
Cuddy: I'm taking over as attending. Get an MRI of her lungs.
House: This is not lung cancer.
Cuddy: We'll find out as soon as we MRI her lungs. [The ducklings file out]
House: You're going to come begging me to save this girl long before I come begging you for pills.
Cuddy: I hope not for everyone's sake.
(The Ducklings are doing an MRI on Abigail.)
Cameron: This is wrong.
Foreman: Cutting House off? Might not work but it's not wrong.
Chase: windows look clean.
Foreman: [into the mic] Abigail, we need you to hold still ok?
Abigail: Can I come out?
Foreman: Just hang in there 2 more minutes and we'll be done.
Abigail: Okay.
Cameron: Because it's effective doesn't make it right.
Foreman: Cuddy's bending the rules to get a patient to do the right thing - who'd work for a doctor like that?
Cameron: And the ends justify the means?
Chase: If the ends involve us keeping our jobs sure. Lung _______ is clean, no masses. It's not lung cancer.
[Abigail begins to start coughing]
Foreman: Abigail, are you ok? [She doesn't reply and continues to cough. The team see her crawl out of the MRI and cough out blood, they rush to attend her]
(Ducklings in Cuddy's office)
Foreman: House was right, her liver's failing.
Chase: Endoscopy confirmed the vomiting was caused by variceal bleeding. Blood work also confirms House's hypothesis--
Cuddy: I get it, House was right it's the liver, lets move on. What causes liver disease and a collapsed lung?
Foreman: Schistosomiasis, parasite could--
Chase: There's no eosinophilia.
Cameron: Cirrhosis could explain--
Wilson: Could be a hepatoma.
Cameron: She's 15, it's not liver cancer. [She is particularly vehement when she says this]
Wilson: It's not unheard of.
Cameron: Cirrhosis fits better; the question is what caused it.
Foreman: Could be hepatitis, Budd-Chiari--
Chase: Or drugs and alcohol. If anyone has a reason to dull the pain it's a teenaged dwarf.
Foreman: I'll do a liver biopsy to confirm.
Chase: And I'll search the patient's home for drugs and alcohol.
[The ducklings begin to exit]
Wilson: Cameron, got a moment? [She pauses and he walks out with her]
[They enter an empty clinic room and he shuts the door behind them]
Wilson: What exactly is your problem with me?
Cameron: Hepatoma is a weak diagnosis.
Wilson: So this is all about the case?
Cameron: What else would it be about?
Wilson: I made this deal to help him.
Cameron: And help yourself at the same time.
Wilson: This is not about my practice, this is not about my car. I gave both of them up to help House, and I would have gone on without them if he hadn't almost maimed that little girl and if he hadn't punched out Chase.
Cameron: Was it an easy choice?
Wilson: Of course not but its right.
Cameron: Then why wasn't it easy?
Wilson: Because he's my friend it's... obviously complicated--
Cameron: It's complicated? When you decided to talk to Tritter your life got a million times better. How do you separate that out? How do you pretend your windfall isn't relevant to this decision?
Wilson: It was the right thing to do.
Cameron: You pretending your motives are pure is why I have a problem.
(House is in Cuddy's darkened office trying to break into a locked drawer. Foreman walks in)
Foreman: Where's Cuddy?
House: In this drawer, it's a rescue mission. I got it under control, you can leave. [He goes back to jimmying the drawer]
Foreman: [checks outside in the clinic before walking in] You were right about the liver failure, patient had variceal bleeding which suggested cirrhosis.
House: I'm off the clock.
Foreman: You predicted this, you obviously saw something.
House: Obviously.
Foreman: Liver biopsy was negative for cirrhosis but it shows sclerosing cholangitis. [He puts the sheet of paper of the results down on the table in front of House. House takes a glance, then ignores it] Even weirder, there's no increase in alkaline phosphotates.
House: Hmm... medical mystery. Sounds like the kind of thing I'd be good at. [He gets frustrated at being unable to jimmy the drawer] Breaking and entering sounds like the kind of thing you'd be good at.
Foreman: I take it that's where Cuddy's been keeping your pills.
House: One theory, one drawer.
[Foreman cautiously takes a look into the clinic then rolls his eyes and accepts]
House: Really? I thought you'd be all for this torture House plan. It works, therefore it's good. On the other hand, I don't want to talk you out of this deal by pointing out your hypocrisy so... patient's life at stake, blah blah blah blah. [Foreman jimmies the drawer while still warily looking out at the clinic] Forget about the specific nature of the liver dysfunction, it's irrelevant. Dwarf's problem is global, that's why the gallium scan was bright, it's going to spread throughout her entire body unless you stop it.
Foreman: If that were true, more than her lungs and liver would be affected. [He notices House looking at drawer and jerks his head to indicate House should be helping him to keep a watch out for Cuddy]
House: It will be. It'll spread through the biliary tree and hit her pancreas next. Stop retracing your steps, get ahead of it. Forget the liver and focus on the pancreas 'coz after that... actually after that, it doesn't really matter what it is because all roads lead to a dead dwarf.
[Foreman finally springs the lock on the drawer. He stands up but blocks the drawer]
Foreman: I get why you don't want to go to rehab but only an idiot goes to prison for being stubborn.
House: Only an idiot stands between Ahab and his whale. Move. [He opens the drawer and quickly searches but doesn't find any vicodin.]
Foreman: Sorry.
[House shoves the drawer close in frustration]
(Back in the conference room)
Chase: Santa's got gifts. [He starts taking stuff out of his bag that he got from Abigail and Maddy's home] Olive oil wasn't in the kitchen; it was in the medicine cabinet.
Foreman: Home remedy for ear infections.
Cameron: Ear infections are fairly typical amongst CHH dwarfs.
Chase: Or it's a symptom.
House: It certainly wouldn't indicate a pancreatic problem.
Chase: Or House is wrong and it's a symptom. [Foreman turns around and starts writing on the board] Laxatives - don't think they were used to maintain her girlish figure.
Cameron: Again, intestinal problems are common.
Chase: Again, might be a symptom. Glucosamines suggests chronic joint pain.
[Cuddy walks in with Wilson behind her]
Cuddy: Who ordered an alpha-1 antitrypsin deficiency test?
Foreman: I did.
Cuddy: You think the problem's in her pancreas?
Foreman: I think it will be, I think we need to forget about the liver.
Cuddy: We just forgot about the lungs, now we need to forget about the liver?
Foreman: We need to stop retracing our steps and get ahead of this thing.
[Cuddy and Wilson realise where his information is coming from]
Wilson: House, you've tanned.
Foreman: You don't think I could have come up with this?
Cuddy: Did you?
Foreman: You suspended House because it'd be dangerous having him in charge but getting his opinion--
Wilson: I'm sure he gave you that opinion simply because he was worried about the patient?
Foreman: Just because House wants his pills doesn't mean his theory is wrong.
Cuddy: No, the test results mean that. Your test was negative. And the biopsy indicated severe duct inflammation. Do an ERCP to check the liver for bile duct cancer.
Foreman: Just because it wasn't alpha-1 doesn't mean the pancreas isn't next.
Wilson: You needed an organ, he needed a fix. He'd have made up any story for a pill, you didn't give him anything did you?
Foreman: No.
(House is in the clinic of some hospital, a doctor is checking House's cheekbones and jaw)
House: Ow. There's no bruise or nothing but it really hurts.
Doctor: Unfortunately that pain and lack of bruising is typical of a zygomatic break.
House: Wow, sounds bad.
Doctor: Hmm, bones are aligned properly. Which ER did you go to after the car accident?
House: Princeton-Plainsborough. [He reaches inside his jacket to get a piece of paper] Here's my discharge slip.
Doctor: Okay, going to get you some acetaminophen with codeine.
House: I err... I tried that, it makes me nauseous.
Doctor: Err... there's a drug called gabapentin which is good for certain kinds of pain.
House: Great, I haven't slept in days.
Doctor: Gabapentin's not really going to help with the sleep.
House: Oh. Is there something else you could give me?
Doctor: Vicodin's your best bet with sleep issues.
House: Thanks so much.
Doctor: [holds up a finger] Unfortunately our policy forbids prescribing opiates to new patients.
House: How can a clinic have a rule against relieving pain?
Doctor: Just for the opiates, we find that it helps weed out drug-seekers.
House: You think I'm a drug-seeker?
Doctor: I'm not saying that.
House: Well then give me the vicodin.
Doctor: I can't.
House: Because you think I'm a drug-seeker?
Doctor: I just said I didn't.
Doctor: No, you said that the policy was to stop drug-seeking. Then you said I'm not a drug-seeker, policy doesn't apply.
Doctor: I'm sorry, that's the policy.
House: Gabapentin works on nerve damage; you're prescribing it for a broken face! Might as well hand out band aids for a severed carotid!
Doctor: You're a doctor.
House: Not by this clinic's definitions since I'm neither a moron nor a mindless drone! [The doctor quickly picks up a phone and starts dialling]
Doctor: Security--
House: Forget it, I'll throw myself out.
(Back in Abigail's room)
Abigail: That tube is going all the way down to my liver?
Foreman: Don't worry, you'll be sedated.
Wilson: Sometimes doctors have to do things that make people uncomfortable to help them. [he looks over at Foreman]
Foreman: But we always want to respect the patient's wishes and not shove things down their throats.
[Abigail seems to be spacing out]
Wilson: Foreman. [Foreman bends down to check] You haven't given her the sedative.
Foreman: No. Abigail? [He checks her pupils] Abigail? She's unconscious.
Wilson: Check her airway.
Foreman: Airway's clear. Her breath smells fruity.
Wilson: Diabetic ketoacidosis.
Foreman: [to the nurses] Hang ________ this drip at .1 ____ per _____ per hour. [then to Wilson] Pancreas is failing, you ready to call House yet?
[Wilson sighs]
(Cuddy is House's front door and he opens it looking very ruffled and obviously starting to detox.)
Cuddy: You were right; the patient's pancreas is failing.
House: Told you you'd come begging me for help. [His voice is very rough and husky]
Cuddy: Her insulin production is almost non-existent. [House is about to close the door in her face when Cuddy blocks the door]
House: Give me my pills, or lose an arm.
Cuddy: The girl is dying!
House: So give me my pills.
Cuddy: Take the deal and I will.
House: You'd rather kill this girl than give me my pills?
Cuddy: I would rather lose one patient now than the dozens we will lose while you're in prison.
House: Well have fun explaining that to her itsy bitsy grieving mother. [he slams the door at Cuddy]
(Next day in Cuddy's office.)
Cameron: What if we sacrifice this girl and House still goes to jail?
Cuddy: I'd feel bad, can we get on with this? House correctly predicted the spread, means we've got a global systemic illness affecting lungs, liver and pancreas so far. Ideas?
Chase: Langerhans cell hystiocytosis attacks multiple organ systems.
Foreman: Hystiocytosis usually starts in the brain then moves to the internal organs. Abigail's brain is fine. Cystic fibrosis.
Wilson: _________ function is normal. Hodgkin's lymphoma - it's a systemic cancer which her dwarfism predisposes her to.
Cameron: Any ideas that aren't cancer?
Wilson: Cancer fits.
Cameron: Autoimmune fits better, we should treat her with prednisone for lupus.
Wilson: That'll spike her blood sugar and put her back in a coma. It's much safer to run a double-stranded DNA test.
Cameron: Not if she dies before we get the results.
Cuddy: One of you is probably right, why don't we hold the sniping until we find out which. Wilson, do an LP for lymphoma, you guys run an antibody test for lupus.
(Wilson is talking to Maddy in the waiting area outside Abigail's room)
Wilson: Because of your daughter's dwarfism, we've had to pick a higher entry point for the lumbar puncture which increases the risk.
Maddy: So why not do the lupus test first?
Wilson: In the interest of time we think it's best to proceed on both fronts.
Maddy: You have no idea what's wrong with my daughter.
Wilson: We have several theories.
Maddy: What does doctor House think?
Wilson: He's... he had to go home sick.
Maddy: My daughter may be dying and he's gone home with the sniffles?
Wilson: Oh he's not--
Maddy: He was the only one who seemed to have any idea what was wrong with her. He better be really damn sick.
Wilson: He is. [She signs the consent form]
(Cameron knocks on House's door)
House: [He says through the door without opening it] Unless you've got vicodin, go away.
Cameron: House, it's me. I err...
[He opens the door looking very pale and with red swollen eyes. The detoxing is definitely going very badly]
Cameron: Oh god. I don't have--
House: No pills, no eggnog.
Cameron: [notices House's arm through the gap in the door where he's poked his head out to talk to her] What happened to your arm?
House: Cut myself. [His left forearm is wrapped thickly in a bandage and one side is obviously still bleeding under it, Cameron walks right in and House shuts the door behind her]
(Next scene, Cameron is cleaning the cut for House and he sits on the sofa looking very ragged and exhausted]
Cameron: Wilson was wrong about lymphoma, kid's not losing any weight, no night sweats.
House: Cuddy send you?
Cameron: No. She doesn't trust me not to give you pills.
House: She right?
Cameron: House, these cuts are straight in a row. You did this on purpose.
House: Cutting releases endorphins, endorphins relieve pain. Can you get me some pills?
Cameron: No.
House: Well then you can leave.
Cameron: No constitutional symptoms means--
House: Soon as the kid gets cured, Cuddy's got no pressure to fold.
Cameron: You really think she's going to fold?
House: Autoimmune fits better than cancer but lupus floods kidneys, usually attacks them first. Kidneys are fine, right?
Cameron: Yeah. House, take the deal. You can survive without vicodin. After you were shot you stayed clean for months.
House: Yeah, only it had something to do with the absence of pain. [She's about to put a bandage on] No leave that, I want to be able to pour alcohol on it so I can distract myself.
Cameron: Then you can rip off the bandage. [She proceeds to bandage the cut up]
House: Kid been sick lately?
Cameron: Got a history of ear infections.
House: You see Abigail's immune system is like a shy guy in a bar. The ear infections - they come in, they try to coax him to... [he sighs in frustration] to hell with the metaphor. You get the point right?
Cameron: _____ gets drunk, thrashes the bar. One of the autoimmunes triggered by a minor infection.
House: Factor in her age, elevated sed rate, anaemia... it's Still's disease. Start her on prednisone, methotrexates, cyclosporin.
Cameron: House, stop this. Please.
[She gets up and leaves]
(Back at the hospital, Cuddy's in the lobby when Cameron returns.)
Cuddy: What'd he say?
Cameron: Still's disease. It's chronic but manageable.
Cuddy: Yes but that's virtually unconfirmable. And with a treatment more dangerous than what we were considering for lupus. How bad is he?
Cameron: Are you asking because you care or because you're wondering whether to trust his opinion?
Cuddy: Both.
Cameron: He's detoxing, in agony, he started cutting himself. [Cuddy looks very sad] But he's still House.
Cuddy: I'll order the treatment.
(Next day, Wilson is at the nurse's station signing something when House comes up in the lift. He's wearing his overcoat and looks extremely weak. He clears his throat loudly to gain Wilson's attention and starts walking towards him.)
House: Your plan isn't working. Two days down, one to go. Figured I'd show you how much it isn't working.
Wilson: Yeah, clearly the drugs have no hold on you.
House: We both know that my pride far surpasses my instinct for self-preservation. You want to redeem yourself, give up now.
Wilson: And you'll go to jail.
House: I've done nothing wrong.
Wilson: And you'll go to jail.
House: Which makes this your last chance to do me a kindness before ruining my life forever. [Wilson ignores him and is about to take off when House stops him, no longer teasing but talking in earnest] Nausea's bad this time. You write me a script for metaclopamine so I can stop puking. They'd give me that in rehab.
Wilson: Then you should go to rehab. I have a patient. [he walks off]
[House notices the chart Wilson left at the nurse's station and he picks it up and reads through it]
(Wilson is in a dead patient's room talking to an old woman who seems to be the wife of the patient.)
Wilson: I'm so sorry for your loss. You know, it's little solace but he went without pain.
[House enters]
Wilson: House?
House: Well, look on the bright side; at least you don't have to go by Mrs. Zebalusky anymore. That's gotta be a relief.
[The lady looks absolutely horrified]
Mrs Zebalusky: [to Wilson] You know this man?
Wilson: I'm sorry, he's sick--
House: You hear my diagnosis on the dwarf? Still's disease. Did you ever consider those ear infections or you just wrote it off as a dwarf thing? You sure he's dead because doctor Wilson sometimes misses things.
Wilson: [gets up and faces House] Trying to embarrass me in front of a grieving widow crosses lines that even--
House: Right, I'm pathetic. I'm strung out, I haven't slept, puking every hour and I still out-diagnosed you. But I'm supposed to let you decide what's best--
Mrs. Zebalusky: Please! Please leave.
House: [subsides] Sorry. I'm done. [he starts to leave but is halted before reaching the door]
Wilson: House, you didn't come in here just to embarrass me, you could do that anytime. [he reaches into House's coat pocket and takes out a bottle full of pills] Stealing oxy from a dead man, yeah, you don't have a problem.
(Wilson is waiting in Cuddy's office, she enters.)
Wilson: How's the girl?
Cuddy: Much better.
Wilson: House was right?
Cuddy: It happens.
Wilson: I thought we could handle this. Still's disease, it never crossed my mind.
Cuddy: Don't beat yourself up, I didn't get it either.
(Wilson and Tritter are seated in a car but the car isn't running. They're having a chat.)
Wilson: [laughs] I feel like a mob informant.
Tritter: You want to go inside? Got a cafeteria in here right?
Wilson: I can't testify. Drug addicts hurt the people around them with their habit.
Tritter: House has hurt plenty of people, you included.
Wilson: He saves lives, people that no one else can save and no matter how much of an ass he is, statistically House is a positive force in the universe. Pills let him do that.
Tritter: Vicodin does not make House a genius, whatever he does on the pills he can do off. He is just not willing to try.
Wilson: I won't testify against him.
Tritter: Then we'll subpoena you, your previous statement will be read into evidence and you'll be charged with interfering with an investigation, and you will go to jail.
Wilson: Again, statistically better me than him.
Tritter: Statistically the two of you will be in jail.
(House is washing his face in the basin of a bathroom in the hospital. He watches as he can't control the way his hand now shakes from the detoxing.)
(Cameron is at the nurses' station when Maddy appears.)
Maddy: Doctor Cameron, come quick, there's something wrong with Abby.
Cameron: Couldn't be too severe, her cardiac alarm didn't go off.
Maddy: It's not her heart, she's bleeding.
[In the room, Abby is bleeding from her ears and mouth and the blood is smudged everywhere on her hands and gown]
(Back to House who limps to the pharmacy in the hospital)
House: Picking up a script for Zebalusky.
Pharmacist: This is err... doctor Wilson's patient.
House: Yeah, Wilson's busy right now what with Mr Zebalusky dying in agony on account of his metastatic lung cancer and not having the pills to relieve that agony because of some moron pharmacist.
Pharmacist: Sign the book.
[House signs it and the Pharmacist hands him the pills. House climbs up a few steps of a flight of stairs and hides in the shadows in private as he takes out the bottle of pills and pops one of them. The relief on his face is almost immediate and he relaxes back against the wall as he waits for the drug to take effect]
(Cuddy's office, Ducklings, Wilson and Cuddy are back to discuss Abigail's new symptoms)
Chase: Bleeding wasn't a ruptured eardrum, ear infection or bleeding disorder. Her heart rate's climbing, blood pressure's dropping, she's on the verge of a multi system failure.
Foreman: Head CT was clean, means it's not a neurological problem.
Cuddy: Basically we have nothing.
Wilson: Cancer's still on the table.
Cameron: Spinal fluid was negative for lymphoma. What other--
Wilson: Leukaemia, we need to do a bone marrow biopsy.
Cameron: None of her blood tests suggests leukaemia. Cancer doesn't explain the collapsed lung.
Wilson: Unless a small clot led to a pulmonary infarction.
Cameron: It's a long-shot, autoimmune is way more likely.
Wilson: Autoimmune diseases respond to steroids which we've given her.
Cameron: And she got better for a while, we stopped the treatment too soon!
Wilson Because she crashed!
Foreman: All we're doing is bouncing back and forth between cancer and autoimmune. We're going in circles.
[Everyone looks at Cuddy expectantly. She looks uncomfortable than rises from her seat]
Cuddy: Give me half an hour.
(House is in the cafeteria having some chips (that's french fries for you Americans ;) ) and a drink. He looks fine now and not detoxing like the last time we saw him. A little girl in a wheelchair clutching a soft toy moves towards his table.)
Little girl: Can I have a french fry?
House: Get your own.
Little girl: You took the last ones.
House: What's wrong with you?
Little girl: I've got spinal muscular atrophy.
House: [sighs] At least it's not contagious. [he sets the plate of chips in front of the little girl] Nice bear.
Little girl: It's a dog. [she starts eating and Cuddy enters]
Cuddy: House, it's not Still's. Steroids helped until the patient started bleeding from the ears and mouth.
House: [looks at Cuddy then back at the little girl] It's a bear.
Little girl: His name is Bill, he's a dog.
Cuddy: You win, you can have vicodin. [she shakes the bottle she's got in her hand and gives a rather funny grin]
House: Words have set meanings for a reason, you see an animal like Bill and you try to play fetch, Bill's going to eat you because Bill's a bear.
Cuddy: Are you on something? [House gives her a look that confirms her question] You got your hands on pain meds.
Little girl: Bill has fur, four legs and a collar, he's a dog.
Cuddy: It's between cancer and autoimmune.
House: See that's what we call a faulty syllogism. Just because you call Bill a dog doesn't mean that he is... [House has a light bulb moment]... a dog. [He looks up at Cuddy] We've got to x-ray our patient's leg.
(Back in House's office, House, Wilson and Cuddy look at the x-ray of Abigail's leg)
Cuddy: Her leg looks fine.
House: Weird huh?
Wilson: Why aren't you detoxing?
House: Willpower. [He pops a pill]
Wilson: What--
House: Normal's not normal if you're not normal.
Wilson: Did you just take a pill?
House: No. [Wilson looks at Cuddy, Cuddy looks annoyed] So how does a dwarf have completely normal growth plates?
Cuddy: It's impossible. We must be missing something.
Wilson: [with his rather one-track mind] How many pills have you taken?
House: Not nearly as many as I'm gonna take. Forgotten how delicious they were.
Cuddy: I didn't give them to him.
House: Can we forget my vices and get back to my virtues? We were missing the fact that just because we called her a dwarf doesn't mean she is a dwarf. Everyone assumed she was because of her mother and there's no test for CHH dwarfism so she lost an identity but we've gained a symptom.
Cuddy: If she doesn't have skeletal dwarfism then her short stature must be caused by growth hormone deficiency.
Wilson: And something's wrong with her pituitary gland and based on her size, it's been wrong for a while.
Cuddy: So what connects a long-term pituitary issue with problems in the lungs, liver and pancreas?
House: Oh you guys and your bickering. Cancer versus autoimmune.
Wilson: Obviously you think it's something else.
House: Nope, I think it's both. Langerhans Cell Histiocytosis - also known as you've got your cancer in my autoimmune disease. The immune component responded to the Still's treatment, led to the short-term improvement, the cancer portion didn't.
Cuddy: We dismissed this earlier because there were no neurological symptoms.
House: Yeah... it's not your fault, the only neurological symptom was her height. Who could have noticed?
(House is with Abigail and Maddy in the patient's room.)
[House pops a pill again - he seems to be popping them at an alarming rate now, very worrying. He puts the bottle down and points to a brain scan in front of them]
House: This is your pituitary gland and this is the granuloma that's been crushing it. No pituitary equals no growth hormone equals... about that much. [He gestures with his hands to indicate shortened growth]
Maddy: She's not a dwarf?
House: Just hormonally challenged.
Abigail: What about my mom?
House: Your mom's the real deal. You're just a tiny little poser. The recent ear infections caused your body to release a cascade of these same cells that made the granuloma, attacked your lungs, moved on to your liver then hitched a ride over to your pancreas. We can nuke them with a mild course of chemo then remove the granuloma.
Maddy: And then what? What will happen to her then?
House: Let me see if I can make this clear. [He picks up his bottle of oxycodone and takes out a pill] This pill represents... a pill. And my mouth represents your daughter's mouth. [He kneels down without even a twinge of pain - he's obviously in no pain at all, not to mention probably high from taking so many oxy in succession to each other] We deposit the pill in the mouth. [he takes the oxy and then stands up] You may never be tall enough to play in the WNBA but you should be able to post up your mom no problem.
Abigail: What if I don't take the pills? What if you remove the thing in my head and give me the chemo but not the pills? Would I still get better?
House: Your body needs growth hormone for lots of things like... to grow.
Abigail: I like who I am now. [Maddy smiles proudly]
House: Nobody your age likes who they are now.
Abigail: I do.
House: You like needing help when you want something off the high shelf? Not being able to press an elevator button about the eighth floor, having to smell ass every time you stand in line? [Maddy draws herself up, obviously insulted] You don't need growth hormone; it's just your ticket out of the freak show. [House takes the scan and walks out of the room, Maddy follows after him outside into the corridors]
Maddy: Can't you deliver a diagnosis without making her feel that her life isn't worth living?
House: I'm trying to help her.
Maddy: You're trying to make her taller.
House: Not too tall. Just tall enough to wipe her own butt. [he chuckles at his own joke. Maddy isn't amused]
Maddy: Are you high?
House: Higher than you.
Maddy: If my daughter doesn't want to choose the easy path, I won't force her to.
House: Then you're a lousy mom. You want your daughter to be a freak.
Maddy: We're not freaks.
House: [sighs] You want her to overcome adversity.
Maddy: Yes.
House: Then why stop at height? Poke a stick in her eye, imagine how interesting she'll be then.
Maddy: Being little is not the same--
House: You and I have found that being normal sucks because we're freaks. Advantage of being a freak is that it makes you stronger. How strong do you really want her to have to be? Tell her what you have to tell her, now you tell her you lied, even if you didn't.
(Back in the room, Maddy talks to Abigail.)
Maddy: This is who you were supposed to be.
Abigail: You hate normal.
Maddy: It's not that simple.
Abigail: If I grow, I'll fade into the background, I'll be boring.
Maddy: We'll get you a funny hat. [Abigail laughs] You could never be boring.
Abigail: You want me to be like everybody else?
Maddy: I want you to have what I can't.
(In House's office late that night, most of the lights are off and House is relaxing in his chair behind his desk listening to some music on his headphones. He's fiddling with an almost empty bottle of pills, probably because he's taken most of them throughout the day. He looks very high when Wilson enters the room.)
Wilson: Abigail agreed-- [he waits for House to pull down his headphones] Abigail agreed to take growth hormone.
House: Who's Abigail?
Wilson: Your non-dwarf dwarf patient.
House: Oh, good. Then the growth hormone makes sense. He stands up and starts picking up stuff.
Wilson: Christmas eve.
House: Yeah, I know. Deal expires tomorrow.
Wilson: You've plans for tonight?
House: You worried I'm going to be popping more pills? [he puts on his coat]
Wilson: Thought you might prefer people over pills.
[House gives a desultory laugh and leaves; Wilson dejectedly stands in the room alone]
(Later that night, House is still fiddling with the bottle in his apartment, it only has 2 pills left. He's seated on the sofa and there's a half empty bottle of whiskey he's been drinking from. He picks up his phone and makes a call.)
House: Hey mom, I guess you guys are already up at Aunt Sarah's. I'm sure dad's in the eggnog and you're probably suffering through another dried out turkey. [Long silence] Just wanted to say Merry Christmas. [He puts down the phone and pops another oxy, chasing it down with more whiskey, an explosive combination]
(Much later in House apartment, there's the sound of knocking on the door.)
Wilson: House? [more knocking] Are you okay? I called 3 times.
[He uses his key and opens the door. House isn't on the sofa and Wilson walks into the apartment to find House lying flat out on the floor next to a fallen lamp and a pile of his own vomit. Wilson rushes to him and checks him. Wilson's hair is damp - it's probably raining outside and House's eyes are so dilated when Wilson turns him over, it's uncertain whether he even knows what's going on. Wilson reaches over for the empty bottle of oxycodone next to House and reads it. It's the prescription that should have gone to the dead Mr Zebalusky, patient of Dr James Wilson. It also says "Take as needed. Not to exceed 4 per day". The quantity in the bottle is but House has far exceeded the maximum and finished all of it in one day. House looks up at Wilson and Wilson merely shakes his head before throwing the empty bottle down and leaving House in his mess]
(Next day, House finds Tritter alone in the detective's office, it's Christmas day. He enters to talk to the man. "Have Yourself a Merry Little Christmas" by Ella Fitzgerald is playing in the background)
House: I'm ready to take the deal.
Tritter: That's off the table.
House: The clock doesn't expire until--
Tritter: Got new evidence. We don't need Wilson anymore. The thing about addicts, no matter how smart they are, they are dumb when it comes to drugs. So I've been keeping an eye on the pharmacy log, seems some patient of Wilson's, name's Zebalusky managed to pick up his oxy prescription after he died. [House glares at him] Jesus walks huh? Merry Christmas.
Lisa Cuddy refuse de donner du Vicodin à House. Or, sans sa drogue, House ne parvient pas à travailler correctement. Il s'enferme chez lui et se taillade le bras. Une jeune fille de 15 ans, Abigail, est hospitalisée d'urgence. Les examens révèlent qu'elle a un poumon déficient, qu'elle souffre d'anémie et que son pancréas ne produit pas assez d'insuline. Peu après son admission, elle sombre dans le coma. Pendant ce temps, Wilson tente d'arranger un accord entre Tritter et House, mais ce dernier refuse catégoriquement.
