Épisode Le grand mal S05E12 - House Saison 5

[Open on a home. It is almost dark. Thunder can be heard n the background. In the bedroom, Jeff is sitting in front of the computer, writing a note with a pencil. At the bottom of the page he writes “I’m sorry” and signs it. He looks at a picture of him with his wife, Lynne, and their son, Zach, all smiling and giving thumbs up. Jeff folds the note in half, removes his wedding ring and puts it on the note. He grabs his car keys and goes to his closet. He looks at a red shirt and pushes it aside. He pulls 5 shirts from their hangers and closes the closet door.]

[Cut to Lynne and Zach, driving in the rain.]

Lynne: Damn it, Zach. This is the last time I’m turning around. The next time you forget something, you're gonna be on your own.

Zach: I can't play without a stick.

Lynne: Then I guess you won't play.

Zach: I don't care. I suck anyway.

Lynne: Don’t say that.

Zach: I’m the worst guy on the whole team.

Lynne: No, you're not.

Zach: Then who's worse?

Lynne: Don’t worry about anyone else. Just do your best.

Zach: See? You can't name anyone.

Lynne: Zach, stop it.

Zach: Then name someone. [pause] You can't, can you?

Lynne: Donny… Mark… Navid.

Zach: You really think I’m better than those guys?

Lynne: Yes. [She pulls into the driveway.] Hurry up and get your stick.

[She pushes the remote and the garage door opens. There’s a line of fabric on the floor by the door. It’s the shirts. Zach looks puzzled as the sees that the car is running. Lynne, who’s still in the car, takes out her cell phone and dials.]

Lynne: Zach, get back in the car. [into the phone as she runs to Jeff’s car and tries to open the door] I need an ambulance at 860 Oakwood Avenue!

Zach: Why is dad's car on?

Lynne: Get back in the car, Zach! [She pulls Jeff from the car and starts performing CPR.] Come on. Come on! Oh, come on. Don’t do this to me, Jeff! Don’t do this!

[Zach has realized what is happening. He looks like he’s about to cry. Lynne keeps working on Jeff. He coughs once as he starts to breathe.]

Jeff: I’m sorry. I just… I couldn't take the pain anymore.

[Opening Credits]

[Cut to House’s bathroom. He is soaking in the tub and grunting from the pain. He flexes his right leg. The scar, while still ugly, has healed somewhat in the three years since Skin Deep.]

[Cut to the hospital lobby. House enters, limping heavily. He picks up a message from the front desk. Cuddy enters right behind him.]

House: Either I need a new watch, or Mowgli is cutting into your Beauty Sleep.

Cuddy: [pulling folders from her bag and handing them to the receptionist.] I was up all night looking at finance reports, and Rachel is doing great. Thanks for asking.

House: Proving that you're a better foster mom than a homeless drug addict.

Cuddy: Departmental budgets are due this week.

House: I’m gonna need an extension. Got some time next decade.

Cuddy: Cameron already turned yours in.

House: That’s nice of her. Two questions — Why did she? And why are you telling me?

Cuddy: Same answer — now you owe her a favor.

House: I’m gonna need an extension. I got some time —-

Cuddy: House, I’ve got a DYFS home visit on Friday.

House: And I’ve got a w-h-o-r-e visit on —-

Cuddy: Mama’s busy. You two are gonna have to go play outside for a while.

[Cut to House’s office.]

Cameron: 32-year-old male with chronic pain all over.

House: This is the favor? I was expecting something involving whipped cream and tongue depressors.

Cameron: He’s seen seven different specialists over three years. No diagnosis and no relief.

House: Oh, I am fascinated already. It’s like I’m treating myself. He gets cured, and I get to learn a valuable lesson about the milk of human kindness.

[The team is listening from the other room while they read the file.]

Cameron: If I thought you learned lessons, I never would've quit.

House: So you're wasting a favor because?

Cameron: I think you can help this guy.

House: [rattling his Vicodin vial] Drug-seeking patients —

Cameron: Don’t attempt suicide with medicine cabinets full of narcotics.

Thirteen: Sounds like fibromyalgia.

Cameron: Sounds like you don't work for House. A diagnosis that provides neither an explanation nor a cure is by definition not a diagnosis.

Foreman: The American College of Rheumatology would disagree. There are specific diagnostic criteria.

Cameron: Which this guy doesn't meet. Putting pressure on his pain helps, doesn't make it worse. He’s got abdominal pain, severe headaches, muscle cramps that come and go.

Taub: And he tried to off himself. He’s obviously mentally ill. Pain’s probably psychological.

Cameron: It is not a sign of mental illness to want to be pain-free.

[House is standing at his desk. He pours the last Vicodin in the bottle into his hand. He stares at the pills and the empty bottle.]

Taub: It is if your solution is sucking on a tailpipe. Sane people don't attempt suicide.

Kutner: Not ever? So if you were being burnt at the stake… And someone handed you a gun…

Taub: I’d shoot the guys with the torches. Not one doctor this guy has seen in the past three years has been able to find a single thing wrong with him. What does that tell you?

House: [who has continued to stare at the pills without taking them] It means they're idiots. It means we got to start from the beginning. [to Taub] We’ll do a pain profile to rule out psychosomatic pain. [to Thirteen] Search the home. [to Cameron] Go home. [to Kutner, tossing him the empty bottle] Get a refill… And a doughnut.

Foreman: I’ll help with the home.

[Cameron and the team all leave. House takes the Vicodin.]

[Cut to Jeff’s room. Taub is doing the pain profile.]

Taub: Choose a statement in each group that best describes how you've been feeling lately, including today.

Jeff: I’m not depressed. I know what I did was stupid.

Taub: I usually sleep well. I have some trouble with sleep. I have a lot of trouble with sleep.

Jeff: I have a lot of trouble.

[Cut to the hallway. Taub is interviewing Lynne.]

Lynne: It’s up and down. Between the pain and the meds, his sleep pattern's pretty erratic.

Taub: He’s a calm person. He’s more nervous than most people. He’s so nervous, he's miserable.

Lynne: He’s definitely calm. Sometimes calmer the worse the pain gets. I think talking, interacting with other people actually makes it worse.

Taub: Interesting.

Lynne: Why? Does that mean something?

Taub: No, it's just we've seen that in other… patients.

[Cut to the lobby. Taub is interviewing Zach in front of the fountain.]

Taub: He can do chores around the house. With help, he can do chores. He no longer can do chores.

Zach: He helps all the time. He’s really strong. He used to play hockey. And he was really good too.

Taub: I believe there's hope. Hoping for things to get better is a struggle for me. Most of the time, I feel completely hopeless.

Zach: He still laughs… All the time.

[Cut to Jeff’s room.]

Lynne: [voice over] He was always optimistic. He still is. It’s just… it's harder now.

Jeff: I guess… I pray for strength more than hope.

[Cut to the garage. Foreman enters from the house holding a large plastic bag stuffed with pill bottles.]

Foreman: There’s nothing in there but a pharmacy's worth of pain meds. This guy makes House look like a Christian Scientist. He’s also more compliant than House. Kept all the inserts, had daily pill dispensers to make sure he didn't mix them up. [He looks at the car.] I guess if you're gonna go out in a car, this ain't a bad one to choose.

Thirteen: If I ever did it, definitely wouldn't be like that. Don’t worry. I’m not making any plans.

Foreman: I certainly wouldn't know. Ever since we kissed, you've been avoiding me.

Thirteen: No, I haven't. Just been busy. Metal polish could cause nerve damage if he inhaled enough of it. Judging by the shine on that car, he used a fair amount.

Foreman: Judging by the fact that he owns a body shop and [holds up a respirator] one of these, I’d say he knew not to inhale. Busy tonight? We can get some dinner.

Thirteen: I don't think so.

Foreman: So making out, okay. Meals, too intimate?

Thirteen: I don't want to kiss you again either.

Foreman: Why? Because we work together?

Thirteen: No. Because I like you.

Foreman: That makes a lot of sense.

Thirteen: What doesn't make sense is me getting involved with anyone.

Foreman: I thought you'd gotten past that. That’s why you agreed to the drug trial. You can't give up on life because —

Thirteen: I’m not giving up on life. I’m just giving up on you. I finally feel like I have a grip on things. I can handle this. What I can't handle is dragging anyone else down with me. [She opens the freezer, which is full of packaged meat.] Does this look like quail to you?

[Cut to the Diagnostics Conference Room. House shakes a couple of Vicodin out of the new bottle and takes them.]

Taub: You think he's had food poisoning every day for the last three years?

Thirteen: Wild quail can be toxic, cause rhabdomyolysis, which would explain his pain, as well as the elevated CK levels.

Taub: So would the carbon monoxide he sucked out of his car. It’s not a toxic reaction. It’s a psychosomatic reaction. The pain profile showed an excessive concern about his physical health, difficulty sleeping, getting out of bed.

House: He’s not in pain because he's depressed. He’s depressed because he's in pain.

Taub: Not according to the pain profile you ordered. It’s not a diet issue. We should start him on antidepressants for his sake, as well as his family's.

House: We’re not diagnosing his family.

Taub: We’re not diagnosing you either.

House: It’s rhabdo. Push IV fluids, check his urine, do a muscle biopsy.

Taub: What muscle? He says it hurts all over.

House: Then she'll biopsy all over.

Foreman: Where are you going?

House: [taking his jacket from the coat tree] If Cuddy can come in late, I can leave early. If you need anything while I’m gone, just ask Cameron to do it.

[Cut to Jeff’s room. Thirteen, assisted by Kutner, is sticking a huge needle into Jeff’s leg while Lynne and Zach watch.]

Zach: So if he just stops eating quail, the pain will go away?

Thirteen: If we're right, it's definitely treatable.

Jeff: My arm! It’s starting to —

Zach: He needs more medicine.

Kutner: BP is down. We need to get him in Trendelenburg position. [They lover the bed.]

Thirteen: Jeff, can you hear me?

Kutner: He’s arresting.

Thirteen: [shouts] We need a crash cart in here!

[Cut to House’s bedroom. He’s lying on his back. Something that sounds like a foghorn can be heard. He checks his watch, sits up and turns on the light. He grabs the Vicodin bottle, shakes it and takes some.]

[Cut to Diagnostics Conference Room. Foreman is hanging up on the speaker phone.]

Foreman: He’s not answering his cell either.

Thirteen: VQ scan showed a pulmonary embolism.

Taub: Means the pain's not psychosomatic.

Thirteen: It also means it's not rhabdomyolysis.

Foreman: Up till now, his heart and lungs were the only places he didn't have pain.

Kutner: Means it's getting worse.

[The phone rings. Foreman puts it on speaker.]

House: Got to let the phone ring more than four times when you're calling a cripple. Chronic pain and pulmonary embolism, go.

Kutner: How’d you know he had —

House: You called after midnight. It’s got to a heart problem. Heart only would be consistent with rhabdo, which means Thirteen and Foreman would be singing in the rain, which means it has to be lungs as well.

Thirteen: Hypercoagulable state could cause pain and a PE.

House: You think the blood clot was caused by a clotting problem. That’s helpful.

Kutner: What if it's a cancer syndrome, like Trousseau's? Explains blood clots, multifocal pain, lack of obvious physical signs.

House: And why he's gone three years without anyone seeing it. Check his chest, abdomen, and pelvis for tumors. [He hangs up.]

Taub: Why did he think only you two would be singing in the rain?

[Thirteen takes the file and leaves. Kutner smirks.]

[Cut to House’s bedroom. He sits on the edge of the bed, rubbing his thigh. He grabs his cane to walk the two steps to the window. He opens the curtains and see’s it’s not raining. Water drips on the back of his neck. He looks up and there’s a leak in the ceiling. He grabs a t-shirt from the bed, puts it on the end of the cane and pokes the leak. A hole opens in the ceiling and dozens of gallons of water drench House.]

[Cut to MRI. Jeff is in the machine, Kutner and Taub in the monitor room.]

Taub: Bone windows are normal.

Kutner: Checking for cancerous masses in the lungs. So, uh, who do you know who committed suicide?

Taub: Hemingway, Goebbels, Romeo and Juliet.

Kutner: Your mom? Dad?

Taub: Saying I wouldn't do it under any circumstances means my whole family was suicidal?

Kutner: Nope, but categorically insisting there are no circumstances means you've got baggage — Personal betrayal, abandonment.

Kutner: Just because you grew up in a Charles Dickens novel…

Kutner: Well, it's people like me who don't do it. When your life sucks from the beginning, there's nowhere to go but up.

Taub: Thorax is clear. No tumors in the lungs. The only betrayal comes from father of the year in there. He has a wife, a kid — People who count on him to have a pulse.

Kutner: Okay. Switching to high-res cuts of the abdomen.

Taub: My parents live very happily in Queens. They never attempted, thought about, or attempted to think about committ — [sees Kutner staring at the monitor] What?

Kutner: There, along his diaphragm.

Taub: That’s not cancer.

[Cut to a man looking at a crawlspace with a flashlight. He’s on a ladder in House’s bedroom. House is sitting by the door, tapping out an asymmetrical rhythm with his cane.]

House: No hurry. I already bathed once this week. I wouldn't want to look elitist.

Plumber: Can’t do anything till I write up an estimate.

House: Fine. Pad it all you want. Here’s a check for the deductible. Don’t touch the piano and lock up when you leave.

Plumber: Sorry, deductible doesn't apply here.

House: Well, I’m no architect, but I’m pretty sure the master bedroom is part of the home, which means the home warranty —

Plumber: Doesn’t cover negligence. This pipe goes through the ceiling, over that wall, and into your shower. It didn't burst. It was pulled apart.

House: Yeah, 'cause I’m clearly a guy who likes to knock out a few naked pull-ups before I greet the day.

Plumber: You hang laundry in there?

House: I’m about to hang a plumber in there.

Plumber: Look, there's no rust. There’s no corrosion. I don't know how it happened, but I know what happened, and it's not covered.

House: So…

Plumber: Whenever you're ready to spend the $2,200… Give somebody else a call. [He takes his ladder and leaves.]

[Cut to Clinical Trials area. Foreman is bending Thirteen’s wrist back.]

Foreman: I promise, I’m only holding your hand to check for choreiform movement. I’m getting absolutely no intimacy from it.

Thirteen: I told you, it has nothing to do with you.

Foreman: I know. That’s the problem. There’s 80 reasons we shouldn't date, but you can't shut everyone out. You’re gonna need help, support.

Thirteen: Look at our patient. 32 years old, not dead yet, and already he's traumatized his wife, his son —

Foreman: And I’ll bet they're cherishing every traumatic minute he has left, wouldn’t trade him for the healthiest guy in the world.

Thirteen: True. And they're stuck suffering with him, hating every day. Only their pain has no prospect of relief.

[Kutner and Taub enter.]

Kutner: This a bad time?

Thirteen: No.

Foreman: [simultaneously] Yeah.

Kutner: No trace of cancer in the patient.

Taub: But we did find edema in his intestines, air in the intestinal blood vessels, and House won't answer his phone.

Foreman: His intestine must be damaged. The air's leaking into his body.

Kutner: If there's a blockage in the superior mesenteric artery, it could be choking off blood flow to his intestine.

Thirteen: Blockages all over his body would explain his pain, why the cramps come and go.

Foreman: Do an angioplasty on the superior mesenteric and find the other blockages before he has another cardiac arrest.

Thirteen: I’ll help. [She grabs her stuff and rushes out the door behind Kutner and Taub.]

[Cut to Diagnostics Conference Room. House comes in, wearing his outer coat. Taub and Foreman are doing paperwork.]

House: Good thing we don't have a suicidal patient with a horrific, undiagnosed pain disorder.

Foreman: We did till we diagnosed it. We found intestinal edema and air in the blood vessels. Pain was vascular.

House: If it was vascular, we would've seen uneven pulses.

Foreman: His blood pressure was uneven. Thirteen and Kutner are doing an angio.

House: He had hemorrhages in his fingers.

Taub: There’s air in the intestine. It has to have come from somewhere.

House: [thinking] Yes, it does. [He leaves.]

[Cut to Jeff’s room. Thirteen is helping him into a wheelchair while Kutner explains the procedure to Lynne and Zach. House is in the hall, approaching fast.]

Kutner: After we thread the catheter through his groin and into position, the blood will start flowing freely again.

Zach: Will that take away the pain?

House: It will be completely ineffective, and the pain will completely go away. Cancel the angio.

Thirteen: He has air in his blood vessels. If we don't open the artery to his intestines —

House: [handing Thirteen his cane] Where can air come from? Hmmm. [He inspects the IV line, started at Jeff and moving toward the IV stand.] Air can either come from a breach in the lumen in the small intestine, or in rare instances, air can come from the air. [He opens a connector in the line and shows it to hem.] Teeth marks. I’m guessing from when he blew into his IV tube.

Kutner: Air bubble caused the PE and cardiac arrest.

House: You tried to finish the job that you started at home.

Lynne: Jeff… Why? You said that you never —

Jeff: I lied. I wanna die. Please just let me die.

House: No. [He leaves.]

[Cut to Rachel’s nursery. Cuddy is changing the baby. House is poking a large, stuffed giraffe on the nose.]

Kutner: He’s in a hyperbaric chamber. A dose of high pressure ought to chase the air out of his blood.

Cuddy: Is anyone keeping an eye on him, because this whole idea of suicidal watch was specifically created for suicidal patients. I realize how you might've thought the name was just a coincidence.

House: Are there any visuals in this room that are key to us learning our lesson? 'Cause the telephone —

Cuddy: I’m inconveniencing you because you inconvenienced me. [pause] When was the last time you showered?

House: Scent of a man! I realize you haven't experienced it sober.

Cuddy: Anyone should be able to handle a depressed pain patient…

Taub: He insisted he was no longer —

Cuddy: Apparently he lied. Didn’t think I’d have to remind you of that remote possibility. I have a DYFS inspection in less than 24 hours, so if you can't control —

Thirteen: Non-motor seizures. [House and Cuddy both look at her.] Sorry, I was thinking about the patient. What were you saying?

Cuddy: Go on.

Thirteen: The pain started in his abdomen near his intestine. The first symptom has got to be key.

House: He’s had multiple EEGs, all of them cleaner and squeakier than Cuddy's rubber nipples.

Foreman: What about a glycogen storage disease like McArdle's? It explains the pain. Plus there's plenty of muscle cells in the wall of the intestine.

House: Fourteen is right. [Kutner smirks.] Go run an ischemic forearm test.

Cuddy: Take the garbage out on your way out. [She hands Kutner a dirty diaper.]

House: If you want a man to take your crap, you have to marry him first.

Cuddy: Or employ him. [The team leaves. Cuddy jiggles Rachel.] Good girl.

[Cut to Clinical Trials area. Janice is there.]

Janice: I don't think I’m ready to run a decathlon yet.

Nurse: Ah, if we can get you managing your life a bit better, that'll be plenty. Dr. Hadley, whenever you're ready. [Janice waves at Thirteen.]

Thirteen: Janice. You look better.

Janice: Yeah, they said my basal ganglian volume’s improved. All I know is for the first time in two years, I can drink a cup of water without spilling it all over myself. Thank you for getting me back in the study.

Thirteen: I haven't even seen you in weeks. I didn't even know our appointments were back-to-back again.

Janice: Well, they weren't. Mine got switched this morning.

[Cut to a treatment room. Lynne and Zach are watching as Taub and Kutner set up a test for Jeff.]

Kutner: We’re gonna take your blood repeatedly. If the increased strain makes your arm hurt more, you have a muscle abnormality.

Lynne: If you're right about this McArdle’s disease, can you take away the pain?

Kutner: With gene-replacement therapy, with lifestyle changes, we can reduce it.

Taub: [to Jeff] Keep squeezing the ball. [Jeff grunts with pain from the effort.]

Lynne: How long does he have to —

Jeff: Maybe you and Zach should get something to eat.

Lynne: Honey, don't worry about us.

Jeff: I’m not. Please get out of here. These tests are all I can handle.

[Lynne and Zach leave.]

Taub: They’re trying to help you.

Jeff: They can't.

Taub: Then how about helping them, you know, by not being —

Jeff: An ass? You have no idea what I’m going through.

Taub: I know it's better than what you tried to go through. [He stands and walks past Kutner.]

Kutner: Sure, no baggage at all. [to Jeff] Where’s the pain worst right now?

Jeff: Left arm.

Kutner: Does it hurt more?

Jeff: Couldn’t.

Taub: And lactate level is steady. It’s not any kind of glycogen.

Jeff: [yells and lets go of the ball as he grabs his leg] Ahhhh! Oh, God! Pain jumped to my leg! That’s never happened before.

Taub: Chest, your abdomen — you feel anything there?

Jeff: No! My leg! It feels like it's being sawed off.

[Cut to Clinical Trials area. Foreman is at the desk. Thirteen approaches.]

Thirteen: Nice.

Foreman: What?

Thirteen: Switching Janice’s appointment time so I could see the skies brighten like a lifetime TV movie.

Foreman: I don't know what you're —

Thirteen: Sticking your most improved study participant in my face. Is that your way of getting into my pants?

Foreman: I don't make the schedule, and if I did, I wouldn't use it as a social lubricant. And this is the first I’ve heard of Janice improving at all. So, hey, thanks for the good news.

[Cut to Diagnostics Conference Room. House is typing on a laptop.]

Taub: Pain started in his abdomen. Now it's hopped from his left thumb to his left leg, skipping the trunk entirely.

House: I need the name of a good lawyer.

Kutner: We're getting sued?

House: Probably. That’s Cuddy's problem.

Taub: Hopping pain, means it's something in her brain, not his body.

House: Except the pain's in two places that connect to two separate regions of the brain. Which means you're not using yours. Come on, you're from one of the 12 tribes. You know must know a ton of shysters.

Taub: What type of lawyer do you need? I’ll bring it up at the next world domination subcommittee meeting.

House: Didn’t say I needed a lawyer. I said I needed the name of a lawyer.

Taub: Pain hopped to another limb on the same side. It’s got to be central —

Kutner: Could still be peripheral. If multiple areas of disc disease —

House: Were consistent with a completely spotless MRI. [to Kutner] Who represented the hospital when you set that patient on fire?

Kutner: Chris Carrick.

House: Chris? That doesn't sound like a very good lawyer.

Taub: If we can't even resolve body versus brain, we're never gonna diagnose the guy.

House: What was the name of the firm?

Kutner: Caddell and Carrick. It’s not like we can chop off his head to see if the pain goes away.

House. [types a final period] Why not?

[He grabs his cane and leaves.]

[Cut to Cuddy’s office. House is sitting on the edge of the desk, running his finger over the wood. Cuddy enters, wearing her coat.]

House: Need to cut off a guy's head. [Cuddy turns to leave.] Got to figure out if his pain's coming from his brain or his body. [She pauses at the door.] A stiff shot of lidocaine below the brain stem should numb him all the way down to his tippy toes.

Cuddy: And hearing me say "no" over the phone wasn't good enough?

House: I’m inconveniencing you because you inconvenienced me.

Cuddy: You know that foster-care official is coming in the morning.

House: If they weren't, there'd be no inconvenience.

Cuddy: Do not try and force me to choose between my child —

House: I’m forcing you to do your job! If you can't also —

Cuddy: Fine, you want to separate a patient's central nervous system from the rest of his body.

House: If the pain stays, it's in his brain. If it vanishes —

Cuddy: And what about options three, four, and five? His respiratory system freezes, or he dies of infection, or he leaks CNS fluid like a fire hydrant, which would make him wish he were dead?

House: You need to scratch option five. He’s already there.

Cuddy: You preach objectivity, but as soon as a patient comes in in pain, all you want to do is look under the hood. You don't care if there's a one-in-three chance you'll kill him.

House: If I don't diagnose him, there's a one-in-one chance he'll kill himself.

Cuddy: [Checks her cell phone which is beeping] I gotta go. Do whatever it is you think is right.

[Cut to Cuddy’s living room. There are pink things everywhere. Rachel is on Cuddy’s knees. She looks for the phone and finds it under a sofa cushion. She dials.]

Cuddy: Tammy, you said you were gonna be a little late. DYFS is gonna be here in an hour, and this place is a disaster. [There’s a knock on the door. James Carlton, the DYFS inspector, is there. Cuddy lets the phone slip from her ear.] Never mind.

[Cut to OR. Jeff is sitting on the table with his back to Chase.]

Chase: This should numb everything from your shoulders down. Any pain that's peripheral should be gone. [House enters, not wearing a mask, of course.] What are you doing here?

House: Just stretching my leg. Carry on.

Jeff: Bad pain day today?

House: [rattling pill bottle] About to get better. Don’t worry. He’s making yours a double.

Jeff: I remember when the drugs still made things tolerable. I still thought I had good days left.

[The nurse helps Jeff lie on his side. Chase drapes his collar with a sterile cloth.]

House: Turns out you have to live to find out.

Jeff: You don't have a family, do you?

House: Left them all back on Krypton.

Jeff: You’re alone. That’s why you can handle your pain. No need to put up a front, to be what anyone else wants you to be. You’re having more bad days lately, aren't you?

House: [quietly after a pause] Yes. [Chase looks at House for a moment.]

Jeff: Take a look at your future. Let’s hope the drugs work this time.

[Chase injects the back of Jeff’s neck. House looks up to see Cameron looking at him before leaving the observation gallery.]

[Cut to Cuddy’s house. She lets Carlton in.]

Cuddy: I really wasn't expecting you till later.

Carlton: Had a cancellation, so I thought I’d knock you off the docket.

Cuddy: Well, I’m sorry this place is such a mess. It’s been a bit of a difficult workweek.

Carlton: Any guns in the house?

Cuddy: Uh, no.

Carlton: Pets? [pause] Besides the ants?

Cuddy: No.

Carlton: [looking at Cuddy’s leather tote] Nice bag. Pricey way to ditch the diapers.

Cuddy: [removing the diaper] That’s not what I usually — Um, I sort of panicked. Mr. Carlton, if you'd just give me a minute to explain.

Carlton: Everything looks fine.

Cuddy: Really?

Carlton: Dr. Cuddy, you've got sufficient income, a high degree of personal and professional stability, and you care enough to be embarrassed by what a mess this place is. Believe me, that puts you head and shoulders above most of the foster moms I visit. See you next year, if you haven't adopted her by then.

[He leaves. Cuddy breathes a huge sigh.]

[Cut to the OR.]

Jeff: My legs… They’re different. Better.

Chase: No pain at all?

Jeff: No, but less. Four out of ten, maybe five.

[House and Chase look at each other, puzzled.]

House: Can’t be. If whatever is causing the pain is in your brain, it's still a ten. Periphery is zero.

Jeff: It is? Some of the pain is gone, but not all of it. What does this mean?

[Cut to Diagnostics Conference Room.]

Thirteen: Maybe Taub was right. It’s psychosomatic after all.

[A gray-haired gentleman enters.]

Carrick: Which one of you is House?

House: The big black guy.

Carrick: [dropping an envelope on the table in front of House] Chris Carrick. Next time you use my name in a threatening e-mail, it won't be just a bill. It’ll be a lawsuit. [He leaves.]

House: [to Foreman as he inspects the envelope without opening it] Can you blame me? The last time that happened, the guy shot me.

Thirteen: What if the spinal block triggered some sort of placebo effect?

House: Guy’s taken the finest opiates Blue Cross can buy. How come they didn't trigger a placebo effect?

[Four beepers go off simultaneously.]

[Cut to the hallway outside Jeff’s room. Zach is on the floor, wailing. Lynne and a nurse are kneeling beside him. The team rounds the corner by the nurses’ station, followed by House. Passers-by are staring at Zach.]

Thirteen: What happened?!

Lynne: He just started screaming, do something! Please, God, do not let it be what his father has.

[House stands midway between Zach and Jeff’s room. He looks at one, then the other.]

House: I think he's faking.

Lynne: How dare you?! What makes you think —

Foreman: House, the kid's in excruciating — [He’s talking to House’s back.]

Lynne: Where is he going?

[Cut to Jeff’s room. House starts tossing the bedding around while Taub and Thirteen look on from the doorway.]

House: Where is it?

Jeff: Where’s what?

House: [producing an empty bottle of rubbing alcohol from under the sheets.] His idiot son distracted the orderlies so that daddy death wish here could down a bottle of isopropyl. Get him on dialysis, or in half an hour, he'll be a corpse.

[House returns to the corridor and hauls Zach to his feet by the forearm.]

Zach: You’re hurting me.

House: Remember the feeling. Maybe next time you want to help pops, you'll do a better acting job.

Zach: You can't help him.

Lynne: Zach, why did you do this?

Zach: Because he's not dad anymore. He just wants it to be over with. Please. Please, just — just let him die.

[House stares while Lynne comforts Zach.]

[Cut to Jeff’s room. Lynne strokes his face. Zach looks tearful.]

[Cut to hallway. The team carries on a DDX as they follow House down the hall.]

Foreman: Fabry disease might be able to cause central and peripheral pain.

House: No angiokeratomata.

Kutner: Lightning pain from syphilis.

House: All the syph tests were negative. [They silently follow him into the Diagnostics Conference Room.] Why aren't you guys still talking?

Taub: Because we ran out of ideas.

Thirteen: Nothing explains this.

Foreman: Something has to.

House: Unless… Nothing does.

Taub: So now you think —

House: Mine’s a more interesting version of nothing. It used to be something. We can't find anything because whatever injury caused the original pain healed a long time ago. The only thing left is the drugs.

Foreman: Opioid induced pain.

House: Pain and the drugs that treat pain work by changing brain chemistry, sometimes to the point where pain receptors read painkillers as killer pain. Take him off the drugs.

Kutner: We can't cure him, so we're gonna torture him?

House: Torture is the cure. Eventually his body will recalibrate itself.

Taub: Assuming you're right.

House: Yes. I find it confusing to assume otherwise.

Thirteen: How would you like to stop taking Vicodin?

House: Good thing I’m not the patient.

[Cut to Cuddy’s house. There’s a knock on the door. Cuddy sees who it is.]

Cuddy: It’s open. [Wilson enters carrying a giant, stuffed duck. She laughs.] Thank you.

Wilson: Is it too big?

Cuddy: She’ll grow into it. You can put it there. [She points to a chair.]

Wilson: I take it the home inspection was pushed back.

Cuddy: I passed.

Wilson: You do realize that's a good thing?

Cuddy: This place was a disaster. I had to stash a dirty diaper in my briefcase.

Wilson: So you buy another briefcase.

Cuddy: I let House supervise himself. That’s like handing a 12-year-old the keys to the liquor cabinet and the car.

Wilson: You passed the inspection. The patient lived. The car is still in the driveway. And the next time my nanny gets sick when House wants to saw someone in half?

Wilson: Did I mention you passed the inspection?

Cuddy: I passed by their meager standard. I failed by mine.

Wilson: Why do women always do that?

Cuddy: Fail?

Wilson: Create ridiculous standards that no human could meet, with your careers, with your kids. You got to be more like us men.

Cuddy: Be lazy? Blame others?

Wilson: Get help! Most men in your position have a deputy and two assistants at work, and a wife and two nannies at home. You’re not superwoman. Don’t be a martyr.

[Cut to Jeff’s room.]

Kutner: We’ll be injecting you with naloxone, which will knock the opioids out of your pain receptors. If we're right, your system will recalibrate within a few hours, and most of the pain will be gone.

Jeff: Hours? I need those drugs.

Kutner: Not if they're causing your pain.

Jeff: Then knock me out, sedate me while you —

Kutner: That takes drugs too. We need to clear everything out of your system.

Jeff: Please, I’ll try anything else.

Taub: That’s what we're trying to stop.

Kutner: [joins Taub preparing the meds] So it's not your parents. Then it's your wife, someone you were close —

Taub: Colleague. We were residents together. I should've done more to stop it. He had the mother of all god complexes. So busy treating everyone's problems, he was blind to his own. Helped himself to a vial of insulin. It’s a miracle he survived. His friends and family almost didn't. He was a selfish ass.

Kutner: [as Taub administers the naloxone] It’ll be over soon.

[Cut to the hallway. House, dressed to go home, is watching Jeff through the glass wall to his room.]

Foreman: This is lunacy. You’re torturing this guy on a hunch.

House: It’s the only hunch we've got. If I really wanted to torture him, I’d manipulate a clinical trial in the hopes that he'd sleep with you.

Foreman: Are you suggesting I got Thirteen in that trial because of some personal —

House: I think you got her in because of your usual Messiah complex. I think you messed with the appointment schedule because of your "I like to have sex" complex. I checked the logs. You moved your most promising patient right before her. False hope being quite the aphrodisiac.

Foreman: How’s it false if the trials are showing results?

House: Well, if it were that promising, you wouldn't have to change the schedule. But, hey… Hope springs eternal.

[He leaves. Jeff continues to moan and groan in his room. Taub and Kutner are in there too.]

[Cut to House’s kitchen. A new plumber, Fernando, is on a ladder, checking the scorched ceiling. House leans on a cabinet, drinking coffee.]

Fernando: This was a cooking accident?

House: First time making cherries jubilee.

Fernando: Awfully big fire.

House: If you ask me, some of the portions in that recipe were off. [He picks up his insurance policy, which happens to be on the counter and leafs through it.] Sure hope it happens to be covered under, say, section three, subsection 2.2, paragraph one, accidental fire damage, in which case you'd have to replace the entire waterline to fix the sagging pipe.

Fernando: I guess so. [House’s beeper goes off] Hate to have your next-door neighbors end up with no hot water. Lucky the fire escaped your pipes entirely.

[House stares at the ceiling as Fernando fills out some papers, smiling slightly.]

[Cut to Jeff’s room. Kutner, Taub and a nurse are with him. He’s still in severe pain.]

[Cut to Jeff’s room, later. Kutner, Taub and a nurse are with him. He’s still in severe pain.]

[Cut to Jeff’s room, later still. Kutner, Taub and a nurse are with him. He’s still in severe pain.]

[Cut to House’s office the next morning. Lynne is waiting when he comes in.]

Lynne: It’s not working.

House: I know. I started him back on the pain meds… [He drops his backpack behind his desk. She’s still standing there.] Which means you can leave.

Lynne: My son was right. I tried for so long to protect him from… But I’m the one who's been selfish. This is no way for him to live.

House: Until we get an answer, it's the only way.

Lynne: There is no answer.

House: There's always an answer.

Lynne: Then what is it? He’s been here four days. Three suicide attempts. You don't have an answer. When I saw you… When I saw the cane… I thought, "thank God. The doctor will understand." Because I sure as hell don't. My husband thinks it's over. So look me in the eye, tell me you'd want to live like that. [House looks down slightly and says nothing.] Then stabilize him. Get him in decent enough shape for the drive home. [She starts crying.] So he can finally…

House: [quietly] Okay.

[Cut to Diagnostics Conference Room. Thirteen, Taub, Kutner and Foreman are there.]

Thirteen: There’s got to be something we can do. We can't just let the patient leave.

Foreman: We didn't. House did.

[Cut to House, lying on his bed, fully clothed, looking at the ceiling.]

Taub: Because he realized there's nothing he could do.

Thirteen: There’s always something we can do, something else we can try.

[Cut to House’s bathroom. He’s running the shower. Fernando is in the doorway.]

Fernando: You’re insane. You know that, right?

House: Because I have principles?

Fernando: Because you paid more to bribe me to lie on your claim than the entire cost of the repair.

House: I don't care if I pay, as long as the people who pocketed my premiums for the last nine years also pay. I didn't break the pipe.

Fernando: Whatever. If you want to stick it to the man, that's fine by me. [He signs some paperwork and gives it to House.] You happy?

House: Nope, but I’m right.

[House takes his cane and follows Fernando into the living room. Fernando is putting his tools back in his toolbox, pausing only to scratch his groin. House grabs heads quickly for the door where he grabs his jacket.]

House: Lock up on your way out. And don't touch the piano.

[Cut to elevator by nurses station. House is in the elevator as it opens. The rest of the team is waiting.]

House: Testicles. What do they make you think of?

Taub: STDs, testosterone issues, that summer on Fire Island.

House: Oh, so close. The correct answer is epilepsy.

Foreman: Epilepsy doesn't cause chronic pain.

House: It does if it spreads to the sensory region of the brain, then rewires the pain neurons.

Thirteen: Would’ve shown up on an EEG.

House: Not if the seizures are in a place you can't see on an EEG, a place too deep in the brain, like the area that controls the muscles supporting the…

[The team stops as they realize what House means. He keeps walking.]

Taub: Testicles.

[Cut to Jeff’s room. He’s dressed and ready to leave. Zach is sitting in the wheelchair. Lynne is packing.]

House: Feels like you got kicked in the nads, doesn't it? [Jeff and Lynne look at him, puzzled.] The abdominal pain, how it all started. It wasn't the stomach. It was lower, right?

Jeff: It’s everywhere.

House: But when it first started.

Jeff: It started in the stomach — cramps.

House: Yeah, like bad gas, or a permeating pain… Like your kidneys were being pulled out through your scrotum.

Jeff: [sits up straighter. House’s description seems to register with him.] Why?

House: Because epilepsy is treatable.

[Jeff, Lynne and Zach look at each other.]

[Cut to a lab where Taub is recording Jeff’s brainwaves.]

[Cut to a lounge. Zach is asleep on a couch. Lynne stands nearby.]

[Cut to Cuddy’s office. She’s working at her desk while rocking Rachel’s stroller with one hand.]

[Cut to the lab. Taub smiles as he looks at the monitor.]

[Cut to Jeff walking down the hall, holding Zach’s hand on one side and wheeling an IV stand with the other. Kutner joins Taub at the nurses’ station.]

Kutner: Looks like we shot the guys with the torches.

Taub: Yeah. Pays to hang around.

Kutner: That selfish ass with the god complex who almost made the stupidest decision of his life — Wasn’t your colleague, was it? It was you.

Taub: No. [Taub writes something in the chart and grabs his briefcase.] See you tomorrow. [He leaves.]

[Cut to Clinical Trials area. Thirteen is curled up in a chair, writing, while getting her IV. Foreman enters.]

Foreman: You’re here early.

Thirteen: I’m feeling better. [He fiddles with the IV.] What's wrong?

Foreman: IV’s leaking a little. It’s no big deal. I’ll be right back.

Thirteen: Foreman. [He stops.] You busy tonight?

Foreman: No.

[Cut to desk outside Thirteen’s room.]

Foreman: Rita, the spike on Dr. Hadley’s IV bag wasn't pushed in all the way. Don't want any dosing errors. [He takes a tissue and cleans the medication off his hand in the manner approved of by toxicologists everywhere.]

Rita: Sorry. It won't happen again. It stinks, doesn't it?

Foreman: What?

Rita: The medication. When we switch out the bags, you can smell it. It’s disgusting.

Foreman: I didn't smell anything.

Rita: Oh, she must be on the placebo, then.

[Foreman looks back at Thirteen who is smiling as she continues to write.]

[Cut to the ER. Cuddy smiles and nods at Cameron who comes over to talk to her.]

Cuddy: You offered to do House's budget because you wanted him to owe you, wanted him to take that case. Why?

Cameron: I thought it would help House. Seeing someone worse off than him, possibly curing a guy who has even less to look forward to.

[Cuddy nods. Cameron starts to go back to a patient bay.]

Cuddy: Can I ask you something? [Cameron stops.] How would you like my job?

[Cuddy smiles at her as Cameron frown in confusion.]

[Cut to House’s bathroom. He’s filling the tub and testing the water with his hand. He turns off the water and takes a firm, two-handed grasp on the pipe that leads to the showerhead. He hops forward, stops and shakes the pipe. It moves freely. He shakes it again and looks down to see the faucets and taps are quite loose. He smiles grimly and lowers himself into the tub.]

[The End]