House (2004–2012): Season 2, Episode 4 - TB or Not TB - full transcript

A doctor campaigns against the epidemic of TB in Africa, possibly at the risk of his own life.

Hey!

Dr. Sebastian.

Two pallets of antibiotics
for tuberculosis.

We've got six pallets
worth of patients.

Stoia Tucker
needs a math lesson.
I'm headed back tomorrow.

Hey! Hey!

Come on, come on.
Come on, kids,
let the truck through.

BOGALE: Move those boxes
quick, quick. Let's move!
Hurry, hurry, hurry!

Let's go!
Let's go, man! Hurry!

I've got some very special
medicine here. It's from
Hershey, Pennsylvania.

One per person.
One per person.



Let's calm down, kids.
Wait, wait.

(BABY CRYlNG)

(WOMAN COUGHlNG)

Help! Help! Dr. Sebastian!
Come quickly!

My son, he fell. He fell
on this log. We were just
waiting for his friends.

(SPEAKlNG lN NATlVE TONGUE)

I got no breath sounds
on the left. Give me that.

Yeah, he's gonna be okay.

SEBASTlAN: The fall
didn't cause him
to drop a lung.

The lung caused him to fall.
TB chewed it up.

He'll be lucky
to live another year.

This is Sarni.
I picked up the tab
for the back brace myself.

The funny thing is,

is that the brace cost more
than the medicine



that would have prevented her
from needing it.

It's your medicine.

All of the antibiotics
that we need are right here

in your warehouses,
in your factories.

We provide
over 10,000 doses a year.
Which is not enough.

You know we'd love to do more,
but our hands are tied.

New car, Jerry?

I saw it on the way in,
looks beautiful.
Don't make this personal.

All the way from Germany, too.
I know that's a lot
of red tape.

I'm not like you.
I'm not ashamed
of making a living.

And I know you didn't become
a chem major for the money.

Now, you want the same things
that I want. You just...

You have to...
You just have
to push a little...

You have to push
a little bit harder...

Harder for it.
Sebastian?

(CLATTERlNG)

MAN: Call 91 1.

Okay.
Is he okay?

Isn't someone here a doctor?

(DOOR OPENS)

Selling subscriptions?
I heard 20 and you get
a new bike.

Dr. Sebastian Charles
collapsed during a
presentation at Stoia Tucker.

Really?
Crushed under the weight
of his own ego?

Wow!
Is there nobody you admire?

Well, there is this gal I met
in Nam who could blow out
a candle without using...

He thinks it's TB.

Good thing he's not
the syphilis expert.
He wants a second opinion.

Second to his own. Okay.

It's not TB.
What is it?

Oh, you want specifics?

Lemma, big Knicks fan.

You've never had an episode
like this before?

No. He died last month.

Stupidly tried to share
his meds with his cousin,

and they only had
enough for one.

Dr. House,
I'm Sebastian Charles.

Patients aren't usually
part of
the diagnostic process.

Well, I'm a doctor.

Listen, I know you guys
don't make a lot of money...

I wrote your people
a check last month.
Oh, well.
Write us another one.

Talk to Chase. He's rich.
My dad, not me.

Every minute
four people die of TB.

Wow!
How can you sleep at night?

There's people dying in Africa
of a disease
that we cured over...

Yeah, I know.
I saw the concert.

Seriously. Let's see,
you sleep six hours. That
means every night you kill

1,440 people.

I guess you got to get
some sleep, but come on.

If you'd stayed up
another 10 minutes,
you could have saved 40 lives.

Do you send notes
to the families
in the morning?

That's gonna take at least
10 minutes. So that's another
40 dead, another 40 notes.

Why don't you go
wrack yourself with guilt
in your own room?

No, thanks. I'll stay.
I'd like to hear
the differential.

Dr. Cameron, tell the doctor
why it's not a good idea
for the patient to be here.

He's an immunologist
and a TB expert.

That'll be very useful
if we need somebody
to say the words,

"l think it's TB."

What is that?

Oh, that. I'm sorry,
that's my body powder.

It's the only thing I've found
that works in the Sahara.

I'm kind of used to it.
I don't even notice it.

Who thinks it smells like
an elephant-dung smoothie?

It smells okay to me.

That is exactly
why the patient
shouldn't be in the room.

If you can't tell a man
that his cologne
makes you want to puke,

how are you gonna tell him
that he's an idiot?

He's not an idiot.

Sure, you say that now,
while he's in the room.

Look, I don't have time
for this. It's TB.
Nope.

The symptoms are too varied.

Well, if you haven't seen
10,000 cases, I agree
that's what you'd think.

I told you he's an idiot.

You said you wanted
a second opinion.
No, actually,

my backers
wanted a second opinion.

Yeah, doesn't look good
if you drop dead while wearing
your shoe sponsor's logo.

It's TB and I'm not dying.
I'm gonna want you
to plant a PPD

and induce a sputum to confirm
the TB. Imaging studies will
determine the progress,

and I think we should probably
take a CT scan of my lungs

just so that nobody
second guesses us.
Wouldn't want that.

(CELL PHONE RlNGlNG)

Hello? No,
I'm feeling much better.

Well, what you can do is,
you can get
your board to approve

the increased
med shipments that... Sorry.

No, don't, don't, don't try.
No, don't do your best.

Just get it done, okay?

That's Stoia Tucker,
and they're the nice
pharmaceutical company.

I'm sorry, but it's
against hospital regs.
Oh, I need the phone.

(PAGER BEEPlNG)
Why don't we focus on getting
you better right now?

What'll you do, throw me out?
No, just the phone.

Sorry. We've got an emergency.

Got to go.

There's a phone in your room.
Yeah, I figured
that there would be.

Right. I just thought...

It's not like the hospitals
you may be used to in Africa.

I don't know
what the facilities
were like, so...

Thank you.

You're welcome.

And thanks for that check.

(PAGER BEEPlNG)
I should go.

The nameless poor have a face,
and it's a pompous white man.

Yeah, what a jerk,
saving all those lives
like that.

What's the emergency?

I can't remember
how to do "walk the dog."

The guy's sick, maybe dying.

And you've forgotten all about
doing a differential
diagnosis.

You just sent us off
to test him for...
Well, I had to
get him out of there.

Now we can all sit around
and call him an idiot.

Who wants to go first?
CAMERON: He's right.

Tuberculosis could present
hundreds of different ways.

Well, by that logic,
everyone in the hospital
should be treated.

Not everybody in the hospital
has been exposed to it
for the last 20 years.

TB takes years to kill you.

Two weeks ago,
he was perfectly healthy.

Now he's got a whiteboard
full of symptoms.

What about
something metabolic?
Welcome aboard the
Good Ship Ass-Kisser.

Nice day for a sail.
Pucker up, me hearties.

It's not metabolic.
Kidney, liver and thyroid
are all normal. No diabetes.

What about his heart?
Obviously big as all outdoors.

Abnormal heart rhythm.
Wave forms
show PR variability.

It's subtle, but it's there.

You think it's his heart?
Sick sinus syndrome?

Loose throttle.
Sometimes beats too fast,
sometimes too slow.

Causing him to pass out.
It would account
for the episode.

I'll put him on telemetry,
do a stress test
and an echocardiogram.

Treat him like every
other hospital patient.

I want to see that pious,
body-powdered tush
hanging out of his gown.

Could you give me a hand
with this thing?

I don't recall
asking for a stress test
or an echocardiogram.

What are you gonna do,
walk out?

Corporate sponsors
aren't gonna like that.

I need your forearm.

What's House thinking?

Sick sinus syndrome.
Well, that's a lot
more serious than TB.

Is that a PPD?

If it changes color
in the next 48 hours...

Yeah, if House doesn't think
it's TB, why would he have
you test for that?

Just covering
all his bases, I guess.

Uh-huh.

He doesn't seem
like a guy who does that.

We have you scheduled
for a 10:30 echo.
Good for you.

(LAUGHlNG)

Every minute that we refuse
to love one another,

another puppy
cries another tear.

You're just mad
because he's closer
to a Nobel Prize than you are.

And yet I've nailed
more Swedish babes.
Crazy, crazy world.

It's not just a trip
to Stockholm, you know.

It comes with a cash prize.

Seriously?

No wonder everybody's
going after that peace thing.

He cures thousands
of people every year.

You cure what, 30?

McDonald's makes a better
hamburger than your mother
because they make more?

Oh, I see.

So you hate him because
the lives he saves aren't
as good as the lives you save?

Yeah, that's the reason.

Nobel invented dynamite.
I won't accept
his blood money.

(WOMAN ON PA)

The top of my head's
killing me.

We spent a week
doing "top of head"
in anatomy.

I know just where it is.

(GROANS)

That is not
the top of my head.
Close enough for clinic.

Your sinuses are clogged.

Judging by the scratches
on your hands,
I'm guessing a new cat.

It was my mother's.
She's dead.

You keep a dead cat?

No. My mother's dead.

Poor cat. You're allergic.

We can control it
with antihistamine.

One pill a day.
Pills?

You don't like to swallow.
Not surprised.

Forget the pills.
We'll give you a nasal spray.

Steroids?

Is there something else
you can give me?

Well, if you live
by the river, I've got a bag.

Hey. Stress test was normal.

But his EKG was not normal.
Echo's normal.

Two for you, one for me.
We need a tiebreaker.

Echo and stress tests
are more reliable.
Tilt table tests.

That never works.

I'll bet you
a week's clinic duty it does.

(LAUGHS)

You're on.

You like this guy?

FOREMAN: You always
tell us our opinion
of the patient's irrelevant.

Medically, it's irrelevant.
It says something about you.

You figure anybody
who gives a crap about people
in Africa must be full of it?

Yes.

There's an evolutionary
imperative why we give a crap
about our family and friends.

And there's an evolutionary
imperative why we don't give
a crap about anybody else.

If we loved
all people indiscriminately,
we couldn't function.

So the great humanitarian's
as selfish as the rest of us?

Just not as honest about it.

Well, you also always tell us
motives are irrelevant.

Dr. Charles, your heart's
handljng the changes
jn orjentatjon just fjne.

No pauses on your EKG.

And House drives in for
the lay-up and no, rejected!

What does
this knobby thing do?
I'm within protocol range.

You're not gonna
get a different result.

The way I figure it is,
this could show you
problems at six,

imagine what it'll tell you
if you crank it to 10.

House, is that you?
Does it go to 1 1?

Would you stop? You lost.
I'm scheduled for clinic duty
Thursday and Friday.

All right, I'm beginning
to feel nauseous.

Would you turn
the damn thing off
before you break it?

SEBASTlAN: Okay,
I'm getting dizzy.

I can't see
and I'm gonna pass out.

I win.
At those speeds,
astronauts throw up.

I'm not talking
about the nausea.

The test revealed the problem.
Yeah? House is insane?

What he just did...
Abusive and unprofessional.

If he hadn't done it,
we wouldn't have
seen the problem.

You've got
an abnormal PR interval.

It could be dangerous,
possibly fatal, particularly
if you're in Africa

away from advanced medicine.

I'm gonna need a pacemaker?

You're scheduled
for surgery this afternoon.

We'll be able to maintain
your pacemaker from anywhere.

You just need to get yourself
to a phone line
every few months.

Better yet, you could join me
at one of my clinics.

I'm kind of spoiled.
Well, we'll get you
a hut with a view.

Do you like sand?
I meant medically.

No PET scans, no MRls...
This is ridiculous.

Dr. Charles...
I know. I know.
Hospital regulations.

Darling, have a seat.
Come on.

You're smart. You'll adapt.

We're going up or down?
Basement.

All right.

You might even find
that without
the technological crutches,

you become
a better diagnostician.

My heart
can handle this, right?

So far, just carnival rides
have set you off.

When you meet these people,
it changes you.

We should
talk about it over dinner.

Are you asking me
to Africa or on a date?

I can ask you halfway around
the world, I can't ask you
to a restaurant a block away?

Well, one's a job,
and the other's...
Yeah, hospital regs.

You can't date patients,
right? I wouldn't wanna risk
your precious objectivity.

You haven't answered
either question, by the way.

You don't think
objectivity's important?

I think doctors like House
cling to objectivity

Iike a three-year-old
to a blanket.
Don't get too worked up.

Stay calm. Stay cool
and maintain
the correct perspective.

The only flaw in their
argument is that when you
have millions of people dying,

the correct perspective
is to be yelling
at the top of your lungs.

Sorry. My head is killing me.
Here, sit on the step.

So, are you gonna go out
with me or not?

Your heart rate's normal.

Yeah, of course it is.
It's one flight of stairs.
I'm gonna be fine.

Hand's a little...

(VOMlTlNG)

Call a code,
second floor stairwell!

You were wrong.
Hey, I have feelings.

I'm trying my best.
Isn't that enough for you?

The abnormal EKG was real.
It's not sick sinus syndrome.

Thank God we found out
before we put
the pacemaker in.

And thank God you dragged him
into a stairwell
to get his heart racing.

We were taking the stairs.
They keep them
in the stairwell.

The guy's a selfish jerk.
Why would you...

Why would you say
he's selfish?

Because he's been
talking to Foreman.
No, I haven't.
I'm just giving my opinion.

(PHONE RlNGlNG)
This kind of altruism
doesn't just naturally...

Excellent briefing.

Hey, the guy's still sick.
Can we talk about that?

Now, headaches point
to a neurological problem.
Acoustic neuroma.

A brain tumor
causes dizziness,
loss of consciousness,

messes with breathing
patterns, heart rhythms...

Get an MRl.

HOUSE: Hello?

Oh, I'm sorry.
I'll be right down.
No problem.

I'll do an extra hour
to make up.

I'm late for my clinic duty.

Here, go be me
for a couple of hours.

Explosive diarrhea, fever,
it's probably the flu.

Wow. You're good.
You a Harvard boy?

You're not Hill, Oliver.
No.

Carter, Cecelia.

They put you
in the wrong room, Cecelia.
Mrs. Carter.

Sorry.

I'll just be
a few more minutes.

Don't take these in order,
everything falls apart.

I have cancer.

I felt a lump.

I'll go get a nurse.
Yeah, see you
in an hour or two.

Lie flat.

Lift your left arm up
and under your head.

Right there?
Yeah.

I felt it this morning.

Oh, my cousin
had the same thing.

It's nothing.

We should check it again
on your next cycle,

but you really don't have
anything to worry about.

That's what they told Donna.

She was dead in six months.
Listen, the edges are smooth.

It has mobility.
It has all the earmarks
of a benign...

Why should I believe you?

Because you're trying
to rush me out of here?

The risks of a false positive
on a biopsy outweigh...

Either you do the biopsy,
or I talk to your superior.

Which is it, Dr. House?

I'll arrange the biopsy.
Thanks.

CAMERON: He asked me out.
I'm shocked.

I'm shocked when patients
don't ask you out.

He also asked me
to come to Africa.

Boy, he moves fast.

I think the two questions
had two different objectives.

Do you like him?
Good-looking single guy,
genius doctor,

cares about the world.
I take it you said no.

You think
I'm that hung up on rules?
He's not House.

There's nothing there.

Yeah, there is.

Did I ask you to plant a PPD?

It was positive. He's got TB!

Well, of course he's got TB.
The guy's been
in the jungle for 20 years.

If he tested positive
for pinkeye, would you think
that was his big problem?

I did a test. It was positive.
Why is that a problem?

Because now he's got
the big red target on his arm,

the stubborn jerk thinks
he's right. He won't let us
do any more tests.

Well, maybe he's not
the only stubborn jerk.

I did an LP, too.
Low glucose, and he has
an increased sed rate.

Everything screams
tuberculosis!
Not everything!

If any of the symptoms
are caused by the TB, it would
throw off our diagnosis.

You're right.
We gotta treat the TB.

Who knows?
Maybe he'll just get better.

You'd like that, wouldn't you?

So, it's TB, but not TB?

I'm complicated.
The guy
does know tuberculosis.

If he says it can manifest...
The guy's
not even a real doctor.

He's a human telethon.
Is that your problem with him?

You see hypocrites every day.
Why is this guy so special?

You think I have
a hypocritical attitude
to hypocrisy?

The problem is, there are 26
letters in the alphabet
and he only uses two of them.

He treats
thousands of patients
with one diagnosis.

He knows the answer
going in. It's cheating.

So it's all because
he's one of them
useless specialists?

Oh, did I hurt
the big-time oncologist's
itty-bitty feelings?

HOUSE: You're a big help
to patients who actually
have cancer.

Other times
you're just annoying.
You've outdone yourself.

I'll say. My salad's covering
a free T-bone steak.

Cecelia Carter, remember her?

Last week they said it was
mystery stew. They owe me.

She was just in my office
crying because of the way
you treated her.

That doesn't sound like you.

Then it probably wasn't.

I get that you like
to shock people,

stun them out of complacency,
out of stupidity.

But this woman thought
she had cancer.

She had a lump in her breast.
What were you trying
to accomplish?

Let me ask you something.
If this were another doctor,

if the patient were
complaining about, let's say,
I don't know, Foreman,

you'd just dismiss this
as the paranoid bitching
of another paranoid bitch.

And file it under "P" for...
Paranoid?

Am not.

You're right.
Good.

Apologize to her
before the end
of business today.

What did you do to Ceci?
I have no idea.

Just the salad today.
Big breakfast.

Hey.

Levofloxacin?

You have
a resistant strain of TB.

Wow, you just
walk right in with these.
That's what we doctors do.

We write down the name
of some medicine,
and someone gives it to us.

You know, there's parts of
the world where you get knifed
walking around with this.

I mean, the regular stuff
is bad enough,

but the treatment
for the resistant strain?

(WHlSTLES)

They get $6 a tablet for that.

And I take it for two years.

Streptomycin. Now,
that's two grand.

Ten grand, cure one person.

I had a patient in Djani once.

It was a mother,
had three little boys.

She had resistant TB.

She couldn't afford these.

She couldn't afford bread.

We gave her
the regular stuff, but

no surprise, she died.
Sorry.

I'm not taking these pills.

Because she couldn't get them,
you're not gonna take them?

That's insane.
Why?

'Cause I'm better than her?
Because letting her die
was wrong,

but letting you die
is just as wrong.

Maybe I won't die.

Maybe somebody will pay
a little more attention
to my story.

He figures
the pharmaceutical companies

(PHONE RlNGlNG)
need something big
to force them into action.

This'll get a lot more
media play than 1,000
African villagers dying.

So, he won't take the pills.

Newsweek's calling you.
And he won't agree
to any more tests.

He has his diagnosis.

See what happens
when you don't listen to me?

Maybe millions
of lives get saved.

Yeah. That's my point.

Increased heart rate,
night sweats,

Ioss of consciousness.
Besides rough sex, what do
they all have in common?

T...
It's not TB!

His autonomic nervous system?

We know that
it's not a brain tumor.
So what else could be
eating his nerves?

Fabry's. Autonomic
dysregulation syndrome.

Shy-Drager syndrome.
It doesn't matter.
He won't let us test him.

(PHONE RlNGlNG)

In my opinion,
Dr. Sebastian Charles
is an idiot.

Yeah, you can quote me.
C-U-D-D-Y.

Sebastian is refusing
life-saving treatment.

He's refusing TB treatment.
You don't think he has TB.

Ergo, you should care less.
He won't let me test him.

And what do you want me
to do about it?
Hold him down.

Have you apologized
to Cecelia Carter yet?

Trust me, she doesn't
wanna hear from me.

Look, the guy
is killing himself!

Am I the only one who realizes
this is a bad thing?

If he was a Christian
Scientist refusing meds,
we'd have 18 attorneys...

You're putting on makeup.

That's not a good sign
for my side, is it?

Sebastian has called
a press conference for 3:00.

He's asked me to be there
to confirm the diagnosis
and the prognosis.

You are as big
a media whore as he is.

Of course I am.
It couldn't possibly
be that I think he's right,

and that I'd like to be
a small part
of what he's doing.

Oh, whores can like the sex.
Doesn't mean
they're not whores.

And with that eye shadow,
I am totally screwed,
aren't l?

Totally.

CAMERON: How you feeling?
A little weak.

You're having a good day.

The symptoms
will quickly focus more
and more on your lungs.

You'll find it
difficult to talk
and eventually breathe at all.

I think I know what I'll have
to look forward to.

I know.

I just came to ask
if you'd be willing
to accept any treatment.

No, if you're trying
to scare me into...
No. Palliative treatment.

Narcotics.

Fentanyl patch, morphine drip,
whatever it takes.

We can make your last days
fairly comfortable.

And if you have
another good day,
maybe dinner.

Thank you.

You want
Third World treatment?
You got it.

Boy, is it hot here in Djani.
What are you doing?

What am I doing?

Putting everything
on the floor of the hut.

What's the magic box
with the moving pictures?

You think he's a hypocrite?
Hypocrite? No.

Everybody in Africa's
got cell phones
and running water.

This thing just
will not flush.

Do you really think
that if you come in here
and make it a little hot,

make it smell a little,

that I'm just gonna fold
and abandon everything
that matters to me?

Lousy sanitation
over there, too.

You are not the same as them.
Your life is not the same.

And you're cheapening
everything they're going
through by pretending you are.

I am the same.
I'm not special.

You can't demand
to be treated like any
Third World sick person

and call a press conference!
They treat me special!

That doesn't mean I am.

And what kind of selfish jerk
wouldn't take advantage
of that fact?

It's all preventable.

Stoia Tucker makes medications
right here in New Jersey.

They have warehouses full of
the stuff. There's more than
enough to go around.

So if I can get them,
why can't Lemma?

Why can't Quesmo?
And why can't Sarni?

Another person just died.
Where is your outrage?

SEBASTlAN: No,
I have no jntentjon
of martyrjng myself.

I'm just puttjng myself...

Sure, they're dying,
but it's got a great beat.

Must be hot as hell
under those lights.
Yep.

Hey, why the page?

He okay?
He's in a coma.

I need you to
apologize to Ceci, Cecily.

Mrs. Carter? For what?
For whatever I did.

You didn't do anything.
That has been
my position all along.

CUDDY: Hjs chest x-rays
are negatjve, so he's not
contagjous at thjs pojnt.

Hjs condjtjon
js currently stable.

Do you ever notice how all
the self-sacrificing
women in history,

Joan of Arc, Mother Teresa,

can't think of any others,
they all die alone.

The men, on the other hand,
get so much fuzz it's crazy.

It's an unfair world.

House, she was scared
and unreasonable.
Insulting a woman
with breast cancer,

that's a move best left
to the pros. Frankly,
you don't have the chops.

I didn't insult her!
I did the unnecessary
biopsy like she wanted.

It was negative
like I knew it would be.

What'd you do,
call them perky?

You are years away
from mad skills like that.

I need you to apologize.

Cuddy's only doing this
because she thinks it's you.

Welcome to the world.

Everyone's different,
everyone gets
treated different.

And you try fighting that,
you wind up dying of TB.

What are you doing?

Testing the patient's
autonomic nervous system.

Of course.
His internal heating
and ventilation should be off.

He shouldn't be able to sweat.

That's why he's got
that awful body powder.

Take it away,
crank up the heat,
stick him under the lights,

he can't cool himself.
He should be turning
bright red.

The picture's fine.

SEBASTlAN: Yeah.

I'm askjng Stoja Tucker

to save these lives,
millions of lives,

including my own.

Dr. House,
I would appreciate it
if you left us...

Get that out of my face.
CUDDY: What are you
tryjng to prove, House?

SEBASTlAN: Dr. House,
I would apprecjate jt
jf you left the room whjle...

He's sweating like a pig.

It's 1 00 degrees in here,
House, because you
turned up the thermostat.

Did they hear me?
The media, did they listen?

He's disoriented.
They have to hear me.

His arteries
are clamping down.
I want everybody
out of here now!

Get the crash cart.
He's having a cardiac arrest.

CUDDY: Get it set up.
CAMERON: All right.

Get them out!

Everyone. I want
everyone out of here now!

(BEEPlNG)

Clear.

Come on, Sebastian.

Clear.

I've got sinus rhythm.

(CAMERAS CLlCKlNG)

That js not TB.
Compelling television.

Do whatever tests you want.
I want to treat you for TB.

Dr. Cameron found low sugar
in your cerebrospinal fluid.

It's a classic finding of TB.
Oh, now you think
TB's the problem?

No.

If TB caused
cardiac arrest on a hot day,

your work in Africa would be
even more futile
than it already is.

Can you get
to your point, please?

That whiteboard in my office,
we're up to about
a dozen symptoms now.

Cardiac arrest,
clearly not TB.

CSF sugar clearly is TB.

The rest of them
could go either way.

Unless we know
which ones are which,
I can't diagnose you.

I'll take any other tests
or treatments
you might want to prescribe.

So you're not special,
but TB is.

People die of TB
because we let them.
It's our choice.

People die of malaria
because we let them.
They die of dysentery. They...

No, TB's my disease.
You own a disease?

Well, I'm sorry I missed
the lPO on dengue fever.

Look, I know I have a way
about me, and I know I piss
a lot of people off.

And a whole lot more
I just annoy.

But you're the first person
that I've ever met

who I think is actually
annoyed by what I do.

Do you think
I'm not saving any lives,
or is that a bad thing?

Right now, I'm just trying
to save your life.

Or do you just have
a problem with hope?

You know, the difference
between our jobs
is not numbers or styles.

It's that I know
I'm gonna fail. Even if
I save a million people,

there's gonna be
another million.
You couldn't handle that.

I think you resent
anyone who can.

Can't we just agree
that you're
incredibly annoying?

Take the pills,
or I'll let you die,

do an autopsy,
call my own press conference

and make sure the world knows
that you didn't die of TB.

Corporate sponsors will be
disappointed, but they'll find
another disease.

Why would you do that?

Because I'm just a mean
son of a bitch.

So, we still have to explain
PR variability, syncope,
headaches

and

Iow sugar?

That was classic TB.
Apparently not.

You rerun the test?
Yeah.

This is good.
Good? This is bizarre.

"Bizarre" is good.

"Common" has
hundreds of explanations.
"Bizarre" has hardly any.

What else could cause
low CSF sugar?

I get to ask the questions.

I've found you look a lot
smarter asking questions than
dumbly not answering them.

High insulin levels
in his blood.
They'd have to be very high.

Okay, very high
insulin levels in his blood.

How could he get
high insulin levels?

We've checked
daily blood sugars,
all normal.

See how smart she looks?
'Cause she asked the question.

And it's not glucagonoma
because he has no rash.

It's not self-induced
because he's not an idiot.

And it's not a tumor
because the CT and the MRl
were both negative.

Which just leaves tumor.

Why do you do this?
Why do you ignore what I say
like I'm not even...

Small tumor.
Really, really tiny.

So small we can't see it.

Nesidioblastoma.

An abnormal growth of
the insulin-secreting cells
in his pancreas?

That only intermittently
secrets insulin...
HOUSE: In response to stress,

Iike if, I don't know,
if someone accidentally puts
the mechanical bull on 1 1.

Easily removed by surgery.

Except if it's so small
we can't see it,

how are we even gonna
prove it's there?

She asked, looking clever.

Just start hacking away
at his pancreas
until he gets better?

How do you prove
something exists
when you can't see it?

Does God exist?
Does the wind blow?

We know
because the leaves move.
Look for effects.

You should look
the other way.

There's Cuddy
with your patient.
CUDDY: Dr. House!

Dr. House has an emergency.

We can't avoid her forever.
Eventually she'll die.

You sure she doesn't
have breast cancer?

HOUSE: We think
you have a tumor.

Easily removed surgically.
We're gonna poke it
with a stick.

And if there's no tumor?
Nothing happens.

HOUSE: Splenic artery,
it's a hard left
off the celiac.

If there is a tumor?

What usually happens
when you poke something
with a stick?

Pokes back.

He's stuck in the
superior mesenteric.

I knew we should have
stopped for directions. Men!

I'm there.

We're gonna inject calcium
into your pancreas.

The beta cells
will release insulin.

If there are
too many beta cells
because of a tumor,

your blood sugar
will drop precipitously.

How do we know
it won't go too low?

Fingers and toes crossed.

HOUSE: Go ahead.

Glucose is holding
steady at 75.

No leaves rustling.
Blow harder.
I already gave him one amp.

Well, I guess now would be
the time to give him
more than one amp.

CAMERON: Fifty.
It's starting to drop.

Forty-five.
I think my arm's shaking.

I'm gonna start him
on a glucose drip.
He's gonna seize.

Not yet.

FOREMAN: It's continuing
to drop.
HOUSE: Not fast enough.

CAMERON: He's seizing.
We've got to reverse this.

He's at 40, 38, 35.

(ACCELERATED BEEPlNG)

Push an amp of D50.
You want to kill the guy?

CAMERON: We're back to 40.

Congratulations.
You have a tumor.

Are you gonna go out with him?

Is that any of your business?
Nope.

I don't think so.

Two days ago,
you were holding his hand.
What's changed?

He practically
lives in Africa.
There's no future.

On the other hand,
maybe there's too much
of a future now.

You weren't attracted to him
because he was prepared
to die for a cause.

You were attracted to him
because he was
actually doing it.

Right. It's that simple.
That was simple?

I put a label on him
and go from there.
Everybody does it.

We are
who people think we are.

People think
he's a great doctor,
so they give him stuff.

He is a great doctor.
The reality is irrelevant.

I'll prove it.

People who know me
see me as an ass,
treat me as an ass.

People who don't know me
see a cripple,
treat me like a cripple.

What sort of selfish jerk
wouldn't take advantage
of that fact?

(GROANS)

Oh, my goodness. Are you okay?

Yeah.
I am so sorry.

It was completely my fault.

It's nothing. I'm fine.

Well, I'm very relieved.
I feel terrible.

Please don't worry
about it. I'm fine.
You sure?

Okay.

How's everything?

I'm gonna go.
My foot's killing me.

What did you do to...
It was nothing.
It was all my fault.

Yeah, listen.
Bogale, relax, okay?

I'm gonna be back on Tuesday.

Tell Sarni I'm gonna bring her
a new brace. All right.

Just in case.
You get them?

Six-months' supply.
Should fix you right up.

I'll see you when you
come back for a refill?

Yeah, I'll see you
in two months.

You gonna give them away?

Well, you know how these
things happen. You leave
a bag on the airplane,

you drop some pills
down the drain.

I have an idea.
You could bring me
the refill in Africa.

I don't think so.

You actually like
working for House?
You find this satisfying?

WOMAN: There he is.

It's good to see you.
Dr. Sebastian.
Thank you.

Thank you. I appreciate that.
I appreciate the support.

It's not about the kids
dying every eight seconds.

It's about the media stroking,
adulation, the pats
on the head.

That's your problem
with him, isn't it?

Look at him.
Loves it, eats it up.

Yeah, the man actually
enjoys what he does.

Listen, I saved his life.

That means I get credit
for every life he saves
from here on out.

I'll make sure
Stockholm knows.