House (2004–2012): Season 3, Episode 1 - Meaning - full transcript

Mark? Mark?

Mark, please ask your father
if he wants a burger.

MARK: Mom.
I know. You're defending
the free world.

Please ask your Dad
if he wants a burger.

Dad?

Dad? Mom wants to know
if you want a burger.

Mom, I don't know what
he wants. You ask him.

BOY: Aunt Arlene!

Want a burger?

Okay.

(FEEL GOOD INC PLAYING)



The guy drove his wheelchair
into a pool.
House would love that.

He'll be bored. It's
a great visual, but it's
diagnostically boring.

What about
post-hair-transplant
aphasia guy?

Infection-throwing clots.
House will shoot it down
and call you an idiot.

Oh, well,
we wouldn't want that.

What about yoga girl?

It has a good hook.

Should we lead with it?

His first day back,
he might want to
flex his sarcasm muscle.

Maybe we open with
one of the weaker pitches.

You ran here?

It's just eight miles.

Why did you...

Why does a dog lick
its workplace-acceptable
euphemism



for testicles?
Because he can.

What have you got for me,
boss?

I thought you said
you needed
eight weeks of rehab.

You should have been
back here...
If I'd come back sooner,

then I'd only be
able to run six miles.
I never would have made it in.

What have you got for me?
You're completely pain-free?

The ketamine treatment
can wear off.

It's been two months.
It's not wearing off.

What have you got for me?
You can take as long as...

Why are we having this
discussion? Want to
hear me thank you again?

Thank you, Doctor Cuddy,
not just for removing
the bullet,

but thank you for putting me
into a ketamine-induced coma

and changing my life.
Happy? I am.

Middle-aged man had
hair transplant
about two months ago...

Infection-throwing clots.
You're an idiot.

Except you're not an idiot,

and she is holding a file
for a 26-year-old female.

What have you
really got for me?

Girl was doing
an inverted yoga pose,
neck snapped,

paralyzed from the neck down,

except the x-rays show
no evidence of spinal injury.

And she's cute.

Oh, well played, sir.

What about Stephen Hawking
trying to do
the 500 butterfly?

Forget it. Brain cancer,
brain surgery. There's
nothing left to diagnose.

I would take the other one.

I'll take them both.

You don't think
he had brain cancer?

Of course he had brain cancer.

Even oncologists
don't screw up
for eight years.

So if there's no
diagnostic issue,
why are you taking the case?

Treatment can be interesting.
Not to you.

I've changed.
No, you haven't.

No, I haven't.
So why are you
taking the case?

The guy tried to kill himself.

The guy had cancer.
He's a lump.

He hasn't been able
to touch his wife,
speak to his kids.

He's been in that chair
for eight years.
His muscles have atrophied.

Maybe I can help him
with the pain.

Isn't that enough of a reason
to want to help?

Not for you.
I've changed.

No, you haven't.

Then why am I
taking this case?

Let's start with
the cute paraplegic.
Welcome back.

Hey.
You look...

Healthy.

Quad with no broken neck.
Struck me as odd.

You can take a whole
two minutes
to ease into being back.

I would've taken
a whole month to ease back,

but eight weeks is
the maximum rehab time

for a gunshot wound
to the stomach and neck,
so go.

We heard they never
found the guy.
There's no new leads.

What? You think
he might have
shot this patient, too?

It would explain her symptoms.
It could be MS.

See? It's not so difficult.
It's not MS.

She had no symptoms
before she
climbed onto her head.

Unless she's been upside-down
for the last 10 years,
MS ain't it.

Could be transverse myelitis,
swelling in the disks,
choking off nerve function.

MRI is negative for that.

Your leg looks fine.
Totally pain-free?

When did this turn into,
"What did you do
over your summer vacation?"

It's a little weird to
discuss the case

while you're staring
at your blood on the floor.

I asked Cuddy to
replace the carpet.

I like the carpet.
What did you do
over the summer?

I...
Redo the tests.

Let's see if the source
of the problem is in the limbs
or the spine. Do an EMG.

Whoa, whoa, whoa, whoa, whoa.

We've got a whole other quad
to cover. This guy's still got
fluid in his lungs.

You don't think
that's from the pool he drank?

Give him an O2 mask.
His leg muscles
have atrophied.

Tendons have shortened
from disuse,
causing intense pain.

Tendon surgery
will make him
more comfortable.

Comfortable?

Scoot.

Thanks for being here.

Not a problem.

My Dad wouldn't kill himself.

You haven't spoken to him
in over six years.

I know my dad.
Mark, the doctor's
just trying to...

- He wouldn't kill himself.
- Fine. I'm wrong.

You obviously have
a better understanding of this man

who drools in front of your
TV set 24 hours a day.

Doctor House?

Look, he must have been
confused, all right?
It must have been an accident.

I hope it was
a suicide attempt.

If he was trying to
kill himself, then he knows
how miserable his life is.

It means there's still
something there to kill.

It means your dad's
still there.

Sorry. Need you.

Thank you.

We were doing the EMG, but we
never got past the insertion
of the conduction pin.

Did she just say, "Thank you"?

I loaned her some money.
What went wrong?

Nothing went wrong.

If nothing went wrong,
then something went right.

You're not gonna tell me
why she thanked you?

You're not gonna tell me
what went right?

You did something
for which she is grateful,
and you're embarrassed?

For you. She saw you
coming up, thought you
were a 14 year-old boy.

I set her straight.

I am not telling you
what went wrong or right

until you tell me why
she said, "Thank you. "

Oh, you got me.
You know I need to know.
I am so gonna fold.

Except you're forgetting
there's one thing
I can do now.

It's either that
or a reflex response.

What happened?

Okay.

This is Doctor House.
House, this is Caren...

Pleasure's all mine.
What happened?

When we inserted
the conduction pin,
she flinched.

She flinched? Did you hear?

Does that mean
I'm getting better?

How big is a flinch?
Bigger than a twitch?
Smaller than a spasm?

Do you smoke?
Socially, not a lot.

You do yoga, and you smoke?

I know it's hypocritical,
but...

No, the world sees your legs.
No one's checking out
your lungs.

How would smoking cause...

It wouldn't.
I just needed a lighter.

House.
Oh, my God!

The case was looking
so promising.
Hey, I'm not faking.

You moved,
therefore you can move.

Get this lunatic out of here
before she bores again.

I'm not faking!

I heard you were
watching surgery
with a patient's family,

talking to a patient's family.

It's because of your
hallucination, isn't it?
After you were shot.

You chose life.
You decided
you wanted meaning,

so you took a case
with no mystery,
something any doctor could do,

a case with no upside
except the satisfaction

of helping
another human being.

She thanked me.

And you felt nothing.

I wasn't sure what
I was supposed to feel.

It's like your leg.
It's atrophied. Keep working
it. The feeling will come.

Sorry. Need you again.

I told you to get rid of her.

It's a good thing we didn't.
Tightness in her chest.

She can't breathe.
It could be pleural effusion.

Right. Either that
or she's holding her breath
like a four-year-old.

Relax. I'm not gonna
burn you again.

I'm going to stab you!

Look, either you're faking,
or you've got
a pleural effusion.

That's a buildup of fluid
around the lungs,
which is very serious,

and I would have no choice
but to stab you in the back
with this needle

and suck all of the fluid
out of you.

So...
CAMERON:
We should give her a local.

That would defeat
the point of me being nasty.

Ready?

Down.
She can't breathe
if she's down.

Down.
She can't...

Down, down, down! Come on!

That's not a pleural effusion.

The problem's in her heart.

Can't fake that.

Had to relieve the pressure
three times
in the last two hours,

so either we figure out
what's causing blood to
build up around her heart,

or I follow her around
with a needle
for the rest of her life.

Echo was clean.
No structural abnormalities.

It could be
an infectious process, TB.

Or vasculitis would also
explain the effusion.

But not the paralysis.
Let's assume that
she wasn't faking it.

She moved,
therefore she could move.
She wasn't paralyzed.

Doesn't mean she was faking.
It could have been a delusion.

Now, either she was faking

and coincidentally
got a real cardiac problem

at the exact same time,
or it's a delusion,

and the fake paralysis is
a real neurological symptom.

Are you thinking
vascular tumor on her spine?

Her platelets are normal.

And she's been scanned up
and down. It's all clean.

So open her up and find it.

FOREMAN:
So what do you want us to do?
Just start at her neck

and just keep on cutting down
her spine until we stumble
on something?

That should work.

His heart rate's
a little high.
Should I be worried?

Probably just means
he's still in discomfort
from the surgery.

I'm gonna up his
morphine a little.

You've been so nice to us.

It's the job.

No, I mean, all the other
doctors, all they did was
obsess on the cancer,

the treatment, the damage,
just trying to fix him.

You're the first doctor
that's ever given a damn
about the quality of his life.

His heart rate's come down.
The morphine worked.
I was right.

What a touching moment.
That's why we become doctors,

for these rare moments
when our hearts are warmed...

Would you like to get a drink?

Are you serious,
or are you just trying to
change the subject?

No, I'm serious.

I drink. You drink.
We could do it at the same
time, the same table.

If you eat,
we could do that, too.

I mean, if the answer's no,
that's cool, but...

No, it's just you're just
coming off of surgery,
and you're not yourself yet,

and I work for you,
and even though last year's...

You're smiling.
I'm saying no,
and you're smiling.

Well, don't take it
personally. It's just
'cause you're full of crap.

You have no interest in
going out with me. Maybe you
did, when I couldn't walk,

when I was a sick puppy
that you could nurture
back to health.

Now that I'm healthy,
there's nothing in it for you.

You are not healthy.

Cuddy wants to see you.

You've been back at work
24 hours,

and you're already
playing hide-and-seek
in a woman's spine.

Who won the pool?

There's no tumor.

Her platelets are normal.
The scans didn't...

What's the worst that can
happen? Might paralyze her.
She won't even notice.

Her lawyers might.
You're not doing the surgery.

And lower the morphine
on your other patient.

Fine, I'll lower it
if you let me do the surgery.

What? You want to trade?

We're not swapping
a couple of goats for your
help putting up a barn.

You want something.
I want something.
We compromise.

It's the grownup way
to resolve our differences.

There already is
a mechanism for that,

it's called
the employer-employee
relationship,

I get what I want,
and you don't.

You tried to swap?

Ran a few more tests.
They came back negative.
The surgery's on.

You really don't give a crap,
do you?

Does that make me evil?

Yeah.

The girl's life is at stake.
All we're talking about
with the guy is...

All we're talking about is
the reason you took the case,
to help someone.

Too bad for them.
Too bad for you.

The reason we crave meaning
is because it makes us happy.

The first level
of happiness...

I'm not going away.

WILSON: The fifth level of
happiness involves creation,
changing lives.

HOUSE: The sixth level is
heroin. The seventh level
is you going away.

You're saving lives,
which is tantamount
to creating lives,

but all you're taking away
from this is the game.

You don't have to listen
to them thanking you.

You don't have to change
the cases you take
or even how you handle them.

You just have to know
that you made a difference.

House! You're not...
I'm not an idiot.

Move.
SURGEON: House,
leave her alone.

Close her up.
You want to know why?

The room's no longer sterile.

True, but it's not
the most interesting reason.

HOUSE:
That is not a sexy big toe.

You'd never put that
in your mouth.

What the hell does
that got to do...

I told you it was interesting,
but it gets even better.

Scurvy?

Yeah. Drink.

Like what sailors get
when they don't eat right?

Aye, aye.
Your arms and leg tissues
are choked with blood.

It makes it hard to move.
It also damages your hair
and toenails.

But I'm on this great diet,
lots of protein, lots of...

No vitamin C. Now drink.

Well, thank you.

And thank Doctor House.

You can send him a note.

The nurse changed his
morphine. I thought
you were worried about...

It's just post-op discomfort.
He's ready to go home.

So he won't have any pain?

Eventually.

Thank you.

Everything else
will be the same.

Well, you took away his pain,
and that changes a lot.

Why don't you put him
in some sort of facility,

some place without a pool?

Yeah, I could dump him there,

except he's my husband.

He's my son's father.

Right. Kids need a dad,

someone to play catch with,
talk about girls.

You know, Mark's learning
that you don't have to
abandon someone

just because...
Get a dog.

I'm taking care of him
for the same reason
you helped us.

Because some guy shot you,
and you hallucinated?

I have a responsibility.

So he's just an anchor,
weighing you
and your family down,

sapping your energy, wasting
your life? That's the meaning
you take from this?

I want to take care of him.

You enjoy this?

I can't abandon him.

So you don't want to
take care of him?

Taking care of him
doesn't fulfill you,
make you happy,

but not taking care of him
would make you miserable?

Hmm.

Okay, here we go.

ARLENE: Okay, slowly.

I don't need your help.
I've done this
a million times.

Here, lie him like that.

Do that again.
Make that sound.

What was that?

That was talking.

You guys are lousy doctors.

You were in such a rush
to make the patient
feel better,

you forgot to check
what was wrong.

Yoga girl walked out of here
two hours ago. You fixed her.

Not her. The other guy.
He had brain cancer.

They removed it eight years
ago. His condition's been
the same ever since.

Until last night. He spoke.

What'd he say?

He grunted?

You want us to
dissect eight years

of medical history
with grunting
in the differential?

Sounds good.
Call me when you're done.

You're fabricating a mystery
because you're bored.

I am not bored.

Damn it!

You didn't tell the wife
it was only a grunt?

Of course not.

'Cause then she would never have consented
to a bunch of dangerous tests.

I don't remember
you being this bitchy.

The Vicodin dulled it.
In the sober light of day,
I'm a buzz-kill.

You're giving false hope
to a family
that's been wrecked.

Don't torture them.
Let it go. Tell the wife
it was only a grunt.

Tell her to go home.

I can't let her down
like that.

I pumped her up
with too much false hope.

I stuck that primo!
How rad am I?

FOREMAN:
2002, patient had dry eyes.

Dry eyes plus a grunt.

It all makes sense.
Could be a neurological issue.

I get hay fever,
I put drops in my eyes.
I don't go to a neurologist.

Dry eyes could indicate
an autonomic dysfunction.

It goes on the board.

What about coughing
or boogers?

Should we include boogers?

I'm happy we're doing this.

I'd much rather do this
than lengthen
some guy's tendon.

Patient's headaches increased.
Doc scanned his head,
found a tumor.

You like wasting your time?
I'm learning.

To do what?
Reconsider solved cases

because you don't wanna deal
with the real world?

He's pushing
where there's nothing.

Cameron,
you are an excellent doctor.

You'll get lots of tearful
thank-yous
from grateful patients.

Yeah, aren't I
such a bitch for wanting that?

No, it's not a bad thing,
but it's not why I'm here.

I took this fellowship
to learn from House.

He's teaching you
to be a masochist.

Dry eyes goes on the board.

FOREMAN: In eight years,
the patient experienced
214 symptoms,

many of them repeated.

Any patterns?

Fever plus frequent urination
could mean prostatitis.

Or a urinary-tract infection.

White count was normal.
No infection.

FOREMAN: If you add pain
into the mix, fever,

frequent urination
could indicate
a kidney problem.

I like it.

No, creatinine and BUN
were both normal.

Not the kidney part.
The pain part.

HOUSE: Abdominal pain
plus all that stuff could
equal a pancreatic cyst.

Perfect. You managed to pick
the one symptom he never had,

abdominal pain.

It's the first symptom
on the board, "grunt. "

Grunting isn't pathognomonic
for abdominal pain.

No, the traditional diagnostic
marker is compression
of the diaphragm,

vibration of the larynx,
leading to the audible sound,

"I have a pain in my abdomen. "

Richard's symptoms are culled
from eight years
of medical history.

They're not patterned.
These are random,
individual events over time.

Illnesses have incubation
periods. Do an upper
endoscopic ultrasound.

His throat will collapse.

Muscle degeneration
in his neck won't
tolerate the scope.

It's an automatic trach.
You're talking about him

like he's an invalid.

We were insensitive.

Does he drool? Can he
hold his neck straight?
Does he choke on his food?

His neck's fine.
His throat's
not gonna collapse.

Cameron,
get consent from the wife.

Open.

I need you to swallow.

Sorry about that.

Here we go.

We're passing through
the lower esophageal sphincter

into the antrum
of the stomach.

There's the tail
of the pancreas.

Looks clean.

Moving medially. The body
and the head of the pancreas
look clean.

Get it out. Get it out.

It's stuck.
I can't move it.
His throat's collapsed.

His vitals are all over
the place. We're losing him.

Cutting.

We trached him, endoscopically
removed the probe,
and he's breathing again,

so, all in all, great idea.

Get a look at the pancreas
before the world ended?

It was clean.

Which means,
barring anything else,

meaning you,
he can go home tomorrow.

This man nearly died.
How can you discharge him?

His throat collapsed
because of what we predicted.

You stick something
down someone's throat,

they gag, spasm, which he did.
It took us a half an hour
to get the thing out.

Except our patient's throat
was sedated,

which means the brain
should have sent a signal
not to do anything.

This could be cancer
or some bizarre
neuro-degeneration,

even a new type of vascular...
Stop it. You're enjoying this.

I find it interesting.

It's interesting
only if you're right.

If you're wrong,
we're torturing this guy
to amuse you.

Half hour to remove the probe?

House.

It's not a spasm.

His throat didn't collapse.
It locked down.

The brain is supposed to tell
every muscle in the body
to relax and contract

at the same time.
This muscle was
only contracting,

which means the signal
from the brain
was not getting through.

There are no lesions
on his brain, nothing
to interrupt any orders.

All it takes is one wire down.

You have no evidence
of any wires down.

A few microtumors on
the meninges, and suddenly
you're choking to death.

You want to look at
the lining of his brain?

The amount of contrast
material you need to
pump up there just to see...

He'll bleed into his brain!
No, he won't.

Because that wouldn't be
interesting. You can get
permission this time.

HOUSE: The brain is enclosed
in a sack called the meninges.

Does this mean
the cancer's back?

No. No, no, no.
House.

If we found cancer, it
wouldn't be the original
cancer. It'd be new.

So, what, more surgery,
more radiation.

Might not be the worst thing.

If this isn't just ancient
history, then maybe it's
something we can correct.

Might even get some
brain function back.

He could get better?

No.

But understanding
what you're saying
will be nice.

Maybe you could figure out
ways to communicate.

Thank God he spoke to you.

Mrs. McNeil, the test to do
this is very risky.
He could die.

He's already dead.

FOREMAN.: Chase, go slow.

I've already injected it
into his spinal canal.

Next stop, his brain.

FOREMAN:
Contrast material entering
into the fourth ventricle.

No parenchymal bleeds.

CHASE: Blood pressure's high,
but it's holding.

Meninges are intact.
No bleeding.

Oh, God. Foreman, get in here.

Surgeon repaired the CSF leak.

You're lucky he didn't die.

I'm lucky?
He's the one who didn't die.

We told you he'd hemorrhage.

You told me he'd bleed
into his brain,
not out of his ear.

You've got to drop this.

We're missing something.

We did a dangerous test,
and something bad happened.
That's all this is.

Give me a tour of the brain,
Foreman.
Walk me through the scans.

1998, what happened?

Five-centimeter,
grade-four astrocytoma
between the parietal...

Nothing. Next?
The speck on the superior
temporal region.

It's a re-growth, benign.

The star thingy
next to the Rathke cleft?

Scar tissue from a biopsy.

House, every speck
is not a suspect.

It's years of surgeons
digging around in his head.
Let him go.

Redo every blood test
he's ever had.
Rescan his head.

No.

He's been sick and suffering
for eight years. I'm not gonna
help you make it worse.

I'm not gonna help you
make it interesting.

That's okay.
Foreman's better
at that stuff than you are.

We need five-millimeter cuts
through the occipital
and hypothalamic regions.

No.

How many millimeters?

HOUSE: I can help him.

That's it?
That's your argument?

It seems like a good one.

If I thought for a second
you wanted to help him,
you'd have carte blanche.

You're doing this
because it's fun.

Does nobody in this hospital

have anything better
to talk about than my motives?

My motives have nothing
to do with the case.

Your motives have everything
to do with your judgment.

For the first time in years,
I got no opiates in my body.

Now you question my judgment?

Twenty-four times a year,
you come storming
into my office,

spouting that you can help
someone, only you never say
those words.

You say something like,

"His pancreas is gonna explode
because his brain is on fire. "

You come here with medicine,
not with platitudes.

I didn't wanna bore you
with the details.

There are no details.
You have a hunch.

House, you don't use hunches.
You always have reasons.

This hospital doesn't exist
for your whims. I'm sorry.

As of 7:00 a. m.
Tomorrow morning,
I'm sending your patient home.

The answer's no.

Cuddy called 30 seconds
after you left and said
you'd try an end-around.

My leg hurt.

How bad?

Enough that I'm telling you.

Did it go away?

Ached for a while.

First time I've felt anything
there since the surgery.

But it went away?

It was muscular.
There was some cramping.

What are you smiling about?

You're 40-something years old.

You've been running
God knows
how many miles a day,

fallen a hundred times off
that skateboard, and you're
shocked to have some soreness?

Just give me a prescription.

For Vicodin?

House, people get
aching joints, cramps.

They put on an ice pack.
They take some ibuprofen.

I know what the pangs
of middle age feel like.

No, you don't
because you've been
stuffing Vicodin

every five minutes
since you turned middle-aged.

The surgery didn't work.

Don't play me.

You think this is a scam?

I think you want me
to feel sorry for you

and either do the end-around
on Cuddy
or give you the drugs.

Either way, you get the high
you think you need.

House, your surgery worked.
You're fine. It's just gonna
take time for it to feel good.

Circumventricular system
senses cytokines

released in the early stages
of the immune response,

but CVOS releases
prostaglandins

that reset the hypothalamic
set point upward

unless it's countered by
antipyretic therapy, so,
yeah, his brain is on fire.

The suicide attempt
was not a suicide attempt.

He drove that wheelchair
into the pool

because he couldn't regulate
his body temperature.

He had a hypothalamic
dysregulation.

And you discovered this
when you stepped into
the university pool?

Fountain. I can cure him.

Cure him!

Even if the fountain
proved anything,

fixing hypothalamic
dysregulation isn't
gonna regenerate brain.

No, but if the scar tissue
on his hypothalamus

is resting against
the pituitary,

the adrenals would shut down.
Addison's disease.

You didn't see any scar tissue
on his MRI, his CT scans...

His brain is functional.
His temperature's normal.

There is nothing wrong
with his hypothalamus
or his pituitary!

I can make him walk.
I can make him talk.
This is a wild guess

that came to you
because you were sweating.

Inject him with cortisol.
The guy will have
sex with his wife again.

He'll hug his kid again.
Hopefully, that's
the combination he was using.

It'd be a shame
if I had cured a pedophile.

You're smiling.
That's a bad sign.

You're high.

I told you,
I haven't had anything
in three months.

This is as high as you get,

a theory that ties
your case up
in a neat little bow,

but you don't have
a lick of
substantiating proof.

Your decision doesn't make
any sense. There is no risk
to a cortisol injection.

If I'm wrong, big deal.

He goes home a vegetable
like he already is,
but if I'm right...

This is not about downsides
or risk management.

It is a big deal
for you to understand
the word "No. "

I'm sorry, House.

He's on his way out of here.

I figured you'd be
on your scooter,
racing down the halls

to stab the patient
in the neck with cortisol.

She was right to say no.

I had no objective reason
to think that I was right.

Just needed the puzzle.

Hold on a sec.

Is everything all right?

Yeah, it's just
something I forgot.

What's that?

This is cortisol,
and it's to fight infection.

Want to hold onto that?
Let's put a bandage on it.

Is he okay?

Yes.

Can we go now?

You can go.

Excuse me.

Richard. Richard.

Dad, you okay?

Richard? Richard! Richard!

Richard!

Richard.

Richard, you're standing.

Thank you.

CUDDY.: He got up.

I have to go tell House.

No. Cuddy, you can't tell him.

I have to tell him.
He was right.

Why did you do it?
Why did you think
he might be right?

Because he's House.

Medically, what made you think
he was right?

Nothing.
He got lucky.
That's all that happened.

Telling him no
was a good thing

because next time,
he won't get lucky.
He'll kill someone.

Just because he was right
doesn't mean he wasn't wrong.

I see him every day.
I can't just...

Everybody lies.

(CAN'T ALWAYS GET
WHAT YOU WANT PLAYING)