House (2004–2012): Season 3, Episode 24 - Human Error - full transcript
A couple risk their lives getting from Cuba to see House, but his preoccupation with staff issues may cost the woman her life.
(HELICOPTER WHIRRING)
(ALARM BEEPING)
Coming up to 50 feet.
Roger that.
We're light on fuel.
Two minutes to bingo.
(MOANING)
Come on, Fisher,
we got places to go, people to see.
Working on it!
So I've heard.
What's taking so long?
SOWINSKI:
Let go of the suitcase!
Let go of the suitcase!
You're gonna have
to hold on to me!
(SPEAKING SPANISH)
Sir, whatever it is,
it's not worth it!
We're at bingo fuel, sir.
You hear that, Fisher?
Bingo!
Either reel him in
or we're leaving them both here!
Okay, sir.
Ditch the damn luggage!
(SPEAKING SPANISH)
(COUGHING)
Marina.
Marina! Marina!
(SPEAKING SPANISH)
Tell him if he was so worried
about his wife's clothes,
he should have
stayed in Cuba!
He says it wasn't her clothes,
it was her medical records.
Says she's sick
and needs to go home.
No home, House!
I need to see Dr. House!
(PHONE RINGING)
(VIBRATING)
You don't answer
your phone anymore.
I'm world-famous now.
Press won't leave me alone.
- It's Cuddy.
- I know.
If it was the press,
I'd be answering.
And since you're not
taking her calls, I am.
Your patient's been
waiting for hours.
She didn't book
an appointment.
No, she risked her life.
If you don't
reach terra firma,
you don't get
any milk or honey.
The woman has 10
different things wrong with her,
including pains
all over her body.
Admittedly,
not as interesting
as staring uselessly
at Foreman.
You know why I find
a goodbye party fascinating?
I think it's kind of insulting to
celebrate when someone leaves you.
- What are you gonna do to keep him?
- Nothing.
He really is gonna leave.
You know that, right?
- Yeah.
- So what are you gonna do?
Nothing I can do.
He doesn't want more money,
better working conditions,
doesn't even
want a better job.
He wants to not be me.
Because he thinks
you're a cold-hearted bastard
without any regard
for anyone but yourself.
He's right.
You need to show him
that you really do care.
Don't!
Foreman's not the only
chocolate-covered cherry in the box.
House, you play a guitar
you got in ninth grade.
Eighth.
You're living in
the same apartment for 15 years,
you drive a 10 year-old car,
you are not good with change.
That used to be true,
but I changed.
He's not afraid to be you, he's afraid
to be who he thinks you are.
CHASE: Rheumatic fever
would explain the skin rash.
CAMERON: But not the double
vision or bloody urine.
They were lost
at sea for three days.
Severe dehydration
causes kidney problems.
And the double vision?
Concussion
during the shipwreck.
It all fits as long as each symptom
started when you think it started.
This would be a lot easier
if we had her medical records.
Any of you
certified deep-sea divers?
She's from a dirt-poor
country in the tropics.
Infectious disease and parasites
are the most likely cause
of unexplained pain, fever and skin
rash. We might as well start there.
If there's one thing
Castro knows,
it's how to look
great in green.
And if there are two
things Castro knows,
it's how to look great
in green and train doctors.
Even without
the medical records,
we can assume she was
drowned in antibiotics
before she risked
drowning to see me.
So what doesn't Castro know?
How to lay his hands on
high-tech scanning equipment.
Pain, double vision
point us toward the head.
Cameron, get an MRI. See what's cooking
in the old cabeza.
Chase,
check out the husband.
Why? He hasn't
complained of any pain.
Basic math. Take all of her symptoms,
subtract his sea symptoms,
the remainder equals
her original symptoms.
(ESTEBAN COUGHS)
CHASE: Are you in any pain?
No, I'm just sunburned.
Any blurred vision?
No.
So my wife,
she is with Dr. House?
She's with another doctor
who is part of Dr. House's team.
No, she's supposed to
see Dr. House.
We have permission.
That's the way it
works with Dr. House.
I came 1,000 miles
to see him!
He doesn't care.
I'm sorry,
but that's who he is,
that's who you
risked your life to see.
And you made
the right choice.
Any other metal?
Must have been
difficult on the boat.
When the storm came,
yes, very much.
I pray while my husband,
he...
(SPEAKING SPANISH)
With the paddles?
You were on a boat
without a motor?
No, no,
we start with a motor,
but it break on
the first night.
My husband,
he can fix anything.
A washing machine,
a car, a computer.
But that is stupid motor.
And me.
These two he cannot fix.
He got you to us.
He never gave up.
No matter what happen,
he kept saying to me,
"Don't worry,
"we will make it.
"I'll take care of you."
That's Esteban.
He refuses to worry or pray.
He believe
if you don't have one,
that you don't
need the other.
CHASE: Husband has a pulled
muscle in his shoulder,
but no other pains
or double vision.
He does have a fever, fungal rash,
cough, and elevated bilirubin.
Foreman's not going anywhere.
- He said that to you?
- He doesn't really wanna leave.
And you don't
really wanna let him.
You'll cave, just like
you did with Cameron.
Foreman's not
as easy as Cameron.
But, of course, who is?
I'm in the room.
He may not want a date,
but he does want something.
Well, maybe it's
something I can't offer.
Then you'll just lie.
- He'd see through it.
- Maybe.
Or maybe he'll just see
what he wants to see.
(DOOR OPENING)
She has MS.
Explains the pain, fatigue,
double vision,
kidney problems.
The kidney problems
aren't connected.
Her husband
has the same issues.
It is possible for
two people to have
the same symptom
for two different reasons.
If we're gonna
take that approach,
then we may as
well just throw out
everything we got
from the husband and start over.
We could do that, or we could do
something productive.
Start her on
Interferon for the MS,
see if she improves.
I do like being productive.
Well done. Do it.
"Well done"? Is that what you think
he wants, a pat on the head?
Go do your job.
She does not have MS.
FOREMAN: I know it's not a pleasant
diagnosis to hear...
But, no! The doctors in Cuba
would have found MS.
(BEEPING)
What's that?
It's all right.
Her pulse ox just came off.
Marina, you can't...
But it hurts.
Her pain is getting worse!
Your treatment isn't working
because it's not MS.
Does this hurt?
(SCREAMS)
Wow! Well, either Foreman's way
stronger than he thinks he is or...
Seriously. Or?
She's too young for
osteoporosis that severe.
And too old for
osteogenesis imperfecta.
- Which leaves bone cancer.
- Cancer's a long shot.
HOUSE: Why? Because metastatic
tumors don't explain the abnormal MRI,
kidney damage, cotton mouth,
double vision.
Oh, wait, they do!
Infection could
do all that, too.
It's not an infection.
Because you know the nonexistent
medical records confirm
that the brilliant doctors
in Cuba treated her for infection,
or because you're trying to
kiss up to Foreman?
Because an infection
would cause a fever,
and the brilliant doctors
who work in my office
have already crossed that off the list
because the husband...
You're the one who said
it's possible for two people
to have the same symptom
for two different reasons.
And you're the one
who said if we do that,
we might as well throw out everything
we got from the husband.
Right, and then you said we should
do something productive
like breaking her arm?
Foreman didn't break her arm.
- Of course he didn't.
- Cancer did.
Put her in a PET scan,
see what else it's breaking.
This isn't gonna work!
He's not a moron!
You can't just agree with
everything he says for two days
and hope he forgets the last three years
and how much he hates you!
Anything else?
When you get the results
of the PET scan, let me know.
I don't really care
if Foreman stays or goes, but...
You're fired.
(MUMBLES)
What,
because I yelled at you?
Because you've
been here the longest,
learned all you can or
you haven't learned anything at all.
Either way,
it's time for a change.
Fine.
FOREMAN:
No tumors in her arm.
Synovial membrane
is working fine.
No hot spots,
no bone cancer.
Maybe we should be
looking for something else.
Is it raining out?
- House fired me.
- What?
Because you yelled at him?
"Time for a change"
was the official explanation.
It makes no sense.
Since when does
House make sense?
He always makes sense.
He's MISTY-
Yes, it's all about you,
Foreman.
He's upset you're leaving,
so he fires Chase.
Excuse me.
On the humerus,
she's got a hot spot.
Why'd you fire Chase?
Sure thing.
First you tell me
the results of the PET scan.
Did you fire him for me?
Would you stay if I did?
You asked him to fire Chase?
' No!
' Yes!
You're frustrated with Foreman
so you lash out,
kick the dog?
He's not gone five minutes
and the name-calling starts.
What's on the PET scan?
Why'd you fire Chase?
Do you know
what's on the PET scan?
You two, out.
Wait!
What's on the PET scan?
You can't dump
your entire department
just because you don't know
how to deal with an issue.
Yes,
they are all irreplaceable.
If only in this country
we'd figure out a way
to somehow teach people
to interpret PET scans.
What the hell's wrong with you?
You fired Chase?
I don't suppose you know
what's on my patient's PET scan.
I told you to show Foreman
you have a heart.
How does that translate
into you being a bastard?
So that's a no.
Pick up the phone
and tell Chase you made a mistake.
Un-fire him.
Chase, if you know what's on
the PET scan, call me back.
Cut the crap.
Chase is a good doctor.
Sorry,
you're in the wrong room.
My name on the door,
my team, my decisions.
My building,
my floor, my people.
(PHONE RINGING)
Hold that reprimand. House.
Dr. Chase! How are you?
Thank you.
You are indispensable.
You're still fired. Sorry.
Wow, that was awkward.
PET scan revealed
a blood clot in my patient's arm.
Which means goodbye.
Still got two people
working for me,
gotta get one of them
to do my job.
A clot means a heart problem.
We have to do
an emergency angiogram.
But you're not sure
it's a blood clot?
PET scan can't determine
that with certainty.
So you have no better idea what's wrong
with her than when we first got here?
- We've ruled out MS.
- I told you it wasn't MS.
Where is Dr. House?
Dr. House has
left for the night.
He'll be here in the morning
to review the results,
if you sign the consent.
But, you know,
you could call him at home.
He doesn't always pick up,
so keep calling.
Thank you.
(RINGING)
ESTEBAN: Dr. House,
it's Esteban Hernandez again.
As soon as you get home,
it's very important you call me.
(PHONE RINGING)
Hello, yes, Dr. House,
it's Esteban Hernandez.
As soon as you get home,
if you can please call me?
The catheter is in
her femoral artery.
Why are you telling me that?
Because you're assisting.
Do I look like I'm assisting?
I had nothing to do
with Chase's termination.
MARINA: ls everything okay?
You're doing fine, Marina.
The dye will take a minute
to work its way through your system.
Why would you tell House
you're leaving because he's a jerk?
Because it's the truth.
Did you give
an angry Cuban my home number?
Why would you do that?
You're not turning into House,
you're worse than him.
Let me get this straight.
Instead of picking up the phone
and talking to
a patient for five minutes,
you gave up on sleep
and drove in here.
My Chest!
(BEEPING)
She's in V-Tach.
- What did you do?
- Nothing!
Must have hit something.
You nick an artery?
She has no pulse.
It hurts.
She has no pulse,
but she's talking.
Cough! Cough again!
Keep coughing!
It'll push blood into your head,
keep you conscious.
Push one
milligram Epinephrine.
Will that help?
No. But it is amazingly cool.
We need to get her on bypass!
We need to keep her here.
If this was a clot,
the force of bypass
will blow it into
her brain, kill her.
If we continue CPR,
she'll lose blood flow,
which will
cause brain damage.
What caused
the heart to stop?
Let's assume
it wasn't human error.
I didn't nick an artery,
it just stopped.
I said let's assume.
The only other option
is electrical instability.
No ST segment changes.
We need to tell the husband.
Tell him what?
We have no idea what happened.
House?
Keep going until
I figure this out.
House!
Jeez.
At 47, I hope my colon looks
better than this guy's.
Isolating
the first transverse...
Help! I'm trapped
inside a monitor!
Not a good time, House.
My patient lost her heartbeat during
routine cardiac catheterization, so...
- Human error.
- It's not human error.
Electrical instability?
Pre-procedure EKG was normal,
no syncope.
Ischemia?
Foreman said no
ST segment changes.
Human error is
the only other possible...
It's not human error.
Of course it's human error!
You don't want Foreman
to have made a mistake
because then
you'd have to mock him.
And that would put a crimp
in your brilliant plan of keeping him
by having a breakdown
and firing Chase.
Did you just
spit on the monitor?
You know I can't see you.
Human error would not
explain her symptoms.
You mean her heart stopping?
I mean her foot pain,
her back pain.
House! I'm busy!
You have a team,
run your differential
with them.
Foreman and Cameron
are doing CPR.
Then you shouldn't
have fired Chase.
Change is fun, huh?
- Five, six, seven, eight!
- Go!
Someone's gotta
talk to the husband.
He thought this whole thing
was gonna last 45 minutes!
A half hour more of this,
nothing to talk about,
we won't be able to bring her back.
We gotta get her on bypass.
House still isn't
answering his phone.
You, get in here.
Go!
Excuse me, my wife was supposed
to be back an hour ago...
As soon as we know anything,
we'll call you.
Thank you.
Human Behavior finals
will also get into
clinical presentations
of mania,
and we'll touch on
Stanislas Dehaene's PET scans.
Excuse me, Professor.
House, when we're
done with our rounds...
My patient
has no heartbeat.
Stopped when we inserted a catheter
during a routine angiogram.
Anyone tells me
why her heart stopped
gets an A in
Dr. Cuddy's class.
Anyone?
Human error?
Yeah. I'm polling
first-year medical students
because I hadn't
considered human error.
Marian Syndrome?
Structural abnormalities
would show up on the echo.
You get a C. Yeah?
Botox injections.
F-
If the injection was tainted
with live botulism, it'd fit.
B-plus.
Unfortunately, she missed
her last Botox appointment
due to a boating accident,
but send me your résumé.
House, time's up.
Good Lord,
you smell like musk ox.
Either our patient goes on bypass,
or I call time of death.
Your patient isn't
already on bypass?
I was worried about a clot.
- How long?
- Three hours.
House. Bypass, now!
NURSE: Clear the hall!
MAN: Out of the way, please!
Let's go! Excuse us!
Dr. Foreman! My wife!
What has happened?
Her heart stopped.
We have to get her on bypass.
He needs to wait outside.
Got it?
Dr. House.
You can vacuum later.
I am not the janitor,
I am Esteban Hernandez.
What happened to my wife?
Her heart stopped.
Why did her heart stop?
Well, if I knew that,
I'd be coming to you.
Tell me where you take her.
Tell me
what is happen to her?
"Happening."
It's a present participle.
Not a particularly
interesting form of speech.
Kind of like
this conversation.
But I risk my life
to see you.
I looked you up.
You fix people.
When everyone else
gives up, you don't!
And now you insult me?
Ignore my wife?
Helps my process.
You do not ignore my wife,
okay?
She is everything to me.
Well, then you do
not ignore your wife.
You just sit here!
You don't talk to people.
How do you fix something
if you don't look at it?
GOODING:
Turn on bypass, please.
Good. Good distal flow.
Need to look
at the heart.
Why?
I can't find my wallet.
Pick it up. Turn it over.
I don't see anything
physically wrong with her heart.
Hearts don't
stop for no reason.
Okay.
Take your look.
You see anything wrong?
Give her a jump-start.
Clear. Clear.
Clear.
And again.
Clear! Clear! Clear!
Again.
Yeah, seventh time
is the charm. Sorry.
I'll keep her on bypass until the
husband has a chance to say goodbye.
I'm not telling
the husband anything
until I can
tell him why his...
it doesn't matter.
Her heart can't start.
She's dead.
I got you something.
I'll miss you.
I know you won't miss me,
but...
I just thought it would be nice
for you to have that.
I will miss you.
Can I have a hug, too?
The surgeon found nothing.
He can't start her heart.
What a thoughtful gift.
Nice reminder
of intellectual theft
to hang at your new
place of employment.
You two can go.
Say hi to Chase for me.
You're wearing lipstick.
We can stay. We can run
another differential.
You two have no theories
about why the heart stopped,
which means I don't need you.
Go.
It's too late for theories.
We need to tell the husband.
- Tell him what?
- That it's over.
- Why?
- Because her heart won't start!
How can we tell him
there's no hope
if we don't know
why there's no hope?
He's not gonna pull
the plug on his wife.
He risked his life
to get her to me.
If he pulls the plug,
it means he's failed.
If he pulls the plug,
it means you've failed.
And you're okay with that?
Go.
(PEOPLE CHATTERING)
- Hey-
- Hey-
You look great.
You know House firing you
has nothing to do with you.
The why doesn't matter.
Foreman will end up staying,
House will call you,
probably yell at you
for not showing up.
It's okay.
He's right.
It's time for a change.
You were right, too.
The whole "it's Tuesday,
I like you." It was silly.
Oh, don't give me that look.
Don't feel sorry for me.
Getting this job was the best thing
that has ever happened to me.
Everything about it.
And losing it?
Well, I think it's
gonna be good, too.
I'll miss you.
Have you got time for
a drink or something?
I think I should go.
Yeah.
CUDDY: How's it going?
The way the security
light hits your legs,
looks good.
Thank you.
If you're here
to yell at me about
the Foreman-Chase situation,
it can wait.
When do you plan
on telling the husband
it's time to say
goodbye to his wife?
Haven't put a clock on it.
Other than your curiosity, do you have
any reason to keep her on bypass?
Patient's husband
prefers her not dead.
Or you want
a storybook ending
for the young man who
crossed the ocean for his wife.
This is not an act.
- I don't care.
- Then pull the plug!
What if I can fix it,
but I just don't know it yet?
I know you care.
I don't care!
I really don't care.
My motives are pure.
If we do an autopsy
and we see, "Oops,
"if I'd thought of that crazy idea,
we could have saved her,"
then the husband
might be upset.
You've done all you can do.
It's time to let go.
I was told
you didn't believe in God.
I don't.
I promise my wife I'll do everything
I can to fix her.
If I don't pray,
then I don't do everything.
It's not working.
She's not coming back.
If you want to say goodbye,
you can come down to the ICU,
and then I'll take her
off bypass.
I'm sorry. I should have...
Marina, I am so sorry.
When you turn
the machine off, that's it?
Yeah.
Right now,
is her brain working?
Probably.
Just not her heart.
She seems like
she's just sleeping.
She's not sleeping.
We double-checked.
(SPEAKING SPANISH)
Her heart? It beat?
No, it's residual
flow from the bypass.
No, I can feel it. Look!
That is her heart, no?
P wave, Q, R, S, T wave.
That's a normal normal.
Esteban?
Marina!
Holy crap.
Is this heaven?
No, it's New Jersey.
God sent you back to me.
It's a miracle.
HOUSE: It's impossible.
CAMERON: Apparently not.
Live hearts don't
stop for no reason.
Dead hearts don't
start for no reason.
Apparently they do.
She's three hours off bypass
and still stable.
And the pain is gone.
No, it's not.
You think she's lying
about feeling better?
Just because it's not there now
doesn't mean it's gone.
Just because
it was there before
doesn't mean
it's coming back.
Chase was probably right.
She had some sort
of tropical infection
that cleared when we put her on
antibiotics during the bypass.
Antibiotics did not
bring her back to life.
Other than a miracle,
it's the only explanation
for her symptoms.
How come God gets credit
whenever something good happens?
Where was he
when her heart stopped?
What if it wasn't human error?
What if it was God's error?
A congenital defect in an artery making
it susceptible to inflammation.
We need to do
another angiogram.
We've looked at her heart 100 different
ways. There was no evidence...
The one time we
looked inside her heart,
we stopped before
we could see anything.
Because it stopped.
Good news.
I think we know
what the problem is.
You mean "was."
Hey, it's my first language,
not yours.
If she wants to outlive Castro,
we need to fix her heart.
(SPEAKING SPANISH)
In case
no one's filled you in,
today is Monday,
which means you've been dead for a day.
If that kind of
symptom comes back, it can get serious.
I need to do
another angiogram.
Wait. Wasn't that what caused
her heart to stop before?
No, God caused that.
He's all-powerful, you know.
(SPEAKING SPANISH)
He was watching
over us in the ocean
and he's watching
over us now.
Your rescuers didn't have wings,
they had a helicopter.
Esteban prayed.
Do you know how many little boys
are praying forjetpacks?
How many priests
are praying for...
Well,
that one actually works.
You didn't bring me
back to him.
And I'm not gonna
take you away from him,
but if we don't do
this test, God will.
You said there was no chance,
no hope, which means...
Which means I was wrong.
But I'm wrong all the time.
My mistakes don't
prove there's a God.
You came a long way
to see me.
You gonna put her life
in God's hands or in mine?
Ready?
I better not
see you praying.
I don't want to have
to fight for credit on this.
Exiting the femoral,
entering the aortic arch.
This is where...
Where we stopped to
have a picnic last week.
Her blood pressure's rising!
Mine's rising, too. Of course,
I am doing battle with a deity.
In the heart.
Injecting the dye.
Right coronary flow is unobstructed.
Left coronary flow looks normal.
Looks like you're wrong.
Either I'm right or this test
is about to go very bad.
What's that?
She has one, two,
a third ostium!
How many is she
supposed to have? Dos.
All the third one's doing is causing
inflammation, throwing off clots,
getting in the way
of the angiogram.
No human would
screw up that big.
Don't worry.
Just one more surgery,
it'll be fine.
Thank God!
Don't make me slap you!
Hi.
It's Tuesday.
No, it's Monday.
I know, I just...
I didn't feel like waiting.
(DOOR OPENING)
I hear you got
another satisfied customer.
One more and I get
a set of steak knives.
Well, this is it.
I appreciate
the opportunity you gave me.
Didn't do it for you.
Thought you were
the best guy for the job.
Thanks, I guess.
Which is why
I want you to stay.
You're an important part
of the team.
I need you.
I know.
But I don't need you.
And I definitely
don't wanna be you.
You're miserable.
I just solved
a case by predicting
a never-before-seen
heart defect.
A case you couldn't solve.
A case you gave up on.
I couldn't be happier.
For two minutes, maybe.
Until the next case
comes along.
Until you're jonesing
for your next fix.
This woman talks while
in full cardiac arrest
and you're more excited
about the talking than the heart dying!
The two were connected.
I don't wanna solve cases.
I wanna save lives.
Do you think she cares?
Do you think
the husband cares?
You think the children
she can now have
because of me are gonna care
why I saved her?
- I care.
- About yourself!
- About your own ego!
- House.
You're the selfish bastard,
not me,
which is why you took
so much pleasure in drawing out
this little goodbye of yours
for the last three weeks.
It wasn't for me,
it wasn't for anyone!
It sure as hell
didn't help anyone!
Nice try.
Nice tries are worthless.
You now have
a bigger office than I do.
Why don't you go enjoy it?
Better be naked pictures.
My resignation letter.
I've gotten
all I can from this job.
What do you expect me to do?
Break down and apologize?
Beg Chase to come back?
No.
I expect you to do
what you always do.
I expect you to
make a joke and go on.
I expect you to be just fine.
I'll miss you.
Genuine American cigars.
You guys can't
get them in Cuba.
100% healthy.
Shouldn't you go home?
Patient follow-u p.
Very important.
She looks great.
I think she's sleeping.
She is sleeping,
I double-check.
So, they all quit?
Two of them quit.
I fired the third.
It must be very hard
to lose your people.
You must be very upset.
Yeah, I must be.
But you're not?
I don't think I am.
I think I'm okay.
What are you going to do?
God only knows.
(ALARM BEEPING)
Coming up to 50 feet.
Roger that.
We're light on fuel.
Two minutes to bingo.
(MOANING)
Come on, Fisher,
we got places to go, people to see.
Working on it!
So I've heard.
What's taking so long?
SOWINSKI:
Let go of the suitcase!
Let go of the suitcase!
You're gonna have
to hold on to me!
(SPEAKING SPANISH)
Sir, whatever it is,
it's not worth it!
We're at bingo fuel, sir.
You hear that, Fisher?
Bingo!
Either reel him in
or we're leaving them both here!
Okay, sir.
Ditch the damn luggage!
(SPEAKING SPANISH)
(COUGHING)
Marina.
Marina! Marina!
(SPEAKING SPANISH)
Tell him if he was so worried
about his wife's clothes,
he should have
stayed in Cuba!
He says it wasn't her clothes,
it was her medical records.
Says she's sick
and needs to go home.
No home, House!
I need to see Dr. House!
(PHONE RINGING)
(VIBRATING)
You don't answer
your phone anymore.
I'm world-famous now.
Press won't leave me alone.
- It's Cuddy.
- I know.
If it was the press,
I'd be answering.
And since you're not
taking her calls, I am.
Your patient's been
waiting for hours.
She didn't book
an appointment.
No, she risked her life.
If you don't
reach terra firma,
you don't get
any milk or honey.
The woman has 10
different things wrong with her,
including pains
all over her body.
Admittedly,
not as interesting
as staring uselessly
at Foreman.
You know why I find
a goodbye party fascinating?
I think it's kind of insulting to
celebrate when someone leaves you.
- What are you gonna do to keep him?
- Nothing.
He really is gonna leave.
You know that, right?
- Yeah.
- So what are you gonna do?
Nothing I can do.
He doesn't want more money,
better working conditions,
doesn't even
want a better job.
He wants to not be me.
Because he thinks
you're a cold-hearted bastard
without any regard
for anyone but yourself.
He's right.
You need to show him
that you really do care.
Don't!
Foreman's not the only
chocolate-covered cherry in the box.
House, you play a guitar
you got in ninth grade.
Eighth.
You're living in
the same apartment for 15 years,
you drive a 10 year-old car,
you are not good with change.
That used to be true,
but I changed.
He's not afraid to be you, he's afraid
to be who he thinks you are.
CHASE: Rheumatic fever
would explain the skin rash.
CAMERON: But not the double
vision or bloody urine.
They were lost
at sea for three days.
Severe dehydration
causes kidney problems.
And the double vision?
Concussion
during the shipwreck.
It all fits as long as each symptom
started when you think it started.
This would be a lot easier
if we had her medical records.
Any of you
certified deep-sea divers?
She's from a dirt-poor
country in the tropics.
Infectious disease and parasites
are the most likely cause
of unexplained pain, fever and skin
rash. We might as well start there.
If there's one thing
Castro knows,
it's how to look
great in green.
And if there are two
things Castro knows,
it's how to look great
in green and train doctors.
Even without
the medical records,
we can assume she was
drowned in antibiotics
before she risked
drowning to see me.
So what doesn't Castro know?
How to lay his hands on
high-tech scanning equipment.
Pain, double vision
point us toward the head.
Cameron, get an MRI. See what's cooking
in the old cabeza.
Chase,
check out the husband.
Why? He hasn't
complained of any pain.
Basic math. Take all of her symptoms,
subtract his sea symptoms,
the remainder equals
her original symptoms.
(ESTEBAN COUGHS)
CHASE: Are you in any pain?
No, I'm just sunburned.
Any blurred vision?
No.
So my wife,
she is with Dr. House?
She's with another doctor
who is part of Dr. House's team.
No, she's supposed to
see Dr. House.
We have permission.
That's the way it
works with Dr. House.
I came 1,000 miles
to see him!
He doesn't care.
I'm sorry,
but that's who he is,
that's who you
risked your life to see.
And you made
the right choice.
Any other metal?
Must have been
difficult on the boat.
When the storm came,
yes, very much.
I pray while my husband,
he...
(SPEAKING SPANISH)
With the paddles?
You were on a boat
without a motor?
No, no,
we start with a motor,
but it break on
the first night.
My husband,
he can fix anything.
A washing machine,
a car, a computer.
But that is stupid motor.
And me.
These two he cannot fix.
He got you to us.
He never gave up.
No matter what happen,
he kept saying to me,
"Don't worry,
"we will make it.
"I'll take care of you."
That's Esteban.
He refuses to worry or pray.
He believe
if you don't have one,
that you don't
need the other.
CHASE: Husband has a pulled
muscle in his shoulder,
but no other pains
or double vision.
He does have a fever, fungal rash,
cough, and elevated bilirubin.
Foreman's not going anywhere.
- He said that to you?
- He doesn't really wanna leave.
And you don't
really wanna let him.
You'll cave, just like
you did with Cameron.
Foreman's not
as easy as Cameron.
But, of course, who is?
I'm in the room.
He may not want a date,
but he does want something.
Well, maybe it's
something I can't offer.
Then you'll just lie.
- He'd see through it.
- Maybe.
Or maybe he'll just see
what he wants to see.
(DOOR OPENING)
She has MS.
Explains the pain, fatigue,
double vision,
kidney problems.
The kidney problems
aren't connected.
Her husband
has the same issues.
It is possible for
two people to have
the same symptom
for two different reasons.
If we're gonna
take that approach,
then we may as
well just throw out
everything we got
from the husband and start over.
We could do that, or we could do
something productive.
Start her on
Interferon for the MS,
see if she improves.
I do like being productive.
Well done. Do it.
"Well done"? Is that what you think
he wants, a pat on the head?
Go do your job.
She does not have MS.
FOREMAN: I know it's not a pleasant
diagnosis to hear...
But, no! The doctors in Cuba
would have found MS.
(BEEPING)
What's that?
It's all right.
Her pulse ox just came off.
Marina, you can't...
But it hurts.
Her pain is getting worse!
Your treatment isn't working
because it's not MS.
Does this hurt?
(SCREAMS)
Wow! Well, either Foreman's way
stronger than he thinks he is or...
Seriously. Or?
She's too young for
osteoporosis that severe.
And too old for
osteogenesis imperfecta.
- Which leaves bone cancer.
- Cancer's a long shot.
HOUSE: Why? Because metastatic
tumors don't explain the abnormal MRI,
kidney damage, cotton mouth,
double vision.
Oh, wait, they do!
Infection could
do all that, too.
It's not an infection.
Because you know the nonexistent
medical records confirm
that the brilliant doctors
in Cuba treated her for infection,
or because you're trying to
kiss up to Foreman?
Because an infection
would cause a fever,
and the brilliant doctors
who work in my office
have already crossed that off the list
because the husband...
You're the one who said
it's possible for two people
to have the same symptom
for two different reasons.
And you're the one
who said if we do that,
we might as well throw out everything
we got from the husband.
Right, and then you said we should
do something productive
like breaking her arm?
Foreman didn't break her arm.
- Of course he didn't.
- Cancer did.
Put her in a PET scan,
see what else it's breaking.
This isn't gonna work!
He's not a moron!
You can't just agree with
everything he says for two days
and hope he forgets the last three years
and how much he hates you!
Anything else?
When you get the results
of the PET scan, let me know.
I don't really care
if Foreman stays or goes, but...
You're fired.
(MUMBLES)
What,
because I yelled at you?
Because you've
been here the longest,
learned all you can or
you haven't learned anything at all.
Either way,
it's time for a change.
Fine.
FOREMAN:
No tumors in her arm.
Synovial membrane
is working fine.
No hot spots,
no bone cancer.
Maybe we should be
looking for something else.
Is it raining out?
- House fired me.
- What?
Because you yelled at him?
"Time for a change"
was the official explanation.
It makes no sense.
Since when does
House make sense?
He always makes sense.
He's MISTY-
Yes, it's all about you,
Foreman.
He's upset you're leaving,
so he fires Chase.
Excuse me.
On the humerus,
she's got a hot spot.
Why'd you fire Chase?
Sure thing.
First you tell me
the results of the PET scan.
Did you fire him for me?
Would you stay if I did?
You asked him to fire Chase?
' No!
' Yes!
You're frustrated with Foreman
so you lash out,
kick the dog?
He's not gone five minutes
and the name-calling starts.
What's on the PET scan?
Why'd you fire Chase?
Do you know
what's on the PET scan?
You two, out.
Wait!
What's on the PET scan?
You can't dump
your entire department
just because you don't know
how to deal with an issue.
Yes,
they are all irreplaceable.
If only in this country
we'd figure out a way
to somehow teach people
to interpret PET scans.
What the hell's wrong with you?
You fired Chase?
I don't suppose you know
what's on my patient's PET scan.
I told you to show Foreman
you have a heart.
How does that translate
into you being a bastard?
So that's a no.
Pick up the phone
and tell Chase you made a mistake.
Un-fire him.
Chase, if you know what's on
the PET scan, call me back.
Cut the crap.
Chase is a good doctor.
Sorry,
you're in the wrong room.
My name on the door,
my team, my decisions.
My building,
my floor, my people.
(PHONE RINGING)
Hold that reprimand. House.
Dr. Chase! How are you?
Thank you.
You are indispensable.
You're still fired. Sorry.
Wow, that was awkward.
PET scan revealed
a blood clot in my patient's arm.
Which means goodbye.
Still got two people
working for me,
gotta get one of them
to do my job.
A clot means a heart problem.
We have to do
an emergency angiogram.
But you're not sure
it's a blood clot?
PET scan can't determine
that with certainty.
So you have no better idea what's wrong
with her than when we first got here?
- We've ruled out MS.
- I told you it wasn't MS.
Where is Dr. House?
Dr. House has
left for the night.
He'll be here in the morning
to review the results,
if you sign the consent.
But, you know,
you could call him at home.
He doesn't always pick up,
so keep calling.
Thank you.
(RINGING)
ESTEBAN: Dr. House,
it's Esteban Hernandez again.
As soon as you get home,
it's very important you call me.
(PHONE RINGING)
Hello, yes, Dr. House,
it's Esteban Hernandez.
As soon as you get home,
if you can please call me?
The catheter is in
her femoral artery.
Why are you telling me that?
Because you're assisting.
Do I look like I'm assisting?
I had nothing to do
with Chase's termination.
MARINA: ls everything okay?
You're doing fine, Marina.
The dye will take a minute
to work its way through your system.
Why would you tell House
you're leaving because he's a jerk?
Because it's the truth.
Did you give
an angry Cuban my home number?
Why would you do that?
You're not turning into House,
you're worse than him.
Let me get this straight.
Instead of picking up the phone
and talking to
a patient for five minutes,
you gave up on sleep
and drove in here.
My Chest!
(BEEPING)
She's in V-Tach.
- What did you do?
- Nothing!
Must have hit something.
You nick an artery?
She has no pulse.
It hurts.
She has no pulse,
but she's talking.
Cough! Cough again!
Keep coughing!
It'll push blood into your head,
keep you conscious.
Push one
milligram Epinephrine.
Will that help?
No. But it is amazingly cool.
We need to get her on bypass!
We need to keep her here.
If this was a clot,
the force of bypass
will blow it into
her brain, kill her.
If we continue CPR,
she'll lose blood flow,
which will
cause brain damage.
What caused
the heart to stop?
Let's assume
it wasn't human error.
I didn't nick an artery,
it just stopped.
I said let's assume.
The only other option
is electrical instability.
No ST segment changes.
We need to tell the husband.
Tell him what?
We have no idea what happened.
House?
Keep going until
I figure this out.
House!
Jeez.
At 47, I hope my colon looks
better than this guy's.
Isolating
the first transverse...
Help! I'm trapped
inside a monitor!
Not a good time, House.
My patient lost her heartbeat during
routine cardiac catheterization, so...
- Human error.
- It's not human error.
Electrical instability?
Pre-procedure EKG was normal,
no syncope.
Ischemia?
Foreman said no
ST segment changes.
Human error is
the only other possible...
It's not human error.
Of course it's human error!
You don't want Foreman
to have made a mistake
because then
you'd have to mock him.
And that would put a crimp
in your brilliant plan of keeping him
by having a breakdown
and firing Chase.
Did you just
spit on the monitor?
You know I can't see you.
Human error would not
explain her symptoms.
You mean her heart stopping?
I mean her foot pain,
her back pain.
House! I'm busy!
You have a team,
run your differential
with them.
Foreman and Cameron
are doing CPR.
Then you shouldn't
have fired Chase.
Change is fun, huh?
- Five, six, seven, eight!
- Go!
Someone's gotta
talk to the husband.
He thought this whole thing
was gonna last 45 minutes!
A half hour more of this,
nothing to talk about,
we won't be able to bring her back.
We gotta get her on bypass.
House still isn't
answering his phone.
You, get in here.
Go!
Excuse me, my wife was supposed
to be back an hour ago...
As soon as we know anything,
we'll call you.
Thank you.
Human Behavior finals
will also get into
clinical presentations
of mania,
and we'll touch on
Stanislas Dehaene's PET scans.
Excuse me, Professor.
House, when we're
done with our rounds...
My patient
has no heartbeat.
Stopped when we inserted a catheter
during a routine angiogram.
Anyone tells me
why her heart stopped
gets an A in
Dr. Cuddy's class.
Anyone?
Human error?
Yeah. I'm polling
first-year medical students
because I hadn't
considered human error.
Marian Syndrome?
Structural abnormalities
would show up on the echo.
You get a C. Yeah?
Botox injections.
F-
If the injection was tainted
with live botulism, it'd fit.
B-plus.
Unfortunately, she missed
her last Botox appointment
due to a boating accident,
but send me your résumé.
House, time's up.
Good Lord,
you smell like musk ox.
Either our patient goes on bypass,
or I call time of death.
Your patient isn't
already on bypass?
I was worried about a clot.
- How long?
- Three hours.
House. Bypass, now!
NURSE: Clear the hall!
MAN: Out of the way, please!
Let's go! Excuse us!
Dr. Foreman! My wife!
What has happened?
Her heart stopped.
We have to get her on bypass.
He needs to wait outside.
Got it?
Dr. House.
You can vacuum later.
I am not the janitor,
I am Esteban Hernandez.
What happened to my wife?
Her heart stopped.
Why did her heart stop?
Well, if I knew that,
I'd be coming to you.
Tell me where you take her.
Tell me
what is happen to her?
"Happening."
It's a present participle.
Not a particularly
interesting form of speech.
Kind of like
this conversation.
But I risk my life
to see you.
I looked you up.
You fix people.
When everyone else
gives up, you don't!
And now you insult me?
Ignore my wife?
Helps my process.
You do not ignore my wife,
okay?
She is everything to me.
Well, then you do
not ignore your wife.
You just sit here!
You don't talk to people.
How do you fix something
if you don't look at it?
GOODING:
Turn on bypass, please.
Good. Good distal flow.
Need to look
at the heart.
Why?
I can't find my wallet.
Pick it up. Turn it over.
I don't see anything
physically wrong with her heart.
Hearts don't
stop for no reason.
Okay.
Take your look.
You see anything wrong?
Give her a jump-start.
Clear. Clear.
Clear.
And again.
Clear! Clear! Clear!
Again.
Yeah, seventh time
is the charm. Sorry.
I'll keep her on bypass until the
husband has a chance to say goodbye.
I'm not telling
the husband anything
until I can
tell him why his...
it doesn't matter.
Her heart can't start.
She's dead.
I got you something.
I'll miss you.
I know you won't miss me,
but...
I just thought it would be nice
for you to have that.
I will miss you.
Can I have a hug, too?
The surgeon found nothing.
He can't start her heart.
What a thoughtful gift.
Nice reminder
of intellectual theft
to hang at your new
place of employment.
You two can go.
Say hi to Chase for me.
You're wearing lipstick.
We can stay. We can run
another differential.
You two have no theories
about why the heart stopped,
which means I don't need you.
Go.
It's too late for theories.
We need to tell the husband.
- Tell him what?
- That it's over.
- Why?
- Because her heart won't start!
How can we tell him
there's no hope
if we don't know
why there's no hope?
He's not gonna pull
the plug on his wife.
He risked his life
to get her to me.
If he pulls the plug,
it means he's failed.
If he pulls the plug,
it means you've failed.
And you're okay with that?
Go.
(PEOPLE CHATTERING)
- Hey-
- Hey-
You look great.
You know House firing you
has nothing to do with you.
The why doesn't matter.
Foreman will end up staying,
House will call you,
probably yell at you
for not showing up.
It's okay.
He's right.
It's time for a change.
You were right, too.
The whole "it's Tuesday,
I like you." It was silly.
Oh, don't give me that look.
Don't feel sorry for me.
Getting this job was the best thing
that has ever happened to me.
Everything about it.
And losing it?
Well, I think it's
gonna be good, too.
I'll miss you.
Have you got time for
a drink or something?
I think I should go.
Yeah.
CUDDY: How's it going?
The way the security
light hits your legs,
looks good.
Thank you.
If you're here
to yell at me about
the Foreman-Chase situation,
it can wait.
When do you plan
on telling the husband
it's time to say
goodbye to his wife?
Haven't put a clock on it.
Other than your curiosity, do you have
any reason to keep her on bypass?
Patient's husband
prefers her not dead.
Or you want
a storybook ending
for the young man who
crossed the ocean for his wife.
This is not an act.
- I don't care.
- Then pull the plug!
What if I can fix it,
but I just don't know it yet?
I know you care.
I don't care!
I really don't care.
My motives are pure.
If we do an autopsy
and we see, "Oops,
"if I'd thought of that crazy idea,
we could have saved her,"
then the husband
might be upset.
You've done all you can do.
It's time to let go.
I was told
you didn't believe in God.
I don't.
I promise my wife I'll do everything
I can to fix her.
If I don't pray,
then I don't do everything.
It's not working.
She's not coming back.
If you want to say goodbye,
you can come down to the ICU,
and then I'll take her
off bypass.
I'm sorry. I should have...
Marina, I am so sorry.
When you turn
the machine off, that's it?
Yeah.
Right now,
is her brain working?
Probably.
Just not her heart.
She seems like
she's just sleeping.
She's not sleeping.
We double-checked.
(SPEAKING SPANISH)
Her heart? It beat?
No, it's residual
flow from the bypass.
No, I can feel it. Look!
That is her heart, no?
P wave, Q, R, S, T wave.
That's a normal normal.
Esteban?
Marina!
Holy crap.
Is this heaven?
No, it's New Jersey.
God sent you back to me.
It's a miracle.
HOUSE: It's impossible.
CAMERON: Apparently not.
Live hearts don't
stop for no reason.
Dead hearts don't
start for no reason.
Apparently they do.
She's three hours off bypass
and still stable.
And the pain is gone.
No, it's not.
You think she's lying
about feeling better?
Just because it's not there now
doesn't mean it's gone.
Just because
it was there before
doesn't mean
it's coming back.
Chase was probably right.
She had some sort
of tropical infection
that cleared when we put her on
antibiotics during the bypass.
Antibiotics did not
bring her back to life.
Other than a miracle,
it's the only explanation
for her symptoms.
How come God gets credit
whenever something good happens?
Where was he
when her heart stopped?
What if it wasn't human error?
What if it was God's error?
A congenital defect in an artery making
it susceptible to inflammation.
We need to do
another angiogram.
We've looked at her heart 100 different
ways. There was no evidence...
The one time we
looked inside her heart,
we stopped before
we could see anything.
Because it stopped.
Good news.
I think we know
what the problem is.
You mean "was."
Hey, it's my first language,
not yours.
If she wants to outlive Castro,
we need to fix her heart.
(SPEAKING SPANISH)
In case
no one's filled you in,
today is Monday,
which means you've been dead for a day.
If that kind of
symptom comes back, it can get serious.
I need to do
another angiogram.
Wait. Wasn't that what caused
her heart to stop before?
No, God caused that.
He's all-powerful, you know.
(SPEAKING SPANISH)
He was watching
over us in the ocean
and he's watching
over us now.
Your rescuers didn't have wings,
they had a helicopter.
Esteban prayed.
Do you know how many little boys
are praying forjetpacks?
How many priests
are praying for...
Well,
that one actually works.
You didn't bring me
back to him.
And I'm not gonna
take you away from him,
but if we don't do
this test, God will.
You said there was no chance,
no hope, which means...
Which means I was wrong.
But I'm wrong all the time.
My mistakes don't
prove there's a God.
You came a long way
to see me.
You gonna put her life
in God's hands or in mine?
Ready?
I better not
see you praying.
I don't want to have
to fight for credit on this.
Exiting the femoral,
entering the aortic arch.
This is where...
Where we stopped to
have a picnic last week.
Her blood pressure's rising!
Mine's rising, too. Of course,
I am doing battle with a deity.
In the heart.
Injecting the dye.
Right coronary flow is unobstructed.
Left coronary flow looks normal.
Looks like you're wrong.
Either I'm right or this test
is about to go very bad.
What's that?
She has one, two,
a third ostium!
How many is she
supposed to have? Dos.
All the third one's doing is causing
inflammation, throwing off clots,
getting in the way
of the angiogram.
No human would
screw up that big.
Don't worry.
Just one more surgery,
it'll be fine.
Thank God!
Don't make me slap you!
Hi.
It's Tuesday.
No, it's Monday.
I know, I just...
I didn't feel like waiting.
(DOOR OPENING)
I hear you got
another satisfied customer.
One more and I get
a set of steak knives.
Well, this is it.
I appreciate
the opportunity you gave me.
Didn't do it for you.
Thought you were
the best guy for the job.
Thanks, I guess.
Which is why
I want you to stay.
You're an important part
of the team.
I need you.
I know.
But I don't need you.
And I definitely
don't wanna be you.
You're miserable.
I just solved
a case by predicting
a never-before-seen
heart defect.
A case you couldn't solve.
A case you gave up on.
I couldn't be happier.
For two minutes, maybe.
Until the next case
comes along.
Until you're jonesing
for your next fix.
This woman talks while
in full cardiac arrest
and you're more excited
about the talking than the heart dying!
The two were connected.
I don't wanna solve cases.
I wanna save lives.
Do you think she cares?
Do you think
the husband cares?
You think the children
she can now have
because of me are gonna care
why I saved her?
- I care.
- About yourself!
- About your own ego!
- House.
You're the selfish bastard,
not me,
which is why you took
so much pleasure in drawing out
this little goodbye of yours
for the last three weeks.
It wasn't for me,
it wasn't for anyone!
It sure as hell
didn't help anyone!
Nice try.
Nice tries are worthless.
You now have
a bigger office than I do.
Why don't you go enjoy it?
Better be naked pictures.
My resignation letter.
I've gotten
all I can from this job.
What do you expect me to do?
Break down and apologize?
Beg Chase to come back?
No.
I expect you to do
what you always do.
I expect you to
make a joke and go on.
I expect you to be just fine.
I'll miss you.
Genuine American cigars.
You guys can't
get them in Cuba.
100% healthy.
Shouldn't you go home?
Patient follow-u p.
Very important.
She looks great.
I think she's sleeping.
She is sleeping,
I double-check.
So, they all quit?
Two of them quit.
I fired the third.
It must be very hard
to lose your people.
You must be very upset.
Yeah, I must be.
But you're not?
I don't think I am.
I think I'm okay.
What are you going to do?
God only knows.