House (2004–2012): Season 4, Episode 16 - Wilson's Heart - full transcript

WILSON: Previously on House.

HOUSE: I don't know
how I got here.

I saw a symptom
before the crash.

Why was I taking a bus?

KUTNER: Medical hypnosis can bring
the brain to a Class 2 Theta state.

You're taxing
an already injured brain.

Someone's dying
because I can't remember...

HOUSE: It was Amber.

She was
on the bus with me.

She's the one who's dying.

DOCTOR: Her heart won't stop racing.
No idea what's causing it.



Sure it wasn't the bus
that landed on her?

It's not trauma.

She was stable post-op.
This didn't start until an hour ago.

My God.

HOUSE: Delayed reaction
to the trauma.

HOUSE: She lost both her kidneys
in the bus crash,

ripped up
her femoral artery.

We fixed the artery,
got her on dialysis for the kidneys.

Whatever's doing this to her heart,
it isn't from the crash.

- Check her potassium?
- Of course.

Why didn't
you call me?

She's been under the whole time.
She had no ID.

- Pushed adenosine?
- And verapamil.

And floated
a Swan an hour ago.



Coronary angiography?

Three critical patients
ahead of her.

We'll have her in
within the hour.

We're fifteen minutes away
from Princeton-Plainsboro by ambulance.

You want to move her?
Her heart rate is 130.

She's hemodynamically stable.
We're moving her.

You're not her doctor,
you can't make that decision.

Her husband can.

Right?

Move her.

If the trauma
didn't damage her heart...

Why was she on the bus?

I don't know.

If she had
any underlying condition,

the accident could
have exacerbated it.

Why were you with her?

I don't know.

I'm not hiding anything,
I just don't remember.

What else could
damage her heart?

Wilson. Don't get lost.

I'm barely coherent.
I need your help right now.

(HEART MONITOR BEEPING)

V-fib.

(HEART MONITOR FLATLINING)

Charging-

Okay. Okay.

- Clear!
- Wait. Wait! Wait!

Protective hypothermia.

You want to freeze her?
Her heart's not beating.

Her heart's
already damaged.

You restart it,
it'll keep racing,

shoot off free radicals
and kill her brain.

We ice her down, put her on bypass
until you've diagnosed her.

This is not a solution.
All you're doing is pressing pause.

It gives you more time
to find the diagnosis.

House. This is Amber.

Please.

Cold saline solution.

Core temperature
down to 90.

Bypass circulating.

She's stable.

Why are
we doing this?

Bought us time
to think.

The trauma must have stimulated
a pre-existing heart condition.

Auto-immune,
congenital anomaly,

blood-clotting disorder,
lead poisoning...

Could be anything.

Great. Let's explore that.

Quick, get her on panacea.

We can narrow it down
by looking for arterial blockages.

How? On an echo?

Can't see wall motion
when there's no motion.

EKG? Nope, heart's in
the off position.

Thallium uptake scan?
Useless on a cold heart.

Yeah, we get it.
Her heart's not beating.

It's gonna make it
harder to diagnose.

On the other hand, she's not gonna die
while you're whining about it.

What else?

There is another way
to narrow it down.

If you really did see
a symptom in Amber before the crash,

physostigmine
helped your memory last time.

Why not cyanide?
He's a mess, he needs to sleep.

I had a heart attack
this morning.

I can't do
any more drugs till lunch.

Get her an angiogram. it could
show damage even in a stopped heart.

Rest of you,
search her apartment.

Toxins,
heavy metals, drugs...

Anything that might
make her heart race.

I need to know
if there's anything medically relevant

that you couldn't
share publicly.

Is this
a Philanderers Anonymous intervention?

You were obviously
drinking last night.

Maybe you took Amber
to a bar?

I left here on my motorcycle.
Alone.

You ended up drunk on a bus.
Together.

Maybe you met Amber
in the bar?

I was not having
an affair with her.

You can't really say that
if you don't remember.

I lost four hours,
not four months.

Maybe it was
the first time.

If you drank together,
any chance you did any drugs?

I'll run a tox screen.

You coming?

Correspondence.
Letters to patients.

She could have caught something
from one of them.

Copy it to a thumb drive.
Let's get out of here.

Travel. Do you know if she's been
out of the country recently?

It's just video clips.
Maybe she narrates where they are.

WILSON: And action!

Looks like
she didn't travel very far.

- You look beautiful.
-You look nervous.

I've never
done this before.

I have. Trust me.
You'll love it.

- Hey.
- Not even close to relevant.

As long as we don't know
what's wrong,

we don't know
what's relevant.

Yeah, maybe they're having sex
on a pile of asbestos.

Go watch it.

If we were in
a stranger's house,

you'd be
watching the video.

You altered your behavior
because you're friends with her.

Are you okay?

We shouldn't be
treating her at all.

I'm gonna
search her bathroom.

AMBER:
Are you okay?

Can't really say "yes"
when it's a hallucination asking.

Don't worry,
you're just dreaming.

What symptom
did I see in you?

- A myoclonic jerk.
- Boring.

An incredibly rare
neurological symptom is boring?

Am I in someone else's
subconscious?

What did we do
last night?

Was I meeting you
for a drink?

Is that all it was?

A man thinks
a woman is beautiful,

admires
her intelligence,

admires the way she has to get
whatever she wants.

The things he likes
about himself.

And maybe she always had
a little thing for him.

His mind,
his blue eyes.

But someone
gets between them.

So they decide
to meet one night

at an out-of-the-way
little bar...

Does that
sound familiar?

Do I feel familiar?

What do you feel?

Electricity.

Electricity.

I know
I saw the symptom.

I know the memory is locked in my brain,
now I know how to get it.

No.

You don't even know
what I'm talking about.

You need to rest.

I have yet to hear about any study
linking electricity and rest.

Deep brain stimulation.

It's been proven.

Electrical impulses
applied directly to the hypothalamus

can evoke
detailed memories.

My mistake.

Drilling a hole

and shooting lightning bolts into an
already cracked skull is very restful.

It's not fatal at all.

She's right.
You need to sleep.

(MONITOR BEEPING)

Brain activity spiked.

Amber?

Amber? It's me.

Random spikes
are common.

Shut up.

It's gonna be okay.

I'm here with you.

(PAGER BEEPING)

The team
has found something.

Can you ask her
if we can be excused?

What?

The coronary angio
was negative.

So was the tox screen.

That's what you found?
Negative tests?

I could have told you
she doesn't do drugs.

I found these in her apartment.
Sorry.

Prescription diet pills,
SSRIs, amphetamines.

Diet pills cause structural damage
to the mitral valve,

could explain
the tachycardia.

She'd have to be an addict

to take enough for her
to damage her heart. I'd know.

Did you know she was hiding them
in her vitamins?

We have to warm her back up,

get her heart beating
so we can do a CT to confirm.

No.
We've been over this.

Starting her heart
could cause brain damage,

could burn out
the heart muscle.

Test her heart
without starting it.

Crack her chest open. Reach
a finger inside the pulmonary vein,

run it across the valve.

That's the safer course?

It is if we're wrong.

When did we start assuming
we're wrong?

If this were
any other patient...

If the valve is calcified,
that's our answer,

that's our cure. Go.

Thirteen.

Who found
the diet pills?

Kutner.

You didn't even go
in the bathroom, did you?

You're suddenly mute
in the differentials.

A blow-up doll
would be more useful.

And yes,
that's the first time

I've ever implied something negative
about a blow-up doll.

It's Amber. I don't...

Normally,
I'd be fascinated.

Today, don't care.

Get over whatever it is
and do your job.

Wait. Look at her eye.

She's jaundiced.

Her liver's not working.

Diet pills
don't kill the liver.

Put her back in ICU.

FOREMAN: Liver failure means
whatever this thing is, it's spreading.

Despite the fact
that she's frozen.

Hepatic and heart failure
could mean anti-trypsinase deficiency.

We can stick
a needle in her liver.

We see fibrosis,
she's right.

Does Amber drink sherry?

Nocardia
fits just as well,

but there's no way
we can tell,

since we can't
take her temperature.

I had a dream
she was pouring me a glass.

And since I'm a scotch, beer,
gin and rum man...

If we warm her back up, we should be
able to tell if she's got an infection.

Yes, we can get
a diagnosis

by letting the disease
run rampant until it kills her.

If it's spreading,
we need to slow this even more.

We've got to
cool her down further.

I know you love her
and you're scared she's going to die.

But just making her colder
and colder isn't a cure.

It's not dealing
with the reality.

Sherry means
something.

Amber doesn't
even drink sherry.

House,
can we get back to...

If she did drink sherry, it would
mean nothing, but since she doesn't,

my subconscious is obviously
trying to make some other point.

There's a Sharrie's Bar on Third,
right off the bus route.

Wilson's right.
We need to make her colder.

Putting more ice on her
is just delaying the diagnosis.

Not on, in.
Fill her lungs with slurry.

Where are you going?

Taking Wilson out
for a drink.

Is this the place?

Maybe.

Hey.
I assume you are here for these.

Did you see me here
with a tall, blonde woman?

Yeah, I think she joined you
after scotch number seven.

Did she seem sick?

She sneezed.

I gave her a napkin.

Did you see
the color of the sputum?

I assume sputum
means snot.

Look, I see lots
of drunk chicks in here.

I didn't have time to stop and analyze
the color of your girlfriend's boogers.

She's not
my girlfriend, genius.

She was hot,
you seemed into her

and she
bought you drinks.

Last night,
she was your girlfriend.

Blood in her sputum. It could
mean parasites. Any recent travel?

You seemed into her?

If he had a brain,
he wouldn't be tending bar.

Sneezing's
a new symptom.

Let's assume the runny nose
means an infection.

What did House
have to say?

He told me
I was raised by wolves,

and that's why I use the same hand
for my fork and knife.

Whoa.

Not that one.
The slurry tube.

I know this is different.
But it's not.

Everyone dies.

She's not dead.

You're reacting this way
because she might be soon.

Yeah. I am.
Why aren't you?

I'm an Indian guy
named Kutner.

Ever wonder
what happened to my parents?

- I'm sorry, I didn't...
- I was six years old.

I used to like helping out
in my parent's store after school.

A guy walks in
to rob the place,

ends up
shooting them both.

Wasn't fair.

Took years, but I had to accept
that's just the way it was.

So, you gonna help me
fill her lungs up, or not?

Tell me the liver biopsy
showed infiltrates, minor inflammation.

Yeah. How...

Snot on a napkin.

Add the heart,
the infiltrates...

Hep B.

Start her on IV interferon.
I'll go tell Wilson.

Good idea.

And I'll go nap,
because I was concussed last night

and had a heart attack
this morning.

I'll tell Wilson.
You go sleep.

Hepatitis B
is a lame diagnosis.

Oh, God, I get less rest
when I'm asleep.

I rise from the dead
and that's reaction I get?

I'm sorry.
If I had known,

I would have started
a breakaway Jewish sect.

Hep B fits.

Why are
you doing that?

Because Hep B
doesn't fit.

Turn her over.

We're about to start
her second course of interferon.

Which she might not need
once you turn her over.

The small
of her back.

She's bruised.
Why is that significant?

Look closer.

A rash.

How'd you know
what was on the small of her back?

Well, either I'm still asleep,
or I'm starting to remember.

Looks like
an influenza rash.

The flu wouldn't be killing
the organs one by one.

Dermatomyositis.

Wouldn't speed up
her heart.

Maybe it's an allergic reaction
to the interferon?

Yes, the symptom I saw on the bus
was a rare interferon allergy

that flares up
two days before you take it.

How'd you see
the rash down there?

I don't know.
Maybe she leaned over.

Maybe it's not a rash at all.
Could be an abscess.

Thirteen,
stick a needle in there.

If there's pus,
Foreman's right.

Ultrasound is safer.

I'm not asking you to stick
a needle all the way through her.

- Taub, you do it.
- No. Wait, I can do it.

No, apparently,
you can't.

It's not fluctuant.

Clear, it's not pus.

Means it's vesicular.

Rocky Mountain
Spotted Fever.

We had dinner with a friend last week.
We walked their dogs.

I guess she could've
gotten a tick.

It's treatable,
doxycycline.

Allow eight hours
for the antibiotics to take effect,

then we warm her up,
shock her heart.

Wait a minute.
Wait a minute.

If we're wrong,
restarting her heart could kill her.

Run blood cultures first.

Fastest way
to test is to treat.

If we're wrong, still should give us
time to try something else.

We are not starting her heart
until we're 100% certain.

We're never 100% certain.

Run the blood cultures.

After we get confirmation,
we'll restart her heart.

He's wrong.
And you know he's wrong.

You can't change your mind just because
a family member starts crying.

They're always scared.

I said
run the blood cultures.

Sorry. Wide stance.

You're right.

I'm screwing up.

Why are you screwing up?

I didn't even like her.

Did you hate her?

Not enough
to want her dead.

So it's not guilt.
That just leaves fear.

A young woman dying.

A young doctor dying, in fact.
That sound familiar?

(SIGHS)

Yeah, I'm at risk
for Huntington's.

I've dealt with it.

By not getting tested.

Dealing with it
by not dealing with it.

It's clearly
working beautifully.

You're the champion
of not dealing with your problems.

My grandson gave me a mug
that says that.

Okay. Enough hand-holding.

Deal with it, get back in there,
or pack up your stuff.

You're screwing up this case
worse than I am.

House is gonna
kill the patient.

What are you...
What are you doing?

She's up to
80 degrees.

We're gonna
restart her heart.

No, you're not.

There's still time to undo this.
Cool her back down.

You weren't taking
the safe approach.

We've got to know
if the antibiotics are working.

Her EEG's slowed.

Amber.

Amber.

Well done.

We still don't know
what it is,

but you've just let it spread
to her brain!

WILSON: This is exactly what I said
would happen. It's in her brain now.

CUDDY: The brain involvement
gives us a new symptom.

That wouldn't be there
if you hadn't...

It's where the disease was going.
We needed to know that.

This was not
your decision to make!

You went behind my back.
You went behind House's back.

Inside voices.

House wanted
to warm her up.

You just quilted him
into changing his mind.

Heart, liver, rash
and now her brain.

Auto-immune fits best.
Crash trauma could've set it off.

Start her on prednisone,
then we'll warm her up again.

House, if this is
some other infection,

the steroids will
trash her immune system.

He's the attending.
You're the family.

Go spend more time
with the patient.

You can't do this.

That's not
a good argument.

It's not an argument at all.
I'm sorry.

Cuddy's right.
I was afraid to do anything.

I thought if everything just stopped,
it would be okay.

And it's gonna be.

Taub's starting treatment,
we're doing everything...

Not everything.

Before you warm her up...

You said you wanted to try
deep brain stimulation.

But there's no reason.

We know the symptom.
We know what I saw.

What if it's
not the rash?

What if you saw the rash
in the ambulance,

or when we were
putting her on bypass?

What if there is still something else
stuck inside your head?

You think I should risk my life
to save Amber's.

(CHUCKLES)

I'm inserting the IPG probe
into your ventral hypothalamus.

Give me 3 volts.

HOUSE:
I can't hear him.

WILSON:
Can't hear who?

Everything's
in black and white.

Who was talking?
ls Amber there?

You're supposed to be jolting
my hypothalamus. Not petting it.

- We don't want to overload it.
- As long as I'm risking my life,

I might as well
be watching a talkie.

Increasing
from 3 to 5 volts.

Sending impulse.

You're not
getting them back.

Hey! You take my keys,
you gotta give me a phone call.

Who are you calling?

(TELEPHONE RINGING)

Dial-a-Wilson.

I was on call.

(STUTTERS)

Amber was home.

I told her to find you,
have you pick me up.

I said to find Wilson.

He's working.

And I'm willing to suffer this indignity
on his behalf.

WILSON:
Does she seem sick?

Not yet.

Come on, time to go.

Need another round and a drink
for what passes for a lady around here.

- What's your poison?
- Nothing. We're leaving.

We're leaving, leaving, leaving.
Cosmos.

I remember Wilson
buying cranberry juice.

I'll have another,
and she'll have a Cosmopolitan.

The obstinate drunk thing
is not flattering.

Come on,
you called for a ride.

Drink your drink,
or I'll drink them both.

One, and you leave
voluntarily.

Let's go.

Hey!
Need another Cosmo, here.

(SNEEZES)

She sneezed.

What color is it?

Thanks.

Looks like snot.
Seems like a cold.

Nothing else?

No.

Where are
you going?

You think I paid?

House, what are you doing?
You can barely walk.

Go home.
I'll take the bus.

BARTENDER:
Hey, someone's gotta pay for this.

(BURPS)

Hi.

You forgot something.

Boy,
you don't give up, do you?

Yeah, I'm an idiot
that way.

You doing this for me,
or for Wilson?

For Wilson.

Well, then,
it's even more impressive.

(TOASTING IN FRENCH)

(SNEEZES)

Damn.
Do you have a Kleenex?

I got a sleeve.

I got two, actually.

Gonna need more than that.
I'm getting that nasty flu.

Is that it? The flu?
ls there any rare complication?

No. It'll explain the rash,
but nothing else.

Unless...

What?

Don't do it.

It wasn't the flu.

It's what she did for it.
She has amantadine poisoning.

The crash destroyed
her kidneys,

her body couldn't
filter the drugs,

she ODs on amantadine,
explains the heart, the liver...

We just need to start on her dialysis
and flush the drugs out.

What? What's wrong?

Amantadine binds
with proteins.

Dialysis can't clear it
out of the blood.

There's nothing
we can do.

I'm so sorry.

Amber.

Amber.

(CRASHING)

(MONITOR BEEPING RAPIDLY)

He's seizing. Wilson!
I need help, here.

House suffered
a complex partial seizure.

The violent shaking widened his
skull fracture, causing a brain bleed.

FOREMAN: We won't know
if there's any cognitive impairment

until he's out
of the coma.

He was right about
the amantadine.

Amber's body
couldn't filter it out.

That's what caused her heart
to beat too fast for too long.

It caused irreparable
structural damage.

Didn't matter if they shocked her
or froze her or...

Her heart was dead
once it stopped in that ambulance.

What about a new heart?
Transplant?

All of her organs are damaged.
She can't qualify.

There's nothing we can do.
Nothing we could have done.

We should call
time of death.

Technically,
she's still alive.

Could probably survive
a few more hours on bypass.

We could wean her off anesthesia.
Wake her up.

Give you a chance to...

It'd be cruel.
Don't...

Wake Amber up.
See her again.

Tell her what
she means to you.

Wake her up to tell her
that she's...

(CRYING)

You are waking her up so that
you can both say goodbye to each other.

She would want it.

Hey.

Hey.

You're in the hospital.

I'm on bypass.

Yeah.

Do you remember
what happened?

I got on the bus.

I shouldn't have gotten
on the bus.

No. No.
It's not your fault.

It's not your fault.

How bad?

You had tachycardia,
complicated by complete renal failure.

The tachycardia degenerated into V-fib,
followed by hepatic failure.

The flu pills...

Yeah.

I'm dead.

I love you.

I love you, too.

(AMBER CRYING)

We should say goodbye.

She didn't
even like us.

We liked her.

Did we?

We do now.

What do we say?

We don't need to
say anything.

I'm tired.

I think it's time
to go to sleep.

Just a little longer.

We're always gonna want
just a little longer.

I don't think
I can do it.

It's okay.

It's not okay.

Why is it okay with you?
Why aren't you angry?

That's not
the last feeling

I want to experience.

(GASPING)

BP stable.

Still non-responsive.

Pupils are equal,
round and reactive.

Heart rate's normal.

Respiratory rate
is...

You're dead.

Everybody dies.

Am I dead?

Not yet.

I should be.

Why?

Because life
shouldn't be random.

Because lonely, misanthropic
drug addicts should die in bus crashes,

and young do-gooders in love
who get dragged out of their apartment

in the middle of the night
should walk away clean.

Self-pity
isn't like you.

I'm branching out from
self-loathing and self-destruction.

Wilson is going to hate me.

You kind of deserve it.

He's my best friend.

I know.

What now?

I stay here with you.

Get off the bus.

- I can't.
- Why not?

Because...

(CHUCKLES)

Because it doesn't
hurt here.

I lied.

I don't want to be in pain
and I don't want to be miserable.

And I don't want him
to hate me.

Well...
You can't always get what you want.

Hey. I'm here.

Blink if you can hear me.

(SIGHING)

No.
Don't try to talk.

Just rest.