House (2004–2012): Season 5, Episode 23 - Under My Skin - full transcript

(CLASSICAL MUSIC PLAYING)

- It's way too fast.
- It felt good.

If we can clear the stage,
quickly please.

Maury, it's too fast.

It's exactly the same.

Then slow it down.

Everything all right,
Jeremy?

Sure. Ready
whenever you are.

From the allegro please.

What's his problem?

His back's not 100%.



He can't talk to
the conductor like that.

No, he can't.

She could.

You okay with the lift?

I'll be fine unless
you mess up the timing.

My timing is perfect.

Was last night.

Moment of truth.

(GROANING)

Damn it.

(GASPING)

Penelope, are you
all right?

She can't breathe.
Call the doctor!

Are you gonna ignore me
all day again?



I help you.

You tried to kill Chase.

Doing what you wanted,
that's all, boss.

- I exist.
- No, you don't.

I acknowledge my
subconscious exists. Now go away.

(KNOCKING ON DOOR)

Saying it is one thing.
Living it is another.

You're not rational.
Not completely.

Put the phone
on the receiver,

send the hookers home
and get dressed.

- We've got a case.
- I'm taking a personal day.

21-year-old star of the New York Ballet
collapsed on stage.

I love ballet.
But as someone may have mentioned,

I'm taking a personal day.

Cuddy said get your ass
in or you're fired.

She's not going to fire me.

She's not going to fire you?
If you don't go to work?

- Okay.
- How long, do you figure,

till I just disappear?

Hold on.

No tumors or punctures
in the lungs,

no bruising,
no sign of trauma, no STDs.

And supplemental oxygen's
only gotten her saturation level to 60.

Lungs keep collapsing
despite a chest tube.

ER ruled out the obvious,

white count and temp
are normal, so no pneumonia.

The coffee's burnt, Thirteen's wearing
cherry-flavored lip gloss.

Foreman's staring at you.
Any of that helpful?

House.

- STD?
- We just said the tests were negative.

- You think we should...
- No.

She's a dancer.
What about dehydration?

What about
a pulmonary contusion?

CT showed no inflammation
on the lungs.

What about dehydration?

BUN and creatinine
are elevated but within range.

Hey. I'm just
the irrational part of your brain,

but elevated
means high, right?

Dehydration could
hide an infection.

Dehydration could
hide an infection.

Go treat her for the obvious.

IV fluids and
antibiotics for pneumonia.

We're like
Magic and Kareem.

Mr. Pietramala,
you have kidney cancer.

Wow. Is that a bad one?
I mean, they're all bad, but...

The door was closed
for a reason.

Well, now it's open for a reason.
We need to talk.

He just told me
I have kidney cancer.

Then you'll obviously need
a moment to process.

House.

I'm hallucinating.

I'm... I'll be right back.

I need you to sit in
on my differentials,

double-check everything I do.

You can't treat patients...

It's gotta be sleep apnea.

I get a good night's sleep,
and I still feel exhausted.

Lack of delta sleep
can lead to hallucinations.

Do you have any other
neurological symptoms?

Don't think so.

- Aphasia?
- No.

- Memory loss?
- No.

- Irritability?
- Yeah, that one.

Don't deflect.
He cares about you.

- You shouldn't be practicing.
- You care about him. Tell him...

- At least until...
- Enough.

Don't give me the look.
I told you I was hallucinating.

Who were you talking to?

Someone who's not actually here,
beyond that seems irrelevant.

Your mind made a choice.
It means something.

AMBER: You know he's just
gonna keep asking.

Kutner.

Good choice.
He feels bad.

You gonna help me or not?

Yeah.

I could eat from this place
seven days a week.

We practically do.

You can order
tomorrow night.

- Do you want some wine?
- No, thanks.

I have my husband's sperm.

Your dead husband's?

We froze it when
he got diagnosed.

And you kept it?
All this time?

I used to think,
if I didn't find anyone...

You found someone.

I know.

- But...
- What if it goes wrong?

What if I turn out to
be a radical anarchist

with a secret family,
and that I age backwards?

Nobody plans on
getting divorced.

I didn't plan
on my husband dying. But he did.

So, you're saying
you want a pre-nup?

In liquid form?

(SIGHS)

What if it's not
sleep apnea?

Trauma from your
motorcycle accident?

Vicodin abuse?
You need to be admitted.

I know you're wrong
about sleep apnea,

which means you know you're wrong
about sleep apnea.

You're scared.
Tell him you're scared.

I can't sleep
with you here.

(SIGHS)

Did it work?

Do you see someone
standing beside me?

No.

Then no.

So what's next on your list of things
it's not?

Patient's not responding
to the antibiotics. Still can't breathe.

So run a test to confirm
it's pneumonia.

We can't do a bronc
because her lungs are still collapsed.

Transtracheal aspiration.

That's basically
waterboarding.

It is pretty radical.

It's a great idea.

Regular radical, me radical
or me-out-of-my-mind radical?

Somewhere between
regular and you.

So what's the problem?

Everything okay?

No. Our patient
can't breathe.

Either do the test
or come up with a better one.

So we're down to
infection, trauma,

MS, schizophrenia, or pills.

Schizophrenia usually
manifests younger.

That's why it's further
down the list.

I can confirm an infection
with a simple blood test.

An infection can
be treated, cured.

Means you've still got a job,
means you've still got a life.

Doesn't make it a better idea,
just a nicer one.

This the rational
you talking?

Can't do this on my own.

FOREMAN: When we inject the water
it's gonna feel like you're drowning.

But it'll be over
in a few seconds.

And then it'll be better?

A little.

Hold her shoulders
down a little.

Ready?

(MOANS)

(WHIMPERING)

You're doing great.
Here comes the liquid.

(COUGHING)

FOREMAN: Taub.

I slipped.

- Oh, no.
- What?

Her skin came off.

(CRYING)

Her skin's sloughing off
faster than

we can replace it
with the artificial skin.

THIRTEEN: Could be autoimmune.

FOREMAN: ANA was negative.

HOUSE: Focus on the lungs.

FOREMAN: You want us to ignore the fact
that she's lost 80% of her skin?

We know it's not lung cancer.
Could be a liver tumor.

Eats through to the lungs.
Get an ultrasound of her liver.

If you find masses,
get a biopsy.

We can't just
ignore the skin.

It's obviously
the most significant

and dangerous
symptom right now.

I don't think it is a symptom.
I think we caused it.

By doing what?

I prescribed antibiotics.

Toxic epidermal necrolysis? That's a
one-in-a-million reaction.

Yeah, well,
maybe this is the one.

Get swabs of her
old skin to confirm.

Where the hell were you?

I do have a practice.

Ballerina has toxic
epidermal necrolysis.

Are you sure?

About to be.

I'm sorry.

I feel guilty.

You didn't do
anything wrong.

You prescribed
antibiotics.

Any other doctor would have done
the exact same thing.

"Any other doctor"?
Words can hurt, you know.

I have no reason to feel guilty.
It doesn't make any sense.

Unless there's
something wrong

in the limbic area of my brain.

Guilt as a symptom?

It's consistent with MS.

And since the blood tests were negative,
I have to apologize.

If I feel better, then you're right.
I'm just feeling an emotion.

If I feel nothing,
means my limbic brain is shot.

I'm Dr. House.

Anyone explain to you
your status?

They found a mass
in my liver, cancer.

They said they think
they can treat it.

And that the skin
is starting to take.

I'll be able to dance again.

She's half-dead and she's wondering
if she'll ever plié again.

Healthy priorities.
Let the mocking begin.

I'm sorry.

I treated you for infection
before confirming that you had one.

That's why you lost
your skin.

I know you're in pain. I know
that I caused it. I'm sorry.

Very nice.

Thank you.

Nothing.

Maybe you didn't mean it.

I meant it.

Did you do a liver biopsy to confirm...

FOREMAN: Couldn't. The artificial skin
was too thin, she'd bleed out.

Why were you talking
to the patient?

I think skinless women are hot.

Do a transjugular
liver biopsy.

If she bleeds, at least
it stays in her veins.

Did you just check
with Wilson again?

No.

I felt nothing. It's MS.

Apologies aren't supposed
to make you feel better,

they're supposed to make
the other person feel better.

In order to make
you feel better.

Fine. You want to do
an LP to confirm

or is guilt enough to start
filling prescriptions?

Last mass, about a centimeter
to your right.

Problem?

Short burst of flutter.
We're almost done.

Entering the right hepatic vein.

Cameron kept her
dead husband's sperm.

She doesn't like yours?

She likes his better.

Or at least she wants
to hang on to it

in case mine is
unfaithful or something.

Wow.

Advancing two centimeters.

You gotta let her do it.

If you don't, you'll be stuck
with her forever.

I want to be stuck
with her forever.

She married a dying guy.
She has issues.

You cannot leave her.
Ever. For any reason.

Because then you're
not just the guy who left her,

you're the guy
who killed her kids.

(MACHINE BEEPING RAPIDLY)

That's not a good rhythm.
Get out.

Narrow complex tachycardia.
She's gonna crash.

TAUB: Liver biopsy
was negative for cancer.

But the procedure sent
her heart into A-Fib.

We don't know it was the biopsy
that caused the heart problem.

Maybe the heart caused
the lungs to collapse.

Why is Wilson here?

You were looking for cancer.
I thought it'd be helpful if...

- We didn't find cancer.
- Yes,

which you reported
to me five seconds ago.

I thought I'd let him
finish his hols d'oeuvre

before getting the bouncer
to take care of him.

Until we can
regulate the heart,

we can't get any
meaningful pictures,

so we can't tell...

Metoprolol can correct
irregular heart.

FOREMAN: Tried it.
Didn't work.

Is Cuddy making
him oversee...

No.

TAUB: Heart's too irregular for MRI,
other scans wouldn't...

Then you're
making him oversee your choices.

You don't trust yourself.
Why?

Wilson, get out.

Are you sure?

Do I need your approval
to throw you out?

You happy now?

There's only one time her heart's going
to be perfectly still for our pictures

and that's when she's dead.

If it's not MS,
severe mental illness

and Vicodin are
all that's left.

Mental illness means you can
no longer practice medicine.

Vicodin means detox, which means pain.
For the rest of your life.

Which means you can no longer
practice medicine.

Are you saying we
should kill her?

TAUB: No.

If we stopped her heart, we could get
our pictures and then restart it.

What if we can't restart it?

Then she stays dead.

We restart hearts
all the time.

It'll take four minutes for us
to MRI her entire heart.

And we only have three minutes
until there's brain damage.

You sure about this?

Yeah.

Gonna stop her heart
so I can MRI it.

I think it was her idea. The pneumonia
was her idea, almost killed the patient.

"Her"?

Oops.

Kutner was secretly a woman,
that's why he killed himself.

It's Amber.

Your subconscious picked
my dead girlfriend?

Yeah, the irrational part
of my brain

works like the rational
part of yours.

How about that?

It raises questions.

It answers questions.

Who cares?

I've got competing ideas.
They can't both be right.

Everybody gets competing ideas.
Everybody has doubts.

So is it regular radical, me radical
or me-out-of-my-mind radical?

It's on the upper end
of you radical.

Do you have any alternative?

Nothing that anyone in my head
has come up with.

Then you're as safe
as you can be.

Great.

You get the LP results back?

Yeah.

It's a big shock.
You don't have MS.

But while I had your blood sample,
I checked Vicodin levels.

Way too high.

I need the pills.

Not an argument. He knows
that's not an argument.

It could still
be schizophrenia.

House, if you're
on anti-psych meds,

you're not going to
be able to practice...

I know.

You'd prefer
electroshock therapy to rehab?

I'd prefer something
that could actually work.

You're rationalizing.

No kidding.

I know that you're afraid of the pain,
but electroshock...

Don't give me the cancer voice,
that overly earnest tone.

Heart attack, stroke,
seizure, death or worse.

Worse? Double death?

You live but you damage the only thing
you care about:

your rational mind.

I'll make some calls.

I'll actually be dead?

Just your heart.
And just for a little while.

Hopefully.

I had an idea.

Stop having ideas.

Insulin shock.

Yes, that's marginally
less dangerous than ECT,

- puts you in a coma, could cause...
- It could work.

If you had psychosis,
which you don't.

I have no diarrhea,
no sweating, no vomiting,

none of the symptoms
of Vicodin overdose.

Yeah, except the
"I see dead people" thing.

I've been popping pills
for years.

I've only been seeing things for days.
Something changed.

Vicodin addiction
is still more likely.

So we're no longer
dealing in absolutes.

House, I'll be up
in five minutes,

then we can talk about how you'd
rather be in a coma than in rehab.

Actually, if you could be up here
in two, that'd be really helpful.

Why?

Because I'm about to put myself
into insulin shock.

Left atrium is fine.

Left coronary
artery also fine.

- We're almost at three minutes.
- Keep going.

- Chordae tendineae clear.
- Right atrium is fine.

- I gotta start her back up.
- We have some time.

- We're over.
- Right coronary artery is fine.

The three-minute threshold
is a guideline.

She might have less.
We have to stop.

What's that by the aorta?

- I don't see anything.
- I'm restarting her heart.

That's a shadow!
Two centimeters...

You're only scared because you know
this is going to work.

We're over three minutes.

I need glucose in here!

(SIGHS)

You could have died.

It worked.
Where are my pants?

Are you sure?

She's been everywhere
I've been for days.

She's not here. Ergo...

This was not
the next rational step.

Now who's being biased?

You wanted me to detox
as much as I wanted...

I forgot how
to do my zipper.

Any other
neurological deficits?

You don't seem to annoy me as much
as usual. Not sure that's a deficit.

And I'm all better.

- Is she really gone?
- Absolutely.

I can feel myself
repressing all kinds of icky things.

I check out, don't I?

(PAGER BEEPING)

Damn.

He didn't see anything.
He saw an artifact on the monitor.

It was a shadow
on her heart.

She'd already been
technically dead for three minutes.

I thought keeping her alive took
precedence over prolonging the photo op.

Any brain damage?

No, all tests
indicate that...

Obviously you had more time.

Best of luck.

I assume we can't kill her again,
take more pictures.

You don't want to
check with Wilson?

- Good one.
- It's something, a lesion.

Tumor, scar tissue.

Could be an abscess.
Infection.

Explains why it's invisible
in the blood.

It's doing its damage
behind closed doors. Sealed off.

See, the problem
with speculation is

you make a "spec" out of you
and some guy named "Lation,"

which really doesn't
affect me at all.

We have to guess.
It's all we've got.

We can't do a biopsy.
Last time we went into her heart

she had a major
cardiac event.

Which just leaves...

What are you looking for?

I don't know yet.

Picture doesn't change. She lies there
in pain, he sits there worried.

Nothing changes.

I just had an epiphany.
All by myself.

Popped into my head
out of nothing.

Care to share?

He's too devoted.

Too devoted?
You think he feels guilty?

Right, I'm being cynical.

People can care because they care,
and not because they cheated.

Theoretically true,
but gonorrhea fits better.

No. No STDs. We tested her.

You tested her blood.

TAUB: That is the test.

That's not where
her problem is.

Gonorrhea disseminated
to her heart.

If it got walled off in an abscess,
it'd be invisible.

And would look
like a shadow.

No need to test her again.
But we can check Prince Charming.

Once you confirm,
cut the abscess out of her heart.

Here are your onion rings,
extra well done.

Thank you, Molly.

And another beer
when you get a chance. I'm celebrating.

Alone?

Thank goodness.

(CELL PHONE RINGING)

Don't tell me,
I was right.

Yep. Boyfriend has gonorrhea.

And everyone's a winner.

He's not too happy about it.

He insists he's never cheated,
must have gotten it from her.

Don't think so.

Timing would fit.

He's got no symptoms
and she's dying.

Lying would fit, too.

He's not hanging out
in her room anymore.

What does it matter?
You were right.

We're prepping
her for surgery.

I saw guilt in him.

If he's not actually guilty,
I wasn't right, I was lucky.

House, you made
a brilliant deduction about her heart.

And if I was just lucky...

(AMBER HUMMING)

(SINGING) Enjoy yourself

It's later than you think

Enjoy yourself

While you're still
in the pink.

The years go by

(LAUGHING)

As quickly as a wink

Enjoy yourself

Wilson, come get me.

It's later than you think

(LAUGHING)

I know a nice facility
outside Philly.

I went to undergrad
with one of the directors.

Thanks.

How many shirts do I need?

They said three.
They have laundry.

Like living with Mom again.
Delightful.

(CELL PHONE RINGING)
It's probably Foreman.

He's unavailable.

Tell him the infection's
made her septic.

We can't remove the abscess
until we get her BP up,

and it's not responding
to fluids, it's not...

He's off the case.

Patient okay?

Yeah.

He's lying.

Why don't I feel scared?

I'd say you're unaware
of what you're feeling at this moment.

I feel like crap, my life is falling
apart, but I don't feel scared.

Not of the rehab, anyway.

We've always been able
to find a way to cheat.

It won't work.

You want it to
work this time.

Do we?

House, it's
your only option.

And what do I do
if my only option won't work?

You don't give up.

It's either that or electroshock
every six hours.

Good night, Wilson.

What if we put her on
a heart-lung machine?

She's septic.

We don't need
a heart-lung machine.

We need a blood vessel
holder-together machine.

FOREMAN: We could try
a high-dose dopamine.

It's a vasoconstrictor.

It'll close the blood vessels
so she won't bleed out.

Her heart can't take
that much dopamine. It'll explode.

FOREMAN: And if we don't
use the dopamine, it'll implode.

Is House really done?

Sounded that way.

Dopamine it is.

It's late and I'm tired.

Can we get to the talking part
of this conversation?

(SIGHS)

I quit.

Great.

My nanny is off
the clock at 7:30.

So your week off,
bigger desk,

tighter nurses' uniforms,
or whatever

other stupid thing
you're about to demand

is gonna have
to wait until...

You can go suckle
the little bastard child

who makes you feel
good about yourself.

Screw you.

Don't do this.

I'm hallucinating.

From the Vicodin?

Ruled out everything else.

We can admit you
through the ER

under a pseudonym.
No one has to...

I'll cheat, scam,
find some way to keep using.

These people know
what they're doing.

These people don't know me.

You do.

She's not your keeper. She has
no responsibility for you.

I need you.

Let me call my babysitter.

TAUB: Blood pressure
is 90 over 60.

We know.

I'm just saying, it's still 90 over 60.
It's holding.

Abscess is intact.

Doesn't look like any of
the surrounding tissue is affected.

She's gonna be fine.

NURSE: Doctor.

We've got a problem.

(BREATHING HEAVILY)

Lie down.
I'll get you some tea.

Yeah, then I'll be better.

You really think she hasn't searched
this place for your secret stash?

I already did this room,
and the bathroom and your bedroom.

Where should I look
in the kitchen?

Coffee cup.
In the top shelf.

That was a test.
I already did the kitchen.

Nicely played. She'll think
you've come clean, given her everything.

There's more.

Don't. You're hurting already.
It'll only get worse.

House, you should
tell me where it is now,

because you won't have the will
to tell me in two hours.

In my shoes.
In the closet.

It's like I don't even know
who you are anymore.

(GRUNTING)

It's okay. Hold my hand.

Am I Okay?

We were able to successfully remove
the abscess from your heart.

But the dopamine
caused the blood vessels

in your hands and feet to clamp shut.

We need to amputate or the gangrene
will spread, and you'll die.

(CLEARS THROAT)

My feet?

And your hands.
I'm sorry.

No. I'm a dancer.

The tissue can't be saved.

No.

TAUB: We know what
House would do.

CHASE: House would have
never woken her up to ask for consent.

If you can't live with the answer,
don't ask the question.

You're saying
we should accept her decision?

Bold idea, I know.

Maybe we can get the boyfriend
to convince her to do it.

Yeah, boyfriends get
everything they want.

Forget it. The boyfriend
doesn't want to talk to her at all.

TAUB: Where are you going?

Home. The case is over.

No, it's not.
Not until we come up

with something
that might work.

It's a shame
that she might die

because House has some personal crap
to work through.

Technically, if she dies,

it's because House
has some personal crap to work through

and we weren't smart enough
to get the answer without him.

False alarm.

Drink this.

That's your advice?
Drink this?

It's ginger.
It'll ease the nausea.

You know what
would calm the nausea?

Vicodin. Marijuana. A coma.

Don't pretend
you didn't see it.

I saw it,
which means you saw it.

Send her away.

Too bitter.
I already have enough bitter.

I'll add some honey.

You're pathetic.

If you want the pill,
just send her home.

But you can't, because that would be
admitting defeat to her.

Now this is interesting.

If you take the pill,
you don't deserve her.

If you secretly take the pill,
you don't deserve anyone.

No!

No. No!

This isn't going to work.

It might work.
That's all we're going for.

Vasodilators can...

Big jump from reopening
to reanimating.

I'm out of the ulnar.

Not seeing any clearing.
This won't work.

This probably won't work.

Radial artery's really tight.

Don't go too fast. If it clots,
she loses the hand.

If it clots,
she's dead.

I can't believe it.

What?

It might be working.

Can you stop?

The breathing.

Air goes in,
air goes out.

Use your nose.

You're supposed to feel like crap.
You're doing great.

- And after?
- You come back to work.

What if I can't?

Opioid dependency
can make you think

you have more pain
than you really have.

You're going to be okay.

You're telling me what I want to hear,
with no evidence.

I'm telling you what I
believe to be the truth.

With no evidence.

You're hardly the most
unbiased observer.

Neither are you.

I'm your hospital's
biggest asset.

Is that why you
think I'm here?

That's why you're here, that's why
you're lying to me about...

I haven't lied
to you in 20 years.

Sure you have.

Which means that
you just said that

because you want to tell me what
you lied to me about 20 years ago.

You're an ass.

Am I wrong?

I wasn't in your
endocrinology class.

You sat next to me.
I cheated off you in the mid-term.

I audited your
endocrinology class.

Why would you...

Because I thought you were
an interesting lunatic even then.

I'm not here protecting
hospital property.

We're alone.

We've been alone all night.

No, I mean Amber.

She's gone.

Where's Jeremy?

He left.

You Okay?

The surgery worked.

Congratulations.

I can't do it.

You have doubts.

You don't?

No.

That's

naive.

I want to spend the rest
of my life with you. I love you.

That's how I feel
right now,

but I don't know.

I'll wait until you do.

I can't know.
No one knows.

I do.

I'll see you in later?
I have some papers to push for you.

Thank you.

You want to kiss me,
don't you?

I always want to kiss you.