House (2004–2012): Season 8, Episode 11 - Nobody's Fault - full transcript

TAUB:
Pressure.
l need pressure.

JESSICA:
Give me sutures...

TAUB:
We need an Epi.

JESSICA:
Alert trauma.

(EXHALES)

(BEEPS)

Let the record show
that we are officially

convening
a disciplinary hearing

regarding the events
on February 3rd, 2012,
in patient room 209.

Dr. House, this recording
will be transcribed
and published

along with all supporting
documentation and rulings.



Do you have any questions
before we get started?

Yeah.

Who the hell are you?

I'm Walter Cofield.
Chief of Neurology,
Mercy Hospital.

I'll be deciding
your fate today.

Cofield.

You were the Residency
Director at Hopkins
before you moved to Mercy.

Which means
it's safe to assume
that you trained Foreman.

Which means it's
also safe to assume
that he trusts you.

This hearing isn't
about me, Dr. House.

I know you'd like
to make it about me

because then
it wouldn't be
about you.

It's interesting that
he picked the old mentor
to judge the new one.

Interesting,
but not relevant.



The facts of this case,

on the other hand...
The facts are
in the file.

If you have trouble
reading my handwriting,
give me a call.

I'm going back to work.

If I just consider the file,
the facts aren't
in your favor.

The facts say
you should be suspended.

Which,
from what I understand,

would mean
a revocation
of your parole.

The patient was
a 32-year-old high school
chemistry teacher.

He collapsed
while out jogging.

He was paralyzed in
all four extremities

despite the fact
that the scans...

...show no sign of stroke
or structural lesions.

Did you put out
an APB for a car

with a man-shaped
dent in the grill?

No broken bones,
no signs of trauma.

Transverse myelitis.
Boring.

No enhancement
on the MRI.

I just don't know
what to do.

Please, you have to
help me solve this thing.

A little poetic license.

What are you doing?

Taking my vic-amins.

Those are Vicodin?

Did you have
surgery recently?

About a decade ago.

My leg is no good
at judging time.

Were you taking Vicodin
during this case?

(SIGHING) Uh...

Yes.

And during
about nine years'
previous cases.

(CLATTERING)

My process is proven.

Good things usually happen.
Bad things sometimes happen.

And when bad things happen,
we should figure out
what went wrong

so we can learn from it
and correct it.

So we can assign blame.

Instead of recognizing
that bad things
sometimes happen.

It was nobody's fault.

And then what happened?

Those who can, do.
Those who can't, teach.

Those who can't teach,
teach gym.

And those who can't
move their arms or legs
teach us to laugh at others.

House actually
presented the case
in that way?

Or are you just trying
to make him look bad?

Why would I be trying
to make him look bad?

Could be your
not-so-subtle way

of implying
this was House's fault.

Given what's happened,
it's understandable

that your opinion would
color your testimony.

But I just want to
know what you said,
what you did

and what you were
thinking at the time.

I don't think
it was his fault.

Just tell me
your initial theory.

I thought the patient
had a liver problem.

Hepatic encephalopathy
explained why he passed out,

why he couldn't
move his limbs.

But that's not the idea
House went with?

He thought Taub's idea
was stupid.

And what about
your idea?

He thought that
was stupid, too.

(LAUGHS)

No. I meant,
what was it?

Oh. I thought
the patient had normal
pressure hydrocephalus.

And why did House think
that was stupid?

HOUSE: Oh, come on.

Unless you're an idiot,
you know why I thought
Park was an idiot.

The patient had
low opening pressure
on his LP.

That's what I said.

No, you idiot.

The patient had
low opening pressure
on his LP.

Try unsquinting your eyes
and reading the labs
next time.

Are you intentionally
trying to get me
to dislike you?

That wasn't me.
The chair squeaked.

You're testifying
for the record

that you actually
used the phrasing,
"unsquint your eyes"?

This is not the place to
exorcise your guilt,

I just want to
know exactly...

I actually
used the phrasing
"unsquint your eyes."

He's hypokalemic,

could indicate
a problem with his heart,
which would...

EKG was normal.

HOUSE: But, Chase,

a doctor who
actually takes the time

to read the lab reports,
has a point.

The guy's
potassium is off.

Could be
thyrotoxic paralysis.

Start him on steroids, PTU,
and beta blockers.

Mmm-hmm.

And how did
these orange smudges
get on the patient file?

Seriously?
That's your follow up?

I eat a lot of Cheetos,
I forget to wash my hands.

Is my snacking
really relevant
to this case?

Might be, if these were
actually Cheetos stains.

What are they?

Seriously, House?

You're blaming me?

You used Adams' shampoo.

I didn't do it.

HOUSE:
It was a harmless prank.

My team is made up of
Type A personalities.

They need somebody
to break the tension
every once in a while.

So this was a team
building exercise?

Is that what
he called it?

It's what he implied.

House prefers
chaos over cohesion.

He believes that
disagreement and mistrust
lead to better ideas.

He's not wrong.

As opposed to
being right?

So you treated
with steroids.

And then what happened?
They worked.

Our patient woke up.

EMILY: Bill?

Can you hear me?

Yeah.

I'm thirsty.

That's normal.
You've been in a coma
for several hours.

Can you tell me
your name?

Bill. Bill Koppelman.

Can you tell me
what happened to me?

We're treating you for
an overactive thyroid.

We think that's
why you passed out
and couldn't move.

Can you wiggle
your fingers for me?

Is he going
to be okay?

Excuse me,
but only family members
are allowed.

It's okay.
They're my students.

Everyone back at school
is so worried about you.

Is he sick because
of the explosion?

What explosion?
What explosion?

What explosion?

A chemistry demonstration
he was doing for
his class went wrong.

Then why was it
not already in
the patient history?

Because the patient
was unconscious.

But I'm assuming
Dr. House spoke
to the wife.

The wife didn't know
about the explosion.

And I was the one
who questioned her.

So if there was
an oversight,
it was mine.

Does Dr. House
not attach importance
to patient histories?

No. He thinks
they're crucial.

He just doesn't think
being in the same room
as the patient is crucial.

House thinks
avoiding patients

allows him to
stay as objective
as possible.

He's not wrong.

That sounds like
a very diplomatic way
of saying he's lazy.

That's also true.

Either way,
I'm covered.

If you want an accurate
patient history,

don't ever talk
to the patient.

Everybody lies.

Except me.

To you.

Would never do that.

Okay. Say you're right.

If you had
actually been in the room
questioning the patient,

you could read
body language,

you could ask
follow up questions,

and warn him
of the cost
of lying to you.

Don't forget thumbscrews.

Can you dispute
the possibility

that had you visited
the patient sooner,
maybe talked to the wife,

been directed to
one of the students,

that this case might have
ended very differently?

BILL: It wasn't exactly
an explosion.

It was a controlled reaction
that went a little haywire.

JORDAN: It was, too,
an explosion.

Simon Harris
filmed the whole thing
on his camera phone

and posted it
on YouTube.

It got, like,
over 75,000 hits already.

Looks like you've
gone viral, hon.

(GAGGING)

(RETCHING)

He had a loss
of consciousness,
temporary paralysis,

but when I was told
that the patient
coughed up blood,

things really started
to get interesting.

Your patient was
doubled over in pain
and coughing up blood.

And you found
that interesting?

Why, is that bad?

It's interesting.

I do this demonstration
every year.

But I usually
have a student aide
help me set it up.

Apparently this year
he added extra
hydrofluoric acid,

which is why
it exploded.

The student aide was
just trying to
make a viral video,

not hurt anyone.

Ended up doing both.

So we figured
the patient inhaled
the extra large dose

of hydrofluoric acid,
and...

...burned his lungs,
which is why he
coughed up blood.

If only burnt lungs
explained the passing out
and paralysis.

The explosion does.
Check out the video again.

He smacked his head
against the wall.

If that caused swelling
in his brainstem

that would have led
to the eventual loss of
consciousness and paralysis.

So we discussed it
a little longer

and House decided to
treat with heparin.

I wouldn't mind
a couple more details.

It was aerosolized heparin.

You skipped over
the actual DDX,

and now you're
averting your eyes.

I'm growing more
and more curious
by the moment.

(SIGHS)

He smacked his head
against the wall.

If that caused swelling
in his brainstem

that would have led
to the eventual loss of
consciousness and paralysis.

HOUSE: Nobody move.
Ugh!

He had on a what?

Gas mask.

The stink bomb
was Chase's.

He was getting revenge
for the orange hair

and rigged it
in House's office.

But House found it.

Mmm-hmm.

You can leave when
I have an answer.

Might help if
we knew the question.

How do we treat
chemical burns
inside the lungs?

Maybe we can use
a bronchoalveolar lavage
to wash them out with water.

Sorry, my fault,
I should have clarified.

How do we treat
chemical burns
inside the lungs

without killing
the patient?

Silver sulfadiazine
works well
on chemical burns.

HOUSE: Burn cream
would drown him
faster than water.

Well?

Aerosolized heparin.

Me likey.

CHI: But that's
only experimental,

it's never actually
been used before.

Not true.

It's been used
in sheep.

Uh-huh.

The guy was
going downhill fast.

We needed a treatment
that was a slope changer.

So you busted out
the sulphur dioxide
stink bomb?

It was a team
building exercise.

No, it was manipulation.

You were pressuring
your team into coming up
with unsafe medical ideas

just to get out
of that room.

You say pressure,
I say inspire.

The usual, safe ideas
were not going to work.
Aerosolized heparin might.

And everyone else just
went along with this?

No. I told House
I thought
it was a mistake.

And those were
your exact words?

I think I might
have said "insane."

You thought it was insane
and yet you let it happen.

No, I...

If you disagree
with Dr. House
on patient safety, Doctor,

it is your duty
to speak up.

Otherwise,
you're equally to blame.

I did speak up.
I tried.

And you failed.

And that's why I went
to Dr. Foreman.

The heparin could
cause the patient

to bleed into his lungs
even faster.

It is crazy.

But House doesn't do crazy
just for crazy's sake.

If he thinks
this is the only way
to help the patient...

COFIELD: You did not
tell me you were
involved in this case

when you asked me
to do this.

I wasn't.

The heparin decision
didn't have anything
to do with the outcome.

If signing off on
everything House does
is a pattern,

it affects
the way House behaves,

it affects the way
House's team reacts
to the way House behaves.

House

is brilliant.

I give him
the benefit of the doubt
most of the time,

because I've seen
what he can do.

Getting House
out of prison

is the biggest decision
you've made as Dean
of Medicine, right?

And if he's suspended
as a result
of this hearing,

he violates his parole
and he goes back.

And that probably
leaves you as former
Dean of Medicine.

I suppose so.

You didn't choose me
to oversee this

because you thought
I could be objective,

you chose me
because you thought
I'd have your back.

And I'd think twice
about making a decision
that would get you fired.

Eric,

I'm sorry.

But if your
get-House-out-of-jail-free

experiment blows up
in your face..

it's not my job to
get you out of it.

After you'd
administered the heparin,

I see there was
a discharge order
in the chart.

Yet the patient
never left.

House ordered
a therapeutic bath first,

to wash off
any residual chemicals
from the blast

but we wound up
finding something.

JESSICA: You have
a bit of a rash.

Can you raise
both your arms?

We just need to
see how far it goes.

BILL: You told me
I was gonna be okay.

And now there's still
something wrong with me.

It probably
doesn't mean anything,
but we want to make sure.

Of course you do.

I gotta get out
of here. Okay?

JESSICA: Just relax.

Please just let me
get out of here.

It'll just
take a minute.

We need to
get a good look
at the rash.

The rash? That was nothing.
Just some irritation
from lying in bed all day.

The problem was
the patient's brain.

He freaked out.

I gotta
get out of here.

I gotta
get out of here!
Easy.

JESSICA:
"Freak out" is
a little strong.

In my opinion at the time,
it was the rash that
was going to kill him.

Invasive strep.

Reasonable theory,
supported by the evidence.

The evidence pointed
to psychosis.

We caused it
by giving him steroids
when he first came in.

What'd you think?

I thought Park and Adams
were both right.

But that their conclusions
were both wrong.

The neuro symptoms
and the rash

were both signs of
an underlying disease.

Together with the lung,
it added up to Wegener's.

How does Dr. House handle it
when three smart doctors

come up
with three different,
but equally valid ideas?

I run a diagnostic trial.

HOUSE:
Start the patient on
high dose steroids.

Multiple birds,
single stone.

If Taub is right,
then he can walk
out of here cured.

If Adams is right..
he will spike a fever,
get hypotensive,

we can treat it
and he can walk
out of here cured.

If Park is right
and he goes all
Cuckoo's Nest on us,

we can cross
"brain" off the list...

...diagnose him,
and he can walk
out of here cured.

Are you trying to
make this easy for me?

By your own admission,
if you give
the patient steroids,

two of the three outcomes
could make him worse.

What's making
the patient worse
was not having a diagnosis.

This was the fastest way
to get it.

It was the perfect
diagnostic moment.

In light of
what happened,

do you still think
it was the perfect
diagnostic moment?

Yes.

My theory accounted for
all the medical outcomes.

It did not account
for the disobedience
of my own team.

What are you doing?

I think you're right
about the strep.

Can't hurt
to biopsy the rash
while we're waiting.

Thanks.

At the time,
it seemed like
a good idea.

I know this is hard.

But please tell me
exactly what happened next.

CHASE: Draw up
a little anesthetic.

JESSICA:
Two cc's Lidocaine.

Get away from me!

(GASPS)

(GRUNTING)

Bill, you're in
a hospital.
Calm down!

(GRUNTING)

Code Grey!

So your position is that
your team's disobedience
caused this?

That's not what I said.

You said
you didn't anticipate
their defiance.

You implied that
all would have
been fine otherwise.

So who do you blame?

Dr. Adams or Dr. Chase?

Or both?

I don't blame either one.

So who do you blame,
Dr. House?

(YELLING)

JESSICA: Code Grey!

Get Haloperidol.

TAUB: Got it.

(GROANS)

Oh, my God, Chase!

Prep the OR!
Get a gurney.
Start an IV!

JESSICA: Come on.

Bleeder's gotta be
in here.

Got it!
Which artery?

It's his heart.

Fortunately,
only the knife tip reached
the cardiac muscle.

Made a laceration
in the left ventricle

about the size of
the tip of my index finger.

At that moment,
he could only stay alive

as long as my finger
plugged the hole.

Hmm.

It could've been me
on the floor.

It should have been me.

It was my theory.

I held the needle
in front of the patient
that set off his paranoia.

If you're looking
for someone to blame,

blame me.

Please continue.

Getting some ectopy.

Coming through!
CHI:
Good carotid pulse.

JESSICA: Regular?
CHI: No.

Got a PVC.

Gotta move it,
people.

My diagnostic test worked.

It proved that the patient
had a steroid induced
psychosis.

That's what you took away
from this situation?

The brain was not a symptom
of an underlying disease.

Your colleague
was stabbed.

Are you telling me
you didn't care?

How bad is it?

TAUB: Bad.

Patch.

Ready.

I can't take my finger out,
he'll bleed.

I don't think
he can take it.

HOUSE: Oxygenation's
100 percent.

He's as ready
as he's gonna be.

We gotta go for it.

JESSICA: On my count.

One, two,

three.

TAUB: Suture.

Got it.

CHI: BP is stable.

Patch is holding.

What was his heart rate?

He doesn't have one.
He's on bypass.

Not Chase, the patient.

You're DDX'ing?

Park, come with me.
Taub's got this.

My friend is here
because you didn't
listen to me.

I did listen to you.
Chase didn't listen to me.

At this point,
being here makes
you feel better,

you're not helping
Chase or our patient.

Fine.

So he just walked out?

There really was
nothing for him to do.

It speaks to
a certain callousness

on Dr. House's part,
don't you think?

Who cares if
House was callous?

Are you going to
punish callousness?

But you agree that
empathy is a useful
quality for doctors?

House is
not the problem.

Your friend got stabbed.

He may die
from those wounds.

If you had been
in that room, maybe that
could have been you.

I wouldn't have
been in the room.

Implicitly, you just said
that Chase was at fault.

We all knew
a psychotic episode

was one of the three
possible outcomes.

And Chase brought
a scalpel in there.

He endangered Dr. Adams,
he endangered himself,

and he endangered
the patient.

Thank you.

Lungs, rash,
and now excessive
RR variability.

Go.

It's a hospital.
There are lots of doctors
that can take care of him.

And your thinking is
that only you guys

are qualified to
sit in this room,
doing nothing?

If you're motivated
by caring,

just bear in mind
he's a dedicated
chemistry teacher

with a pretty wife
and adoring students
and a baby on the way.

She's not pregnant.

Would it make a difference?
Because I could knock her up.

Autonomic dysregulation...

Shut up.

CHASE: Can you guys
keep it down?

You made it, bud.

JESSICA:
You're in the PACU.

You've been in surgery.
The anesthesia's
just wearing off.

Did I have an epidural?

No.

Because I can't
feel my legs.

(DOOR OPENS)

COFIELD: Dr. Chase?

Robert?

Yeah.

I'm Walter Cofield.

I'm a neurologist
over at...

I know who you are.

Good.

You think you're up
for answering a couple
of questions?

Well, it's not like
I can get up
and run away.

Wasn't my best joke.

(CHUCKLES)

I'm smiling because
for the last 12 hours

I've been picturing you
with orange hair.

I dyed it back.

(BEEPS)

Were you angry
with Dr. House?

It was a prank,
it wasn't uncommon.

So I've heard.

That doesn't mean
you couldn't get angry.

Might actually contribute
to that reaction.

Can I ask why
that matters?

Are you trying to prove
that I was distracted,

that my judgment
was compromised?

Who do you think
was at fault

for what happened
to you, Dr. Chase?

Again,
why does it matter?

You're a smart doctor.

You know what happened here
better than anyone

and you've
worked with Dr. House
longer than anyone.

And I suspect
that you've spent

every minute since
this has happened

trying to answer
that very question.

I don't think it
was anyone's fault.

I was angry
but I wasn't distracted.

And I think
if there's any chance
I'm gonna walk again

it's because
Dr. House is a genius.

What about warmth?
Can you feel the sheets
on your skin?

I just said
I don't feel anything.

Objectivity, House.

What about
posttraumatic syringomyelia?

A syrinx formed in
the subarachnoid space,

blocking the flow of
cerebrospinal fluid.

That'd mean
the damage was permanent.

No.

Forget the nerves.

House, if it's
total paralysis
he must have...

Not necessarily.

Think arteries.

Blood flow to
his spinal column
is cut off.

It's a clot in
the radicular artery.

That could be fixable.

Prep a room
for an embolectomy

and let's get
that thing out of there

before it does
any more damage.

And if it's not a clot?

Then you can ask Foreman
if hospital insurance
covers ramp-vans.

You're through
the aorta.

CHASE: There.

Sensory level is at L5,
it must be
the descending branch.

Can I see the monitor?

Stop there.
Shoot the dye.

There it is.
TAUB: Don't get
too excited.

We still gotta get it out..
still could have
done permanent damage.

Patient does not have
autonomic dysregulation.

There's blood
in his urine bag.
Kidneys are failing.

House, not now.
Gotta be now.

Foreman's
transferring our guy
to Princeton General

as soon as
there's a bed available.

Says the doctors here
can no longer be objective
since the stabbing.

In the middle
of a procedure that could
basically save your life,

House is actually trying
to drag people away?

How do you work
with a guy like that?

He wasn't trying to
pull anybody away.

Everyone had
already refused to
work on that case.

He knew the answer.

He wanted to check on me.
But he needed an excuse.

Otherwise he could
be accused of caring.

So your testimony is that

Dr. House's
complete lack of concern

is evidence of
his deep concern?

Did you just do that?

What?

Wiggle your toes.

Do you feel that?

Congratulations.

It was the clot.

Short occlusion time
of the artery,

when the swelling
goes down,

you should
gain back at least
some of the function.

One more thing. Sorry.

You knew that your patient
was at risk for
a psychotic break

when you brought
a scalpel within
his reach.

Why did you ignore
that risk?

I thought I was right
about the rash.

I would do it again.

I thought so.

That's it?
"I thought so"?

What the hell
does that mean?

You brazenly
defied your boss.

Now that happened
either because Dr. House

has established that
that's okay in his world.

Or his prank war
distracted you.

Or House makes
medicine a game

and you just wanted
to beat him.

Whatever the reason,

it boils down
to the fact that you may
never walk again

because House
created an atmosphere
that promotes recklessness.

(DOOR OPENS)

This will be
our last round
of questions.

I've spoken
with Dr. Chase.

You know
he regained movement?

No.

(BEEPS)

Are you really
this indifferent

to the fact that
Dr. Chase is hurt?

Are we going off the record
because this is irrelevant

or are you going
to hit me?

Why don't you
go tell the guy
you're sorry...

I didn't do
anything wrong.

It's not
an admission of guilt.

He's your friend
and he's not well.

He's a co-worker.

Co-worker whom you've
known for almost 10 years
who nearly died.

And who's still scared
he may not walk.

Are you going
to have me fired
for bad manners?

I'm just trying
to understand you.

Why a man
in your position,
with your abilities,

is incapable of
shaking the impulse
to act like an ass.

Could we go back
on the record and
get this over with?

(BEEPS)

Put the Vicodin away,
Dr. House.

My leg hurts.

(LAUGHS)

Is that supposed
to be funny?

Two explosions.

(DOOR OPENS)

We're not done here.

(THUNDER RUMBLING)

HOUSE: Hey! Hold on!

COUMONT: Close it up.

Take him out of there.

Dr. Foreman said
you'd try this.

Said to tell you
he's no longer
your patient.

Hey!

(SIREN WAILING)

Wait.

Wait.

I have to get to my car.
I want to be...

Your husband has a tumor
in his lymph nodes.

You've been wrong
every time.

Not this time.

The explosion
in the classroom

caused the cancer cells
to break open.

It's called
tumor lysis syndrome.

His body was flooded with
an excess of phosphates,
potassium, acids,

all kinds of
cancerous junk.

That explains
the paralysis, the bleeding,
the heart and kidney issues.

Everything.

What about
the psychotic break?

Turns out we caused that.

(ELEVATOR DINGS)

This is treatable.
Okay?

You have to tell
the new doctors he needs
total body radiation

and plasmapheresis.

Move your cane, please.

Where's Cofield?

He said you walked out.

I'm walking back.
I'm not done testifying.

Apparently you were.
Said he'd have
his decision tomorrow.

(BEEPS)

COFIELD:
This case is a fiasco.

I didn't sleep
last night.

Dr. House is
obviously brilliant.

Well, I think
we've heard enough.

But Dr. House is
also a fiasco.

If I were to
exonerate him,

condone his completely
reckless, immature,
almost misanthropic behavior,

I would essentially
be sending a message

to all the other doctors
in this hospital

that it's okay to
act that way, and...
(DOOR OPENS)

Sorry.

We're in the middle
of something.
EMILY: I know.

I came to speak
with Dr. House,

and when they told me
he was in here

I thought
I should say something.

I mean,

he wasn't
the nicest doctor
I've ever met.

Well, I think
we've heard enough.

But he was right.

They found the tumor.

They are removing it,
and they are starting
plasmapheresis.

They expect
a full recovery.

He saved
my husband's life.

Well, I guess that's it.

Thanks again.

(DOOR CLOSES)

As I was saying,

Dr. House's process
is dangerous
and inappropriate.

But he is effective.

I've decided that
I would be doing this
hospital a disservice

if I did anything to
change that process.

Congratulations,
Dr. House.

This unfortunate
stabbing incident is
officially nobody's fault.

(TURNS OFF TAPE)

Coward.

Excuse me?

HOUSE: You've got like
20 pages of notes there.

You were expecting
to bore us for at least
half an hour.

You've got
my parole form in here.

You were going to
send me back to prison.

House, stop.

Good things usually happen,
bad things sometimes happen.

The fact that
that would-be widow

came in just in time to
sob all over your soft,
mushy heart,

and the fact
that her husband
is going to live,

does not change
whether or not
I did the right thing.

(CHASE BREATHING HEAVILY)

(EXHALES)

How'd you get
the firing wire into
the Vicodin bottle

without me noticing?

Why'd I even have to?

What was the point
of the orange hair?

Your hair smelled
like Adams'.

Since there's no way
you're doing her
without me knowing,

it means you were
just doing her shampoo.

Which means you were
out late drinking
with some new girl

or because there is
no new girl.

You were trying
to make up time
by showering at the hospital,

but you were too lazy
to buy your own shampoo.

So I found a way
to let you know
to not be late.

You couldn't just ask me
to stop being late?

What fun would that be?

None of this is fun,
House.

(GRUNTS)

They decided that
your being stabbed

was nobody's fault.

They're wrong.

I'm sorry.

Anything else?

I'm kind of busy.

No. That was it.

I've got it.

(CHASE GRUNTING)