House (2004–2012): Season 8, Episode 19 - The C Word - full transcript

When the team takes on the case of Emily, a six-year-old girl who has numerous preexisting health problems, they must work with her mother Elizabeth, who happens to be doctor herself, specializing in her daughter's condition. The team must also deal with the battles raging between Emily's mother and father who have conflicting views on how to handle her health issues. When searching the family's home for clues to Emily's illness, the team realizes that Elizabeth's determination to cure her daughter could be the very thing that is killing her.

SIMON: Three, two, one!

Ah!
(GIGGLES)

(LAUGHS) Whoo!

(GRUNTS)

What do you want to do next?

Uh...

Swings?

Okay. Crawl tube?

- Nah.
- Nah?

Well, I think we're running out
of options, honey.

I want to go on the
merry-go-round.



The... Again?

But this time all by myself.

On... (LAUGHS)

I don't know, jelly bean.

Daddy, I'm six.
I'm not a baby anymore.

Please?

Thank you.

You ready?
Uh-huh.

All right. Come here.

I'll take Beary.

Now, you promise you're not going
to tell Mommy, right?

She'll kick my butt
if she finds out.

Pinky swear.

All right.
Go get 'em.



(BELL RINGING)

- Remember to hold on tight.
- I will!

(BELL RINGING)

(MUSIC PLAYS)

SIMON: Stop the ride!

Emily!

Emily! Where are you!

Em?

Emily?

Emily?

Emily, where are you, honey?

Emily? Emily?

Honey?

(YELLING) Help me!

(DOOR OPENS)

Is that our precious
little bundle of tumor?

They grow up
so fast, don't they?

- How did you know I was here?
- How do you think?

Foreman.

Actually, that would have been
easier. No, I followed you.

It didn't occur to you
that that might mean

I don't want you involved
in my cancer treatment.

I'm not here as a doctor.

I'm here as a towering
pillar of strength.

Be a pillar in the
parking lot.

No.

How many times have I told
you I wanted to be alone

and you've made yourself
a pain in the ass?

I owe you.

My word, not a word.

Realizing I'm most likely going to
regret this, all right.

(CLANGING)

What are you doing?

My best friend has cancer.
Cut me some slack.

Also, it's spring break.

I'm on vacation.

Although looking at
you now, I can tell

that the wet t-shirt contest
is probably going to suck.

House taking time off
is a bad sign.

(LAUGHS ) "A bad sign."

You think the apocalypse is coming

because House
wants to be there for Wilson?

Yes.

You're new.

FOREMAN: We've got a case.

Six-year-old
with a nose bleed

and breathing problems. She was
born with a rare mutation of A-T.

Emily has a unique variant
on both of her ATM genes.

Her disorder mimics A-T,
but not all of the symptoms.

This is Dr. Elizabeth Lawson.

She's a developmental
geneticist attached to JHU

and an expert
on the girl's condition.

Elizabeth Lawson.

Emily Lawson.

I'm here as a doctor,
not a mother.

Nose bleeds and breathing
problems are common symptoms

of ataxia telangiectasia.

We could just be seeing
the natural progression of...

It's not. A-T patients have a life
expectancy of 20 years.

Emily is only six.
It's something else.

I examined her lungs two days ago.
They're functioning normally.

It says she fell off a carousel.
Head trauma could...

If the diagnosis was easy,
I wouldn't need you people.

I'm here because according
to Eric, you're the best.

CHI: We are.

Have you considered
Wegener's granulomatosis?

It's a good fit.

But she can't have x-rays.

A-T makes her hypersensitive
to ionizing radiation.

I'll get her prepped
for an MRI.

She knows more about her daughter's
genetic condition than any of you.

She'll be an asset.

Or she won't, Eric.

This isn't a request.
Use her.

The tumor's spread
to the surrounding tissue.

We're gonna have to shrink it
before we remove it surgically.

I'm more interested in exactly
how you plan to do that, Mike.

We start conservative.

Daily radiation treatments
for three weeks.

And if it doesn't shrink enough
after that, we'll add the chemo...

And if it hasn't shrunk
enough after that, I'm dead.

Look, you have over a 75% chance that
the radiation alone is enough. Relax.

We've caught this in time.

Catching it in time would have been

before it invaded the tissue
around my thymus.

I want the radiation
and the chemo concurrently.

Why stress your immune
system unnecessarily?

Let's just go with my plan.
Okay?

- The radiation first and...
- I'm gonna get a second opinion.

Are you serious?

Look, I've seen you recommend
this exact treatment dozens of times.

We're done here.

I'll look for a doctor
with some actual balls.

Hey, you need to
talk to your friend.

He's embarrassing himself.

A doctor should be able
to handle his own illness

- with a little bit more dignity.
- I agree with Wilson.

My recommended
treatment is sound.

No, I meant about
the ball-less part.

Explains the office.

SIMON: (LAUGHS) It was a
merry-go-round.

She's a kid, Liz.
We were having fun.

- You should try it sometime.
-Fun?

She's six, not you. You know
she has balance issues.

I know that she's...
(CLEARS THROAT)

This is Emily's father, Simon.

He was with her
when the symptoms occurred.

I had her all week.
She was fine.

- We could come back.
- No need.

Patient's ready for transport.

Wake up, sleepy head.

I saw it in the gift shop.
I know how much you like them.

Thanks.

They're going to take
you for an MRI now.

It means
"magic really cool images."

I thought it stood
for magnetic resonance imaging.

We've spent a lot
of time in hospitals.

B-9.

Hit. And I hate you.

(GROANS)

I'm done.

- I sunk your battleship?
- No.

But I think I'm going to puke.

Good. Now that you're
sufficiently buzzed,

what was the reason
behind you freaking out on Kondo?

You scared? In denial?

I know you get confused any time
someone thinks that you're wrong.

But it's not considered freaking out for
a patient to ask for a second opinion.

Okay, well, here it is.
Kondo was right.

You should be in
radiology right now.

Well done. You've kept
your word for almost two hours.

Every day you wait, our pal, Tumie,
is growing larger in your chest.

You want to live, stop screwing around
and do something about it.

Good idea.

I think I'll start with spending
spring break on my own.

How are you feeling
in there, Emily?

EMILY: Good, I guess.

Something wrong?

I was only pretending
to be asleep.

You think that's dishonest?

That's...

My daughters do that, too,

but they know that sometimes when it
seems like mommy and daddy are fighting,

it's really only because
they're worried about you.

And does your wife
ever want a divorce?

No. Everything's fine at home.

Hold still now.
No more talking.

What do you think
of her mother?

She called her
daughter "the patient."

If my kids were born
with an expiration date,

I don't...

(EMILY EXCLAIMS IN PAIN)

(CRYING IN PAIN)

Where does it hurt?

I want my daddy!
Where's my daddy?

We were able to restore circulation
to her hands and feet

before any permanent
damage set in.

Primary Raynaud's?

The cold inside the MRI room
could have set it off.

Stress can also precipitate
the condition.

She's shown no evidence
of cold sensitivity

and she has no problems
with MRI machines.

There are other kinds of stress.

She heard you and
your husband fighting.

Unfortunately, she's heard a lot
worse than that before. It's not stress.

Could be secondary Raynaud's.

Lupus is consistent with
Emily's symptoms.

ELIZABETH: Her lymph nodes
aren't enlarged

and she has shown
no signs of immune activation.

It could be heavy
metal poisoning.

From what? The carousel?

She was only on
it for a minute.

Simon moved into an old
apartment building three weeks ago.

I'm sure he has no idea
what the insulation's made of,

what kind of paint.

He's a good father, but when
it comes to Emily's health...

I'm gonna get his keys
and check for environmentals.

Lupus is a better fit.

I don't mean to pull rank
here, but I am her mother.

I thought you said you
were here as a doctor.

And as a doctor, I need
parental consent. See above.

While I'm gone, please start her on
chelation therapy.

She's the mother.

So let's treat her like
any other mother.

I think we just hit the environmental
mother lode.

Funny she never mentioned
an entire basement

full of dangerous
chemicals and drugs.

You think she'd even let
Emily down here?

Yeah.

And apparently a lot.

You ever heard of LEX-2?

I've read about it.

It's an experimental
aminoglycoside antibiotic.

Supposedly it can override
DNA errors in the ATM gene.

Doesn't mean she's giving
it to her daughter.

Anyone studying A-T
would be researching it.

How?

You see any lab
rats down here?

The only cage I see
is right there.

(DOOR OPENS)

Go away.
I have a headache.

We don't have to have sex.

Sometimes it's nice just
to cuddle and talk.

Me first.

You don't want
a second opinion.

You're already on your fifth.

You have Evans at Mercy,
Shaw at County,

Foster at Johns Hopkins.

Every one of them
has given you the same advice.

You're nuts.

You don't just want chemo.

You want a dose so high

there's a one-in-three chance
it will kill you outright.

The question is,

why didn't you tell me?

Because you knew
I'd stop you.

Which means you've already
found someone insane enough

or desperate enough

to give you what amounts to
a death dose of chemicals.

But who would be that stupid?

I'm thinking that the "who" is you.

Where exactly were you
planning on killing yourself?

'Cause I don't think Foreman
is going to let you do it here.

My place. I've been
stockpiling equipment.

No. No! Stop.

I'm still healthy,

why not go the extreme route now when
there's a better chance of surviving it?

Statistically,

this treatment has about the same chance
of killing you as the thymoma does.

But a hell of a lot faster.

Nancy Wells.
Cervical cancer, 70% survival rate.

Died November 6, 1998.
64 years old.

Bernie Jones,
melanoma, 89% survival rate.

October 10, 1999.
He was 52.

John Taylor. Thyroid,

96% survival rate.

I promised him he'd be fine.

Eight years old.

I am not going to die slowly in a
hospital bed under fluorescent lighting

with people stopping by to gawk
and lie about how I look.

Even a small chance of that happening
is too big a chance for me.

You're an idiot.

And the odds say
you're going to die.

We'll do it at my place.

The only environmental factors we
think caused your daughter's illness

are the ones you
shot her full of.

I tested the drug.

This is what I did for
a living for 10 years.

She's your child,
not a guinea pig.

I tested it first.

On myself.

And in six months I didn't
document any adverse effects.

A trial of one is
basically irrelevant.

(SIGHS)

Respiratory infections
are common with A-T.

With Emily's mutation, they are deadly
and they get worse every year.

LEX-2 won't be approved for at least
the next five years.

Emily, on the other hand,
wouldn't have survived the winter.

(SIGHS)

What was I supposed to do?

There's a reason for FDA requirements.
A study at Jackson Memorial...

I know about Gaines' research.
He's publishing next month.

Was. I just spoke to him.

His team just linked the use of LEX-2
to renal failure in mice and rats.

She needs an ultrasound-guided renal
biopsy to check the damage.

Hopefully, it's reversible.

(JAZZ MUSIC PLAYING)

To stupidity.

Not quite done.

To muscle aches, spasms.

To your joints feeling
like they've been ripped out

and replaced with shards
of broken glass.

Should I be writing
any of this down?

Your stomach fills with bile.

When you vomit it feels like

someone's forcing a white hot hammer
down your esophagus, tearing your flesh.

Blood's dripping down
the back of your throat,

choking and gagging you with the slick,
coppery taste of burnt pennies.

I am an oncologist, I know...

If you did,
we wouldn't be sitting here.

Day two.

Your white blood cells are gone,
opening up your system to attack.

Your temperature skyrockets.

One second, your skin feels like it's on
fire,

the next second, it's entombed in ice.

Every pain sensor in your body
is firing at the same time

until agony isn't even
a word or a concept.

It's your only reality.

You hallucinate.

You dream of death.

And then the race begins.

Can your body claw its
way back in time

before the hostile organisms
and parasites claim you permanently?

Win, you live.
Lose, you die.

Now, what are we
doing here, Wilson?

Kidney number one looks good,

which means we'll probably
take the biopsy from two.

Hey. You're doing great.

Brave as always.

Pretty cool, eh?

Wanna try?
(LAUGHS)

ELIZABETH: What's wrong?

(MONITOR BEEPS)

My chest hurts.

(FAST BEEPING)

(COUGHS)

Definitely not her kidneys.

(CRYING IN PAIN)

I promise this'll taste just as good
coming up as it did going down.

(GRUNTS)

If things go wrong,
I just want you to know...

If you're going to say that you've
always been secretly gay for me,

everyone always just
kind of assumed it.

I just want you to know

that I appreciate the
risk you're taking.

Pumping a human being full of
lethal chemicals in your living room.

If I die, it probably won't go over
well with your probation officer.

That's not going to be an issue.

I'm glad at least one
of us is confident.

Not me.

I've already identified
a couple of spots

to dump your body if this goes south.

I've always enjoyed
Trinity Park.

It does have a nice
access to the lake.

- Muscle spasms already?
- No. It's nothing really.

Good news.

Takes most people two bags
to get to that stage.

You're way ahead
of schedule.

WILSON: You'll think
it's stupid.

HOUSE: That hasn't
stopped you before.

(BREATHING WEAKLY)
I just always thought

when I got old or sick I'd have
a wife or kids to look after me.

(SIGHS)

And in this scenario,
are your loving wife and kids

holding the life-support cord

or are they thumbing
through your will?

I'm in it, right?

(GRUNTS)

You have everything you
need right here.

We both do.

Painkiller,

industrial strength,

level awesome.

We're on vacation.

(SIGHS WITH PLEASURE)

That is nice.

CHASE: Her kidneys are fine.

I don't think we're looking at
side effects from the LEX-2.

She's prone to respiratory
infection. Pneumonia?

No persistent cough,
chills, or excess sweating.

What about a
pulmonary embolism?

Fits coughing up blood,
but a clot? From what?

Bruising from when she
fell off the carousel.

Contusion damages a
deep vein, causes a clot.

Piece breaks off,
travels to her lungs.

We need to get her
on heparin now.

Another embolism could cause
a heart attack or a stroke.

(PAGERS BEEPING)

What's wrong? Is it Emily?

Sort of.

ELIZABETH: You can't do this.

I'm taking her to Mercy.

Everything you people have done
has just made her worse.

You don't have the right.
We have joint custody.

Where was my right when you were
treating our daughter like a lab rat?

She'd be dead if I hadn't.

Stop it.

CHASE: Your daughter deserves
better than this.

It's okay, sweetie.

Mommy and I are just
going to talk. Okay?

CHASE: Wanna get some candy?

We believe Emily has
a clot in her lungs.

If you leave now, she could die before
her new doctors are even up to speed.

What, from her A-T?

From the fall off the carousel.

Now can we just stop blaming each other
and do the right thing here?

What, you're really going
to equate the two?

No. You were giving her two minutes
of fun. I was trying to save her life.

What's her best friend's name?

What's the name of
her favorite teacher?

Why did she hate that
stuffed animal you gave her?

She's been having nightmares
about penguins all month.

What's her blood type?

Rh factor?
Her serum immunoglobulin levels?

I don't care. Those are letters and
numbers. That's not her.

What about the variant in her E14 ATM
intergenic promoter region?

'Cause that's what's
killing our daughter.

Unless I can find a
way to reactivate it.

Just make her better.

(MOANS)

BOY: You don't look
too good, mister.

(MUTTERING INDISTINCTLY)

(BREATHING HEAVILY)

How did you get in here?

The door.

Are you, like,
sick or something?

Where's House?

Where are your parents?

I know you.

You live in the building, right?

- What's your name?
- You don't remember?

House.

(GROANS)

You promised me I'd go
home again, Dr. Wilson.

(CRYING)

You said it wasn't my fault.

It wasn't, John.

If I didn't do nothing
wrong, why did I die?

(CRYING) I don't know.

I shouldn't have done this.

Am I dead?

- Not yet.
- Not yet.

It just feels that way.

Are you okay?

Apart from the pain, vomiting,
diarrhea and cramps?

(MOANS)

TAUB: I worked six months in a
research lab after med school.

You get so focused.

Once I didn't eat
for two days.

It's easy to forget
what actually matters.

I didn't.

Yeah, it sucks I got her
the wrong doll but...

(MACHINE BEEPS)

Good news.

Emily's lungs are
clear. No clot.

And bad news. We still don't
know what's happening to her.

Whatever it is, there's liver
involvement. Her eyes are jaundiced.

Her liver is failing.

TAUB: We found a blockage
in her hepatic vein

which is restricting blood
flow to her liver.

CHI: Polycythemia vera?

JESSICA:
Her red blood counts are normal.

Could be some sort of
connective tissue disorder.

What if...

What if we're just seeing
the end result of her condition?

She's unique.

One screwed up gene
from each of us...

Let's stick with our process.

I shouldn't be here.

CHASE: What are we missing?

Advanced Lyme disease?

- Would have seen it in the blood.
- He said "advanced."

We wouldn't pick it up in her blood

if it's in her organs
and nervous system now.

It fits everything but
the nose bleed.

But why is it attacking now,
all at once?

What's changed?

Elizabeth has.

She stopped giving
Emily the LEX-2.

It's an aminoglycoside antibiotic.

It's what was keeping
the Lyme in check.

We need to start her
on amoxicillin.

(GROANING)

(VOMITING)

(MOANING)

You lied.

It doesn't taste better
coming back up.

Here's another one.
You look good.

What's the white
blood cell count?

It's down to 1,000.
Still dropping.

- I need more morphine.
- We're out.

You've been using my personal
supply of pain killers

for the last eight hours.

You have enough for both of us?

I've got enough stashed
around here for a minion.

(MOANS)

Just remember
they're a gift,

so it's rude to keep
throwing them up.

Found that out with those
candlesticks you got me.

(LAUGHS WEAKLY)

We think it's Lyme.

ELIZABETH: I would have seen
signs of that.

Not if the LEX-2 was
keeping it in check.

We live in the city,
we don't have pets.

She's never even
been in the woods.

Yes, I have.

With Daddy.

(LAUGHS)

I should have told you,
but I know how you feel about it.

I grew up hunting with my dad.

I wanted to share it with
my daughter at least once.

We only took pictures.
You don't need to be mad.

- Maybe we should step outside.
ELIZABETH: No.

We can't protect her from everything.

I assume you'll need a lumbar
puncture to confirm.

(GROANING)

(BEEPING)

HOUSE: You lost a contact?

Going to the
little boy's room.

They're called adult
diapers for a reason.

- Use it.
- I did.

And if you think
I'm gonna let you change me...

It's okay. I'm a doctor.

Hey, just leave me alone!

(GROANING)

It's pathetic.

I'm pathetic.

An oncologist with cancer. Of all
the things that could be killing me...

It's like the universe is giving
me the big middle finger.

- The universe doesn't care.
- Why me?

I was always telling my patients
not to torture themselves

because there's no answer.

Sound advice.

It's cruel advice.

They were just trying to make sense
of what was happening to them

and I'm there telling
them not to bother?

I should've spent my life
being more like you.

I should've been a manipulative,
self-centered, narcissistic ass

who brought misery to everything and
everyone in his life.

(PANTING)

You'd still have cancer.

Yeah. But at least I'd feel
like I deserved it.

Do you think my parents
will get back together?

I don't know.

I'm sure they love
each other but...

They only fight about me.

That's because they
care so much.

So, maybe when I die,
they'll get back together.

- Emily, what's wrong?
- I can't move my arm.

(MONITOR BEEPING)

Keep your arms up for me.

- SIMON: What's happening to her?
- She's having a stroke.

(BEEPING)

(MOANS)

Okay, your heart rate's up, BP's
tanking. White blood count's at 500.

- We have to go to the hospital now.
- No.

I don't have the equipment
or the meds to handle this.

No! Win or lose.

Win or lose.
That was the deal.

That was the deal when
there was an "or."

You can't win this.

No. No.

I'd rather die here,

not in an ambulance.
(CRYING)

Not in the hospital.
I can't... Please.

You can't do that to me.

House,

please promise me that you won't
do that to me.

Promise me.

Okay, I promise.

(COUGHING)

Stroke,
a blockage in her hepatic vein,

coughing blood, trouble breathing
and Raynaud's.

If we hadn't already
ruled it out,

it sounds like textbook
pulmonary embolism.

- What mimics a clot, but isn't a clot?
- Fungal infection?

Her CSF was clean.
No bacterial or fungal markers.

Anyone tried calling House?

- TAUB: He's not picking up.
- CHI: Or returning messages or texts.

We're on our own here. So just give
me some theories we can use.

Hematologic malignancies.

A-T patients are more prone
to that form of cancer.

You think cancer would present
and kill her in three days?

Not cancer,

but a tumor could act like a clot.

An atrial myxoma.

CHASE: A primary heart tumor.

The swinging motion
of the myxoma

intermittently blocked the flow of
blood through the right atrium.

Inflow blockage stagnated
the hepatic vein,

which clotted and caused liver failure.

Outflow blockage caused the Raynaud's
phenomenon and stroke.

Pieces of the tumor broke off
and lodged in the lungs,

causing Emily's breathing problems
and the coughing blood.

We'll remove the tumor surgically

and hopefully the biopsy reveals
it's benign.

(MUTTERING)

You really look like crap.

Been fighting a cold lately.

Seven to 10 days
for the swelling to go down,

then we rescan
and schedule the surgery.

I seem to recall I said
some things to you...

You talked a lot.

I stopped listening after you
confessed your fear of dolphins.

Can we just tone down the bromance
a few notches? My leg is killing me.

One last favor?

I'd like to actually make it
to the bathroom this time.

(GROANS)

I thought you said you
had plenty of Vicodin.

Everybody lies.

So the way I felt, you feel that,
what? Most of the time?

It really does suck being you,
doesn't it?

At least I don't have cancer.

The tumor was benign.

JESSICA: And we were able
to remove all of it.

Does this mean
I'm not sick anymore?

(SIGHS)

No.

Honey,

the tumor didn't cause
your genetic condition.

You're still sick.

SIMON: But we never let that
stop us before, right?

(CHUCKLES)

So what do you want to do
when we get out of here?

You been to the aquarium?
It's pretty cool.

- Can we go, Daddy?
- You bet.

- Me too?
- Can she come with us?

You know Mommy
never has to ask.

(ELEVATOR DINGS)

(SIGHS)

I'll see you at lunch.

(POP MUSIC PLAYING)

(CHUCKLES)