Clear!
Charging! Clear!
Okay, I'm calling it.
Time of death...
8:32.
Hello, Diana.
Shall we?
LV tear is within a zone of fresh tissue necrosis,
implicating a recent myocardial infarction
as the instigating event.
Unfortunately, the medical records show
that Dr. Penza never suspected heart disease,
instead giving steroids for an erroneous diagnosis
of asthma, thereby causing the fatal tear.
I suggest these findings warrant further investigation
into Dr. Penza's standard of care for this patient,
making this my...
third such recommendation regarding Dr. Penza this year.
Concluding autopsy with examination of the brain.
Dr. Treiber...
I'm cold.
== sync, corrected by elderman ==
Yes, it's mine.
And yes, I know that I can't drive stick.
And no, I don't care that I parked in a handicapped spot.
"Staring death in the face
The cliche is to lead a more meaningful life.
I've taken a holy vow
to lead a less meaningful one.
I've spent my life caring,
giving, and searching for the profound.
Now it's time for selfishness, indifference,
and embracing the shallow.
Your scan's in three days.
Tell me this isn't just you killing time
until you find out if your cancer's gonna kill it for you.
I just paid $75,000 for a ridiculously impractical car,
the depth of shallowness.
And tomorrow, I'm driving it to Cleveland
to meet my boyhood crush.
The years have not been kind to David Cassidy.
Julie Christie. Dr. Zhivago, Shampoo.
I was precocious.
She's opening some kind of
charity animal clinic or something.
I'm neglecting my patients
to fulfill a silly fantasy.
Textbook selfishness and indifference.
Or you've made sure that your patients are well-covered,
car is a rental,
and while waiting to get Julie Christie's autograph,
you'll adopt a puppy.
I don't even care whether you believe me or not.
Indifference.
He tried to cut open his own skull.
Head CT and tox screen were clean.
Interesting.
Cotard delusion.
Also known as "walking corpse syndrome."
Disconnect in the amygdala convinces you
that you're secretly dead.
Case solved.
Rendering it...
What's the past-tense of "interesting?"
No prior history of mental illness,
and before you say it was caused by antivirals,
I've already ruled that out. Plus, Cotard's
doesn't explain the paresthesia in his hand.
Also...
Treiber won't let any other doctor near him.
He trusts your work.
Treiber's the patient?
What's the future tense of "interesting"?
How's Wilson doing?
Wilson's scan is at the end of the week.
If his kick-ass chemo shrunk the tumor to an operable size,
he'll live.
If it didn't, he'll die.
That must be very hard.
Is there anything we can do?
Other than the prayer circle, what is there?
Patient's AST is high.
Psychosis could be brought on by liver failure.
Maybe Hep C?
Bilirubin and serum protein levels were normal.
Doesn't explain the tingly hand or why Chase hates him.
I don't hate him. He hates me.
He hates all doctors, and it's mutual.
He only hates the ones that screw up.
And you.
And they only hate Treiber because he finds their mistakes.
Mistakes are a wee bit easier to find on a dead patient,
a distinction he fails to recognize.
He's a rat.
Who makes the hospital a safer place
by keeping doctors accountable
and focused.
What if he got something from a cadaver?
He handles a lot of 'em. You suggesting we DDX them all?
No, just his last one.
She had bad knees.
She used dimethyl sulfoxide for joint pain.
Current from the defibrillator could've converted it
to dimethyl sulfate. When Treiber cut into her,
her blood released toxic fumes.
Everyone in the basement would be sick.
Gas would've dissipated quickly.
His lungs are fine. Blood clots make more sense.
One in his hand explains the paresthesia,
one in his carotid explains the psychotic episode.
You two look for toxic exposure.
Adams, you can help Chase ultrasound
his evil nemesis for evil clots.
I know House doesn't like seeing his patients,
but doesn't a fellow doctor rate an exception?
Psychosis appears to be intermittent.
Just snapped out of it long enough to ask
if House actually ordered this test.
Don't worry.
We're simply carrying out his direct orders.
Right. Forgot.
It's what you were hired to do.
Which is fine, his diagnostic error metric
is.17 compared to the hospital average of.32.
You actually think you can quantify
the value of every doctor?
Someone should.
And since I'm the only one who sees everything—
Right, you were hired to diagnose people
after they're already dead.
No sign of stenosis or clots.
Every doctor, every diagnosis, every treatment, every result.
It's pretty impressive.
It's pretty Orwellian.
All written in his secret code.
He has to keep it confidential.
Just like the Wannsee conference.
The "Big Brother" metaphor wasn't pointed enough for you?
You had to throw in Hitler?
A couple years ago,
he noticed a link in child deaths,
and it's completely changed hospital policies all over—
I get it. Treiber is nerd king.
The more people we kill, the more lives he saves.
Test is negative for dimethyl sulfate,
her blood is not toxic.
Then we should look for toxic exposure from something else.
You really think the hospital is idiotic enough
to issue toxic supplies?
Have you seen his tools?
Treiber doesn't always use hospital-issue.
Then he's the idiot?
No, but I don't want
to explain that assumption to House.
Found something.
Thought we'd make it a road trip.
'80s music, junk food, beer.
I have a dental appointment.
That I'm going to make now.
Ah. I'll let you drive.
Not worth listening to you whine
about your feelings and fears for three days.
It's not gonna happen. I've taken a vow.
People don't change. You are a person, ergo, pass.
Yes, that's why I brought this.
20 CCs of propofol.
You can accompany me willingly,
or I will, when you least expect it,
inject the contents of this vial into your bloodstream.
The fall might result in a concussion,
or fractures,
or you might get lucky
and simply wake up somewhere near Allentown
with a nasty headache.
The choice is yours, and in case you've forgotten,
I am indifferent.
We leave tomorrow morning at 8:00 a.m.
No clots.
No gas.
But we found enough of this
to reanimate the entire morgue.
He's jacked on caffeine.
Stimulant psychosis.
How many times do I have to solve this case?
So all we have to do is hydrate and observe him for 24 hours.
Why don't you tell him it was your idea?
He might warm up to you.
If you get an ear in the mail, it's probably mine.
My abdomen!
It's my abdomen!
It's just the effects of withdrawal.
The pain is normal.
No! No!
This isn't right!
Abdominal pain and distention
means we were wrong about stimulant psychosis.
It could be coexistent problems.
He might just have an obstruction.
You know what House says about coincidences.
I didn't feel any masses when I examined him,
and no bowel sounds.
Where's House?
He hasn't come in yet, and neither has Wilson.
I've already tried them three times.
Here we go again.
Diabetes could cause nerve damage in his hand,
and guts, and—
Except his glucose levels are normal,
and he probably would've mentioned he was a diabetic.
What about ulcerative colitis?
Earlier attacks caused thrombosis—
We already looked for clots,
and there was no blood in his stool.
Try him again.
And Wilson's.
Wherever they are, they don't want to be disturbed.
We take 78, we can do
the "sweet treats and salty eats snack food trail."
My trip, my itinerary.
We have to cover 300 miles today
to be there with plenty of time
to catch Julie by 4:00 tomorrow.
And that thing I said about letting you drive,
I lied.
What?
I'm—I'm impressed.
Not by that.
But by your real effort to maintain the facade.
It's been almost an hour,
and there's been no mention of the elephant in the car.
Well, I declined the elephant option.
Uh-huh.
In three days, you're gonna find out
if you live or die.
You don't want to talk about it.
No, but obviously you do.
So, we're gonna talk about it,
but because I want to.
I am neither talking about it,
nor talking about not talking about it.
You are hard-wired to talk about it.
It's how you cope, it's who you are.
Yeah, well,
from now on, I'm not me.
I'm... I'm...
Kyle Calloway.
I thought your porn name was Rusty Packard.
Kyle is roguish, carefree,
and shares no qualities with James Wilson.
Can Kyle drive stick?
Treiber won't let us do anything without House.
House just took himself off the case.
You said no bowel sounds when you examined him.
"No" like diminished, or none at all?
- None. - You think it's an intussusception?
If it is, it could mean cancer's behind everything.
Let's get a plain film of his abdomen.
Treiber will refuse any procedure
that wasn't ordered by House.
Only if he knows it wasn't.
You want to lie to a guy
whose favorite pastime is getting doctors fired.
We're adults with advanced medical training,
not children left alone with scissors.
It's one X-ray.
If we had a phone,
we could've found somewhere a little less charming.
If we had a phone, you'd be making calls,
downloading porn, and playing Angry Birds.
This trip is about me, and I like this place.
This is not about you not wanting me to have a phone.
You're weak.
You knew that you'd backslide
and spend your time talking to teary ex-wives and your parents,
trying to make them feel better about you being sick.
Bacon burger with fries looks awful.
I'll have that.
I'll have the Big One.
You sure? It's $79.
Unless I finish it in an hour,
in which case, it's free.
It's an 80-ounce steak.
I'm hungry. And an iced tea, please.
Big One's up!
This place doesn't take credit cards.
My meal is going to be free,
and I'm going to be inducted into the wall of pain.
Hello, Kyle.
Belly film was normal.
No sign of an intussusception or any other obstruction.
House says it's there.
Sometimes House is wrong.
Run my bowel.
That's serious surgery.
General anesthesia, long recovery...
We can do a contrast enema if you need more proof.
I have drawers filled with people who had clean scans.
I know how easy it is to miss something
unless you use your own hands and eyes; Run my bowel.
We'll let House know how you feel.
How I feel is twisted in white-hot agony.
His orders were to look for an intussusception.
Until you actually do that, I refuse any other tests.
Fine.
Uh, no. Not fine. We need to talk—
And I want you to do the surgery.
Statistically, you're the best surgeon in the hospital.
Kyle! Kyle! Kyle!
Come on, you got this!
You got this!
Come on!
25 seconds.
You've got this.
Come on, home stretch, Kyle, home stretch!
15 seconds!
Now, don't chew, just swallow.
Muscle it down!
Six, five...
Four...
For the love of God, swallow!
Three, two, one...
Time!
Yes! Yes!
Oh, you magnificent bastard!
Yeah. Smile!
That still counts, though, right?
No hard feelings, right?
You'll find out when you wake up.
If you really think I'm a good doctor,
why do you treat me like an idiot?
It's not because you lack talent.
It's 'cause you've wasted it.
Did you know I applied to be a fellow with House
the same year as you?
No.
Quit my other program, relocated,
broke up with my girlfriend.
Then your father made a call, and suddenly you had the spot.
That was almost ten years ago.
Do you know what I could've done
after even three years with House?
Gone to the CDC, W.H.O.
Started a diagnostics department
someplace they'd never even heard of such a thing.
You've been given everything.
Looks, talent,
my future.
Nine years later, look what you've done with it.
Ah...
Must be nice to be puking for the old-fashioned reasons.
Ah.
I'm glad I did it.
You see those people out there cheering for me?
I was a hero.
For one fleeting moment,
for an incredibly stupid reason,
for a bunch of morons I'll never see again.
God, it felt good.
And now, if you'll excuse me.
I think I've made room for dessert.
How long do you think you'll work for House?
As long as he lets me.
When House was in prison,
you worked at Mercy in plastics, right?
Know what I did?
Surfed. For nine months.
Yes, and if I didn't have two daughters and alimony,
I might have done the same.
A fellowship's supposed to train you to stand on your own.
Foreman's Dean of the hospital,
Cameron's head of emergency medicine in Chicago.
And Kutner and Amber are dead,
and Thirteen is having sweet, sapphic sex on some island.
Look at this.
The small intestine.
Is it an intussusception?
No.
Guess Treiber was right.
He hasn't checked his voicemail.
Or his email.
It's been almost 24 hours.
Shouldn't we call Foreman or the police?
I think this makes him a fugitive.
We don't have to tell anyone.
Treiber's symptoms started in his frontal lobe,
and moved through his nervous system, hands, bowels, muscles.
Intermittent porphyria. He's in the middle of an attack.
The longer we wait to treat with hemin,
the more damage it causes.
The longer we wait to tell him House isn't running the case,
the more damage that causes.
It's fraud.
It's only an issue if we're wrong.
It's more than one X-ray.
More than exploratory surgery, even.
This is a drug that will damage him if you're wrong.
Same principle.
I want a threesome.
Shouldn't we try a twosome first?
Two women.
Oh. I know they're probably overrated,
and I'll probably be gravely disappointed,
but I want one anyway.
No, you don't.
Well, Kyle wants one.
Kyle's only one day old. He doesn't know what he wants.
I don't want to think about consequences.
I don't want to think about—
I don't want to think about anything.
I just want to do.
I need you to do exactly what I tell you.
Yeah, yeah.
Porphyria?
I know the anesthesia makes it hard to focus,
but we need to start you on hemin right away.
House believes very strongly.
This is the right call.
Okay.
This thing is peeling.
Well, that is the cost of cowardice.
Should've gone for the real thing.
I feel like I'm cheating.
A, it is only cheating if you don't have cancer,
and B, it's Wednesday afternoon.
Pickings are slim,
and more importantly, sober.
The cancer cut is the surest way to the pity pooty party.
One down, one to go.
What? Wait, wait, wait.
She said yes?
To a threesome?
She's empathetic.
She's a hooker.
- Gave me a cancer rate. - No.
I have never paid for sex in my life.
You still haven't.
It's my treat.
It's either that, or you find two very open-minded women
to fall in love with you in the next hour.
Bartender seems nice.
Seems female.
Want something to eat?
My friend is dying of cancer.
Oh, you poor thing.
It took my mother two years ago.
But you can't give up hope.
He's pretty much resigned.
Just wants to go out with a bang.
And another pun, what time do you get off?
Pleural effusions. It's not porphyria.
We're gonna need to put in a chest tube.
I wanna talk to House.
We'll tell him exactly what's happening.
I wanna talk to him!
I want House.
Where is House?
Where is he?
Where's House?
We don't know.
You didn't have to sleep out here.
Four's a crowd.
Apparently they left a long time ago.
So, how was it?
Was the amateur as good as the pro?
It was confusing.
Perfunctory.
- A bit sad. - Never mind.
And exactly what I needed.
Thank you.
You feel like buying me breakfast?
One of them stole my wallet.
You're lucky he's not pressing charges.
Porphyria was a legitimate call.
Until the pleural effusions.
We've done everything House would've done if he'd been here.
You lied to a patient.
Treiber's condition is declining rapidly.
He's agreed to let me take over the case.
Dr. Chase will have no further contact with the patient.
Fine.
I didn't say you were off the case.
Sit down.
Ordered a cardiac MRI.
Enlargement of the left ventricle
suggests an infiltrative disease.
It's sarcoidosis.
We'll start him on corticosteroids
and do a cardiac biopsy to confirm.
I disagree. I was wrong about the porphyria,
but I wasn't wrong about the nervous system.
It's a Prion disease.
That's why his symptoms have progressed so rapidly.
It's possible he was exposed and didn't know it.
Brains are often stored
and not tested until weeks after autopsy.
Treiber's too good to not take the right precautions.
Maybe the problem is he thinks the same thing.
His job's built on the premise
that doctors make mistakes; That includes him.
We should do a brain biopsy.
In his condition?
Then we biopsy the brains in the morgue.
Find the one that exposed him.
It's a needle in a haystack.
There's four of us.
Come on, we can at least
start him on amphotericin to halt the progress
while you do your heart biopsy.
No, we can't. Amphotericin plus the contrast dye
for the biopsy would overwhelm his kidneys.
We have to choose one or the other.
Biopsy his heart.
Wallets go in the minibar freezer.
If there's no minibar, the toilet tank.
I've got exactly $20 left.
I'm sorry, I wasn't familiar with hooker protocol.
We can use your credit cards.
No, we won't.
I'm still on probation.
Leaving the state without permission
will really P.O. my P.O.
Doesn't matter.
We can't even afford gas to get home.
We're three hours behind schedule.
We have enough gas to get to Julie.
I don't care about anything else.
What this time?
Just wondering how long this can last.
You're still hoping that I'm gonna wake up
and admit that Kyle Calloway is just
some lame excuse to have some naughty thrills aren't you?
I'm actually hoping you won't.
I like Kyle.
Oh, come on.
Move! Move!
Whoo!
Whoo-hoo!
Whoo!
House.
You okay?
My leg still hurts.
Come on.
We got 20 bucks to go 11 miles.
Why aren't you answering your pages?
Busy.
The biopsy showed fibrosis in his cardiac muscle.
So it's not a Prion disease.
It means Foreman was wrong too.
He wants everyone to meet in his office to DDX.
So he can tell us all it's an infection?
Interesting. Or maybe you should consider
not being such a baby.
First instinct was an exposure from a corpse.
Treiber spends all his time here.
If it's not toxic gas,
not Prions...
Then it has to be something else.
He's not perfect.
Are you trying to cure him or discredit him?
Treiber can only see me as not House.
Foreman too.
And they're not wrong.
So you're not coming upstairs.
No.
And when this case is over,
I'm quitting.
He's not quitting.
He already called other hospitals.
Treiber did get under his skin.
He'll get over it.
Fibrosis has to be a response to an infection.
Chase said you'd say that.
We'll test the biopsy samples for viruses
and start him on antivirals.
You're not even gonna talk to Chase?
He didn't leave after he got stabbed in the heart.
I think we're okay.
Either you're right,
and your friend is just really upset,
or you're wrong, and he's come at this calmly and rationally,
and you're about to lose a good doctor.
Either way...
This is Oubliette, Ohio.
Buses don't run here after 1968.
Ina said there's a bus every 15 minutes.
Ina is living in Alzheimersville.
Been here at least half an hour.
Where are you going, Ina?
Naples, Florida.
Ben and I have a beautiful three-bedroom condo.
All on the one floor.
You're waiting for a bus to Naples?
Comes every 15 minutes.
Ben'll be wondering where his dinner is.
Cab.
Whoa, cab!
20 bucks, 11 miles. Come on.
Come on, let's go.
Julie's gonna be at the clinic
for another 45 minutes; We can make this.
She thinks she's in Florida.
Okay, bring her with.
I'm waiting for the bus.
Bus isn't coming, Ina. But this cab is going to Naples.
Ben'll be getting awfully hungry.
House.
We'll tell the cabbie to call the cops.
They'll come pick her up, take care of her.
Then I'll stay with her until they do.
Good-bye, Kyle.
Bus comes every 15 minutes.
Oh, shut up.
Find anything?
Not yet.
Running tests for MRSA.
You've got everybody worried about your quitting.
You here as my boss or my friend?
If I was here as your boss, you'd be suspended by now.
I've learned a lot here.
Enough to run my own team.
It's time I moved on.
Unfortunately, that's how I felt last year.
And the year before that.
Maybe there's a reason you haven't left.
You need structure.
And support.
Somebody else calling the shots.
You didn't come down here as my boss or my friend.
You came down as House.
You're trying to insult me into making a decision.
We've both seen it work.
Either you rise to the challenge
and quit,
or you stay.
As a team member.
Dr. Treiber!
Dr. Treiber.
He stopped responding when I was changing his I.V. bag.
Peter, open your eyes.
Coma.
Treiber's comatose.
All brains on deck.
Where should we start? We think you might be right.
I'm not.
You couldn't have gone through all of these.
Don't have to.
Treiber's reports are thorough to a fault.
His methods are fastidious.
The answer isn't down here.
Treiber didn't miss anything. We did.
So what?
Psychosis, abdominal pain, pleural effusions,
enlarged heart, coma.
Autoimmune, maybe Goodpasture's.
Kidneys are fine. Vasculitis?
- No fever. - Lymphoma?
Would've seen it on the heart biopsy.
Soap.
It's the soap.
I blew it.
Oh, God, here it comes.
As always.
All I wanted was some meaningless fun,
and I couldn't even last three days.
Sound asleep.
I'm sleep talking.
I had the chance to fulfill a lifelong dream.
I swear, I will jump out of this moving bus
if you don't shut up.
But instead, I sat with a sad, old woman for 11/2 hours
who forgot I existed three seconds after she left.
And the stupidest thing.
I never even had a crush on Julie Christie.
In 12th grade I was madly in love with Melanie Robbins,
who happened to look exactly like
Julie Christie in Dr. Zhivago.
And she really liked me.
Played spades every lunch period in Mr. Charlton's classroom.
But of course, there was this other guy.
A great guy. Very popular. He had a car.
He had a band,
a mustache...
Kyle Calloway.
I assumed that—
I hoped that we would go to the senior prom together,
but she asked me for a favor.
She asked...
If I minded if she went with him.
She asked me if I minded.
And I said I didn't.
And that was it.
And I just did it again.
I let it go,
like I let everything go.
And here I am, sitting on this bus,
with tickets I bought with my watch,
heading back home, so a...
a CT scan can decide my f-fate.
I don't wanna go back, House.
I just—
I just wanna keep being Kyle.
Kyle would've ditched
that sad, old woman from the bus stop.
Probably would've ditched me too.
I can live without Kyle.
Snoball?
Guess this isn't heaven.
We found out who screwed up.
You.
It was your industrial-strength antibacterial soap.
The additional triclosan does two things well:
Kills MRSA
and makes your thyroid look stupid.
It thinks the triclosan is a real hormone
and closes up shop.
Excessive use over time
combined with excessive use of this
led to hypothyroidism.
Which went undiagnosed until it presented with psychosis.
When the ER put you on the sedatives,
it kicked you into myxedema crisis.
Don't know that I ever would've thought of that.
House told us to look for irony.
Hey.
This wasn't House.
My locker key.
I'll give you your own team.
Thanks.
But it's time to step out of the shadow.
It's about time.
Any news?
Not yet.
You come here so I could talk you out of it?
I came to say thank you.
It's been fun.
Fun?
Sounded pithier than...
"We've shared a variety of situations."
Let me know about Wilson.
Why did you let him go?
Legal loophole. 13th Amendment.
Abraham Lincoln may have looked great in that hat,
but his labor policies...
House.
== sync, corrected by elderman ==