Episode 12: Needle in a Haystack
Aired 2/06/07
A sixteen year-old named Stevie is making out with his girlfriend
Leah in a car when he has a hard time breathing. He turns blue.
House takes his car into work because of the weather, but when
he pulls into the hospital lot he finds that the handicapped parking
space closest to the building is already occupied. There is a sign
over the space that reads "J. Whitner, MD." House has
been assigned a more distant space than he had before, and Whitner
has his old spot.
Foreman approaches House about Stevie's case, but House is more
interested in the new parking situation and the identity of J. Whitner.
Cameron explains that Dr. Whitner is a new female researcher confined
to a wheelchair. Foreman tries to get him focused on the case, pointing
out that Stevie suffered respiratory arrest with no history and
that his ER work-up showed a bloody pleural effusion. That last
part finally grabs House's attention. House suggests a blood leak
and orders a veinogram.
House tracks down Dr. Whitner in the research lab. Since her wheelchair
is motorized, he figures there must be some parking mix up because
he has to walk while she only needs to push a joystick. Whitner
points out that it's hard for cars to see her so the parking lot
is dangerous. She won't be giving the spot back.
As Stevie struggles with breathing and chest pains, Foreman is
unable to track down the boy's parents to sign consent forms. Leah
offers to have her parents sign, but that's not legally viable.
Stevie claims his parents are probably at a conference and had to
shut off their cell phones. Suddenly, his oxygen stats plummet.
Foreman has no choice but to perform the veinogram now. He will
deal with the fallout later.
As Foreman begins the procedure, Stevie notices a diffusion pattern
on the monitor and declares that it is Graham's law. He figures
the leak has to be in his pulmonary veins in order to get into his
lungs. Impressed, Foreman asks if he is studying this in high school.
Stevie claims to read things on his own, and then he quickly changes
the subject. When nothing shows up on the test, Stevie wonders how
he can have a bloody effusion without any bleeding.
Cameron and Chase go to Stevie's home to look for drug use. The
first thing they find is rotting food in the kitchen. Chase sees
two people having sex in one of the bedrooms. The couple has no
idea who Stevie is.
The doctors confront Stevie about the address he supplied. He tries
to cover, but they know he's lying. Leah finally admits that Stevie
is Romani, which is a gypsy. Stevie explains that the doctors cannot
go to his home because their mere presence will spiritually pollute
it and his parents treat that very seriously. He promises to tell
them anything they need to know as long as they don't go where he
lives. His family earns its living by buying and selling anything
they can. Stevie was just in Chicago with his father last week on
such a venture.
House confronts Cuddy about the parking issue and the debate quickly
devolves into a bet. Cuddy predicts that House couldn't last one
week in a wheelchair. He accepts the challenge. The team spots House
rolling around the lobby and they update him on the case. Stevie's
veinogram showed no leakage, and none in the lymphatics. House,
adamant that blood outside the circulatory system could only come
from a leak, advises his charges to stop trusting Stevie's claims
and find some answers on their own. Either that, or they can thin
out his blood for another veinogram.
Taking matters into their own hands, Cameron and Foreman perform
an arteriogram first. Foreman suspects deep vein thrombosis from
Stevie's recent long drive to and from Chicago. Cameron begins inserting
a tube into a leg artery and Stevie cries out with stomach pain.
The dye Cameron injected is entering Stevie's liver but not leaving
it. The liver is completely blocked.
The team reconvenes with House, who sticks with his leak theory.
Figuring a mass could be poking holes in Stevie's arteries, House
asks for a CT, an MRI, a sputum and an ACE level. Then he wheels
off. Stevie, who's beginning to turn yellow, enters the MRI. Foreman
laments that Stevie's intelligence is being wasted by parents who
are forcing him to sell scrap material. The doctors think they've
spotted a granuloma on the MRI just as Stevie's parents barge into
the room.
Foreman tracks down House in the parking lot and breaks the news
about the granuloma. They now know it's Wegener's. House, encouraged
by the development, tells Foreman that a liver biopsy will take
too long. They need to start treatment with cyclophosphamide before
things get worse. House then lifts himself from the wheelchair to
his car, asking Foreman for help folding up the wheelchair. Foreman
refuses and walks back into the hospital.
Foreman checks up on Stevie and notices that the parents Franklin
and Constance have taken over the room, providing him with their
clothing, their blankets and their food. Foreman chafes, noting
that the hospital needs to control the environment in order to know
if the tests are working. Stevie's parents argue that their son's
life is simply out of balance and they're helping to restore it.
Later, Foreman returns for another checkup and finds Franklin and
Constance shouting at Leah to get out of the room. They blame her
for Stevie's troubles. Stevie begins to moan in agony. When Foreman
pulls back the blankets, a large bloodstain covers Stevie's groin.
The team reports to House that the treatment for Wegenger's caused
a massive hemorrhage in Stevie's bladder. House thinks that's good,
which baffles his team. Everything else is ruled out. They have
the correct diagnosis but the wrong treatment. They need to change
the immune system, and House mentions an experimental drug named
FT-28. Stevie's immune system is attacking his blood vessels. They
can change his immune system so that the drug doesn't react to the
blood vessels but works everywhere else. Cameron, ever mindful,
points out that FT-28 isn't FDA approved. It has, however, worked
for Crohn's disease. House suggests that they say Stevie has Crohn's
so that they can administer the drug.
Franklin and Constance flatly refuse to allow the hospital to experiment
on their son. Franklin mentions the medical experiments at Auschwitz
and Foreman counters with the Tuskegee experiments. With no gains
made in the argument, Foreman consults with House who advises him
to become a better salesman. He must somehow earn the family's trust.
Stevie's extended family is now in the patient room and there's
a festive, happy air. Foreman hooks up a new IV and then asks the
family to give them some privacy so he can change the bandages around
Stevie's groin. When the room is emptied, Foreman explains to Stevie
that the doctors want to alter his treatment but that his parents
won't let them. Stevie realizes that their resorting to experimental
treatment means they must be out of answers. How can he trust Foreman?
Foreman gives him the medicine and instructs him not tell his parents.
If they find out, then Foreman will lose his license. That's how
he knows he can be trusted. Stevie begins writhing in agony from
intense pain.
A surgeon removes Stevie's ruptured spleen and gives it to Foreman
to perform a biopsy for Wegener's. House watches from the observation
deck in his wheelchair. He doesn't spot anything out of the ordinary
or granulomas. House asks them to run Stevie's bowel, but the surgeon
begins closing him up. House needs to get downstairs quickly, but
he also needs to win his bet. The elevator is taking too long, so
House bounces his wheelchair down the stairs and barges into the
OR, insisting that a granuloma is indeed present. House stands up
and sticks his gloved hands into Stevie's body to feel the small
intestine for granuloma. The surgical team immediately stops working
in fear of a lawsuit. House reaches the end of the small intestine
and finds nothing. There is no granuloma. Stevie's parents were
right.
House and his team head back to the drawing board. Still suspecting
the bowel, House orders a colonoscopy. They will need to move fast
because Stevie is in the ICU, which has limited visiting privileges.
The doctors must get to Stevie before the family cuts off their
access. The colonoscopy, like everything else, comes out normal.
Suddenly, Foreman spots a toothpick. Stevie chews on them like his
father does. He must have accidentally swallowed one. During his
make-out session, an awkward movement could've pushed the toothpick
through the colon wall and into the lung. From there, it traveled
to the liver, then the kidney, then the spleen.
Franklin processes this news, then immediately blames Leah. If
she wasn't kissing Stevie, this never would have happened. Leah
blames Franklin for passing such a disgusting habit on to his son.
Foreman visits with Stevie and says he will be fine in a few days.
Foreman then mentions that the hospital lab has a paid internship
which is usually given to a university student. He promises to arrange
an interview for him. Stevie thanks him but passes on the offer.
Foreman implores him to put his mind to use, but Stevie notes that
Foreman, Cameron and Chase are all single and alone. Stevie wants
a family.
House goes to reclaim his parking spot from Cuddy, but she knows
that he stood up in the operating room. He lost the bet. House accuses
Cuddy of never planning on giving him the space. That would explain
why Dr. Whitner wasn't concerned about losing her parking when House
confronted her earlier in the week. House asks Cuddy if she feels
even a little bit guilty about her scheme.
That night, as he leaves the hospital, House sees a maintenance
worker putting his name back on the spot closest to the building.
- From Fox.com
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