Episode 20: House Training
Aired 4/24/07
While a hustler is running a three-card monte game, his shill Lupe,
gets confused and blows the game for him. Lupe collapses to the
ground. Much later, Lupe explains to Foreman that she felt like
she couldn't move inside her head. Foreman says she had an abulia,
or the inability to make a decision or exercise will. This is part
of a bigger issue called Transient Ischemic Attack. The blood was
cut off to a section of Lupe's frontal lobe. She claims she has
no drug use, so toxins might be another explanation.
The team argues about possible causes, but Foreman is adamant that
Lupe is a drug-abusing scam artist. Chase thinks it is toxins. Yet
her tox screen comes out clean. House is more interested in why
Wilson was talking to his second ex-wife. Wilson says that she merely
asked him to start looking after their dog. House then confesses
that he asked Cuddy out to a play. He was only testing her. She
said she was busy, but then why did she say yes to Wilson earlier?
Foreman's dad, Rodney, waits in the hospital for his son. He wants
Foreman to come to his mother's upcoming 60th birthday party. She
should see him while she still knows who he is.
Chase and Foreman go to Lupe's apartment for an environmental check.
Chase finds a number of possible toxic causes in the apartment,
but Foreman sees a crack pipe, which seemingly gives him the stronger
argument. Chase says he will do the tests on the pipe so that Foreman
can visit his family, something he doesn't really want to do.
Foreman tracks down his family at a nearby hotel and his mother
is thrilled to see him. As she talks to him about the past, symptoms
of her Alzheimer's come rushing to the fore.
Later, Foreman confronts Lupe about the pipe but she denies that
it's hers. He advises her to warn whomever it belongs to that they
have arsenic poisoning. Lupe starts hacking with a cough and then
spits up blood on Foreman's jacket. She begins choking on the blood
that's filling her throat.
Chase and Cameron run a CT scan on Lupe after a hair test only
shows trace amounts of arsenic in her system. The scan reveals a
mass just outside the lingual. A biopsy later shows white blood
cells in the walls of the blood vessels, which isn't normal. Figuring
this has to be some sort of autoimmune issue, Foreman is ready to
start a treatment of steroids. House wants to know exactly what
autoimmune disease it is. In the meantime, they are to begin the
steroids.
Foreman checks up on Lupe, dismissing her explanations about a
one-time drug use. She realizes he doesn't like her, then accuses
him of being like someone who quit drinking or lost a lot of weight
and looks down on those who can't. Just because he got out of the
projects, he thinks anybody who hasn't is weak and stupid. Throughout
this speech, Lupe struggles with a cough. Foreman studies her eyes,
noticing yellow in the sclera.
Foreman reports back to the team that Lupe's liver is failing.
It's not an autoimmune disease. He suspects lymphomatoid granulomatosis,
which is incredibly rare even by their standards. He suggests that
they start total body radiation immediately to fight the rapid spread
of the cancer. House instructs Foreman to get her consent in order
to begin the process. Foreman explains that Lupe doesn't like him
so much. House jumps up to get the consent. If she doesn't like
Foreman then he is dying to know why.
When House asks about Foreman, Lupe complains that he thinks he
is better than he is. After explaining the myriad possible side
effects, House hands Lupe the consent form. She freezes, and falls
under another attack. House calls in the nurses, instructing them
to have Lupe sign the consent form when she comes out of the attack.
Cameron and Foreman check up on Lupe after the radiology. Foreman
detects a heart murmur, which is a bad sign. Cameron tightens the
cuff on Lupe's arm to check her blood pressure and Lupe begins screaming
in agony. After receiving news of this latest development, House
realizes just how much trouble they're in.
Foreman asks Wilson for advice on how to break a terminal diagnosis
to patient. Wilson tells him to be honest and to be there when the
patient needs support. Foreman slides in Lupe's room and flatly
informs her that she's dying. He estimates less than 24 hours to
live. She came into a hospital with an infection and they didn't
catch it. The radiation is the worst thing they could've possibly
done because it destroyed her immune system, allowing the infection
to spread to her heart. Now, there's nothing that can be done. Lupe
angrily tells him to get out.
Foreman tracks down House in the ICU and declares that he is wasting
their time and causing Lupe more pain. House counters that he needs
to know what they missed. They have Lupe wheeled back into a private
room. Foreman apologizes to her, but admits that he doesn't expect
her forgiveness. When he learns that she has no close family or
friends, he sits down to spend the night in her room.
When Lupe wakes up the next morning, Foreman confesses that she
was right. He did have a problem with her at first. But she was
also wrong. He explains that he had a rough past but received another
chance. He still feels like someone will send him back from where
he came if he's not always the smartest person in the room. He put
distance between himself and Lupe only because he knows there isn't
any.
With Foreman still at her bedside, Lupe falls into a coma and her
vitals flat line. Foreman calmly switches off the monitoring equipment
and notes the time. He calls in the time of death to House, who
readies himself for an autopsy. Wilson later finds House in Lupe's
room. House explains that Lupe scratched herself with her bra hook
and developed a staph infection.
House finds Foreman in his office and tells him to absolve himself
for Lupe's death. He should only try to improve himself. Foreman
is torn up that they blew such a simple diagnosis, but House consoles
him that he'll do it again. This is a good thing. They are a special
band of doctors practicing a special kind of medicine. They will
miss on a few patients, but they will also save the ones any other
doctor would think are hopeless causes.
That night, Foreman goes to his parents' hotel and tells his mother
that he hurt somebody. She throws her arms around him and forgives
him. She can see that he'd never hurt anybody on purpose. Foreman
asks his mom if he knows who he is. She hugs him again and says
that her little boy's name is Eric. Foreman is devastated.
- From Fox.com
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