Episode 24: Human Error
Aired 5/29/07
A Coast Guard helicopter hovers over the ocean. A Cuban refugee
named Marina Hernandez sits in the cabin, wrapped in thermal blankets
and shivering from hypothermia. An officer struggles to save her
husband Esteban from the choppy water below, but Esteban refuses
to let go of Marinas suitcase. With the chopper running low
on fuel, the officer dunks Esteban which forces him to release the
suitcase before pulling him to safety. On board, Esteban screams
in Spanish that Marinas medical records are in the suitcase
and that Dr. House needs to see them. Esteban watches helplessly
as the suitcase floats away.
Cuddy tries reaching House, but he is no longer answering his cell
phone because he has become world famous. Instead, House
watches from a distance as Foreman attends a going-away lunch with
the nursing staff.
Later, Chase and Cameron go over Marinas admission exam while
Foreman checks his email. House saunters in to see where they are.
Since Fidel Castro emphasizes medical care in Cuba, House figures
that Marina has already been filled with antibiotics. He rules out
simple diseases like parasites or infection and requests an MRI.
He also wants the team to check Esteban for any symptoms caused
by being stranded at sea. They can subtract those from Marinas
list.
Chase observes that Foreman isnt going to leave. This piques
Houses interest. Chase thinks Foreman doesnt want to
leave and that House doesnt want to let him leave. He assumes
House will cave, just like he did with Cameron. Foreman obviously
wants something from House, so Chase suggests he try telling Foreman
what he wants to hear.
Foreman discovers that Marina has Multiple Sclerosis. They should
start her on interferon and see if she improves. Esteban complains
that Cuban doctors would have spotted MS. Marina cries in pain.
When Foreman rotates her forearm as a test, her bones snap in a
spiral fracture. House suspects bone cancer because metastatic tumors
would explain the abnormal MRI, kidney damage, cotton mouth and
double vision. House orders a PET scan to see what else the cancer
is breaking. Convinced its not cancer, Chase argues that House
is stupid to think that Foreman will forget the last three years
and stay there if House starts agreeing with him. House ignores
him and again asks for the PET scan.
Chase finds House in his office and starts talking about Foreman
again. House cuts him off and fires him. He explains that Chase
has been there the longest. Either he has learned all he can or
hasnt learned anything at all. This means that it is time
for a change. A stunned Chase shuffles out of the office.
Foreman and Cameron perform the PET scan but dont find any
signs of bone cancer. Chase comes in to break the news that he has
been fired. Suddenly, Chase sees a hotspot by Marinas humerus
on the scan.
Cameron and Foreman barge into Houses office, demanding to
know why he fired Chase. Then Cuddy enters, kicks out Foreman and
Cameron and asks the same question. She orders him to rehire Chase.
House calls Chase and asks about Marinas PET scan. Chase says
that there is a blood clot in the arm. House doesnt hire him
back.
Foreman informs Esteban that Marina will need an angiogram to confirm
the presence of a clot. Esteban demands to see House, but he has
left for the evening. Foreman gives Esteban Houses phone number
and instructs him to keep calling because House doesnt always
pick up. Foreman smiles at his prank.
The next morning, Foreman and Cameron perform the angiogram in
the middle of arguing about Chases firing. An exhausted and
angry House comes in, questioning whether Foreman gave Esteban his
home number. After he leaves, Foreman marvels that House would stay
up all night listening to the phone ring rather than talking to
a patient for five minutes. Cameron notes that a trick like that
makes Foreman worse than House. All their bickering stops when Marina
goes into V-Tach. Although her EKG flat lines, Marina keeps talking
to them. She loses consciousness and the doctors begin CPR.
The doctors are still working on her three hours later. They have
yet to start bypass surgery because House fears the clot will break
loose and head for the brain. Foreman explains the situation to
House and Cuddy together. Cuddy immediately okays the bypass. As
the doctors rush Marina into surgery, Esteban finds House relaxing
in his office. House is disinterested, but Esteban emotionally pleads
that he looked him up because he has a reputation for fixing people
when other doctors have given up. Esteban questions why House is
just sitting there and not tending to Marina. House thinks for a
moment and then heads into the OR.
House has the surgeon turn over Marinas non-beating heart
but there is nothing physically wrong with it. He asks the surgeon
to shock the heart, but seven attempts dont revive it. The
surgeon is merely keeping bypass going until Esteban can say goodbye.
Marinas heart simply wont start. Shes dead.
House retreats to his office in an attempt to figure out why the
heart wont start while the bypass is still keeping Marinas
brain alive. Cameron and Foreman argue that its over, but
they realize House doesnt want to tell Esteban because that
will mean House failed.
Cameron goes to meet Chase at a nearby bar. She tells him that
everything will work out in the end, but Chase has already come
to grips with the firing. He figures it probably is time for a change.
Late that night, Cuddy finds House in his office and asks when
he plans on telling Esteban that Marina is dead. Cuddy wonders whether
House was hoping for a storybook ending, but House argues that he
honestly doesnt care. He just wants to know what the problem
is. House tracks down Esteban in the chapel and informs him that
nothing seems to be working. He can say goodbye to Marina before
House removes her from bypass.
Esteban apologizes to his wife, kisses her one last time and House
begins shutting off the machines. Esteban leans down to hug his
wife and feels her heart beating. House explains that it is just
residual blood flow. Esteban grabs Houses hand and places
it on Marinas heart. House flicks on the EKG and sees that
her heart is beating normally. Her eyes open and she regains consciousness.
House is shocked. Esteban thinks its a miracle.
Three hours later, Foreman reports to House and Cameron that Marina
is still stable. Her blood pressure, EKG and kidney function are
all normal. House thinks about the angiogram and wonders if human
error wasnt to blame. Maybe it was divine error. A congenital
heart defect in an artery would be susceptible to inflammation.
This causes arrythymia, which causes angina and clots. They will
need another angiogram to be sure.
The procedure begins and House injects the dye into Marinas
heart. The right and left coronary flow both look normal, which
makes House worry that this test is about to go bad. Cameron spots
something odd on the monitor. Marina has a third ostium. Humans
should only have two. This third one is causing inflammation, is
becoming infected and sending out clots. This is everything that
has been plaguing Marina. After one more surgery she should be fine.
That night, Chase opens his apartment door to find Cameron on his
stoop. They kiss and head inside.
Wilson meets up with House in the doctors lounge. Foreman
enters and the room freezes. House says he wants Foreman to stay
on because he is an important part of the team and he needs him.
Foreman agrees, but says he doesnt need House. House tries
to argue that he just solved a case by predicting a never-before-seen
heart defect even though Foreman gave up on it. Foreman points out
that House is only happy for now. Soon he will be jonesing for the
next case to come along. Foreman doesnt want to solve cases.
He only wants to save lives. House becomes angry, and yells that
Foreman only cares about himself and his ego. This is the reason
he dragged out his quitting over three weeks. Foreman looks at House
and then simply walks out.
House retreats to his office. Cameron is waiting for him with her
resignation letter. House asks if she expects him to break down
and ask Chase back. Cameron smiles and says she expects House to
make a joke, move on and be just fine. But she says she will miss
him.
- From Fox.com
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