House M.D. Episode 3.13 Needle in a Haystack

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.