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House M.D.

Episode 5.04 : Birthmarks

House M.D. Poster

TV Info


Episode Premiere

October 14, 2008

Distributor

Fox TV

Genre

Drama

Show Period

2004 - 2012

Production Company

Heel and Toe, Shore Z, Bad Hat Harry

Cast and Crew


Director

David Platt

Screenwriter

Doris Egan, David Foster

Main Cast


Additional Cast

  • Christine Healy
  • Raymond Ma
  • Jack Conley
  • Diane Baker
  • Jonathan Palmer

Synopsis


A young Chinese-American woman named Nicole searches for her birth parents in a Buddhist temple in China. She spots a couple that she believes is her parents and has an interpreter named Fang speak to them. They reject her. Nicole goes to the Buddha that the couple had been praying at and lifts it from its stand. Fang says that, if she cannot lift the Buddha again, her wish will be granted. Nicole bows her head for a moment then tries to pick it up. She struggles, falls to one knee and begins to vomit blood.

House tells the team about Nicole's case. Although Chinese surgeons removed a foot of rotted bowel, her pain has increased. Thirteen suggests Meckel's Diverticulum. When House's mother tries to phone him, House announces to the team that his father died. They urge him to take his mother's call. He says he is fine and that he didn't even like the man.

House moves the ultrasound wand gingerly over Nicole's fresh surgical incision. The wound is raw and runs the vertical length of her abdomen. Her parents enter the room with a box of items from her apartment. The parents are dismayed that they found alcohol because they thought she quit drinking. At the nurse's station, House tosses a bag of licorice root herbs to Foreman. The Chinese were treating Nicole for SARS, which might explain her cough, hypoperfusion and the ischemic bowel.

Cuddy comes to give House a shot because everyone who came into contact with Nicole must be treated as a precaution. House rolls up his sleeve but Cuddy suggests a bigger muscle. House drops his pants and she injects him in the rear. Cuddy lets him know that his father's funeral is tomorrow and that his mother wants him to deliver a eulogy.

As Kutner tends to the patient, House paces outside Nicole's room, reading her file. Suddenly, he collapses to the ground and falls unconscious. Nicole winces in pain and clutches her stomach. Kutner begins palpating it through her patient gown when the cardiac alarm blares. Her stomach has a spider web of bulging, blue veins crisscrossing her upper abdomen. Her liver is failing. This isn't SARS.

House wakes up in the passenger seat of a car. Wilson is driving, wearing a dark suit. House realizes that Cuddy drugged him. His mother didn't call Cuddy -- she had called Wilson. House is pleased that Wilson cares, but he rejects attending the funeral. House goes to reach for a Vicodin and Wilson takes a bottle out of his pocket. While steering with his knee, Wilson removes the bottle top off and gives House one Vicodin. A cell phone rings "MMMBop" by the boy band Hanson. Wilson grabs House's phone from his pocket. Foreman and the team are gathered around the office speakerphone. Thirteen says that Nicole had a clot in the hepatic vein. Chase sucked it out and saved her liver. Kutner tells House that there are no signs of a tumor or venous malformations. Taub suggests that multiple blood clots would tie together the bowel ischemia, the lungs, and the liver.

House hangs up and tells Wilson that he needs to pee. Wilson tosses him an empty water bottle. He will just pee on the floor. Wilson can't hold back a slightly satisfied smile. House lowers his window and throws the floor mats out. He unzips his pants. Wilson gives in and pulls up to the handicapped spot of a rest stop. House struggles to get out of the car because he does not have his cane. Wilson offers his hand but House wants his cane instead. Wilson goes to the trunk to get it and House smacks the car keys out of Wilson's hand with the cane. The keys fall down the storm drain that runs alongside the car. Wilson tries to fish his keys out with a coat hanger. House tosses the flashlight down the sewer. Wilson lies and says that Amber gave him the keychain which is trapped down there.

Kutner finds Nicole outside the hospital, sucking on a cigarette. He tells her that he was also adopted. Kutner goes to take her blood but the gauze pad he just put on is already soaked. He puts another pad over it. It won't stop bleeding. Meanwhile, Cameron looks up flower delivery online. She asks Chase and Foreman what they think would seem like it was sent by House. "Send one of those giant cookies shaped like a coffin. His mom would believe it was from him," Chase jokes. Kutner comes to tell them the patient is bleeding and clotting. The schistocytes on her smear are indicative of DIC, which means she's got cancer. Cameron wonders if it could be leukemia. Foreman thinks belly pain points toward a GI tumor. Foreman instructs Kutner to run a CT.

Back in the car, House admits to Wilson that he figured out his father was not his biological father when he was twelve. Suddenly, House jams the tip of his cane down on Wilson's foot and the accelerator. The car lurches forward, picking up speed which causes Wilson to swerve around a cop car. They are pulled over. While the sheriff grills Wilson, House talks to the hospital on speaker phone. Foreman tells House that it appears Nicole has a mass in the pancreas. The sheriff has Wilson and House get out of the car. He pushes Wilson over the hood, saying there is a warrant for his arrest in Louisiana.

House and Wilson sit unhappily in the police station. Wilson whispers to House that he thought he had taken care of this. House says that he did. Wilson tries to explain to the sheriff the story of what happened when he was at a medical convention in New Orleans and met House. Wilson had been sitting at the hotel bar, trying to unwind when someone kept playing the same song on the jukebox. He asked the man to stop, then threw a bottle at an antique mirror which started a bar brawl. House bailed him out of jail because it was a boring convention and he merely needed somebody to drink with. The Sheriff releases them because Louisiana does not want to pay to get Wilson back.

Chase presses on Nicole's scarred abdomen. She winces with each touch. The CT confirms gallstones. Her urine is brown. As Wilson and House pull up to the funeral home, House gets on the phone with the team. He tells them to inject bubbles into Nicole's cyst to see if they end up in her other organs.

House and Wilson enter the funeral home. House's mother approaches and kisses her son. She delayed the funeral for his arrival. She asks him to please do the eulogy. House sees the man who he thinks is his real father.

Kutner explains to Nicole's nervous parents that her liver is compromised. The detox will cause her muscles to continue twitching, even under sedation. She needs to be paralyzed to do this procedure. As small bubbles shoot into her pancreatic cyst, Kutner and Taub perform an ultrasound. Taub reacts to her heart on the screen. Taub says House was wrong -- the cyst is just a cyst. This is advanced dilated cardiomyopathy.

House goes to the podium, seemingly speaking from buried anger. "Maybe if he'd been a better father, I'd be a better son. But I am who I am because of him," he eulogizes. House stops short, his voice on the verge of breaking. He goes to the coffin and looks down. Then he leans in close to kiss his father goodbye. Wilson, worried about House's emotional state, gets up to be ready for House. But House, armed with a nail clipper, chops off a tiny piece of skin from the tip of his father's ear for a DNA sample. Wilson admonishes him to put it back while the mourners watching are confused. House and Wilson continue arguing in a separate room set up for another wake. Wilson is angry and House is deliberately goading him. He claims Wilson is scared to lose him. Wilson grabs a bottle of bourbon and hurls it through a stained-glass window behind the casket.

Later, House and Wilson sit in a diner. House wants Wilson to admit that they just had fun. House confesses that he saw Wilson in New Orleans carrying a package from divorce attorneys. It was when Wilson's first wife had just filed for divorce. Wilson takes in the significance that House had done something nice for him.

House dials the team. Taub informs him of the advanced dilated cardiomyopathy. Kutner thinks it looks like an atrial myxoma but the ultrasound images are a little grainy. House knows that this indicates an iron overload. House orders an MRI for a better view and then calls Fang, the translator in China. He wants to know if Nicole's biological parents look tan. House explains that the disease she has is genetic and that they should have it too. Iron deposits in skin cells would build up extra melanin, giving the skin a bronze color. Fang tells House that he is not convinced that are her parents since they said they have no daughter. The man was adamant but the woman seemed angry and frightened. House wonders about that reaction. Wilson remembers that China introduced the One Child Policy in 1979. Perhaps they didn't want a girl and they tried to kill her. House asks how that might be relevant to her health now.

The team is in the office when House walks in and asks for the MRI. Since Nicole was vomiting, there was no test done yet. House tells them how her parents tried to kill her as a baby, and this caused her to get sick twenty-five years later trying to lift a Buddha. House tells them to quickly have Taub stop the MRI and instead get a brain x-ray. It reveals a cluster of pins in Nicole's brain. House explains that if pins were pushed through the soft fontanelle of an infant, the hair hides the entry wounds. At the temple, there must have been a magnet inside the Buddha. When Nicole picked it up, it moved one of the pins deeper into the sympathetic nervous center of her brain. The pins over-stimulated her sympathetic nervous system, causing the blood clot in the liver, the pancreatic cyst, and her heart problems.

Kutner talks with Nicole's parents while she lays in a coma. The pins will be removed surgically, and she'll be fine. Kutner holds up a copy of the x-ray to the light and shows them a pin pressing directly on her addiction center.

House sits alone with a drink on his desk. Wilson comes in, and House shows him the DNA test proving that he was not related to the man who raised him. House says that it doesn't make any difference at all, which depresses him. Wilson informs House that he spoke with Cuddy. He is coming back to Princeton-Plainsboro because House was right -- their trip was the most fun he has had since Amber died. House sadly realizes that his father is dead. Accepting Wilson's condolence, they walk out together.

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