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House M.D.

Episode 7.15 : Bombshells

House M.D. Poster

TV Info


Episode Premiere

March 07, 2011

Distributor

Fox TV

Genre

Drama

Show Period

2004 - 2012

Production Company

Heel and Toe, Shore Z, Bad Hat Harry

Cast and Crew


Director

Greg Yaitanes

Screenwriter

Liz Friedman, Sara Hess

Main Cast


Additional Cast

Synopsis


It's 6:30 a.m. when Cuddy shuts off her alarm and reaches across the bed for House. But he's not there. "House?" she asks, stepping out of bed and stretching. Suddenly a hand darts out from under the bed and grabs her ankle. "Oh my God - what the hell?!" As she looks down, the rest of House appears from under the bed. "Gotcha!" he says.

"It's like dating a ten-year-old," Cuddy sighs. "God I hope not," House says, smiling. She bends down to kiss him. "Now that we're down here ..." he says. But Cuddy has to use the bathroom first. As he cracks open a book and lies back down to wait for her, she calls to him from the bathroom, worried. "House? There's blood in my urine."

"You really don't have to be here," Cuddy says, dressed in a hospital gown and sitting up on a bed in an operating room. "You're my girlfriend," House says. "I'm being supportive." But she's not talking about House - she's talking about the team, who House has dragged in there with him.

House says there's almost certainly nothing wrong with Cuddy; whereas, his new patient definitely has something wrong with him. "16-year-old male, spit up blood during a pick-up basketball game. E.R. couldn't find the source in his lungs or the GI tract," Chase says. Masters says it could be vasculitis, bronchiectasis, or inhaled particles, while Taub wonders if it's angiodysplasia.

Cuddy's doctor is ready to perform her cystoscopy, so she tells House to get rid of the team. "My urethra is not for public entertainment." "But it is good time-adjacent," House says, sending the team off with instructions to check the teenager out for angiodysplasia. House leans in to the doctor as he stations himself between Cuddy's legs. "Hey, I'm missing a watch, so if you could keep your eyes open while ..." And that's enough to get Cuddy to kick House out as well.

Taub is explaining to the 16-year-old, Ryan, his dad, Todd, and his mom, Kay, that the tiny capsule Ryan will swallow contains a camera that will show them if he's got any vascular malformations in his GI tract. "Your records show you've lost some weight over the past year. Was that intentional?" Taub asks. "Not really," Ryan says. Todd quickly points out that Ryan's been eating less since he quit the swim team. "You have to get up early for swim," Ryan tells Taub. "It wasn't fun anymore."

Taub tells Ryan's parents he's got to ask Ryan some personal questions about sexual activity, so they leave the room. With them gone, Ryan starts to tell Taub about his history, but Taub interrupts him. "How long have you been cutting yourself?" He can see the scars on Ryan's stomach, but Ryan insists they're from a skateboard accident. Taub knows he's onto something. "So, no to cutting, but yes to appetite and sleep changes, and you quit something you used to enjoy. How long have you been depressed?"

Taub finds House on a bench in the hallway. "Imaging showed no sign of upper GI issues," Taub tells him. "But, the kid did admit to me to being depressed, and to smoking pot to take the edge off." The pot could be laced with formaldehyde or lead, which could cause a pulmonary hemorrhage, leading to the spitting up of blood. Taub's pretty pleased with himself for working all that out. "Run a lead level; push five liters IV fluid," House says, while handing a wad of cash to a passing lab technician in exchange for a manila envelope.

Moments later he's walking into Cuddy's office, reading a report from the envelope. "Cystoscopy was clean, cytopathology was normal ..." Cuddy wants to know why he has her lab results, but to House, the more important thing is that Cuddy is OK. "Unless the blood came from my kidneys ..." Cuddy says, as she reviews the report.

"Your hypochondriac mom had a brush with mortality last month, and it's understandable that you're worried more than usual," House says. Cuddy tells him he's probably right; it's probably nothing. "Meet me in the cafeteria in ten," House says, getting up to leave. "There'll be a corn dog with your name on it ... I mean an actual corn dog. They fixed the deep fryer." But when he's gone it's clear Cuddy is still worried. She makes a call: "I need to schedule an ultrasound."

Taub is prepping Ryan's IV. Ryan's grateful to Taub for leaving out the part about marijuana when he explained to Ryan's dad about a "minor chemical exposure." "I know what it's like to be sixteen," Taub says. "And you also know what it's like to be depressed," Ryan says. "The way you figured out my deal after only a few minutes. I've been fooling my friends and parents for months." Taub tells him it's his job to notice things, and maybe talking to his parents would help. "I've tried," Ryan says. "They take it personally that I'm not happy, and then I end up having to make them feel better. They don't get me. No one does." Taub relates a story from med school: "It seemed like everybody else could handle the pressure. I couldn't. I ended up hurting myself. Stupidest thing I've ever done."

But as he's talking, he notices something about Ryan's eyes. "You've got red spots in your eyes," he says, shining a pen light in Ryan's face. "They weren't there before."

Cuddy is again on a hospital bed - this time in an imaging room, as Wilson performs an ultrasound on her kidneys. "You have nice skin," Wilson says. "Thank you - shut up," Cuddy answers. "Just treat me like any other patient." Suddenly she can see Wilson look alarmed as he checks the monitor. "Wilson?" He tries to be reassuring: "Ultrasound isn't definitive. We should run other tests -" Cuddy tells him to quit talking like a doctor and tell her what he sees. He turns the monitor toward Cuddy. "There's a mass in your kidney."

The team is discussing Ryan's case in House's office. Not only do they not know why he coughed blood, but now he has small hemorrhages in his eyes. "Sounds like an acquired coagulopathy, which gives us a pretty wide differential," Foreman says, but Masters thinks it could be a lot narrower if they factor in his depression. "Oh, don't do that," House says, disapprovingly, but not looking up from his laptop. "Mood swings can be a symptom of physiological illness ..." Masters says. House looks up. "I'm not talking to you," and he looks back to the screen. Taub points out that mood swings are also a symptom of being a teenager, plus the weight loss and sleeping issue started a year ago. "Infection makes the most sense," Chase says. "He shoots hoops at school. Showers in the locker room. I'm thinking staph." "Damn!" House says, but again he's staring at his computer. "You don't think -" Masters starts. "Not talking to you!" House says, and slams his laptop shut. Chase asks if everything is OK with Cuddy. "She's fine," House says. "She's just too stupid to accept it." He orders nafcillin for Ryan to treat for staph.

House walks into Cuddy's office as she's meeting with an attorney. "All that's in the First Mutual safety deposit box. The retirement accounts ..." House can't believe she called a lawyer to draw up a will after one ultrasound. She looks at him. "OK," he admits. "I hacked into your online schedule." Cuddy sighs, but he continues. "Look, tests always show something. Mass in your kidney could be a complex cyst, could be benign ..."

Cuddy interrupts him. "I'm a single mom. I need to set up a trust, appoint a guardian. It's silly that I haven't done it before now." House says she's only doing it now because she thinks she's sick. "The freaking out can at least wait until after the biopsy this afternoon." Cuddy tells him her biopsy isn't until tomorrow; it was the first opening available. "For the Dean of Medicine," House says, "the first opening in the schedule is -" he holds up his watch - "oh, look, now!"

But she says her worry isn't any more important than anyone else's. "Actually, it is," House says. "But I'm not sick, right?" she pointedly asks him. House has to admit she has a good point, so he makes his exit.

Meanwhile, Ryan is talking to a not-so-friendly visitor in his hospital room. It's another teenage boy who says, "I want my stuff, asshat." "I told you, man, I don't have it here," Ryan tells the boy. Taub busts in. "Hey, guys - everything OK?" The boy says he's on his way out - but promises to see Ryan later.

Taub starts to change Ryan's IV and asks what's going on. Ryan is hesitant but he talks. "My friend gave me some left over Klonopin he had when he switched his seizure meds. I sold them to Roid Rage for 80 bucks, but I landed in here before I could deliver, and now he's going to rip my arms off." Ryan says it was only one time. He had the pills and needed the cash, so he thought why not. "It was a bad idea," Ryan says. "The pills are at my house. I could have a friend go get them." Taub pulls out $80 from his wallet, and tells him to give the boy his money back. "One time only," Taub says.

There's a knock at the door of an upscale-but-bachelor-friendly apartment, the main setting in a classic 90s-era family sitcom. The audience ooohs as Wilson, meticulous but casual in khakis and a button shirt with the sleeves rolled up, opens the door to find an officer bringing home his young charge. "Rachel Cuddy - you were supposed to be home half an hour ago," Wilson sternly tells her. The audience roars when spunky Rachel, eight years old, says, "Don't blame me - he's the one who wouldn't run any red lights." The wisecracking cop says Rachel's mouth makes Mel Gibson sound like Nelson Mandela. "Where'd she learn that?" he wonders. Cheers and clapping as House, a little sloppy in a bowling shirt and popping chewing gum, enters the scene. "I don't know why you're here," he tells the cop. "But I didn't do it." More woo hoos from the audience. Apparently Rachel was shoplifting at the mall. "Are either of you this girl's father?" the officer asks. "Nope, but since her mom died, she's my favorite tax write-off," House says, to howls from the audience. "Officer, you have my word it won't happen again. Next time, she won't get caught!" And he shuts the door on the cop and high-fives Rachel. Wilson shakes his head at the two of them, and then smiles as he walks over to give them both the sitcomiest hug ever, to cheers from the audience ...

Cuddy wakes up from this canned laughter nightmare with a start. She looks over to her nightstand and sees the bottle of sleeping pills Wilson prescribed for her.

The next day, Cuddy is sitting with her sister at the table, going over some papers. "I mean, if you're OK with this," Cuddy says. "You have three kids of your own." Her sister says it's not even a question, as she signs the papers. "And House is cool with this?" she asks. Cuddy tells her they've only been together a few months. "Seems like a lot longer. Probably because you've been talking about him for ten years. And by 'talking,' I mean ranting about wanting to smash his teeth in with a stapler for being such a jerk." The sisters manage to smile at each other. Cuddy tells her that people change.

Masters and Taub are in Ryan's room, while Ryan's in the bathroom. "Good for you," Masters says. "You could have assumed he was a drug dealer, but instead you took his word for it. It's nice to finally see someone have a little faith in humanity around here." Great, now she's ruined it. "Why would you do that?" Taub asks. He calls for Ryan in the bathroom. "You OK in there?" Ryan says he's not sure. "I think I just peed blood."

"Looks like peeing blood is the new black," House says, as he and the team go over Ryan's case in House's office. Foreman thinks that they can move on from infections since Ryan had a night of antibiotics. And with no signs of a bleed in his bladder, it could be a kidney problem. "Probably some kind of mass ..." House says, looking away. Chase says a mass wouldn't explain the coughing blood or hemorrhages. "Antiphospholipid syndrome, on the other hand." House says it makes sense, but it doesn't rule out a mass. Cancer? He says a mass doesn't have to be cancer. "Could be a real hematoma."

Masters starts to object, but it's clear that House isn't talking about Ryan. "Cuddy has a mass on her kidney?" Masters asks. House says it's probably just a complex cyst or an angiomyolipoma. "It's a mass, not a mystery," Foreman tells him. "They'll do the biopsy, then you'll have your answer. You just have to wait." Taub tries to get everyone back on Ryan's case. "Patient admitted to using pot. Who knows what else he's doing. This could be heroin-induced nephropathy." "I thought you trusted this kid," Masters says. "And then you pointed out how sweet that was," he answers. At any rate, if it was heroin, there'd be withdrawal by now, so antiphospholipid syndrome makes more sense. House orders plasmapheresis for Ryan. Meanwhile, Taub's going to search Ryan's house for drugs.

House walks in to Wilson's office but seems surprised to find him there. "What are you doing here? Cuddy's biopsy is in an hour - you should be keeping her company." Wilson takes a deep breath before he begins. "OK, you've been worried that your relationship is getting in the way of your diagnoses. You're protecting your patient. Either that, or you're an ass." House says there's a third possibility: "I hate the smell of death." "The chances of Cuddy having renal cell carcinoma ..." Wilson starts. But House isn't talking about her illness. "I'm talking about our relationship. She needs support and comfort. Both things that I famously suck at. Which will inevitable lead to ..." "You know what's good for that? Practice. Doing it, oh, I don't know - once?" Wilson says.

But House doesn't want to act like there's a crisis before they know there is one. "There's no proof that there's anything wrong with her," he says. "There's no proof she's being stalked by ninja squirrels, either, but if she's scared of them, as your boyfriend, it's your job to figure out how to help her feel better," Wilson tells him.

It's Chase who comes to see Cuddy as she's waiting for her biopsy. "House told me to keep you company. He also told me to give you antibiotics." She says that she's fine, but Chase picks up an old magazine and takes a seat to wait with her. "Do you want me to quote from 1 Corinthians. Because I can do that," he offers. "As a Jew, I'm going to have to decline that offer," Cuddy says. Chase tells her House will show up eventually. "You don't actually believe that. But I do," Cuddy says, smiling. "All these years, he's never stopped trying to annoy me for more than 15 minutes. Now he can't even walk into the room." " 'Love hopes all things,' " Chase says.

Foreman and Taub are searching Ryan's house. "What is it with you and this kid?" Foreman asks. "He's doggy-paddling in the sea of misery," Taub says. "I remember what it's like." "How far do you have to reach back for that memory - last night? Sometimes I hear you in the living room watching TV at three a.m.," Foreman says. Foreman tells him fixing Ryan isn't going to fix him. His cell phone rings, as Taub is thumbing through Ryan's yearbook. Foreman says that Ryan's lost all feeling in his right arm, but Taub's found something equally disturbing. In the yearbook, Ryan's defaced the students' pictures, with gruesome imagery and taunts like "Waste of oxygen" and "Should have been aborted."

House steps off the elevator in the hospital, but instead of a bright, busy corridor, it's a frightening place - empty and dark, with scaffolding, debris, and random spooky lights. He spots Chase down the hall, faced away from him. "Chase? How'd it go with Cuddy?" House asks, as scary sounds surround him. But Chase isn't answering. House walks to him, and touches him on the shoulder of his dingy lab coat. Chase turns around - he's a zombie! They immediately begin to fight, with Zombie Chase tossing House around the hallway. House looks defeated ... until he reaches for his cane and frees himself. When House stands up, his cane sprouts a double-blade, with which he decapitates Zombie Chase. "Good thing I brought my ax-cane," House says, marching on toward Cuddy. "House! Help me!" He can hear Cuddy calling for him. Now his cane is a shotgun. "Please!" Cuddy begs. Zombie Taub staggers out in the hallway, followed by Zombie Masters. "Looks like we got company," House says, as he blows them both away. Then, behind him, perhaps the most menacing: Zombie Foreman. One shot - he's still standing. Two shots - he starts to fall back. It takes three shots to fell Foreman. "House!!" Cuddy screams. He races to her room. He can hear her scream in agony. When he gets to her room, he can't believe his eyes: the entire Zombie Team is feasting on Cuddy's live body! "No!" House yells.

House wakes with a start in his office chair, surprised to see Not Zombie Chase and Not Zombie Masters in front of him. "Are you OK?" Masters asks. "I was sleeping," House says. "What could go wrong?"

Later, they're all reviewing Ryan's case in House's office. "Patient lost feeling in his arm while on steroids, rules out autoimmune," Masters says. "So what causes bleeding, kidney problems and unilateral numbness?" Foreman asks. "And," House adds, poring over his laptop, "a complete absence of any record of Cuddy's kidney biopsy. She must have put it under a false name so I couldn't rush the results." But the team is still trying to diagnose Ryan. "What if we had it backwards, and it's not a bleeding problem - it's a clotting problem," Chase asks.

House isn't paying any attention to them. "There is no patient file created in the last two days for anyone having that procedure," he says. Foreman says clots could explain everything, including the numbness. "We should do an angiogram of his brain, see if we can find it." They all look at House, who's too wrapped up looking for info on Cuddy to respond. "House, we're worried, too," Chase says. House insists he's not worried - he just wants the results so Cuddy can stop worrying. He tells them to do the angiogram on Ryan - but wants Chase and Masters to go to Pathology and look at Cuddy's slides. But how will they know which sample is hers? "I guess you're going to have to look at them all," House says.

As the team heads out into the hallway, Chase wants to know what's up with Taub. "Just because House is too distracted to notice your distraction doesn't mean we didn't," he says. Taub says he's focused, but the yearbook thing is bothering him. "The kid scratched out the faces of half his class - you don't think that's a problem?" Foreman says it's not their problem, and Chase says it's not a problem at all. "I violently executed my tenth grade geometry teacher about five different ways in my mind." Not wanting to be left out, Masters says what while she didn't ever want to kill anybody, "I just wanted to torture them slowly in my basement. Preferably with acid. Do you guys ever think about what you might do to House?" Well, that shuts them all up, as they enter the elevator.

Wilson finds House in a clinic room watching his soap. "What are you doing? I was going to send Chase to tell you what the obvious, right thing to do here is, but then I realized if you were too stupid to know how stupid that was, you might miss the irony. So: you have to be with her."

House thinks he's got it covered. "She needs artificial support for an artificial problem. She's fine. Chase did an excellent job." Masters knocks on the door, but before Wilson leaves he says, "House, I'm not going to tell you a third time. Do not screw this up. Because I really don't want to clean up the mess." Masters tells House that she found 14 patients with kidney biopsies. "I tabulated them against their urinalysis results. Six men, three diabetics. One LCDD, one kid, two seniors and, by default, one Cuddy." She hands him the folder. "The biopsy was inconclusive," she tells him. "The mass is near the center of her kidney. They couldn't get a readable sample."

House knows that means they'll have to remove the mass to find out if it's cancerous. Masters says that they're doing imaging now, so the surgeon has a better idea of what he's dealing with.

So, naturally, House goes to Foreman's apartment. He's playing a video game in the living room when Foreman gets home. "Can we order pizza?" House asks. "There's nothing in the fridge. At least not anymore." House wants to know about Ryan. Foreman tells him the angiogram showed a clot in a branch of his middle cerebral artery. "Started him on streptokinase to break it up. Although, maybe we should have just played a few rounds of Savage Scape 2: The Revenge. Because that's obviously the best way to make someone feel better," Foreman scowls at him. "You keep talking like Wilson, your face will freeze like that," House says. "However bad you think you're going to be in that room, not being in the room is worse," Foreman tells House. But it doesn't look like House is going to leave, so Foreman sits on the couch and picks up a controller. "When she breaks up with you, you're playing by yourself," Foreman says.

Cuddy bursts into a cheery, wholesome, black-and-white 1950s-movie style kitchen, and says, "Honey, I'm home!" House's hair is neatly pressed to his head and he's clad in a full apron. "Just in time," he says, happily. "Pot roast is ready." Cuddy, in a sharp, black business suit and white gloves and a pearl necklace, tells House it smells wonderful. "I cured all my patients, so I came home to spend time with Rachel," House says. Cuddy turns to Rachel, sitting at the table. "And how was your day today?" Pig-tailed Rachel tells her it was great. "I got a 100 percent on my spelling test and a 170 on my LSATs!" But wait - LSATs? Rachel's only eight years old. "We've been studying together," House tells Cuddy, while stirring a big mixing bowl. "It was supposed to be a surprise." Cuddy says that's wonderful. "I think Rachel deserves a treat," House announces, offering her a sucker. "No thanks, Daddy. It might spoil my appetite," Rachel says, so House sticks the candy in his mouth. There's someone knocking at the door. Who could it be? It's the delivery boy, Wilson! He's got a cake with candles lit. "Delivery for you, Mrs. House! Happy 29th birthday." Cuddy laughs and says she's not 29, and when House walks over to take the cake, she notices something else: "You're not limping." She looks worried. "This isn't possible. None of this is possible." House turns to her: "A girl can dream."

Cuddy is awakened from her dream by a knock at the door of her house. It's Wilson, but there's no cake this time. "I've got your scans from today." She holds up the pictures, looking worried.

House's cell phone rings while he's playing games at Foreman's. He doesn't say anything for a while, just listens. He finally says softly, "OK," and hangs up. "What's going on?" Foreman asks. "Imaging shows enhancing masses across multiple lobes of Cuddy's lungs." House is staring vacantly. "That's what kidney cancer looks like when it metastasizes," Foreman says. But House knows that, too. "She's dead," he says.

Taub, Foreman, and Chase are watching a video in House's office. Taub copied it off of a flash drive he found at Ryan's. "What's up losers?" Ryan asks in the self-filmed, handy-cam video. He's dressed all in black with a black skull cap, alone in the woods. "I hope you're enjoying being alive. Today's lesson: natural selection. Excellent system, made us who we are today. But then we invented seat belts and grocery stores. Things that keep idiots and weaklings alive. And let's be honest: most of you don't really deserve it."

In the video, Ryan sets off a pipe bomb, exploding a pile of leaves. Taub wants to know if they think he should go to the cops. "Yes," Chase says. "'Officer, I'd like to report an assault. The victim was a pile of leaves.'"

But Taub says the video gets even more disturbing. "He talks about bombing his school." Foreman doesn't know how Taub can explain any of it, since he stole it from Ryan's house, which he broke into.

Masters walks in and says Ryan's not responding to the streptokinase. They don't have long before the damage becomes irreversible. They either need to up his dosage or go into his head and get the clot out. Chase wants to know where House is.

"Hopefully with Cuddy. She did just get some pretty awful news," Foreman says. But Masters has already called Cuddy. She doesn't know where he is either. Foreman leaves to find him.

He checks Wilson's office first. "Have you seen House?" Wilson says no, but doesn't look too concerned, which seems strange to Foreman. "He left my place last night after you called. No one's seen him today. Any idea where he'd be?" Again, Wilson says no, and keeps right on working at his computer. "... And you're not worried about that?" Foreman asks. "He not good with bad news." "Yes, I'm worried," Wilson says. "But this isn't about House. It's about Cuddy. She's the one who could be dying and he's trying to make this about himself. I'm not playing." He looks up at Foreman. "She still believes he'll show up. He'll either get over himself and be who she needs him to be, or he won't."

Taub is outside Ryan's room, talking to his parents. "We'd like to do an embolectomy. We'll run a corkscrew-shaped instrument into Ryan's brain, and pull the clot out." Ryan's parents are understandably worried, but they agree to the procedure. Taub tells them about the videos, too. "He's blowing up pipe bombs, and threatening people in his school," he says. "Oh, God," Ryan's mom says. But his dad thinks Ryan was just messing around. "Our son wouldn't hurt anybody." Taub isn't so sure. "I know this looks bad," his mom says, "but Ryan's a good kid. He's had a rough couple of years since he started high school, but I really think he'll come out of it."

Taub tells them their son needs help. "Maybe he does," Ryan's dad says. "But, this gets out - he'll get suspended, maybe expelled. How about you focus on keeping him alive?"

Later, Taub and Masters watch Foreman and Chase perform the embolectomy from the operating room balcony. Masters asks him what he's going to do. "What do you think I should do?" Taub asks. Masters snorts. "So you can do the opposite? There are kids all over the country, doing dumb, potentially violent things. But the percentage of them who would actually kill anybody is miniscule." So he shouldn't do anything? "Hmm, while the odds are low, the fallout could be huge. Tens or even hundreds of lives," she says. So he should call the cops? "Of course, over-identification with the subject could skew the calculation towards being extra-protective," she advises. "Or, alternatively ..." But Taub's had enough. "You suck at this!" "Hate the statistics, not the statistician," Masters says.

Down in the operating room, Foreman asks for a little more dye, as they try to find the clot in Ryan's brain. They see it on the monitor. But then it's gone. "It just disintegrated when you touched it," Chase says. What was that thing?

It's the late 1890s. In a dusty, sepia-tinted hideout, our wounded heroes, House and Cuddy, are surrounded from all angles by the Bolivian cavalry:

"I got a great idea where we should go," House says.

"I don't want to hear it," Cuddy tells him.

"You're gonna love it. Australia's Finest. It's a great karaoke bar in Newark."

"I hate karaoke."

"They got every song, by every Aussie artist. Midnight Oil, Men at Work, Olivia Newton-John."

"I do a mean version of 'Physical,' "

"And the barbecue shrimp is amazing."

"What about the fries?"

"Hot, salty, and delicious." He pulls out a candy bar and tears into it, with Cuddy watching. "Talking about food made me hungry."

Cuddy thinks for a minute. "You ate candy in my other dreams."

"Means you're stressed at work. All dream symbols mean you're stressed at work. Or castration anxiety.

"I was hoping you could figure out a way to handle all this. Maybe you can't because you're still a child."

"I can do better." They get up slowly, painfully.

"Might be too late."

They look at each other and then run out side-by-side, guns firing. Cuddy looks around, but House isn't there anymore.

Cuddy wakes up in her hospital room, distraught. But now when she looks around, she sees House in the doorway. "I should have been here," he says. "I'm sorry." "I knew you'd come," Cuddy tells him.

In House's office, the team talks about Ryan. "What was that thing, and why did it just dissolve in the middle of surgery?" Taub asks. And now his liver is shutting down. They've started him on lactulose, but at the rate his liver's declining, he'll be dead in a day. "Should we page House?" Masters asks. Chase tells her he's busy.

And he is busy, holding Cuddy's hand in her hospital room, as she signs paperwork before her surgery.

"House can't do anything for her now!" Masters says. "We need him. By his own logic -" Chase interrupts her and continues. "Patient's blood tests were negative for barbiturates, acetaminophen, he's not on a high-protein diet. House couldn't concentrate on the case before she was dying - you think he's going to get in the game now?"

House is with Cuddy as the nurse wheels her away to the operating room. "If you don't make it, I won't sleep with anyone for at least a month," House says. "Make it two," she answers. "Bitch," he says, but she just smiles.

Masters says that AIP can cause uremia and tank the liver, but Chase snipes that AIP causes abdominal cramping, not abdominal bleeding. "Oh, because fucosidosis was such a brilliant idea?" she says. "Guys," Taub says, trying to get them back on track.

Meanwhile, Cuddy's in the operating room, about to go under.

"Type II citrullinemia fits," Chase tells the team. There are no signs of hyperlipidemia or pancreatitis, but Taub says those can take years to emerge. "Closest we've gotten," Foreman says. "Start him on IV sodium benzoate to reduce the ammonia levels in his blood. Run a genetic test for citrullinemia."

As the anesthesiologist is placing the mask over Cuddy's mouth, she looks up in the balcony of the operating room one last time and sees House watching over her, before she drifts off to sleep ...

"Forget your troubles, come on get happy, you better chase all your cares away ..." House, in a jazzed out top hat and tux, with fingerless white gloves and an oversized red tie, is singing at the foot of a long white, curved staircase on a stage like a macabre ringmaster. "Shout Hallelujah, come on get happy, get ready for the Judgment Day ..." Doctors and nurses in risqué costumes and garish make-up do a sinister dance down the stairs around him. "The sun is shining, come on get happy, the Lord is waiting to take your hand. Shout Hallelujah, come on get happy, we're going to the Promised Land ..."

Menacing men in blood red hospital scrubs rise from smoke and twirl Cuddy around on the operating table. The tempo picks up and it's a grotesque burlesque around Cuddy, with House leading. "Forget your troubles, come on get happy, you better chase all your cares away. Shout Hallelujah, come on get happy, get ready for the Judgment Day ..." The doctors and nurses race around in a craze on tricycles to the sound of calliope music, as Cuddy watches, smiling, with House. Then, suddenly, Cuddy is the star, in a white gown with long white gloves, singing while House accompanies on the piano, next to stacks of doctors and nurses. "Forget your troubles, come on get happy ..." She's writhing around on the ground and House offers her his cane to help her up. They dance and sing and race up the stairs, but now panic sets in. Cuddy's alone on stage in her hospital bed.

Cuddy wakes up in her hospital room, and sees House waiting in a chair next to the bed. He leans in. "Guess who doesn't have cancer? Me. Also, you." The tumor was a benign oncocytoma. She'll be fine. Cuddy is relieved, of course, but what was in her lungs? "Once they ruled out cancer, I remembered that your mom was allergic to antibiotics, so I had them test your blood. Your IgE levels were through the roof. The lung masses were an allergic reaction. So now you're off the antibiotics - your lungs should clear right up."

And he's brought a present for her. "Say hello to your tumor," House says, pulling a small, clear container with a mass inside. She looks at it and sighs. "We should call it fluffy," she jokes. "There are so many things that I could be afraid of, and most of the time I manage to lock them up behind doors. This happens - all those doors just burst open," Cuddy says. And that gives House an idea. "You just figured something out about your patient, didn't you?" Cuddy asks, when she sees his mind is elsewhere. "Go. Do what you do," she says to him, smiling.

"Take him off the meds," House says as he walks into Ryan's room. "He's got a staph infection." But they treated him for staph three days ago, and it didn't work. "Bacteria already in his system responded, but once the door's been busted open, more just keep coming," he says. Masters pipes up. "Oh! He's talking about an abscess." House explains to Ryan's parents. "An abscess is a gooey, little cream puff of an infection. Probably burst when your little pride and homicidal joy took a hard foul."

It's good news, but they've got to find it. "I think I know where it is," Taub says. He walks over to Ryan and lifts his shirt to reveal his scars. "What if these aren't from skateboarding? The kid has been blowing up PVC pipe bombs. If he got hit by shrapnel, the body walls off the foreign object. Which, because it's plastic, doesn't show up on imaging and provides a perfect home for bacteria. Antibiotics attacked the infection, causing pieces to break off. Some hit the liver, one lodged in his brain and dissolved when Foreman touched it. Once we drain the abscess and remove the shrapnel, the antibiotics can do their job. He'll be fine." The only question left is: What's Taub going to do now?

Cuddy's sister is helping her recuperate at home. "All right, I put the rest of the soup in the freezer, so you'll have some a little bit later." Cuddy repositions herself on the couch. "Thanks for everything," she says. "Are you going to tell mom?" "So she can show up here to take care of you by harassing the housekeeper and criticizing your bathrobes? Yeah, I think I'm going to wait a few years," her sister says, and gets up to leave. "Oh, and I moved your sleeping pills back in the medicine cabinet, because I just worry - Rachel always calls them candy." Suddenly it's Cuddy who seems worried.

"You took Vicodin." Cuddy has gone to House's apartment to confront him about her suspicions. His face drops. "When you came to my hospital room that night, you were stoned." House just looks down. "This is where you tell me I'm wrong. How did I make myself forget for months that you're an addict? My subconscious was trying to tell me you could never get through this without drugs."

House says it was a one-time thing. "It's not about the pills, House. It's about what they mean." "I was scared because I thought my girlfriend might die," he says. "No, you don't take Vicodin because you're scared. You take it so you won't feel pain. Everything you've ever done is to avoid pain. Drugs, sarcasm, keeping everybody at arm's length so no one can hurt you," Cuddy says.

"As opposed to everyone else in the world who goes looking for pain like it's buried treasure?" he asks. "Pain happens when you care," she says. "You can't love someone without making yourself open to their problems. Their fears. And you're not willing to do that." House tells her he came there that night to be with her. "But you weren't with me, not really," she says. "I wanted to be," House says.

But that's not enough for Cuddy. "I can do better," he says. She looks at him, sadly. "I don't think you can. You'll choose yourself over everybody else over and over again because that's just who you are." She takes his head in her hand, crying. "I'm sorry." House realizes she's leaving him. "No, no, no, no, don't ..." he starts.

"I thought I could do this," she says.

"Don't, please don't," he continues.

"Goodbye, House." And she leaves him, stunned.

At a post office box, Taub is dropping off a letter addressed to the Trenton Police department.

Cuddy is crying with her sister in the dining room of her house.

And House is on the floor of the bathroom in his apartment with a bottle of Vicodin in his hands. He twists off the cap and pours out two pills into one hand. He just looks at them for a while, and looks around the room. Then he quickly swallows the pills.

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