WHAT'S HOT?

House M.D.

Episode 8.16 : Gut Check

House M.D. Poster

TV Info


Episode Premiere

April 09, 2012

Distributor

Fox TV

Genre

Drama

Show Period

2004 - 2012

Production Company

Heel and Toe, Shore Z, Bad Hat Harry

Cast and Crew


Director

Miguel Sapochnik

Screenwriter

Jamie Conway, David Hoselton

Main Cast


Additional Cast

  • Greg Finley
  • Christian Lalonde
  • Will Shadley
  • Joe Kelly

Synopsis


"Nice to meet the pride of Trois-Rivi'res. Still got your Wings rookie card." Bobby Hatcher of the Trenton Toros confidently squares off against his older rival in a minor league hockey game, amid chants of "Hatcher! Hatcher!" from the half-filled arena. "So what's that worth?" his opponent asks. "It's a collector's item. They don't make 'em like you anymore," Bobby taunts the man.

The two men eye each other and square up as the referee drops the puck between them. They drop their gear, and it's a full-on brawl on the ice, with Bobby clearly getting the better of the older man, landing multiple punches in a row as the crowd erupts. As the ref drags Bobby away, suddenly he starts to cough uncontrollably, heaving blood on the ice.

House introduces Bobby's case to the team: "Twenty-two-year-old enforcer with hemoptysis." Taub, no fan of hockey fighting, thinks that Bobby just broke a rib and punctured a lung while breaking someone else's rib and puncturing their lung. "Nice conclusion," House says, "to which the ER already jumped 18 hours ago."

Chase suggests sarcoidosis. "Nodules could be too small to show up on an x-ray," he says. "And fighting's the best part of hockey. Without it, you've got the Ice Capades."

"Fighting has nothing to do with hockey; it's like the cheerleaders at a basketball game," Taub responds. That doesn't do much to sway Chase. "Cheerleading's the best part of basketball. Without it, you've got . . . basketball."

Adams thinks that Bobby could have contracted psittacosis while duck hunting recently. Every suggestion that Taub makes relates to a possible hockey fighting-related injury. He had teeth knocked out a few weeks ago, and the infection could have led to oral bleeding. Or he took an elbow to the gut that caused an esophageal tear.

"Chase, CT the patient. Check for sarcoid," House says. "Adams, sputum cultures and serologies for psittacosis. Taub, I'd tell you why I think your theory is not just wrong but ill-conceived, but it's more fun to prove it by having you check the stool for blood."

"The faster you guys can do this the better," Bobby tells Taub and Adams. "The NHL's been sniffing around, and being in the hospital's not really helping my marketability."

Bobby has been leading the league in penalty minutes. "And visits to the ER, not counting ones you've caused," Taub notes. Bobby argues that he's actually preventing injuries: "I take the hits so the smaller guys don't have to. I thought you'd appreciate that." Ouch!

"Neighbor's baby again?" House finds Wilson catching a nap in his office, leading to an analysis of Wilson's insomnia. "It's not the crying that's keeping you awake. The sound of a needy child is stirring your paternal juices."

"The sound of a crying child at 112 decibels has stirred my inner murderer, so don't mess with me," Wilson warns, though he admits that it's crossed his mind. "It's not a big deal. So I'll probably never be a dad. It sucks. I'll lose a little sleep, but . . ."

"You're not supposed to feel bad when you dodge a bullet!" House interrupts. "There are actually things in this world," Wilson starts, "that give life even more meaning than soap operas and monster trucks. And we happen to be missing out on at least one of them. So, unless you want to adopt a child with me, please shut off the lights on your way out."

But before he leaves, House has a bit of news for Wilson about an old girlfriend named Beth: "The night the two of you split up, you came around to my place, wallowing in self-pity and tequila. You passed out. She called that night, asked me to give you a message. She said she was pregnant. Which, God and Planned Parenthood willing, means you are the father of an 11-year-old. I told you the next morning, hypothetically. I asked you how you'd feel if Beth had gotten pregnant, and you said, and I quote, 'It would be the worst mistake of my life.'" Wilson is stunned. He thinks House is putting him on. "Just as well," House says.

"I want to kill my mother." Park is complaining while she and Chase monitor Bobby in the CT chamber about having to take care of her grandmother at her mother's request. "I have to take her shopping, to her friends, to Atlantic City."

"If only there was some solution, some place where you could live, that's not there," Chase muses. Park thinks moving out would be a sign of disrespect. "Not everyone's lucky enough to have your independence," she tells him. "Don't worry. When you lose your family, you'll have it, too," Chase says. Meanwhile, Bobby doesn't have sarcoidosis. He does, however, have a super-sized spleen.

"Deep vein thrombosis, caused by any one of his many injuries or surgeries." That would be Taub's guess. Adams thinks his problem with hockey fighting is clouding his judgment when he quickly dismisses Park's suggestion of leukemia. "We should get an ultrasound for DVT and a WBC for leukemia," Chase says.

"Give me some good news, Kenny." Bobby takes a call from his agent as Taub swabs his arm for a blood draw. Taub's eyes are quickly drawn to Bobby's chest: his breasts are enlarged.

House finds Wilson late in the evening, on the patio outside his office. "I called Beth," Wilson says, haltingly. "I have an 11-year-old son."

"Liver failure could alter hormone levels, cause of normal breast development," Chase says the next morning. Park thinks that it might be alcoholism and wants to search Bobby's home. "Note that the person who wants to search the home didn't sleep in one last night," House says, noticing the imprint of a seatbelt buckle on her cheek. "I got into a fight with my mother," she responds.

"What about leptospirosis?" Adams wonders. "That's a good fit," Taub says. "If you ignore the fact that he's a pro athlete who looks like the Incredible Hulk. Which means he's got to be on steroids, which is a better fit. Steroids could cause polycythemia, and could explain the spleen and the hemoptysis."

Taub maintains that even though he doesn't like Bobby, his judgment isn't affected. House orders Adams and Taub to run antibody titers for leptospirosis, and Chase and Park to check out Bobby's home and locker room "for booze, steroids, and Taub's objectivity."

"At least you're free. You going to get your own place?" Chase and Park rummage through Bobby's locker and discuss Park's living situation. She's not anticipating much luck finding an affordable option. "If you want, you can crash at my place," Chase says. "I have a spare bedroom." Meanwhile, he finds a beer and a half-empty bottle of pain killers, but no steroids. Park thinks that it might be weird for them to live together. "Hey, if you'd prefer your car, be my guest," he says.

Park finds a prescription for ganciclovir in a nearby gym bag. "If his neighbor has mono, it could mean he has mono. If he has mono, it explains his spleen and hemoptysis. And it's caused by Epstein-Barr virus, which explains his liver. And my moon roof leaks. Thank you." Looks like she'll be bunking with Chase.

"Why don't you just assume that you're not the dad." That's House's helpful advice to Wilson as they stare down the aisle of a toy store. Wilson pulls out a cell phone picture to show House. "Huh. Either you're the dad or she cheated on you with your dad." Isn't he worried that the child might be bitter, without knowing what Beth has said about him? "Raised by a lunatic mother and abandoned by his father. Oh, I know! Squirrel handcuffs. Think he's got any of those?"

Wilson wonders if House didn't want him to act on the information, then why'd he tell him at all? "Because you were pining for a kid, and you deserved to know that you already had one," House explains. "But your parental cravings are more theoretical than applied. You want vicarious immortality more than you want a lifelong burden."

"You're assuming he's going to be a nightmare," Wilson says. "What if he's a good kid?" "He's a kid. The best you can hope for is he's a nightmare," House says. Wilson knows that this could all end badly. "But the point is, my son wants to meet me. And I want to meet him."-"Popo, I presume." Chase comes home to see an elderly Korean woman knitting in his living room, and he correctly guesses she's Park's grandmother. "I thought the whole point of this was to get away from Popo?" Chase asks Park in the kitchen. "My dad's getting a cyst removed, and my mother had to take him to the clinic. Don't worry. She'll be gone in an hour." "I'm not worried, because it's not my issue," Chase tells her. -"Bobby?" Taub comes to Bobby's patient room, but he's not in his bed. He's huddled in a ball in the corner, crying.

"He's crying because his liver failure threw his hormones out of whack," Park suggests the next day. "Aside from the crying, he's actually recovering nicely," Adams notes. "Aside from the guy in the book depository, the Kennedys had a lovely trip to Dallas," Taub says. "Repetitive blows to the head can cause chronic traumatic encephalopathy, the symptoms of which are aggressive behavior and depression." So Taub's theory is that his aggressive behavior caused his aggressive behavior?

"He's not depressed," House says. "He's just bummed because he knows he's a talentless moron who's only one lost fight away from being a barista." Taub says that if Bobby quits being an enforcer, it could save his life. "You don't want to save his life. You want to kill his career," House says.

House casts an eye toward Park, who completely freaks out. "I moved into Chase's apartment!" Chase is surprised. "He knows! He was staring at our matching cups. I told you we should split up. We're not having sex," she tells House. "With each other." Now House is even more curious. Does Chase want to sleep with Park? "I was doing something nice," he says. "No, that doesn't fit," House says. Guilt? "Chase convinced you to leave mommy, and now he feels responsible." And he wants a psychiatric evaluation for Bobby. "If he doesn't start weeping again, send him home."-"Dr. Wilson?" Wilson is anxiously waiting in a diner when a young boy approaches. "Duncan! Uh, James," he says, shaking the boy's hand. "It's nice to meet you." Both of them don't quite know what to say. "How're you doing?" Wilson asks. "Good," Duncan tells him.

Wilson gives him the present he settled on: a portable game system, which unfortunately Duncan already has. "I can always use a backup, though." When the waitress comes by to take their order, she notices the gift. "Is that a GameDeck? Nice going, Dad," she says, which makes Wilson smile.-"According to your psych eval, the only thing happier than you is Disneyland." Taub gives Bobby the results in his patient room. Bobby apologizes and tells him it must be the medication. "But they must be working, because I'm feeling a lot better now." Taub brings up CTE, but Bobby knows all about it. "My aunt sends me every article she can find on it." So he knows that it can kill him? "In the long run, like a lot of things." And he doesn't want an MRI to confirm it. "I have enough evidence of head trauma in my file already."-"My mom said you had trouble maintaining relationships with normal people?" Duncan is trying to get to know his dad. "She also said you were a nice guy. I always figured she was lying because she didn't want me to hate my deadbeat dad," Duncan says, laughing. But he knows now that Wilson just learned about him. "I got to go, but it was really nice meeting you," Duncan says. "You want to hang out again?" Wilson laughs. "Absolutely." "Tonight?" Wilson is a little startled, but he tells him that tonight would be great.-"Thank you. How'd you talk him into it?" Taub sees that Chase has somehow persuaded Bobby to get an MRI. "He agreed once I promised him anonymity," Chase says. "Unfortunately, we've wasted his time and proved House right." Taub thinks that he spots something that Chase dismisses as an artifact. "I know you think I'm convincing myself, but this brain has been hammered for years, meaning evidence may be subtle, but it's there."

"Meaning you see what you want to see," House says. It's him in the MRI machine, not Bobby. "Unless, of course, Chase is an idiot, and I do have brain damage." Before House can humiliate Taub any further, they get beeped: Bobby is stroking out in his room.

"The good news is, it's an isolated ophthalmoplegia," House tells Bobby, as he sees Bobby's eye has rolled back into his head. "Which means you didn't have a stroke. The bad news is, Taub was right. You're still sick." But it's not CTE, which House makes sure to berate Taub about in front of Bobby. Before House and team leave, Bobby asks if he can speak to House alone.

By the time House comes out, Taub already has another theory of why Bobby is sick that relates to his profession, but House cuts him off. Doesn't Taub want to know why Bobby wanted to talk to him? "He was doing what he always does," House says. "Sticking up for the little guy. Told me to apologize to you, or he would excrete down my throat. I'm paraphrasing. So, if he should ask, I was a gentleman, or I will excrete down your throat."

"Microscopic polyangiitis fits," Chase says. "We should start plasmapheresis immediately," Taub says. Chase wants to perform a test to confirm, but Taub says they can't wait. "We may not have time before it reaches his lungs."

"Miserable yet?" House sits down with Wilson in the cafeteria. Wilson, however, has only good things to say about his new son. "He's polite, well-adjusted, and a straight-A student." Wilson is going to make him dinner tonight. "I could give this kid a quinoa salad, and he would eat it just to be nice."

House thinks that this is all going to end badly. "Because we like each other?" Wilson asks. "Yes, because of the statement, 'We like each other.' You've known him 25 minutes. All you know about him is he'd lie about a quinoa salad, whatever the hell that is." Wilson thinks that he knows what's going on: "You're jealous of an 11-year-old because you are an 11-year-old."

"So tell me about yourself. You're smart, you're nice, what else?" Wilson and Duncan are making pizzas in Wilson's condo. "I don't know. I'm a kid," Duncan says, looking around. Maybe this isn't going to go so well after all. It turns out all he was wants is prosciutto. "Is that weird?" Duncan asks, sheepishly. Wilson is thrilled, because he loves prosciutto, too. And goat cheese, which Duncan also requests.-"I think that was the best pizza I ever had," Duncan says as Wilson drives him home. "It was the hint of Dijon." Wilson asks if Duncan has any other relatives, but apparently Beth got into some fight with them, and they aren't talking.

Wilson says that his parents are going to be very excited to meet Duncan. "That's awesome," he says. As he's getting ready to get out, he gives Wilson a big hug and says, "I love you, Dad," which catches Wilson completely off-guard.-"Can't be easy doing what you do. I mean, do you love it? Is it fun?" Taub is administering the plasmapheresis and having a chat with Bobby about hockey. "Every winter my dad would flood the backyard and make a rink," Bobby remembers. "I was Lemieux, my little brother was Gretsky. I was good. I won the NDHA scoring title three years in a row. I kept getting bigger and stronger and better, until I didn't. My Juniors coach told me if I wanted to stay on the team, that I'd have to use my size. Every game I got less and less ice time, until it was all fighting and no hockey."

Suddenly Bobby looks concerned. "I, uh, there's something going on with my arms. I can't feel them!"

"Patient's arms are now paralyzed. ANCA panel was negative; it's not MPA." Taub presents House with the latest the following morning. Chase is awfully sleepy from staying up late playing cribbage with Park's grandmother.

House thinks that he has a problem similar to Wilson's: "Except you're haunted by the pitter-patter of tiny skanks. You don't feel guilty about getting Park thrown out of her home. You feel guilty about all the women that you've screwed over. My mother needs a thousand bucks for snow tires."

Taub notes that the paralysis is descending, which could mean botulism. Maybe not from ingesting, but injecting: "He was treated for intractable muscle spasms by the team's trainers. Sometimes they use Botox." They need to test first to confirm, because the antitoxins could cause anaphylaxis.

House thinks that Taub's new fondness for Bobby is just as harmful for diagnosing as his hatred was. "Last time you said there wasn't enough time to test prior to a more dangerous treatment. Give him the antitoxin."

"Anything?" Park checks in on Taub and Bobby, but there's no adverse reaction yet. She also wants Taub's opinion on Chase. He let her move in to get away from her grandmother, and now he's practically inviting them both to stay. "He's being way more than nice." "So, which answer is it," Taub asks. "Chase feels guilty for pushing you to move out?"

Park says he didn't really push her. "Guilt about skanks?" Taub asks. "He loves skanks!" Park says. "It's not the other option," Taub warns. Park is offended, telling him, "There are people that like me. People even want to sleep with me. Some of them are even good-looking." That good-looking? Just then Bobby's hand moves. His feeling is coming back.

"I could give you crap for making me wait 11 years. But instead, I'm going to thank you for not making me wait another 11," a chipper Wilson says to House while they ride in the elevator. House thinks that it's only a matter of time until Wilson gives up on Duncan.

"The only relationship you haven't quit on has been with me," House says. "Hmm . . . a needy, truculent narcissist," Wilson says. "I think it's been perfect training for parenthood." "It's not even close," House says. "This is the rest of your life. You screw this up, you don't get to run away. You get to ruin both your lives. This is a bigger responsibility that anything you've ever taken on and screwed up." "I know," Wilson says. "That's why I'm so excited about it."

"You know the best part of my day is when I'm sitting in that penalty box after I beat someone up," Bobby says. "It's the only time I know I'm safe." Bobby looks happy and much improved as he talks to Taub about how he's going to give up enforcing, whatever it costs him. Suddenly Bobby starts panicking and struggling to breathe. "We need a team in here!" Taub yells.

"He's completely paralyzed, and he tested negative for botulism." Now House is looking for long shots: polio, MLD - both of which Taub dismisses. "I say that not because there's no treatment for MLD," he assures House. "But because it's a bad fit. His cognitive abilities are unaffected." And he doesn't want it to be a prion disease, because the test for that is a brain biopsy. "Given his history, there's got to be brain swelling. We can't risk drilling into his skull." Taub threatens to go straight to Foreman.

"He's not your friend," House says. "I get it, he's a patient . . ." Taub starts. House comes clean: "He never had your back. He didn't insist that I apologize to you. He asked me to take you off the case. Biopsy his brain."

"Hey, Dad. Sorry I'm late. Got into a fight with my mom. She's such a tool," Duncan says as he meets Wilson for breakfast in the diner. Wilson tells him that he's sure Beth means well. "She wants to open a reserve in Costa Rica to rescue birds-of-prey," Duncan says. Wilson remembers Beth talking about a lot of things but never being serious. "She bought plane tickets for Monday," Duncan says.

As Wilson tries to tell him that Costa Rica might not be so bad, Duncan says, "Oh, I'm not going. It's her stupid dream, not mine." So where does he plan on staying. "I, uh, thought maybe I could stay with you?" Duncan says. "Your place is only three miles away from my school. I could bus it every day. And I do my own laundry. I keep my room tidy."

Wilson is shocked, but he looks like he's at least considering it. "Duncan, this is very sudden," he says. "I know, I'm sorry. Please don't send me to the jungle," Duncan pleads. Wilson can't say no. "If it's OK with your mother, it's OK with me."-"Take me off the case. I've obviously completely lost my objectivity. I'm not helping. I'm not even neutral." Taub wants off Bobby's case, and House asks then why shouldn't he be taken off all of their cases. "Because you were right. I hate bullies." Then how does he square that with working for House?

"I've known a lot of bullies," Taub explains. "People who didn't like me because I'm short. People who didn't like me because I'm Jewish. You relentlessly mock, but it's not for self-aggrandizement. It's because ideas are bigger than feelings . . . at least, that's what I choose to believe." Um, no. "You little heeb," House begins. "Here's some ideas for you. You screwed up. You kept on screwing up. Everything you said is true, except it doesn't mean you walk away. You just learn to trust nothing. Everything you think you feel. Everything you think you know. Question every call. Play through every whistle." That gives Taub his very own "light bulb" moment."Stop! It's not prions." Taub and House burst into the operating room just as Chase is about to drill into Bobby's skull. "Epstein-Barr gave him mono. It also gave him Miller Fisher syndrome. The plasmapheresis 'played through the whistle.' We gave it to him for MPA, but when he got worse we took him off. When he got better, we thought it was the antitoxins, but it was actually the plasmapheresis still working. We had the right treatment, just the wrong diagnosis." House of course takes credit for the metaphor that set Taub on the right track. "Put him back on plasmapheresis. He'll be fine."

"His mother is moving to Costa Rica. He asked if he could move in with me." Wilson is sprawled out on the couch in his office again when House shows up. Wilson laughs like he can't believe it. "And I said yes." House has some typically helpful advice: "It's only six or seven years." "I said yes, knowing I'm not remotely ready for that!" Wilson says. "Knowing he's not ready to be separated from his mother. This isn't the act of a mature, rational adult. I can't do this, House. You were right."

"I have an idea," House says. "It can make this entire problem go away." But Wilson doesn't want any clever jokes right now. "You were right. About everything. This is life. It's real. It doesn't just go away." But as it turns out, none of that is true. House opens Wilson's door, and Duncan walks in - well, actually Wendell, a local child actor, walks in.

"If you're going to get pissy, remember: it was House's idea," Wendell says. The whole thing was a setup. "You were regretting not having kids, so I gave you one, thereby rendering you regret-free," House explains. "It's a priceless gift." For some reason, Wilson doesn't see it that way. "Get out!" "I just got the call: three-year-deal, $2.1 million." Bobby tells Taub the news the next morning. "What about the flooded back yard? Pretending to be Lemieux?" Bobby tells him that's why he took the offer. "After all I did to get here, half a dream is better than nothing. Maybe my new coach will see what my Juniors coach did."-"I'm not sleeping with you," Park assures Chase as they catch an elevator ride. "That's a shame," Chase says nonchalantly. Then Park gets it: "This is about Popo. You were jealous of me, my family." "Maybe you've got too much, and I've got too little," Chase admits. "I might sleep with you after all," she tells him, as they leave the hospital. Later, Chase plays cards and drinks with Popo, while Park returns home to talk with her mom.

"The woman that I called - that was really Beth?" Wilson and House are making pizzas in Wilson's condo. House found Beth on Facebook. And she didn't even charge anything. "She's still pissed at you. Pass the bacon." "I thought you liked prosciutto?" Wilson asks. "Nobody likes prosciutto," House says.

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