House M.D. Episode 8.20 Post Mortem

"Clear! Charging! Clear!" Dr. Penza's repeated attempts to revive his patient are futile. "Time of death, 8:32." The middle-aged woman is unplugged from the machinery; she lies still while her husband and son say goodbye to her. Later, orderlies move her from the bed to a gurney and she's transported to the morgue.

"Hello . . . Diana," Dr. Treiber reads from the woman's chart before beginning the autopsy, recording his findings while he works.

"Unfortunately, the medical records show that Dr. Penza never suspected heart disease, instead giving steroids for an erroneous diagnosis of asthma, thereby causing the fatal tear," Treiber notes. "I suggest these findings warrant further investigation into Dr. Penza's standard of care for this patient, making this my third such recommendation regarding Dr. Penza this year."

Treiber prepares to conclude the autopsy with an examination of the woman's brain: he grabs his scalpel, looks down at the woman, then, looking confused, he takes the scalpel and cuts his own scalp along the hairline. A shocked orderly walks in to see Treiber covered in his own blood, but standing still, as if in shock. "I'm cold," Treiber says.

"Yes, it's mine." House pulls his motorcycle into the hospital parking garage and is astounded to see Wilson driving - or, trying to drive - a cherry red sports car. Pulling into a handicapped spot, no less. "And yes," Wilson continues, "I know that I can't drive stick." House thinks Wilson is a walking cliché - staring death in the face has changed his life. But Wilson's turned the cliché on its ear. He has no intention of leading a more meaningful life.

"I've taken a holy vow to lead a less meaningful one," he says. He's done caring, giving, and searching for the profound. "Now it's time for selfishness, indifference, and embracing the shallow." But first he'll need to figure out how to use the remote lock for his new toy.

"Your scan's in three days," House reminds him, as they walk in. "Tell me this isn't just you killing time before you find out if cancer's going to kill it for you." He won't just be killing time: he's driving to Cleveland tomorrow to meet his boyhood crush. "The years have not been kind to David Cassidy," House warns him.

Wilson tells him the crush is actually actress Julie Christie. "She's opening some kind of charity animal clinic. I'm neglecting my patients to fulfill a silly fantasy. Textbook selfishness and indifference."

House is unconvinced. He wouldn't be surprised if Wilson has all his patients handled in advance, rented the car, and comes back from Cleveland with a new puppy. "He tried to cut open his own skull. Head CT and tox screen were clean." Foreman presents Treiber's unusual case to House, who takes two seconds to look at the file before determining Treiber has Cotard delusion. "Also known as Walking Corpse syndrome. A disconnect in the amygdala convinces you that you're secretly dead."

But there's no past history of mental illness, and if House was planning on bringing up antivirals, those have been ruled out, too. "Plus, Cotard's doesn't explain the paresthesia in his hand," Foreman says. Oh, and there's one more thing: "Treiber won't let any other doctor near him. He trusts your work."

Chase's reaction to hearing Treiber's name makes it clear he doesn't like him. Taub's no fan, either, though Park says doctors only hate Treiber because he finds their mistakes. "Mistakes are a wee bit easier to find on a dead patient. A distinction he fails to recognize. He's a rat," Taub tells her. Park maintains Treiber makes the hospital safer by keeping doctors accountable and focused.

Chase has a thought: maybe he became ill from his last cadaver? "She had bad knees. She used dimethyl sulfoxide for joint pain. The current from the defibrillator could have converted it to dimethyl sulfate. When Treiber cut into her, her blood released toxic fumes." House looks impressed, though he'd never admit it.

Park disagrees: "His lungs are fine. Blood clots make more sense. One in his hand explains the parasthesia. One in his carotid explains the psychotic episode." House sends Taub and Park to look for toxic exposure, and tells Chase and Park to ultrasound for clots.

"I know House doesn't like seeing his patients, but doesn't a fellow doctor rate an exception?" Treiber asks Chase and Adams as they perform the ultrasound. Suddenly he seems quite coherent. And he wants to make sure House ordered this test. "His diagnostic error metric is .17 compared to the hospital average of .32," he says. No clots.

"Every doctor, every diagnosis, every treatment, every result." Park stands in awe of the massive whiteboard chart Treiber keeps in the morgue, with everything written in a code only he understands, which Taub thinks reeks of Big Brother. But there's no toxic blood from his last cadaver. However, the do find something else: lots of empty cans of an energy drink.

"Thought we'd make it a road trip." Wilson proposes '80s music, junk food, and beer, but House is sure what he'll actually get is three days of Wilson telling him his feelings and fears. Wilson isn't taking no for an answer. He pulls out a small bottle of propofol.

"You can accompany me willingly, or I will, when you least expect it, inject the contents of this vial into your bloodstream," Wilson says. "The fall might result in a concussion, or fractures. Or you might get lucky and simply wake up somewhere near Allentown with a nasty headache. The choice is yours. And in case you've forgotten: I am indifferent. We leave tomorrow morning at 8:00 a.m." "No clots, no gas," the team tells House. But they found enough energy drinks to reanimate the entire morgue. "Stimulant psychosis," House thinks. The cure: hydrate and observe for 24 hours. "My abdomen! It's my abdomen!" Treiber is screaming in pain, but Park tells him it's just normal pain from caffeine withdrawal. His distended abdomen sure doesn't look normal, though.

"Abdominal pain and distention means we were wrong about stimulant psychosis," Chase tells the team, now sans House. They eliminate an abdominal obstruction, diabetes, and ulcerative colitis before deciding to try to find House. Adams dials, but why do they hear his phone ringing? They follow the sound to Wilson's office next door, where they find not only House's cell phone but Wilson's, left behind before they hit the road. "Wherever they are, they don't want to be disturbed," Chase says.

"If we take 78, we can do the Sweet Treats & Salty Eats Snackfood Trail." House is navigating while Wilson drives the convertible. But Wilson's got a strict itinerary to follow if he wants to make it to Cleveland in time to see Julie. House's impressed by Wilson's effort to maintain the facade of nonchalance.

"In three days, you're going to find out if you live or die. And you don't want to talk about it?" he asks. Wilson doesn't want to talk about it, and he doesn't want to talk about not talking about it, despite House's insistence that he's hard-wired to talk about it. "Well, from now on, I'm not me. I'm Kyle Calloway," Wilson says. "He's roguish, carefree, and shares no qualities with James Wilson."

"Treiber will refuse any procedure that wasn't ordered by House." Chase wants a plain film of Treiber's abdomen, thinking he might have an intussusception and possibly cancer, but Adams reminds him that Treiber wants House and only House. Chase has a simple solution: lie.

"You want to lie to a guy who's favorite pastime is getting doctors fired?" Taub asks. "We're adults," Chase says. "With advanced medical training. Not children left alone with scissors. It's one x-ray." "I'll have the Big One," Wilson casually tells the waitress at a roadside diner. All the diner patrons hush and look over to see who's ordered the $79 dollar, 80-ounce steak. It will be free if Wilson can eat it in an hour, which is exactly what he plans to do. "Hello, Kyle," House says approvingly.

"Belly film was normal. No sign of an intussusception or any other obstruction." Taub and Chase tell Treiber the results, but he's still writhing in pain and he demands that they run his bowel, since if House thought there was an obstruction, there must be one in there somewhere. And he wants Chase to do it: "Statistically, you're the best surgeon in the hospital." "Kyle! Kyle! Kyle!" House and the other diners are cheering on Wilson, who's got full-on meat sweats and only 25 seconds to down the last few bites of steak: 5, 4, 3, 2, 1! He did it! He ate the entire steak! And then he throws it all up. "That still counts, though, right?" House asks the waitress. "If you really think I'm a good doctor, why do you treat me like an idiot?" Chase asks Treiber as he's being prepped for the surgery. Treiber doesn't think he lacks talent; it's because he thinks Chase has wasted it. Treiber applied to be a fellow on House's team the same year Chase did. He quit his other program, relocated, and broke up with his girlfriend - and then Chase's father called the hospital and Chase was given the spot.

"Do you know what I could have done after only three years with House?" he asks. "Gone to the CDC, WHO, started a diagnostics department some place they'd never even heard of such a thing. You've been given everything: looks, talent, my future. Nine years later, look what you've done with it." "I'm glad I did it," Wilson announces to House, after he finishes throwing up in the bathroom. He was a hero to the people cheering him on. "For one fleeting moment, for an incredibly stupid reason, for a bunch of morons I'll never see again. God, it felt good." "How long do you think you'll work for House?" Chase asks Taub, as they inspect Treiber's bowel. "As long as he'll let me," Taub says. Chase is starting to think about what Treiber said. When House was in prison, Taub worked at Mercy Hospital, while Chase spent the whole time surfing. "A fellowship's supposed to train you to stand on your own. Foreman's dean of the hospital. Cameron's head of emergency medicine in Chicago . . ." Of course, Taub reminds him of some less fortunate fellows: Amber, Kutner & Thirteen.

"It's been 24 hours. Shouldn't we call Foreman, or the police? I think this makes him a fugitive," Park asks the team, who still can't find House. Chase doesn't want to tell anyone; he just wants to solve the case: "Treiber's symptoms started in his frontal lobe and moved through his nervous system: hands, bowels, muscles." Intermittent porphyria.

"The longer we wait to tell him House isn't on the case, the more damage that causes," Adams says. "It's fraud." But Chase is adamant that they don't tell. "I want a threesome." The latest request from 'Kyle' catches House off-guard, but he agrees to help arrange for the tryst. "I need you to do exactly what I tell you," House says.

"House believes very strongly this is the right call," Chase tells Treiber, who's eying him skeptically as he injects him with hemin. "This thing is peeling." House has Wilson don a bald cap to make him look sicker. "I feel like I'm cheating," he tells House. "A: it's only cheating if you don't have cancer," House says. "B: it's Wednesday afternoon. Pickings are slim. More importantly, sober. Cancer card is the surest way to the pity pooty party."House procures a hooker over Wilson's objection. For woman #2, Wilson aims for the pretty bartender, and House lays it on thick: "My friend is dying of cancer," he tells her. "He's pretty much resigned. He just wants to go out with a bang. And another pun. What time do you get off?" "Pleural effusions. It's not porphyria," Adams tells Chase, who runs in to Treiber's room and finds him struggling to breathe and demanding to talk to House. He won't be put off anymore. "Where is House?! Where is he?!" Treiber yells. "We don't know," Chase tells him. "You didn't have to sleep out here." House napped in the car while Wilson had his threesome in a cheap hotel room. It was exactly what he needed, he tells House. Except for one thing: "One of them stole my wallet."

"You're lucky he's not pressing charges!" Foreman knows what's up now, and he's furious. Chase maintains they did everything just as House would have done. It doesn't matter. Foreman is in charge of the case now, and Chase is not to have any contact with Treiber.

Taub thinks it's sarcoidosis, so Foreman orders corticosteroids and a cardiac biopsy to confirm. But Chase now thinks it's a prion disease.

"It's possible he was exposed and didn't know it," Adams says. "Brains are often stored and not tested until weeks after autopsy." Treiber's not in any condition for a brain biopsy, so Chase suggests doing biopsies of the brains in the morgue. With four of them, they should be able to do it, saying, "We can at least start him on amphotericin to halt the progress while you do your heart biopsy." Except they'd damage his kidneys with both the amphotericin and the contrast dye from the biopsy. They have to choose one or the other. "Biopsy his heart," Foreman says. "Wallets go in the mini-bar freezer. If there's no mini-bar, the toilet tank." House fills Wilson in on hooker protocol. They only have $20 left. And they can't use House's credit cards, because he's not supposed to be out of the state. They don't even have enough gas to get home. "We have enough gas to get to Julie. I don't care about anything else," Wilson says. House is starting to like 'Kyle.'

Chase heads to the morgue and picks out a brain in a jar to do the first biopsy. "Oh, come on!" Wilson and House are forced to stop, though the don't see why at first. Then they see the hearse: it's a funeral procession, slowly snaking its way down the road. Suddenly Wilson takes off, speeding past the cars and yelling, until he drives right off the road, through a fence and into a field. The car is totaled, but Wilson grabs his bag and starts walking. "Come on. We've got 20 bucks to go 11 miles."

"Why aren't you answering your pages?" Park finds Chase in the morgue to tell him the biopsy showed fibrosis in Treiber's cardiac muscle. So it's not a prion disease, but that means Foreman was wrong, too. He wants everyone upstairs to work on the case.

Chase isn't going anywhere. He's convinced there must be something in the morgue that made Treiber sick. "Are you trying to cure him or discredit him?" she asks. "Treiber can only see me as not-House," Chase says. "Foreman, too. And they're not wrong. When this case is over, I'm quitting." "He's not quitting!" Foreman tells the team, even though Chase has already called other hospitals. If Chase didn't leave after getting stabbed, he's not going to leave because of one doctor's opinion of him, Foreman thinks. "Fibrosis has to be a response to an infection," he says. They'll start him on antivirals and test the biopsy samples for viruses. "This is Oubliette, Ohio. Buses don't run here after 1968." Wilson has them sitting at a lonely bus stop, but House is skeptical, to say the least. An older woman, Ina, told Wilson a bus comes by every 15 minutes. "Ina is living in Alzheimersville," House says.

It turns out Ina is waiting for a bus to Naples, Florida, to be with her husband, Ben. House might be right. "You're waiting for a bus to Naples?" Wilson asks. She smiles brightly and nods. "Comes every fifteen minutes. Ben will be wondering where his dinner is." Suddenly House spots a cab in the distance and flags it down.

"Come on, let's go!" he tells Wilson. "Julie's going to be at the clinic for another 45 minutes. We can make this!" But Wilson doesn't want to leave Ina, and Ina refuses to go with them, not even when House tries to convince her the cab is going to Naples. House wants to call the police and they can pick her up. "Then I'll stay with her until they do," Wilson says. "Goodbye, Kyle," House whispers as he watches the cab drive away.

"You've got everybody worried, about you quitting," Foreman tells Chase, who's still running tests. Chase thinks it's time for him to move on. He's learned enough to start his own team. "Unfortunately, that's how I felt last year, and the year before." Foreman thinks maybe he hasn't moved on because he needs structure and support. "Somebody else calling the shots."

Chase knows he's just trying to insult him into making a decision, not unlike House. "Either you rise to the challenge, and quit. Or you stay, as a team member," Foreman says. "Dr. Treiber! Dr. Treiber!" Treiber stops responding as Park changes his IV bag. Neither she nor Taub can rouse him.

"Treiber's comatose," Foreman tells Chase, with the other team members trailing him. They think Chase might be right now. But now Chase doesn't even think he's right. "Treiber's reports are thorough to a fault. His methods are fastidious. The answer isn't down here. Treiber didn't miss anything. We did." As Chase is washing up, he has an idea: "Soap. It's the soap."

"I blew it." Wilson and House take a late bus back home. "As always. All I wanted was some meaningless fun, and I couldn't even last three days." It's just the kind of talk House was hoping to avoid.

"I swear I will jump out of this moving bus if you don't shut up," House says. And the worst part? He never had a crush on Julie Christie. He had a crush on a girl in high school who looked like Julie Christie, who liked a popular boy with a band and a car and a mustache . . . Kyle Calloway.

"I assumed - I hoped - that we would go to the senior prom together," Wilson says. "But she asked me for a favor. She asked if I minded if I went with him. She asked me if I minded. And I said I didn't. And that was it. And I just did it again. I just let it go. Like I let everything go. And here I am sitting on this bus, with tickets I bought with my watch, heading back home so a CT scan can decide my fate. I don't want to go back, House. I just want to keep being Kyle."

"Kyle would have ditched that sad, old woman at the bus stop," House says. "Probably would have ditched me, too. I can live without Kyle." "We found out who screwed up. You." Chase is there to greet Treiber as he wakes. "It was your industrial strength antibacterial soap. The additional triclosan does two things well: kills MRSA and makes your thyroid look stupid. It thinks the triclosan's a real hormone and closes up shop." His excessive use of the soap, combined with his excessive use of energy drinks, led to hyperthyroidism, which went undiagnosed until his psychosis. "And the ER put you on sedatives, kicked you into a myxedema crisis." Treiber doesn't think he ever would have thought of that.

"House told us to look for irony," Chase tells him, walking out the door. "Hey," Treiber calls out, "this wasn't House," he says, nodding his head slightly. "I'll give you your own team," Foreman offers Chase, after Chase turns in his locker key. But Chase wants to step out of House's shadow. "It's about time," Foreman says, and he hugs Chase goodbye. "Any news?" Chase finds House in the CT booth looking at the monitors while Wilson's having his scan. There's nothing yet. "Did you come here so I can talk you out of it?" he asks Chase. "Came to say thank you," Chase tells him, extending his hand. "It's been fun," House says, shaking his hand. "Fun?" Chase asks. "Sounded pithier than, 'We've shared a variety of situations,'" House says.

Just as Chase leaves, and he and Wilson begin to talk, House sees something on the monitor. He looks shocked. But he doesn't say anything or give any indication if it's a good thing or a bad thing.

"House?" Wilson asks.