House M.D. Episode 4.13 No More Mr. Nice Guy

Nurses are striking outside of Princeton Plainsboro Hospital. Nurse Deb Tallridge walks the picket line with her husband, Jeff. A delivery man with a hand truck loaded with boxes approaches and rams Deb with his cart. Jeff steps up to diffuse the situation. He puts his arms around the guy, giving him a hug. Jeff's eyes roll back in his head and he passes out.

The emergency room is filled with patients as frustrated doctors rush around without help. Cameron watches House wander in. He finds a seat, picks up a magazine and notices Jeff patiently waiting for treatment. Jeff can only manage to smile.

Cameron lists Jeff's symptoms for House. He has fainting spells and a recent history of dysgeusia. Everything tastes like lemon meringue pie. House accepts the case.

House writes three things on the white board: dysgeusia, syncope and niceness. Foreman and the Fellows throw out possible prognoses such as metabolic disorder, toxic exposure, carcinoma of the tongue metastasized to the brain and epilepsy. The wonder if "niceness" is a real symptom. House tells Foreman and Kutner to check Jeff's home for toxins. Taub and Thirteen are to run an MRI for tumors and an EEG for nerve damage.

Since Wilson is preoccupied with Amber, House is forced to bowl with a new partner - Chase, who warns House that he might not be able to destroy Amber. House with Amber for joint custody of Wilson. Wilson sees this is House's way of accepting them as a couple. Amber offers up Wednesdays but Wilson must be home by eleven. They can swap weekends.

Kutner and Foreman search the Tallridge home. There is a closet filled with cleansers and solvents. The Hydrofluoric acid not only lowers calcium, but it can cause fainting and be the reason for the taste issue.

As Wilson stands off to the side eating chips, Amber and House present their side of the joint custody dispute to Cuddy, who takes the opportunity to read House his performance review. She asks him to sign it. House says he will only sign if she gives a ruling. Cuddy responds, "I'll give you a ruling if you agree to do reviews on your team."

House goes to see Jeff, pronouncing, "You're either perfect or sick." Deb says he's not sick. He is just nice. House diagnoses Williams Syndrome because Jeff is missing the genes that make him suspicious. Jeff starts to suffer a stroke and the doctors work to stabilize him.

House assembles his team. Jeff tested negative for Williams. House thinks it is neuro-syphilis which wouldn't show up on an MRI without contrast. Kutner, Taub and Thirteen leave to run the tests. Foreman offers to do the employee reviews for House, who gladly takes him up on it.

Jeff denies he has syphilis because he tested negative for it ten years ago in the Peace Corps. Meanwhile, Amber delivers Wilson to House late for their mini-golf night out.

Thirteen tells Foreman that she thinks Jeff has a heart defect. A patent foramen ovale explains the stroke and the syncope, and a PFO wouldn't show up on an echo. She'll do a bubble test. Foreman starts giving her a performance review but she leaves. Kutner enter and says that there was enough blood left over from Jeff's anemia test on admission to run the VDRL. He believes House wouldn't let them go on until they ruled out neuron-syphilis. Yet it is neuro-syphilis. The tests were positive.

RWhile Kutner hangs a bag of IV penicillin for Jeff, Deb wonders aloud, "You really think I've been in love all these years with a symptom?" Kutner explains that if syphilis created lesions in Jeff's brain, then the lesions caused personality changes.

In the cafeteria, Taub and Kutner discuss House. "How can House be an ass without it being an illness, but niceness is a biological crime?" Kutner asks. Foreman wants to do Taub's review, and Taub explains House's real scheme. "He knows it'll annoy us; and we'll stand up to you which will force you to confront the fact that even though you think you're our superior, you're no different than us," Taub says. Foreman stops, realizing that he is right. Kutner says if there's something wrong with this guy, there must be something wrong with House.

A sober House gets Wilson drunk in a dive bar. Wilson confides that, if he gets any drunker, "it" might not work. House gets a call from the team because the patient is vomiting blood. Kutner says the Hematemesis is probably from liver damage caused by the ethanol in the cleansers or the penicillin. That leaves viral hepatitis.

The team is exhausted as they work on liver function tests and serologies into the wee hours. Thirteen finds the GGT's normal, so alcohol is ruled out. Kutner notes that House has syphilis as well.

The team approaches House to inform him that he has syphilis. Kutner explains how they found a vial of his blood in the lab and tested it. Thirteen places pills on his desk.

House enters Wilson's office without knocking. Amber is there. She warns House, "Either I stop you or I stop seeing Wilson. So I'm gonna stop you." House declares that the next person who violates the contract gets a finger cut off.

House is sitting at his desk sulking when Foreman enters with a file and takes a seat in front of him. House admits he had to exploit Foreman. "If the team fears you, they don't question you; if they don't question you, they don't find answers; if they don't find answers, they're useless," he explains. Taub enters to tell them the patient tested negative for sarcoidosis. House has him run tests for everything he can think of.

Jeff is pale, drawn, sweating, and angry. He contorts in pain, clutching his chest. He is having a heart attack. Deb calls for help but there are no nurses. Taub hurries toward the room.

House and the team are brainstorming. Kutner adds the terms rage and heart attack to the white board. He thinks that the prednisone given to Jeff could cause "'roid rage." Taub suggests an allergic reaction to the penicillin. Thirteen was about to test for a heart issue before the syphilis. This could explain the heart attack, while reduced blood flow to the brain could have triggered the rage. House shrugs passively without an opinion.

House informs Wilson that his team thinks he has syphilis and that he gets better, he will become nicer. He knew they had access to an old blood sample and would test it. Wilson says he won't tell Amber.

Taub and Kutner perform a bubble test on Jeff. Kutner does an ultrasound on Jeff's chest as Taub injects a sedative into his IV line. They both study the monitor. Amber enters to let them know that House doesn't have syphilis. House told Wilson he switched the blood samples. Bubbles appear in the right side of Jeff's heart. Kutner abruptly drops the ultrasound wand and heads out of the room to seek House.

Kutner tells House that he either has syphilis or the test was wrong twice. Maybe he gave the team someone else's blood. The only other option is that House has something that tests positive for syphilis. Kutner thinks the Chagas caused encephalitis. He holds up an MRI.

Kutner gives Jeff the news that he has a parasite called Chagas disease. House explains Jeff's brain has been swollen just enough to alter his personality.

House enters Cuddy's office and drops the performance review files on her desk. She opens up the first folder, and, to her surprise, it is legitimately filled out. Yet as she turns to the second review, she finds they are all the same. Foreman wouldn't type his up and there is an extra one in there -- a cruel review of Cuddy. She tells him that Amber called her, complaining that House talked to Wilson on her "time." They are both losing fingers.

Jeff seems better. Deb brings him ketchup for his lunch. He doesn't like the taste anymore. Deb looks at her husband in a whole new light.

An elderly patient lies in bed as House and Amber unhappily and clumsily change his sullied sheets. They want a better punishment than that.