House M.D. Episode 7.04 Massage Therapy

Rain is pounding outside, but Margaret McPherson is safely lounging inside on the couch and watching television. A noise startles her; frightened, she takes a look around and then checks outside. Nothing. She calls her husband, Billy, who assures her that he's on his way home. But why was the door open? She walks upstairs when she hears a thumping noise, but it's just the wind banging a door shut. Then, suddenly, there's a loud bang downstairs. Margaret races down . . . right into the arms of a man in a hooded sweatshirt. It's Billy. He tells her everything's fine, but her relief is short-lived as she soon begins uncontrollably vomiting and screaming in pain.

At Princeton-Plainsboro, House is introduced to Kelly Benedict, the pretty, twenty-something, light-brown-haired new doctor Chase found - on House's orders - to temporarily replace Thirteen. "Nice to meet you," Benedict begins tentatively. "I just finished my psychiatry residency at St. Jude's. I loved studying the mind, but I thought I could make more of a difference and, or . . . at least -"

"Man, you're hot. I mean seriously." House is clearly not interested in her credentials. Foreman tries to steer the team to Margaret's case, but House wants to find out why Chase picked a doctor who he thinks is more like a Cameron replacement than a Thirteen replacement. "Did you ever marry a dying man, and, if so, did you freeze his sperm?"

Foreman takes the reins. "Thirty-year-old female with severe vomiting and abdominal pain preceded by three days of moderate pain. Slightly elevated LFT."

Taub begins to suggest lead poisoning, but House stops him. He wants "Dr. Shameron" to lead the differential. Without using the patient files.

"OK." Benedict is ready for the challenge. "Hepatitis A -"

Foreman cuts her off. "Serologies were negative."

"Right, uh, appendicitis," she says. Foreman looks at her skeptically. "That hasn't ruptured by now? It's hepatic fibrosis," he says confidently.

"At the risk of having Foreman snark at me, too," Taub says, "lead poising could also work."

House orders a liver angiogram to check for fibrosis and a search of Margaret's home for heavy metals. Meanwhile, he and Wilson visit a motorcycle shop and talk about Cuddy. Wilson wants to know if she's staying over at House's place yet, but he says she leaves after they "hook up," though he's a little vague on whose idea that was.

Is he spending time with Rachel? "As little as possible," House tells him. "That is one boring child."

Wilson senses impending doom, but House says that they'll get to it when they get to it.

Chase and Benedict are performing Margaret's liver angiogram. He assures Benedict that she did fine in the differential; House was trying to get at him, not her. Then why doesn't Foreman like her? Chase doesn't really have an answer for that. "Well, he takes a little while to warm up. In my case I'm hoping year seven does the trick." They spot something on the left branch of Margaret's hepatic artery. Scar tissue from a previous surgery? A closer look at her rib case show's she broken five or six bones. Why didn't Margaret tell them about that earlier?

Foreman and Taub are searching Margaret's house. Pipes and paint check out clean, so it's not lead poisoning. Taub wants to know why Foreman was giving Benedict such a hard time. "I'm sorry," Foreman says. "We should all be super-polite in the DDxs, fail to correct each other, and then treat patients for diseases they don't have." But Taub thinks Foreman just doesn't like her because he still has romantic feelings for Thirteen.

Foreman finds a credit card receipt in one of Margaret's drawers for a cafe in Trenton on the day of her collapse - but Margaret told them she was working a cleaning job in Summit that day.

"I'm not hiding anything; I just got the days wrong," Margaret tells the doctors, and Billy, back in her room. And breaking her ribs? A cycling injury from her college days. She didn't think it could possibly be related to what's happening now. They'll need to see her medical records from the accident to make sure what they're seeing in her liver isn't due to a botched surgery.

At House's place, Cuddy is getting dressed again to leave for the night, despite House's pleas for her to stick around . . . to play video games. But she's got to get home before the babysitter leaves. "Oops, you're right. Scram. I've got a massage coming by at five."

Cuddy leaves just in time to see House's masseuse arrive - a tall, beautiful blonde masseuse in a tank top and a tiny skirt.

Back in House's office, Benedict says the university hospital where Margaret claims she had her surgery has no record of it. In fact, she was never even registered at the university. Other local hospitals? Nothing. Benedict ran Margaret's Social Security number and found no credit history up until three years ago. And her Social Security number suggests she was born around 1945. Margaret stole someone's identity. Suddenly all the doctors' pagers are beeping.

"Supraventricular tachycardia! 150 BPM," Taub tells them, as tries to place an oxygen mask on Margaret's mouth. "Get the pacemaker. We can overdrive her."

When Margaret wakes up, House is at her bedside. "What's wrong with me?," she wants to know. "Well, on the one hand, you've got some mysterious heart and tummy problems. On the other, you look great for a sixty-five-year-old. So who are you?"

At first Margaret denies it, but after House presses, she comes clean. She tells Billy and the doctors that five years ago she was married, to a jealous drug abuser. She got a restraining order and ran away - but he found her and broke her ribs. She moved away again, to Arizona, but one day she came home from work to find he'd broken in and poisoned her dog. She bought a dead woman's identity, changed her name, and moved to New Jersey. She attends a support group at Trenton General Hospital; that's why she had a credit card receipt for the restaurant there on the day she collapsed. Margaret's real name is Jenny.

In House's office, the grilling of Benedict continues, as House singles her out for a rapid-fire face-to-face differential with him.

"Arrhythmia and elevated LFTs rule out hepatic fibrosis. So, heart and stomach."

"Gastritis."

"Explains the stomach, not the heart."

"Atrial fibrillation?" "Explains the heart, not the stomach."

"Sorry, sorry . . . cystitis."

"Explains the . . . nothing."

"I meant cholecystitis."

Foreman's had enough. "It would have showed up on the physical exam. Do we have to sit here all day?"

House says that if you put the symptoms together with the abusive ex, the fact that she'd just eaten, the open door . . . "Rhymes with 'moison.' " But Benedict says even if the ex-husband found her somehow, poisoning doesn't make sense: "These abusers have a pattern. He'd beat her with his hands. The poison's too impersonal. It doesn't fit." Except for the fact that he poisoned Margaret's dog. "Oh, right," Benedict says. Now even Chase is a little embarrassed for her.

Foreman thinks maybe he used the same pesticides he killed her dog with to poison Margaret's dinner. House orders pralidoxime. Riding in the elevator with Chase, Foreman can't help but tease him about Benedict. Foreman says that House was wrong about it being a convoluted Cameron-related reason: Chase just wants to sleep with her. Chase says that she was editor of her undergrad newspaper so she's got guts and determination, and she was great in the interview, but Foreman thinks he already had his mind made up and just saw what he wanted to see.

Billy can't believe that this man who he never knew existed could have broken into their home to poison Margaret. "It was the worst time in my life," she tells him. "I wanted to block it out. I'm sorry." But Billy can't accept that.

Cuddy catches up with House in the clinic to ask him about his masseuse, who Cuddy thinks seems a bit "slutty."

"She's a hooker. If she's not slutty, she's doing something wrong."

Cuddy is not reassured. "What? Did you have sex with her?"

He didn't. At least, not yesterday. He still gets massages from her, minus the "happy ending." House claims that she's the best massage therapist he's ever found.

"So you really think that I would be OK with you getting a massage from a hooker you used to have sex with?" But House says that since there's no sex anymore, why should it bother her? Cuddy wants him to switch to her massage therapist, and until House gives Brandy up, she won't be seeing him anymore.

Chase and Benedict are in House's office. While Chase is getting ready to leave, Benedict wants to keep researching. "I'm feeling a lot of pressure here," she tells him. "You were the editor of your school's paper. I think you can handle a little pressure," Chase says. Except, she wasn't. Chase misread her resume. Fortunately for both of them, his pager starts beeping: Margaret's husband has been admitted to the E.R.

House takes his problem to Wilson, who's already been primed by Cuddy. "Ah, yes. The age-old hooker/massage conundrum." Wilson advises House to give in, even if he thinks he's right.

"This is not a point of pride," House says. "This is a point of principle."

"Right, you're the Rosa Parks of hooker massages."

House thinks if he gives in, he's setting a bad precedent from the start. But Wilson says he's got to learn to bend. "Relationships are hard. You have to make sacrifices. So, sacrifice being crazy. Go get her a gift. Apologize." Suddenly House seems to agree, which Wilson knows can't possibly be a good thing.

On their way to see Billy in the E.R., Chase tries to help Benedict "think like House." If Billy is presenting with symptoms to Margaret, the cause could be environmental. But when they pull back the screen on Billy's bed it's clear it's not environmental: he's been in a fight. He found a "Carl" - the name of Margaret's ex - in her address book and looked him up. But this Carl said he didn't know what Billy was talking about and didn't appreciate Billy's accusations. It was just a guy named Carl who she used to work with, not her ex-husband. Billy wanted to find the guy who poisoned his wife, but when Foreman calls from Margaret's room to say she's got pyrexia, they know she wasn't actually poisoned at all.

It's back to the differential, and for some reason House has set up a slide projector. Foreman suggests endocarditis. But Benedict says that the EKG was normal and there were no Osler nodes. "Right, Dr. Kelly," House pointedly says. Chase corrects him: Kelly is her first name. But House is just getting started.

"Allow me to present Theory 2.0 of why Chase hired you. Dr. Kelly, meet your doppelganger." And he shows a slide: it's Chase, around aged 8, and his mom, who bears a more than striking resemblance to Benedict.

But Benedict isn't letting him get to her. "I'm assuming he thought I'd be a good member of the team. And on that subject: what about Legionnaires'? Taub said he saw a ratty old air conditioner in the patient's house." But there's no lung involvement. Benedict says dehydration from the fever could be hiding the pneumonia. House orders hydration and treatment for Legionnaires'. Not so fast: Foreman looks at Margaret's patient files and notices Taub hasn't written anything in there about an old AC system. Taub says he never told Benedict . . . but he did tell Chase. So whose idea was the Legionnaires'? She admits Chase came up with it. House delights in humiliating her.

Chase and Foreman have it out in the stairwell. What is Foreman's problem with Benedict? Foreman says that if they hire someone unqualified, they'll all be carrying dead weight. Him, especially. And then Chase gets it: Foreman's not angry at Benedict; he's angry because he still feels like he's at a different level from everyone else, yet House gave Chase the chance to hire the new team member.

"I am at a different level," Foreman argues. "Which is reflected in what, exactly?" Chase asks. "Your title? No. Your salary? Not really. Your responsibilities? Hardly. Your attitude? Huh, I think we finally found it."

Meanwhile, Cuddy is hard at work in her office, when a tall, handsome, Latin man with a folding massage table arrives, with instructions from House to give her a massage. On the table, Cuddy asks him how long he's been a masseur. He doesn't know what that is. A massage therapist? Nope. House has hired a prostitute to give Cuddy a massage.

Outside the hospital Chase finds Benedict moping, feeling like a cheater and a liar after trying to trick House. She wants to quit, but Chase tells her to hang in there. She knows she's not like the rest of them. Chase says a lot of the job is about reading people, and her background is in psychiatry so she should use that.

Benedict finds Margaret's husband sitting outside her room, twisting his wedding ring. He's called Trenton General: there's no support group for abused women. What else is she lying about? Maybe she wasn't abused. Maybe she's a criminal. Benedict tells him that Margaret's behavior is consistent with abuse victims. Their personalities are affected, and they find coping mechanisms. She advises him against confronting Margaret.

Cuddy can't believe House would hire a male hooker to give her a massage. "I'm sure some part of you believes this idiocy," she says. "But you can't possibly be stupid enough to think that you could convince any part of me. And that can only mean you're trying to sabotage this relationship." She thinks he's trying to keep some distance between them because he's scared of being in a serious relationship.

"How about you?," House asks. "You won't let me sleep over. You basically haven't introduced me to your daughter." He knows they can't be a real couple if she keeps hiding Rachel from him. Cuddy says that she needs to protect her daughter. If she introduces House to Rachel, and he goes away . . .

"I'm not the only one who's holding back," House says.

Despite Benedict's advice, Billy tries to gently confront Margaret about the support group at Trenton General. Suddenly, she begins to scream and experience terrifying hallucinations. Whatever she has, it's in her brain now.

Abscess? Lymphoma? Wegener's? They'd have to biopsy to be sure. Benedict suggests maybe the symptoms aren't actually related. Chase tries to quickly correct her: House doesn't believe in coincidences. But she says Margaret's delusions are consistent with a mental illness, like bipolar disease. House isn't buying it. "So her mind just happens to fall apart right after her body. I thought I was having a bad week."

This time, though, Foreman stops House from his mocking. If they keep picking at Benedict, of course she'll make mistakes. Foreman says it would irresponsible of him to let that continue. House orders a biopsy for Margaret.

Chase and Taub are about to cut into Margaret's head when Taub notices that her temperature is normal again, which it shouldn't be, because she's been taken off the cooling blanket they'd been using to treat her fever. One symptom has vanished. Relapsing-remitting fever. Malaria? Dengue? House wants to know why she wasn't actually much cooler during the day. They had the blanket on her all day, yet she was a normal, comfortable 98.6. Benedict says she adjusted the blanket so as Margaret's fever dropped, the cooling power was lowered. But it's been on the lowest setting since the day before, so if she hadn't adjusted the blanket, they'd have known then that Margaret's fever had passed.

Taub says maybe with a fever that brief it was a reaction to medication, maybe antibiotics. House wants to know when she last vomited, but she hasn't since she's been admitted. Two symptoms gone. House leads the team to Margaret. "Shooting for three." And he unplugs her pacemaker. No tachycardia. That just leaves the delusions, if they're still there. Benedict again makes the case for bipolar disorder, possibly prompted by the physical symptoms. That gives House an idea: Benedict has the cause and effect backwards. He orders haloperidol and lorazepam for Margaret.

The whole team is there when Margaret wakes up. She's still hallucinating, but she can talk to them. House knows that she's been lying the whole time. She was seeing a doctor in Trenton who was treating her with risperidone, which was causing her stomach pain. There was no abusive ex-husband. She's suffering from schizophrenia: everything else was a result of the side effect of the drug being used to treat it. Her symptoms - the side effects - faded when she was off the drug, but the delusions came back. House leaves, but not before making a dig at Benedict for having recently completed a psychiatric residency yet missing Margaret's mental disease.

But Billy doesn't know what to do. This isn't the woman he married. "Of course she is," House says. "You just didn't know it." Billy says it's going to be too hard. "It's always hard," House tells him.

In the elevator, Chase tells House he was right about Benedict: she's not ready to be on the team. House leaves it up to Chase. He doesn't like her any better than he did before, but at least she got him to the right answer.

Cuddy walks into her office only to find House at her computer. But he was only looking for the number of Cuddy's massage therapist; he's going to give up Brandy. "I will get you the name," she says. "Let's stay at my place tonight, OK?"

In the doctors' locker room, Benedict is packing her things when Chase walks in. She wants to quit before House fires her. "Maybe there's a bright side. You really looked out for me. You seem like a really good guy. And I never date anybody who I work with, but . . ." "Yeah," Chase says. "Sorry it didn't work out. You want to get dinner tomorrow night?"

House, Cuddy, and Rachel are sitting at the dinner table at Cuddy's place. When Cuddy gets up to go to the kitchen, Rachel takes House's new cane and promptly starts chewing on it. House is able to wrestle it from her and wipe off the baby spit, but he's not at all pleased. "Aren't you adorable?" he grouses.