Hey, guess what, guys! There’s virtually NO FOURTEEN in this week’s episode! Can you believe it? I almost couldn’t. Someone took pity on me. I’m not sure if I traded up, though, as this episode prominently features an academic term that’s used so egregiously that my old political philosophy professor would stick a pencil in his eye if he saw this episode. Thankfully for him, I don’t think he owns a television.
We join this week’s guy at a fancy-smanchy restaurant. “Nick,” a high-powered editor, is having dinner with one of his bestselling authors. Nick, however, appears to have too much alcohol. He calls the author “mathematically illiterate” and insults his publisher before he notices he’s got a nosebleed. He falls out of his chair and the room gasps.
The team passes Nick’s file to House when he walks in, as the case reminds them of Phineas Gage because the patient is experiencing frontal lobe disinhibition. House thinks it’s the chardonnay talking, but Taub insists Nick was sober when he was admitted. The MRI revealed no tumors on his brain, but Thirteen thinks there could be one in his nasal cavity. House orders a nasopharyngoscopy to check it out.
Nick, meanwhile, is playing cards with his daughter on the hospital bed. He keeps telling her which cards he has, so she keeps winning. I feel like I’ve seen this plot device before, somewhere… Taub and Kumar come in to do the nose-scope and Nick insults Kumar’s bedside manner. I’m glad someone finally did. Kumar ranks only slightly above Thirteen on my List of Doctors Who Will Never Touch Me EVER. Nick’s wife reveals that his daughter has an “auditory processing disorder” (this will come up later) and asks if she can step out to make a call about the Breast Cancer Walk she’s organizing. “Yeah, you do that. I’ll pretend to be macho while a guy shoves three feet of plastic up my nose. [To Taub] It’s too bad it’s not your nose. Lots more room to maneuver.” Mean, yes. But still funny. Nick starts bashing on his wife’s profession of choice. It’s getting to be awkward. “Make this go away,” Nick pleads, “… god, that honker really is huge, isn’t it?” Taub’s trying really hard to stay professional, and I commend him for that. Because I would have shoved that plastic tube up Nick’s nose with no mercy whatsoever. But that’s why I’m not a doctor.
As they trot down the corridor, House is trying to get Wilson to go to a monster truck rally with him. Wilson declines, and admits that he doesn’t like monster trucks. He only goes to the rallies because House likes them. “I can only watch so many hyped-up dune buggies crush so many motor homes without feeling the urge to go see La BohÃ¨me — and I hate opera, too.” Wilson, that’s ridiculous! No one can hate La BohÃ¨me. House thinks Wilson’s hiding something. “I’m saying it loud and proud: ‘death to monster trucks.'” Kumar interrupts to report that there’s no tumor, and that Nick’s marriage is going to be on the rocks if he keeps saying everything that pops into his head. “You always led me to believe you were one of a kind,” Wilson jabs at House. “Luckily, jerkiness is a temporary condition for this guy,” Kumar says. “No it’s not,” House responds, “We may be able to fix his impulse to say his thoughts out loud, but he’s always going to be the guy who thinks them.” “But he’s also going to be the guy who doesn’t say them,” Wilson jumps in, “If he’s spent his whole life constructing this nice-guy persona, isn’t that as much who he really is as anything else?” “You would argue that,” House fires back, “You’re all persona.” Kumar then interrupts with a Harry Potter reference about sorting hats that I don’t understand, because I’ve tried to stay as far away from that particular phenomenon as possible. It has something to do with putting kiddies in magical houses. House and Wilson look as confused as I feel. “There’s damage in his brain. Go find it,” House orders.
Foreman and Thirteen (gack – it’s okay, though, it’ll be quick) are doing a functional MRI on Nick in order to check the blood flow to different parts of the brain. “I don’t mean to be abrasive,” Nick apologizes to Thirteen, “especially since you’re such a pleasure to imagine naked. Again, sorry… thank you for understanding. I’d do you, though — really, my apologies, this stuff just comes–” “That’s okay,” Thirteen reassures. I think she’s enjoying this just a little. Cuddy bursts in because House paged her. “Woah,” Nick muses, “I would do her in a minute with fudge and a cherry on top… would someone please explain to this woman? There’s only so many apologies I can–” Thirteen saves him, explaining Nick’s problem to Cuddy. “I’ve already embarrassed myself with one doctor, whom I am, at this moment, imagining with you in a king-sized bed with a mirror on the ceiling — I am so, so sorry. But if I couldn’t have both of you together, you would definitely be my first choice,” Nick admits, looking at Cuddy. “It’s like trying not to think of an elephant. Not that you’re an elephant. Your breasts, in fact, are all homo sapiens…” Cuddy wants to know where the hell House is, at which point the lights in the observation room come on, revealing House (DUN DUN DUN) kicking back in one of the chairs, looking pleased as Carrie Bradshaw in the aftermath of a Jimmy Choo sale. “Your tush is like the pistons in a Ferarri,” Nick calls after Cuddy as she leaves. House follows her out. “You’re welcome,” he says. House was basically using the guy who can’t tell a lie to let Cuddy know that she looks nice. “You don’t get the slightest kick out of that?” he asks her as she heads into the elevator. “Don’t be ridiculous, House,” Cuddy warns as the doors close. Left alone, though, she lets herself have an amused little smirk. A little bit of objectification can be nice.
“I hope you know your pistons are second to none,” Foreman reassures Thirteen in the observation room. Aww, ten whole minutes of no Fourteen — I knew I was getting my hopes up too high. Thirteen brushes it off, but Foreman thinks she looks upset. Thirteen points out that Nick was being annoying (duh) and she was uncomfortable being cast in his mental porno. She distinguishes between being attractive sexually and having the “whole package” being attractive. They decide to ask Nick if he votes the same way as his wife in order to stimulate his brain for the test. “God no,” he responds, “she believes I voted for Hilary Clinton in the primary and Obama in the general. You’re thinking that I’m secretly Republican, right? Wrong. I secretly don’t vote. Ever.” Foreman and Thirteen find a problem area in the cingulate gyrus, but it’s too close to the brain stem to operate on. Foreman thinks it’s neurosarcoidosis, which can be treated by steroids. Foreman checks out Thirteen’s ass as she leaves.
Taub and Kumar get lunch at the cafeteria, worrying about bedside manners and big noses. Taub drops title of this week’s episode in the context of his big nose: “Maybe that’s the social contract. You tell me I look great, I tell you you’re a people person.” Jean-Jacques Rousseau is rolling over in his grave. Really House, meanwhile, sits down for lunch with Wilson. House berates Wilson for being a nice, spineless amoebae. “Why do you think the world will end in chaos and destruction if you’re not there to save it?” House asks, chomping down on a French fry. “Because when my put me in the rocket and sent me here, they said, ‘James, you will grow to manhood under a yellow sun–‘” Wilson starts, but before he can get any further on this giggle-inducing metaphor, House cuts him off to ask what the hell Wilson’s doing instead of going to the monster truck rally with him. Turns out he’s playing racquetball with Taub and didn’t tell House because he didn’t want to rub House’s nose in the fact that he was doing something House can no longer do. Ouch — that’s pretty cruel for Wilson.
Foreman walks into Nick’s room to find him short of breath. His kidneys are failing — dialysis, stat!
The team tosses out new diagnoses as Taub examines his nose with the help of a spoon. Systemic sclerosis and chronic lymphocytic leukemia are both ruled out, leaving diabetes or a congenital metabolic disorder. House can’t let go of the racquetball issue and, apparently, Jews can’t be athletes. Whatever, House. He wants the daughter tested for peripheral nerve damage and Nick tested for diabetes via glucose tolerance test. He also assigns Taub to do the blood tests (every couple hours) as punishment for lying– er, playing racquetball with Wilson.
Kumar sets Nick’s little girl up for the peripheral nerve damage test (pads on her hands and feet that get hot or cold — she’s supposed to let Kumar know when they get uncomfortable) and tells her, “The better you do, the better we know your dad is.” While Nick’s wife angsts about what a dickwad her husband is, Kumar notes that Nick’s little girl should be feeling something by now. She screams — the pad burned her hand, but she wasn’t saying anything because she wanted to help her daddy. Universe 1, Kumar’s Bedside Manner, 0 (it should be like -47,569, but we’ll start with a clean slate for this episode).
While getting his blood drawn, Nick gives Taub the “actions speak louder than words” speech, interrupting it to note that Taub must have cheated on his wife, and everyone knows about it. Say whaa? Presumably Taub’s acting shifty here because he’s being reminded that he’s lying to House, because I’ve been getting nothing but “happy couple” out of Taub’s interactions with his wife.
Enter… morgue. Okkaaay. House is sitting in the corner, tossing a ball into the air. A fresh corpse is keeping him company. Taub walks in, as House paged him. House wants an update on Nick’s condition, and would Taub please do that while hitting the ball against the morgue wall with a racquet? Cool. Blah blah, sugar levels didn’t rise — Taub isn’t doing too badly with that ball, actually. Until he hits it too high and it destroys a row of shelving. CRASH. Oops? “Fine! I’m not playing racquetball with Wilson, I was never playing racquetball with Wilson, I have never played racquetball with Wilson. I thought it would be helpful if a department head owed me a favor, but it’s not worth this,” Taub admits. House tells him he put on a good show, but he’s holding a squash racquet in his hand. D’oh!
Kumar now gets to do a thyroid scan, but Nick’s being rather pushy about wanting to know why his little girl has a bandage on her hand. Kumar explains, but Nick insists she’s got no disability, she just daydreams and gets below-average marks in school, so Mommy Dearest has rationalized her poor performance by attributing it to neurological problems. Nick’s little girl runs off at the insinuation that she’s stupid, Mommy hot on her heels. Nick tries to go after them, but he’s got a fever and his lungs are full of fluid. Bring on the morphine! That little girl is definitely scarred for life.
So Nick has an infection. House orders the crew (except Taub, who’s still in time-out) to get a detailed history on Nick. Taub enters Wilson’s office and tells him he’s been made — House sent him back to Wilson as a double agent.
Kumar’s with Nick again, and Nick tells his wife to go home and get some sleep, mainly so she won’t hear any more insulting crap come out of his mouth. His wife LIES that his daughter still loves him, despite the terrible things he said earlier.
Kumar repots back to House, who’s loitering outside Wilson’s office. Nick’s pretty boring, but his wife rescues dogs and recently brought home a Rottweiler that insists on marking its territory all over the living room. Kumar thinks the dog got into Nick’s juice when he set it down on the floor. Nick’s eyes are red, so House suspects Weil’s Disease and tells Kumar to start Nick on antibiotics. Taub emerges from Wilson’s office and hands over an e-mail of Wilson’s that confirms an appointment at NY Mercy from a J. Gonzales. Taub thinks this refers to Joan Gonzales, an oncologist there. OMG WILSON HAS CANCER? Maybe… House first thinks Wilson’s gettin’ it awwwwn with Joan, but when Taub tells him there was a password-protected patient file attached to the e-mail, House starts to suspect it’s Wilson. He searches for articles by Joan Gonzales, and it appears she mostly publishes on suicidal oncology patients. So… Wilson’s depressed and he has cancer? Talk about worst-case scenario. House tells Taub to amscray.
Foreman’s with Nick now, and his condition is improving. His infection is gone, but the brain damage (a.k.a. saying everything that comes to mind) will persist. The only way to get rid of it is to remove the damaged area, but it’s too close to the brain stem to operate on. Kumar exhibits another bout of terrible bedside manners and Nick kicks he and Foreman out of the room.
Wilson strolls in through the front doors of the hospital, only to be given the third-degree by House, who observes that Wilson only takes walks when he needs to think about something. House brings up Gonzales. “Taub… another graduate of the House School of Being a Dick,” Wilson says as he connects the dots. “Private Dick,” House responds. Wilson runs off to get some hot coffee because he left his coat upstairs and it’s really really cold out. House starts psychoanalyzing him and Wilson finally flips. “Has it ever occured to you that when I don’t share something, it might not be meant as a challenge? It might just mean that I’d like there to be one MOLECULE of my life that goes unexamined by Gregory House,” Wilson declares before walking off. Oooooh. Angry!Wilson is not a flavor we see very often. It’s refreshing.
House returns to his office to find Nick waiting for him. Nick wants his disinhibition taken away permanently. He wants the surgery because he’s willing to take being dead over his current condition. He’s a bit of an impatient guy, but he’s worked hard to keep his mouth shut in order to make his wife and little girl happy. He wants that life back.
Cue Chase in the locker room! Hiiii, Chase! That scruffy look is mighty fine on you. House hands Chase Nick’s file and asks him to take it to his boss, who’s a neurosurgeon. Chase could assist — wonderful resume builder! Chase wants to know why House cares. When Nick leaves the hospital, he’s probably going to lose his family. The anvil dropping here indicates that House can relate to Nick at the moment, as it seems that his only family (Wilson) is deserting him for being a disinhibited prick. Chase will see what he can do.
Operating Room. House looks on as Wilson joins him in the observation area. Wilson kinda sorta apologizes, and House points out that Wilson only snaps on one issue — losing people. He went back to the e-mail and discovered that there’s a Javier Gonzales who’s a nurse in the psych ward. Wilson’s brother, Daniel, was admitted there when he was found sleeping in the lobby of an office building in Manhattan and got rough with the cop who asked him to leave. Daniel was put on anti-psychotic pills earlier in the week and should be able to talk to Wilson later that night. “House, you and I don’t have the normal social contract,” Wilson admits, “I don’t expect you to tell me the lies–” “I am fully capable of lying to you. I’ve lied plenty of times,” House interrupts. “I mean collaborative lies. Giving someone a hand who maybe needs to deceive themselves, just a little,” Wilson explains before heading towards the door. House won’t lie to him that everything’s gonna be all right, but he will accompany Wilson to New York. (Now, stay with me for a sec, I think it’s cool that the writers are repeating this social contract theme and all, but it’s just a little too neat. House and Wilson are working off the same concept of the social contract that was discussed by Taub and Kumar earlier, but they clearly weren’t around for that conversation, and it’s certainly a unique conception of the social contract that’s unlikely to be shared by large numbers of people. It bugs, just a little.)
Nick gets out of surgery and Foreman removes the tube to see if he can breathe for himself. Nick can, and it seems all is well until it becomes apparent that the disinhibition is not gone. Oops? Nick’s temperature starts falling and his heart starts beating erratically. Foreman calls for the paddles. Clear!
The crew convenes in House’s office because Nick’s temperature is still dropping, and Taub can’t reach House. It’s not cancer, but something is messing with Nick’s internal temperature, and the brain damage appears to be spreading. Foreman orders a full body scan and Taub continues to text House updates, despite the fact that he’s being unresponsive.
Wilson and House sit in the waiting room of the psych ward as Wilson shares Daniel’s history with House. Daniel had been going to Princeton when he disappeared thirteen years ago. After he disappeared, Wilson used to travel to Princeton whenever he could to check all the homeless shelters. He saw Daniel once, outside the window of a deli, but by the time Wilson got outside, he was gone. House’s phone rings, but he ignores it.
The full body scan found a small abdominal aneurysm, a cyst in the plura, and a density in the liver. Foreman then drops a lot of very big words that I don’t understand, but it comes down to the fact that the team needs to do an angiography with embolization. Whatever that means.
House is still in the waiting room with Wilson, but he’s getting text messages from the team. Wilson tells House, after some prodding, that Daniel’s schizophrenia began when he was a teenager. Despite the fact that he was taking medication in college, he still exhibited antisocial behavior. Wilson was away in medical school, and Daniel called him every day to talk for hours. Hours that Wilson didn’t have. One night, Daniel called in a tizzy and Wilson hung up because he had to study for an exam. The next morning, Wilson found out that Daniel had run away and left his meds behind. House thinks that incident is why Wilson’s so eager to please people. Daniel overreacted just as much as Wilson did. This realization, of course, sets House off into medical epiphany land. “His glucose was normal,” House mutters, and Wilson surmises they’re not talking about his brother anymore. House gets in the phone, leaving Wilson to face his brother by himself. House has deduced that Nick has Doege-Potter Syndrome, as the steroids should have caused his glose levels to rise, but the Doege-Potter tumor (the cyst the team found in the full body scan) causes low blood sugar. Nick’s body went into overdrive and produced a large quantity of antibodies to attack the tumor, causing the organ failure. Take out the tumor, and he’s fixed.
Post-tumor removal, Nick packs up his things while he’s waiting for his wife to pick him up. He apologizes to Taub for telling him he has a big nose. Nick’s wife awkwardly arrives and tells Nick she was offered a higher position, coordinating cancer walks in not one, but three cities. Nick tells her that’s great, but she’s clearly thinking that he’s putting on a front. This relationship will never be the same.
House and Wilson wait for the elevator and Wilson tells House that he’ll be seeing Daniel again next week. He’d like House to meet him. House agrees. Wilson says he thought seeing his brother again would change everything — it would be wonderful or terrible. Instead, they’re just strangers. Anticlimactic. “Does it bother you that we have no social contract?” House asks. Oh, goodness. Not this again. “My whole life is one big compromise. I tiptoe around everyone like they’re made of china. I spend all my time analyzing; what will the effect be if I say this? Then there’s you. You’re a reality junkie. And if I offered you a comforting lie, you’d smack me over the head with it. Let’s not change that,” Wilson says. House agrees. “No, see,” Wilson realizes,”if you were implementing the social contract, you’d say that, but only because it makes me feel better.” See, Wilson? House really does care! “It is kinda fun, watching you torture yourself,” House says. “Do you think things will work out with my brother?” Wilson asks, not too hopefully. House doesn’t think so, but if things go wrong, it won’t be Wilson’s fault. “You do actually like monster trucks,” House tells Wilson. “Absolutely,” Wilson lies, and they walk off into the night together.
Okay, well, despite the fact that it had promise, I think they boffed the social contract metaphor — it felt forced to me. Like, “Hey guys! Remember the title! We’re talking about it here! In multiple contexts! And look — it manifests itself in Nick’s disorder too!” I am, however, eternally grateful that the Foreteen subplot was kept to an absolute minimum, so much so that twenty minutes into the episode, I forgot they were even together anymore. Horray! More interaction between House and Wilson to go around!
Next week — erm, this week. Last Monday (sorry, folks, I am waaay behind my recap-load): something about a kitty and James Bond. Cue obligatory Pussy Gallore jokes.