House: Let Them Eat Cake

Filed under: Recaps & Reviews

In this episode, the team treats a Fitness Guru who collapses on the job, House and Cuddy get tangled up in Office politics, Thirteen starts in Foreman's drug trial and Dr. Kumar starts up a moderately legal medical advice website.

The Patient

This week's patient is a fitness guru who collapses and rolls down a bunch of stadiums steps mid workout. Ouch.

For most of this diagnosis, Foreman and Thirteen are off doing their drug trial thing, so Drs. Kumar and Taub get some quality Fella Time. Their initial thought is that perhaps the fitness guru has been dipping into the juice, but her negative steroid tests prove that she is legit (2 legit 2 quit!). Kumar also suggests allergies, and Cuddy totally butts in and suggests exercise induced asthma. Kumar and Taub head off to the lab to try and recreate the conditions of the attack.

During the stress test Ms. Fitness Guru tells Taub that she doesn't get any fat in her diet, that she doesn't feel the need to indulge herself, ever. Then she falls to the floor in a cardiac arrest. The good news is she doesn't have asthma. But when they do an EKG, her heart appears to be healthy. So she has lung problems that have nothing to do with her lungs and heart problems that have nothing to do with her heart. Next theory: she has a tumor.

When Kumar and Taub do the CT scan to check for a tumor they discover that the Fitness Guru had her stomach stapled! Gasp! Then she had the records removed from her medical files so no one would find out and her DVD sales wouldn't suffer. Oh my! So the good doctors start examining possible complications from her bypass surgery. Thirteen suggests maybe she is has mal-absorption issues, and Kumar agrees, pointing out that there could be a blind loop in her bowel that is letting bacteria into her bloodstream. Yuck.

Taub and Kumar do a stool test to check and see if there are bacteria in the Fitness Guru's poop. But there aren't bacteria in her poop, so they rule out the bowel problems and are left with: sleep apnea. While Taub and Kumar are busy discussing their online patients (see below) in the sleep lab, Fitness Guru slips out of bed decides to go for a run...on her broken ankle. Taub asks her if running on her ankle hurts, and she says no. She also cannot feel her leg bleeding at all because her leg is paralyzed. And she doesn't have sleep apnea.

The ascending numbness in the patient's legs suggests some kind of nerve or brain problem. But when Taub goes to run a test to find out if it's her nerves or her brain, the Fitness Guru can no longer hold out her arm which suggests something is wrong with her muscles. House comes up with a theory that includes some kind of toxin building up in her system, but I'm distracted by him smashing a toilet during the differential and I don't really understand what he means. Anyway it doesn't matter because the test they do comes back negative for toxins (toxicity?)

Next they decide she has Guillain-Barré Syndrome and put her on plasmapheresis. But shortly after she has a hallucination that the people from her program surround her bed and all try to sit on her. So whatever is causing her nerve damage and muscle weakness and lung problems and heart problems is now in her brain, and it's not Guillain-Barré.

House is convinced she has a brain tumor, but Cuddy listens from the next room and makes House test for a bunch of other things before she'll let him do a brain biopsy. At this point in the differential, our fitness guru is starting to lose her fight. She realizes that none of her possible outcomes are good and starts to get depressed. Taub suggests that she eat a piece of chocolate cake.

Miraculously, after she eats the chocolate cake the Fitness Guru starts to feel better. And finally, we have our answer! The Fitness Guru has hereditary coproporphyria, which means that she doesn't make enough of a particular enzyme and the treatment is a high carb diet that is rich in sugar. Fitness Guru says thanks, but no thanks. She'd 'rather be pretty than healthy'. Now there's a nice moral to the story for you.

A Bad Case of Loving You

The House-Cuddy will-they-or-won't-they drama continues this week as Cuddy takes over House's office, she figures that since House is responsible for wrecking her office (technically the guy holding the gun was responsible, but whatever) she should get to take his office. Lots of asinine pranks ensue.

If two weeks ago it seemed like House was the one who really wanted a relationship with Cuddy, then this week the roles are totally reversed. Cuddy does everything she can to be near House and to pester him into noticing her: dressing in tight low cut outfits, removing the furniture from his office, she even plays the 'I can't hear you game'. I'm sorry, are we in junior high?

Wilson plays the voice of reason and tells Cuddy, "Don't pretend like all you're doing is taking his office, you chose his room because you want to be there, but sitting near him and hoping isn't gonna get it done." Well played, Wilson.

But Cuddy decides a few more pranks are all she needs to get House to fall for her and/or let her have his office. So she sets off a stink bomb in his office and then heads home for the night. I'm sorry, are we in junior high?

Of course House cannot just let Cuddy get away with this, so he breaks her toilet with a sledgehammer (how much fun would that be to film!?) and then gets the construction crew to install a bidet in it's place. Just a bidet.

Eventually there is a showdown between them. Cuddy tells him: "Everybody knows this is going somewhere." And House responds by feeling her up. Classy. Cuddy feels hurt and surprised and walks away. She also puts all the furniture back in House's office and thereby admits defeat.

House realizes that he has made a mistake and even feels a little bit bad about it. He somehow manages to find Cuddy's old desk from med school and has it delivered to her newly reno'd office. Cuddy is touched and thinks that maybe, just maybe he has changed his ways?

But just as she heads into House's office to thank him for the desk, Cuddy stops and sees him flirting with The Boob Lady (see below). She shakes her head and walks away, I can't be certain but she might have even shed a single tear. I don't know folks. Are these two ever going to get it together after all? Or is House's heart two sizes too small?

Dr. Techno Superstar

Dr. Kumar has set up an online second opinion clinic. I know, you'd think this would be totally illegal, but apparently giving out medical advice over the internet is legal in all but 9 states. The best part of this whole scheme is that he set it up in House's name: Dr. Gregory House's Second Opinion Clinic with Medical Advice Direct from Dr. Gregory House. His first mistake is telling Taub about the site, which costs him a 30% of all profits to keep the secret.

One of the patients from the website ('The Boob Lady' as Kumar calls her) keeps emailing, complaining that her breast implants are causing joint pain and chronic fatigue. Taub suggests telling her she has a virus, to get her off Kumar's back. But The Boob Lady shows up at the hospital, ready to talk to Dr. House. Luckily Kumar and Taub catch her in the elevator before she can storm House/Cuddy's office and divert her downstairs to the ER where Cameron can take care of her. They are convinced that she just has a staph infection.

However, the Boob Lady has now gone completely crazy and is singing the first line of Harry Nilsson's classic 'Coconut' over and over again. Cameron points out that this woman is clearly having some kind of mental breakdown, and oh look, she has blood coming out of her ears.

Kumar has a little pow-wow with Chase and Cameron in the cafeteria, trying to get them to help her with the differential. They agree that The Boob Lady needs to be checked for a tumor, which Chase happily agrees to do: for a 25% cut of Kumar's website earnings.

When Kumar and Taub head back to the ER to check on The Boob Lady, she's gone. The nurse tells him that she had a respiratory arrest and she didn't make it. Uh-Oh. They head down to the morgue to make sure she's really dead and also to feel bad about the sub-par medical care that they gave her. House makes a grand entrance and tells them he's going to kill them slowly and painfully. He proceeds to chew them out for setting up a fraudulent website, and for not coming to him for help. What she had was easily treatable, he says, so simple it might still be possible...

He climbs on top of the dead girl and starts to give her CPR, and she...gasps for air and comes back to life. And me and Kumar and Taub jump about 30 feet in the air in the "Gotcha!" of all time. Turns out House hired an actress to play The Boob Lady, and got Chase and Cameron to get in his little scheme. Kumar says he's going to shut down the site immediately, but House tells him he has to keep it running so he can pay him 50% commission, plus the 25% he is already giving to Chase.

The Drugs Don't Work

Since almost dying last week, Thirteen has decided that maybe she should do Foreman's Huntington's drug trial after all. But hanging out with other, more advanced Huntington's patients in the waiting room is really freaking her out. She tries to back out of the trial, at first saying that she doesn't think it's fair that she got in just because she knows the guy running the trial. Then she starts wasting his time by not showing up for her appointments (or showing up very late).

Foreman breaks into Thirteen's house after she missed and appointment (hello conflict of interest, violation of privacy, take your pick). You see, her nerves have already started to degenerate and she is a prime candidate for this drug trial. He needs proof that she has started slipping back into her self-destructive patterns so he can take her out of the trial, but it turns out she has been following all of his instructions to the letter.

At first Thirteen tells Foreman that the other patients are freaking her out and she doesn't want to be constantly reminded of her future every time she has a doctor's appointment. But really what's bugging her is that she is remembering her mother, how she used to yell and scream at her, and mostly that she hated her mother and never said goodbye to her. When she admits this to him, Foreman gives her a heartfelt hug. Do I smell a budding romance?


Kumar: "Actually, House may sort of mind because I sort of set it up in his name."

Taub: "And by set it up in his name, you mean..."

Kumar: "I mean it's Dr. Gregory House's second opinion clinic with medical advice direct from Dr. Gregory House."

Taub: "You're insane. With two days to live."

House: "Where are the smart guys?"

Taub: "If you mean Foreman and Thirteen, apparently the first part of the drug trials is an all day thing."

House: "And I said yes to this?"

Fitness Guru: "If surgery could make you taller, would you do it?"

Taub: "Sure, but I wouldn't call a meeting of the lollipop guild and tell them they could grow if they work real hard at it."

House: "What are we looking for?"

Kumar: "You don't know?"

House: "I'm doing my famous Socrates impression, I think I really nailed the accent!"

Wilson: "You did do the math on this right? Screwing with her office means her renovations will take longer, which means she'll be in your office longer."

House: "I'm having a bidet put in instead of a toilet, not in addition to, instead of. You wanna know what happened to the old toilet?"

Wilson: "She'll be with you, where you claim not to want her."

House: "I smashed it with a sledgehammer."

Wilson: "I think in some ancient cultures that was actually considered a proposal of marriage."

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