House: The Greater Good

Posted by: Sarah Miller  //  February 6, 2009 @ 11:44pm

It's House's 100th episode! A woman who collapses during a cooking class turns out to be a renowned cancer researcher who gave up her career to pursue personal fulfillment. This prompts the docs to grapple with their own pursuits of happiness (thanks fox.com!)

The Patient

This week's patient is Dr. Dana Miller, and she's a doctor who needs a doctor. The team wants to treat her because she's a famous cancer researcher. Thirteen tells House they need to take this case because she's maybe five years away from curing retinoblastoma. Dr. Dana's initial symptom is that she has a spontaneous pneumothorax- which is doctor speak for a collapsed lung (really, could they not just say collapsed lung and spare me the time wasted trying to look up medical jargon on Wikipedia?).

There are a lot of things that can cause a collapsed lung, and House wants the team to let a dozen other doctors rule out the boring stuff first, but Thirteen insists. It seems if they save the cancer researcher they can save the world (I think that may have been a first draft of a heroes episode). The team decides to put her on steroids for asthma and do a CT scan to look for hyperinflation in the lungs to confirm their diagnosis.

Dana tells Thirteen and Taub that eight months ago she had a uterine myoma and had to have surgery. It made her think: "I can't die yet, I haven't been happy." So she quit, and now she does what she wants instead of what she's supposed to do. How wonderful.

The CT scan reveals that Dana doesn't have asthma, her lung volume is normal. Taub thinks that maybe her central line IV from her myoma surgery nicked a hole in her lungs that has gradually been expanding. But Kumar thinks that there is an indication of pulmonary fibrosis on the scan, so House sends them off to do a biopsy. But Dana won't let them do the biopsy because she doesn't want to be out of commission for weeks. But as Taub is trying to convince her, she feels her belly and something is wrong. Taub grabs a humongous needle and starts draining blood from her abdomen. Ouch.

So in addition to her lung problems, Dana now has got unexplained liver failure. An MRI revealed no tumors or cysts, and Foreman thinks that a tiny spot on the X-ray could be a granuloma that rose up into the hepatic artery. Thirteen thinks that maybe Dana had blastomycosis that was asymptomatic until they gave her steroids for the asthma. The only problem is now they really need a biopsy of her lungs to test Thirteen's theory.

Meanwhile, Wilson goes in to see the patient to see if he can talk her into going back to the lab once she's better. But no dice, she is determined to live her life and be happy and she can't be happy in the lab. During the conversation Dana keeps scratching herself, which she thinks is a symptom of the liver failure. But during the night she keeps scratching in her sleep and manages to scratch right through her skull to her brain matter, the team figures there is probably something seriously wrong. After she undergoes surgery to fix her brain scratch, she wakes up complaining that she is still itchy, which indicates the problem is in her brain, not her skin.

The team does an MRI on Dana's head to see if she has a brain tumor or MS, but it comes back negative. House thinks maybe she has polyneuropathy and her problems are in the nerves, not the brain. But the patient started experiencing spinal shocks before the treatment could be administered. Taub thinks that an aggressive spinal hemangioma could cause the liver failure and lung problems as well as the brain problems.

The only problem is that when Taub and Kutner do an MRI they find a whole bunch of unexplained masses throughout Dana's body. Taub thinks that Dr. Dana has cancer, mesothelioma to be specific. It seems a little bit too poetic that a cancer researcher who quit is now dying of cancer. They call in Wilson to get a biopsy.

Wilson takes one more chance to talk it out with Dr. Miller about quitting. He actually can relate to her more than he admitted at first. You see, he feels stuck because he is still hung up on Amber. He still lives in her apartment, surrounded by her things and he can't move on and get past it. He isn't happy either. At the end of the episode, Wilson finally washes a coffee cup that amber drank out of before she died. It's a small, symbolic gesture that he's going to at least try and move on.

The biopsy that Wilson does during this little psychotherapy session comes back negative, and Dana also started to bleed during the test, which is not consistent with mesothelioma. As they are trying to diagnose her, her heart fails. She also starts bleeding from her eyes, nose and mouth. Taub and Kutner giver her transfusion after transfusion, but they can't keep up with her blood loss.

House tells them that they need to cut of the blood supply to the tumors throughout Dana's body if they have a shot at saving her. The only problem with this strategy is that they will also be killing a bunch of her healthy tissues that surrounds them. And generally you want to keep your lung tissue if you can.

Luckily, House has his epiphany at just the right time. It turns out that Dana has been menstruating through this whole (ladies of the world can I get an "Oooooooow!") ordeal. So she is bleeding from her uterus and bleeding from everywhere else at the same time. Coincidence? It seems that when Dana had her uterine myoma removed a few months ago, it released a whole bunch of endometrial cells into her body where they took up residence in her liver, lungs and brain. In the days leading up to her next period, when her uterus is supposed to swell, everything swelled. This is the worst period ever. The good news is once her cycle is over and they go in and surgically remove all the masses she'll be fine.

It doesn't appear that Dr. Dana has changed her mind about resuming her cancer research through this whole ordeal though. She tell Taub that this time she didn't lie on her deathbed thinking about how unhappy she was or wondering "what if?" She tells him to make sure he goes to bed happy tonight. Through two minimal scenes between Taub and his wife we have learned that Taub is thinking about having kids, but his wife doesn't want them. So we are left with the hanging question: can Taub be happy without kids? I assume this will be answered in the weeks to come.

Foreteen

First thing after the credits, we are treated to a scene of Foreman and Thirteen waking up in bed together. He tells her she drools. Yuck.

When Thirteen's peripheral vision start to go and she admits to Foreman that she has been having headaches, he is forced to come clean about switching her from the placebo to the actual drugs. Thirteen is naturally freaked out, because she's only been dating Foreman for two weeks and he has already risked his medical license and the entire drug trial for her. She's not sure she's ready for that kind of commitment.

Thirteen goes off the drugs, but her headaches don't get any better. Foreman gives her an MRI and finds that she has developed a brain tumor. He is filled with remorse and wants to go to the drug company right away to tell them what he's done. House talks him out of it, telling him that he should at least wait and see what happens when the drugs have had a chance to clear Thirteen's system.

But when Foreman goes home to tell Thirteen about his conversation with House he finds her on the coach, nursing a bleeding leg. It seems that she went to answer the phone and tripped over the coffee table because she can't see. Her vision is completely gone.

House helps Foreman administer radiation to Thirteen to try and kill the tumor, and it appears to work as when she wakes up she can see again. But in the end Foreman makes the decision to tell his supervisors in the drug trial what he did. The good news is that Foreman will get to keep his medical license, so long as he doesn't try to participate in any more drug trials. Alls well that ends well I guess.

Cuddy Mama

After House's antics forced Cameron to quit last week, Cuddy is back to work and she is not happy about leaving her baby at home. While watching a webcam of Rachel at her desk, Cuddy tells House that she will do her job, but if she has to be miserable at work then she is going to drag him down with her. Congratulations House, you have officially dragged Cuddy down to your level.

Cuddy's grand scheme to get back at House involves a series of Marx brothers-esque pranks. First, she hires one of the maintenance guys to put up an 'out-of-order' sign on the elevator doors whenever he sees House coming. She also sets a trip wire up in House's office, steals his cane and calls his building pretending to be "Mrs. House" and asks to have the heat and power shut off because they're moving.

House takes all of this surprisingly calmly and with no retaliation. When Wilson asks House what he's planning to do to Cuddy in return he tells him: nothing. You see, Cuddy is not playing games, she's out for pure, unadulterated vengance. The only time for him to strike back is if he wants something, and right now all he wants is for things to go back to normal. You see, the only way to win this war is to lose it.

Wilson, always the voice of reason tries to intervene when it seems that House's plan on non-action is not working. He points out to Cuddy that she really does like being at the hospital and working with House otherwise she could just fire him and go home to be with her baby. Good point.

For once it seems like Wilson's speech did the trick, and Cuddy gives House back his cane and apologizes for her childish antics. House responds by making a dick of a comment back to her. And thus the natural order of things is restored!

Houseisms

House: "Thank you Rationalization Man, you have saved the village!"

House: "I'm happy for you. A love so deep, you're ready to chuck your medical license to give her powerful unproven drugs with dangerous side effects. I don't want to make any assumptions about your feelings for me, but I do have a birthday coming up."

Cuddy: "What the hell is wrong with you?"

House: "Yesterday, you hate me. Today, you're practically weeping on my shoulder. I can only assume that what I'm hearing is your Aunt Flow..."

Cuddy: "When I was being a jerk you suddenly act human, but when I act human you turn back into a jerk!"

House: "I guess our cycles aren't matched up yet."

House: "Yes ladies, I'm blaming her period."

Tags: House, 100th Episode

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