This week: the team deals with a patient whose death was predicted by a cat and the economic recession really hits home for Dr. Taub.
This week's patient is the amazing, incomparable Judy Greer. She's the head of nursing in an old folks home. She comes in to the clinic complaining about having colds all winter long, she feels run down 'like something big is coming on'. And then she drops to the floor and has a seizure. Also, her pee is green (we know this because she is conveniently wearing white pants)
Taub is particularly grumpy today and takes exception to this case; he seems to think it's not worthy of his time. Taub's diagnosis is that she has adult onset epilepsy and really likes green St. Patrick's Day beers. House sends him and Kumar off to check her office and the old folks home for toxins. Taub finds methylthioninium chloride which apparently turns your pee green. He thinks Judy faked a seizure and took the chloride to turn her pee green.
House sends Taub off to check her house for other toxins, but mostly he just wants him to get out of the way so he can disprove his theory. When House tries to provoke a seizure in Judy by flashing lights in front of her face he discovers that Taub was right and she did fake the seizures. But Judy insists that there really is something wrong with her. She is convinced she is going to die because a cat predicted her death.
Apparently Debby the clairvoyant feline only sleeps next to people (usually patients in the nursing home) when they are about to die. And last night Debby curled up next to Judy. She starts going into respiratory arrest while she is trying to convince House to take her case. Luckily Foreman is there to check her breath sounds because House is convinced she's faking and won't even look at her. Apparently, her bronchospasm is real because you can't fake whatever type of breath sounds she is making.
Foreman starts thinking that the cat might be the cause of the deaths rather than predicting them. The cat might have worms that have jumped from Debby to Judy and they're now breeding inside her lungs. Gross. House gets Foreman and Thirteen to do a scope of the lungs and they don't find any worms. Back to the drawing board. House decides to test the theory and brings the cat into the coma patient's room. After trying to get the cat to sleep next to three different patients, Debby finally settles down next to coma patient. Now all they have to do is wait and see if he dies.
House thinks that Foreman's airborne allergen theory seems the most probably at this point so he sends the team off to do a methacoline challenge. In the meantime House brings Judy outside for a goodbye smoke before Cuddy forces him to discharge her. He blows cigar smoke in her face and attempts to induce another bronchospasm. He is successful.
Thirteen starts the patient on steroids for the broncospasms. When she goes to check on Judy she has gone to the bathroom and her urine is brown. This time she swears she didn't take anything to change it's color. The team checks for all the normal signs of brown urine, and she is negative for all of them. Foreman thinks that maybe she has a tumor in her intestines that is causing purple urine which mixes with the green already in her system to form brown urine.
The team does a pill cam of Judy's intestines but doesn't find anything. Kumar comes up with a far-fetched theory that maybe just maybe she has skin cancer that metastasized in her intestines. He sends the team off to go and check for melanomas, but House is finally getting ready to send Judy home. Then she suddenly develops spider veins. New Symptoms!
House determines that Judy has Cushings. But Kumar thinks it has got to be something way worse because...the coma patient has died! Duhn Duhn Duhn. Also, they lose the cat. House does an autopsy on the coma patient while Chase does a sampling of Judy's veins. Unfortunately, Judy goes into cardiac arrest while Chase is performing the test. So now they think that Judy has probably got something wrong with her brain and she'll need her pituitary gland removed.
Chase goes to ask Judy her permission to do a surgery to cut out part of her pituitary gland to permanently fix her Cushings. Judy opts to have the surgery and Chase asks her if she's going with the more dangerous option because of the cat. Chase thinks that the place for faith and prayer is the waiting room, not the operating room. But Judy insists that she needs there to be a higher purpose and so she wants to listen to the cat's warning and have the surgery.
While House is in his office thinking over the case, the cat came back (haha) and sits on House's computer. House has his epiphany! The cat was not predicting death, it was trying to keep warm. Three of the patients who died had fever, the others were all covered with heating blankets when the cat slept with them.
House figures out that Judy has a tumor in her appendix. Apparently there is a certain kind of cancer that can cause all of the symptoms of Cushings (except central body obesity-which Judy didn't have) and they didn't find the tumor on the pill cam because the camera doesn't go through the appendix. Amazing! House rushes to make the call to the OR to stop Chase from cutting out her pituitary gland. Looks like Judy and Debby are both gonna be fine.
Taub starts the day off particularly grumpy, and when Kumar asks him if he's ok he very nearly bites his head off. He also tells Kumar that they're not friends. Ouch. Later on, he runs into an old high school friend who is down in the clinic. Apparently the guy tripped and fell or something because he's been having problems with dizzyness. Taub gets the guy to lay on his side and sort of shifts his head around and voila. Dizzyness cured.
It turns out that Taub's old high school friend is actually the CEO of a biomedical company. He is so greatful to be rid of his inner ear difficulties that he wants to take Taub out for dinner. Taub declines. He says he's old, married and boring now. I guess old, married and boring people don't go out for dinner.
So instead Taub's CEO friend sends him a box of Cuban cigars, which House opens and starts smoking in the office (while he's stroking death-cat on his lap and pretending to be a Bond Villain). When Taub gets angry that House stole his cigars, House announces to the world at large that Taub lost all of his money in the market last year. The money problems evidently account for his grumpiness.
Kumar lends Taub an ear about the money troubles. He's more worried about his wife and having to change her lifestyle and downsize. Kumar is a little too sympathetic and points out that it's probably hard for Taub's wife to have married a guy in one situation and now she suddenly finds herself married to the same guy in a totally different situation. Not helping, Kumar.
Then in an attempt to egg Taub on and keep pushing his buttons, House asks him to clean the litter box. That's the last straw from Taub and he leaves work to go and have drinks with his highflying CEO friend. Taub spills his guts to the CEO and eventually asks him for a job. The CEO is a little reluctant to offer a job due to the economic downturn and all, but Taub wants to invest in one of the new laser scalpels the company is developing. The CEO finally agrees. So Taub quits. House is sure that he'll be back though so he tells him to get a box of donuts when he returns.
Over at the biomedical company, Taub waits and waits and waits for the CEO to come meet with him. Finally, a receptionist comes out and informs him that the CEO actually doesn't work there anymore. In fact he was really just a temp who had been scamming people to invest in his new inventions and he was now under investigation by the FBI. Oops. Luckily Taub hadn't given him any money yet. He buys a box of donuts and heads back to PPTH with his tail between his legs.
Judy: "A cat predicted my death."
House: "Cats make terrible doctors. Oh no wait, that's women."
House: "Can you come back later? I have some business I'm conducting with the Prince of Nigeria."
Kumar: "Why are you pushing a crash cart?"
House: "Because patients sometimes crash and they haven't yet invented a crash tractor for me to drive wildly around the hallways."