House: Locked In

This week's episode we get to see almost entirely from the perspective of the patient, special guest star Mos Def. Warning: this episode may cause seizures with the fuzzy out of focus, rapidly moving camera. Just don't stare at your screen too long.

The Patient

The patient this week is Lee, a guy House picked up in the ER at Middletown hospital. House was in the ER because he crashed his motorcycle, in case you were wondering. The ER doctor is convinced that the patient is brain dead, but House thinks that he has locked in syndrome. Lee screams that he is alive, and wonders why only the people watching him on their TVs can hear him. The ER doctor is about to try and contact the family to try and get them to donate his organs when House asks him to blink once for yes and twice for no. Lee blinks once.

Lee was in a biking accident, where he smashed into an open car door. In a flashback we see that as he was biking toward the car, he recognized that he should hit the brakes, but his hands wouldn't do it. The ER doctor finally accepts that Lee is not brain dead, but rather than thinking there is hope for recovery for him, he tells Lee he needs to just accept what has happened. House, on the other hand is totally fascinated by Lee poses that if locked in syndrome was the cause of the crash, not a result of it there might be a chance of fixing Lee.

Lee's wife Molly comes to visit him. While she is there House and the ER doctor get in a fight over his CT scans. Molly asks Lee if he wants her to bring in their kids, he says no. He doesn't want to scare his kids, but all he can tell Molly is two blinks for no.

Wilson and the team (minus Taub) arrive at Middletown Hospital and Kumar brings House a delicious looking cheeseburger and fries. We learn from House that Lee is an active bike rider. In his head, Lee laments that the last thing he ate was a melted power bar, and watching House eat the cheeseburger is killing him. Thirteen thinks that Lee might have a tumor in his brain that the initial CT scan missed. An MRI with contrast might show something the other scan didn't.

House forges some forms to order Lee an MRI and the team takes him upstairs to get scanned. While in the MRI machine, Lee gets to use these new fangled MRI video goggles that simulate the beach. Unfortunately for Lee, House shows up in his relaxing beach scenario too. Lee tells House that he thinks God sent him to fix him, it's just too much of a coincidence that there would be a brilliant diagnostician lying in the bed next to him.

The MRI shows a small lesion in the ventral pons but House think that there's no way head trauma caused it. Convinced that Lee has cancer, House insists that Lee needs plasmapherisis. The other problem is that the ER doctor has got Lee on antivirals that might kill Lee. But House's evil genius plan is that if they almost kill him, then the ER doctor will realize he is wrong and release Lee to House's care.

After Lee has a seizure, House gets Molly to agree to release her husband to his care. So Lee gets transferred to Princeton Plainsboro. As he's being wheeled in to his new room he gets to witness some first class Cuddy-Wilson flirting and House telling Taub that he's decided to accept his resignation after all. Taub stutters that he decided to stay, but House thinks he's not motivated anymore and so he won't come up with any more good ideas.

While they are performing some tests, Taub and Kutner notice blood in Lee's urine. The tea thinks that Lee may be an alcoholoic or taking some kind of drugs that have caused the blood in the urine, but with only yes or no for communication it's hard for them to get a complete medical history. House wants to biopsy his brain stem to get a clearer picture of what they're dealing with.

Thirteen puts a new catheter in for Lee (I'm pretty sure that having to get a catheter put in by Olivia Wilde is every male's worst nightmare) because blood clogged up his old one. Then Molly brings the kids in to see their dad. He can't even hug them or talk to them. He starts crying and Thirteen has to wipe the tears away for him.

In the operating room, Dr. Chase tells Lee that they're going to have to put him out to drill the hole and then they'll wake him back up for the actual biopsy. When they wake him back up Chase asks him a few yes or no questions and when he gets to the third one, all of a sudden Lee can't blink his answer back anymore.

The brain biopsy revealed severe damage to the myelin sheath. But without a medical history they can't be sure what to treat for. Taub rigs up a brain-computer interface (BCI). When Lee thinks "up" it moves the cursor upwards, if he thinks "up" enough times, it learns how to read what he's thinking. Taub hangs out with Lee over night, telling him all about his problems and how he's wavering back and forth about whether he wants to keep his job or not. It seems, Taub isn't sick of House, he's sick of being scared out of his mind to go to work every day. Just when Taub is ready to give up on him, Lee manages to move the cursor on the BCI.

The team tries to do a history using the BCI and they find out that Lee told his wife he was in St. Louis, but he was actually staying at his friend Dave's house. Kumar finds resumes and cover letters in Dave's basement. His business wasn't going too well, but he didn't want his wife and kids to know. Lee temped a few times as a janitor to make extra money. He worked at a factory that makes battery, and Taub and Kumar think he may have contracted heavy metal poisoning.

Thirteen comes to close Lee's eyes so he can get some sleep. She does a test that involves dropping some dye in to his eye and blinking it a few times. They find puss in his eye and it means that he doesn't have cadmium poisoning. He's locked in, his kidneys blew a fuse and now his eye is oozing puss. Foreman tries to perform an LP on Lee to see if he has an autoimmune disease, but when they roll him onto his side he goes into cardiac arrest.

When he finally comes to, the team finds out that Lee has an itchy right foot, that apparently signals to House that he has liver failure. Liver plus eye plus kidney, according to Foreman equals leptospirosis. It seems that Lee caught an infection from rats in Dave's basement. The infection got in through a paper cut on his finger and cause the liver failure which released toxins in his system which eventually led to the locked in syndrome. The good news is that once the infection is cured, Lee's brain will heal and he'll be able to move again. Kutner gets him to move one finger. Too bad he could do two fingers to make the victory sign.

Missing in Action

Cuddy and Wilson cannot figure out what House was doing up in New York. He gives them all kinds of stories: that he was on his way to buy a guitar once owned by Duane Allman, that he was on his way to the ex, ex, ex, Mrs. Wilson's house to tell her about the extra money her ex-husband is earning on the lecture circuit, or even that he was on his way to visit Foreman's brother at a correctional facility in upstate New York.

But finally House tells Wilson he was in New York because he was checking out a girl that Wilson has been seeing. She's a nurse from his brother's psych ward, and she's a caregiver like all of Wilson's other failed exes. However, Wilson is too smart for House and figures out that the good doctor was actually going to see a psychiatrist. Bwah!? But now that Wilson knows about it House doesn't want to go anymore. He insists that whining on someone's couch doesn't work and so he deletes the contact from his phone. Good going Wilson.

Working for the Man every night and day

It turns out that House is not going to let Taub off the hook so easily from his attempt to resign last week. Taub begs House for his job back. He realizes that what they do at PPTH scares him, and overcoming his fear is the only way he can bring his life meaning. House tells Taub that the only way to get his job back is to come up with a good idea that is worth keeping him around for. Unfortunately for Taub, Kutner is the one who comes up with the leptospirosis diagnosis (hey, it rhymes, catchy!). But Taub takes credit for it anyway, without asking. Nice.


"This is my diagnostics posse: Hot, Dark and Darker." (pointing to Thirteen, Kumar and Wilson).

Kumar: "Shouldn't we be entertaining our patient?"
Taub: "I performed Euripedes with sock puppets, you just missed it."

Lee: (in response to Foreman telling him a story about his first girlfriend) "Really? Seriously? Could you tell this story to someone who can actually walk away?"

Tags: House, Locked In, Season 5 Episode 20

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Original Comments Posted (2)

Ariana says...

How did both me and my pvr miss this episode?

Apr 13, 2009 7:42pm

sarahm says...

I don't know! Good thing there was a recap for you to read.

Apr 14, 2009 9:13pm

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