By Sara M
House finally has a patient with vasculitis! Hell freezes over, pigs fly out of people's asses, and then patient Kayla starts vomiting blood after a follow-up exam by Chase in which he fails to see her bleeding ulcers. One of them perforates, leaving Kayla with kidney and liver damage. She'll die if she doesn't get a new liver, but a match for someone with her rare blood type is very unlikely. So her aggressive brother steps up and offers a piece of his own liver, along with the lab tests to prove that it's a healthy match. House does a little bribery and blackmail to get a surgeon to agree to perform the risky surgery, and everything seems cool until Kayla gets a fever...and hepatitis...and liver cancer. Whoops! Her brother's liver wasn't so healthy after all! He feels bad about that (and probably not so good about the liver cancer he just found out he has), so he arranges to get Kayla a new liver from the Mexican black market. That's never going to end well, and Chase is able to convince Kayla to go die at home with her daughters. Peace out, Kayla. Brother comes back for a post-cancer-op exam and tells Chase how Kayla's daughters are going to have to leave the house they grew up in with their dead mother because he can afford black-market livers and fudged lab test results, but not a mortgage. Knowing this will guarantee Kayla's family the lawsuit money they need, Chase and his guilt complex admit to missing Kayla's ulcer -- because Chase was hung-over. Lawsuits fly, Stacy gets involved, and to top it all off, Chase and House have to go in front of a peer review committee to explain away Chase's mistake. Fortunately, House knows that Chase wasn't hung-over that day, but grief-stricken after finding out about the death of his father. House convinces Chase to tell the committee the truth, and they decide to suspend him for a week instead of fire his ass. As for House, he didn't do anything wrong (except the endless discussions with Stacy about the state of their relationship and ability to work together OH MY GOD WHEN WILL IT END?!?), but the committee doesn't like him, so they sentence him to one month's direct supervision under another doctor. And that doctor will be Foreman. Kind of ridiculous, but at least it'll give Foreman something to do.
We begin backstage at what appears to an elementary school talent show. I was hoping for a glimpse of Miss Radfafa, but apparently she had something better to do. Various children rehearse and get ready to perform various acts on stage, and I am amazed to see that not one of them will be singing perennial talent-show favorite "Wind Beneath My Wings." A woman tends to her two daughters' costumes while they bitterly and ungratefully complain that rival Sally Ayersman brought her dress at Bloomingdale's, while they had to settle for something homemade. "We're gonna look stupid!" the younger one whines. What a bunch of brats! But Mom takes it all in stride, telling them that Aretha Franklin was poor and one of the best singers ever, and also that she'll be keying Sally's dad new convertible if Sally is mean to her daughters again. I guess the bratty apple doesn't fall very far from the tree in that family. Or maybe the first symptom of Mommy's Mystery Disease is the inability to keep one's inner monologue inner.
The daughters get onstage and sing "Little Bitty Pretty One" (I'm going to give them the benefit of the doubt and assume they're doing the Thurston Harris version and not the Billy Gilman one), accompanied by some rather risqué dance moves for ten-year-olds. Maybe I'm just being over-sensitive about that, but then again, this is a show that featured a thirty-year-old giving a nine-year-old her first kiss, so who knows? Fortunately, the girls' arrhythmic writhing is halted when their mother starts screaming in pain. Don't you just hate stage mothers?
It's now six months later, and Cuddy informs Stacy that Chase and House's disciplinary hearing has been moved from two weeks from now to tomorrow due to a "scheduling disaster" that Cuddy doesn't want to explain because the writers didn't want to have to think of one. Not that I really care to hear about it except for the fact that it would give Cuddy more screen time, which is always a good thing. What isn't a good thing is that it's Stacy's job to provide House and Chase with legal counsel, so she'll be featured prominently in this episode. Stacy is happy to counsel Chase, but says she'd rather not deal with House. Cuddy tells her that since almost half of PPTH's lawsuits involve House, she'll have to find a way to work with him or find another job. Please let it be the latter. Please please please.
Even House and Wilson know how boring their endless conversations about Stacy and her feelings about House are, so they've created a volleyball-like game to play with two pencils and a chain of paperclips serving as a net, coins serving as balls, and their hands serving as goals while they have Stacy Is Mad At House Conversation #546. The high point of the entire conversation is when Wilson scores a point and gets way too excited about it. A cold frost settles over the room as Stacy enters, angrily asking where she can find Chase. I know you'll be surprised to hear that House's response is a sex joke about Chase "servicing" Stacy. Wilson makes his usual "please stop poking the bee's nest" face, but remains silent. Stacy slams some legal documents on House's desk and orders him to sign them. The first agrees to the hearing date changes, and the second says House has been advised of his legal rights. Stacy assures House that there's nothing he needs to know from her, and that he can just go ahead and sign the papers.
Stacy then gives Chase the complete opposite advice, telling him to put off the hearing as long as possible because "tempers fade." When it comes to someone drinking the last of the milk before you could put some in your morning coffee, sure. When it's about someone DYING under a doctor's possibly negligent care, I have to believe that two weeks really won't make much of a difference. Chase seems to agree with me, and signs the consent form against Stacy's wishes. He's never had a peer review before, and Stacy warns him that a bad outcome could cost him his career. Chase confidently says that all he can do is tell the peer review committee what happened. Stacy informs him that there are several ways to say the same thing, and that she's there to advise him as to which way will give him the best result. She asks him to start telling her his side of the story, and away we go to Flashbackland!
Our patient -- whom Stacy tells Chase to refer to by her first name, Kayla -- came to the Clinic complaining of joint and stomach pain. Foreman was called in to do a neurological consult, which he accomplishes by having Kayla touch the tip of his finger and then the tip of her nose over and over again. Kayla's impatient brother paces around and grumbles about how long they've been waiting in the Clinic just to have a doctor come in and play patty-cake with his sister. Foreman tells him that he could've gone to the ER last night if this was so urgent, but Brother says there wasn't anyone to watch Kayla's kids. So she ruined the talent show by screaming in pain and then didn't think she needed to go to the hospital immediately? Come on now, Kayla. Back in the present, Stacy asks Chase to stick to the medical aspects of the story and not to veer off into the negative portrayals of the patient's family members. Chase says that Foreman found uveitis in Kayla's eye, which is what got House interested in the case.
House and the Cottages assemble in the meeting room. The Cottages list off possible diagnoses for Kayla, while House has difficulty opening a medicine bottle, which is starting to become a trend for him. He tosses the bottle to Chase to open it, but Stacy's voice comes in mid-throw and freezes the frame with its icy edge. She says she doesn't care about the Vicodin, so it disappears with a "pop" and the scene continues. Vasculitis is thrown around as a possible diagnosis for Kayla. A form of it called Behçet's Disease is consistent with all of Kayla's symptoms, except for the tell-tale oral or genital sores. House sends Chase off to look for them, and we are transported back to the present, where Stacy asks why House sent Chase off to examine Foreman's patient. Chase sighs, and we go back to the past, where Chase is fiddling with House's Vicodin bottle as House sends Foreman off to look for genital sores. Suddenly, the cap flies off the bottle, scattering House's precious pills all over the table. Chase knows exactly what's coming to him for that, and isn't surprised when House assigns him to examine Kayla's privates instead of Foreman. You'd think this would teach Stacy a lesson about not deciding what is or isn't important to a story until after the entire story has been told, but you'd be wrong.
Chase examines the hell out of Kayla's vaginal region. Unsurprisingly, his patient isn't having the greatest time of her life, so Chase tries to make conversation to put her at ease. That's nice of him, but really, I personally would rather not engage in conversation with someone while he's looking at my personal areas. Then again, I don't even like to talk to people in other bathroom stalls, so maybe I'm just neurotic. Kayla apologizes for her unease, saying that she hates hospitals. Chase says he's loved them ever since he got his tonsils out when he was twelve years old and got to skip school and eat lots of ice cream. That's what made him want to be a doctor. He should have just become an ice cream man. You still get to give kids tasty frozen treats, but there's a lot less school involved. Just an Associates in Good Humor, I believe. Kayla says she also had a childhood hospital experience, but hers was slightly less fun: when she was eight, she spent months at Princeton General watching her mother die. Chase flips through Kayla's file with his still-gloved hand -- which I'll bet the folks down at medical records will really appreciate -- and sees that Mother Kayla died of DTs. This creates a nice bonding moment for Chase and Kayla over their shared alcoholic-mother experiences. Chase talks about how his father left him to take care of his mother, and Kayla asks if he's forgiven his father for that. "No," Chase says sadly. Then Stacy interrupts to ask if Chase's dad is relevant to the story. Chase says he isn't, and Stacy says that they don't need to mention it, then. Brilliant, Stacy. Chase adds that he found some ulcerations in Kayla's genitals and prescribed prednisone and Tums for the Behçet's, and a pathergy test on her arm to confirm the diagnosis, which I'm sure it won't since Behçet's is vasculitis and it's never vasculitis. Chase tells Kayla to have a doctor check the reaction at the test site after twenty-four hours. Twenty-four hours later, Kayla came back to the Clinic and found Chase, who found the disgusting-looking pustules that indicate a positive reaction and, therefore, a confirmed Behçet's diagnosis. No way! I thought we'd have to wait for the series finale for a vasculitis case! I have to say I'm kind of sad. It's like I don't have anything to look forward to anymore. Chase refers Kayla to a rheumatologist. She sincerely thanks him for his help, and Chase grins and walks away, full of satisfaction in the good work that he does and the good people he helps every day.
As if Stacy's overly-Botoxed face wasn't enough to prove that she wasn't born yesterday, she asks Chase to tell her what really happened.
We go back to the Clinic, where Chase is on the phone. Kayla walks in and interrupts his phone conversation. He hangs up and asks Kayla what she wants, apparently not remembering her from just the day before. Kayla reminds him, and he checks her arm, giving us a second shot of those really delicious-looking pustules. He confirms the positive result, and tells her to make an appointment with a rheumatologist. He tries to get away, but Kayla complains that her stomach still hurts. Chase just scribbles out a prescription for a stronger antacid, saying that either the Behçet's is stronger than they thought or she's having a reaction to the prednisone; he practically throws the prescription at Kayla, and starts to walk away. But Kayla again calls him back with a question. "Yes?" Chase snaps, obviously not wanting to talk to her anymore. Kayla decides that it's not important enough to mention after all. Chase runs off before Kayla can call him back again.
"I made one little mistake," Chase says. Stacy says that one "little" mistake like not checking out a patient's stomach complaint could have some very big consequences. Oh, don't act so high and mighty, Stacy. You only know that because you're looking at it in hindsight, which is always twenty-twenty.
Wilson and House walk down a hallway. Nosy Wilson finds it odd that Stacy is advising Chase and not House when they're both going in front of the peer review board. House says he never even met Kayla. "Your disdain for human interaction doesn't exculpate you; it inculpates you!" Wilson says. I didn't even know "inculpates" was a word. And I have to think that, when it comes to the opinions of one's fellow doctors, one's inability and non-desire to deal with humans can only be seen as a positive thing. Even so, Wilson points out that House signed off on all of Chase's charts, so he's just as responsible for Chase's actions as Chase is. House says that means that whatever help Stacy gives Chase will therefore also help him. Wilson points out that Stacy could tell Chase to sell House out to protect himself -- something we all know Chase is very capable of doing. Wilson illustrates this by doing an impression of Chase telling the committee it was all House's fault, and while Wilson's Australian accent sounds more Scottish than it does Australian, he still manages to incorporate the important weaselly side of Chase and prove his point. House insists that Chase loves House too much to do something like that. "Cameron loves you. Chase loves his job," Wilson replies, adding that Stacy hates House enough to want to ruin his career. "You think emotion only affects doctors' judgments?" Wilson asks, all excited to get the thematic line for once. House takes some pills.
Stacy asks Chase why he was too distracted to give Kayla an appropriately thorough exam. If he was rushed and overworked, it's the hospital's fault. But if it was a personal issue, like, oh, say, an emotional problem, then Chase is liable. Chase doesn't think it's anyone's fault: any doctor would have assumed the stomach pain was related to Behçet's, as he did. Unless, of course, that doctor watched House and knew that vasculitis is never the real reason someone is sick. Stacy isn't buying it, since Chase called Kayla an hour after she left the Clinic. Chase admits that it occurred to him later that Kayla might have had an embarrassing question that his brusque manner discouraged her from asking. He didn't realize this when she was there because he "wasn't thinking clearly." Stacy tells him that's a bad answer, but doesn't ask any follow-up questions about why, say, Chase wasn't "thinking clearly." Instead, she asks Chase what he thinks Kayla might have been trying to tell him. Chase figures she found blood in her feces, which indicates a bleeding ulcer. I'm sorry, but I really don't see how any of this Chase's fault. How stupid are you to not realize that BLOODY POOP is a serious problem that requires immediate medical attention?! Or to know that, but be too embarrassed about it to mention it to a guy who just spent fifteen minutes the day before inspecting every millimeter of your privates? How are you that puritanical and yet still manage to have had sex at least twice? Not to mention that Kayla didn't even have an appointment at the Clinic; she just showed up and ambushed Chase when he was obviously busy with something else. If Chase ends up getting in trouble for that, I'm going to walk up to various doctors on the street and tell them I have a headache and then sue them when they inevitably tell me to get lost instead of asking me follow-up questions.
Kayla never got a chance to return Chase's call, because she was too busy vomiting massive amounts of blood and being transported back to PPTH via ambulance. Chase follows the stretcher into an exam room, and Foreman wanders in and asks why their Behçet's case is back with some decidely un-Behçet's-like symptoms. Chase sticks a camera into Kayla's stomach and finds a bleeding ulcer. He cauterizes it as House walks in, also curious as to why the patient Chase told him was cured is now dying in the ER. "She was fine two hours ago!" Chase says. And just in case you thought Kayla only had the vaculitis and a bleeding ulcer to deal with, her monitors start beeping wildly. She's still bleeding, even with the ulcer closed. House directs Chase to keep looking around Kayla's stomach, and they find a second ulcer. But this one is perforated. Uh oh. "Get her to an OR!" Chase screams. Back in the present, Chase tells Stacy that the surgeons sewed poor Kayla's stomach back up, but her stomach contents had already spilled out all over her body, making her septic and causing liver and kidney damage. Hey, Kayla, you know what's even more embarrassing than telling a doctor you poop blood? When your liver stops working and you turn all yellow with jaundice and then you die. Sort of like how you might feel like a bad mother leaving your kids alone to go to the ER for your severe stomach pains, but it's still better leaving your kids FOREVER because you put a necessary ER visit off a day. Chase says he knows how bad this looks, but that he did do everything "by the book." Stacy leaves to get some coffee.
Stacy eschews the coffee for a hot cup of gossip, running to Cameron for the real reason Chase didn't pay enough attention to Kayla's stomach complaint. Obviously, everyone wisely decided to leave Cameron out of the loop, knowing her tendency to tell people things she shouldn't: she just says that, as far as she's concerned, Chase made a minor mistake. Stacy asks Cameron exactly how far her concern goes, having heard through the hospital grapevine that Cameron and Chase had sex. Wow, that sure did get around fast. I wonder who spread the rumor around? Only two people besides Cameron and Chase knew about it, and Foreman doesn't exactly strike me as the gossipy type. Nor do I believe that enough people would talk to House for the rumor to be spread through him. That just leaves Chase bragging about his sexual exploits to anyone within earshot. Cameron wants to know what pathetic rumor mill managed to spread the information about her having sex but missed the really juicy stuff about how she was high on her patient's drugs while doing it. Stacy tells Cameron that the proper response to any questions about her and Chase is that they aren't involved, like anyone on that peer review committee is masochistic enough to call Cameron forward to testify and endure the three-hour-long speech about how Kayla's death reminds her of her Poor Dead Husband that would inevitably result. Cameron insists that she has no idea why Chase screwed up. She tells Stacy that the best person to ask is House. Hey, Stacy -- when freaking Cameron is telling you to put your Issues aside and do your job properly, you should really pay attention.
Of course, Stacy won't be doing anything reasonable like that, so she runs to Foreman, who's in a really bitchy mood. I guess Stacy does have that effect on people. He tells her that Chase "doesn't give a crap about his patients," and always tells them the same story about having his tonsils removed, which isn't even true. Plus, Chase makes fun of his patients the second he's out of their earshot because he wants to be just like House. Foreman -- who wears House's sneakers and is more like House than anyone else on this show -- doesn't think House is someone to aspire to being. Stacy wisely decides that Foreman won't be testifying at the review hearing. Foreman asks her what House had to say about the whole thing.
The incredibly talented Greg Winter is playing House's latest Clinic patient, a guy named Chuck who's had a bad cough for the last two months. I have to say, Greg Winter really sells his performance here. What a talented and handsome young man he is! And my opinion is in no way influenced by the fact that I know him. Anyway, it's really hard to pay attention to House in this scene when you have the magnetic screen presence of Greg Winter, but I'll try. House scolds Chuck for spending money on trivial things like watches and MP3 players and then not being able afford health insurance, thereby forcing him to wait so long to see a doctor at a free clinic. For a guy who owns both a Gameboy DS and a PSP, House is surprisingly unsympathetic to today's gadget-loving man. Stacy -- who we all know is no stranger to walking right on into occupied patient exam rooms -- suddenly enters and demands to speak to House in another room. "It's confidential," she says, like House and his patient aren't. What if House were looking for herpes on the penis of some guy Stacy knows when she walked in there like that? House knows that there's safety in numbers, and refuses to go anywhere alone with Stacy. They compromise when House covers Chuck's ears with his stethoscope and tells him to listen to his loud, crackly lungs so that he and the Misses can have their conversation in private. For some reason, I don't think "preserving patient confidentiality via loud lung sounds" is part of the HIPAA guidelines.
"Why did Chase screw up and how bad was it?" Stacy asks. House refuses to acknowledge that Chase screwed up, which is interesting considering how quick House usually is to point out Chase's mistakes and inadequacies, be they real or imagined. I wonder if he's trying to protect Chase because that will automatically absolve him of all blame as well, or if he's doing this because he actually likes Chase and wants to help him. Stacy tells House that he can stop lying because Chase already admitted to her that he did, in fact, make a mistake. House doesn't think that admitting fault is a particularly good legal strategy, but Stacy says it's better than lying to the lawyer who's trying to defend them (well, one of them), and thinking that a lie that works on a lawyer will also work on a committee filled with fellow doctors. House has to admit that Stacy has a point there, and he begins to tell her his side of the story.
We're back in the ER. Chase cauterizes Kayla's first bleeding ulcer again, and then House limps in and criticizes Chase for not realizing that Kayla had a problem when she was there only two hours ago. The monitors beep. "I'm guessing those are celebratory bells," House snarks. That was funny, and made me wish that I could have some celebratory bells of my very own. Chase once again looks around Kayla's stomach and finds the second perforated ulcer. Kayla is wheeled away, leaving House to yell at Chase for missing Kayla's problems when she came in for her exam, and not asking her the necessary questions about diarrhea or rectal bleeding. Chase protests that doctors skip those questions all the time, an argument that would have held more weight if Kayla were perfectly healthy and not currently dying because Chase didn't give her stomach complaint the attention it deserved. Chase says he just made a minor mistake. "Mistakes are as serious as the results they cause!" House yells back, and they might want to not yell so loud because I don't think other patients should be hearing this. "This woman could die because you were too lazy to ask one simple question!" House certainly is a passionate and noble guy in his own flashbacks. Chase responds that this is House's fault, too, because he couldn't open the Vicodin pill bottle. By that stunning logic, I guess we should really blame the company that makes House's Vicodin, who in turn can hold whoever created Vicodin responsible and then that guy can blame his second-grade science teacher who got him interested in science in the first place. Sooner or later, the blame always goes back to Mrs. Stillman. House tells the camera/Stacy that he responded to Chase's remark with some clever insults that made Chase cry and shouldn't be repeated to the review board, unless Stacy's trying to turn Chase against him and get House in trouble for her own personal reasons.
At this point, Chuck voices his request to hear some more juicy details. Instead, House tells him a story about a guy named "Buck" who didn't think health insurance was necessary and suddenly got a horrible lung disease that needed a very expensive lung transplant to treat. Buck can't apply for health insurance to cover that expense because it's a "pre-existing condition" now that a doctor has diagnosed it. Buck should have made sure he had insurance before he got that diagnosis. Now he'll die for sure. Poor Chuck thinks House is telling him that he has that same lung disease and hauls ass out of the exam room to buy some insurance before House can diagnose him. Or maybe he's assuming that he does have a fatal disease and is off to kill himself so that he won't have to suffer. House had better hope it's not the latter. I hope so, too, because Greg Winter was awesome in that scene and they should bring him back and they can't do that if he's dead. Stacy is horrified that House could inform someone in such a flippant manner that he has a terminal disease, but House tells her to relax; Chuck just has a cold. And soon he'll have health insurance, too! There's no such thing as Stacy insurance, though, so we still have to listen to her angrily accusing House of being a manipulator.
This continues as they leave the exam room and go out into the hallway, where Chuck has put a few Chuck-shaped holes in the wall in his eagerness to buy health insurance RIGHT NOW. Stacy and House talk about his therapy-file-stealing exploits and resolve absolutely nothing, and then Stacy asks House why he didn't fire Chase for making that mistake. "He has great hair," House answers. Stacy grabs House and spins him around to face her. She demands to know what he's hiding from her. "I'm gay," House admits, adding that this does explain why he spends so much time with Wilson and has that shoe obsession. That rustling sound you hear is the sound of thousands of HoYay lovers deciding that HoYay has now become too played out and mainstream for them and trying to come up with something new and cutting-edge to like instead. I really, really hope it won't be PetYay.
Stacy returns to Chase with coffee and a bad mood. She asks Chase why he didn't ask Kayla those necessary questions, and Chase figures out that she talked to House. He maintains that he made a simple mistake that doctors make all the time. Stacy asks what happened after Kayla's operation.
Cameron tells Kayla's brother, Sam, that Kayla's kidney damage can be treated with dialysis, but that the liver damage can only be fixed with a transplant. Sam volunteers part of his own liver, but Cameron says thatsurgeons won't operate on a living donor unless he's had a lot of time to really consider his decision. "There's black markets," says Sam, who has apparently been reading too many of those urban legends about the guy who brings a girl home and then wakes up in a bathtub full of ice and "call 911 or you will die" written in lipstick on his chest. Chase rolls his eyes at the stupidity while Cameron tries to stammer out an answer that won't make Sam mad enough to punch her in the face.
Kayla groans from her bed. Her stomach hurts. Her monitors beep. She has a clot, and has to go back to the OR. Back in the present, Chase explains that the sepsis lowered Kayla's blood pressure, causing clots. They cut off the blood supply to her liver, totally killing it. She needed a transplant immediately, or she'd die. Stacy is shocked that Cuddy would put someone in such bad health on the sacred transplant list. If only Kayla were a famous alcoholic; then she could have all the livers she wanted!
But she isn't, so Cuddy has no intention of putting Kayla on any transplant list. House tells her that the reason Kayla is in such bad condition is because a PPTH employee didn't do his job properly. Chase tries not to cry as House continues to say that the jury won't take kindly to a mother of two dying as a result of a hospital employee error. Cuddy says she's well aware of the hospital's liability in this case, but still won't put her on the list. And Cuddy still won't get a wardrobe that isn't tragic. Who thought that high-and-wide collared blazer was a good idea? Besides, of course, Queen Elizabeth I. This show really needs to stop raiding the period costumes wardrobe department for Cuddy's clothes. (I also think they should stop raiding the "hip guy in his 20s" t-shirt drawer for House's clothes, but a lot of people seem to disagree with me there.) House points out that if Kayla's family wins a lawsuit against PPTH, it'll put the hospital out of business, and then they won't be able to treat anyone at all, so denying Kayla a liver really does compromise patient care. That doesn't seem like a very good argument to me, but Cuddy tells them to "start praying for a twelve-car pileup on the Turnpike, 'cause we're not exactly swimmin' in livers over here" as she signs the transplant papers. Well, that was easy. I guess the transplant committee had the day off or something.
Stacy recommends that Chase leave the details about Kayla's transplant out of the hearing, like Chase didn't know that when he didn't tell Stacy about it in the first place. He says it didn't matter in the end anyway, as we go back to the past, where Foreman and Chase tell Sam that Kayla's on the list, but that her rare blood type makes the chances of getting a compatible liver in time very unlikely. Sam looks over at Kayla's sad daughters and whips out a file that shows he's a perfect match to donate part of his liver to Kayla. He says he knows a guy in medical testing who got the results rushed for him. Back in he present, Stacy wants to know how they were able to convince a surgeon to do the operation after telling Sam that no surgeon would do it on such short notice. "House took care of that, too," Chase says.
House butters up the "best transplant surgeon in the hospital" and tells him that Kayla will die without his Godlike powers. "Get her in this afternoon," the surgeon says as he basks in the glow of his heroism. "Thank you very much," House says, humbly and warmly. "My pleasure!" says the surgeon. They're about to shake hands when Stacy freezes it because she knows none of that is true.
Back in the present, we see that House has been telling this part of the story, of course. Stacy asks him what really happened with the surgeon. He says he'd rather not tell the hospital's lawyer about any unethical activities he may have engaged in with another hospital employee. Stacy reminds him that whatever he tells her is protected under attorney-client privilege, which should inspire lots of confidence there, since that whole doctor-patient confidentiality thing always works so well. Not to mention the fact that PPTH is Stacy's client here, not House. But House is convinced and tells Stacy the truth. "It was kinda cool," he says.
The surgeon is furious that House would even suggest that he basically execute a woman who's dying well enough on her own anyway. House whips out an envelope full of money -- five grand, with fifteen more to come after the surgery. The surgeon laughs out loud and says he won't be "tanking" his "percentages" for a measly twenty thousand dollars when he makes $600,000 a year. Furthermore, he hopes House and Chase both get fired very unceremoniously. House smiles and says he'll just be going to inform the surgeon's wife that her husband has been sleeping with several nurses, which should cost the surgeon about $300,000 of alimony payments a year. You see, at last year's Christmas party (which I have a really hard time believing House attended), House noticed how familiar Nurse Cutler and the surgeon were with each other. He also noticed the used condom stuck to the surgeon's shoe, which I'm assuming House was checking out because he does, after all, love shoes. House would hate to have to send the surgeon's wife an anonymous letter detailing her husband's exploits, but he does have an OR booked this afternoon that the surgeon is free to use if he wants to avoid this fate. The surgeon agrees to do the surgery. House informs the surgeon that while he may be the "worst transplant surgeon in this hospital," he is the best transplant surgeon who's also cheating on his wife.
Needless to say, Stacy doesn't approve of the bribery and blackmail. House says that if he hadn't done it, Kayla would have died. Instead, she'll have surgery performed by the worst transplant surgeon in the entire hospital who's too stupid not to notice a used condom stuck to his shoe and is doing the surgery under duress. Stacy asks House about "that incident in the parking lot." We cut to a hysterical blonde woman keying the hell out of the surgeon's convertible as he begs her to stop and says he "didn't do anything." House grins that someone sent an anonymous letter to the surgeon's wife. By the way, the surgeon's last name? Ayersman, which just happens to be the same last name of Kayla's daughters' talent show rival, the one whose convertible Kayla threatened to key. Well played, writers.
"You just can't control yourself, can you?" Stacy accuses, obviously no longer talking about Dr. Ayersman. House says that if they're going to discuss this, they might as well drop the pretense of talking about anything other than him stealing Stacy's therapy files. I'd prefer it if they dropped the entire conversation, then, because I really don't want to hear yet another discussion of House and Stacy's feelings for each other, which is exactly what follows. House thinks Stacy's really mad at him because she liked where things were going between them before she found out why House was being so charming to her. He says he is sincerely sorry for that, and that he was stupid. That's a big deal for House to say, but it's not enough for Stacy (nor, do I think, should it have been), and she just walks out. House sighs and turns back to his heretofore unseen patient, who has a stethoscope covering her ears. He wants to tell her a story of a patient named..."Fusan." Hee.
Dr. Ayersman does the transplant as Chase watches outside, looking sad and remorseful. The surgery was a success, but two months later, Kayla came in for a follow-up exam. "Honestly --" Chase starts, and Stacy interrupts to ask if that implies that he's been lying up until now. Fed up, Chase asks her if they can cut a deal where he doesn't say "honestly" again and she stops taking out her anger at House on him. Stacy's reaction is a slight movement of her eyebrows into what I'm guessing is her "oh, I just got TOLD" facial expression. Chase adds that he didn't want to see Kayla again, but House made him do her exam instead of, say, a doctor who specializes in post-transplant operation care.
Chase asks Kayla about her daughters, and, contrary to what Foreman said before, really does seem interested in what she has to say. But he's even more interested in the fact that Kayla has a slight fever. He asks her as many follow-up questions as possible about coughing and urination pain, then says that the immunosuppressants she's on from he transplant are supposed to block fevers, so even a slight one is odd. He's going to do a full work-up on Kayla because, as he tells Stacy, he wasn't about to make any more mistakes.
Back in the meeting room of the past, Foreman looks at the results of Kayla's latest bloodwork and says she's rejecting the new liver. Chase insists that it's just a simple strep infection, no matter what Foreman says to indicate otherwise, until House tells Chase and strep to "get a room already." Hee. Sam walks in and asks House if he's House. House stands behind Foreman and asks Sam if he's planning on hitting Dr. House, pointing to Foreman, who does the most awesome double take. Sam doesn't think House has the right to be "cute" with him, considering that House hasn't even seen the woman he's treating. True, but if House did that, this show wouldn't be nearly as entertaining. Sam wants to know if his sister has hepatitis, and shows off an impressive knowledge of the disease for someone who isn't a doctor. House finds that suspicious. "He just donated his liver," Cameron points out. House notes that Sam's face is flushed, indicating that he's sick as well, and that he has a crappy homemade tattoo, a common way of getting hepatitis C. House guesses that Sam knew he had hep C and paid that lab tech off to conceal the fact so he'd be able to give Kayla his diseased liver. "You paid someone off?! That is totally unethical!" House says, knowing exactly how hypocritical he sounds. He orders MRIs for both Sam and Kayla. Sam asks if Kayla got hep C from him. I'd say that's a pretty safe bet, genius. But House reassures him that that's not the case. He's pretty sure Sam gave Kayla cancer. I thought he was being sarcastic at first, but he looks dead serious as we cut to commercial, so I guess not.
Chase tells Stacy that Sam had a previously undiagnosed hepatoma (malignant liver tumor) that got a free ride into Kayla's body during the transplant, where it grew rapidly thanks to those immunosuppressants Kayla was taking. Stacy is pretty amazed at House's skills, and at the human body's ability to turn hepatitis into cancer. Chase says that House's instadiagnosis (accuracy rate: now .01%!) actually saved Sam's life, because they were able to catch and remove the cancer before metastasized. Kayla was not so fortunate. Her body was rejecting Sam's liver, and there was no way to relist her for a transplant because she had cancer. Stacy says this is a good thing as far as Chase is concerned, because they can now blame Sam for Kayla's death. Chase points out that Kayla would have died six months ago if Sam hadn't done that transplant. Probably so, but Stacy says they can't prove that, since it never happened. Then her pager goes off. She reads it in less than a nanosecond and tells Chase to come with her.
Off we go to Cuddy's office, where Cuddy is super-pissed to find that Kayla's family is suing PPTH and Chase for $10 million for negligence and malpractice. Stacy is surprised at the high figure, saying they'd have to be saying Chase was grossly negligent for the punitive damages to be that high. Chase says that the lawyer must be out of his mind, then, but Stacy knows who the Kayla family's lawyer is, and that he wouldn't sue for this much unless he had a very good reason. Which means that Chase and House have been lying to her. House denies lying about anything, and points out that he's actually not the one being sued here, which is a funny and unusual feeling for him. Stacy wants to know what they're hiding from her. Chase looks at House. House looks at Chase. Chase says that Sam did manage to find Kayla a second liver. On the Mexican black market. Cuddy rolls her eyes so hard that her entire head moves with them.
Back in the past, Foreman and Cameron can't believe that Chase would be okay with his patient flying off to Mexico City to get what Foreman assumes will be a pig's liver in an operation performed with a hacksaw in the back of a van. Well, I'm sure it will be a clean van, at least. Chase tells them to go tell on him to House, but he's sure House will agree with him that if there's a one in a billion chance to save their patient, they should take it. Foreman says that Kayla is being manipulated by her guilty brother and doctor. Chase is pretty sure that Kayla is just as determined not to die as they are. "She's dying either way!" Cameron says. Foreman points out that third-world organ transplants have a success rate of zero, and that this will just get Chase in more trouble than he already is. Smart of Foreman to appeal to Chase's self-preservation instincts.
Chase enters Kayla's room, where Sam is running around packing her stuff in preparation for their flight to Mexico. Chase tells Kayla that they need to talk. "I made a mistake," he says. He's not talking about the bleeding ulcer thing, though, but about not being realistic enough with Kayla about her chances of survival. Sam begs Chase to stop talking, but Chase keeps going. He says that the flight to Mexico alone could kill her, never mind the surgery or the cancer. "My dad died. Lung cancer," Chase says, and we finally find out what happened to Chase the Elder. Chase says that his father never told him he was sick, even when they saw each other a few months before he died. Chase gets all emotional and says he wishes his dad had told him the truth. Kayla has a chance to tell her daughters the truth and be with them when she dies instead of three thousands miles away from them. "You don't want to do that to them," he says. "I'm sorry, Sam," Kayla says. Sam begs her to keep fighting, because if she dies from this, then it will be his fault. Also, it looks like cancer gives you dark circles under your eyes, if Kayla's and Sam's makeup is anything to go by. Kayla tells Sam that he gave her three more months with her daughters and she got to save her "baby brother" when they found the cancer in her and therefore him. They hug and sob. Aww.
Back in the present, Chase says that Kayla died a week later, and that Sam was really pissed off and filed that lawsuit. No one believes him. Stacy points out that Sam saw Chase for a follow-up exam just last week, which isn't exactly consistent with him hating Chase. Something must have happened between that last appointment and now -- something personal that would make Sam want to sue Chase and no one else, not even House. Stacy wants to know what it was.
We go back to last week. Chase examines Sam and asks about Kayla's daughters. Sam says they're kind of sad about their mother being dead and all, and the fact that Sam has to move them out of the house they lived in with their mother is sure to make things even worse. But he hasn't been able to work since the transplant surgery, and the disability checks aren't enough to cover the mortgage payments. And Kayla apparently didn't have life insurance. Smart, Kayla. Sam sincerely thanks Chase and shakes his hand. "I killed your sister," Chase says. "I misdiagnosed her ulcer. I killed her." Sam tells Chase to shut up. Kayla liked him. Chase says that when Kayla came back to her pathergy test check, he was hung-over and didn't give a crap what was wrong with her stomach. Sam knocks something over.
Back in Cuddy's office, House asks if he can have a minute alone with his "future former employee." They go outside to the patio Cuddy apparently has connected to her office, where House asks Chase why he lied to Sam about being hung-over so that Sam would sue PPTH. He knows that Chase wasn't hung-over that day; House would have fired him back then if he thought he was. So drinking too much gets you fired, but a freaking meth hangover is okay? Chase doesn't think it matters whether he was hung-over or not; Kayla's still dead and it's his fault. At least now Sam will get all the money he'll need to take care of Kayla's daughters. House says he knows what was really wrong with Chase that day. He's pretty sure who called Chase before Kayla walked in, and why.
Back in the past, Chase gets his phone call. His expression changes from confusion to shock as he listens to the other end. "What did he die of?" he asks. Pause. "That's impossible. I saw him two months ago. If he had lung cancer he would've --" and then his stepmother apparently tells him that his father didn't want to tell him about the cancer. Numb, Chase starts to put the phone down. Kayla walks in.
House says he's figuring that, now that both of Chase's parents are dead, the chances of a grief-over-parental-death-related mistake not happening again are pretty good. It then occurs to Chase that House shouldn't have had any reason to think that Chase was distracted because his dad died. Except for the fact that Chase the Elder was supposed to be a world-famous doctor whose death would, I'd assume, be widely reported in the medical community. House sighs and admits that Chase the Elder told House about the cancer and asked House not to tell Chase. Chase is kinda pissed that House "hung [him] out there to be blindsided," and it's probably House's guilt over that that's the reason he didn't fire Chase in the first place. House tells Chase that he can either tell the committee about his dad, which will let him keep his job and still give Kayla's family enough money to keep their house, or Chase can keep lying and lose his job. Just like he did with Chase's dad, House will keep his mouth shut about the truth, even though, as he points out, it's much better for House legally if Chase lies. I think he only said that because he figured Chase would be mad enough at House to tell the truth just to get House in more trouble.
House twirls his cane. Chase talks to the review board. Stacy takes a seat and asks House if Chase is telling the committee about his dad. How does Stacy know about that? Did House tell her? Didn't he just say he wasn't going to tell anyone the truth if Chase didn't want him to? House asks Stacy what happened to her advising Chase to sell him out. Stacy says she would never do that; House is her client, too. Where was this professional stance when Stacy was refusing to deal with House and telling him to sign papers that she then told Chase he shouldn't? House asks Stacy how they're supposed to deal with each other as co-workers when they have feelings for each other, be they positive or negative. I'm guessing they'll do it the way they've done it all season so far: by asking each other this question in every episode and resolving absolutely nothing until Sela Ward's guest-starring contract is done. It seems to work well enough for them, if not the viewers who are subjected to the same freaking scene over and over and over again. Stacy says her feelings for House aren't "all" negative. She loves and hates him. He will always be the one. WE KNOW. Man, I was really hoping this crap would end when Stacy found out about the therapy file theft, but no. Nothing has changed. "So, what do we do?" House asks. "I don't know," Stacy responds. Well, neither do the writers, apparently.
A doctor calls House into the room. The committee has reached its decision: Chase's error resulted in a patient's death, and he lied to his superiors and Sam. But the mitigating factor of Chase's dad's death means they won't be firing Chase -- just suspending him for one week and putting a note in his file. Chase looks relieved. And now he knows that he can get away with anything as long as he has an emotional issue to use as an excuse! As for House, he didn't do anything wrong, but no one likes him, so they're going to punish him anyway. For the month, he will have to be supervised by a doctor Cuddy will choose. The arbitrary committee meeting is adjourned.
House storms back to the meeting room, where Cuddy, Cameron, Wilson, and Foreman are waiting. House angrily asks Cuddy if she knew about this. She says the committee "contacted her" an hour ago, which would make it seem like they had made their minds up before they even talked to House or Chase, wouldn't it? Unless review committee hearings last all day. I wouldn't know. Cameron asks what happened to Chase. House rips off his tie and tells Chase he's fired. "No, he's not," Foreman says. "Meet your new boss," Cuddy says. Well, that's kind of ridiculous, although as long as it gives Foreman something to do, I'm all for it. Wilson makes a great "whatwhatWHAT?!?!" expression. Foreman's ego swells. Cameron has no idea what's going on. Wilson breaks the silence by saying he's apparently Foreman's best friend now. House smirks just a little bit.