The Mistake

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 risqu 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.

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 Behet's, and a pathergy test on her arm to confirm the diagnosis, which I'm sure it won't since Behet'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 Behet'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 Behet'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 Behet'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 Behet's case is back with some decidely un-Behet'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.

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.