We join House at an off-track betting house. I always thought of OTBs as shady and possibly illegal, but this one appears to serve food and beverages and looks like a fun place to hang. House shoves his way through the crowd ("cripple coming through!") to get to the registers or whatever they're called (when I bet on horses, I like to do it at the track, so I'm not much of an OTB expert) in time to place his bets for an upcoming race. Unfortunately, he's stuck behind some guy who's more interested in the cashier's birthday than he is in placing his bets in a timely fashion in order to allow the people behind him to do the same. House is irritated. Special guest star Cynthia "Miranda Hobbes" Nixon overhears the scuffle from her spot in another line and steps forward to expertly place bets for the stupid guy. She hands the cashier the guy's money, possibly pocketing some of it for herself, and winks at House. House finally gets to place his bet on a horse named "Seminal Uprising," and Cynthia Nixon makes fun of him, saying that the horse is a loser. I'm just disappointed that there aren't any horses with my favorite name, "Hoof Hearted." Say that a couple times fast and you'll see what I'm talking about. Anyway, House's dream girl goes to bet on a horse named "Termigator," but the race closes before she can. She's pissed, but House tells her it would have been a losing bet; he knows that Seminal Uprising's jockey is bulimic, and throws up after weighing in, which somehow gives him an advantage. Horse turns his attention to the race, but the rest of the crowd is focused elsewhere: the floor that Cynthia Nixon is currently seizing all over. House would rather watch the race than help a sick person, so he asks the crowd if anyone is a doctor. A guy steps forward and starts trying to do chest compressions on a woman who clearly doesn't need them, since she is still able to breathe her heart is beating, and House orders him just to call an ambulance. He notices some weird streaky bruising on Cynthia Nixon's stomach, and that's what finally tears him away from the horse race. He kneels down to check it out and tells the guy to tell the paramedics to take Cynthia to PPTH: "Her doctor's name is House." Termigator wins the race. Seminal Uprising's jockey wanders off to eat a lot and barf again.
It's snowing in New Jersey! The Cottages have assembled to discuss their newest patient. Cameron's primary concern is, of course, House's personal life, and she wonders what he was doing at an OTB. I'm surprised she knows what an OTB even is. Maybe she frequents them now that she does meth. Foreman explains that, since House is addicted to pain pills, he must also be addicted to everything else in the world one can be addicted to, including gambling. Chase protests that House is only addicted to pain pills because he has a pain problem, and House walks in and says that winning on that race would have alleviated some of his pain. He starts discussing their newest patient, a "hot OTB babe," with seizures and weird bruising. Foreman notes that her blood alcohol level was high (0.13 -- not exactly through the roof, but well over the legal driving limit), and assumes that Cynthia is an alcoholic, which explains all of her health problems, case closed. Never mind the fact that she may not even be an alcoholic. Chase decides that an attractive woman at an OTB must be a prostitute, and that Cynthia might have a prostitute-y STD that explains her symptoms. But Foreman's the boss this month, so he tells them to give Cynthia heparin for her alcoholism-relatd blood clotting, which explains the seizures and bruising. House protests that Foreman is being a little quick to judge. Dutiful and loyal Cameron comes up with three possible diseases that have nothing to do with Cynthia's shady lifestyle, and House tells them to get started looking at those, starting with Cushing's. Puh-leeze -- if it were Cushing's, wouldn't Cynthia be fat and unpopular? That's what I've learned from this show, anyway. Foreman asserts his authority and tells them to do a full work-up on Cynthia instead. House will be taking her medical history, because that's the most embarrassing thing for him to be forced to do.
“ House says he wishes Chase were in charge instead of Foreman. Too bad Chase had to go and kill that patient! ”
House and Foreman hang out in the booth while Anica is wheeled into the MRI of DOOM. House is thrilled with himself for being right about Anica having Cushing's, which Foreman has to point out was actually Cameron's idea. He checks out Anica's MRI scans, but can't find the pituitary tumor re-growth they're expecting to see. He goes on the intercom and asks Anica to stop moving her head. "Sorry!" she sings, extremely cheerful about her possible brain tumor. It's almost like she's enjoying all these tests and attention. Foreman still can't find anything. House says that they must be dealing with a "micro-adenoma" that is too small to see. Or exist. When Foreman finds out that House didn't do a lumbar puncture on Anica because he was so sure she had Cushing's, he turns off the MRI machine and orders him to do that.
House tells Anica to curl into a fetal position. Anica wants to know why Cameron is standing around when she's never had two doctors in any of the other lumbar punctures she's had done before. She sure does know a lot about medical tests! House non-reassures her that Cameron is there to make sure that he doesn't paralyze his patient. Anica looks worried for the first time since she didn't get to post her Termigator bet. House goes in to do the lumbar puncture, and Anica jumps and gasps in pain. "Whoops!" House says. That's something you never want to hear from the guy poking around in your spine. He makes a few more unsuccessful attempts, and Anica starts to sweat as she shrieks in pain. House comments that LPs are a lot harder than he remembered them being. Cameron finally gets up the courage to step in and asks to take over. "Eighth time's a charm!" House says, and goes in for yet another poke. Anica's blood pressure skyrockets as she complains that her chest feels tight. Cameron orders House to stop lumbar puncturing. He gets up, calmly walks over to an attending nurse, and orders her to treat Anica for a "hypertensive crisis." "She'll be fine. Cameron -- meet me in my office," he says. Cameron rolls her eyes.
House scribbles "hypertensive crisis" on the whiteboard and boasts that he was correct in his Cushing's diagnosis after all, since Cushing's + stress = hypertensive crisis. Um, wouldn't it have been slightly less painful and risky to the patient just to do the freaking LP correctly to diagnosis this? I don't know what's worse -- House deliberately sucking at the LP just to prove that he was right, or House actually being that bad at LPs. House plays with one of the candy canes that someone insensitively put in his office while Foreman ticks him off about mangling the LP and says that alcoholism could explain the hypertensive crisis just as well as Cushing's, provided that you, like Foreman, are obsessed with being right and House being wrong, and that you assume that people are addicts even though there isn't any proof of that. Anica's blood pressure could have gone up because she's in alcohol withdrawal. It's a simpler explanation than House's invisible tumor theory. Surprisingly on House's side, even though he isn't the boss to suck up to, Chase says that there could be a cortisol-secreting tumor somewhere else on Anica's body. House says he wishes Chase were in charge instead of Foreman. Too bad Chase had to go and kill that patient! Chase looks like he either wants to kill himself or House. Ease up on the guy, House. You just almost paralyzed a woman in your unnecessary quest to prove your medical awesomeness. Cameron, hanging out by four Christmas stockings that I'm guessing were put up after Foreman was put in charge, just looks confused. House tells Foreman that they should do a scan for tumors. Foreman doesn't move. House clasps his hands and grovels sarcastically until Foreman relents, even though he still thinks their patient is an alcoholic, which he still doesn't have any proof of, nor has he even tried to find any. I never thought I'd say this, but shut up, Foreman.
“ Chase points out that Cameron wouldn't be able to say no to House as his boss. Because when it comes to saying no to people, Chase is the king. Cameron sighs as she hopefully realizes the truth and vows to make a few changes in her personality and professional conduct. ”
Anica is wheeled into a tube that gives Chase and Cameron an awesome 3-D scan of her internal organs. How is she paying for all this stuff? She said she was unemployed, so I doubt she has health insurance. She'll have to win a lot of racing bets to pay for this! Chase tries to do his job and check out the image while Cameron wonders aloud why Foreman was asked to run the department instead of her. Chase says he wasn't asked to run it, either. "You were suspended," Cameron snorts. I guess her confused face before was because she was just realizing why Foreman became her new boss and Chase got in trouble, and the fact that it took her a week to figure all that out indicates to me why she should never be put in charge of anything, ever. Cameron guesses that it's because Cuddy didn't want another woman to be in charge, and Chase has to laugh. "You sabotaged yourself," he says. "You went on a date with House, you slept with me -- putting you in charge of this department is like a sexual harassment suit waiting to happen." And Dr. "I Hired You Because You're Very Pretty" House isn't?! Foreman was put in charge because, out of all the Cottages, he's the most experienced and has been a Cottage longer than Cameron. If one of them had to be Houses boss, Foreman's the obvious choice. Chase points out that Cameron wouldn't be able to say no to House as his boss. Because when it comes to saying no to people, Chase is the king. Cameron sighs as she hopefully realizes the truth and vows to make a few changes in her personality and professional conduct.
House is watching television in the comfort of his office when Foreman walks in, his hands full of files and his head full of outrage. It seems that House ordered MRIs for the entire maternity ward. House says that one of them is necessary, so Foreman will have to comb through every single file to figure out which one it is instead of dismissing them all outright. Throwing a wrench into the works of providing adequate healthcare to new or expectant moms -- way to take a stand, there, House! Foreman turns House's TV off -- he's watching a monster truck rally, by the way -- and asks him what he's supposed to do in this new position. House tells him to act like his employee and "bitch," and then pulls out a year's worth of discharge summaries and happily tells Foreman to get to work signing them, since they're Foreman's responsibility now. That doesn't make sense to me, since House was the doctor in charge of those particular cases, so I would have thought he'd still have to sign off on them, demotion or not, but Foreman just tells him to "keep it coming." He can take whatever House dishes out!
Cameron and Chase enter with some bad news. Anica has a mass on her pancreas and, according to Chase, two months to live. "On the bright side," House reports, his blue eyes shining with triumph, "I was right!"
“ House takes a sniff of it himself and says it 'smells like vaginosis.' Ew. Ew. Ew. Vaginosis smells like fish. I have to wonder if the patient assumed she was secreting caviar. ”
Even though I'm soon to be a Sirius customer, I love the XM satellite commercial where David Bowie steals Snoop Dogg's bling. Mr. Bowie just looks so damn proud of himself.
Anica's scarfing down some chocolate pudding when Cameron enters her room. Anica asks to see House instead, as she apparently enjoyed his little game of pin-the-tail-on-Anica's-backbone before. After that, I personally would have wanted to see any doctor but House, but Anica's a different case, isn't she? Cameron says that she has some news for Anica -- news that Foreman, in his infinite supervisory wisdom, thought Cameron should be the one to deliver: "We found a mass in your pancreas. It looks like cancer." She sighs, and reluctantly explains that pancreatic cancer is super-deadly, with fewer than 20% of its victims surviving past a year. "What's the treatment?" Anica asks, all matter-of-factly. Cameron says that they'll biopsy her pancreas and then "look at" her options. "Sounds good!" Anica says, still digging into her pudding. Cameron asks for her consent to do the biopsy. "Wish me luck!" Anica says. Hey, when Andi was all brave like that, everyone thought she was a hero. Cameron is more confused by Anica's behavior than she admiring of it, though.
House and Chase perform the biopsy. Anica must be thrilled to have, in charge of this procedure, one doctor just coming off suspension for killing his patient and another whose attempt to do an LP put her into a hypertensive crisis. Wilson and Cameron observe, and Cameron comments on how casually Anica took the news about her cancer. Maybe it's because you didn't exactly spell out the fact that she was going to die, Cameron. As for Wilson, he doesn't really care about that because he's so entertained by the fact that House has been forced to assist Chase.
House enters the Clinic exam room and looks up from his patient's chart to see his female patient de-pantsed, stirruped, and waiting for him. "Perfect," he says, and then immediately moves to the phone to call Foreman in for a consult. Hee hee hee. He puts his gloves on and starts checking out his patient's lower area. She explains that she's been using a contraceptive jelly for the last few weeks because her boyfriend doesn't like condoms. House goes in to get a sample as the patient shows him the jelly she's been using. Its main ingredient isn't spermicide; it's strawberries. The patient has been smearing Smucker's in her nether regions. House stares for a second in disbelief, and then manages to say that they're dealing with a neurological problem. "There's something wrong with my brain?" asks the patient, who is too stupid to figure out the difference between contraceptive and fruit jelly, but somehow knows that a neurologist is a brain doctor. An attending nurse, who totally rules but is certainly no Evil Nurse Brenda, tries not to laugh. House gets a Q-tip full of his patient's jelly-encrusted discharge and proceeds to wave it in the entering Foreman's face, asking him to smell it. Ew. House takes a sniff of it himself and says it "smells like vaginosis." Ew. Ew. Ew. Vaginosis smells like fish. I have to wonder if the patient assumed she was secreting caviar. Foreman informs House that "Anica's" (way to say a patient's name in front of another patient, there, boss) biopsy was negative for pancreatic cancer. Surprise! He leaves, and the patient asks House how long she'll have to wait to have sex again. "On an evolutionary basis, I'd recommend forever," House predictably responds. The scene cuts before we can see the part where House and the nurse exchanged high-fives.
“ Chase says that the mass on Anica's pancreas must have been some harmless scar tissue, not cancer. If that was a possibility, why the hell didn't they tell Anica that before the biopsy? Geez! This is the worst hospital ever! ”
Back at the office, Chase says that the mass on Anica's pancreas must have been some harmless scar tissue, not cancer. If that was a possibility, why the hell didn't they tell Anica that before the biopsy? Geez! This is the worst hospital ever! Foreman's pleased as punch, because this means his theory is totally right, even though Anica hasn't exhibited any symptoms of alcoholism aside from that 0.13 BAC she came in with, which really isn't that high for an alcoholic. Plus, she's eating freaking pudding and chilling out in her room, which isn't exactly consistent with the DTs. Drop it already, Foreman. House is still sure Anica's got Cushing's, noting that her bloodwork showed she had ACTH at Cushing's levels. They just don't know what's triggering it. "There is another possibility," Cameron pipes up. Foreman tells her to continue, thinking she's going to talk about alcoholism or something that makes him look good. But no, Cameron's idea is that Anica doesn't have anything wrong with her at all and knows it, which is why she was so calm when Cameron told her about the cancer: "Maybe she injected herself with the ACTH." Maybe Anica has Munchausen's! Every hospital show has someone with it eventually, after all. Like Grey's Anatomy, which scooped House on this (in an episode that hasn't been recapped here yet, so, no link yet).
Unlike everyone else, Cameron actually took the time to read Anica's medical records and noted that Anica's been hospitalized four times in as many months. Her pancreatic scarring could have come from Anica injecting herself with ACTH to induce the Cushing's symptoms. House points out that Anica had brain surgery, and brain tumors are pretty hard to fake. Unless you're on this show, in which case everyone assumes you have a brain tumor until they figure out that it's just a worm or rabies or something. Cameron says that invisible tumors are fairly easy to fake, since they are invisible. She wants to search Anica's apartment for syringes or other things she might be using to make herself sick. Foreman agrees, and sends Cameron to do it. She will be accompanied by House. I think that's the only reason Foreman supported Cameron in this at all -- because it gave him the chance to get revenge on House for making him break into all those houses. Otherwise, a guy with a bum leg is really not the best person for these types of covert missions.
House gets double-punished, as he now has to listen to Cameron whining that she didn't get to be the new boss. She wants to know if she's done something wrong to deserve this. House tells her to "shut up," and explains that Cuddy only picked Foreman because he's black. And that, people, is a racist thing to say. But it's not the only racist thing House will say in this episode, so I'll save the rant for later, especially because I can explain part of House's statement here by the fact that he would have said anything to shut Cameron up. It doesn't work, though, as Cameron asks him what he thinks of her leadership skills. House responds that they're "excellent" except for the fact that they're also "non-existent." "Kind of like Anica's tumor" is a great retort that Cameron does not offer. She whines that "there's more to being a leader than being a jerk!" First of all, Cams, you asked House for his opinion and he gave it to you. Sorry it wasn't what you wanted to hear, but you did ask. And second of all, House wasn't saying you had to be more of a jerk, he said you had no leadership skills. Hush, now.