A sweet guy named Andres has Alzheimer's. But before his wife can get him into the risky experimental drug program, he starts vomiting blood. So House's team does its usual round of blind guesswork and treatments that nearly kill him before they discover that he was taking aspirin that his wife was using to feed the plants.
The main interpersonal dynamic is provided by Foreman, who's taking Taub's place on the team. Taub is off with a sick daughter or something, and frankly, I didn't miss him. He just mopes around and that's not nearly as much fun as House sparring with Foreman, who's trying to be the boss while simultaneously help out as House's temporary underling. House has been hiding index cards around the place that are supposed to show his ability to predict the future, but it's all just a complex ploy to get rid of that ankle bracelet that's never really restricted his movements all that much anyway.
And in the side plot, Wilson has a woman with a bladder infection who cheerfully tells him that she and her husband are asexual. House takes that as a challenge and goads Wilson into betting a hundred dollars on his ability to find a medical reason for it. It turns out that the husband has a pituitary tumor repressing his libido and the wife has probably been sneaking out to have the occasional sex. This vaguely ties into the main plot, where Mrs. Andres has a boyfriend.
A woman tells a man, "We're in a car, honey. We're going to a hospital for tests." Then, when they're in the hospital, she tells him they're in a hospital. She's helpful! I appreciate having someone around who's willing to carry all the exposition duties. Eventually, they find themselves in a room where a lady doctor is holding up a can opener. The man is unable to identify it by name, although he knows you use it to "get the food from inside" and then gets angry at her for trying to make him look stupid. He tells the doctor to kill herself and then gets calmed down by his wife, who calls him Andres. He apologizes, explaining that he has Alzheimer's. Well, that would seem to wrap up the week's medical mystery, right? That was easy! Anyway, he's there because he's going to be going on a drug trial. On this show? What could go wrong? Well, for one thing, he starts vomiting blood immediately. Even before the dangerous experimental drugs? This guy's got an awfully sensitive system! Either that or the drugs can travel back in time to affect you before you take them.
House sidles into his office, where Foreman is giving the team the rundown: early-onset familial Alzheimer's, and the client is of Brazilian descent. His only recent issues are a sore throat a few weeks ago. The wife shut down a floral business recently. House is whiny about having to work, naturally, but Foreman says they need to do this case because of the drug test. Foreman will be sitting in because Taub is out with a sick daughter. Good thing they brought that character back, huh? They're doing such rich, interesting things with him. House denied Taub's leave, but only after Foreman approved it. House asks Adams to read the index card taped under her chair. It is a vaguely racist chess-themed prediction that Foreman would start trying to actually act like House's boss. And House got the day wrong. With all that out of the way, Park makes a suggestion about the case. They can't tell if she's right until they take him off anti-emetics to let him vomit freely. Free your vomit, man.
Wilson is in the clinic with a woman who insists she can't possibly be pregnant. Because she's never had sex with her husband. "Neither one of us is interested in sex," she explains. "Celibacy is a choice. This is our orientation." This hospital sure gets a lot of people who can't possibly be pregnant.
Walking through the hallway, Chase pokes at Foreman, telling him he should either overrule House when he disagrees with him or stay out of it entirely. Foreman whines that House griping about Foreman's rule doesn't seem rational, since House needs Foreman to write a petition to his Parole Officer to get the ankle monitor removed.
Andres is being intubated, I think. His wife has set up a whiteboard explaining what's going on so he can see it as soon as he wakes up. Or any time he glances over, I guess. The wife exposits to Park and Chase that Andres had a youth soccer team once. A dude comes in, and Mrs. Andres introduces him as Joseph, a "good friend." Park is a hardliner about "family only" and kicks him out. Chase thinks Park is undiplomatic to be ejecting the man that Mrs. Andres is clearly sleeping with. Oh, and they find a Mallory-Weiss tear in Andres's esophagus.
House and Wilson in the cafeteria. Wilson talks about asexuality and House talks about plowing his furrow for him. Guys, it's more fun if you pretend everything is just subtext. House says the husband must be gay, since he doesn't believe in asexuality. Then he proposes a hundred-dollar bet that he can find a medical reason for her disinterest in sex. Wilson sets the condition that House not talk to her. No contact at all! House is fine with that, since he doesn't like talking to patients anyway. And he's always wanted to light a cigar with a hundred-dollar bill.
Foreman is busy in his office, but House brings in the whole team in to talk about the case. This presents the interesting point that Foreman ought to have other things to do than act as a temporary Taub. Foreman has a giant Magic Screen in his office that he touchscreens around. He suggests steatohepatits and also offers to check for fatty liver with an ultrasound. House accepts the first part but overrules the second because he wants to sedate Andres and open him up to look at the liver directly. House starts to leave, but Foreman has decided that House is trying to trick him into defining himself as a subordinate. So he insists on an ultrasound. House agrees with that in a suspiciously friendly way.
House stops Chase and Adams as they wheel an ultrasound machine through the lobby. He accuses them of diabolically circumventing his orders. Then he finds an index card upon which House wrote, "Cuddy dark will waste his afternoon chasing conspiracy theories."
With that out of the way, Andres is vomiting again. And he punches Mrs. Andres! And there's blood in his urine! Here's what I think is going on: I think she's been poisoning him. She probably used her flower business to grow deadly nightshade or something and has been slipping it into the meals she's been cooking him for the past six years. She likes to feel needed. Münchausen by Proxy. I always think it's Münchausen by Proxy on this show.
Adams says they should increase the sedation and return the antiemetics. Park thinks he punched Mrs. Andres for sleeping with that guy. House suggests that it's okay for her to do that, and Adams insists that cheating on a marriage is always bad. She kind of goes on about it, because that's her primary character trait; she's "the one who gets mad when people cheat." They run into Foreman, who says Andres should have stayed on the antiemetics. House says the punch gave them viable diagnostic information about his emotional problems and anyway, House wanted him sedated. So either way, House blames Foreman.
Park reads a recently-hidden card that says "The patient will punch his wife." Foreman is not impressed, because House clearly wrote that prediction after it happened. Then House reads a card where Foreman accuses him of writing that card after the fact. And he has a picture of himself with last week's paper. Then there are some more diagnoses that lead to plasmapheresis, which is a technique, not a disease. They're going to go all plasmapheresis all over Andres.
Mrs. Andres sends Joseph away. He kisses her on the forehead and leaves. She tells Chase they're not having an affair and that it's really hard doing this herself. Chase asks when she last got a full night's sleep, and she says it's been three years. "People who are sick are not the only ones who need to be taken care of," says Chase, and he sends her away, promising Andres will be fine for one night.
House, Adams and Park study Wilson's patient's blood tests. House waxes rhapsodic about the sex drive and how great it is. Park suggests spinal problems, but Adams goes with psychological intimacy issue. Suddenly, Park mentions that she's "tapped over thirty guys" that she never spoke to again because she lives to a Jewish frat. Because Park's character trait is "The one who says unsettling things." Adams thinks the patient is better off without a sex drive, if only because she's immune to most advertising. House appears to get a new idea. After he leaves, Adams asks Park, "Thirty?" Park claims that everybody lies, but that doesn't tell Adams whether the actual number is above or below thirty.
Mrs. Andres returns. But Andres is gone. He's apparently walked out! Foreman says the police have been notified. Mrs. Andres is furious at Chase for telling her it was okay to leave. It's a fair complaint. House stops her from leaving. He tells her she's "guilty" because she was under Robert. She admits it, but no one much cares, least of all me. House wants to reconstruct Andres's old routines. He once trained for a marathon. There was soccer practice. Chase spots that the soccer trophy is gone. The field he used to be a coach on is close. It's on Chesterfield. That detail means nothing to me, but if you're constructing a map of the area around PPTH, it might help you.
External shot! Snowy soccer field. They find Andres underneath the bleachers and get a neck-thing onto him. He's got no pulse, but he could just be frozen.
He's brought in and House insists that he get warmed up fast to stop the brain damage. There's a danger that doing it too fast could damage his metabolism, but House doesn't care. It's time for extracorporeal circulation!
Foreman explains to Mrs. Andres that "extracorporeal circulation" means that they're warming up his blood outside his body and then sticking back inside to warm him up, and that this will start his heart somehow. So even though he's not breathing and has no heartbeat, he's still alive. Chase and Adams discuss the situation. Chase thinks he was trying to kill himself to save his wife the pain. Adams is appalled. There's brain activity. Chase tells sad stories about himself as a child taking care of his siblings and watching his mother die. He wishes his mother had shot herself instead of drinking herself to death.
BEEP BEEP BEEP! Ventricular fibrillation! Drugs! Paddles! His heart is shocked back into rhythm. Foreman tells Mrs. Andres that they're not done yet.
House has gotten Wilson's patient's husband in for a "free flu shot" so he can test him. Wilson interrupts. House points out that he was only not allowed to contact the patient, not the patient's husband. His new theory is that she's only pretending to be asexual because her husband is. So the hypothetical medical problem could be in the husband. And he doesn't care about Wilson's complaints about ethics. House admits that he's suspicious of claims of happiness, but he believes that Wilson is a sucker. I think Wilson has some kind of Memento problem, because surely he should know by now that House isn't going to stop doing something just because it's wildly unethical.
Mrs. Andres wakes up to see that Andres is mostly awake. He says "Me sinto quente," but neither Mrs. Andres nor Park speaks Portuguese. BEEP BEEP BEEP! Body temperature rising! Commercial break, during which I google ""Me sinto quente and learn that it means... "I feel hot." Well, there you go, then.
Foreman goes through the symptoms on the whiteboard and House heckles him. The fever could be illness-related, or it could have been cell necrosis from hypothermia. House still likes plasmapherisis. Foreman wants to add the language-loss to the list of symptoms and declares encephalitis. House accepts it (after complaining about Alzheimer's) and suggests interferon.
Mrs. Andres is skeptical about Chase and Adams being unsure. "So, best-case scenario, I just had a glimpse into his future?" She's not psyched about this whole situation. She and Andres got married after knowing each other six months, and he started forgetting things a year later. She's known him longer with Alzheimer's than without. See how well this fits my theory about her poisoning him?
Back on Wilson's asexuality thing, House tells Wilson that he's pretty sure there's a tumor near the pituitary, causing erectile dysfunction. Wilson is not delighted about this, because it could destroy the patient's identity. Well, the patient's husband's identity. House doesn't care: "So don't tell him!" Wilson flip-flops and says he has to tell him about the tumor in his head. House points out that Wilson obviously wanted him to meddle.
Foreman looks at the petition House's PO sent over. He holds a pen above it, then pauses.
Foreman barges into House's office to make a dramatic speech. "You played me. This whole thing was about your ankle monitor." He now thinks House deliberately pumped up Foreman's confidence so he'd think he could control him. House says that the great part of the plan is that if Foreman sees through it that still means that Foreman feels in control. The monitor, he suggests, is basically training wheels for controlling House. Foreman should try it without that leverage. Foreman tears up the petition. House admits, "Second half of my plan might need work." BEEP BEEP BEEP!
Foreman is testing Andres's pulse when House goes in with the paddles. Adams pulls him off at the last second. House does a mocking apology where he says "....clear." after everything is done. This scene seemed pretty pointless.
House tells Foreman that all this is probably not worth the drug trial. Are they still waiting on Andres for that? Foreman suggests aseptic meningitis. House asks Foreman to reach under his chair. There is no prophetic index card, just wet gum. Ah, good times. House suggests toxins. Foreman says the wife cleaned the house. House sends the team to the, um, house. Foreman overrules this and tells everyone to work on a test for meningitis. House goes upstairs to talk to the wife, who he derisively calls "The toxicology PhD."
He interrogates her. There are no gifts from South America. He's interrupted by Andres mumbling in Portuguese. House speaks it, of course, and translates it as "blue shack" He wants to talk to Mrs. Andres about a possible cleaning woman and she begs him to translate what Adres is saying. House complies: "When I saw her waiting, waiting for me at the table, the way her eyes looked when she smiled, I felt like crying. I knew that she was the woman I wanted to marry. Every time I see her, I saw..." The last three words are "Le esta ela," which Mrs. Andres translates along with House as "There she is." She seems fond of him. She says, "He's still in there." Then Andres he asks who she is. House has a heart of stone: "Don't get your hopes up. Have your boyfriend get me those samples."
Wilson tells Mr. No-Sex that House just happened to notice a tumor on the blood tests. And he admits that there might be some behavioral changes. Increased libido, specifically. The guy interprets that as the treatment making him want to have sex, which freaks him out. The wife tells him maybe it won't be so bad. "It's actually pretty fun... from what I remember." Wilson looks away (but is still like a foot from them). The guy is uncomfortable.
Foreman meets with a big donor who wants to see a five-year plan for the hospital. He keeps glancing at flowers on the table. They're from last week, so they should be dead by now. Foreman gets the Epiphany Shot! Good for him!
Foreman tells House it's Reye's syndrome. The aspirin that caused it wasn't in the medicine cabinet. Mrs. Andres ground it up for the soil. House agrees with the diagnosis. Clearly, Andres had a sore throat, took an aspirin, and repeated... a lot. And Foreman has already had Chase start him on steroids. "So why tell me?" "Because I wanted you to hear it from me." Foreman walks away, somewhat smugly.
Andres wakes, smiles at his wife, and says, "There she is." And he asks what happened to her eye. "Nothing I can't handle," she says, choosing not to tell him that he punched her in the face.
House plays with a lighter. Wilson comes in to say that the guy was diagnosed with macroprolactinoma. He's doing the treatment. "And the wife?" Wilson hands House a hundred-dollar bill. House soothes Wilson with the thought of saving a life. He does, in fact, set the bill on fire and light a cigar. Wilson lights his own cigar, because why not? Wilson does feebly object that they can't smoke in there, but he doesn't seem that insistent on it. A guy enters. "Is one of you Dr. House?" It's an order to deactivate and remove his ankle monitor.
Chase, to strummy guitar music, calls his sister. It's been years. "I thought of you on mom's birthday." He awkwardly makes small talk. I don't care about Chase's long journey to this phone call.
House enters Foreman's office. Foreman signs on to that training wheel metaphor. House knocks over his pencil cup in as petty a manner as possible, which made me laugh. Out loud, as the kids say.
Follow Monty on Twitter at @montykins and read his blog, Mysterious Exhortations.
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