House, M.D./Histories

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Histories
House-Histories.jpg
Season 1, Episode 10
Airdate February 8, 2005
Production Number HOU-111
Written by Joel Thompson
Directed by Daniel Attias
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House, M.D.Season One

Histories is the tenth episode of the first season of House, M.D..

Starring:

Guest Starring: Leslie Hope (Victoria Matsen), Larry Clarke (Officer Gilmar), Smith Cho (Julia), Ogy Durham (Chris Dewey)

Co-Starring: Leslie Karpman (Jodi), Charles C. Stevenson, Jr. (Walter), Suzanne Ford (Mrs. Whitney), Tomiko Martinez (Tall Girl), Patty Onagan (Girlfriend), Bonnie Perlman (Mom), Farrah Skyler Greye (Nurse), Troy Robinson (Cop #1), Paul Sklar (Cop #2), Kevin Moon (EMT), Brandon Brocato (Phil)

Contents

Plot Overview

A homeless woman collapses at a rave where she is looking for someone named James. Foreman is ready to dismiss her case, but Wilson insists something is wrong and convinces House to take the case, although she has no medical history on which to base a diagnosis. In a fit of dementia, the woman bites Foreman. He investigates her tent and finds bats and a series of comic books she has drawn about a character named "Mr. Fury." A surgical pin reveals her name as Victoria Matsen. As Chase and Cameron find what they believe to be ovarian cancer or tuberculosis, House delves into Foreman's and Wilson's past to find out why they are at odds over the case. Victoria suffers light sensitivity, a fear of water and high fever, indicating the benign tumors on her ovaries are not her biggest problem. She also escapes the hospital despite being under heavy sedation. The cops bring her back, and House learns she is numb in part of her leg, and Foreman is numb where she bit him, proving she has an advanced case of rabies. Foreman and Wilson investigate and learn that James is her baby son and Mr. Fury her husband, who were killed in a car accident she survived. Foreman poses as her husband to forgive her. After she is dead, House learns Wilson has a homeless brother.

Clinic Patients

  • Angela Whitney: (Note: Unseen doctor's patient.) A high-maintenance, overprivileged plastic surgery patient whose data Foreman swipes to get Victoria Matsen scheduled for an immediate MRI.
  • Diamond Kids: Three children whose mother admits them because "the little ones are licking each other again, and Harry's got a seeping wart on his extra toe." House sneezes to fake a cold and avoid treating them, leaving them instead to Cuddy.

Notes

Medical Terms

(See the Medical Dictionary for all definitions.)

  • When Victoria Matsen first starts seizing, Wilson orders Ativan. Foreman checks and finds her blood sugar is low, so Wilson also orders D-50.
  • Despite the seizure, Foreman is still convinced Victoria merely has diabetes and took too much insulin. Wilson thinks her twitch indicates a tumor, which is why he has consulted Foreman, a neurologist.
  • Once House takes on Victoria's case, he asks his staff for a differential diagnosis on the twitch in her arm. Chase hypothesizes a subdural hematoma, but Foreman counters there is no evidence of this. Cameron agrees with Wilson that it could be a tumor, so Foreman dismisses it, saying, "If you're so worried about it being a brain tumor, get her an MRI. When she's clear on that, then you can bounce her out of here." They find insulin in her bag and a sweater covered in vomit, which House tastes to find a salty taste. To correct the probable malnutrition, House orders a banana bag.
  • When Victoria suffers a fit of dementia, Foreman orders Ativan. She bites him, but Chase assures him "she's negative for HIV and Hep C." Nonetheless, Foreman vows to get a tetanus vaccination and demands Victoria get an MRI.
  • As Cuddy chews Foreman out for stealing another patients MRI to give to Victoria, Foreman defends himself by saying the doctor whose patient was stolen is a plastic surgeon. Cuddy says a surgical pin appears in Victoria's CT scan, which would be dangerous in the magnetic MRI. House argues that neurologist Foreman believes Victoria has a brain tumor (Foreman does not), and that is why she needs an MRI immediately.
  • After Foreman sees Victoria's medical history, he gave her iron dextran - to which she is allergic - to treat anemia. Chase gives her epi for her allergic reaction.
  • Cameron's study of Victoria's medical history finds she was prescribed Prozac for depression. A cancelled appointment with an oncologist leads Wilson to conclude she may have ovarian cancer, but Chase says her CA-125 is normal. Foreman adds that cancer does not account for her symptoms, but House hypothesizes that it may be neoplastic syndrome from the cancer.
  • The ultrasound of Victoria's ovaries turns up a mass, which Wilson says shows signs of necrosis. House suggests it might not be cancer but, rather, a tuberculoma. "The odds are she's got TB," he says, "why can't she have a nice, benign growth to go with it?" Although ovarian cancer is more likely, House orders INH, rifampin and streptomycin - a tuberculoma treatment, because that at least is treatable, while ovarian cancer is a death sentence.
  • Although Victoria's fever rules out a tuberculoma as her sole problem, a biopsy confirms she does, in fact, have one. To explain the fever, Cameron hypothesizes serotonin syndrome from the Prozac. House prescribes Bromocryptene to treat this and orders more tests.
  • After her ice bath, Victoria's lumbar punctures show that her white blood cell and protein counts are high. Her CSF test is not done yet, and her Gram stain is inconclusive, so Cameron hypothesizes meningitis, for which House prescribes Ceftriaxone.
  • When Foreman tells Wilson and Cuddy of Victoria's escape, Wilson accuses Foreman of screwing up, saying she couldn't walk with Haldol in her.
  • House's student Julia hypothesizes that Jodi, the ultra-thin woman admitted with a sprained wrist and wildly different stories of how it was sprained, has Cacchi-Ricci disease, which House dismisses outright. When Jodi's story changes again, House reveals Jodi's real problem is Korsakoff's syndrome, which prevents her from making new memories, and for which he prescribes thiamine.
  • When Officer Gilmar brings Victoria back to the hospital, Foreman orders adenosine for her supraventricular tachycardia.
  • Foreman manages to stabilize Victoria's arrhythmia, but he is stumped by what caused it.
  • All of Victoria's symptoms lead House to diagnose rabies, which tests confirm, but her case is too advanced to treat.

Music

  • "On Fire Like This" by Mutaytor: Victoria Matsen visits a rave.

Arc Advancement

Happenings

Characters

  • Wilson: Wilson reveals that he has two brothers. House claims to have met one. The other is a homeless man whom Wilson says he does not know whether he is alive.

Referbacks

Trivia

The Show

  • Parental Advisory: This episode originally aired with a parental advisory at the beginning.
  • $100 Bill: The bill House tries to bribe Officer Gilmar with is clearly fake, as the portrait of Benjamin Franklin looks nothing like that of a real $100 bill.

Behind the Scenes

  • Kaplow's Pawn Shop: One of Victoria's drawings depicts "Kaplow's Pawn Shop," a reference to series writer/producer Lawrence Kaplow.

Allusions and References

  • Alien Series: When Cuddy chastises House and Foreman for trying to give an MRI to a patient with a surgical pin, she asks, "Do you like the Alien movies?" The Alien movie series began in 1978 with the Ridley Scott-directed film of that name, about a spaceship which picks up a strange, vicious, unkillable alien life form on another planet. Three official sequels were made: Aliens in 1986, Alien3 in 1992 and Alien: Resurrection in 1997, and in 2004, the monsters from Alien were paired up against the alien hunters from another popular film series in AVP: Alien Vs. Predator. The Alien films are all famous for their imagery of the Alien's offspring bursting violently out of the stomachs of their hosts - usually humans.
  • "Baby, It's Cold Outside": As Cameron reviews Victoria Matsen's medical history, she reveals that Victoria was treated for frostbite. Foreman says, "Baby, it's cold outside." This is the title of and lyrics from a 1949 Oscar-winning song by composer Frank Loesser, about a romantic couple trying to end their evening together who convince themselves not to end it, because it is too cold to go home.
  • The O.C.: When Wilson finds House studying Foreman's background for a clue to his hatred of homeless people, Wilson says, "You really don't need to know everything about everybody." House counters, "I don't need to watch The O.C., but it makes me happy." The O.C. is a nighttime soap opera that, like House, M.D., airs on FOX, about the trials and tribulations of a kid from the mean streets who is adopted by a family in wealthy Orange County, California.

Memorable Moments

  • Foreman investigates the unknown homeless woman's name and returns with comic books and other drawings he found in her tent. House examines a desert landscape drawing and claims to see Philadelphia. He and Wilson claim to see a smashed car in a cactus and the month of October symbolized by the water. He even claims the page number 22 gives him an exact date: October 2, 2002, meaning she was in a car accident in Philadelphia on that date. At last, they reveal to House's staff they have gotten all the information, including the patient's name - Victoria Matsen - by tracing the surgical pin they removed from her arm.
  • Cuddy has given House two students - Julia and Chris Dewey - to train. They work on the case of an ultra-thin young woman with a sprained wrist and wildly diverging stories of how she came to sprain her wrist. House tells the students the answer to her problem starts with "C." After the students turn up nothing, House visits the patient while wearing a pin of a bird and carrying a notebook with a picture of a Ferris wheel on it. He asks the patient, Jodi, how she sprained her wrist, and Jodi claims to have been attacked by a seagull while she was on a Ferris wheel. House reveals that Jodi has Korsakoff's syndrome, and her brain is filling in the lack of memories with visual cues, as it did when Julia and Chris interviewed her. Julie points out that "'Korsakoff' doesn't start with a 'C.'" House says, "I didn't say 'C.' Or did I? Lesson to be learned: Treat everybody as if they have Korsakoff's. We all lie, anyway." When Chris says House was cruel to Jodi and made her cry, House re-enters the room and again asks how she sprained the wrist. This time, Jodi starts to tell the story of "this weird old guy. He had a cane." House turns to his students and says, "See? It's like it never happened. Perfect forgiveness."

Quotes

  • Wilson: You know, in some cultures, it's considered almost rude for one friend to spy on another. Of course, in Swedish, the word "friend" can also be translated as "limping twerp."
  • Chris Dewey: You're reading a comic book.
    House: And you're calling attention to your bosom by wearing a low-cut top. Oh, I'm sorry, I thought we were having a "State the Obvious" contest. I'm competitive by nature.