House, M.D./Poison

Poison
Season 1, Episode 8
Airdate	January 25, 2005
Production Number	108
Written by	Matt Witten
Directed by	Guy Ferland
Stream
← 1x07 Fidelity	1x09 → DNR
House, M.D. — Season One

Poison is the eighth episode of the first season of House, M.D..

Starring: Hugh Laurie (Dr. Gregory House), Lisa Edelstein (Dr. Lisa Cuddy), Omar Epps (Dr. Eric Foreman), Robert Sean Leonard (Dr. James Wilson), Jennifer Morrison (Dr. Allison Cameron), Jesse Spencer (Dr. Robert Chase)

Guest Starring: Roxanne Hart (Margo Davis), John Patrick Amedori (Matt Davis), Kurt Fuller (Mark Adams), Andy Milder (Bus Driver), McNally Sagal (Mrs. Miller)

and Shirley Knight (Georgia Adams)

Co-Starring: Jim Lau (Chou-Young Ling), Linda Wang (Jen Ling), Molly Mankiewicz (Amy), Kenya D. Williamson (Nurse), Christopher Malpede (Math Whiz), Ulysses Lee (Chi Ling)

Plot Overview

Student Matt Davis collapses during his AP calculus exam, and Foreman is intrigued by the case. House thinks it's drugs, although Matt's mother Margo denies this. Further seizures lead House to believe it's a pesticide, but the staff needs to determine the precise pesticide to treat it. Cameron finds an empty can at his home, but Margo says the pesticide was cleaned out and refuses treatment, so House bullies her into allowing it just as an unrelated kid from a distant home is admitted with the same symptoms. Chase and Cameron check the schoolbus for toxins and find one, but Margo has referred Matt's case to the CDC, so House sends Cameron – the only doctor on his staff Margo does not yet distrust – to convince her. Despite their efforts, both boys worsen under the treatment. Another check of both homes leads House to hypothesizes that the pesticide came from laundry detergent used on their new clothes. Parents of both boys say the new clothes were worn without being washed. House concludes that the clothes themselves were contaminated with the pesticide and he has Chase con Margo into thinking the CDC is stalling her to convince her to allow treatment. Both kids improve, proving the clothing theory was correct. When he is conscious, Matt admits that he bought the clothes very cheaply from the back of a truck. House's team learns that the truck driver used the same truck to haul pesticides and had a spill which he did not clean up before he loaded the stolen clothes.

Clinic Patients

• Georgia Adams: An 82-year-old mother who comes to the clinic and tells House she feels good. "When I see a guy with a cute butt," she says, "I can't stop looking at him. Or... a sexy beard," she says while looking at House's beard. She describes her sexual fantasies about Ashton Kutcher and says Kutcher and House have the "same bedroom eyes." "People are always mixing us up," House says. Georgia offers to let House check her heart and starts to open her blouse. He declines, but says he wants to run tests. As he leaves, he says, "I'll have a nurse come in and admit her. I'm too handsome to do paperwork." Later, House diagnoses her with syphilis. Her obnoxious middle-aged son Mark is at first offended, but Georgia confesses to have contracted a case in 1939 on prom night. The shocked and horrified Mark says, "You said Dad was your first love," to which Georgia replies, "He was. We're talking about sex." House assures her by saying, "It's the 21st century. We've got flying cars, robot dogs and penicillin," the latter of which he prescribes. Still later, she comes back to the hospital to ask if the feelings of sexual euphoria she has are all the result of syphilis. He tells her they are. She therefore returns his prescription, even though she will die, because, "It's not likely I'm going to infect anyone. ... And... I really don't want to play canasta for the rest of my life. I-I like feeling sexy again and.. making a fool out of myself with handsome young doctors." House smiles and asks her, "Do you think that I would have given you this if it would stop you from flirting with me?" He explains that the brain damage caused by the bacteria has already been done and cannot be reversed, so she is "doomed to feeling good for the rest of your life." She thanks him and promises him, "When I stop being contagious, I'll come by for a check-up."

Notes

Medical Terms

(See the Medical Dictionary for all definitions.)

• When Foreman first presents Matt Davis' case to House, he says Matt had severe bradycardia and did not respond to atropine. House dismisses it as drugs and recommends charcoal and naloxone. Still trying to convince House, Foreman mentions Matt's clean CAT scan and says, "It's not diabetes."

• Once House agrees to take Matt Davis' case, he turns to his staff for a differential diagnosis. Cameron hypothesizes shigellosis, but that doesn't fit with the bradycardia. Chase hypothesizes viral myocarditis, which doesn't fit with the neurological symptoms. When House says the tox screen turned up nothing, Chase suggests it might be a poison not typically found by a tox screen, such as 1,4-Butanediol, which House says has the "same punch as GHB. Little pricier, way more dangerous."

• When Matt Davis has a seizure, Chase orders diazepam.

• House comes across Cameron and Foreman testing Matt Davis' tomato sauce in the lab, which Cameron says could have caused botulism or other infection which may have led to gastroenteritis. House eats some of the tomato sauce and reveals that Matt has had a seizure. They deduce he has been poisoned by a carbamate, organophosphate or organochlorine.

• After House and his staff identify Matt Davis' illness as an organophosphate poisoning, they prescribe pralidoxime.

• House and his staff return to the drawing board. Foreman mentions the work done by one of his professors, but says, "There's a different hydrolase treatment for each poison. We need to know if Matt got hit with Orthene or Malathion...."

• To keep Matt Davis' heart beating, Chase inserts a tube "through the superior vena cava, into the right atrium, through the tricuspid valve, and lodging to the wall of the right ventricle."

• When she goes to the Davis home to investigate the pesticide poisoning Matt, Cameron finds an empty can of disulfoton.

• As Matt Davis' condition deteriorates, House tells Chase to give him more oxygen. Chase says, "We're risking damage to his retina."

• House tells Georgia Adams she has syphilis, which she calls Cupid's disease and for which she was treated 60 years earlier. House says, "Now it's back, and the spirochetes that cause syphilis are eating away at your brain cells." Georgia calls that revolting, but House says, "It's not as revolting as chlamydia." He prescribes penicillin.

• After she and Chase have checked the schoolbus for pesticide contamination, Cameron reports back to House, saying, "The county's worried about West Nile so they sprayed ethyl-parathion right next to the bus route."

• Once the bus pesticide has been ruled out, House realizes that they were poisoned through the skin before they got on the bus. He asks Cameron about their acne cream, which she says contains lanolin, which may be contaminated. She, House and Foreman list other products containing lanolin, including shaving cream, deodorant and flea powder.

• When Georgia comes back to House after he has released her, he says, "The fact that the sexual pleasure center of your cerebral cortex has been overstimulated by spirochetes is... it's a poor basis for a relationship. I learned that one the hard way."

• As Foreman and Cameron desperately check the two boys' houses for common products, Chase tells House, "Matt's ALT's are up to eight hundred. If they get any higher, we can toss his liver."

• After House deduces the offending pesticide was on the boys' clothes, Foreman runs tests and identifies it as phosdrin.

Arc Advancement

Characters

• House and Foreman: Several references are made to the similarity in the characters of House and Foreman. As Foreman and Cameron search the Davis home for signs of drug use, Foreman says House believes it is a drug overdose because House is himself an addict (Foreman says to Vicodin, although other episodes suggest that is not the only drug which House may abuse). Cameron says Foreman is "deflecting a personal question with a joke," like House does, and points out they have "matching gym shoes." Later in the episode, Foreman tells Margo Davis that House assumed she was wrong, as most of their patients often are, and she accuses him of being "just as pompous and superior as [House] is." At the end of the episode, as she and Matt are checking out, Margo calls House and Foreman "the arrogant jerks that saved your life." House and Foreman overhear this and notice they are, indeed, wearing the same shoes. It had previously been suggested in 1x07 - Fidelity that House rides Foreman harder than he does Cameron and Chase. Later episodes will play up that Foreman, although more respectful of authority and protocol, is as brilliant or almost as brilliant a medical mind as House is, and that he may share other similarities with his mentor.

Trivia

The Show

• Parental Advisory: This episode originally aired with a parental advisory.

• Real Time vs. Episode Time: The fact that Matt Davis is taking his AP calculus exam suggests this episode takes place in May, although it aired in January. Later in the season, references would be made to suggest that episodes take place more or less when they air, and that one episode represents one week in the characters' lives - even more if there is a break between new episodes. However, that "real time" connection has clearly yet to be implemented at this point in the series. For instance, although the story in 1x05 - Damned If You Do ends on Christmas Eve, it aired a week and a half earlier on December 14. Thus, although the succeeding episode, 1x06 - The Socratic Method, aired four days before Christmas on December 21, it would theoretically have taken place anytime between December 26 and mid-May, as would 1x07 - Fidelity. Also, 1x04 - Maternity aired in early December, but a clinic patient whose baby is due in late March is due in five months, which would place the episode time around late October.

• Foreman's Alma Mater: As House and his staff discuss more effective cures for Matt's pesticide poisoning, Foreman mentions the work done by one of his professors at Columbia University. In the pilot, Foreman claimed to have attended Johns Hopkins University, but it is possible he completed his undergraduate coursework at one university and his graduate coursework at the other.

• "I Hate Sports Metaphors": House realizes that someone needs to talk Margo Davis out of contacting the CDC, but she has already expressed her dislike for House, Chase and Foreman. House says, "Well, only one man left in the bullpen, and he throws like a girl," indicating Cameron. Cameron sighs and says, "I hate sports metaphors." This is the first time she says this sentence, although she would repeat it several times throughout the series, and it would become a catchphrase for her.

Behind the Scenes

• Lead-In: This was the first episode to have American Idol as its lead-in. (The promos at the time compared House to Idol's Simon Cowell.) Although ratings were already relatively strong with The Rebel Billionaire as the lead-in, the boost from the more popular Idol would help make this a runaway hit.

• Chase's Accent: Throughout the episode, House teases Chase for being British (although he knows Chase is Australian). In the end, when Chase poses as a caller from the CDC and calls Margo Davis, House hears Chase repeat his fake Southern American accent and says, incredulous, "You fooled her with that?" This is, of course, something of an inside joke. Although actor Jesse Spencer is, indeed, Australian, Hugh Laurie is British, and thus every line he speaks as House is a line done in a faked American accent.

Allusions and References

• Gone with the Wind: Georgia Adams claims she first noticed her increased sexual awareness when she got the wrong DVD in a rented copy of Gone with the Wind. The 1939 film Gone with the Wind, about the life of a Southern belle who survives the Civil War and subsequent restructuring of the South, starred Clark Gable and Vivien Leigh. It received 13 Oscar nominations and won 10 (counting two non-competitive awards), including Best Picture. It was also the highest grossing picture in Hollywood history for almost 30 years, and it is still considered a classic.

• Ashton Kutcher: The DVD Georgia got instead of Gone with the Wind is a film starring Ashton Kutcher, about whom she has sexual fantasies. She tells House he reminds her of Kutcher, and he says, "People are always mixing us up." American actor and heartthrob Ashton Kutcher first rose to prominence in the TV series That '70s Show, but at the start of the 21st century, he became a major star with his appearances in such films as Dude, Where's My Car?, Just Married and Guess Who. More recently, he has become equally notable as a TV producer, as he is one of the key figures in the creation of Punk'd and Beauty and the Geek. (It should probably go without saying that Kutcher and Hugh Laurie look almost nothing alike, although Kutcher does sometimes wear a scraggly beard.)

• Godot: When Chase says Margo Davis will not allow any treatment until she hears from the Center for Disease Control, Wilson sarcastically remarks, "Godot would be faster." The 1952 absurdist play Waiting for Godot by Samuel Beckett tells the story of two tramps - Vladimir and Estragon - who wait, day after day, to meet a mysterious character named Godot. In the end of the play, Godot never arrives.

Quotes

• House: I am extremely disappointed in you. I send you out for exciting new designer drugs, and you come back with tomato sauce. Bet you paid twice as much. I got mine online.

• House: I assume "minimal at best" is your stiff-upper-lip British way of saying, "No chance in Hell."

Chase: I'm Australian.

House: You put the Queen on your money. You're British.

• House: What can I say? Chicks with no teeth turn me on.

Wilson: That's... fairly disgusting.

• Margo Davis: Who are you?

House: I'm the doctor who's trying to save your son. You're the mom who's letting him die.

• House: Mr. Adams, would you step outside for a moment?

Mark Adams: Why?

House: Because you irritate me.

• Cameron: I hate sports metaphors.