House, M.D./Three Stories
From The TV IV
Three Stories is the twenty-first episode of the first season of House, M.D., and the twenty-first episode overall. On many fan websites and forums, it has been voted as not just a highlight of the first season, but the highlight. Many go so far as to name it a highlight of its era in television. The praise is not limited to fans of the show. The episode was a factor in the series winning a Peabody Award for 2005, and it was awarded an Emmy for "Outstanding Writing for a Drama Series." (As television is a writer's medium, this is considered the highest honor the Emmys can bestow upon an episode of a dramatic series.)
Guest Stars: Sela Ward (Stacy Warner), Nicole Bilderback (Caring Student), Andrew Keegan (Rebellious Student), Josh Zuckerman (Keen Student), Brent Briscoe (Farmer), Stephanie Venditto (Brenda), James Saxenmeyer (Late 30s Man), Carmen Electra (Carmen Electra)
Cuddy orders House to teach a diagnostics class while the professor is sick. Meanwhile, House's ex Stacy Warner asks House to examine her husband, but House does not want to help. House presents the class with three cases of leg pain: A Farmer fixing a fence, a teenaged Volleyball Player and a golfer. One will be near death within two hours, and one will be expelled from the hospital as a drug addict. The Volleyball Player has a simple case, but Cameron gets too involved and orders painful tests. The golfer swipes narcotics and injects them into his leg. Chase and Foreman find a rattlesnake as the Farmer's problem, but he has an allergic reaction to the antidote. Tests show the Volleyball Player has a thyroid problem. House realizes the newly caught snake has too much venom in it and he orders an antidote for a different snake. He subjects the drug addict to a painful test. The Volleyball Player becomes hypersensitive to touch, the Farmer's condition worsens, and the addict has blood in his urine. The Farmer has no family, and his dying thought is for his dog, so House realizes the dog bit him. The drug addict is suffering muscle death, but the doctors do not catch it, although the addict himself does. The Volleyball Player has a tumor in her leg. All three may require amputation. Foreman and Cameron realize the drug addict is House. In the past, House orders bypass surgery for his leg over Cuddy and Stacy's objections. After the surgery, House suffers pain and goes into cardiac arrest, where he sees the Farmer - who survives the amputation - and the Volleyball Player - who keeps her leg. While he is in a coma, Stacy authorizes the removal of the muscle, although she knows he would object. Back in the present, House's class - which had started out only one-third full, but is now overflowing with listeners, including Foreman, Chase, Cameron, Wilson and Cuddy - is over. House calls Stacy and accepts her husband as a patient.
- Stacy Warner: Stacy first comes to House in the clinic to request that he examine her husband, but he refuses.
- Farmer: House tells the class that all three case studies have come to the clinic. As a case study, the Farmer is therefore included.
- Volleyball Player: Because she is another case study, she is also a clinic patient.
- Gregory House: When it is revealed that Carmen Electra/the Late 30s Man is House, it is thus revealed he was a clinic patient.
In a rare occurrence for the series, three regular characters appear in the cold open: House, Cuddy and Stacy.
(See the Medical Dictionary for all definitions.)
- House tries to bow out of teaching the class by saying he may have the clap. Cuddy says she wants him either because the world hates him or because the class is on diagnostic medicine. "Pick whichever reason feeds your narcissism better."
- House says Stacy's husband's charts are not indicative of vasculitis and he is "poorly endowed," as his "pancreas is pathetic."
- House tells the class about 12% of leg pain is due to varicose veins caused by pregnancy.
- The Farmer tells House he has no family history of osteogenesis imperfecta or multiple myeloma. The Caring Student recommends a CBC and D-Dimer to look for blood problems. The Rebellious Student also recommends an MRI for vascular problems, and he and the Caring Student argue over whether an MRI or a PET scan is more useful.
- Cameron tells the middle-aged man substituting for the Volleyball Player he has tendinitis.
- Cameron finds no Parkinson's in her thorough family history of the Volleyball Player.
- Cameron's thoroughness with the Volleyball Player turns up a possible problem with her thyroid gland.
- House finds a lack of reflexes in the golf-playing Carmen Electra's patellar tendon. The Rebellious Student hypothesizes a slipped disc. Once Carmen becomes the screaming Late 30s Man, the Rebellious Student orders Demerol.
- Once Chase has identified the responsible snake, Cameron treats the Farmer with CroFab antivenom. When he has an allergic reaction, she orders epi.
- House tells the class that the Volleyball Player's T4 was low on her biopsy, which he had earlier implied was unnecessary.
- Cameron treats the Volleyball Player with thyroxine.
- Foreman tells House the Farmer's allergic reaction was controlled by epinephrine.
- To find out if he is really sick, House inserts a "hard rubber tube" into the Late 30s Man's urethra.
- After the Volleyball Player becomes hypersensitive, Chase hypothesizes adenoma on her parathyroid and hyperthyroid.
- At the Caring Student's request, House slowly tells the class he told his staff to check the Volleyball Player's PTH.
- House orders his staff to perform a tecnetium sestamibi on the Volleyball Player. He changes the subject and jumps ahead three months to the Farmer. Cameron says she has tried giving him the first antivenom plus steroids.
- House asks the class for a differential diagnosis on the Late 30s Man's tea-colored urine. He says the "blood tests show elevated creatine kinase," or CK. After Cameron reveals the answer House is looking for is muscle death, the Caring Student says that would release myoglobin.
- Cameron finds an osteosarcoma on the Volleyball Player's femur on her MRI.
- Foreman tells the Farmer that their tests of his dog's saliva turned up the strep bacteria responsible for flesh-eating disease.
- House tells the class the Late 30s Man's muscle death was caused by an aneurysm that clotted that lead to an infarction.
- Once the drug addict has been revealed as House, Cuddy tells him, "The necrotic tissue has to be removed."
- Trying to convince him to get an amputation, Cuddy says the dead muscles release cytokines.
- As House is in agonizing pain after his surgery, he begs for more morphine.
- House requests more calcium gluconate because his QRS is widening. He warns if he does not get it, he will go into tachycardia.
- Cuddy warns Stacy that, even in removing House's muscle, there is a risk of reperfusion injury.
In a series which has been criticized as formulaic, Three Stories flaunts its defiance, not just of the formula of the series, but of procedurals, medical dramas and linear storytelling itself. Three Stories even rewrites the rules of nonlinear storytelling. House's contemporary Lost made frequent use of flashbacks, and the Seinfeld episode 9x08 - The Betrayal told its story with the scenes in reverse chronological order, three years before the film Memento would become famous for the same gimmick. But in most stories which use flashback, the flashback illuminates the present plot. In Lost, for instance, the flashback - before the characters came to the island - illuminates an aspect of their story in the present - on the island - and thus alters our understanding of that story. The same is true of the flashbacks in Twin Peaks and The X-Files. Yet in Three Stories' single-viewpoint narration, the truth of the flashback itself is disguised and then illuminated in the present story, altering our understanding of the flashback. This in itself is not unusual. One of the most famous instances of this device is executive producer Bryan Singer's classic film The Usual Suspects. However, in that film and most other instances, the revelation of the truth about the flashback is a twist ending. Here, it is a twist plot development which changes both everything we've been told about the story thus far and the remainder of the story, of which there is quite a bit. At other points, the flashbacks become indistinguishable from fantasies, and characters from the present interact with the flashback/fantasy characters as though they were physically present, or characters in flashbacks react to House's narration as if he were speaking it in their time. As House himself says in a line which Einstein would approve, "Luckily, it's been well-established that time is not a fixed construct." And yet Three Stories is never intentionally confusing nor opaque, as is so often the case in stories which use first-person narration in this manner.
If only due to these fourth-dimensional alterations, were Three Stories a feature film, it would be the subject of film crit students' graduate theses for decades to come. But it is not a feature film. It can only be an episode of House, M.D. No other medical drama has a main character with the quirks which make this episode possible. Much of its dramatic tension is the result of it being the first episode in which House's character history and that of other series characters is revealed in more than just innuendo and off-handed references. Also, like many episodes of Lost - albeit far more subtly than that series - Three Stories raises as many questions as it answers. It is funny, touching, intelligent, emotionally charged, full of action and dramatic - an example of this series at its best.
- House and Cuddy: Through House's flashbacks, we learn Cuddy was someone important at the hospital - perhaps even the administrator. Although she herself did not treat him and thus did not overlook the problem which led to his muscle death, she informed Stacy and consented to her decision to remove the muscle, which is why House no longer has full use of the leg. Although it is not stated conclusively, the way House speaks of her in the flashbacks (e.g.: calling her "the doctor" instead of by name) suggests this may be the first time they have met.
- House and Stacy: Stacy sees House for the first time in five years, reveals she is married and presents House with her husband's case. Also, through the flashbacks, we learn Stacy was House's live-in girlfriend (although not his wife), and she made the decision - knowing House would object - to remove his leg muscle, saving his life but causing his permanent limp.
- 1x12 - Sports Medicine: Stacy Warner is seen on-screen for the first time. She was first referenced in that episode, as someone from House and Wilson's past with whom Wilson was having dinner. House also told Cameron he "lived with someone."
- 1x20 - Love Hurts: When House first sees Stacy, he tells her what he has been up to for the last five years. In that episode, Cuddy revealed House's last relationship ended five years ago, thereby proving Stacy was the relationship in question.
- First Appearance: Although she was first referenced in 1x12 - Sports Medicine, this is the first full appearance of Stacy Warner. In 1x20 - Love Hurts, House was seen looking over a photo booth picture of himself and another person. Although the pictures were only seen from behind, through a light, the other person's dark hair and high cheekbones are unmistakably those of Sela Ward, and thus Love Hurts is the character's first cameo appearance.
- Recurring Characters: All three credited nurses have appeared in this series before. Stephanie Venditto plays Brenda, the nurse who informs House of his clinic patient, who turns out to be Stacy. Brenda was previously seen in both 1x19 - Kids and 1x20 - Love Hurts. The character credited as Nurse #2, who assists Cameron as the Farmer has an allergic reaction is played by Bobbin Bergstrom - who is also the show's on-set medical advisor. In 1x17 - Role Model, Bergstrom played the ICU Nurse who assisted Senator Gary H. Wright as his condition worsened. And Nurse #3, who is with House as he predicts his own cardiac arrest, is played by Ingrid Sanai Buron, who played Kimberly, the nurse who attended to mobster Joey Arnello when he returned to the hospital after being released in 1x15 - Mob Rules.
- Unanswered Questions: Although several questions about House, Cuddy and Stacy's past are answered in the flashbacks, several more are left open. First of all, it is stated that House was a drug addict - to several narcotics - before he hurt his leg and Stacy left him. It is also suggested that House had much of his caustic personality at that time, as well. Most interestingly, although Wilson has already indicated, in 1x12 - Sports Medicine, that he knows Stacy from years ago, he is conspicuous in his absence from the flashbacks.
Behind the Scenes
- Awards: Writer David Shore won the Emmy for Outstanding Writing for a Drama Series for the 2004-05 season. Also, the Directors Guild of America nominated director Paris Barclay for Outstanding Directorial Achievement in Dramatic Series' Night.
- DVD Cover: The picture of House from the cover to the House, M.D.: Season One DVD is inspired by the scene in which House and Wilson discuss Stacy's return.
Allusions and References
- "Girls Gone Wild": When Stacy asks House how he has been, he says, "The last five years have been like... you ever see those 'Girls Gone Wild' videos?" "Girls Gone Wild" is a popular set of mail-order videos from Mantra Entertainment which features drunken young girls - most of them college students - baring their breasts, genitalia and buttocks in popular spring break destinations.
- Baywatch: House uses Carmen Electra for one of his case studies, and the Keen Student calls her "the Baywatch chick." Baywatch began as an NBC drama about lifeguards on a California beach. After one season, it became a syndicated series, which it continued to be throughout the remainder of its run. Although never praised for the quality of its acting and writing, for most of the 1990s, it was one of the most successful television shows in the world - at one point, its international viewership was estimated to be in the billions. Carmen Electra had already gained some success as a singer, model and MTV personality by the time she joined the Baywatch cast for its 1997-98 season, but her work on that show increased her celebrity dramatically.
- Meryl Streep: The Caring Student says Carmen Electra's pain "doesn't seem real." House says, "She's here to play into my fantasy, not 'cause she's Meryl Streep." American movie star Meryl Streep has received 13 Oscar nominations and two wins, three Emmy nominations and two wins, and 20 Golden Globe nominations and five wins for her work in such films as Sophie's Choice, Kramer vs. Kramer, Out of Africa and Adaptation. She is widely considered the finest living American actress.
- Cujo: When House realizes the Farmer was bitten by his dog, House calls the dog "Cujo," in reference to the dog in the novel of the same name by Stephen King about an enormous St. Bernard who contracts rabies and becomes a killing machine which terrorizes a stranded woman and her young son. Although King goes to great lengths to explain Cujo is a good dog until he gets sick, the name has become synonymous with large, vicious dogs of all breeds.
- The Keen Student, the Caring Student and the Rebellious Student have entered House's story/fantasy/flashback, in which he is examining the Farmer, who chews a staff of wheat and wears a straw hat and overalls. As the students argue over which tests to run on their patient, House says, "Bzzt! Sorry! Thanks for playing. The patient's dead. You killed him." The students see the imaginary Farmer lying dead on the table. House explains they should examine the hurt leg. The students look again, and now it is Carmen Electra chewing the wheat and wearing the Farmer's clothes, because, according to House, "If we're gonna look at a leg...." House asks Carmen to take off her pants and watches her longingly as she strips off her overalls. After she sits back down, he lets his eyes roll slowly down her leg until he sees a wound. He looks up and tells the class, "Puncture."
- House tests the golfer Carmen Electra's reflexes - with her pants off - and finds they are impaired. The three students appear in the fantasy, and House asks Carmen how badly her leg hurts. When her response is unconvincing, the Caring Student says, "It doesn't seem real." She guesses Carmen is the drug addict. "Oh, for God's sake," House says, "she's here to play into my fantasy, not 'cause she's Meryl Streep. Fine!" Carmen is replaced with a Late 30s Man who is screaming, "Do something!" House and the students try to ask where the pain is, but he is screaming too much to answer. The Rebellious Student orders a narcotic painkiller, but the Caring Student says he may be allergic. House holds the syringe in his hands waiting for a decision. While the students debate, the Late 30s Man snatches the syringe out of House's hand and injects it into his leg. "Apparently, he's not allergic," House says.
- House tells the class how the Farmer did not respond to the antivenom, and a long, ugly sore has opened on his leg. He also says only three poisonous snakes are commonly found in New Jersey, and only two of them have the type of venom for which the Farmer was treated. The Caring Student says, "So we give him the antivenom for the other one?" House asks, "Is that a question?" The Keen Student points out that could kill the patient and suggests they search for the right snake, as the one which bit the farmer may be less common. "No need," House says. "Odds are by the time you get back, the autopsy results will tell you what kind of snake it was." The Caring Student says, "So we do give him the antivenom for the other one?" House says, "Again, was that a question? I asked what you would do. It seems unfair for you to ask me what you would do." He asks the class how many of them would treat the Farmer with the other antivenom. Half of them raise their hands. When he asks how many would search for the right snake, the other half raise their hands. The Rebellious Student says, "I assume that one choice kills him, the other one saves him." House agrees. The Caring Student says, "So half of us killed him, and half of us saved his life." Again, House agrees. The Keen Student starts to object that they cannot be blamed for making the wrong call, but House interrupts him. "I'm sure this goes against everything you've been taught," he says, "but right and wrong do exist. Just because you don't know what the right answer is, maybe there's even no way you could know what the right answer is, doesn't make your answer right or even okay. It's much simpler than that. It's just plain wrong."
- House has colored a large tea-colored spot on a piece of paper. He says the Late 30s Man's urine was this color and asks the class for a differential diagnosis. The Caring Student hypothesizes kidney stones causing blood in his urine, but House says that only accounts for the yellow and red color of his urine, not the brown. The brown is caused by kidney failure, so House asks what might cause that. She hypothesizes trauma or infection. House asks what else it could be. She pauses, and he shouts, "Come on! Come on!" She says she does not know. "You're useless," House says, "but at least you know it." House reveals the results of the Late 30s Man's blood tests, and the Rebellious Student repeats the Caring Student's hypothesis of trauma and says the Late 30s Man should "take it easy for a few days." "You sure?" House asks. The Rebellious Student starts to explain, but House interrupts him to say, "You know what's worse than useless? Useless and oblivious." He asks the Keen Student for a diagnosis. The Keen Student stammers out that it's "hard to think when you're in our face." House shouts at him, "You think it's gonna be easier when you got a real patient really dying? What are you missing?" Cameron, who has just entered the auditorium, says, "Muscle death." House tells her it is not her case, but she says, "Nothing wrong with a consult."
- Cuddy takes over as the doctor on the Late 30s Man's case and tells him she may need to amputate his leg. We cut back to the class, where House says an aneurysm in the Late 30s Man's leg clotted and caused the muscle death. By now, Foreman, Chase and Cameron have all joined the class. "My God," Foreman says to Cameron, "you're right. It's House." We cut back to the scene with Cuddy, but now the Late 30s Man has been replaced by House.
- The night before each of their surgeries, we see how each of the three patients prepares for his or her possible amputation. The Volleyball Player's family prays over her. The Farmer writes, "NOT THIS LEG" on his good leg in Magic Marker. Stacy writes on House's good leg, "NOT THIS LEG!" On his bad leg, she writes, "NOT THIS LEG EITHER."
- House checks his own read-outs and orders more calcium gluconate from Nurse #3 based on their numbers. She says she will ask the doctor. "Well, you better make it fast," he says, "'cause I'm about to go into cardiac arrest." When she still protests, he shouts, "Listen, it's not a narcotic! I'm not looking for a buzz. You got about 20 seconds." Just as he says that, he starts panting, and his machine starts beeping. As he dies, he says, with mild surprise, "I was wrong."
- At House's request, Cuddy injects him with drugs to induce a coma so he can avoid the worst of his pain. Before House drifts off, he says to Stacy, "I'll see you when I wake up. We'll go golfing. I love you." "I love you, too," she says. "I'm sorry." Not realizing she is apologizing for something she has not done yet, House says, "You have nothing to be sorry about." He drifts off into his coma. Stacy walks immediately over to Cuddy and orders that House's muscle be removed. "You're saving his life," Cuddy says. "He won't see it that way," Stacy says.
- When class is over, House - who had taken over the class because the regular professor was sick for the umpteenth time in weeks - says to Cuddy, "I'm not doing this again." He picks up a hand-painted "World's Greatest Dad" mug he found in the desk and tried to drink water from but spat it out. "And this guy is not the World's Greatest Dad," he says. "Not even ranked. Who the hell lets their kids play with lead-based paint? That's why he's always sick. Find him some plastic cups, and the class is all his again."
- Stacy Warner: I know you're not too busy. You avoid work like the plague. Unless it actually is the plague. I'm asking you a favor.
House: I'm not too busy. But I'm not sure I want him to live. It's good seeing you again.
- House: Three guys walk into a clinic. Their legs hurt. What's wrong with them? (The Keen Student's hand shoots up.) I'm not gonna like you, am I?
- House: And C.), we've got Carmen Electra golfing.
Carmen Electra: (Makes a mini-golf shot.) Yes!
Keen Student: Whoa, whoa. Y-you treated the Baywatch chick?
House: The Baywatch thespian. And no. I gotta disguise the identity of each of the patients, and I got tired of using the middle-aged man. Carmen seemed like a pleasant alternative. Also, she's apparently quite the golfer.
- Keen Student: Well, obviously we should care about all our patients, no matter what age....
House: Yeah, right. I saw the way you were looking at Carmen. She's mine. Stay away.
- Cameron: I went back three generations. No history of cancer, Parkinson's or any other degenerative condition. But there's this boy at school, and he's on the boys' volleyball team, and they made out at a party, and now he won't call her back, and this friend of hers at school said this boy didn't like her and never did.
House: You got all this from an examination of the knee?
Cameron: I think she's depressed.
- Wilson: You think this is easy for her? The only reason she'd be anywhere near you is if she was desperate.
House: So I should help her because she hates me?
Wilson: She doesn't hate you. She loves you. She just... can't... stand to... be around you.
- House: On average, drug addicts are stupid. (Pops a Vicodin.)
- House: How do they teach you how to tell someone that they're dying? 'S kinda like teaching architects how to explain why their building fell down. Do you role play and stuff?
Keen Student: Yeah. One of us gives the bad news, and one of us gets the bad news.
House: What do you have to do to get an A in You're Dying 101? They grade you on gentleness and supportiveness? Is there a scale for measuring compassion? This buddy of mine, I gotta give him ten bucks every time someone says, 'Thank you.' Imagine that. This guy's so good, people thank him for telling 'em that they're dying. (Examines his drawing.) Eh, needs brown. I don't get thanked that often. (Cuts to him talking with the Farmer.) You're dying.
- House: It's a basic truth of the human condition that everybody lies. The only variable is about what. The great thing about telling someone they're dying is that it tends to focus their priorities. You find out what matters to them, what they're willing to die for, what they're willing to lie for.
- House: It is in the nature of medicine that you are gonna screw up. You are gonna kill someone. If you can't handle that reality, pick another profession.
- House: Patient made the right choice. Tell a surgeon that it's okay to cut a leg off, and he's gonna spend the night polishing his good hacksaw.
- Stacy: God, you're an idiot.
House: I think I'm more of a jerk.
- House: Personally, I choose to believe that the white light people sometimes see, the visions this patient saw, they're all just chemical reactions that take place while the brain shuts down.
Foreman: You choose to believe that?
House: Well, there's no conclusive science. My choice has no practical relevance to my life. I choose the outcome I find more comforting.
Cameron: You find it more comforting to believe that this is it?
House: I find it more comforting to believe that this... isn't simply a test.