Sunday, June 7, 2009

House: Maternity (Season 1, Episode 4)



Dr. House discovers an epidemic that strikes several newborn babies in the hospital’s maternity ward.

The Plot (Spoilers):

Karen & Ethan Hartig (Ever Carradine & Sam Trammell) name their newborn daughter Maxine. The baby spits up despite not having eaten anything and they call the OB/GYN (Kenneth Choi), who notices that she is lethargic and feverish. She then goes into a seizure.


The Hartig Family

Dr. House (Hugh Laurie) is watching his soap opera in the OB/GYN lounge when the Hartig’s OB/GYN and another come in, discussing the Hartig’s baby. The OB/GYN has diagnosed the problem as a bowel obstruction and thinks the baby will be fine.


House chillin' in the OB/GYN Lounge

House takes off to investigate himself and finds another newborn baby with a fever, diagnosed a few hours earlier. He decides there is an infection spreading through the maternity ward. He tells both Dr. Wilson (Robert Sean Leonard) and Dr. Cuddy (Lisa Edelstein) but neither believes him, so he takes his team through the maternity ward hunting for more sick babies. They find a third baby with a fever, and a fourth showing early symptoms, which convinces Cuddy to shut down the maternity ward.


Rounding up the sick babies

Symptoms include the spiking fever and plummeting blood pressure. Dr. Foreman (Omar Epps) says they could be dead within a day, and the four babies don’t seem to have had anything in common. Cuddy sets off to put together a team to start swabbing, while House and his fellows try to diagnose. They suspect a bacterial infection and have several possibilities. They don’t have time for tests so House starts them on vancomycin for MRSA and aztreonam for the others and orders MRIs, before heading to the clinic. The MRIs don’t show anything. Dr. Cameron (Jennifer Morrison) has trouble talking to a family to tell them how sick their baby is and Foreman has to step in. Cameron tells him giving bad news isn’t a hard as receiving it and that its easier to die than to watch someone die. Cuddy gathers up med students and has them search for the infection.

In the clinic, House sees a woman (Hedy Burress) who says she’s been feeling sick a lot and has been training for a marathon but can’t lose any weight. House determines that she’s pregnant (initially referring to the baby as a parasite) and shows her the baby on a sonogram. The woman has a birth control implant and says she was told she might not have any periods if it was working, and House points out the same thing could happen if it’s not working. She admits that she cheated on her husband with an old boyfriend at about the same time as the baby was conceived, so House offers a paternity test as well, but she doesn’t want her husband to find out. House asks is the old boyfriend resembles her husband and when she says yes he recommends that she just have the baby and her husband will never know.
House and the pregnant woman

Two of the babies are experiencing kidney failure caused by the antibiotics. If they leave them on both antibiotics they’ll die of kidney failure but if they stop both they’ll die of the infection. The team has no idea what the illness is or which antibiotic is causing the kidney failure, as it’s a possible side effect for either one. House order one baby be taken off the vancomycin and the other off the aztreonam, giving them different treatments for the same illness. House’s team and the hospital lawyer (Cress Williams) all express their concerns about the fact that one baby will almost surely die based on the flip of a coin, but Cuddy lets House go ahead in the belief that they will learn how to save the other six babies, of which there are now a total of six. Foreman tells the Hartigs that they think the disease is MRSA and they are keeping their baby on vancomycin and tells them how serious the situation is, preparing them for the worst, while Cameron gives the other family, whose baby is being kept on aztreonam, a more reassuring report that makes them feel relief. Wilson criticizes her for not preparing them for the worst, but Cameron says that if the worst happens they aren’t going to care what she said the day before and she’d rather give them some hope.

The pregnant woman from the clinic shows up at House’s office with her husband, saying he needs a blood test for “Mono,” which House eventually realizes means she wants the paternity test done, without him knowing. House agrees to schedule them for a test. Meanwhile, Cuddy is still on an obsessive search for the cause of the infection, while Wilson tries, with little success, to keep her calm.

Cuddy is handling the stress well

Dr. Chase (Jesse Spencer) is talking to a concerned Mrs. Hartig when the baby that was kept on aztreonam crashes and dies. House has Chase double-up all the babies on vancomycin and tells Cameron to tell the family. She tries to get out of it, first suggesting Chase do it and then saying House is the attending physician. House tells Wilson to make sure she does her job, but when she tries she freezes up and Wilson has to step forward and tell them himself.

Cameron has some bad news to deliver

Chase reports that the Hartig baby is also getting sicker: the vancomycin isn’t working either. House sends the team home for the night, and conducts an autopsy on the dead baby. The next morning House announces that they were on the wrong track all along: the autopsy showed a virus infected the heart.

House does an autopsy

The babies only have enough blood to do five or six tests, so House leads the team, along with Wilson and Cuddy, in a brainstorming session to determine which tests to run. They get to a list of eight, which Chase says is pushing it, but they go ahead with the tests. House asks if there are any babies left in the hospital who didn’t get sick, and Cuddy says there is one. House has his blood tested as well to serve as a control. The sick babies test positive for three of the viruses, and the healthy baby for two of them, and House realizes that as infants they still have their mothers antibodies, so to get the whole picture they have to test the mothers of the sick babies and whatever the babies test positive for but the mothers don’t is what they have. Testing the mothers reveals the answer is Echovirus 11, and the hospital gets a promising experimental antiviral to treat the babies.

Cameron feels sorry for the Hartigs being unable to hold their daughter, so she asks them to hold her while the nurse changes the sheets. In the morning, House asks Foreman how Cameron is handling things and he says she’s fine. House goes to the clinic to tell the pregnant woman that her husband is definitely the cause of her “mono.” She is thankful and wants to get House a gift; he replies that “sometimes the best gift is the gift of never seeing you again.” She asks him if he could handle her prenatal or deliver the baby, and he declines, but pauses as he leaved the exam room.

All the remaining babies recover and are released. House talks to Cameron, saying that anyone who is that awkward either has no experience with death or too much experience with it. He asks where she got the idea to have the Hartig parents hold their baby, and then asks if she lost someone. She leaves angrily.

House is hanging out in the lobby outside the maternity ward, looking for the source of the virus, which is only spread by humans. Cuddy has tested the staff, but the babies didn’t have any common personnel. He spots an elderly hospital volunteer (Donna Stearns) with a hacking cough handing out stuffed animals.

The spreader of the virus

House is again watching his soap opera in the OB/GYN lounge. The OB/GYNs from the beginning come in and tell him he isn’t supposed to be there, and House says he’s performing a delivery for a patient he just took on and will need one of them to supervise. He gives them the due date and when they say that its 5 months away, House replies “Thank God these chairs are comfortable.”

At least now he has an excuse

My Review:

Episode 4 is the best yet with an interesting mystery that doesn’t quite fit into the typical “patient of the week” formula, some drama with Cameron and some humor with House and his clinic patient. The dialogue in this episode is especially good. In addition to House, Wilson and even Cuddy get some fun lines. Cuddy cutting off the med student’s tie is a high point. As far as House’s team goes, Cameron gets the focus in this episode, like Foreman did in the last one, and it’s hinted that Cameron has some tragedy in her past, but we don’t get any details yet. They were already doing a good job, but now the actors seem to be getting comfortable with their roles and their interactions seem to be a little more natural. I think the interaction between Wilson and Cameron is the first significant interaction Wilson has had with any of House’s fellows, and I think it is also the first time Cameron’s first name, Allison, is mentioned on screen. Also, during the autopsy, House gives the date, Thursday, December 2, 2004, which was within a week of this episode’s original airdate, for what that’s worth. I don’t really like how the babies are saved with an experimental drug; it seems like if this were real life, the story wouldn’t have had a happy ending. Despite that one point, Maternity is still a great episode of House.

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