Sunday, June 7, 2009

House: Paternity (Season 1, Episode 2)


Dr. House and his team diagnose a 16 year old lacrosse player with blurry vision and night terrors, while House makes a bet with his colleagues over the patient’s father.

The Plot (Spoilers):

A high school lacrosse player (Scott Mechlowicz) experiences double vision during a game, leading to him being hit in the head and knocked down.

Dr. Gregory House (Hugh Laurie) is hiding in a clinic exam room, avoiding patients, and his boss, Dr. Cuddy, until he is off work in five minutes. His friend Dr. Wilson (Robert Sean Leonard) finds him and suggests he just tell Cuddy that he has an urgent case and has to leave early, but House says he doesn’t have any cases. Wilson asks what his team of hand-picked specialists is doing. House says Cameron (Jennifer Morrison) is answering his mail and Chase (Jesse Spencer) and Foreman (Omar Epps) are doing “research” (Chase is doing a medical crossword puzzle; a bored Foreman occasionally helps with the clues).


House in hiding

House’s time is up and he checks out, but is approached by a man (Robin Thomas) who says he has an appointment. House points out that it is a walk-in clinic and there are no appointments, and as his wife (Wendy Gazelle) and teenage son Dan, the lacrosse player, step forward, he produces a letter signed by “Greg House” that says that he will see them. House notices that the handwriting isn’t his and confronts Cameron. She says that the 16 year old is suffering from double vision and night terrors with no apparent cause. The night terrors get House’s interest, so he goes to examine the patient. During the exam, house asks him to name as many animals as he can that start with the letter B, and after a long pause the best he can come up with is “baby elephant.” House says that in teens the two most likely causes of night terrors are post-traumatic stress and sexual abuse. Dan admits that he was hit in the head during the lacrosse game, which they hadn’t mentioned before. House attributes Dan’s symptoms to the trauma. The father protests that the Emergency Room found no concussion and Dan says he had double vision before he was hit. House says the ER must have screwed up and Dan also needs glasses. House starts to leave and Cameron argues with him (and we learn Cameron is NOT an lonely child) when House notices a myoclonic jerk in Dan’s leg, which should only happen when he is falling asleep. House has him admitted.


House talks to a patient!

House gets his team together. Foreman says that the myoclonic jerk combined with night terrors means there’s a serious brain problem, but Chase says that if the night terrors were really just bad dreams it could be something less serious outside the brain. House says that he thinks Dan’s father isn’t really his father. Foreman doubts it, and bets House $100. House orders a polysomnogram, which determines that Dan is really having night terrors.


House and the team


Dan's "night terror"

The team runs a series of test which all appear normal, but House says he sees something on the MRI of Dan’s brain. The team tries to figure it out, and from House’s clues Chase guesses some bowing in the corpus callosum, which is correct and House says there must be a blockage leading to his symptoms. While testing to find the blockage, Foreman notices that Dan and his father both have a fleck in their eye, suggesting they are father and son, but Chase says House won’t accept that as proof. They find a blockage and schedule Dan for surgery to remove it.


Where's Waldo?

House is in the clinic, seeing a young mother (Kylee Cochran) with a baby, whose face has swollen. The baby doesn’t have a fever and her glands are fine, but House notices she hasn’t been vaccinated. The mother says she isn’t vaccinating, because she thinks they are just a way for drug companies to make money. House, in a very insensitive way, points out that vaccinations are necessary because the mother’s antibodies only protect the baby for six months and the price of vaccinations is because they help keep babies alive. This terrifies the young mother, and House tells her the baby just has a cold.

House with the young mother and baby

Dan’s surgery is over, but the team found that the blockage was just another symptom and tests suggest that Dan has Rapidly-Progressive Multiple Sclerosis, but the tests aren’t definitive. House orders Dan started on MS medications, despite Cameron’s opinion that they should wait until they are sure. Chase informs Dan and his parents about the unpleasant symptoms to come.


House decides Dan has MS


The family gets the bad news

That night, a nurse discovers Dan is missing from his room. Security reports that he hasn’t left the hospital so the team starts searching the building. Foreman calls House at home. House is there but doesn’t answer and comes to the hospital because Foreman said he was needed immediately. When Foreman explains the situation, House leaves to go back home, because he’s bad at search parties, but he says to be sure to check the roof because orderlies leave the door propped open so they can smoke. The team rushes to the roof, where they find Dan, who believes he is standing on his lacrosse field. He nearly walks off the edge but Chase tackles him.


Dan on the roof

The next morning, when House is told about Dan on the roof, he realizes that Dan was never having night terrors but was conscious in an acute confusional state, which isn’t consistent with MS. He says Dan has an infection in his brain. Cameron suggests neuro-syphilis. Chase says that the test was negative, but House points out that the rate of a false-negative is 30% and has them start treatment by injecting penicillin.

In the clinic, House examines a man (Alex Skuby) with an abscess in his leg, and has stabbed it with his wife’s nail file to relieve the pressure. House deduces that the man has sued doctors before and is going to end up suing him, because he drove 70 miles and passed two hospitals to get a simple treatment, so the doctors at those hospitals refuse to see him.



The litigious patient

House treats the man anyway, and explains to Wilson that for all he knows the other doctors had it coming. Dr. Cuddy (Lisa Edelstein) confronts House about the rumors of the paternity bet on the patient’s father. She thinks the father really is the father, and wagers with House to get him to attend a symposium versus no clinic hours for a week.


House and Wilson

During a treatment, Dan has an auditory hallucination (hearing voices), suggesting their diagnosis is wrong. House orders more tests, covering for the fact that he really has no idea. He has lunch with Wilson, and is spotted by Dan’s parents who confront him about not caring about their son, until House rattles off a list of stats on their son’s condition, and tells them to go hold his hand, offering to bus their trays for them. They leave, and House takes their coffee cups and has Cameron run DNA tests on them.

The man from the clinic comes back and serves House with a lawsuit for emotional distress, saying he’s willing to accept a settlement. House counters that he has a lab result saying the man has gonorrhea; he has to report it and the state will tell his wife. House says he could clear his name by having a doctor run a second test. The man tries to take back the legal papers, but House doesn’t let him.

The team runs the DNA tests and finds out that NEITHER of Dan’s parents are his real parents: Dan’s adopted. Meanwhile, the parents are in Cuddy’s office saying they want to take Dan to get a second opinion, which Cuddy says isn’t a good idea, when House barges in and blames them for not giving an accurate family history of Dan’s biological mother. They counter that the information they gave was correct. House asks if the biological mother was vaccinated. House surmises that when Dan was an infant, he caught a measles virus that mutated and hid in his brain for 16 years, an incredibly rare condition. Because of the other treatments they’ve attempted, they won’t get a reliable result from a typical test, so they perform a retinal biopsy through the pupil of Dan’s eye, which confirms the diagnosis. Dan is treated with interventricular interferon.



Dan's ready for his retinal biopsy (NOT a Night Terror)

As Dan is in surgery to start the treatment, Cuddy confronts House about running a $3200 dollar DNA test to win a bet. Cuddy says she will only let House out his week of clinic duty after he pays for the test. He says that she owes him $100, and offers her $100 he won from Cameron, $200 from Foreman, and $600 from Wilson. After the surgery, Foreman and Cameron give Dan the “name the animals” test again and he does better, and he reveals that even though his parents never told him, he knew he was adopted since fifth grade when he researched genetic traits, because he has a cleft chin and neither of his parents do.

My Review:

This episode has an interesting mystery, but the mystery over the parents and the bet is more interesting, as are some of the side bits, like Dan’s “night terror” about House cutting off his toe, and House’s talk to the mother who won’t vaccinate. Unlike in the pilot, where he seemed to be regulated to the background, Jesse Spencer’s Chase got some nice banter with Hugh Laurie’s House in this episode, where he guessed at what House saw on the MRI and when House asked who thought there was a third option, Chase raised his hand, House asked what the third option was and Chase said “No idea; you just asked if I thought there was one.” Chase’s scene on the field/roof with patient Dan was also well done. Cameron and Foreman have their moments, but not as much as Chase. There isn’t a whole lot of Wilson and Cuddy here either, but its still an enjoyable episode.

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