House: Poison (Season 1, Episode 8)

To save a boy suffering from pesticide poisoning, House and his team have to find out how he was poisoned.

The Plot: (Spoilers):

High school student Matt Davis (John Patrick Amedori) is taking his AP Calculus exam when he starts feeling nauseas and disoriented and collapses on the floor. At Princeton-Plainsboro, Dr. Foreman (Omar Epps) reports to Dr. House (Hugh Laurie) that Matt’s heart rate is falling and he’s not responding to atropine. House asks why he cares. Foreman says that Matt’s toxicology screen was negative, his CAT scan was clean, there’s no infection and no diabetes. House realizes that Foreman doesn’t care and just finds Matt’s illness interesting, which House thinks is a good thing. House sends Dr. Foreman and Dr. Cameron (Jennifer Morrison) to search his house for drugs that the toxicology screen wouldn’t detect, like copier toner. While they are gone, Matt has a seizure. All Cameron and Foreman find (aside from Cameron’s observation that Foreman now wears the same type of shoes as House) is some potentially contaminated tomato sauce, but the seizure rules it out. Cameron says that pesticide poisoning fits Matt’s symptoms, and Foreman realizes he DOES wear the same shoes as House.

That's how calculus presents

House goes to the clinic and sees an 82 year old woman (Shirley Knight) who has suffered a personality change and has become flirtatious, including with House, much to the annoyance of her middle-aged son (Kurt Fuller). He admits her for tests.

Matt’s blood tests confirm he is suffering from an organophosphate and he is given medications, but his heart stops. The treatment isn’t working. Foreman mentions that his old professor at Columbia developed a series of targeted treatments for the Army, but they have to know exactly what Matt was poisoned with to know which one to use. Foreman goes to call his professor, Cameron goes to check the home for pesticides and Dr. Chase (Jesse Spencer) implants a pacing wire into Matt’s heart. Cameron finds an empty can of disulfoton at the home and House has Chase give Matt the treatment, but Matt’s mother (Roxanne Hart) protests that Matt didn’t use pesticides on their garden because it was part of a school project and pesticides were prohibited and she won’t let Chase give him the treatment. House goes to Dr. Cuddy (Lisa Edelstein), wanting a court order to force Matt to get the treatment, but she doesn’t offer any help, so House talks to Matt’s mother and convinces her to let them give Matt the treatment, but by then another high school student has been admitted to the hospital with the same symptoms. They go to the same school, but don’t seem to have anything else in common. The other boy’s family lives in an apartment and they have no pesticides at home. The team realizes that they both had to be poisoned from the same source, but they have to find it. They discover that both kids ride the same bus, and Chase and Cameron check out the bus. The driver reports a truck spraying near the bus route.

After receiving her test results (and a love poem, entertainingly read aloud by Dr. Wilson (Robert Sean Leonard)) House goes to see the old woman from the clinic, whose tests reveal that she has syphilis. She admits she got it in high school, before she met her future husband, but she was treated. House says the treatment only suppressed it, and now it’s back and has attacked her brain. He gives her a prescription for penicillin.

The team has discovered the County sprayed ethyl parathion along the bus route to combat West Nile Virus. The parents of the second kid approved the treatment, but Matt’s mom refused, waiting for a second opinion from the Center for Disease Control (CDC). House sends Cameron to convince her to allow the treatment, which she does, but both boys go into seizures. The team was wrong and the boys were poisoned some other way.

Cameron "hustles" the single mom

House says that the progression of their symptoms suggests that the poison was absorbed through their skin, and from their admission times they must have been poisoned before they got on their bus. House thinks they must have been poisoned through a contaminated consumer product that came in contact with their skin as part of their morning routine, and sends Cameron and Foreman to each of their homes to find a product they have in common.

House’s elderly patient returns and tries to give back the prescription, because she doesn’t want to stop the feelings she’s having, but House tells her that the damage to her brain is permanent, so she agrees to take the penicillin.

Cameron and Foreman find the same laundry detergent at both homes. House thinks the detergent could have been contaminated and the boys were poisoned through their freshly-washed clothes, but the parents of the second boy say that his clothes were new and were never washed, and he doesn’t even know how to use the washing machine. House checks Matt’s clothes and finds his jeans were also new. House orders the clothes tested for contamination. They determine the chemical is phosdrin. One again, Matt’s mom refuses treatment, waiting for the CDC, and this time she refuses to be convinced. House goes into Matt’s room with the medicine and his portable TV, telling Matt’s mom he’s going to wait there in case she changes her mind. She gets a call, and is told the CDC can’t make a determination, leaving it up to her. She agrees to the treatment. House gives Matt the treatment and leaves the room, and Chase reveals it was he who made the call, pretending to be the CDC (with a bad southern accent).

House waits while Matt's mom gets a call

It turns out both boys had bought stolen jeans out of the back of a truck near the school, from a man who also worked as a day laborer in a field, and had apparently spilled pesticide in the back of the truck that contaminated the jeans. House and Foreman run into Matt and his mom in the hall, and she reveals that the real CDC called, implying she knows what they did, but she lets it slide. Matt asks who they are, and his mom says “they’re the arrogant jerks who saved your life.” House and Foreman get into the elevator to leave and notice their matching shoes.

House and Foreman wear matching shoes

My Review:

This episode has an interesting mystery, as the team figures out the big picture right away, and then has to spend the rest of the episode hunting down which pesticide is the culprit, making it a lot more like a police investigation than some other cases. All their ideas are plausible, though the theory of being exposed on the bus to spraying along the road doesn’t entire work, as if that were the case shouldn’t most of the students on the bus have gotten sick? They also end up finding the pesticide by testing the boys’ clothes, but it seems like that would’ve been an easy way to test most of the other theories along the way (Matt accidentally spaying himself with pesticide while gardening or exposure on the bus to spraying along the road), saving a lot of time and trouble (but giving us a less interesting episode). I like the mystery overall though. Matt’s mom was well played by the actress, but I find it hard to believe that a mother would actually act that way, and the drama was a little overdone. The side plot with the 82 year old woman is fun and entertaining and is probably the best part of the episode. The episode is also a little bit of a Foreman episode, showing that he is starting to accept House’s way of practicing medicine and is become more like him. Knowing what will eventually happen to Foreman in later seasons, it’s interesting to see this development so early in the series. We don’t see much of Cuddy or Wilson in this episode, though Wilson’s reading of the love poem was great. Poison is an entertaining episode of House.

House: Fidelity (Season 1, Episode 7)

House and his team try to cure a woman who sleeps 18 hours a day.

The Plot (Spoilers):

Ed (Dominic Purcell) comes home from jogging with his friend to find his wife Elise (Myndy Crist) is still in bed at almost 4 in the afternoon. She tells him to call her boss and say she’s not feeling well, and he reminds her that it’s Saturday; she hasn’t been to work or even out of bed since Wednesday. He tries to get her out of bed and she suddenly and violently slaps him, and she realizes there might be something wrong with her. Elise is admitted to Princeton-Plainsboro, where she averages 18 hours of sleep a day, which gets Dr. Cameron’s (Jennifer Morrison) attention. She brings the case to Dr. House (Hugh Laurie), who initially assumes clinical depression, but Cameron says Elise isn’t depressed. House notices that the file says Elise is “unusually irritable” according to her husband and takes the case claiming Cameron’s interest is interesting.

Ed and Elise are worried

House gets the team together. Dr. Foreman (Omar Epps) also assumes depression, but House points out that depression couldn’t cause Elise’s fever. Cameron says Elise’s elevated sedimentation rate suggests inflammation and Foreman says her other symptoms point to the brain. Dr. Chase (Jesse Spencer) suggests parasites, but Cameron says Elise has never left the country. House suggests a tumor on the brain and orders an MRI to find the tumor.

In the clinic, House treats a woman for shortness of breath, which she says is more of a tightness. House thinks she might be a little anemic and is about to perform an EEG on her chest, when he discovers she has breast implants: a gift for her husband’s 40th birthday. After “consulting” Dr. Wilson (Robert Sean Leonard), House orders an EKG and blood tests. House also notices that Wilson has a new green tie, and suspects him of cheating on his wife, because his wife hates green.

House finally enjoys seeing a clinic patient

The team doesn’t find a tumor, and Elise goes into a seizure. Chase suggests Lyme Disease, but her “clingy” husband never noticed a rash. Wilson suggests paraneoplastic syndrome caused by breast cancer. Cameron searches for breast cancer, but doesn’t find any. Wilson says that in 12% of paraneoplastic cases, no tumor is ever found and the patient dies. Wilson says they should do a PET scan. House says to treat the symptoms with IV immunoglobulin and if there is a tumor, it will get bigger and easier to find. He sends Foreman to check out where Elise works, because if its not paraneoplasitic and there is some kind of toxin responsible, it couldn’t have come from her home because her husband is healthy.

Elise works in a fancy French restaurant. The owner keeps the kitchen very clean and none of his other employees are sick. Foreman notices that the restaurant serves rabbit. Elise says her arm itches, and hallucinates spiders crawling out of an imaginary wound. They have to sedate her to calm her down.

Spiders under the skin: never a good sign

Wilson says that the hallucination is consistent with paraneoplastic syndrome, but Cameron says the fact that they already had Elise on IV immunoglobulin rules it out. House suggests an infection. Foreman says her tests, timeline and symptoms rule out almost all bacteria, viruses and parasites. House suggests African Trypanosomiasis, also known as African Sleeping Sickness, because in late stages all the parasites that cause it are in the brain and undetectable by tests, but she has never been to Africa and never had a transfusion. Foreman suggests tularemia, or rabbit fever, which she could have inhaled while chopping rabbit meat at the restaurant. Cameron says in that case she should have had respiratory symptoms but Foreman says she could’ve thought it was just a cold. House says that they rejected Lyme Disease because her husband never saw a rash and the respiratory systems would be even more noticeable. The treatment for tularemia can cause aplastic anemia and the treatment for African trypanosomiasis kills one in 10 patients.

As the team tests Elise for tularemia, House again confronts Wilson about his suspected girlfriend, and Wilson admits he had lunch with a new nurse, just to be nice. Dr. Cuddy (Lisa Edelstein) delivers the test results for the woman from the clinic. She says the tests look normal, but House notices something on the EKG and goes to talk to her. Her EKG showed a slightly decreased heart rate, and he asks if her husband has high blood pressure. She reveals that he was diagnosed six months ago and makes their oatmeal for breakfast. House tells her that her husband has been adding his blood pressure medication to their oatmeal, as the beta blockers cause a decreased sex drive and he thought as long as his were reduced, hers might as well be too. House suggests she start making her own breakfast, and have an affair. This train of thought gives House an epiphany, and he realizes that Elise could have gotten sleeping system from sex if she had an affair. Since the test for tularemia was inconclusive, House has Foreman and Chase ask Ed and Elise separately if they noticed Elise’s respiratory symptoms or if they had an affair. They both deny both the respiratory symptoms and an affair. Meanwhile, House reveals to Cameron that after he noticed how she was affected by the sick babies in “Maternity,” he checked her medical records and learned that she had never been pregnant. Naturally, the invasion of privacy upsets her, and she storms off.

With both Elise and Ed denying an affair, the team treats her for tularemia. As Cameron gives her the second dose of the treatment, Elise slips into a coma. The team realizes she doesn’t have tularemia and must have sleeping sickness.

Elise falls into a coma

House talks to Ed, and tells him the diagnosis. He again denies an affair, and House says that means Elise must have had one, which he doesn’t believe. House asks him if he thinks there’s a chance that she had an affair just one, and when Ed says he doesn’t know if he trust her that much, House has Foreman and Chase starts the treatment of melarsoprol, which comes in glass syringes and with special IV tubing because it melts plastic.

A biohazard label on your medicine: also not a good sign

Ed reveals to Cameron that if Elise recovers, it means she betrayed him and part of him hopes she doesn’t get better. He asks if that makes him a terrible person, and Cameron says yes.

Cameron tells Ed he's a terrible person

House finds Cameron in the lab, crying over a centrifuge. She tells House what she said to Ed, and House asks why. Cameron reveals that when she was 21, she got married to a man who died six months later of thyroid cancer that metastasized to his brain. House realizes that thyroid cancer would have diagnosed a over a year before he died, so she knew he was dying when she married him, maybe even when she first met him. He tells her that she can’t be that good of a person and be well adjusted.

Cameron tells House her sad story

Elise’s fever spikes and her blood pressure falls. The treatment is destroying her heart. House tells Ed, and he begs Elise not to die, and she comes out of her coma. Later, Cameron watches from outside the room as Elise tearfully admits the affair to Ed. Ed walks out on her, and Cameron goes after him, telling him how lucky his is that Elise is alive and lover him, but he says that she couldn’t have done what she did if she loved him. House asks Elise who she had the affair with and sends Cameron to notify him that he needs to be treated. It turns out to be Ed’s friend that he was jogging with at the beginning of the episode (who himself has a wife and son).

Ed begs Elise not to die

My Review:

This episode has an interesting mystery, with the diagnosis being hindered by being a very rare condition and the patient’s lies, but the highlight of this episode is the revelation about Cameron’s late husband. The episode also reveals a little more about Wilson’s past, mainly that he’s been married multiple times. This episode nicely includes some continuity with past episodes, including “Maternity” in the Cameron subplot and “Damned If You Do” in the Wilson subplot in adding support to the idea that Wilson’s marriage isn’t going too well. As usual, the clinic adds some levity to an otherwise serious episode, and this time the lone clinic patient leads House to his epiphany, as one of the clinic patients in the pilot episode did. While the mystery makes this a good episode on its own, the important information about Cameron’s past makes this a significant episode, and perhaps the most important episode up to this point in the series.