House - "Not Cancer" (Episode 502)

We open on a vigorous tennis match between two athletic ladies. All of a sudden, one of the women clutches her chest and falls to the ground. At a construction site, a crane operator passes out and almost squashes his co-worker with a huge flatbed truck container. A mixed martial arts fighter collapses while pummeling his opponent. A man playing a french horn (or is that a tuba? It's been a long time since music class!) starts coughing up blood - and collapses. A teacher is leading a class when Thirteen barges in (gee, that was a surprise, I thought she was going to collapse too!) She asks the teacher if she had had a corneal implant five years earlier and she said that she had. Thirteen informed her that she got an implant from a donor who had also given organs to all of the people we saw collapse. They're now either dead or dying - and she's next. Wow, what an introduction to our patient of the week!

Over at Princeton-Plainsboro, there are four dead patients and one well on his way - all of whom recieved different organs from the same donor, but who all expired in different ways (for example, the tennis player got a replacement kidney and her heart exploded.) The gravely ill man, Frank, got an intestinal implant and his pancreas was now failing, but they didn't know exactly why. All of these cases occured within eight months of each other. The complications came suddenly and without warning. House is still preocupied with Wilson, who unceremoniously dumped him as a best friend last week before leaving the hospital...for good...? (He said Wilson "made me laugh on a rainy day, made me see the colors I never knew...") Thirteen assumed that the donor's blood was bad, which caused the deaths of the other patients and, since corneal implants were bloodless, that Apple, the patient of the week, would be fine. Foreman asked if she felt confident enough about her theory to send Apple home, but she decided to wait and see what Frank's diagnosis was. House was still going on about Wilson and Kutner cut him off by saying Wilson "paid for your lunch, liked monster trucks and was your conscience." (Oh, and he suggested Frank may have some sort of autoimmune disease.) Foreman and the gang ruled out pretty much every diagnosis, and Thirteen suggested cancer. Foreman insisted it wasn't cancer, because cancer had a progression and affected specific organs. House said it "was cancer" (maybe because then he could have an excuse to contact his favorite oncologist - Wilson?) Foreman said that a battery of tests and four autopsies proved that it wasn't cancer. House told him to redo all of the tests - and to test the donor. Kutner said the donor didn't die of cancer; his head was chopped off in an industrial accident. House said to find out which type of cancer would have killed him. He orders Taub to check his home for carcinogens, which might be difficult as the donor had been dead for over four years, and his home was most likely being occupied by someone else. House said to find out what cancer killed them. House told Foreman to check Apple's eye.

In an attempt to find a new "best friend" to replace Wilson, House tried to get another doctor to pay for his lunch. His latest victim, Dr. O'Shea, actually reminded me a little of Wilson, and he did pick up the check. House thought he may be on to something and followed him to a table. As it turns out, he takes his kids to see the monster trucks and he grills House about the many pills he takes. House says he could be "falling in love." Foreman interrupts this awkward moment and says that Apple's right eye is failing. House said that couldn't be the case, as with the other patients, the donated organ wasn't the one that caused the problems. Foreman says the eye has to come out. House says it's her only working eye, but Foreman said he could remove the other one - which wasn't killing her. House then asked Dr. O'Shea "Do you have solme ethical problem with what I'm doing that you can express it in a unique way which might actually make me think I'm wrong, even though I'll never admit it?" Dr. O said "yes" to which House replied "You are funny." House said the problem wasn't in Apple's eye, it was in her head. He asked Dr. O to come over and Dr. O replied that he wasn't gay. House said "Neither am I...if you don't want to have sex, that's cool with me." Dr. O still refused the invite and House told him "I'll grow on you." House checks Apple's eyes. She's not happy to be sharing a room with the dying Frank. She misreads a line on an eye chart and Foreman says the eye needs to be removed. House said she didn't squint to read the chart, which meant her eye was fine, but her brain wasn't. He told Apple he wasn't going to remove her eye, he was going to remove her head - and then took a cleaver and headed towards her. Of course, that was a hallucination, which House asked Foreman "that's a brain thing, right?"

House and his team try to connect Apple to the other donor recipients. He watches a video of the MMA fighter's last brawl may have had some sort of neurological problem, but Foreman said he was just hit in the head. Thirteen says they may be able to connect some of the problems that killed the others, but said that nothing could cause simultaneous   brain and heart problems. Taub said that the cancer diagnosis made no sense and the head and heart made "less than no sense," after which the janitor piped in and said "that makes no sense." Taub retorted that he was just making a point and the janitor said "Oh...good...I thought you were an idiot", which gets raised eyebrows from House. Taub asked why he felt the need to put his two cents in and the janitor replied, "Oh, the man doing manual labor can't have an opinion?" Kutner came in and said that the donor's tests came up clean and the janitor laughed. Kutner said he couldn't be a janitor as he was wearing argyle socks. Huh? Apparently, this janitor isn't a janitor - he's a private investigator that House hired. Kutner said that the donor had no history of unusual infections and didn't travel internationally - which resulted in another peal of laughter from the P.I. - who said that the man had been in Madrid and the Bahamas with a secret girlfriend (his former high school sweetheart and best friend's wife) who paid for everything. (She also had a four-year-old son - presumably with him - whose only medical complaint was a tummy ache.) He was also exposed to mercury, mold and hydrochloric acid because his "sex pad" was adjacent to a garage that was demolished after the toxins were found. The P.I. finished his report and presented House with a $2300 bill (which included the boxing match shot from four different angles and facts and figures on all of the people in the audience for the fight. House was impressed, and the P.I. will be a regular fixture on the show.

Foreman finally admitted that the blow during the MMA match wasn't the reason that the fighter collapsed. He had a temporal lobe seizure. Kutner asked if he wouldn't have to search patients' homes anymore now that a P.I. was on House's payroll. House replied, "that's the whole reason you went to medical school, I'm not going to take that away from you." House told Foreman to biopsy Apple's brain and Foreman (while reluctantly admitting that House was right) said he wouldn't. Taub agreed, saying that they risked making her a vegetable. House then wondered if there was someone with less to live for that they could examine (he of course was referring to Frank, the ailing old man.) Taub was faced with getting permission from Frank's wife for the operation and she was highly skeptical. Apple begged her, but she refused to budge. Apple then pulled out the "young mother card" (she had a two-year-old daughter) but Mrs. Frank thought she was lying, as she hadn't had any visitors or phone calls since she checked in. Mrs. Frank asked Taub if what Apple said was true and, looking over to see the worst poker face ever, said no. Mrs. Frank and Apple began to squabble and Frank expired. House told Taub to save the brain, because they didn't need permission for an autopsy.

Frank's brain was thoroughly examined and it turned out to be clean as a whistle. Everyone feels they keep moving backwards. House again brings up the cancer theory. Foreman finally confronts House and said he kept bringing up cancer so he could talk to Wilson again. Kutner suggests that the donor could have had a perforated intestine which got infected and spread infection through the bloodstream, affecting all of the organs. House said that if Apple experienced any abdominal pain that someone should "shove a tube up her rear before it can get away" and to test anyone else with any kind of pains in their midsection. Thirteen said everyone else was dead. House reminded her that someone else had the donor's DNA - his young daughter. No one wants to do a colonoscopy on a child and Thirteen doesn't want to scare her mother. Of course, the kid gets the old tube in the no-no hole. Meanwhile, House joins his P.I. on a surveillance mission (holed up in an ice cream truck.) P.I. tells House that Dr. O'Shea isn't "right" for him, but he is curious to know why House can't trust anyone. (These two are so good together - P.I. had a sign in the ice cream truck that said "closed", but a kid beat on the window looking for frosty treats. P.I. guy yelled at her that she wouldn't get anything until she "learned to read.") P.I. told House that there were three types of people who employed him - those who are right, those who are wrong, and people like House - who don't care if they're right or wrong. They just hired him to investigate the wrong person. P.I. said House wanted him to investigate Wilson. House was actually surprised that he even knew about that whole situation (forgetting that the man spied on people for a living.) P.I. told House he wanted to know that Wilson was "pining" and if they will ever be friends again. P.I. then says he can't find any indications that they'll ever do that. House gets a page and heads back to the hospital. The little girl's colonoscopy was negative. Kutner thinks they need to see the colon at work and says that it's relatively simple to create "pressure" in the recently deceased. He suggests shooting a water jet used to test cardiac workload through Frank's intestine. House tells him to proceed. Kutner and Foreman perform the experiment and it's really gross. As the water courses through Frank's intestines, bodily fluids leak out. Foreman appears grossed out as well. Kutner can't find a leak, but Foreman thinks he sees something. Kutner increases the water pressure a bit too much, and Foreman gets coated with internal organs (I told you it was gross!)

Apple's getting worse. Her heartbeat is irregular and she's having trouble breathing. House and the ducklings are stumped and House says that no one can suggest theories that were previously discussed. House starts Apple on chemo, because at least it's treatment for "something." House asks Apple to sign a consent for chemo and she asks why. House says it's a "placebo effect" and if her brain thought she was getting the right treatment, that she'd be better. She signed the consent form and told House that she was an architect, not a teacher, before she got her corneal transplant. Hous couldn't believe she gave up such a lucrative career after she regained her sight. She asked him if his life would be markedly better if his leg were fine. He didn't answer. She said the doctors told her life would be so much better after the transplant, but she found out that wasn't the case. House said she was a downer and she said they weren't actually that different. House joined the P.I. on another surveillance job (actually following a girl he thought was attractive), and P.I. told him that Wilson had already landed another job and was attending grief counseling. Cameron has been at his house to talk to him ("about death" - he knows this because he's been at the same grief counseling sessions because he lost his mother. He really did. He confessed that he wasn't a very good liar.) Cuddy and Foreman have also stayed in touch with him. The topic of House has never come up. House is called back to the hospital and discovers a vomiting Apple. Foreman says that the chemo is actually working on her, but House says it's not cancer.

House informs his team that despite the fact that Apple's looking healthier, she's going to get sicker and die soon. House now insists that he never thought it actually was cancer but rather a disease that acted like cancer. The team now all believe that it actually is cancer. House (via the P.I.) found that the horn player was taking some drug to counteract the effects of arthritis, and that could be a factor in his demise. He says they need to find "what's cancer and not cancer." Exchange of meaningful looks. House then says that "something's missing." He actually goes to Wilson's in search of "an epiphany." Wilson looks less-than-thrilled to see his old friend, but House is in need of answers about Apple. Wilson tries to send him away, but House refuses to leave. Wilson says he's trying to move on, but House asked him how he could do that by talking to Cameron and Cuddy. Wilson then finds out that House hired the P.I. and was really annoyed. He told House that he had the right to walk away from him and said "the next time you knock, I'm not answering." Ouch. Of course, the P.I. heard the whole conversation and apologized to House the next day. P.I. kind of took Wilson's side on the whole thing, equating their "friendship" to the whole "cancer or not cancer" debate. Whatever he said caused House to have his long-awaited "epiphany" and said Apple's world wasn't as ugly as she thought it was. House went into Cuddy and asked to do brain surgery on Apple, because there's something near her occipital lobe that shouldn't be there ("brain but not brain.") Cuddy said she would trust his first instinct and continue the cancer treatments. (He's apparently trying to get the hospital to pay for the P.I. too.) House told Cuddy that the donor had cancer cells that were embryoinc - they could become whatever kind of cells they wanted to be - but they couldn't perform the same way. The chemo shrunk the cells/tumors, it's hiding the real problem. Cuddy still refuses and, in anticipation of House doing something drastic to Apple to prove she needs brain surgery, stations two security guards outside of her door. House is perplexed. He makes a phone call and a mysterious nurse causes Apple to crash (and that nurse is wearing argyle socks. That House is a sneaky one!)

House, as always, gets his way, and Apple loses the top of her skull - temporarily. Chase (oh, how I miss him) is doing the surgery when he finds out that House replaced the chemo fluid with saline and said the surgery was no longer necessary. Chase apparently forgot who his former boss was for a brief moment, but eventually continued with the operation. P.I. visited House in the operating theater and was worried he could have killed her by replacing her meds. House tells him what he discovered and the P.I. feigns interest, as he observes that House is paying him to listen to his every word. And, as always, the surgeons find the problem, fix it and House saves the day. House visits Apple and tells her that the world isn't as ugly as she made it out to be. She's fine, her eyes are fine, but her brain wasn't (pre-surgery.) Apple was finally able to see things for what they were and immediately told House he "looked sad." Our parting scene was House calling the P.I. and asking if he could put him on retainer. Anyone who pays attention to the gossip surrounding the show knows that the P.I. may be the subject of a "House" spinoff, so he'll be around for a while.