Out with the old (and dead), in with the…old (and dead). A mere two episodes after we lost one character, we’re re-visited by another deceased doc from the Princeton Plainsboro roster. House is having trouble sleeping but he isn’t drinking warm milk or counting sheep. This insomnia won’t go away easily and neither will the form it’s taken. Our Gregory’s being haunted by Wilson’s dead girlfriend, Amber. Possible residual guilt brought on by Kutner’s suicide? Remember, it was his fault she was on the bus, after all. But his prickly disposition didn’t force K to eat lead. Or did it…? Nah!
House drags himself to work to discuss this week’s new case: a deaf high school wrestler floored during a match by “imaginary” explosions in his head. According to his chart, his deafness was a complication of meningitis contracted at age 4. The team begins throwing speculations around and Amber takes to the whiteboard. She points out the boy’s lack of a cochlear implant and makes a weird reference to “the limp leading the blind.” House is too distracted and exhausted to concentrate, so he leaves the team to get help. Amber follows.
House stops by Wilson’s office to get a scrip for sleeping pills and finds Wilson commiserating with Cameron over an open case file. They quickly close the file folder when House enters and Wilson runs to his desk for the prescription pad without lecturing him on addiction. Hmmm. Interesting. Cameron claims they’re just discussing a difficult case, but Amber knows better; she directs House to create a diversion so he can grab the secret file and find out what they’re really talking about. Inside, he finds brochures for bars and other venues. Cam confesses that they’re planning Chase’s bachelor party. House wants in, but Wilson and Cam are scared. Wilson already knows what a maniac House is because he planned Wilson’s bachelor party. Unmentionable things happened and Wilson doesn’t think there should be a repeat. But House isn’t listening; he’s doing it, anyway.
Foreman and Thirteen conduct testing on Mos Deaf to see if his explosions could be the result of a seizure. The strobelights fail to induce a seizure but they do cause the poor boy to lose his sight on top of his hearing. As a possible explanation for exploding head syndrome plus vision loss, Taub proposes subclavian steal syndrome (retrograde, or reversed, blood flow in the vertebral artery). Thirteen thinks they should conduct an angiogram, but House doesn’t care what they do. He swipes a bottle of sleeping pills from the hospital pharmacy and finds an empty exam room. Well, not quite empty – Amber is waiting for him. “The limp leading the blind…” He wonders how he knew the strobes would lead to blindness. Amber (a.k.a., House’s subconscious mind) explains that she noticed elevated C-reactive proteins in his file and expected that stress induced by the seizure lab would drive inflammation even higher, leading to optic neuritis. House is fascinated by this doorway to the deepest recesses of his brain. Amber tells him to go play the boy some music.
House visits Mos Deaf’s room with a huge boombox blasting Public Enemy’s “Fight the Power” and places it on his chest. The patient’s mother isn’t amused and tries to remove the stereo, but her son stops her. He signs to her that he can feel the song’s vibrations in his chest but not in his hands. Amber’s suggestion has allowed House to discover a new symptom: neuropathy.
Foreman is curious how House knew about the neuropathy and so is House. Amber appears holding three bowling pins. House deciphers the riddle and tells Foreman that Mos Deaf was pinned three times in his last few wrestling matches, despite a 15-0 record; he figured the boy’s balance was off due to diminished sensation in his extremities. Foreman suggests increased intracranial pressure from a brain tumor, but House points out that they would’ve caught that on a head CT. Thirteen thinks it could be rhabdomyolysis (rapid muscular degeneration) as a result of dropping weight for wrestling, but House tells her Mos Deaf actually went up one weight class three months ago. Amber steps back in and nudges House back to Foreman’s hypothesis, which also leads him to another symptom: the deaf kid’s deafness. House tells the team that meningitis could’ve just been a coincidence and the patient’s deafness might be the result of neurofibromatosis type 2 cancer; if so, then his hearing loss is reversible. He sends Taub off to perform an MRI and sends Foreman and Thirteen to scout out strip clubs for Chase’s bachelor party.
Foreman and Thirteen don’t hesitate and head straight to the nudie bar, both glad for a chance to shove dollars down g-strings. I’m sure most men at home have been quietly hating Foreman for weeks and now get a major reminder why. I don’t want to sound naïve, but can someone please tell me what a “backward cowboy” is? Anyway, back to the story. Foreman is dying to know why House is so intent on throwing this party for Chase and now so am I. Is House really trying to break him and Cameron up via stripper?
Back at PPH, Taub tells Mos Deaf and his mother about the possibility of reversing his hearing loss through cancer treatment. Mos only wants to treat the cancer but leave his “disability” intact. His girlfriend, a fellow deaf student, is by his bedside and she pleads with him to get the treatment otherwise he may die. He doesn’t want to have to change schools and not see her, but eventually he relents. Prior to treatment, Taub conducts an MRI but discovers it isn’t cancer. House orders a brain biopsy. During the procedure, Amber keeps hovering around, telling him to do things. Like invite the stripper from Wilson’s bachelor party to Chase’s shindig. And instruct Chase to insert a cochlear implant.
When Mod Deaf wakes up, he’s horrified to discover he can hear. His enraged mother demands that they remove the implant. For violating the patient’s rights, Cuddy takes House off the case and places Foreman in charge. Soon after, Mos develops a fever. The team thinks it could be a post-op complication until Taub suggests Epstein-Barr. With another nudge from Amber, House agrees. Foreman prescribes ribavirin for the virus.
Mos Deaf wants the doctors to remove the cochlear implant and his mother tells him they can’t operate again until his fever stabilizes, but he’s not hearing that (no pun intended). She calls out his name in exasperation and it sounds so sweet to his newly opened ears that he surrenders to the idea of hearing. Everything looks rosy for about 15 seconds, until he begins to pee the bed…and pee…and pee gallons and gallons.
Though still not in charge (yeah, right), House gathers the team to discuss the massive urination problem and taste test flash frozen liquor for the bachelor party (what an incredible idea – frozen pints of brandy). Amber helps him remember a similar case from med school that leads him to cardiac complications. He recommends they do a 12-lead EKG on the patient and watch it for four hours. However, the team finds no arrhythmia. House is still convinced that there’s something wrong with the heart (at least Amber says so). But how to prove it? Amber suggests amping up the stress with asthma medicine, telling him his girlfriend dumped him, or attempting to kill him… Huh?
Mos Deaf’s girlfriend is happy that he has a cochlear implant and tries to convince him that the changes in his life are going to be nothing but positive. Unfortunately, she negates all that by asking Thirteen out loud for the bathroom. Mos hears for the first time how strange she sounds and realizes that he must sound this way too. He’s so disturbed, he rips his implant out. Problem solved: the stress of this incident reveals the heart arrhythmia. Thirteen suggests thrombocythemia (excessive platelet production causing clots); Foreman orders a VQ scan of the lungs.
House retreats to the morgue to practice a flaming drink trick he performed at Wilson’s bachelor party. While igniting shot glasses and accidentally setting a corpse on fire, he ponders what the similarities are with all the patient’s symptoms… Heat! If Amber hadn’t nudged, this would’ve been eureka. Oh, well. At least he solves the case: Uhtoff’s Phenomenon, or the worsening of neurologic symptoms in multiple sclerosis. He orders a double dose of interferon for the MS and heads to the party.
As miserable as he is, House is definitely a perverted hedonist. He sends fake immigration officers to the hospital to kidnap Chase and bring him to the party. Since Wilson wouldn’t agree to come to the party, House brings the party to him and throws it in W’s apartment. There are strippers, body shots, a towering inferno of liquor, Wilson losing his pants, and just widespread debauchery. But once he gets everything going, the master of ceremonies hides out in the bathroom with imaginary Amber. Whew! That’s the House we know and love.
Back outside, Foreman convinces Chase to have one more body shot, this time off the stomach of Wilson’s stag night stripper, Karamel. He takes one lick and collapses – Karamel is wearing strawberry body butter which causes Chase to go into anaphylactic shock! House is horrified to realize that he knew Chase was allergic to strawberry. Is this why his subconscious kept nagging at him to invite Karamel? Why was he trying to kill Chase?!
Chase arrives at PPH by ambulance with Foreman, Thirteen and Taub. He’s fine but they’re wasted! Cuddy tells them that Mos Deaf isn’t getting better. In fact, he’s dying. She tries to reach House but he’s still reeling from his murder attempt. Amber chimes in and tries to help – sounds like it could be eosinophilic pneumonitis (a pulmonary disease). House mentions out loud that it can’t be that and quickly gets off the phone. Foreman thinks House actually may be right. They can only diagnose it by checking to see if the patient’s voice is hoarse, something they never would’ve been able to do if he hadn’t gotten the cochlear implant.
When Foreman checks Mos Deaf’s voice, it’s clear. Disappointed, he attempts to reintubate but then stops. He notices that Mos’ teeth are stained from chewing tobacco, a habit he acquired to make weight for wrestling. The toxins in the tobacco suppressed his immune system. When he stopped chewing, the lack of toxins brought out sarcoidosis.
House eventually makes it back to work and goes to Cuddy for sleeping pills. He hasn’t slept since Kutner died and now he’s sick to death of imaginary Amber. The following morning, he wakes from an incredibly deep and restful sleep. Alone. No Amber. He goes to the bathroom. No Amber. Splashes water on his face. No…
Next Week: She’s baaaaaaaaack! Amber’s still hanging around and House thinks he’s losing his mind. In the meantime, a young ballerina loses her skin.
