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House 319 - Act Your Age

House Episode 3-19 : Act Your Age
Airdate April 17, 2007

The Hook:

Day care center. An eight year old boy, Jasper, is being treated for a nose-bleed by the center director, Janie. Jasper's father , Deran, a fifty-ish college professor comes in and takes over the treatment. The boy has been has been fighting. The other boys have been teasing him, saying he "smells". His six year old sister, Lucy, is playing ‘doctor' and wants to help with the treatment. Deran begins to worry as the boy's nose has been bleeding for ten minutes now, and he tells Janie, a young attractive woman, to phone the paramedics. Before they arrive the bleeding finally stops and Deran, relieved, starts to tell the Janie to cancel the ambulance. But the boy points to his sister, "Lucy", and we see her in the throes of a seizure. Good thing that ambulance is already on the way.

Act 1

Cuddy brings the file to House, who tries to avoid it. "Restrictive pericarditis." "Boring." "She's in kindergarten." "Less boring." [Also intriguing : shouldn't a six year old be in first grade?] "Unless grandma's been held back a few years." "It's calcified and she's hypertensive." "She should be in surgery." "She already is." "Tricky procedure. It's going to take all night : sleep tight," as slacker House throws the file on the desk and dashes : at least as much as House can dash, anyway - for the door. But Cuddy pursues "No congenital defects, no health problems, but her heart is strangling itself." House counters that the pericardium analysis will take forever. Cuddy counters that he can start on the blood analysis, which is in the folder she thrusts back at him. House throws the folder to the Hice, and exits with a brisk and cheery "All taken care of, sleep tight." Well, there'll be no sleep for the Hice tonight, anyway.

Over the credits we see Lucy's six year old heart exposed in the OR as the Hice observe and swap diagnoses. Chase likes a virus. Cameron likes TB, but Chase snipes at her suggestion. Cameron snipes at Chase's until Foreman is driven to distraction and has a diagnosis of his own: "I take it you two aren't sleeping together any more?" Oh, naïve Foreman, as if sleeping together prevented arguments : I wish! Foreman favors doing what House said "Test for everything." Chase begs off and goes home, declaring since House will call them all idiots tomorrow, he might as well be a well rested idiot. I like the way that boy thinks.

The next morning, House calls them all idiots, because Cameron and Foreman stayed up all night and have nothing to show for it. Foreman thinks eliminating wrong answers should count for something [which Thomas A Edison would agree with]. A fresh Chase breezes in with the pathology report and a suggestion of ‘fungal infection' earning an attaboy from House, and a complaint from Cameron "He went home!" "Work smart, not hard," says House, earning a narrowing of the eyes from Cameron and the enmity of wage slaves everywhere, who've found bosses put that slogan on their walls but never really mean it. I mean, if you work smarter and come in at ten and leave at four, getting more done that the drone who comes in at seven and leaves after dark, getting less done, guess who gets the promotion. Go ahead, guess. House assigns Chase and Cameron to follow up the fungus theory, overruling Cameron's objections to working with Chase.

First they stop by to actually look at the patient, who is objecting to ‘more shots' as her brother, Jasper, parodies her in that sing-song voice that all kids do and all kids hate when other kids do. As Chase biopsies Lucy's lymph nodes, Cameron talks with the Deran about possible sources of fungus infections, ‘anywhere moist, pools, locker rooms, shower rooms.' Deran says she doesn't go to any of these places, doesn't even like playing outside. No trips since their mom dies last year of brain cancer [Ding, ding, ding goes my clue alarm, although apparently not Cameron or Chase's, yet.] In the middle of the exam Jasper suddenly ages ten years and starts coming on to Cameron. "Nice necklace." "You like video games?" "Your place or mine?" No, he really didn't say that last one. Cameron's flattered, Chase is annoyed. Lucy asks for her bunny, but can't take it when offered because she's seeing two of them. New Clue!

The team discusses this new development and Chase reports there was no trace of fungus in Lucy's lymph node biopsy. The Hice twitter over possible new diagnoses when House gets a far-off look and asks about the dog that didn't bark : Lucy's knees have no sign of injury, unlike most six year olds. Cameron says she doesn't like to run around outside. Perhaps, House says, this is because running around outside hurts. If there's anyone who should know about leg pain, it's House. Batter up : "juvenile rheumatoid arthritis".

As House strolls though the hall and discusses this with Wilson, he changes the subject and offers Wilson two tickets to a play, as he suddenly whips into an exam room and does a most un-House-like thing, examining a clinic patient. The patient reports he's ‘peeing all the time' though not drinking more. House asks Wilson if he's interested. In the pee or the play? The play. "Sure, want me to pick you up?" "You thought this was a date?" House asks, as he returns to the patient. The patient's stomach hurts, he has back pain and muscle aches and feels dizzy, the patient says, and he has trouble concentrating. Hey, I've got all these symptoms. It's called getting old. But the patient is a young man, so it must be something else. House again asks if Wilson wants the tickets. He says he doesn't want to go because "dudes" only go to plays if they're taking someone they want to see naked. So why offer them to me?, Wilson asks. Maybe there's someone you want to see naked. Must be nice to have a friend who's also a straight man. House returns to the patient. No fever. Nothing unusual in his pee. Urine sample? The man objects that he can't pee in public : we have bathrooms for that, House says. No, not even in a public bathroom, the young man replies. But he'll run home and fill the cup.

Back in Lucy's room, Foreman counsels Deran about juvenile arthritis, as Jasper plays with army men. Lucy tried to call her father, and makes the strangest face, her jaw seemingly unhinged. Foreman jumps up and examines her retina with a light, concluding "she's having a stoke'. So far we've got hardened myocardium, arthritis, and a stroke, in a six year old!

Act 2

Treating the clot, the team debates the reason for Lucy's thickened blood, which caused the clot that caused her stroke. Possible reasons: Carbon monoxide, cigarette smoke - House sends Chase and Cameron off or examine the patient's house to see if Deran, is a smoker despite having denied it. Cameron doesn't want to go with Chase, and says House is intentionally punishing them. By making you do you job? House sympathizes. He assigns Foreman to treat the excess blood cells.
As Cameron and Chase leave, Jasper presents Cameron with a nice bouquet of flowers. A skeptical Chase reads the card in them "Congratulations on Your Bundle of Joy". Smooth, Jasper. "Something you forgot to tell me?" Chase asks Cameron. Chase asks a security guard to make sure both Jasper and the flowers get back to where they belong. Cameron removes one of the blooms for a keepsake and kisses Jasper on the cheek, Jasper looks smitten, the exchanges dagger-eyes with Chase.
Foreman discusses the case with Deran, as he drains Lucy's excess blood to reduce the chances of another stroke. Forman says they are also giving her drugs to suppress the formation of excess red blood cells. All this must sound like progress in the wrong direction to a parent, and Deran is worried that Lucy still hasn't spoken, but Foreman tells him there's a good chance Lucy will make a full recovery. The security guard returns Jasper, who explains he was "exploring" and seems rather blasé about Deran's concerns and immediately asks "can I have two dollars?"

Chase and Cameron examine the patient's house : no carbon monoxide from the stove, and Chase wants to know why Cameron encouraged the little flower thief. "He did something sweet'. Cameron seizes the opportunity to tromp on Chase's heart a little more, heckling him for being jealous when she's already ended their "relationship". Chase says she's "encouraging a delinquent" and bolsters his argument by discovering letters from school detailing Jasper's "fights, detentions, and parent-teacher conferences". "I know, I know," he says "bad boys are hard to resist." It's just an innocent crush, Cameron says. "So this is us now?" Chase asks, "sniping at each other?" Cameron avoids the question by diving under Lucy's bed to look for a vent, because the garage directly below has many possible carbon monoxide sources. She finds a vent that appears to have something in it. Chase dives under with her, and Cameron sinks her chin in the floor in grump. Chase says this isn't right, she dumped him, she doesn't get to be angry. But he says it in a tender voice. Cameron says she's angry because he broke the rules, not keeping their thing purely for physical enjoyment. Cameron responds with tenderness as well : there's healing going on under there. I guess under a bed's got to be the next best place for that to on top of one.

In the vent they find a bloody t-shirt.

Cut to the hospital, where Cameron says Lucy is being abused. Foreman says that kids get hurt all the time. "That amount of blood?" Chase says. "Oh, crap." Foreman complains : not that he agrees with the abuse diagnosis, yet, but that "You two are agreeing again." There goes his divide and conquer strategy, down the toilet. Cameron argues classic signs of abuse "father overwhelmed, brother acting up in school, social isolation". But no physical evidence, no marks, no bruises. This sucks, House says, now we've got to spend half a day to find out if the blood is a biological symptom or a symptom of abuse : full physical, including vaginal. Chase sputters that if Deran is abusing Lucy he'll never give permission for a vaginal exam. "Never is just ‘reven' spelled backwards," House Yodas.

It falls to Foreman to get the permission. He opts for the direct approach "Are you abusing your daughter?" with a serious angry-black-guy stare. He shows Deran the bloody t-shirt (in bi-hazard plastic, thank you). Deran says he doesn't know anything about it. Foreman says even if it was someone else, Deran doesn't seem too up on his parenting skills, pointing out that Jasper has disappeared again. Deran's angry, but he signs the form. Especially since Foreman points out the alternative is Foreman calls in social services and the exam gets done anyway.

Cameron draws the curtains and begins Lucy's exam. Cameron is tender with what has to be one scared little girl, who still can't talk. Lucy is cooperative and her eyes are wide and focused intently on Cameron. When she gets to Lucy's vaginal area, it's Cameron's eyes that widen. "Oh my God!" but she says is in a soft voice so as not to frighten Lucy.

Cameron strides down the hall with Chase and Foreman, reporting that Lucy has cuts all over her genital area, some almost healed, some new. Now it's Chase that's saying she might be doing it to herself, and Foreman arguing she's too young to do that. But of course she's already got four or five other problems she's ‘too young' for, so what's one more. Complication : the cuts aren't deep enough to account for the blood. Could the blood be from forcible penetration? No evidence of it from the exam. Arriving at House's office, they find him absent, so Foreman goes into House mode, and questions their original assumptions : is the blood even Lucy's?

House is back in the clinic with Shy-Man, reviewing the urine test results. When he asks what they say, House tells him that now he wants some of Shy-Man's blood. Why? To see if you will say ‘I can't bleed in public'. Then he get down and dirty : "That wasn't your urine, was it?" "Why would I give you someone else's urine?" Shy-man asks. Possible reasons House lists are (1) Athletes hiding steroid abuse (does not apply) (2) Someone hiding drug use. (He says not. House responds "I am!")) and lastly, door number three, the big winner ‘You have insurance but your friend doesn't, so you come in here and describe your friend's symptoms and give me their urine, which is stupid because this is a free clinic.' [Now this has intrigued me about this show for some time. Do your hospitals run free clinic, viewer-friends? I don't know any that do around here. A lot of emergency rooms amount to free clinics, because they have to treat everybody that shows up, and many of these don't pay their bills, but that's not the same thing. All the free clinics I've ever seen tend to be in store-fronts on the run-down side of town with overworked harried volunteer doctors and staff. Is it different in New Jersey? Anybody? End rant.] Cuddy sticks her head in the door and says she needs House, like, NOW. House for once does exactly what she asks. As House leaves, Shy-Man asks if he's OK? Is it diabetes? "No, you're pregnant," parting-shots House.

In the hall, Cuddy berates House for not reporting suspected abuse. Dad consented to the exam, and is therefore not the possible abuser is House's response. He tries to divert her with questions about her makeup, and social life. Cuddy tells him she went to a play last night (aha!) and orders him to go back to his office and report suspected abuse to social services RIGHT. NOW. "What play?" House responds. We never hear another word about social services, which I guess shows how far Cuddy's authority extends.

Wilson is having a sandwich in the cafeteria. House accuses Wilson of seeking to bed Cuddy, and we get a few rounds of back and forth entertaining irrelevancies, before Wilson blurts out "Yes, I slept with her." House is shocked. Or is it mock-shock? "Seriously?" "No." A look. "Yes, you did!" "Yes, I did." Seemingly genuine shock. "Seriously?" "No. You've got a problem, House." Before this can go another round, Foreman interrupts to say that the tests on the T-shirt blood are back, and it's full of endometrial cells. Not Lucy's blood then? Nope, that's tested too, and it is, which means the six year old is menstruating! She's started puberty.

Act 3

Cameron is bending over her groggy patient, and incidentally pointing her rear-end at Deran, a habit that will come back to haunt her, later (foreshadowing!). She counsels over her shoulder that Lucy's body is over-producing sex hormones, causing her body to get confused and start changing too early. They must find the source and cut it off. Deran says he's never even talked to her about sex : he doubts she even knows what a period is. Jasper is tired and using dad's leg for a pillow. Deran gently eases him off to go to his daughter, who's stirring. He kneels at her side and tells her she's going to be Ok, and he loves her, while stroking her cheek. Lucy recovers enough to talk, and they discover she hid the T-shirt because she was scared and embarrassed and a friend told her to put a T-shirt in her underwear. The cuts were from her attempts to shave off developing pubic hair with her dad's razor. Foreman favors a tumor-based reason for the overactive pituitary gland that's the source of Lucy's excess hormones, Cameron thinks an environmental cause is more likely citing an epidemic of mass early puberty in Puerto Rico once because of estrogen in the poultry.

Even as Cameron spouts possible sources of hormone contamination, House directs Foreman to start looking for the tumor, in brain or reproductive system. He'll allow Cameron to ‘waste her time' looking for contaminants, though.

As Chase and Foreman watch Lucy disappear down the MRI tunnel, Chase announces that Cameron was the one who broke their affair off. Foreman professes disinterest, even as he rules out area after area. But Chase can't let it alone, and keeps talking while Foreman tries to concentrate. Finally he declares that Chase is an idiot, and Cameron is either lying or genuinely emotionally detached, and which one sounds more like Cameron. "Neither," says Chase. Well you've got to chose one, Foreman responds. They find a bright spot on the image of her ovaries : looks like a solid tumor, Foreman says.

In the hospital gift shop, House is perusing a tabloid. "(Something Illegible) Report". PTERODACTYL TERRORIZES CITIZENS reads the headline, which is illustrated. And HIDDEN TREASURE FOUND IN MAN'S BRAIN. Also illustrated. House slams the tabloid shut and proudly announces to one and all "They printed my letter!" Wilson sprints up and says Cuddy sent him flowers after their date, with a mushy note indicating she wants him. She wants him, man! Cuddy approaches and Wilson panics and leaves. House tells Cuddy they printed his letter, brandishing the tabloid some more. Cuddy asks what's up with Wilson and he tells her (without explaining) that Wilson is freaked because he, House, sent Wilson flowers.

Cameron is in the hall when she's approached by Jasper, who's gliding on those cool shoes with inline skates built in. It they'd had those when I was a kid, I'd have totally lived in them, or maybe died in them since I was and am something of a klutz, balance-wise. Cameron's carrying plastic bags of food and products taken from Jasper's home, which Jasper totally fails to notice as he queries her about her love life, and is that other doctor your boy friend? No, just a friend, Cameron explains, the crush apparently not seeming quite so cute anymore. Do you like him? Jasper want to know. Do you like him like him? Cameron is in her civies, not her smock, and has some smokin' hot white pants on like my wife used to wear when we first got married, and I can still feel all warm when I remember those pants. She turns and bends over to set down her burdens in her office, and Jasper takes every opportunity to check out the smokin', pants fillin' action. When she turns back around he offers "I could be your boyfriend." Cameron struggles to come up with a non-devastating but still discouraging word, and Jasper adds "He seems like a tool." Which some of us have thought, from time to time, Jasper, but don't press the lady too far : she'll be forced to defend her colleague. She chastises him a little less gently and turns him around, hand on shoulder, to take him back to his father. Encouraged by the intimacy, Jasper places his hand around her at about his shoulder height, which just by accident, I'm sure, happens to be right on Cameron's oh-so-tight ass. She gasps. He smiles.

As Chase and Foreman operate to biopsy the tumor, Lucy goes into arrest and has to be defibrillated. After a few tries, her heart is restarted.

Out of the OR, Chase theorizes that the heart arrhythmia must have been a reaction to the blood thinning drugs, and they should be discontinued. Which of course would put her back in danger of a stroke Cameron points out. Should be cured by resecting the tumor, Chase says. But it turns out that the tumor wasn't a tumor, but a benign cyst, Foreman says, rearing up from the microscope where he's been examining it. Which news actually brightens Cameron's day, because she now realizes she must have been on the right track about environmental sources. The team looks glumly at a table full of suspicious consumer products and Foreman says he's ‘feeling another late night.' This time he's the one who ducks out, leaving Chase and Cameron to do the analysis. Chase doesn't look too disappointed at the prospect of spending the night alone with Cameron, though I suspect she's not going near any janitor's closets.

Late that night, in a quiet moment in the break room, Cameron and Chase discuss their relationship in a more friendly manner, and Jasper's ass-grabbing. Chase cops to having been a boy once, too, and knowing how they think. "You were a pervert at eight?" "Um, maybe… eleven." It's a sweet moment. Cameron apologizes for hurting Chase. But she's not giving on the main point, that she was only in it for the sex. Chase on the other hand wonders how she can have feelings for puppies and patients she barely knows, but not for him. He reminds her of their times together and gently strokes her arm, and asks if she really feels nothing? Before she can answer, Jasper comes down the hall, sees the two of them together, and attacks in a rage, knocking Chase down and biting him on the arm. Jasper is quite the little bulldog, and Cameron has some trouble pulling him off.

House is at home watching Wrestlemania, when they call to report the bite. House professes disinterest at first and hangs up. But the watching ‘roid raged monsters slamming each other around the ring, the light bulb goes on over his head. He calls them call back. House figures this is a new symptom, meaning that Jasper's sex hormones are working overtime, too, and Jasper may be in as much trouble as Lucy.

Act 4

So now it's Jasper's turn down the MRI rabbit hole, and the team says he has about one hundred times too much testosterone. Foreman's sold on environmental causes now, since the odds of brother and sister developing the same sort of hormone secreting tumor at the same time are nil. Only problem with that, Cameron say, is she and Chase worked all night not finding any source. Chase wonders it there could be a genetic factor, shared with their recently deceased mother : who died of a brain tumor. They start to look for similarities between the two and their deceased mother.

Lucy and Jasper are sharing the room now, in side by side beds, and Jasper grouses because it's Foreman inserting his blood release line rather that Cameron. In the midst of Jasper's exam, Lucy begins shrieking that her tummy hurts. A few x-rays later, we discover she now has a cyst in her pancreas, two more in her kidneys, and one in her lungs : none of which were there forty-eight hours ago. One in her brain or heart can kill her, House says.

Now Cameron's gone over to glandular theory, and thinks the excess hormone is coming from an overactive pituitary gland, which will have to be removed. Which would leave her dependent on hormone replacement therapy for the rest of her life. House argues the cause must be environmental, despite the team's examination of the patient's home coming up negative. Cameron argues that the patient has been out of the home environment for four days and the symptoms are still getting worse. It's wonderful how the team keeps switching sides, and making the same argument for their new side that they used to make for their old one. Both House and Cameron use the ‘just because we haven's found anything yet doesn't mean it isn't there' argument, she for a pituitary cyst, he for an environmental cause.

Cameron is determined to persuade Deran to sign a consent form for brain surgery. House seems a little impotent in the face of her determination, like he's not completely on his game this week. House interrupts Cameron's pleading to argue, a bit unprofessionally in my opinion, in front of Deran. House still argues for environment, but the only environment the brother and sister share outside their house is the day care center and none of the other children there are sick, Deran says. Finally, Cameron plays the ‘my husband died of a similar cause' card. House makes up a ‘my wife died from signing a consent form' story on the spot, but Deran sees through it and signs the form.

As Cameron whips off to sharpen her brain-surgery tools, House asks Deran how he knows none of the other children are sick when Deran's been here at the hospital for four days. Deran says he ‘would have heard' and House begins to put one and one together and come up with his second light bulb of the case.

House visits the day care center asks inappropriate questions of a four-year old, who runs off calling for "Miss Janie." He confirms that Deran is dating Janie, but she says she's never been to Jasper and Lucy's house, never brought anything there that could be a source of hormones. House detects that Janie has had her lip waxed and wonders why at her age she'd be having that done : a sure sign of excess facial hair in a young woman- which could be caused by excess hormones. He phones the team : "It's always the dad."

Back at the hospital, House confronts Deran and gets him to admit he uses a ‘male enhancement cream' to keep up with the much younger woman he's dating. But, he says, he keeps it at the gym and never brings it home, so there's no way it could be the source of the children's problems. But he brings himself home, House points out, and excess hormone is excreted through the skin, and every hug delivered a dose to his children - case solved.

In the aftermath, House is in his office reading his letter in the tabloid. We get a full front-and-back cover view, but lacking HD TV, your poor recapper can't deliver any more juicy headlines. Wilson comes in and agonizes over how to handle Cuddy's mash-note. Finally he says he's going to walk straight into Cuddy's office and kiss her. "I'll either get a girl friend or get fired." House is being uncharacteristically supportive. Wilson leaves. Then he come right back accusing "You, you, you…you were going to let me do that?" He's seen through House's ruse. After each plays with the other's mind a little more, they part, still BFF.

Cameron and Chase meet in the locker room. Chase has brought her flowers labeled "Not Stolen". Chase still doesn't want a relationship, but the flowers touch her. They leave. [Recapper's note. There's a shower in this locker room. Do men and women doctors really have unisex, showering locker rooms? Or do you have to lock the door to take a shower?]

House and Cuddy stand on the balcony and watch the now-happy semi-family leave and puzzle a bit over relationships. House says "I've got tickets to a play", and Cuddy wonders, "Haven't I just heard this line?"

- Cecil

See "House Keeping", 4/24/07 article for a big whoops concerning this review
Next Week:
A woman screams. She's become acutely sensitive to touch. How do you cure her if you can't touch her?

Prev Episode: 3-18 Airborne
Next Episode: 3-20 House Training

Guest Cast Ep. 3-19, "Act Your Age" Aired 4/17/2007

Deran____________E. Erich Anderson
Janie_____________Carla Gallo
Jasper____________Slade Pearce
Lucy_____________Bailee Madison
Eddie_____________Joel David Moore

Posted by Cecil on April 19, 2007 3:04 AM
Permalink |

I love House, but I thought this episode was one of the weakest in the past two years, and I've seen them all. The storyline between the staff was fine, but the girl/dad/cream angle, I thought was kind of lame.

Second issue, how does the wardrobe department get Jennifer Morrison in those pants? Not complaining, but wow, when she bent over, before getting goosed by the young kid, I was worry the seam was going to slice her in half!

-- 1. Posted by: Bryan at April 19, 2007 10:25 AM

I agree, the medicine in this story was pretty weak. I've seen all the house episodes, too, although I've only been writing this blog for the last three. In reviewing the shows I put together a folder of links to articles on the medical issues behind each episode, and I really don't have much to show for this one.

But boy, coudn't Bailee Madison make wonderful faces as a little girl in distress?

They didn't even give a name to the condition, so it's been hard to research, or uncover links to real-world examples of this happening. Wonder if some medical advisor to the writers just began speculating?

On the other hand, wasn't the interplay between House and Wilson funny? I especially enjoyed Robert Sean Leonard's cry of exasperation that House was just going to let him walk down and plant one on Cuddy without revealing the joke that, fortunately, Wilson saw through. And their continued toying with each other's perception of reality - Really? No. Actually, yes. Really? No.

As to Morrison's pants, there may be two schools of thought - perhaps there's a fabric shrink-fit technology we males know nothing of, or maybe, if you look close, those seams are painted on.

-- 2. Posted by: Cecil Rose at April 19, 2007 11:23 AM

so informative, thanks to tell us.

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