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House: 504C - Birthmarks

House Episode 5-04C - "Birthmarks"

Airdate: Tuesday October 16, 2008


The Hook:

A young Chinese-American woman searches thought the dark streets of - some Chinese town - with an interpreter. She's looking for the parents who gave her up for adoption in infancy. The interpreter suggests they try the home again, but the woman persists in searching. She spots a couple and insists they are the ones. She babbles out words though her interpreter at the confused couple. The man reacts angrily, the woman appears frightened and confused.

The couple hurries away as the young woman asks the interpreter what the man said. "He wants you to leave them alone." The young woman scurries after them asking for 'just ten minutes.' The man literally spits out angry words and again turns to go as the interpreter apologizes over and over. Now the interpreter tells the young woman "He said, they have no daughter. I'm sorry you wasted a trip." The young woman repeats that she knows that that couple are her parents. She turns to a Buddhist shrine and asks "How does that work?" The interpreter tells he to make a wish and lift the Buddha. She wishes for understanding from the couple, and easily lifts the idol. Now make the wish again and try to lift the Buddha, he tells her. If she cannot lift it, her wish will be granted. This time she makes a strong effort, but fails, collapsing and coughing up blood as the interpreter calls for help in Chinese.

Act 1

In his office, House ponders the case while Kutner tell him his mother called twice, sounding worried. "That's the way women sound when their spouse of fifty years dies." House says offhandedly. The rest of the team exchange glances at the news of House's father's death. They try to sympathize but House puts them off, preferring to discuss the new case, who is of course the Chinese-American girl. It's not sublimation, he really doesn't care.

The patient, who has a history of alcoholism, he tells them, vomits blood on a trip to China. The Chinese doctors cut out of foot of bowel, but didn't cure the problem. Taub tells House to call his mom. House analyzes that Taub has told his wife of his infidelity. [I guess this answers my questions from last week about Taub's "We need to talk." But I thought Taub's wife already knew about his infidelity. Wasn't that why he left his plastic surgery practice - to save his marriage? Or maybe this is some new infidelity. I'm so confused,] Taub won't be deflected. Yes, he told her, Taub says, but no, she didn't kick him out. Foreman wonders if anybody can read the Chinese surgeon's reports? House says Kutner's the closest thing they have to a Chinese, so sends him off to get a translation. Hadley suggests a diagnosis that requires an ultrasound to confirm, and House volunteers himself to do it. Foreman say let him do the ultrasound while House calls his mom. House says he's fine and "didn't even like the man."

House examines the patient who has a huge abdominal scar. She tells him she was in China to track down her bio parents. As he feels her lymph nodes, she coughs in his face. The adoptive parents stride into the room, telling the 'doctor' who they are and that they brought all her meds. House claims to be 'just a technician', but examines the meds. The girl is annoyed her parents 'went through' her apartment. Mom mentions they found alcohol which she'd claimed to have quit. Dad wants to know if her drinking caused the problems. 'No', says technician House. "Can you tell her it did?" Dad asks. Wow. Daddy issues. Are we sure this isn't "Lost"?

House tosses a package from the box to Foreman, stating "licorice root." "No, thanks," says Foreman. House is annoyed. The Chinese doctors gave it to her, apparently as a remedy for SARS. [That clicking sound you hear in the background is the hospital locking down.] House says it would explain all her symptoms. Foreman thinks the lung involvement isn't as severe as SARS would cause. House nevertheless says to start her on ribovirin and interferon, more Western treatments.

Cuddy comes into House's office and commiserates over House's father, or maybe it's solomiserates, since commiseration would seem to require two parties and House isn't having any. Cuddy says her visit has a second purpose - the hospital is giving IG shots to everyone exposed to House's patient, so drop'em and bend over buster. Cuddy looks like she enjoys it. She also tells House to be on the 6:45 flight to Lexington, there to deliver a eulogy at the next day's funeral at his mother's request. House resists.

The patient is in a glass room, accompanied only by a bemasked Kutner, while mom, dad, and assorted siblings look in from outside. She crabs that her parents yanked her brother and sister out of college, as if she was dying, of heaven's sake. Kutner tells her SARS is a big deal. He asks her for the name and number of everyone she's been in contact with. She wants to know how the doctor she coughed all over is doing, Fine so far, says Kutner.

In his office, House tries to stand and collapses.

The patient erupts in abdominal pain. Her abdomen is jaundiced and yellow. "He liver's failing", Kutner says, "it's not SARS."

House comes to. In a moving car. Wilson is driving, and they're headed West through the countryside. Looks nice. They must be out of the Garden State already. "I am not doing this because I care," Wilson says. House half-smiles.

Act 2

"Cuddy drugged me," House correctly deduces. House says he knew Wilson couldn't stay away, because he loved House too much. Wilson says he's doing it for House's mom. House says he's not going. House discovers his vicodin is gone. Wilson doles him out a single pill.

House's phone rings somewhere in the car, and House recognizes his team's ring-tone. When Wilson is finally persuaded to let House have his phone, House's first words are "Help, I'm being held captive against my will! Call the police." The team, used to House's antics, ignore him and begin describing Nicole's (for that turns out to be the young woman's name) new symptoms and the treatments they've given. Clot in a hepatic artery but no malformation of the liver or anything else that would explain what they've seen... Kutner starts to say, but Hadley interrupts "She's an addict." Not the alcoholism but the smoking (deadliest sin in today's medical society) They suspect that the ravages of smoking plus some genetic defect could create all her symptoms and Foreman orders blood work to find the genetic needle in the symptom haystack. House signs off, his input apparently not being asked for. And tells Wilson "My ringtone for you is 'Dancing Queen' by ABBA."

In the hospital, Kutner finds Nicolle to be MIA.

House request a pit stop from a still-sullen Wilson. At the next rest stop Wilson opens the door for House but refuses to give him his cane. House grouses about how his father stopped talking to him for a full summer. Wilson tell him to just go for his mother's sake. House offers to go if Wilson will give him his cane. Wilson does and House promptly uses it to knock Wilson's key out of hand, and they fall though the bars of a storm-sewer grate.

Kutner finds Nicole sitting on a bench outside the hospital smoking. He chides her that the hospital prefers its patients on the inside, then when they make them better they go outside. She correctly rebuts that they don't let you smoke inside. In fact most of the hospitals I've been to lately don't even want you to smoke on the grounds outside. (Yay!) Kutner, obligingly, has all his medical equipment with him, so sits down, gloves up, and prepares to take blood samples.

A passerby give the two a look. Kutner jokes "It was such a beautiful day we thought we'd do all our doctoring outside." Nicole take the look to have been a comment on her Asianness, or perhaps them as a mixed couple and relates how she always got stares when out with her New Jersey parents. "Which one of these doesn't fit." (I think the stare was more likely about "How can you stink up this beautiful day for the rest of us?") Kutner tells her he was adopted by a white couple himself after his parents were killed in their store, and how he didn't mind being different - it made him feel special. He's take is first sample, but the needle prick won't stop bleeding. "sS that a problem?" Nicole asks. "This is why we prefer inside," Kutner says, grabbing girl and tray. The scene ends here, but I'd like to have seen how hard it was to get her to turn loose of that ciggy as they dash inside.

Act 3

Wilson is winding up his no-battery flashlight and preparing to fish his keys out of the storm sewer. House comments on Wilson's disgusting state of preparedness. Wilson asks House to hold the flashlight and House promptly tosses it in after the keys. House and Wilson talks as Boy Scout Wilson pulls another wind up flashlight out of the trunk and winds it up, then begins fishing. Wilson tells House his delay won't work, his mother will hold the funeral for his arrival. House thinks she won't - his disgustingly punctual father's memory wouldn't allow it. Wilson retrieves the keys.

At a nurses' station, Cameron is in front of a computer wondering what flowers she should send in House's name. Chase suggests "one of those giant cookies shaped like a coffin - his mum would believe it was from him." Foreman says he didn't expect her to send flowers for House, he just wanted them to know them depraved he was. Kutner comes up and reports that the patient seems to be bleeding and clotting simultaneously. Certain signs point to cancer, but what kind of cancer? Foreman says to go run a CT.

Chase says he doesn't buy House's act. "When my father died I wound up killing a patient, and I hated the man." [1. I believe Chase means his father, not the patient. 2. Didn't they reconcile, at least a little, just before Chase's dad flew back to Oz (without telling Chase about the tumor)? 3. Chase killed a patient? I remember Foreman killing the patient with the bra-hook lesion that became infected when he thought it was cancer and suppressed he immune system. I don't remember Chase killing anybody recently.] Chase thinks House is a mess (over his father) despite the uncaring act.

Wilson tells House he's biologically programmed to have feelings for his father even if he was a bastard. House says no he's not - he figured out when he was 12 that his dad wasn't his bio dad. His evidence is his father's deployment schedule, the fact their toe-lengths don't match, and a birthmark that doesn't match his dad but does match a "certain friend of the family." House takes his cane and jams the accelerator pedal down, causing Wilson to speed and pass in a no-passing zone right in front of a cop. Lights and sirens come on, and House retracts his cane and becomes an angel.

Kutner and Taub feed Nicole into the cat scanner as Kutner relays how Nicole's parents adopted her because they thought they couldn't have children, then promptly had three, making her feel unneeded, therefore unwanted. Taub says everybody has problems with their parents, birth children just as much as adopted. Kutner says that she's an addict -something must have gone wrong. They find something in the pancreas as the machine beeps, and Kutner says "I think we may need to call House again."

House and Wilson talk as the cop runs their ID's. Wilson didn't even try to blame House, just took the apologetic approach. Wilson says he just wants to get House to the funeral as quickly as possible, as the phone rings from House's team again. 'Mass in the pancreas.' Foreman reports. House asks for a detailed report. The trooper strides back to the car and demands Wilson get out. Foreman describes the mass in the pancreas as Wilson is getting handcuffed outside the car. House begins one of his analogies of a 'steamroller in a construction site' as the cop grabs his phone and demands he get out of the car as well. They're Hell on speeders in Kentucky, especially if they have New Jersey license plates. As he pats House down, the cop tells Wilson there's a warrant for his arrest in Louisiana.

Act 4

Back in New Jersey, the team tries to figure out House's steamroller analogy. Foreman wants to go with what the symptoms tell them but everybody else plays metaphor, metaphor, who's got the metaphor.

House and Wilson sit on a bench in front of the cop's desk. House asks for his phone so he can call the team, The cop says he's sure there's other smart doctors. House says "You'd be surprised." Wilson says to House "You told me you'd taken care of it." House says he did. "First words you ever said to me." "I took care of it." Wilson tries to tell the cop they need to be at a funeral. "Nobody is going anywhere or taking any phone calls till I hear back from Louisiana." Wilson tries to plead to the cop that the charges are old and "so minor". "Vandalism, destruction of property, assault," the cop reads. Wilson tries to explain, but the cop doesn't want to hear it. Wilson tries anyway, something about a medical convention but House tells him, "You heard the man, he doesn't want to hear it." The cop has his back turned making a cup of coffee. [Break for it, boys!]

"I'm not going to sit here wasting time just so you can avoid your father's funeral!" Wilson erupts. This gets the cop's attention. "He's my father, I have the right to avoid his funeral if I want," House pouts. "Not if your mother's alive you don't." says the cop, drawing closer. [I'm beginning to like this guy. If the detective's out, can he become a recurring character, maybe transferring to New Jersey?] "OK, explain."

The team narrows down the pancreas problem to either gallstones or - sounds like "dweasle's". [Isn't that Frank Zappa's son's name?] They settle on gallstones just as Kutner runs up to tell them "it's gallstones!"

Wilson explains he was at the hotel bar trying to unwind whiles some jerk kept playing Billy Joel's "Leave a Tender Moment Alone" over and over on the juke box. Wilson almost loses the cop, a Billy Joel fan. House toadies by agreeing with the cop. Wilson says he politely asked the man to stop. But of course he didn't, and like any repressed introvert, Wilson remained polite until he exploded and threw a bottle into the 10 foot antique mirror over the bar. But he had nothing to do with the subsequent bar fight, Wilson says, and he paid for the mirror.

The cop and all of us have been assuming that House was the ass playing the song, but nope, he was the guy who bailed Wilson out. That's how they met. House felt sorry for Wilson and also grateful for his enlivening a boring convention. House told Wilson he 'took care of it', hiring a lawyer and everything, but neglected to tell Wilson he still had to show at the arraignment, and they bicker back and forth until the cop breaks in with "You can go." It seem Louisiana doesn't consider Wilson's charges important enough to pay for extradition. But don't get any more tickets or attend any conventions in New Orleans, Wilson. House grouses about the slackness of rural justice, but the cop gets in one parting shot, "Stop acting like such an ingrate, and go pay your respects to your father."

The team briefs Nicole on her upcoming gallstone operation but Chase notices her urine has turned brown. "It's not the gallstones."

Act 5

"Well of course it's not gallstones," House says on the phone as the car enters Southern suburbia. House tells Wilson to turn around since it's two hours past funeral time. House says there were multiple cysts, not just the one in the pancreas. But how are they going to find them? Exploratory surgery is too risky in a patient with kidney failure, Hadley suggests injecting bubbles into the cysts and seeing where they drift. House tells the to do that. And Wilson pulls up at the funeral home.

Nicole is jerking as Taub tries to inject air into her cyst. She says she's nervous, but Kutner correctly figures it's DT's, She's had a smoke break but no liquor break.

House and Wilson come into the funeral parlor, heavily populated with Marines in dress uniform, and the funeral has not take place yet. Wilson gloats a little. House's mom is relieved to see her "Greg" and thanks "James." She wants a eulogy from House, who'd rather it was a minister or one of his dad's buddies from the Corps, but mom won't be denied.

Kutner explains the DT problem to Nicole's parents. They need to paralyze her with Phenobarbital to allow the procedure to take place. The parents recall all the times they've recued her from her addictions. Nicole doesn't think she can save herself any more. "Let's make you healthy,: Kutner says, "then we'll worry about making you sober."

A minister begins the service with a prayer. The coffin is open, Greg's dad on display in his dress blues. A flag drapes over the coffin. As the prayer continues, House and Wilson exchange whispers, House still resisting speaking. "He's here." "Who's here? The man you're pretending is your father?" Hope House's mother can't hear this. She's sitting right beside them. Wilson speculates on how House would have told his father that he thought someone else was his father. House says he did so, only with different words than Wilson had guessed. Wilson is flabbergasted that a 12 year old do such a thing, "Why do you think he didn't talk to me for a whole summer?" House asks. House's mom must be a real intense pray-er because she appears to have heard none of this.

Now House's mom is introducing him for a eulogy. House gets up and begins to give a most ungracious eulogy - bio dad or not, does he not realize what a strain med school must have been on a Marine's pay? Wilson is mortified. Mom appears not to notice, at first. Midway though House hesitates and changes tone, and paints a more conciliatory picture of his father. Then he falters and can't go on. Is that a tear? He hobbles to the coffin and kisses his father's forehead.[ Betcha R. Lee Ermy needed all his (real) Marine corps discipline for that one.] Then he leans closer and ships a piece out of his father's earlobe as Wilson grows suspicious and joins him at the coffin, hissing "Put it back!" But House uses Wilson's fear of distressing everyone else to keep his genetic sample, and they walk from the room as the service continues.

In another, empty, room, they argue in front of someone else's open casket. Wilson protests House's callousness and ingratitude. House contends Wilson liked coming along for the ride. House plays unfair by bringing up Amber, saying Wilson was unprepared for her death and now is scared of losing the only remaining person that matters to him (i.e. House). Wilson says House's ego makes everything about him. His father's death, Amber's death. House chides Wilson to "admit it" that he's angry and scared of losing House. Wilson protests. House repeats his "admit it" over and over. Wilson, enraged, picks up a bottle from a table and tosses it though a stained glass window, into the room where the funeral is still taking place. Wilson gapes. "Still not boring," House says. Guess there's gonna be two states Wilson has to stay out of.

Act 6

A diner, presumably outside Kentucky. Wilson asks House if House knew Wilson was going to do that. House says he knew Wilson had trouble losing people. In New Orleans House saw Wilson carrying around this express package that he couldn't open, but couldn't let go of. Divorce papers from Wilson's first wife. House calls the team. They say the problem wasn't cysts but a bunch of big words meaning a heart problem that they could see on the rather grainy ultrasound. House tells them the images aren't grainy. She's got an iron overload. The iron particles make the picture look grainy. MRI her for a better view, then call him back. He asks them for a phone number.

House calls the interpreter in China to ask him a couple of questions. Were the parents tan? Not especially. How were their teeth? About what you'd expect from a farming village with no dentist. But, for what it's worth, the interpreter add he's not sure they were her parents. The father was adamant that they had no daughter and the mother looked confused and frightened.

Why, House wonders, would a middle aged Chinese woman be frightened when a girl comes to her and tells her she's her daughter? Perhaps she's a threat?, Wilson speculates. Inheritance? Wilson asks what year she was born. '83. "She's not supposed to be alive," he says, "China introduced the one child policy in 1979." They didn't want a girl and tried to kill her. The father bungled killing the baby, they speculate, and gave her to an orphanage without telling her mother, who freaks out when presented with this specter from twenty five years in her past. But how can a mistake twenty five years in the past be killing her today? "Maybe they gave her something toxic," Wilson speculates, engaged, "it would have to be fat soluble." "This is fun, isn't it?" House asks.

PPTH. House strides in and asks to see the MRI. "Don't have one, Taub says, she started vomiting as soon as they started to push her in. House says go ahead with it and let her vomit. "That's what nurses are for." Taub departs and House tells the rest "Her parents tried to kill her." However they tried, it's something that would make her get sick twenty five years later trying to lift a Buddha. Why? "Poison?" Foreman wonders. "The Buddha wouldn't make it worse." "Strain on her back?" Hadley asks. "Could be, if she's never lifted anything in her life." Kutner observes "She actually didn't get sick until she tried lifting it the second time. I'm guessing the weight changed." 'Yike! Stop that MRI!' House realizes. Before it kills Nicole. "X-ray her brain."

And there they are. Pins in the brain. Pushed into the soft skull of an infant, the hair hiding the entry wounds. The Buddha had an electro-magnet [just like an MRI], to make it heavier on the second lift. When it activated it pushed one of the pins deeper in her brain, causing all her symptoms in China and thereafter,

Kutner explains the operation to remove the pins to Nicole's parents. They wonder if their fragile darling can take the news her bio parent tried to kill her. Kutner tells her she may not be a fragile as they think. "See this pin here?" he says pointing to the x-ray. "It's been impinging directly on her addiction center for twenty five years. It's not her fault. She's not who you think she is,"

House sits alone in his office. Wilson comes in. House says he's celebrating. He doesn't look or sound like he's celebrating. He got the genetic results. His father's DNA sample showed no match to his own. Wilson commiserates. Wilson says he's not sure if we can choose out parents, or even our friends. House's interest is piqued. Wilson has spoken with Cuddy. She hasn't filled his old position yet, and will take him back. [That sigh you hear is the oncology department all realizing they're not going to get a step up.]

Wilson admits that strange annoying trip they just took was the most fun he's had since Amber died. [And what the hey, let's take some more, there's 47 states left where I'm not person no grata .] "You hungry?" Wilson nods.

They prepare to go. House says quietly, "Wilson." "Yeah?" " My dad's dead." "Yeah. My sympathies."

The two friends walk off together.

- Cecil

Next Week:

Cameron says "Hadley said the seizure patient took the drugs about five hours before the seizure." How would she know? "She was with the patient last night." Quick scenes of bi love. House rolls his eyes. "A doctor with an incurable disease tries to save her patient's life while she destroys what's left of her own. House fires Hadley. "I'm already taking responsibility for one doctor with a drug habit." Gulps another vicodin.

Below the line analysis:

Whaaa! No more R. Lee Ermy!

Whaaa? No more Lucas? I protest. Can't we find some way to keep him around?

Last Episode: 09/30/08 5-03 Adverse Events
Next Episode: 10/21/08 5-05 Lucky Thirteen

Cast Ep. 5-04, "Birthmarks" Aired 10/16/2008

Cast and Crew

Director:...David Platt
Writer:......David Foster II


Hugh Laurie.................Dr. Gregory House
Lisa Edelstein...............Dr. Lisa Cuddy
Robert Sean Leonard....Dr. James Wilson
Omar Epps....................Dr. Eric Foreman
Jesse Spencer................Dr. Robert Chase
Jennifer Morrison.........Dr. Allison Cameron

Recurring Roles:

Olivia Wilde................Dr. Remy Hadley (Thirteen)
Peter Jacobson.............Dr. Chris Taub
Kal Penn......................Dr. Lawrence Kutner

Bobbin Bergstrom........Nurse

Guest Stars:

Samantha Quan................Nicole
Esther Kwan....................Wu An Lan
Raymond Ma...................Wu Zheng
Christine Healy.................Janice
Scott Paulin.....................Bob
R. Lee Ermy..................John House
Diane Baker....................Blythe House
Ho-Kwan Tse..................Fang Dong We (Interpreter)
Jack Conley.....................Sheriff Costello
Jonathan Palmer...............Minister

Posted by Cecil on October 13, 2008 6:15 PM
Permalink |

I'm pretty sure Chase was referring to a season three episode where he mis-diagnosed a young mother named Kayla (I think, it has been awhile.) Kayla's brother had convinced her to go to Mexico to get an organ from the black market and then wound up donating his own organ to her. Turned out he was sick as well and her system couldn't take it. Chase was brought up for review and he tried to lie and say that it was because he was hung over, but House knew about his dad and figured it out. And that was probably way more info than is strictly neccesary. :o)

-- 1. Posted by: Kate at October 23, 2008 10:35 AM

Hi Cecil! If you still want to watch the UT vs. Alabama game this weekend, the UT Alumni will be at:

www . blincos . com

I think the game starts at 7:45. Hope to see you there and anyone else that's a LOST or House blogger from near the Raliegh area.


-- 2. Posted by: BunnyLover aka HouseHater at October 23, 2008 11:39 AM

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