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House 509C - Last Resort

House Episode 5-09C - "Last Resort"

Airdate: Tuesday November 25, 2008

This is a capsule review - it will be supplemented soon by a full review.

The Hook:


The PPTH clinic. Doctors, staff, and patients stroll around, to no apparent purpose. Patients sit glumly, or converse in small knots. A large man stops talking on his cell phone as Hadley strolls by, to request a refill prescription for his migraine meds. Hadley briskly tell him to sit glumly and wait, he isn't an emergency, to which he correctly comes back that "This isn't an emergency room." Hadley brushes him off again as Foreman approaches to ask her if she's like to star in one of his clinical trials of a new medication for Huntingdon's disease. Not only 'no', but 'hell no', is the answer and she isn't doing anything else for her disease, either. Forman looks worried. As he leaves the camera focuses on a small nerdy looking guy sitting quietly in a chair.

The nerdy looking guy's eyes stray to the office door of one "Lisa M. Cuddy, Dean of Medicine". Inside, however is a most non-Lisa looking guy going through her desk. Guess who?

The nerdy looking guy enters Cuddy's office, politely asking for her and receiving a smart-alec answer from one Greg House. Nerdy looking guy apologizes and leaves. Back in the clinic, he stands with hung head and hang-dog expression for a while, then slowly reaches into the waistband at the back of his pants and under his coat and PULLS OUT AN AUTOMATIC PISTOL! Totally unobserved by anyone in the clinic, by the way.

Seconds later he's plenty observed as he ushers a crowd of staff and clinic patients into Cuddy's office, led by Hadley. House starts another smart remark, then sees the gun. "Shut up" says the not-so-nerdy-looking-any-longer guy. He says, "I'm sick, and I want to know why. I want the best doctor in this hospital, here, now! Or I'm going to start killing people." Big Guy, who is among the clinic patients, really, really hates Hadley now for not giving him that prescription earlier.

"What seems to be the problem?" says a, for once, meek sounding House.

Act 1

The No Longer Nerdy Looking Guy directs his hostages to barricade the room and close all the blinds. NLNLG hands House his medical records. House has recovered and is making smart remarks again. NLNLG says he's been to sixteen doctors in the last two years and been subjected to numerous tests and therapies without getting cured. He can't breathe, he's tired, he gets skin rashes, heart palpitations, and has insomnia. House smarts off but NLNLG tells him to "Shut up and do your job." And takes his cane away to boot.

Outside, the hospital is hastily evacuated, as Cuddy bucks the flow coming in with her cell phone pressed to her ear.

House is examining the NLNLG with a gun in his ribs when the phone rings. NLNLG clicks it on/off to shut it up. House asks for elucidation on the breathing problems. Shortness of breath, sharp pain in inhalation. House speculates on the NLNLG's history - "wife left you..." NLNLG says he was never married. House asks the NLNLG if he has a match. Hadley volunteers to look in Cuddy's desk. House cuts her off saying Cuddy doesn't smoke, "but he does", pointing at one of the hostages, Suited Guy, citing his yellowed teeth. Suited Guy denies it, saying he's never smoked. When another hostage, Young Curly Haired Teenager reaches for his pocket, the gunman reacts with his weapon, but it was only to bring out a lighter.

House directs NLNLG to hold it out as far as he can and try to blow it out. NLNLG only sort of wheezes at the lighter at arm's length with no effect, but apparently that's enough for House to diagnose pulmonary scleroderma. "A simple alkylating agent and the case is solved, see you on visitor's day." NLNLG can't believe it's that simple. The phone rings again and he hands the phone to House. "Crime scene", House answers jauntily, and Cuddy asks him what's going on. House asks her to send in some propofol to confirm his diagnosis via a guard. NLNLG says, no guards, Cuddy must bring the drug. House rubs his leg as NLNLG holds the gun on a weeping woman hostage as Cuddy knocks at the door. House answers, but Cuddy can see the gin trained on the hostage. Cuddy is worried for House and the others, but NLNLG snaps "say goodbye or I shoot her." House relocks the door and returns with the drugs.

House prepares a syringe, but NLNLG says to give it to someone else first. House says most of the people in the room are sick, and can't handle it or are on pain killers with fatal interactions. NLNLG says Big Guy isn't on painkillers, he heard him ask for some from Hadley. BG tries to shift the shot to Hadley, but House tells him she's sick and you, BG are a very large creep and come take your medicine both literally and metaphorically. He injects BG. "Satisfied?" House asks and tells NLNLG to roll up his sleeve, but before he can do so BG collapses. "You think I'm an idiot?!" NLNLG screams. House says he thought he had a little more time with a guy that size.

NLNLG racks his automatic and points it in House's face, which, since nothing comes out of the action, means that the gun was incapable of firing up to that point, and the hostage taker is an idiot, or else the writers are. And had a bullet had come out of the action, it would mean he was wasting a perfectly good, unfired round and the same two conditions still apply. My money's on the writers being typical Hollywood wimps who've never held an automatic in their lives, but see lots of actors doing the same thing in the movies.

House points out that NLNLG still needs him. NLNLG, agrees, but says he also needs House to know he's serious, and shoots Suited Guy in the thigh, a la Jack Bauer [and wasn't is great to see him back in action last Sunday?] The phone rings. "It's for you," says House.

Act 2

As Hadley treats Suited Guy, NLNLG repeatedly pick up the phone and drops it back on the cradle, only to have it ring again.

Outside "Lt. Bowman, Princeton SWAT" introduces himself to Cuddy and Holey Moley! it's Avon Barksdale from "The Wire" (actor Wood Harris) nice to see him working on the right side of the law for a change. He's wearing body armor but, unlike his men, no helmet, since the big actors hate for anything to obscure their faces.

In a hallway [guess PPTH couldn't be completely evacuated] Taub, Kutner, and Cameron treat bedridden patients. Taub grouses that House is going to get someone killed. Kutner says he couldn't think of a better doctor to be in that situation, which I guess you can take two ways. Cameron is more in the Taub camp. House pages them.

Foreman, Cameron, Chase, Kutner, and Taub call from a safe location. House describes the gunman's symptoms. Chase frumps that "playing this game" will lead to copycats and leaves. House begins writing suggestions on the wall of Cuddy's office with a permanent marker. Guess Cuddy will always have a souvenir. Chronic lung infection. Cancer. Nervous disorder. Heart defect. House says they'll draw blood for Foreman to test. Cameron to comb though medical records. Taub and Kutner to search NLNLG's apartment for neurotoxins. NLNLG give s them the address without hesitation.

Lt bowman picks up the phone as House reports one lower limb flesh wound [that's a diagnosis? Lazy writers again, I fear.], one unconscious guy... NLNLG cuts off the phone and tells everybody to shut up. He instructs a female hostage, Hot Woman, to open a blind a few inches. She protests "why me?" and when he points his gun at her collapses and vomits. Hadley opens the blinds, we see SWAT sneaking up and, NLNLG ducks behind a bookcase and threatens to kill Hadley if they don't back off. They back off. House diagnoses another symptom, hyperacusus - extremely acute hearing - which House says makes the nerve disorder the leading candidate. Hadley notices a microphone planted on the window but wisely refrains from drawing attention to it. House has NLNLG smile, which is lopsided, and diagnoses post herpatic neuralgia. NLNLG protests he doesn't have herpes. Could also be cause by chicken pox, House tells him. NLNLG says he needs proof. House says the test is dangerous and painful, though the treatment is safe and painless. That is, the test is painful if you don't have the condition but not if you do, he clarifies. The phone rings. Bowman is on the other end "Jason, don't hang up the phone again." We have a name! House request that 200 micrograms of capsaicin be sent in, and two syringes. Bowman bargains, and Jason agrees to give him two hostages. But no officers, Cuddy only to bring stuff in. When Cuddy agrees, Bowman is worried she has an emotional investment in somebody inside.

Covered by SWAT, Cuddy pushes in the meds and pushes out Suited Guy. Big Guy has recovered sufficiently to walk out on his own. Curly Haired Teenager volunteers to be the guinea pig for the painful shot, but a nurse-hostage objects he's too young (covered by the gun exception to the parental consent rules, House says) and besides that stuff can cause nerve and muscle damage. Married guy hostage gets pointed out but objects, and Hadley says she'll do it.

Act 3

Hadley bares a shapely midriff, as House chastises her for volunteering in her condition. She collapses from the pain of the injection in her hip. House turns to Jason and continues to speculate why he's so desperate to turn to drastic measures for a diagnosis as he prepares to inject him. House's next guess is a work issue. Jason says he just wants an answer. And collapses in pain himself. Wrong again. House crosses one possibility off Cuddy's wall.

Taub and Kutner enter Jason's apartment. Kutner finds thousands of dollars in unpaid medical bills and preaches to the audience about how someone with huge unpaid medical bills was bound to do something inexcusable. [I sense some Obama fan writers here - more bad writing.]

Foreman and Cameron work in the lab. Negative on the blood tests, no infection here.

House crosses off another possibility, leaving heart and lung cancer.

Kutner reports a pic of Jason's mom - droopy eye, fat face, thick neck, classic signs, Cameron says on the phone, of an upper lobe tumor. Or an adrenal problem, Kutner says. Listening in, Hadley says "it's his heart" pointing to a distended jugular vein in Jason's neck.

House hobbles over to Jason, drawing a startled reaction. He wants to check Jason's pulse. "Racing, 160." "We need to get paddles," Hadley says. House starts to massage Jason's neck, which he explains is an alternate treatment for regulating the heart. House says if they used defibrillator paddles on him his trigger finger would twitch and maybe kill someone. There's a tense moment with Jason demanding the paddles and House refusing and Married Guy helpfully saying "Just let him die," before Hadley says they can "cardiovert chemically," and says she's going to get the drugs. Jason doesn't want to let Hadley go, but finally motions over Curly Haired Teenager to suffer the penalty if Hadley doesn't return.

Bowman and Cuddy are listening to this drama over the hidden microphone.

Jason gives Hadley 30 seconds. She runs. SWAT knocks on the window and tries to talk her out. House and the nurse have a morality debate over whether Hadley should/will come back. Jason watches his watch. Time up, he raise his gun, but the nurse volunteers to be shot instead. But when the gun shifts to her she begs for her life. Before the trigger can be pulled, Hadley runs back in. Everybody, even Jason, breathes a little easier.

Still, Jason demands Hadley take the drug first. House protests that "adenosine slows the heart", fine if yours is racing like Jason's, but not so fine for a normal heart. Hadley injects herself, and quickly collapses. House injects Jason, bringing his heart back to normal, with no sign of a heart defect, but notices he's sweating on only one side of his face - which he says is due to a tumor pressing on a sympathetic nerve - diagnosis lung cancer.

Act 4

The nurse monitors Hadley's pulse - below 50. Jason still wants proof of the cancer. House phone consults with Wilson. House tells Jason to spit on the floor. When he can't, House points to dry mouth as another symptom confirming his diagnosis. Wilson directs House to check for swelling on the back of the neck, another confirmation. Jason still wants some sort tangible proof, not just these poking and proddings. Jason wonders how many hostages a trip to radiology costs. Pregnant Woman hostage and Hot Woman hostage bolt from the room.

Inside Jason ties the rest of the group in a circle around him [did they send out for rope?] and the group shuffles down the hall to radiology. It seems to be House, Hadley, Married Guy, Curly Haired Teenager and the nurse. House still wants to know why Jason snapped. "HMOs?" "Shut up." The rest of the hospital fantasizes about bringing guns to work so they could say that. "I just want an answer, that's all."

The group enters radiology as SWAT infiltrates the hall outside. Jason stations all the hostages in the line of the MRI and says he'll shoot if anyone moves. House says it can't be just curiosity, but Jason says it is just the desire to know as he slides into the breach of the machine, gun in hand, After he come out again, House tells him he has to give up the gun to get an answer, and shows him the starburst in the MRI image from the metal in the gun. No diagnosis there. "Now give me the gun and get your answer or shoot me," House says. Jason raises the gun, and says it's not choice "A".

We see the hallway with SWAT pointing their guns. The nurse and Married Guy run out of radiology and are hustled away. The nurse explains House got Jason to give up his gun and they just ran. House sits at the MRI console, gun next to the keyboard. House asks Curtly Haired Teenager why he's still there. "Curious," he says. A budding House. The phone is ringing. Jason emerges from the MRI. Jason says SWAT will be through the door any time - show him the tumor. House says there isn't one. "So it's over," Jason says, hanging his head, "thanks for trying.". House hands him back the gun as the teenager grimaces.

Act 5

House picks up the phone and quickly says Jason overpowered him and got the gun back, then hangs it up again. Hadley accuses him of being a coward, afraid of being wrong. House accuses Hadley of being a coward, terrified of death, and taking chances to make it come sooner. Curly haired teenage just wants to go.

Outside, Bowman correctly classifies House as the obsessive-defiant kind and therefore lying about the overpowering thing. He tells his team to get a "frame charge" ready, and calls House Cuddy's "boy friend". House calls the team, and is berated by Wilson. House just wants to diagnose. Now Foreman thinks Chase was right and leaves, too. Taub suggests philoriasis. Ruled out because Jason's never been to Cameroon. Q fever (Cameron)? No exposure to goats. Histio-cytosis-x (Kutner)? House notices that Jason is turning his head, favoring the left, meaning he's partially deaf in the right. This suggests Cushing's to Cameron.

House calls out and requests dexamethasone and enough time to get a reaction to confirm a diagnosis of Cushing's disease. Bowman says 'no'. Jason agrees to release Curly Haired Teenager and not test any more drugs on Hadley. House prepares to inject Jason (if he has Cushing's it will slow his breathing) when he reneges and says "give it to her first." House objects but Hadley takes the syringe and injects herself.

Jason asks her how long she has to live. "Eight, ten years." "And it doesn't have a cure?" "No." Now Jason gets in the act, accusing Hadley of being insane for taking risks with no upside, unlike himself, who at least had something to gain. He says.

Now Hadley has a racing heart and fever. And Jason's breathing is unchanged. Wrong again? Hadley's kidneys are shutting down - now why aren't Jason's?

Act 6

Hadley yelps in pain. House asks the team the same question as above. Cameron speculates maybe some of Jason's other meds are protecting his kidneys. House tells Jason that he needs to slap him for diagnostic purposes. The twitch he notices after the slap is Chvostek's sign, sign of a calcium deficiency. Now what does all this add up to? More suggestions. Leishmaniasis? But he's not an Arabian Bedouin. Melioidosis? But he's never been to a a tropical climate. "Never been anywhere south of Florida" Jason confirms. "You idiot!" House exclaims. Just what does he thing Florida has? "Florida counts?"

House requests three grams of ceftazidime to treat the Melioidosis. Bowman says 'no'. Jason offers House for the drug. House suspects, correctly, that Jason intends to give Hadley a dose first. After all this, he's still worried about drug interactions.

House and Jason shout at each other. Hadley drags herself off the table to tell House to get out. Hadley tells House she doesn't care if the drugs kill her or Jason kills her.

Cuddy hands the drugs to a SWAT team member, who approaches the door as House walks out.

Inside, Hadley asks Jason if he really doesn't feel bad about killing her. Jason says not if she doesn't feel bad about killing herself. She says she doesn't want to die, he says she does, but wants somebody else to do it for her.

Outside in the hall, SWAT makes preparations. Hadley prepares to inject herself, then stops and begs Jason for her life. He lowers the gun. She raise the hypodermic again. She trembles with fear. The gun trembles in his hand. She closes her eyes and lowers the needle, then stops again and screams "I don't want to die!" Jason holds the gun nearer to her, then grabs the syringe and plunges it into his own arm, just as SWAT blows out the wall. Both fall to the floor. House cringes in the smoky hallway, as does Cuddy.

Flashlights beams and weapon muzzles precede SWAT's advance. Jason is taken out. House rushes to the unconscious Hadley. Her eyes are open. "Why are you still alive?" "He didn't make me take it."

SWAT clears out of the building. Cuddy sees House gobbling a vicodin or two, handcuffed Jason in the background. House and Jason exchange looks without words. Jason sighs, knowing at last, and gives a grim smile, then is led away.

Foreman sits by Hadley's bed. She awakens, and he tells her a week of temporary dialysis will have her kidneys back to new. He apologizes for leaving the differential. She tells him she'd like to take part in his Huntingdon's drug trial.

Cuddy surveys her desecrated office [Hey, at least it was radiology that got the wall blown in.] House comes in and tells her the tests confirmed Melioidosis. Retrieves his cane. Cuddy remonstrates with him for seeming to care only about the diagnosis. He says she enabled him. She asks if he thinks that means she cares about him. Cuddy says it proves they can't be "a thing". He sort of suggests they might have a relationship. She asks if he wants one. "God, no," is his reply. Coward! He walks off. House stops at the door as she starts to open her desk drawer. When she does everything falls out. What he'd been doing (and the reason he didn't want Hadley looking in her desk), was inverting the drawer so everything falls out when she opens it. Cuddy grimaces. House smiles and leaves. So third grade, House!

- Cecil

Next Week:
"Let Them Eat Cake" - Cuddy moves into House's office while hers is repaired.
"House discovers the joys of sharing."
"The blessings of good health."
"And the gift of song" [lime in the coconut]
All with Nutcracker playing in the background... Can Christmas be far off?

Last Episode: 11/18/08 5-08 Emancipation
Next Episode: 12/02/08 5-10 Let Them Eat Cake

Cast and Crew Ep. 5-09, "Last Resort" Aired 11/25/2008

Cast and Crew

Director:... Katie Jacobs
Writers:.... Matthew V. Lewis
..............Eli Attie


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

Bobbin Bergstrom........Nurse

Guest Stars:

Zeljko Ivanek....................Jason
Marcus Chait......................Mitch
Evan Jones.........................Bill
Natasha Gregson Wagner..Sandra
Alex Sol.............................Larry
Sarah Thompson................Nikki
Evan Peters........................Oliver
Tracy Vilar........................Nurse Regina
Wood Harris......................Bowman (aka Avon Barksdale)
Jack Guzman....................Security Guard #1


Herzog...........................Chris Clark,
Glue of the World.........Four Tet,
A Chronicle of Early Failures, Part 1.....The Dead Texans,
Between the Lines..........Bonobo

Posted by Cecil on November 25, 2008 6:02 PM
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