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House: 513 - Big Baby

House Episode 5-13 - "Big Baby"

Airdate: Monday January 26, 2009

The Hook:

Setting. An elementary school class. Special kids. A teacher, Sarah, who looks barely older or larger than her wards roams the room. A boy, Johnny, is distracted by the presence of a new aide in the classroom. The old aide left to get married, which leads to a discussion of love and marriage and reveals Johnny has a crush on Sarah, which she lets down gracefully. Sarah begins to comfort a girl who's had a small accident, but suddenly Sarah coughs up blood and collapses.

Act 1

Cameron catches House stealing a bagel in the cafeteria and buys it for him as a peace offering to ease the fact that she's assigning him work now - specifically a 29 year old teacher who collapses and bleeds for unexplained reasons. House twists the situation into sexual innuendo, but is taken aback by Cameron's quiet "That's why I took the job," as she hands him the file and departs.

House describes the case to the team but catches Foreman smirking at House taking orders from Cameron. The rest of the team is surprised to hear this. Hospital and Taub try to discuss the case while Foreman and Kutner speculate on the coming House/Cameron war. Speculations abound. Leukemia. Thoracic tumor. House chides Hadley and Foreman for disagreeing, saying it's a smoke screen to disguise the fact that they have a relationship, which is news to Taub and Kutner. Hadley admits the situation matter-of-factly, Foreman would rather the discussion be canned. House tells them to go run a bleeding time test to confirm there's something wrong with Sarah's blood. (He likes Foreman's leukemia suggestion).

Hadley runs a scalpel across Sarah's arm, starting the clock. Kutner is impressed she didn't flinch. Sarah says she 'went to my happy place," which is her classroom and she relates inspiring upbeat stories about her kids. Clearly, Kutner and Hadley both decide, we have to protect this optimist from House. Her blood doesn't clot. Kutner says not to worry, they'll run some tests, but Miss Optimism isn't worried, which impresses Kutner even more.


Cuddy sits and rocks baby Rachel as Wilson visits. He coos over mother and baby. Cuddy's replies reveal little motherly involvement with the babe. Cuddy recognizes this in herself, and she's worried about her lack of feeling. She reassures a worried Wilson that she's taking care of the baby and not neglecting her, just not feeling what she thinks she's supposed to feel.

Hadley and Foreman report the clotting proteins in Sarah's blood look OK, but the platelets are malformed. (Sarah doesn't appear to be black, but why is no one suspecting sickle cell anemia?) Now House is worried because they agree. More suggestions. Lymphoma? (LDH too normal)." ITP and start her on methotrexate?" Kutner wonders. "Absolutely," House agrees, and "total body radiation, too." The team is horrified at this suggestion, which will kill all the bacteria in her body, leading to death if the diagnosis is wrong. Kutner is especially negative. "It's premature, reckless, and irresponsible." House wonders whose job it is to stop him from being at least two of those things.

House barges in on Cameron and proposes the radiation approach to treating ITP. Cameron screws his plan up by agreeing. House responds with more innuendo, which Cameron ignores.

Hadley and Foreman report that Sarah hasn't responded to methotrexate. No change in bleeding response, either. Now House has a problem. He doesn't really want to irradiate Sarah, he just proposed something totally crazy so Cameron would go along with something only a little crazy later. Now he's got to fake it. Hadley proposes a charade - irradiate the patient without the radiation. House likee. He also directs them to double the methotrexate dose and add prednisone.

Foreman and Chase discuss his ethical dilemma concerning knowing Hadley is on the placebo in the drug trial. Chase advises him not to be an idiot and change anything due to his knowledge.

Sarah interrupts the non-irradiating radiation treatment because she has to pee, but on standing up she collapses and has no pulse. They shock her back to a heartbeat.

Act 2

Kutner reports Sarah has no structural defects in her heart. House examines images of the vessel. House wonders why Sarah had to go pee in the middle of things in the first place. Heavy metal toxin? Drugs or alcohol? Cold-temperature aglutinen? House likes that one and orders an ice-bath - which might give Sarah another heart attack, but that would confirm the diagnosis, so it's win-win.

Cuddy is reproaching Cameron for approving the radiation. Cameron say it was her call. She said "yes" because House wanted her to say "no". Cuddy warns against "getting cute." House comes in and says he'll wait for Cuddy to leave. He then chides her for leaving the new baby alone with the nurses, and accuses her of really wanting to dump the baby. Wilson is so busted. Cameron is horrified, but Cuddy says it's not a big deal - she was just having a bad heir day. House continues to rationally analyze the situation horrifying both women. When Cuddy leaves, an irritated Cameron asks "What did you want?"

House strides from Cameron's office and tells the team they have a 'green light', but has to admit to his chagrin and Hadley's delight that Cameron is making him do cold-clumping tests to confirm the theory first. Smirks all around.

Kutner arrives to draw Sarah's blood to find Johnny visiting with his mom in a no-visiting zone. Mom explains that only Sarah can bring Johnny out of his non-verbal autism to which he was starting to revert without her. Kutner says he'll draw the blinds and they can stay as long as they want.

Hadley and Foreman are running the test and a little clumsiness by Hadley concerns Foreman. Hadley says she feels great. Foreman cautions her about the possibility that she's feeling the 'placebo effect', but Hadley thinks she feels too good for that to be the case. The blood clumps. Hadley thinks House's diagnosis is confirmed.

Foreman stops in to see Cameron. Cameron apparently has been talking to Chase, and without even asking why he's there says "Don't be an idiot."

Sarah shivers in the ice bath. House stops in, bringing mocking comment from Taub "Cameron make you?" Sarah tells wonderful heart-warming stories about her kids and the room number mistake that she made in grad school that turned her into a special-ed teacher. House is of course disgusted by the wholesomeness. The time is up and no heart attack - diagnosis not confirmed. House says "I'm not surprised - she obviously has brain damage."

Act 3

Taub doubts a numerical mistake six years ago can lead to a brain damage diagnosis. The rest of the team agrees with him. House thinks possible multiple sclerosis and wants to do a brain biopsy. Kutner thinks a pancreatic tumor could explain the same facts and be simpler and less invasive to diagnose.

They argue their theories in front of Cameron. Cameron sides with House but orders am MRI before any biopsy. House says "No" to more tests. Cameron stands firm.

Cuddy goes into Wilson's office. She doesn't want to go home, and discusses House's "Give her back" prescription. Cuddy's depressed. Wilson says "Parents make sacrifices." Cuddy's not sure she wants to. Wilson is speechless.

The MRI does not back House's theory. House cancels the biopsy and tells them to go ahead with the RCT.

Foreman wants to have a serious talk with House "about Remy," a name House doesn't recognize. "13." House presents a simple syllogism. Will the drug cure her? Not likely, only alleviate symptoms, for a time. Then is giving her a little extra time worth your medical career? "No" a crushed Foreman concludes and turns to go, when House stabs him with "unless you love her." Not something Foreman expected from House. "If you love her then... you'd do stupid things."

Kutner, Taub and Hadley are proceeding with the treatment when Kutner notices that Sarah's lungs are failing. "House was right!" They put her on pure oxygen and remove the tube down her throat. "Do we have to tell him?"

Act 4

Foreman reports they've drained plural effusions. House exults in being, well not right, exactly, but at least in the right area - brain. He proposes a nerve conduction study on the surface of her brain - a little procedure that requires cutting off her skull and exposing the brain. Kutner still thinks it could be a pancreatic tumor that the previous test wasn't sensitive enough to see - he wants to do an endoscopic ultrasound. House says they don't have time if the brain is the problem. Kutner says he'll just go start the test anyway while House asks Cameron for permission to cut Sarah's skull off.

House peeks in to Cameron's office. She already knows - Kutner told. Cameron says she didn't realize skull lifting was an approved treatment for MS. House says he's not looking for MS, but for what set it off - equine encephalitis which mainly affects horses but that are cases of transmission to humans, he says. But it's winter so where did the mosquitoes that transmit is come from, Cameron wonders. Cameron wants some confirmation first.

Foreman and Hadley examine the classroom, looking in all the vents. Hadley decides she wants kids - eventually. Foreman's concerned about her making long term plans.

Wilson comes by Cuddy's with a gift - he claims it's a picture of her baby computer age-adjusted to 18 years. Cuddy is unimpressed by the moral he draws. Wilson admits it was just the picture that came with the frame.

Act 5

House reports on the classroom visit. "Kid with a raging viral syndrome, three dead mosquitoes." Cameron correctly interprets the 'virus' as a common cold and the 'mosquitoes' as fruit flies. House shrugs. But Kutner found nothing with his ultrasound. Cameron asks "What do you want me to do - say 'yes' just because you're House?" House thinks that would be jim-dandy. Cameron says "yes".

Kutner is horrified, and accuses House of pushing things just because it's Cameron. He says they should try removing her spleen first - splenic lymphoma could explain this as well. House says "If this doesn't work, the spleen's all yours," and heads for surgery.

Sarah is conscious during the test. Her brain is totally exposed, and I'm wishing I hadn't seen a certain Hannibal Lector movie. At least no one makes wok jokes. House asks her reasoning questions to stimulate the brain as they measure conduction. Cameron assists in the procedure. They're looking for areas where conduction is slow, but not finding any.

Kutner is in the observation gallery tattling on the phone to Cuddy. He holds the phone up to the intercom and Cuddy orders "House, step away from the patient." Cuddy as people-Viper. Rachel begins crying in the background as Cuddy and House back-and-forth about the operation.

Cuddy says 'cutting into this woman's brain is not necessary". "The woman" in question is hearing all of this and becoming concerned. A little late. Cuddy goes on speaker to hold the baby. Sarah is annoyed by the crying. And her brain conduction even speeds up while her blood pressure drops. Cuddy yells at Rachel. Sarah wants the phone turned off. Cameron is terminating the operation as the BP drops ominously. After a little yelling. Rachel stops crying, and now it's Cuddy's turn. Then the tears turn to laughter.

Act 6

House and Cameron mull over the operation. Kutner is game to remove Sarah's spleen, but it'll be two hours before Sarah will be in shape for a second operation. House wonders how a patient that loves all things annoying is annoyed by a baby crying. Annoyance is not a low BP symptom.

House mulls some more in front of the white board o' symptoms. Cuddy stops by. She's decided to keep Rachel. House dismisses her bonding as a chemical reaction. She pushes Rachel into House's arms. House promptly gets spit up on. House mulls on how we find baby puke cute - epiphany time!

Kutner is explaining to Sarah how she'll do just fine without a spleen. House barges in and says her spleen is fine. House and Kutner bicker a bit, then House says it's her brain, just the low down on the left side of the chest part of it, and starts ultrasounding Sarah's heart.

There's an opening there that closes up for most people when they are born. "Patent ductus arteriosis!" exclaims an amazed Kutner. When she gets stressed, the duct opens up and detours blood to various areas of the body, including the right side of her brain and away from the left, making a natural tranquilizer - why she's so good with those annoying kids. They can fix the heart, he says, but of course she may no longer be able to stand her 'special kids," I half expect Sarah to say "then I don't want the operation!" but that doesn't happen.

Cuddy and Cameron coo over Rachel. Cuddy praises Cameron's "great work." Cameron says she quits. She'll always say 'yes' to House, anyone else would always say 'no', leaving guess who to ride herd on House? Cuddy looks bleak.

The fast becoming typical musical montage ends the episode. ( On My Side by Corey Chisel and the Wandering Sons).

Johnny rushes to Sarah's bedside knocking her water over on her as House observes from outside. To House's disgust, Sarah is still sweet and understanding. Could his world-view be wrong?

Foreman changes the numbered label on some drug-trial I/V bags. Wonder who now gets the placebo and is condemned to Huntington's?

Hadley comes in for treatment, smiling.

Cuddy rushes out the door for work, a sitter holding Rachel for a kiss. Rachel begins to cry. Cuddy grits her teeth, heaves a sigh, and leaves.

- Cecil

Next Week:

Is House talking Siamese twins? Hadley discovers she's been 'helped' by Foreman, and apparently has a tumor. "Nukee, nukee." Hadley... blind? House falling? It's the 100th House episode.

Last Episode: 01/19/09 5-12 Painless
Next Episode: 02/02/09 5-14 The Greater Good

Cast and Crew Ep. 5-13, "Big Baby" Aired 01/26/2009

Cast and Crew

Director:... Deran Sarafian

Writers:...... David Foster (II)
...............Lawrence Kaplow


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

Recurring Role:

Bobbin Bergstrom........Nurse

Guest Stars:

Erika Flores..............Sarah
Andy Scott Harris.......Johnny
Sam Gregory............Screaming Kid
Tammy Dahlstrom......Tammy
Saige Ryan Campbell...Jessica


On My Side...............Corey Chisel and the Wandering Sons

Posted by Cecil on January 26, 2009 4:36 PM
Permalink |

Thanks for the review, Cecil Rose!

I really liked the dynamic between House and Cameron this week, it's a shame they have ditched it after only one episode. The main diagnostic case was interesting (though I agree, someone should have been more concerned about her misshapen platelets!), but it was the subplots that kept me hooked...Cuddy wants to take the baby back?!? 13 wants to have kids?!? Even after her "nightmare" childhood watching her own mother die? Foreman possibly LOVES 13?!? Well looks like we cleared up his issues of being he's a guy willing to ruin a medical test trial and his own career for a non-committal dying bisexual!

Brilliant character development on many levels, I hope the rest of this season remains this good.

Although my previous comment stands...Jesse Spencer, wash your hair! Grunge went out with the 90's...

-- 1. Posted by: FenwayBen at January 27, 2009 10:06 PM

The ethical problems wee discussed last week seem to be coming to fruition next week. I'm not sure if it's 'career ending' as they seem to imply on the show, but it could certainly be 'job ending'.

Yeah, the character arcs all seem to be movintg along nicely, excepting possibly Chase.

Am I the only one that read some double entendre into Cameron's responses to House this week? Seemed to me there might be some remainder of her old infatuation lingering there.

-- 2. Posted by: Anonymous at January 28, 2009 9:21 AM

That last post wasn't really meant to be anonymous - it was me. It just got away from me.

-- 3. Posted by: Cecil Rose at January 28, 2009 9:23 AM

If you read this review earlier and thought you saw "Jessica" as the teacher's name, your eyes weren't fooling you. I get the cast list from the web, but the characters names aren't always used liberally, if at all, in the episodes, so sometimes figuring out which, say. female character's name (and actress) goes with which role isn't always easy to do.

I flubbed, but have corrected it now. Thank heaven for universal search and replace, and that her name didn't overlap with any other character or word.

-- 4. Posted by: Cecil Rose at January 28, 2009 12:05 PM

I'm dissapointed. Not one person has jumped on the horrible pun in the review of act 2.

-- 5. Posted by: Cecil at January 30, 2009 2:37 PM

Cecil, I didn't even notice the pun the first time through...but yes, that was bad!

The romantic in me says if you love some one, do whatever you can to help them. The logician in me says the reasons for drug trials are to prove whether they even work (and what side effects they might have) and you can't do that without a test group and a control group. If every doctor wanted to save everyone by administering the drugs early, we'd have a lot of people put on medications with unknown later consequences.

It seems to me that Foreman is throwing away his career for a woman who will more than likely dump him by the end of the season, regardless of her illness's progression. Not smart, but at least he's no longer boring...

-- 6. Posted by: FenwayBen at January 31, 2009 8:53 PM

Yeah, like House said - if you love someone, you'll do stupid things.

Like the stupid things House is doing with Cuddy, do you think?

-- 7. Posted by: Cecil at February 2, 2009 10:49 AM

I have no idea what the writers are doing with the House/Cuddy/Wilson triangle. It really doesn't seem to have any traction. Plus we all know from moonlighting that the two of them ending up together would be the demise of the show.

I'd rather them bring Sela Ward back personally.

Anyhow, I don't think House is being any stupider with Cuddy than normal. He has to make it impossible for anyone to like him while also making it impossible for them to live without him. It's part of his self-loathing schtick.

-- 8. Posted by: FenwayBen at February 3, 2009 12:09 AM

@ 5 Cecil - You said "I'm dissapointed. Not one person has jumped on the horrible pun in the review of act 2."

You know Cecil, I had to read that act three times to fine the pun... "just having a bad heir day." And you're right, it was horrible!

Enjoyed the review ever so much. I read all your reviews, just don't post that much. (Too much time over at the LOST blog... my bad... NOT!)

Looking forward to your next review. Take care! HH/BL

-- 9. Posted by: HouseHater/aka/BunnyLover at February 3, 2009 5:06 PM

Been watching House episodes only the last two years...these regular formula episodes are getting on my nerves!

they always the same, goes something like this...

1. Principal patient is talking normally in an adult situation with other people, then, suddenly they are afflicted with some bizarre health problem that has them spilling blood from any of the body natural orifices, or either horrible close-up vomiting right from their mouth.

2. Then newly patient is assigned a team of doctors to evaluate the diagnosis, along with Dr. House.

3. After a series of mis-diagnosis(es), and treatments, which in real-life would have killed the patient, under normal medical environment. Then, Dr. House pulls the right diagnosis and treatment for his patinet right from his ass, after hit with a brainstorm of thoughts from conversations with others. This happens with about 3 minutes left, before the show ends.

Some serious flaws is that these doctor actual go and do the investigations into the lives and houses of their patient. Does not happen in real life!
It seem like all the patients in the show have this "cadillac type- health insurance plan" that spares no expense as to tests, treatment done on them and having a team of five doctor at there beek and call being applied to their particular case. That not happening in the real world I, or you live in.
Come-on! Keep it real!!

-- 10. Posted by: jeffrey at February 3, 2009 6:25 PM

Um, this isn't St. Elsewhere, we're not all inside Timmy's snowglobe. I hate to disappoint you, but if you are looking for a realistic portrayal of the US Healthcare system, House is not the show for you.

-- 11. Posted by: FenwayBen at February 3, 2009 8:40 PM

You just prooved my point...this show is not's becoming more of a continual "soap opera". If you like the make-believe and soap operas, be satified watching these formula storylines. The mythical Dr. House gets the right diagnosis at the can always bet on it...ALL THE TIME! BORING! Then, you probably likes the soaps. then you'll surely like this show. "House's Head" was a fantastic episode...excellent imagination in the writing in this episode. More of that, less of the other, is all i'm saying.

-- 12. Posted by: jeffrey at February 7, 2009 10:57 PM

so informative, thanks to tell us.

-- 13. Posted by: DedoVioheds at September 29, 2010 8:35 PM

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