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House 604 - Instant Karma

House Episode 6-04 – “Instant Karma”

Airdate: Monday October 12, 2009

The Hook:

A man sits in a chair at the end of a flagstone walk. A woman approaches and summons “Mr. Randall” to a meeting. We see him walking into a mansion, where a group dressed for business sits around a table. He’s the CEO of an oil firm , and makes a bold business decision, but tables all further business to go upstairs. There his son, Jack, lies in a bed with and oxygen tube in his nose. The doctor there tells Randall that the boy’s illness is not clostridium, and the boy needs to go to a hospital. Jack is afraid of going to the hospital and asks if he’s going to die. Randal assures him that he won’t.

Act 1

Randall is talking to Cuddy. He tells her he wants House to diagnose his son. Cuddy tries to tell him how good House’s team is, but Randall wants the best, and he’s been informed that that is House.

Cuddy breaks the news to Foreman that House, though still license-less is in charge of the case. She also tells Foreman that he’s presenting the case of Dibala, the African dictator from last week to the M&M (Morbidity and Mortality) briefing coming up. Presenting a slight problem describing how they killed their patient.

Hiring House doesn’t mean actually seeing House, of course. Cameron is examining the boy and explaining that Dr House rarely personally examines patients. The symptoms so far are fever, dehydrations and weight loss. Cameron finds something odd when she palpitates the boy’s abdomen.

Foreman and Chase work on their story to avoid revealing that Chase switched blood to cause the wrong treatment and bump off Dibala. House comes in on the end of the conversation and kibitzes. Cameron reports in that Jack has and impacted, constipated colon,

Foreman tells Randall that the boy likely has Hershpring’s syndrome, and they’ll confirm with a barium enema and a biopsy.

House finds Hadley in the cafeteria making travel plans with her laptop. She says she’s not coming back. House professes to appreciate that, saying he’d hate to lose Foreman if she came back and Foreman tried to reestablish their relationship. Hadley tells him she actually enjoyed working for him. She tells him she’s going to Thailand, and goodbye.

Jack is improving, fever gone, appetite back. But Cameron notices that his abdomen, though now soft, seems larger. Then he stops responding and goes into a seizure. Foreman requests consent to operate, drilling holes in the boy’s head to reduce the intracranial pressure before he has irreversible brain damage.

Act 2

The team reviews the situation. Jack is continuing to build up fluid in his abdomen, though there have been no more seizures. Foreman notices something unusual about the dural covering of the brain in the boy’s x-rays. House says to test the boy for brain cancer.

Hadley is on the way to the airport when she discovers that her airline reservations have disappeared.

Cameron and Chase are breaking the bad news to Randall. Chase gets a page that Foreman needs help with the M&M prep. Cameron volunteers to help,. But Chase tells her they can handle it and he’ll meet her at home.

Hadley returns to the hospital and accuses House of sabotaging her trip. House denies it and tell her he doesn’t want her on the team because she distracts Foreman/

Foreman has found a problem with the fake blood sample Chase sent the lab in the Dibala case. The HDL was 20% too high. Now how do they explain that?

Act 3

Cameron awakes to find that Chase hasn’t been home.

Back in the hospital cafeteria, Foreman and Chase are still trying to figure out how to explain the blood anomaly, Chase doesn’t think they’ll have to explain it, but Foreman worries about stacking lies upon lies. Cameron stops by with the biopsy on Jack – not cancer.

In conference, House proposes that it’s still cancer, just in a different location. He wants the team to check for carcinoma of the stomach, which he says could present with the same symptoms. Chase and Cameron go off to make the test, and House takes the opportunity to quiz of as the why he cancelled Hadley’s reservations. Foreman pleads ignorance.

Chase and Cameron explain the situation to Randall, who seems to feel his family’s bad luck is the universes way of evening out his karma for being so successful in business – first his wife and now his son. Jack begins seizing again, but not due to intracranial pressure.

Act 4

Now the team’s best guess is Cushing’s disease, and they begin treating Jack for that.

Chase and Foreman argue some more. Chase proposing another cover-up lie. Foreman saying he’ll just tell the truth, which turns out to be telling Cuddy he doesn’t have time for the M&M. Cuddy isn’t biting.

Cuddy asks House about the Hadley situation. House says it wasn’t Foreman. House’s beeper sounds off.

Mr. Randall finally gets to meet House. Unfortunately, House has no comfort to offer, and Cameron appears to say the tests for abdominal epilepsy, the latest guess, were negative.

Act 5

“Fever, seizures, peritoneal and subdural food collection, and now spots.” House lays out the latest symptom list. They reach a conclusion of polyarteritis, but before Cameron can rush off to test the hypothesis, House changes his mind, and diagnoses Dagoe disease, sending a chill down everyone’s back, because it’s incurable and fatal. Our newly self-actualizing House sets off to do the grim task of informing the parent himself.

House tell Randall that Jack has mere hours to live. Randall protests that the team is wrong again, but House says they rechecked the biopsies and confirmed the Dagoe. House actually apologizes and tells him Jack has a day at the most to live.

Chase agonizes over his own situation. He enters Cuddy’s office to tell her that Foreman can’t present the M&M, and is on the verge of confessing his sins when they’re interrupted by a nurse alerting Cuddy to the presence of lawyers in the pediatric ICU. The lawyers are Roy Randall’s board of directors, who are trying to dissuade him from basically bankrupting himself. He’s sure that if his finances go to pot, it’ll take the bad karma pressure off his son’s health, as the universe balances out. He signs the papers.

Jack immediately goes into arrest.

Act 6

Hadley enters Wilson’s office and confronts Wilson about cancelling her airline reservations. She traced him through Cuddy’s IT people. Wilson says he did it to help his friend, House. He tries to persuade her to stay but she’s not interested, and leaves.

Wilson goes to House and confesses confessing. House knows Wilson didn’t do it, which I guess means it was House after all, on Wilson’s machine. Asked why he’s being a jerk, House responds “Because I was born with a heart three sizes too small,” then gets that thoughtful/epiphany look on his face, and dashes off to Jack’s room. There he tells Foreman that the coronary event is large blood vessels and therefore can’t be Dagoe, so now he’s diagnosing “primary anti-phosphilibate syndrome” [don’t hold me to that spelling], and prescribes a treatment.

Chase finds an envelope by his laptop. He goes to Foreman to ask ‘where’d you find it?”
Foreman disclaims all knowledge. The papers in the envelope show that a previous doctor prescribes a drug to Dibala that would explain the HDL discrepancy. Which means…They both look rueful.

House awakes on his couch to find a newspaper by his head with an article about Randall’s bankrupting himself. He returns to the hospital to find a smiling Randall, beside q smiling Jack. “It worked.”

Chase sits at House’s desk toying with the giant tennis ball. He asks House how he found the information. House said he know a fat old man had to be taking something for his cholesterol.

Music plays as…

…Cameron wakes up alone in bed again.

…Chase watched while…

…Foreman presents the M&M.

… Hadley boards an airliner for Thailand.

…Roy and Jacks’s mansion home sit with a “For Sale” sign.

…Roy and Jack laugh together in the hospital

... House ponders life and karma.

- Cecil
Next Week:
“House is hearing things.” “Chase is hiding things. (from Cameron?), and Something freaks out House and Foreman in the OR.
Last Episode: 10/05/09 6-3 The Tyrant
Next Episode: 10/19/09 6-5 Brave Heart

Favorite Quotes:

“Unless he’s dead, comatose, or insane, I want him (House) treating my son – today!” CEO Randall demanding the best of the best for his boy.

“That’s my son, he’s dying, and none of you seems to have the slightest clue why.” “I know, that’s what makes it so interesting.” Randal-House dialogue, House destroying illusions about the world’s greatest diagnostician.

“People don’t get what they deserve, they just get what they get. There’s nothing anyone can do about it.” House, newly sane, but cynicism intact.

“You’re not as big a jerk as everyone thinks.” “Yes, I am”. House responding to Wilson.

“Whether you want to be in charge or not, you are… and you always will be/” Chase, acknowledging the master.

Cast and Crew Ep. 6-04, “Instant Karma” Aired 10/12/2009

Cast and Crew

Director: ___ Greg Yaitanes
Writer: ____ Thomas L. Moran


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)

Guest Stars:

Lee Tergesen ________ Roy Randall
Tanner Maguire ______ Jack Randall
Cindy Lu ___________ Nurse Diane
Kavi Raz ___________ Driver
Liz Benoit __________ Nurse Anne
Gigi Hessamian ______ Marina
Steve Kramer ________ Ken
Michael D. Connolly __ Oliver
M. K. Bakshi ________ Pete
Tim Kahle __________ Dr. Johnson


"Sarah" by Ray LaMontagne

Posted by Cecil on October 13, 2009 11:22 PM
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