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House Episode Guide

Written by Patti

EPISODE 5 – “DAMNED IF YOU DO”

House

Opening Scene: Festive Christmas music is playing in the background. House says to Wilson that they are condemned to useless labor. Wilson tells House that it is the “fourth circle of hell”. They are in the clinic, Wilson is setting up decorations and House is sitting at the desk trying to catch up on his back load of two weeks worth of charting. Cuddy walks up to House and Wilson and tells House he has a patient in exam room 1, and House tells Cuddy that he is off at noon and it is already five minutes of. Cuddy tells House that the patient has been waiting for him since 11am.  

House walks into the exam room to face three nuns. One of them (Sister Augustine) is sitting on the exam table. One nun tells Sister Augustine to show Dr. House her hands. Sister Augustine shows her hands to House and they are all blotchy and swollen. House asks Sister Augustine if she has been washing a lot of dishes lately and she tells him she helps out in the kitchen. House asks the nuns if there is anything new in the kitchen and one of the nuns tells House they just got a donation of saucepans and pots this week. Sister Augustine tells House she unpacked and washed them. He tells Sister Augustine that she should have spent her time saving souls. He tells all of them that her rash is contact dermatitis. That Sister Augustine is allergic to dish soap. Sister Eucharist tells House that they have always used that soap and never had a problem so why now? He tells all of them that a person can have an allergic reaction to something that they have used repeatedly. He then tells them it is good news, that they get free samples. House gives Sister Augustine some medicine, which she then takes and he goes to leave. Wilson is still at the main clinic desk and tells House he still managed to be out of the clinic by noon. Then one of the nuns comes out and tells House thank you for his patience. Wilson and House can not believe she is referring to him. She tells House that it is good to get a secular opinion as sometimes the Sisters interpret their symptoms as divine intervention. House then asks her, don’t you? She tells House that if she were to break her leg then she would believe it was God’s will but she knows that God would still want her to put a cast on it. Another nun races out of the exam room yelling to House that something is wrong! Sister Augustine is now wheezing and having trouble breathing. House goes to examine her, House tells Sister Augustine she is having an asthma attack and he needs her to relax. House tells the other nun to roll up Sister Augustine’s sleeve and he is going to give her an injection of epinephrine. That it will open her lungs and help her to breathe. Sister Augustine’s wheezing now subsides and she can breathe again. House tells all of them that the pill he gave her set off an allergic reaction. House tells Sister Augustine he will put her on steroids instead of the anti-allergy medicine. Sister Augustine asks House if her heart is supposed to be feeling so funny? House checks Sister Augustine’s pulse and tells her that her heart is beating too fast and for the other nun to go get a nurse. House calls a code and asks the nurse for a defribulator, he tells the nurse that Sister Augustine has no pulse. House starts to give Sister Augustine chest compressions.

Sister Augustine is now in bed at the hospital with the other nuns around her praying. House is in Cuddy’s office reviewing the procedures House did on Sister Augustine and what occurred. Cuddy tells House he presumably used 1 cc of epinephrine and House counters he used 0.1 cc the standard dose. Cuddy tells House that people do not go into cardiac arrest over .1 cc of epinephrine. House counters back that Sister Augustine must have had a pre-existing heart condition that got exacerbated by the epinephrine. Cuddy tells House that it is too bad you didn’t make a notation in the chart. House says he can make a note now, and Cuddy tells House that the drawer he pulled the syringe out of holds both dosages. He could have made a mistake, and House said he did not make a mistake. Cuddy tells House everyone makes mistakes. House tells Cuddy not to worry that they are going to get sued, they probably will just “hit his hand with a ruler”. She asks House does he think that the hospital discipline board will go with that option? House asks Cuddy if she is going to report him? Cuddy tells House what choice doe she have? Cuddy tells House she can justify keeping Sister Augustine in the hospital for a 24-hour observation. If House has not found an underlying cause for the cardiac arrest by then, she will have to notify the hospital’s attorneys. House checks his watch and walks out of Cuddy’s office.  

House meets up with Cameron, Chase and Foreman and starts to do a differential. House tells them it is not an allergy because allergies do not cause cardiac arrest like this. They continue to toss around ideas as they all enter the office. House looks down and sees a jar of candy canes. He asks Cameron is she mocking him? Now Cameron is all flustered and explains it is Christmas and she thought…, House breaks in and tells her to relax, that he was just kidding with her. Foreman says that if it were any other attending doctor, he would believe that doctor made a mistake and gave her to much epinephrine. Foreman tells House that everyone screws up, at least that is what House always tells them. House again insists he did not screw up. House tells the team what tests to run and what medication to give her. He now mentions to them that their patient is a nun. Chase says he hates nuns. House answers him, who doesn’t?  

Back in Sister Augustine’s room the other nun is watching the TV. The team enters her room and the nuns get flustered for getting caught watching the TV and try to explain they thought the control was for the bed. Cameron introduces Foreman and Chase to the nuns. Sister Augustine tells them she has not seen TV for over 20 years. Chase asks Sister Augustine if she considers it the work of the devil, or do they just not get cable where they live? Foreman asks Sister Augustine how she is feeling and she tells him better, that they gave her some medicine. He tells her they gave her prednisone, which is a steroid to help with the inflammation. She asks the team if House has figured out what she has and will she be okay? Cameron tells her they don’t know what is wrong yet and she will have a chest CT in the afternoon to help them diagnose her.  

The team leaves the room and Foreman continues to insist nothing is wrong with the patient and that House just made a mistake. Cameron ask him doesn’t he trust House? Foreman tells her he does not trust a man who will not admit he might be wrong. Foreman tells Cameron that he noticed she did not tell Sister Augustine their idea of what she has and Cameron tells Foreman she does not give a patient bad news without proof. She believes House might not be correct about his diagnosis but he did not make a mistake in the clinic. Foreman then asks Chase his opinion on the whole issue. Chase tells them that all he knows is that if House did not make a mistake in the clinic and he is right about the diagnosis, then their lives will be good for a few weeks. And if House did make a mistake then he will be upset and make their lives miserable for months.  

House is walking the halls talking to Wilson about the case. He tells Wilson that if Cuddy thinks he made a mistake the least she could do is suspend him from clinic duty. Wilson tells House that Cuddy does not confuse a mistake with being incompetent. House says to Wilson great, now it is lesson time. House tells Wilson he does realize that he is human and capable of making a mistake. Wilson asks House might he have screwed this up? House says to Wilson “no”.  

Then Houses enters an exam room back at the clinic and finds a man on the exam table dressed as Santa. House starts to sniff the air and guesses the patient has inflammatory bowel disease. The patient asks House if it is that bad and House says yes. House then reviews his chart and what treatments he has been given. The patent tells House that because he has to run to the bathroom all the time, that the store he working at is going to fire him. House tells him he is going to give him a new prescription that is cheap and works well. House gives the patient the prescription and he tries pronouncing it, which he does incorrectly. House tells him he should try cigarettes. One twice a day, no more, no less. House tells the man that studies have shown that smoking a cigarette has been able to control inflammatory bowel, plus he kids him, that studies also show he will look 30% cooler. The patient asks House is he kidding him? House says yes to looking cooler but no to helping his bowel problem. House tells the patient that all the drugs he prescribes are addictive and dangerous. The only difference with this is that it is legal. House leaves the room and wishes the man a Merry Christmas.  

Cameron is taking Sister Augustine to get some tests done. Sister Augustine asks Chase if he knows a nurse that she was talking with earlier. Chase says he does not know them. She is amazed that the nurse can take pictures with his phone. She goes on to tell Chase about other staff she has had conversations with and Chase comments she knows the staff better then he does. Sister Augustine asks Chase if he always wanted to be a doctor? He tells her always. He asks her did she always want to be a nun? She tells Chase her parents died when she was six. She went on to be raised in a foster home run by the Church. When she was 18 she went to the monastery where they let her take her vows. She has known no other life and she does not want to. Sister Augustine is now getting a MRI and Foreman tells her just to lie as still as possible. Sister Augustine asks the team if it supposed to smell funny in there? Another nurse tells them that someone earlier had thrown up and they cleaned up as best as they could. Cameron, Chase and Foreman ask each other about their own personal beliefs. Chase looks at Sister Augustine’s MRI and says she has no vascular pathology. This means no Churg Strauss disease, which also means House was wrong. Cameron starts tossing out other ideas and Foreman asks her how she can have complete faith in one man? Sister Augustine interrupts them and says the smell is getting really bad. The team rush in to check on her. Sister Augustine sits up yelling that she sees Jesus and that he is coming for her! Sister Augustine is having visions and she start to seize. Foreman looks under Sister Augustine’s gown and sees she has a rash on her thigh. 

The team are back at the office giving House the results of all Sister Augustine’s tests. Cuddy speaks up and says prednisone compromises the immune system, isn’t that what they gave her? For a problem she doesn’t have? House tells Cuddy that sounds like a trick question. Cameron speaks up and tells them Sister Augustine does have a severely compromised immune system. Two doses of prednisone would not have caused the reaction she just had in the MRI room. Cuddy asks them are they hanging their diagnosis on an adverb? House tells Cuddy that in 10 seconds he is going to announce he made a mistake in the clinic. Cuddy asks House is he admitting negligence? House says only if she does not leave the room. If she stays in the room that she will have to testify against him in court. House starts counting down while Cuddy stands there looking on. House starts mocking Cuddy by telling everyone he was in the clinic drunk and opened the drawer then closed his eyes, and took the first syringe he could find… Cuddy takes off. After Cuddy leaves, House gets back to work asking the team what causes are there for a compromised immune system? They all start giving different answers. House decides to put Sister Augustine in a hyperbolic chamber to treat her. Foreman and Chase tell House there is no protocol for putting someone in a high oxygen chamber to treat autoimmune disorders. House tells the team to forget the protocols, prep the nun and discontinue the prednisone. As Chase and Cameron leave, House tells Foreman he is amused that Foreman thinks that Houses should be less stubborn than Foreman is. Foreman asks House if he remembers the Hippocratic Oath? House answers is that the one that starts, “first do no harm”. Foreman starts to tell House all the problems that could happen by putting Sister Augustine in the chamber. House answers him that all treatments have dangers. Foreman reminds House that is why they only treat when they are certain about the problem, House answers Foreman that he is convinced and Foreman is not. House asks Foreman what is he going to do about it?  

Cuddy is in her office on the phone, the door opens and she tells the person on the phone she will call them back. Foreman is standing there and Cuddy asks him what is up?  

Chase is getting ready to put Sister Augustine in the chamber and explains what is going to happen. Sister Augustine wonders will these treatments fix her, and Chase tells her that after they do 10 treatments they will reevaluate the situation. Sister Augustine wants to know how confident House is about this treatment. The fact is because she reacted to strongly to the prednisone, that told them she had an underlying problem. Sister Augustine tells them that she guesses that having that reaction was a blessing of sorts.  

House is down in the hospital chapel hanging out and watching his mini TV. Sister Eucharist comes in and starts to pray. She reminds House that he is in a chapel, a House of Prayer. He tells her jokingly, that explains the good reception and that is why no one is ever there. She tells House that Sister Augustine believes in things that are not real. House tells her that he thought that was a job requirement for her people. She tells House that Sister Augustine has been known to lie to gain sympathy, that she is a hypochondriac. House tells her that he guesses she is warning him that he may be treating a nonexistent ailment. She tells House that Sister Augustine always has some physical ailment and there is never a reason for it. That the Mother Superior plays right in to it and lets Sister Augustine off work duties and treats her as fragile, special. House tells her that must make her angry. She admits it does bother her. The nun tells House it is really not in Sister Augustine’s best interests. House asks the nun if she would like some of his candy bar? She says she shouldn’t but takes it anyway and sits down to eat it. He tells the nun that they now have pride, anger, envy and gluttony. That is four out of seven deadly sins in less than two minutes. Jokingly he asks the nun do they keep records of these things? She tells House she has heard he has a gift. House tells her they like to talk. She says House hides behind his intelligence and House agrees. That he makes jokes because he is afraid to take anything seriously and because if he takes anything seriously, then they matters. If they matter and things go wrong, he gets hurt. He says he is not tough, he is vulnerable. The nun tells House she hopes she is right about him, because if she is wrong, then House really is as miserable as he seems. House says from the way she is looking at him right now, she just hit deadly sin number five, LUST. The nun gives him back his candy bar. House goes back to watching his show.  

Cameron is opening the chamber and Chase asks Sister Augustine how she is feeling, and she answers weak. Chase tells her that is from the oxygen. Cuddy catches up with House and asks him mixed connective tissue disease, really? That her ANA is barely elevated and she gives House Sister Augustine’s other stats. House tells Cuddy people have to get over her attack in the clinic, if there is no underlying problem why is she still not getting better and her heart rate is still too fast. Cuddy is finally fed up with House’s treatments and she removes him from Sister Augustine’s case. House looks into his office and sees Foreman sitting in there reading and they just stare each other down. House knows Foreman went to Cuddy and Foreman knows that House knows what he did as well. House just smiles at Foreman.  

Cuddy now meets with the team in her office. They discuss that Sister Augustine has no underlying symptoms. Cuddy asks them what her status is and they tell her. Cuddy tells them what tests and treatments to do and when Cameron mentions what House was considering, Cuddy gets angry and tells them all she is not interested in what House thinks. Cuddy tells the team to get the patient healthy and her leaving through the front door and not the back.  

The team leaves Cuddy’s office and Foreman tries to explain what he did by talking to Cuddy about House. He rationalizes that Cuddy would have found out anyway. Cameron tells Foreman he did what he thought he had to 

House is back at the clinic in the exam room looking through the drawer where he got the original syringe. Wilson walks in and says to House, he (House) can’t get enough of this place. House tells Wilson he was looking for his stethoscope. Wilson says that he (Wilson) should not read too much into the fact that House was looking for it in the drawer where the syringes are kept? House tells Wilson that he wants to clear his reputation. Wilson kids House that he forgot how much House cares about what other people think of him. Wilson questions House about prescribing cigarettes for bowel problems. House asks Wilson if he knows why they have ribbons for breast cancer, and other cancers but not lung cancer? House tells Wilson because people blame lung cancer patients. They smoked, they screwed up so they deserve to die. Wilson tells House he is concerned that he might have screwed up. House tells Wilson he is there because if he is right, Cuddy is killing the patient. Wilson says, okay, but what if you are wrong? House tells Wilson than Cuddy is saving her. Wilson tells House he is going to have to go through every record for each clinic patient for the past two days and hope they are accurate. He reminds House that they know his charts are not.  

Chase is back with Sister Augustine giving her some pills and telling her it will make her kidneys work better. As Chase is checking Sister Augustine’s pulse she asks him if her pulse is good. He tells her yes, and she says he is a terrible liar. Suddenly Chase get a page “from Mom” and goes to leave. He meets House back at his office and tells House his mother has been dead for ten years. House tells him she is always with him in spirit. House asks Chase what he knows about the nun, and Chase actually asks House which one? House says sarcastically the sick one obviously. Chase gives House Sister Augustine’s background. House asks Chase what is she lying about? Chase asks House how does he know she is lying about something? House tells Chase he knows that he was schooled by the church and that makes him do what people tell him, like go to medical school when that is the last thing they want to do. Chase tells House that if Sister Augustine has a secret her boss would know.
House goes to the monastery and meets with the Mother Superior. He starts asking her questions about anything new they have done to the church and she tells him nothing. He asks if there is any way Sister Augustine could get access to drugs, and she tells him no. He asks Mother Superior why he hasn’t asked Sister Augustine these questions directly? He basically tells her his belief is that everybody lies. She asks House has he been speaking to Sister Eucharist? He tells her that she ratted out her fellow sister pretty quickly. Mother Superior tells House the full story of Sister Augustine. House asks her do all of them lie? He tells her that he knows Sister Augustine did not spend her whole life with the church. When he did CPR on her he noticed two things; one, she had nice breasts and two, she has a tattoo on her shoulder. Mother Superior tells House that they consider that their life begins when they enter the monastery, put on their habits and take their vows. What happens before then is irrelevant. House tells her it may irrelevant to her but important to him. She explains Sister Augustine went into foster care when she was six, but left when she was twelve. She lived on the streets and got into drugs. When she was 15 she became pregnant and tried to self-abort. She lost the child and became ill. They took her back in and nobody mentioned anything about this because they did not consider it medically relevant. House tells her the info is not relevant. He looks at the cup of tea the nun gave him and asks if they used local herbs? 

Cuddy is with the team walking down the hall getting an update on Sister Augustine’s condition. Chase and team inform Cuddy she is just getting worse. Cameron again brings up maybe House is right and there is an underlying condition that explains all of her symptoms. Cameron tries to give Cuddy other possibilities but Cuddy just tells Cameron she wants House to be right. A small package is thrown onto Cuddy’s charts. She asks House what is it, hemlock? He tells Cuddy it is figwort tea, great for a little pick me up, it opens the lungs, increases the blood pressure and stimulates the heart. Unfortunately if you get injected with even

0.1 cc of epinephrine you get instant cardiac arrest. House tells all of them that Sister Augustine has been drinking it constantly. Foreman says if you take cardiac arrest out of the equation all of the other symptoms can be explained by a severe long-term allergic reaction. Foreman says that is what Cameron said in the beginning, “well done” says House to Cameron. However, House chastises her that she should have stuck to her diagnosis as she almost killed her. House them tells them to go and try and figure out how to save a nun. Chases stands with the rest of them and says, “Damned if you do, damned if you don’t”.  

House tells the team the allergy has got out of control, compromising her immune system. What is the source of the allergy? The team starts making suggestions, which House then dismisses. They need to put Sister Augustine in a clean room, House agrees. Then gradually introduce allergens and see how she responds. When she reacts to something we will know what is killing her.  

Sister Augustine is now in a clean room with the team, and they are explaining why she is there and what they will be doing to her. Chase tells her he will be back to check on her and Sister Augustine asks if the sisters can come in and pray with her? Chase says it would be better for her without visitors. Sister Augustine starts to cry. Chase tells her he can pray with her. She tells Chase she does not want to die, and why has God left her? Chase pulls up a chair and tells her that he was in seminary school and that they asked him what his favorite passage from the bible was. Chase chose First Peter, chapter one, verse seven. “These trials only test your faith to see whether or not it is strong and pure. Your faith is being tested, as fire tests gold and purifies it”. Sister Augustine answers, “And your faith is far more precious to the Lord than mere gold. So if your faith remains strong after being tested, it will bring you much praise and glory and honor on the day of his return”. Chase tells her God has not left her. That she has a choice, faith or fear and that is the test. She asks Chase why did he leave seminary school? He tells her that test, she passed, and he did not.   

Foreman and Cameron are with the other nuns catching them up on Sister Augustine’s condition and that as long as she is not exposed to anything to aggravate her allergy she should be fine. Chase knocks on the window telling Foreman and Cameron he needs help right now! They start to gown up and Chase tells them to forget procedures and that Sister Augustine is in anaphylactic shock. They start emergency treatment. Cameron announces her breathing has now stabilized.  

House wonders how you get an allergic reaction in a clean room? Wilson says maybe it was the preservatives in the IV, and House says he checked that. Wilson offers up other suggestions, and House says he checked everything. Wilson suggests cancer, possibly leukemia. House tells Wilson that is not that either. Wilson wants House to accept that sometimes patients die for no reason and sometimes they live for no reason as well. House says, “no”, that they just do not know the reason.  

House is in his office thinking about the case, Cameron walks in and tells House she knows he did everything he could. He tells her he does not need verification from her to know that he is doing his job well. That is her problem not his. She tells House she is just being nice and House tells her you don’t always need to do that. Cameron wishes House Merry Christmas and hands him a gift. House takes the gift and then suddenly Chase steps into the office. Chase tells House and Cameron that Sister Augustine wants to check out against medical advice. She wants to go back to the monastery. House tells Chase to talk her out of it. Chase tells House he may have talked her into it. 

House enters the clean room to talk to Sister Augustine. He tells her the room is paid up for the rest of the week and that she might as well stick around. Sister Augustine tells House that this illness is a test of her faith. That if it is God’s will to take her it does not matter where she is and she can accept that. House asks her does anyone believe anything she says? He tells her she is not accepting her destiny but she is running away, just like she always has done. She ran away from the monastery to get laid, ran away from the real world when getting laid did not work. Now things are not working out so well, so off she goes. Sister Augustine asks House why it is so difficult for him to believe in God? House tells her he has a problem with the whole concept of belief. They argue back and forth about what each believes in. House ask her where is the miracle in delivering a crack-addicted baby? Then watching the mother abandon the baby because she needs another score? House tells her she can have all the faith she wants but in the real world he bets that she stills looks both ways before crossing the street. She tells House that when she was 15 she was on every kind of birth control known to man and she still got pregnant. That she blamed God; she hated him for ruining her life. Then she realized something, you can’t be angry with God and not believe in Him at the same time. No one can, not even House.  

House is back out in the corridor and runs into Wilson who asks House how it went? House tells Wilson she has God inside her and it would be easier to deal with a tumor. Wilson says that maybe she is allergic to God.  

House is back with his team telling them they looked everywhere for this allergen except in her. Foreman says her medical history does not mention any surgery, but House said she did have one. He tells them to order a full body scan. If she refuses tell her House is looking for a miracle.  

The team is looking at her body scan ruling things out. Chase asks what is House looking for? Foreman looks at the screen and asks what is that? None of them know at first. They get an enlargement of the object. It turns out to be an old IUD she had implanted years ago. 

House now explains that the copper cross IUD is a form of birth control and was pulled off the market in the ‘80s. Foreman says then that she is allergic to copper. House says it is rare but it does happen. Chases asks didn’t she know she had an IUD and House tells them she had an abortion and the IUD must have been left in. Chase goes to Sister Augustine and tells her all they have to do is remove the IUD and the symptoms will subside. Her washing the copper pots was the last straw that kicked in the allergy.  

She tells Chase about her favorite passage, which is about the prodigal son. That He will be waiting for Chase when he is ready.  

Final Scene: Wilson and House are sitting at the empty clinic reception desk talking. House tells Wilson the nun is getting better, you know just remove their IUDs and they bounce right back. Wilson invites House to Christmas dinner, and House reminds Wilson he is Jewish. Wilson says that maybe he will come to Houses’ place. House ask Wilson won’t his wife be upset? Wilson says she is used to being married to a doctor. Cuddy walks in and tells House he did well with the nun and wishes a Merry Christmas to House and Wilson. We now see Wilson and House eating Chinese food, Foreman playing Santa at the hospital children’s Christmas party and finally House sitting at the piano playing Silent Night. Cameron is doing paper work and picks up a gift wrap package and smiles as she reads the card, Cuddy is taking care of a patient and Chase walks into a Christmas Mass.

Screencap from http://housecaps.fanfusion.org/


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Updated 11/17/11  

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