House, M.D./Mob Rules
Mob Rules is the fifteenth episode of the first season of House, M.D..
Starring: Hugh Laurie (Dr. Gregory House), Lisa Edelstein (Dr. Lisa Cuddy), Omar Epps (Dr. Eric Foreman), Robert Sean Leonard (Dr. James Wilson), Jennifer Morrison (Dr. Allison Cameron), Jesse Spencer (Dr. Robert Chase)
Mobster Joey Arnello is set to join the Witness Protection Program against his brother/lawyer Bill's recommendation, but he collapses and goes into a coma. The feds suspect he is faking it and order House - who is under harsh examination from Vogler with Cuddy as his only defenders - to take the case. Bill tells House to keep Joey in the hospital until he can talk him out of testifying. When Joey snaps out of his coma, Vogler releases him, only to be embarrassed when Joey immediately returns to the ER. Chase diagnoses hepatitis C, but Bill denies the diagnosis and refuses treatment. House realizes Bill's problem is the diagnosis suggests Joey is either gay or has been raped, so he offers to keep the disease quiet. To thank House, Bill gives him a classic Corvette as a gift. House believes Joey's illness is the result of cheap Chinese remedies to quit smoking coupled with the hepatitis, but Joey lapses back into a coma. As Chase administers an experimental drug, House concludes the only unexplained symptom proves Joey is gay. He tells Bill that Joey will die if he is not treated for this disease. When Joey recovers, proving he is gay, Bill says he still loves him, and it's okay if he testifies. Afterwards, Cuddy tells House that Vogler has ordered him to fire one member of his staff.
- Henry's Brother: A toddler who comes in with whistling in his nose. Henry, who is watching the tyke while the parents are away, worries it is the croup, but the problem is a small metal toy policeman, which the kid put up his nose while Henry was preoccupied. Hours later, Henry returns again. As Henry confesses the inspiration for shoving things up his nose came from a magic trick he showed the child, House pulls out a toy metal fireman. On the third visit, Henry's brother has shoved a fire engine up his nose. Henry says his brother is "not too smart." House agrees, but then he notices the pattern of the three toys removed. He pulls out a magnet and uses it to extract the real first object Henry's brother shoved up his nose: A toy metal cat. House deduces the tiny toddler has a "nice grasp of concepts, relationships," and is therefore "very smart, very cool" for his age. He tells Henry, "Your brother was sending in teams to save the cat."
(See the Medical Dictionary for all definitions.)
- As they review House's financial viability, Vogler says House is "saving New Jersey from leprosy."
- House presents Joey Arnello's case to his staff and says he is "an eight on the Glasgow Coma Scale." Foreman says Joey is "barely alive." Cameron asks about head trauma, and House orders an MRI. Chase lists possible metabolic causes, including diabetes.
- Chase says Joey's MRI shows a subdural hematoma. House finds pseudomembranes, which suggest an older condition. He asks about the liver, and Cameron says Joey's LFT's are elevated, but Chase says they are not high enough. Foreman recommends draining the fluid. House says, "The neurologist thinks it's his brain and wants to open up his head?"
- After Joey snaps out of his coma, House orders hepatitis tests.
- On Henry's first visit to the clinic with his wheezing brother, he worries the problem may be the croup, which could lead to meningitis.
- Vogler says House loses money, but Cuddy counters ophthalmology does, too.
- Upon Joey's second admission to the hospital, Chase diagnoses him with hepatitis C, supported by high estrogen levels. House asks about other liver tests. Cameron says Joey has normal albumin levels, which confirm House's theory. House orders a liver biopsy, although he allows Chase to start the hepatitis C treatment.
- Foreman bursts in on Chase and Cameron in the lab and warns Joey's blood pressure is dropping, but thanks to IV fluids, "he's holding a hundred systolic." Cameron asks if Joey is septic, but Foreman says he is not. Chase hypothesizes this may be varices from hep C. House says the biopsy shows "lymphocitic infiltrate and no bridging fibrosis," so Joey's condition is acute.
- As Cameron and Foreman perform toxin tests, she rules out hemlock, which grows naturally in New Jersey. House checks the chest X-ray to see emphysema.
- House tells Cuddy that Joey is ready for release and says the problem is a Chinese herbal quit-smoking lozenge combined with an interferon.
- After Joey slips back into a coma, Chase recommends that they use an experimental nonnucleoside allosteric inhibitor to mutate the hepatitis C virus.
- Once House realizes Joey had steak before both comas, he says the problem is ornithine transcarbamylase deficiency, or OTD.
- "Crazy World" by Daniel Moynahan: House and Wilson take House's new Corvette for a spin.
- House and Cameron: Cameron admits she likes House romantically, and Foreman teases her. House has said in 1x14 - Control that he does not feel the same.
- House and Vogler: Vogler - via Cuddy - orders House to fire a member of his staff.
- 1x13 - Cursed: As they discuss House's case, Vogler says he is "saving New Jersey from leprosy," referring to the disease House cured in that episode.
- 1x14 - Control: Cameron says she has earlier asked House if he liked her and he said no, which happened in that episode. Also, House pulls Foreman off Joey Arnello's case because "somebody told Vogler that I lied to the transplant committee," another incident in that episode, in which Vogler became Chairman of the Board.
- Timeline: Vogler and Cuddy say House has worked at the hospital for eight years.
Behind the Scenes
- Hugh Laurie's Accent: Laurie's New Jersey accent is usually impeccable, despite his actual English origin, but he claims the phrase "federal court order" from this episode, caused him a great deal of trouble, and the scene required multiple takes to get it right. His best efforts notwithstanding, the discerning ear will pick out a slight English accent as he says the phrase in the scene where he protests receiving Joey Arnello's case.
Allusions and References
- The Witness Protection Program: In exchange for testifying, Joey Arnello is to join the Witness Protection Program. He is checked into the hospital under the name "John Smith," and Bill worries he will never see Joey again. The United States Federal Witness Protection Program was set up in the late 1960s to provide security for federal witnesses, particularly those testifying against organized crime. Witnesses are relocated and given new identities which are kept secret even from their own family members.
- "Metroid Prime: Hunters": To try to snap Joey out of his coma, House plays a video game next to his ear. The video game is "Metroid Prime Hunters: First Hunt," a demo version of the 2006 game "Metroid Prime: Hunters" which was included with all North American and European versions of the Nintendo DS system. The sound effects of the game have been altered.
- The Axis of Evil: House's staff recommend releasing Joey, but House says, "Unless I've been named as the fourth part of the Axis of Evil, invaded and occupied, this is still not a democracy." "Axis of Evil" is a term used by President George W. Bush in his 2002 State of the Union address to refer to "regimes that sponsor terror." The term "Axis" evokes images of Germany, Japan, and Italy, against whom the United States, the United Kingdom and their allies fought in World War II. Bush named three countries - Iran, Iraq and North Korea - to this Axis of Evil. A year later, in March 2003, Bush authorized the invasion of US and UK troops into Iraq. The authoritarian government was subsequently toppled, and occupying forces have since worked to install a democratic government.
- Junior G-Man Badge: To help the feds, Vogler calls the Department of Justice to release Joey after he is out of his coma, but when Joey returns hours later, House says, "So, the Junior G-Man badge isn't looking so good." Melvin Purvis' Junior G-Man Corps was a set of premiums included in boxes of Post Toasties cereal in the 1930s. Endorsed by FBI Agent Melvin Purvis - most famous as the agent who killed notorious bank robber and murderer John Dillinger - rewards for sending in the appropriate box tops included club manuals, autographed photos and plastic "Junior G-Man" badges.
- Euripides: When Foreman learns Cameron has for hemlock, he asks, "Dr. Euripides tell you to check for that?" Euripides was a 5th century BCE playwright in ancient Greece, which used suicide by hemlock poisoning as a means of capital punishment, including with Euripides' contemporary Socrates. Euripides is most remembered for his tragedies, including Medea, Electra and Trojan Women.
- Babe: After Joey's blood is filtered through a pig's liver, House rules out toxins. He says, "Our friend Babe helped with that one," in reference to the 1995 Oscar-winning Australian film, based on a novel by Dick King-Smith, about a pig who becomes a sheepdog.
- Chase tries to treat Joey Arnello for hepatitis C, but Bill Arnello asks how Joey would have contracted the disease. Chase says, "It usually involves the exchange of bodily fluids. ... Sharing needles, blood transfusions...." Bill angrily tells Chase, "Nobody talks to my brother like this, OK?" Chase repeats Joey has hepatitis C, so Bill punches him in the mouth and says, "He doesn't have it. Don't mention it again. Don't treat him for it."
- Bill finds House in the clinic trying to extract the fireman from Henry's brother's nose, but the child is fussing and squirming. Bill looks the child in the eyes and yells, "Stop!" The child freezes, and House removes the toy. He says to Bill, "That's a neat trick." Bill replies, "They have to believe you'll actually hurt them."
- House and Wilson run into each other in the parking garage, where House looks around in horror and says, "My car's been stolen." Wilson sees House's parking space and says House's car has been "rein-car-nated" as a mint condition 1965 red Corvette convertible complete with pink slip, a gift from Bill to thank House for keeping Joey's hepatitis C quiet. House says, "You know, they're gangsters, sure, but they're thoughtful, too." Wilson warns accepting the car would be graft, but House says, "Graft is if I tell him I'll only make him better if he slips me a couple bucks, or a payoff for something I'm not supposed to do. If I'd asked for the payoff - which I didn't - I would've done the bad thing, anyway. So there's nothing wrong with this." Still considering whether or not he should keep the car, House asks Wilson, "What do you think a guy like Joey would do if someone turned down a gift? That's... kind of an insult, isn't it?" Wilson says, "He might hurt you. It's definitely possible." House says, "I'm screwed. Gotta take the car."
- Cuddy: You have three choices: Hire a lawyer to fight the order, treat the guy or go to jail for contempt. Up to you.
- House: Jail. You'd like that. No more naughty school girl. Conjugal visit, that's her new fantasy.
- Chase: (On Cameron.) Oh, okay, and, uh... why is her test better than mine?
- House: Because she's cuter. Though it's close.
- Vogler: Well, this is not a team. It's not a boat. It's not a machine that has a lot of parts that have to work together. The metaphors are all crap. This is a business. That's all it is.
- Wilson: Seriously, man, have you ever actually driven an automobile before? There are four gears, you know.
- House: The '66 came with a "shut up" button.
- Bill Arnello: Joey is not gay!
- House: Maybe not gay, but certainly delightful.
- Cuddy: Vogler wants to fire you, lose the whole department.
- House: Good thing you fought for me though, right? Dress was a nice move, but you gotta follow it up. Nasty weekend in Vegas, something that shows off your real... administrative skills.