House, M.D./Role Model
Role Model is the seventeenth 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)
Black presidential candidate Senator Gary H. Wright vomits and collapses at a fundraiser. Vogler offers not to force House to fire either Cameron or Foreman - although not Chase, who is feeding Vogler information - if House treats Sen. Wright and gives a speech supporting Vogler's new drug at a conference. Foreman finds a scar on Sen. Wright's tongue from a childhood accident and a lack of reflexes, which indicates a neurological disorder. Tests suggest Sen. Wright has AIDS, although his strength moves House, who runs a second test, which is negative. As the senator's condition worsens, it becomes impossible for House to run further tests for the leukemia he believes the senator has. However, viral tests clue House to the fact that Sen. Wright's problem stems from a childhood epilepsy treatment. Sen. Wright gets better and tells House he is still running for President, although he knows he will not win, because he believes in doing it. At the conference, House tells the ugly truth about Vogler's drug. That night, Cameron comes to House's apartment to quit her job.
- Susan: A woman who has had a miscarriage but insists she has not had sex. On her second visit, she has bruises which House calls hickeys. He orders tests for the date rape drug. On her third visit, her tests are negative, but she has a rash on her butt, which House calls carpet burn. She says her ex-husband lives downstairs from her and is complaining of "mixed signals" from her. She also says she wakes up exhausted after a night's sleep. House checks her into the sleep lab, where he learns she becomes aroused. He says she is sleepwalking and having sex with her ex. He prescribes an antidepressant, but the fact that she is having sex with her ex suggests "unresolved issues."
(See the Medical Dictionary for all definitions.)
- Vogler asks House to give a speech at a cardiology conference for Vogler's new ACE inhibitor, Viopril.
- When Senator Gary H. Wright's has no reflexes, House orders an MRI and lumbar puncture.
- Foreman says Sen. Wright's LP shows no infections, but tests show a problem with Broca's area in his brain.
- Cuddy chews House out for ordering a brain biopsy on Sen. Wright.
- Cuddy tells Sen. Wright his problem could be a transient ischemic attack.
- Wilson finds toxoplasmosis in Sen. Wright', which House says means he has AIDS.
- Foreman reassures Sen. Wright he can live for a long time with HIV. House says, "You need antiretrovirals, and you need 'em fast."
- House asks Chase and Cameron to "rush the ELISA test for HIV."
- Susan returns to the clinic with petechial bruising, which she fears is a sign of leukemia. House runs tests for GHB.
- House tells Sen. Wright his HIV test was positive and, "Your T cell count is eight, which means there's a good chance you'll die."
- As Sen. Wright's condition worsens, Wilson asks if the PCR test could be a false negative, but House says he "ran it twice." Chase hypothesizes an immunoglobulin deficiency. Cameron suggests an idiopathic T cell deficiency.
- House tells Wilson the vaccinations for hep A and B Sen. Wright took for his Africa trip led to a false positive on the first HIV test.
- Sen. Wright's full body scan turns up enlarged lymph nodes, although House says this is not a sign of lymphoma. Cameron asks if a cyst in his liver could be a sign of central necrosis, but House says it is benign.
- Wilson tries to convince House to give Vogler's speech, saying, "Vicodin sales in Jersey will triple," referring to House's addiction to the drug. Foreman, Cameron, Chase and Cuddy enter with the results of tests on Sen. Wright's lymph nodes, which are clean. House finds antibodies for CD11, but Wilson says they do not indicate lymphoma. House hypothesizes hairy cell leukemia and orders a biopsy of Sen. Wright's spleen, although Cuddy warns it could cause sepsis.
- Foreman warns that Sen. Wright's O2 sat levels are dangerously low, and his "silver stain indicates Pneumocystis carinii pneumonia." Wilson says this is indicative of hairy cell leukemia, but Foreman says a biopsy of his spleen is impossible. House asks what other viruses may appear, and Cameron suggests both HTLV and ATLV. House orders them to "run the titers."
- House says Susan is experiencing somnambulism and she was pregnant and had hickeys and carpet burn because of sexsomnia.
- Sen. Wright's tests are negative for any infection which would indicate hairy cell leukemia, but he is positive for Epstein-Barr.
- House says the scar on the Sen. Wright's tongue is from an epileptic seizure. Sen. Wright says he was prescribed phenytoin.
- House says Sen. Wright has common variable immunodeficiency disease, or CVID, which lowers both the T cells and the B cells. To prove his unlikely diagnosis, House prescribes immunoglobulin.
- House implies Sen. Wright's illness makes it unlikely he will be President. Foreman says, "Kennedy had Addison's. FDR had polio."
- "High Hopes" by Hugh Laurie: House plays this on his piano before Cameron arrives to tender her resignation.
- "It's Okay to Think About Ending" by Earlimart: Cameron quits her job and says good-bye to House.
- House and Cameron: Cameron quits her job because of her feelings for House.
- House and Chase: House accuses Chase of feeding information to Cuddy and Vogler, and Chase admits he is.
- 1x05 - Damned If You Do: House says to Cameron, "I thought you were an atheist." Her beliefs were discussed in that episode.
- 1x15 - Mob Rules: Vogler offers not to force House to fire someone if House can prove he is a "team player." Vogler first ordered House to fire a member of his staff in that episode. Also in that episode, Cameron first stated she is attracted to House. In this episode, House asks why she does, and she later leaves her job because of her feelings for House.
- 1x16 - Heavy: House cannot fire Chase because he is feeding information to Vogler. House tried to fire Chase in that episode.
Behind the Scenes
- Crew Cameo: Bobbin Bergstrom, who plays the ICU Nurse who attends to Senator Gary H. Wright during his stroke, is the on-set medical advisor on the show.
- Actor Aspirations: Foreman is inspired by Sen. Wright's words and decision to run for President, even though he knows he has no chance of winning. In real life, Omar Epps has announced his intention to run for President in 2008 as an independent.
Allusions and References
- Immaculate Conception: House says Susan has had a miscarriage, but she says she has not had sex. He says it is an "Immaculate Conception" and suggests she "start a religion." The Immaculate Conception is a Christian belief that Jesus' mother Mary - unlike every other human born since Adam and Eve - was conceived without original sin, passed down to all humans since Eve's eating from the Tree of Knowledge. Therefore, Jesus would also have had no Original Sin. The term has been misunderstood to refer to the fact that Mary gave birth to Jesus while she was virgin. "Immaculate Conception" is thus, to many, a synonym for "virgin birth."
- NASCAR Dads: When Senator Gary H. Wright worries about voter reactions if he has a brain biopsy, House chides him for "worrying about NASCAR dads." NASCAR dads is a voting demographic which was considered important during the 2004 Presidential elections. The term refers to working-class or lower-middle-class rural White males, who were considered a swing vote in the 2004 race of Republican President George W. Bush vs. Senator John Kerry. A cross-section of fans of the National Association for Stock Car Auto Racing (NASCAR) shows the viewership is more heavily female and much more affluent than the demographic name suggests.
- The Great White Hope: House says toxoplasmosis on Sen. Wright's biopsy "means the Great Black Hope has full-blown AIDS." The phrase "The Great Black Hope" is a reference to the 1970 film The Great White Hope and the Howard Sackler play on which it is based. Both are about a Black heavyweight boxer who overcomes racism in 1930s-era America.
- The New York Jets: House orders a whole body scan for Sen. Wright. Cameron says House hates whole body scans, and he agrees he does, "But when you're fourth down and a hundred to go, in the snow, you don't call a running play up the middle unless you're the Jets." The New York Jets are a National Football League team which plays its home games in Giants Stadium in East Rutherford, New Jersey.
- Sick Presidents: Foreman counters House's argument that Sen. Wright cannot become President by saying, "Kennedy had Addison's. FDR had polio. Two of the best Presidents in the last hundred years." House replies, "If they were running today, they wouldn't stand a chance." They are referring to two Presidents of the United States:
- John Fitzgerald Kennedy: The 35th President of the United States, he oversaw national crises during the Bay of Pigs invasion and the Cuban Missile Crisis. He is famous for inspiring America to send a man to the Moon and for his guidance in the American Civil Rights Movement. Although he suffered from numerous ailments - including Addison's disease and chronic back pain - which conflicted with his image as a young, handsome, vital man, these were hidden until after his assassination in 1963.
- Franklin Delano Roosevelt: The 32nd President of the United States, he served for an unprecedented 12 years and was thrice re-elected. He both ended the Great Depression and led the nation throughout most of World War II. The fact of Roosevelt's polio was well known throughout his Presidency, but he hid that it had left him paralyzed from the waist down. He often used aides or supported himself with a podium to make it appear as if he was standing on his feet - something he could not actually do. Both were elected prior to the post-Watergate Information Age.
- House gets annoyed when Cameron thanks him a second time for agreeing to give the speech for Vogler. She asks, "Do you know why people pray to God? ... Do you think they pray to Him and praise Him because they want Him to know how great He is? God already knows that." House says, "Are you comparing me to God? I mean, that's great, but, just so you know, I've never made a tree." Cameron says thanking House is important to her. House calls her "the most naïve atheist I've ever met" and starts to walk off. He stops and says, "People pray so that God won't crush them like bugs. I'm not gonna crush you." He walks off.
- House pulls off the respiratory mask helping Sen. Gary H. Wright breathe. He calmly says Sen. Wright "didn't fall off the swings when you were eight," and he got the scar on his tongue from an epileptic seizure. He asks what drugs Sen. Wright took for the epilepsy, and Sen. Wright says he has not had a seizure since he was six and has not taken drugs for the illness since he was ten. House says, "Yeah, that's it. Don't worry about what the question is. Don't worry that you're starting to feel dizzy. Just stay on message." Desperate, Sen. Wright says his mother called the drug "funny-something," and House realizes he means phenytoin, so he puts the respiratory mask back on. As Sen. Wright catches his breath, House says, "Everybody lies."
- At the cardiology conference, Vogler introduces House by speaking of his integrity. House steps to the podium and reads his speech, which lasts ten seconds. He turns to leave, but Vogler stops him and says, "That's not a speech." House says, "I thought it was pithy. You got enough for a press release, anyhow." Vogler reminds House he will have to fire Foreman or Cameron if he does not give the speech, so House gives a longer speech, this time describing how the new drug is good, but overpriced and unnecessary. House concludes his speech by saying, "From all the healthy people in the room, let's have a big round of applause for Ed Vogler!" He applauds by himself, then walks off. As he passes Vogler, he says, in response to Vogler's earlier instruction, "I threw in a joke."
- House is home alone when Cameron arrives. House apologizes, saying, "I should've taken an extra couple of Vicodin and just held my nose." Cameron says House did take extra Vicodin, and he admits he did. Cameron announces she is quitting. House asks if she is sacrificing herself to protect Foreman. As "It's Okay to Think About Ending" starts, Cameron says, "I'm protecting myself." She says she is leaving is because of her feelings for House, and because "everything you do, ... you do it because it's right." She holds out her hand to shake House's, but he looks away. On the verge of tears, she says good-bye and walks out.
- Vogler: You can either give one ten-minute talk and one three-minute diagnosis, or you can fire one of your pets. My understanding was that you believed in rationality above all else.
- Cuddy: A brain biopsy can cause permanent neurological damage.
- House: Uh-huh. Whereas tumors are really good for brains, make 'em grow big and strong.
- House: (To Cameron.) I am not warm and fuzzy, and you are basically a stuffed animal made by Grandma.
- House: A few things I forgot to mention. Ed Vogler is a brilliant business man, brilliant judge of people, and a man who has never lost a fight. You know how I know that the new ACE inhibitor is good? 'Cause the old one was good. The new one is really the same, just more expensive. A lot more expensive. You see, that's another example of Ed's brilliance. Whenever one of his drugs is about to lose its patent, he has his boys and girls alter it just a tiny bit, patent it all over again, making not just a pointless new pill, but millions and millions of dollars. Which is good for everybody, right? Except the patients, but, pfft, who cares? They're just so damn sick. God obviously never liked them, anyway. From all the healthy people in the room, let's have a big round of applause for Ed Vogler!
- Cameron: I'm protecting myself. You asked me why I like you. You're abrasive and rude, but I figured, everything you do, you do it to help people. But I was wrong. You do it because it's right. There are only two ways that I can deal with things. One is in my control, and that's to leave. Good-bye, House.