house

Season Two Episodes:

  1. Acceptance
  2. Autopsy
  3. Humpty Dumpty
  4. TB or Not TB
  5. Daddy's Boy
  6. Spin
  7. Hunting
  8. The Mistake
  9. Deception
  10. Failure to Communicate
  11. Need to Know
  12. Distractions
  13. Skin Deep
  14. Sex Kills
  15. Clueless
  16. Safe
  17. All In
  18. Sleeping Dogs Lie
  19. House vs. God
  20. Euphoria (Part 1)
  21. Euphoria (Part 2)
  22. Forever
  23. Who's Your Daddy?
  24. No Reason

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Barbara Bardach: I know, I need to loosen up, I'm overprotective.I saw 'Finding Nemo', I get it. I don't need another story
Foreman: You're not just being overprotective. You're one of the most overprotective parents I've ever seen.
Barbara Bardach: She has the best private tutors. I let her friends visit. I'm not going to apologize... she almost died three times during her childhood - penicillin, bee stings, peanuts... six months ago, we leave her home alone for the first time on a weekend. She goes out, buys one chocolate chip cookie. Peanut butter in the dough. She's forgotten her EpiPen. She drives to the hospital, passes out, has an accident. Steering wheel crushed her chest. She ended up losing her heart. So when you say to me that I'm one of the most overprotective parents you've seen, please, please introduce me to the ones who were more overprotective, so that I can find out what they're doing right.
— Safe

Safe is a 2nd season episode of House which first aired on April 4, 2006. Melinda, an immunocompromised heart transplant recipient, goes into anaphylactic shock in her home clean room. The team has to deal with her increasingly severe symptoms and her wish to rebel against her mother's overprotectiveness. Meanwhile, the relationship between House and Wilson becomes increasingly strained as Wilson continues to live with House after separating from his wife.

The episode is mostly an interaction between the medical mystery, where House interacts with his team, and the main sub-plot - Wilson's recent separation from his third wife. In the beginning, House's involvement in the case is solely because Wilson is living with him, and, in the end, House can't solve the case without Wilson's help.

Although almost every episode explores the relationship between House and Wilson, in this episode, the relationship is put under the magnifying glass when Wilson has to spend all his off hours with House as well as working next to him at the hospital. In most cases, it would be the host in this relationship who would find stress in the situation, but House is flying through what would otherwise be an inconvenience. Instead, it's the guest who gets stressed out, having to put up with House's deliberate antics that seem destined to drive him away.

However, as Wilson later says out loud in The Social Contract, House may be a good friend, but he's not the type of guy to let you cry on his shoulder and tell you everything is going to be okay. In this case, Wilson is under the delusion that everything will be back to normal once he gets his own place to live. It's House who has to snap him back to reality - that Wilson's third marriage is over too, but everything is going to be all right despite that.

House's mechanism for doing this is trying to start a prank war. In ordinary circumstances, these two ultracompetitive Type A personalities would go out of their way to outdo each other. Had House not been crippled, they would have been doing it on the golf course or the jogging track. However, given the options, House all but dares Wilson to prank him by assuring him that he will feel better once he does. Eventually, Wilson takes the advice and proves House right.

By comparison, the medical mystery trots out some tropes that get explored in the series time after time, particularly the tensions between teenagers and their parents. In addition, Jennifer Morrison and Omar Epps also get to stretch their acting skills as Cameron and Foreman start to assert themselves.

Recap

During a visit from her boyfriend, an immunocompromised girl goes into anaphylactic shock despite the precautions they have taken to turn her bedroom into a clean room. Her mother manages to treat her with an EpiPen.

Wilson comes to tell House about the case. They get into an argument about who was supposed to wash the dishes. House is intrigued when he finds out the girl suffered from an allergic reaction despite being immunocompromised and in a cleanroom.

Cuddy briefs the team. They have tested the patient and her environment for four days without finding anything. House thinks someone is lying and asks his team to redo the environmental scan. Meanwhile, the patient is angry that her parents won't let her out of her bedroom. She wants to go back to school.

The mother and Foreman get into a confrontation about how protective the mother is. The mother says that she is overprotective because her daughter has had three life-threatening illnesses, including a recent heart transplant - the result of an auto accident after suffering an allergic reaction.

Chase and Cameron review the patient's bedroom and realize that the boyfriend could have snuck in the window. They confront the boyfriend, who admits to sneaking in and having sex with the patient. They obtain a semen sample, but tests show the patient is not allergic to her boyfriend's semen. House wants to check if he brought any other allergens in at the same time. House confronts the boyfriend, and he admits to taking unprescribed antibiotics, and House points out that his semen can pass on penicillin, which the patient is allergic to.

They decide that a reaction to penicillin would explain all her symptoms, and they choose to release her. Just as they are about to, she has a heart attack due to congestive heart failure.

The team can't think of any condition that would cause both anaphylactic shock and heart failure. They decide to concentrate on heart failure.

During the patient's MRI, Foreman and Cameron discuss teenagers having sex. The MRI shows no problems. The patient gets into a discussion with Foreman about how long she may live with her transplanted heart. Although Foreman is optimistic, the patient knows she is unlikely to make it more than ten years.

They perform a heart biopsy to determine if her heart is suffering from transplant rejection. Meanwhile, House has hung a stethoscope on his doorknob to inform Wilson that he is in there with a woman. Wilson has to wait outside of House's home for several hours. When House finally comes out, Wilson learns that House just wanted privacy to work on the case. They get into another argument.

The biopsy shows negative for rejection, and the blood tests don't show an infection. While Foreman discusses the situation with the parents, they discover the patient has run away. Foreman figures out she is heading for the roof to be outside and finds her in a stairwell. The patient starts talking about her problems with her overprotective mom. Foreman notices that her left leg appears to be partly paralyzed, and it is ascending quickly.

The new symptom doesn't add up either. The only possible disease that causes all three symptoms is tick paralysis, but there is no sign of a tick. They decide to concentrate on the paralysis. However, none of the tests are positive and the paralysis is getting worse. The best explanation they can come up with is Guillain-Barré syndrome, so they start treating her for it in the hope she will improve.

Wilson confronts House about erasing Wilson's phone messages about a possible new apartment. House admits to it and tells Wilson if he wants to confront him about not doing chores, he should be more proactive. House accuses Wilson of avoiding the fact he has to divorce his wife because if Wilson finds his own apartment, he will have to admit his marriage is over.

Meanwhile, the patient is getting worse, and her mother feels that she had resigned herself to death. Her usual personality is combative. The patient has another attack, this time because the paralysis has reached her lungs.

The patient is put on a respirator. The speed of the paralysis rules out Guillain-Barre, which moves far more slowly. The patient's parents lose confidence in House and turn to Cuddy to supervise the treatment. The team once again tries to determine a possible diagnosis. They decide on botulism as a possibility despite the fact the paralysis is going the wrong way (paralysis from botulism doesn't ascend, it descends). House finds Cuddy and Wilson examining the patient before an MRI. House examines the patient, but the only revelation is that the boyfriend wasn't using penicillin but another antibiotic, which rules out an allergic reaction. However, the boyfriend did walk through high grass, so House starts looking for a hidden tick. He is unable to find one before the patient goes into shock again. With the parents irate, Cuddy tosses House out of the room and calls for a cardiologist. Wilson covers for House and makes an excuse to suggest that she be taken to intensive care.

House is convinced there is a tick, and if they don't find it quickly, she will die, as the tick will keep pumping toxins into her body until they remove it. Cuddy overrules House and decides on a course of drugs and intensive care. They get ready to move the patient to the Intensive Care Unit on Wilson's recommendation; a ploy by Wilson to get House and the girl alone in the elevator.

House and Foreman intercept the patient in the elevator, and House pushes the emergency stop button and starts looking for the tick again. The patient is still in distress as House and Foreman argue about House's actions. Foreman finally decides to let House look and gives him three minutes. The patient's heart rate starts dropping while House and Foreman frantically look for the tick. Despite a thorough search, the patient's heart rate becomes critically low. Finally, House asks the patient if it was the first time she had sex, but she's unresponsive. He surmises that she wouldn't be used to the sensations in her groin and decides to examine her vagina. The elevator doors open as the father sees House looking at the daughter's pelvis underneath a modesty screen. As the father goes to attack House, House triumphantly comes up with the tick.

House is pleased with himself and thanks Wilson for suggesting that they move the patient, which allowed House to isolate the patient in the elevator.

Wilson denies that this was his intention.

At that moment, House's cane breaks, and he sprawls on the floor, looking around him, shocked.

Wilson notes in passing that it looks like someone cut partway through the rod and as he walks off, House smiles before he leans over and picks up his now broken cane.

After the patient recovers, her parents agree to let her out of her clean room and go back to school.

House goes home to Wilson, who has finally called a divorce lawyer.

Due to House having put Wilson's hand in warm water while he slept, it seems as though Wilson did pee himself on the couch where he was asleep.

Major Events

Zebra Factor 5/10

Tick paralysis is not uncommon. There are dozens of cases a year, and the disease can appear anywhere ticks are found, particularly in warmer months. Suburban New Jersey is a great habitat for ticks. Some tick species will wander on a human body in search of the best spot to attach itself, and can be transfered between people during this time. Therefore it is also believable that the tick was transferred from the boyfriend to the patient during bodily contact. House was also right that the tick can attach to any part of the body.

Title

The title refers to several things:

Trivia & Cultural References

Music

Reviews

Reviews of the episode were generally positive. Many of the critics noted that unlike other episodes, the secondary characters like Foreman and Cameron, in particular, were allowed to develop and to break out of their typical, predictable behavior. However, the highest praise was reserved for guest star Trachtenberg who was considered for an Emmy nomination for her work in this episode.

Medical Ethics

Treatment of minors and parental consent

The law and codes of medical ethics are clear - for a minor (anyone under the age of 18), the parents have a complete say over medical treatment choices. This extends to respecting the parents' wishes about informing their child about the nature of the treatment and their prognosis. In other words, if the parents want to lie to their child about how ill they are and the risks of treatment, that's entirely up to them.

However, these ethical protocols are often difficult to apply once a minor reaches the age of reason (about the age of seven) and often becomes impossible in a very old minor who can usually figure out things on their own. Indeed, with an older child, if the parents want to pursue a non-traditional treatment for philosophical reasons (anything from refusing a blood transfusion to refusing a vaccination), the ability of the child to understand the consequences of that choice, and agree with the decision, often forestalls the appointment of a guardian ad litem for the child.

In this case, although Melinda's parents make sound choices about her treatment for her acute medical condition, their decisions about her chronic medical condition are more borderline, particularly when looking at Melinda's wishes, which would also be acceptable choices for an adult in the same situation. However, Barbara is within her rights to admonish Foreman for telling Melinda there is no further need for her to be kept in a sterile environment. Technically, that is Barbara's choice. Also, Barbara is within her rights to stop Foreman from discussing the matter with her and trying to change her mind.

The series also explores this issue in many other episodes, including Autopsy, Skin Deep, Poison, Paternity, and Detox.

Non-protocol treatment

Although diagnoses are important, it is also important to ensure that a patient is stable before embarking on any course of testing or treatment. When a patient is not stable, it is critical to get their blood pressure and heart rate under control. This is why trauma patients who need surgery are still taken to the emergency room first - the emergency room has the equipment to get the patient's vital signs under control - the operating room does not.

As such, House's choice to continue the "magic tick hunt" was probably ill-considered. He could have continued to press Cuddy about it once Melinda's heart distress had been brought under control. Even House said it would take at least an hour for her to die, and with intensive care, she could have been kept on life support for much longer.

As Dr. Schaffer pointed out when she fired Eric Foreman in 97 Seconds, there is a reason why doctors have to follow protocol instead of going after hunches. Even House admits he's "almost always eventually right" and, although he succeeded this time, there was no guarantee that he was right. Had he been wrong, the consequences for Melinda could have been serious.

Goofs

Quotes

Wilson: [enters House's apartment after waiting for hours outside his door] Where's... the hooker, I assume?
House: [points at his own head] Right up here, buddy.
Wilson: You said... you'd hang the stethoscope if you were having sex.
House: I didn't say it had to be with another person. Can you think of anything that would tie together anaphylaxis and heart failure?
Wilson: No. I was waiting out there for hours!
House: Well, I need a lot of foreplay. And then there's the cuddling afterward.
House: [snatching the marker back from Foreman who was writing on the board] Sorry, there's a reason they call it the whiteboard. It's not my rule. What ties both of these conditions together?
Foreman: [the others can't come up with anything that ties the two conditions together] OK, we can all stare at each other, or we can investigate what caused the heart failure. Just the heart failure. You wanna give me that blackmarker?
House: You wake up in the morning, your paint's peeling, your curtains are gone, and the water is boiling. Which problem do you deal with first?
Foreman: House!
House: None of them! The building's on fire!
Cameron: [to Chase] Too bad it's not you giving the [semen] sample. We'd be done by now.
House: Boyfriend sneaks in to get his freak on the night before the anaphylaxis, and I don't buy that it's unrelated.
Cameron: He loves her! He did everything he could to make sure she wouldn't get sick.
House: [looks puzzled] What does that mean?
Cameron: Love is an emotion certain people experience, similar to happiness... You know, maybe I should give a more relatable example.
House: Oh, snap! What did he do to protect her, brillo-pad his privates?
Cameron: I assume he washed and he—
House: Oh good work, assumptions are so much faster than actual questions.
Barbara: I want a second opinion.
House: Second? I can give you at least eight.
House: Six months without putting out... Dr. Cuddy doesn't need to wear thong panties. It's not our call.
Cuddy: I was wondering when you'd get around to my panties.
House: This is the one downside of teenage sex - you're idiots. You almost killed your girlfriend. She's allergic to penicillin.
Dan: What, do you think there was still some on my lips? I brushed my teeth!
House: Think lower and more fun.
Dan: I mean... it can... it can go through your stuff?
House: Totally, dude! There's this administrator here; whenever she gets sick, she just gives me the prescription!
Cuddy: Ticks aren't usually invisible.
House: They are until you FIND THEM! [holds up comb triumphantly] No, that's dandruff. Okay, well, that wasn't nearly as dramatic as I'd hoped. It just means that next time'll be even better!
House: Everything sucks. Might as well find something to smile about.
House: Inaminrone was a stupid idea unless you wanted me to get that girl in the elevator.
Wilson: I wouldn't do that.
House: Wouldn't respect you if you did. [House's cane breaks, and he falls down]
Wilson: Wow, looks like somebody... filed halfway through your cane while you were sleeping.
Chase: Melinda's dying.
House: We're all dying. How fast?
Chase: We're going to need a semen sample. You can use the bathroom over there.
Dan: Right... uh... how do I...
Cameron: Aim and shoot.
Chase: No thinking about Dr Cameron - we'll know.
Foreman: [to Cameron] So I hear you don't want teenagers having sex. Teen suicide rate isn't high enough for you already?
House: I said it's fine if you stay.
Wilson: Yeah, that's why you're making me miserable.
House: Maybe I just want to make sure you do your fair share around here.... What's weird about it? The girl with the allergies.
Wilson: Yeah. She's immunocompromised.
House: What are you doing?
Wilson: What? You asked me—
House: You knew that I was interested, that gives you a valuable bargaining chip. Could have had me doing dishes for a week.
Wilson: Ok. The allergic reaction happened while she was in a clean room.
House: It's like an Agatha Christie mystery.
Chase: Maybe it's not what was there; it's what she was doing.
House: Exercise allergy. Love it. What sort of exercise could a strapping young man and a nubile teenage nymphet possibly be—
Cuddy: Mom was in the room within seconds.
Chase: So the boyfriend brought in an allergen and is lying about it.
Cameron: Or the girl snuck out and she's lying about that.
House: Or the parents are lying about the room being clean.
Cuddy: These are your big ideas? Somebody's lying?
House: Hasn't let me down yet.
House: What's the good news, what's the bad news?
Chase: Congestive heart failure.
House: Is which?
Chase: Good news.
House: Why?
Chase: I don't know, it just sounded like you.
House: New puzzle piece, always good news. What's the bad news?
Foreman: We've got two puzzle pieces from two different puzzles.
House: Seems that way.
Wilson: You erased my messages?
House: Decided I wanted you to stay.
Wilson: You're miserable, and you're lonely, and you're going to trap me here to keep me every bit as miserable and lonely too!
House: Yeah, and you're happy happy happy.
Wilson: Ok, hey, I'm obviously going through a rough patch here. Your wife leaves, tends to bum somebody out....
House: So what? What did I do to you? I scammed you into doing the dishes, made you sit on the steps. I didn't kill your puppy. I did not make you miserable.
Wilson: Oh, so this is therapy?
House: No... just makes me smile.
Wilson: All right, I'm finding a new place tomorrow.
House: Right, but not tonight.
Wilson: Well I figure you wanna shave my eyebrows while I'm asleep I wouldn't want to deprive you of that last smile.
House: You're not going anywhere. You're going to sit on my couch, and depress us both because you just can't admit that it's over with your wife.
Wilson: That's right, I'm here on vacation.
House: You gotten a lawyer yet?
Wilson: That's— that's— not—
House: You even called one? As long as you're here, it's just a fight. As soon as you get a place, then it's a divorce. Everything sucks. Might as well find something to smile about.
House: Are you the boyfriend? I need to borrow you.
Barbara: What's going on?
House: Don't worry. I'll return him in roughly the same condition.
Chase: No alarm on this window.
Cameron: It's a 20 feet drop.
Chase: You can get to the tree from here. There's some bark scraped off.
Cameron: Sure, heart transplant girl swung down the tree on a vine. Maybe she was hooking up with Tarzan and Cheetah down by the elephant graveyard.
Chase: Or, Jane stayed in the treehouse, Tarzan came up.
Dan: Do you have to tell her (her seizure) was my fault?
House: No. Great part of being a grownup, you never have to do anything.
House: Lying to your parents is usually the right thing to do, but there is the impending death exception.
House: Get an LP And do PCRs for the viruses. And get an EMG to check for Guillain-Barré. Foreman's right, we gotta find out why she's paralyzed. But not before staring at me dumbly for a few seconds...
Foreman: We explained the anaphylaxis...
House: What do you mean we? I did! At least I thought I did. Maybe I didn't. Still it was all me!
Foreman: I say we assume House was right about the anaphylaxis...
House: It is tempting.
Dan: But, you know, they've tested Melinda, they said she wasn't allergic to my stuff.
House: Yeah, four days later. By that time the penicillin was crusting up a sock in the bottom of your hamper.
Dan: [about a coma patient] Is he okay?
House: He's just tired from being in a coma so long.
Wilson: Oh, no wonder you were in the mood - this month's New Jersey Journal of Cardiology.
House: Have you seen the centerfold? There's no way those valves are real!
House: Only way to confirm this, inject the rat with her blood and wait for it to get all botulistic on your ass. In the meantime, I'm going downstairs to browbeat a scared, dying teenage girl until she breaks down like...a scared, dying teenage girl.
Wilson: Cuddy called.
House: I know. I saw the caller ID.
Wilson: Young girl, anaphylactic shock.
House: You answered?
Wilson: Turns out, that's what stops the ringing.
Cameron: You had unsafe sex? The whole "unsafe" thing didn't tell you something?


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