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It's a Wonderful Lie (House)
Encyclopedia
"It's A Wonderful Lie" is the tenth episode
of the fourth season of House
and the eightieth episode overall. It aired on January 29, 2008. It is the first episode of the series to feature Olivia Wilde
, Kal Penn
and Peter Jacobson
as main cast members.
The plot centers around the Christmas season; the episode's title is a play on the Christmas movie classic It's a Wonderful Life
.
and coaching her daughter, Jane, on the rock-climbing wall. The daughter falls and suffers a broken wrist. House probes the patient and her daughter, trying to tease out a lie between them, but both insist that they are always honest with each other. As the team tries to cure the paralysis, Maggie loses her eyesight, and her other organ systems begin to shut down.
Maggie is known to have inherited a mutation of the BRCA1
tumor suppressor gene from her mother, putting her at significantly greater risk of developing certain types of breast cancer
. In an effort to avoid these risks, Maggie had an elective prophylactic double-mastectomy
. She had no follow-up reconstructive surgery
; this additional element of "honesty" further interests House, who despite it stands by his theory that everybody lies.
The team believes Maggie's symptoms may be psychological in origin, but this is proven false when she is discovered to have severe calcification
of her entire skeleton, and the lymph nodes in her neck begin to swell and occlude her airway. House and the team conclude that her best hope is a bone marrow transplant
, but she will not allow Jane to be tested for a match, despite Jane's protests. House concludes that the only reason someone would refuse that test is if they knew already that the marrow would not be an HLA
match, not because "it might hurt a little". Maggie confesses that Jane is the biological child of a drug addict who made her promise never to tell Jane about her true background. House, satisfied that everyone does in fact lie, makes a snide remark about the irony of preferentially keeping promises to drug addicts, and encourages her to tell Jane the truth.
Maggie is eventually told she has an unknown terminal disease. When it is revealed to Jane that Maggie has a terminal disease, she tells her she won't live, despite her hopes of a wrong diagnosis. House later tells Wilson, "I saw something amazing. Pure truth. She told her mother that she was dying. Stripped her of all hope. . . . It was like watching some bizarre astronomical event that you know you're never going to see again."
The team, without House, spends the rest of Christmas Eve testing for every disease they can. While they're at work, House has a conversation with Wilson that leads to an epiphany. Entering the lab singing God Rest Ye Merry, Gentlemen, House proclaims that he is about to perform a Christmas miracle, and orders his team to give Maggie risperidone
, an anti-psychotic medication. At Maggie's bedside, House explains how, during fetal development, a layer of breast tissue progenitor cells develops. Eventually, the extra tissue dies everywhere except, as House puts it, in the "fun places". House suspects that this culling
process was faulty in the patient, leaving a deposit of breast tissue somewhere on her body which eventually produced a tumor. Due to the anti-psychotic medication, the tissue has engorged and begun to lactate
; House extracts breast milk from the swelling found on the underside of the patient's right knee, orders her to have surgery and a round of chemotherapy
, and declares the case solved.
In the clinic, House treats another female patient, called Melanie (Jennifer Hall
), whom he initially diagnoses with strep throat
. House notices that she has a necklace of Saint Nicholas, whom she describes as the patron saint of children. At the same time, he notices that she's had HIV tests every 3 months, and that Saint Nicholas
is also the patron saint of prostitutes. Since she isn't a child, he tells her that he's deduced that she is a prostitute, which causes her to smile in response. She later returns with pustules on her neck and chest. House asks if she does donkey shows
, and when she says yes, he gives her a prescription for contagious ecthyma
, a disease she has that can be caught from donkeys. She invites him to see the show, and says he might like it. At the end of the episode, House (an atheist) visits a church, which is putting on a Nativity play
during which his clinic patient rides in on a donkey, playing the part of the virgin Mary
. Not so coincidentally, Saint Nicolas is also the patron saint of the falsely accused.
Episode
An episode is a part of a dramatic work such as a serial television or radio program. An episode is a part of a sequence of a body of work, akin to a chapter of a book. The term sometimes applies to works based on other forms of mass media as well, as in Star Wars...
of the fourth season of House
House (TV series)
House is an American television medical drama that debuted on the Fox network on November 16, 2004. The show's central character is Dr. Gregory House , an unconventional and misanthropic medical genius who heads a team of diagnosticians at the fictional Princeton-Plainsboro Teaching Hospital in...
and the eightieth episode overall. It aired on January 29, 2008. It is the first episode of the series to feature Olivia Wilde
Olivia Wilde
Olivia Wilde is an American actress and fashion model. She began acting in the early 2000s, and has since appeared in a number of film and television parts, including roles in the serial-drama The O.C. and The Black Donnellys. She portrayed Dr...
, Kal Penn
Kal Penn
Kalpen Suresh Modi , best known by his stage name Kal Penn, is an American film and television actor, producer, and civil servant....
and Peter Jacobson
Peter Jacobson
Peter S. Jacobson is an American film and television actor.-Life and career:Jacobson was born to a Jewish family in Chicago, Illinois, the son of Chicago news anchor Walter Jacobson. He is a graduate of Brown University and Juilliard...
as main cast members.
The plot centers around the Christmas season; the episode's title is a play on the Christmas movie classic It's a Wonderful Life
It's a Wonderful Life
It's a Wonderful Life is a 1946 American Christmas drama film produced and directed by Frank Capra and based on the short story "The Greatest Gift" written by Philip Van Doren Stern....
.
Plot
House and his team treat a woman, Maggie, who suffers from sudden paralysis of her hands. The paralysis presented as she was belayingBelaying
thumb|200px|right|A belayer is belaying behind a lead climberBelaying refers to a variety of techniques used in climbing to exert friction on a climbing rope so that a falling climber does not fall very far...
and coaching her daughter, Jane, on the rock-climbing wall. The daughter falls and suffers a broken wrist. House probes the patient and her daughter, trying to tease out a lie between them, but both insist that they are always honest with each other. As the team tries to cure the paralysis, Maggie loses her eyesight, and her other organ systems begin to shut down.
Maggie is known to have inherited a mutation of the BRCA1
BRCA1
BRCA1 is a human caretaker gene that produces a protein called breast cancer type 1 susceptibility protein, responsible for repairing DNA. The first evidence for the existence of the gene was provided by the King laboratory at UC Berkeley in 1990...
tumor suppressor gene from her mother, putting her at significantly greater risk of developing certain types of breast cancer
Breast cancer
Breast cancer is cancer originating from breast tissue, most commonly from the inner lining of milk ducts or the lobules that supply the ducts with milk. Cancers originating from ducts are known as ductal carcinomas; those originating from lobules are known as lobular carcinomas...
. In an effort to avoid these risks, Maggie had an elective prophylactic double-mastectomy
Mastectomy
Mastectomy is the medical term for the surgical removal of one or both breasts, partially or completely. Mastectomy is usually done to treat breast cancer; in some cases, women and some men believed to be at high risk of breast cancer have the operation prophylactically, that is, to prevent cancer...
. She had no follow-up reconstructive surgery
Reconstructive surgery
Reconstructive surgery is, in its broadest sense, the use of surgery to restore the form and function of the body, although Maxillo-Facial Surgeons, Plastic Surgeons and Otolaryngologists do reconstructive surgery on faces after trauma and to reconstruct the head and neck after cancer.Other...
; this additional element of "honesty" further interests House, who despite it stands by his theory that everybody lies.
The team believes Maggie's symptoms may be psychological in origin, but this is proven false when she is discovered to have severe calcification
Calcification
Calcification is the process in which calcium salts build up in soft tissue, causing it to harden. Calcifications may be classified on whether there is mineral balance or not, and the location of the calcification.-Causes:...
of her entire skeleton, and the lymph nodes in her neck begin to swell and occlude her airway. House and the team conclude that her best hope is a bone marrow transplant
Bone marrow transplant
Hematopoietic stem cell transplantation is the transplantation of multipotent hematopoietic stem cell or blood, usually derived from bone marrow, peripheral blood stem cells, or umbilical cord blood...
, but she will not allow Jane to be tested for a match, despite Jane's protests. House concludes that the only reason someone would refuse that test is if they knew already that the marrow would not be an HLA
Human leukocyte antigen
The human leukocyte antigen system is the name of the major histocompatibility complex in humans. The super locus contains a large number of genes related to immune system function in humans. This group of genes resides on chromosome 6, and encodes cell-surface antigen-presenting proteins and...
match, not because "it might hurt a little". Maggie confesses that Jane is the biological child of a drug addict who made her promise never to tell Jane about her true background. House, satisfied that everyone does in fact lie, makes a snide remark about the irony of preferentially keeping promises to drug addicts, and encourages her to tell Jane the truth.
Maggie is eventually told she has an unknown terminal disease. When it is revealed to Jane that Maggie has a terminal disease, she tells her she won't live, despite her hopes of a wrong diagnosis. House later tells Wilson, "I saw something amazing. Pure truth. She told her mother that she was dying. Stripped her of all hope. . . . It was like watching some bizarre astronomical event that you know you're never going to see again."
The team, without House, spends the rest of Christmas Eve testing for every disease they can. While they're at work, House has a conversation with Wilson that leads to an epiphany. Entering the lab singing God Rest Ye Merry, Gentlemen, House proclaims that he is about to perform a Christmas miracle, and orders his team to give Maggie risperidone
Risperidone
Risperidone is a second generation or atypical antipsychotic, sold under the trade name . It is used to treat schizophrenia , schizoaffective disorder, the mixed and manic states associated with bipolar disorder, and irritability in people with autism...
, an anti-psychotic medication. At Maggie's bedside, House explains how, during fetal development, a layer of breast tissue progenitor cells develops. Eventually, the extra tissue dies everywhere except, as House puts it, in the "fun places". House suspects that this culling
Culling
Culling is the process of removing animals from a group based on specific criteria. This is done either to reinforce certain desirable characteristics or to remove certain undesirable characteristics from the group...
process was faulty in the patient, leaving a deposit of breast tissue somewhere on her body which eventually produced a tumor. Due to the anti-psychotic medication, the tissue has engorged and begun to lactate
Lactic acid
Lactic acid, also known as milk acid, is a chemical compound that plays a role in various biochemical processes and was first isolated in 1780 by the Swedish chemist Carl Wilhelm Scheele. Lactic acid is a carboxylic acid with the chemical formula C3H6O3...
; House extracts breast milk from the swelling found on the underside of the patient's right knee, orders her to have surgery and a round of chemotherapy
Chemotherapy
Chemotherapy is the treatment of cancer with an antineoplastic drug or with a combination of such drugs into a standardized treatment regimen....
, and declares the case solved.
In the clinic, House treats another female patient, called Melanie (Jennifer Hall
Jennifer Hall
Jennifer Hall is an American actress. She is most known for portraying herself on HBO reality show Unscripted and Missy on the NBC comedy series Up All Night...
), whom he initially diagnoses with strep throat
Strep throat
Streptococcal pharyngitis, streptococcal tonsillitis, or streptococcal sore throat is a type of pharyngitis caused by a group A streptococcal infection. It affects the pharynx including the tonsils and possibly the larynx. Common symptoms include fever, sore throat, and enlarged lymph nodes...
. House notices that she has a necklace of Saint Nicholas, whom she describes as the patron saint of children. At the same time, he notices that she's had HIV tests every 3 months, and that Saint Nicholas
Saint Nicholas
Saint Nicholas , also called Nikolaos of Myra, was a historic 4th-century saint and Greek Bishop of Myra . Because of the many miracles attributed to his intercession, he is also known as Nikolaos the Wonderworker...
is also the patron saint of prostitutes. Since she isn't a child, he tells her that he's deduced that she is a prostitute, which causes her to smile in response. She later returns with pustules on her neck and chest. House asks if she does donkey shows
Donkey show
A donkey show is a form of sex tourism entertainment most often associated with Tijuana, Mexico, in which a local woman engages in zoophilia with a donkey....
, and when she says yes, he gives her a prescription for contagious ecthyma
Orf (animal disease)
Orf is an exanthemous disease caused by a parapox virus and occurring primarily in sheep and goats. It is also known as contagious pustular dermatitis, infectious labial dermatitis, ecthyma contagiosum, and sheep pox, thistle disease and scabby mouth...
, a disease she has that can be caught from donkeys. She invites him to see the show, and says he might like it. At the end of the episode, House (an atheist) visits a church, which is putting on a Nativity play
Nativity play
A Nativity play or Christmas pageant is a play which recounts the story of the Nativity of Jesus. It is usually performed at Christmas, the feast of the Nativity.-Liturgical:...
during which his clinic patient rides in on a donkey, playing the part of the virgin Mary
Mary (mother of Jesus)
Mary , commonly referred to as "Saint Mary", "Mother Mary", the "Virgin Mary", the "Blessed Virgin Mary", or "Mary, Mother of God", was a Jewish woman of Nazareth in Galilee...
. Not so coincidentally, Saint Nicolas is also the patron saint of the falsely accused.