Lines in the Sand (House episode)
Encyclopedia
"Lines in the Sand" is the fourth episode of the third season of House
and the fiftieth episode overall.
, is learning shapes and words in his backyard. His father, Don, is trying very hard to show Adam words, but Adam seems more interested in drawing lines on his chalkboard. While eating his lunch, Adam gags as if choking, grabs at his chest, and screams loudly.
While House and his team are doing the differential diagnosis for Adam, he notices that the blood-stained carpet in his office has been replaced. He goes to complain to Cuddy, who has no intentions of returning the carpet. As a result, House refuses to return to his office. Cuddy suggests working in the Clinic, but he begins to work in other people's offices during the course of the episode. While House is complaining to Cuddy, the rest of House's team tries to strap Adam down and get him into an MRI machine. It takes time because Adam must first finish a video game, which his father insists that the team does not want to interrupt. After the MRI, Chase and Cameron go to Adam's house to run tests. Foreman tells House that all the tests are negative. House then meets with his team in the clinic and orders his team to get a stool sample. Before the team can take the sample, Adam has another fit and coughs up fluid from his lungs. House moves into Wilson's office after he is evicted from the clinic by Cuddy, and Wilson is not happy. The team finds a heart problem, but House brushes this off and continues with his diagnosis. In the end Foreman is instructed to do a biopsy of his lung.
Foreman consults Wilson, who recommends taking a biopsy of the lymph node
under Adam's arm to look for cancer. Foreman tricks Wilson into doing the biopsy in order to avoid dealing with Adam himself. The biopsy finds liver cells under Adam's arm. Another differential in Wilson's office suggests that Adam may have suffered liver damage, leading to its cells flowing into the lymphatic system. House then moves to Cuddy's office for the differential and is discussing the presence of calcium carbonate
in Adam's stool when he is evicted by Cuddy again, with the news that Adam is in a cardiac intensive care unit. Adam is stabilized, and House considers the possibility of pica
, believing that Adam may have been eating non-food items since calcium carbonate is found in blackboard chalk. He orders his staff to get samples from the house. While searching the backyard, Foreman finds jimson weed and suspects that might be the source of the problem. However, House is skeptical.
When Adam's eyeball moves awkwardly, a surgery is scheduled for a possible tumor. House continues with the differential, this time in the hospital chapel. They decide to do a CT scan of Adam's head for tumors, and to remove the eye if the CT scan doesn't reveal anything.
Sitting amongst Adam's toys, House finally makes a connection. He shows that the boy has roundworms floating in his eye; they have also infested his heart, lungs, and liver. Adam picked up the parasites by eating sand contaminated with raccoon
feces from his sandbox. The lines he kept drawing were actually the worms that blocked his vision. House orders anti-parasitic medication and laser eye therapy to clear up the problems.
Wilson notes that House's apparent interest and connection with his autistic patient indicates a possible diagnosis of Asperger syndrome
in House himself, but soon dismisses this idea and concludes that House is simply a jerk.
As Adam and his parents are leaving, House observes them from a nearby seat with Wilson. He comments on their lack of genuine joy, inventing an arbitrary happiness scale and giving them a relatively low score. He reasons that this is because they are dreading the return to their heavily regimented lifestyle with an autistic child. As they stop to thank House, Adam holds eye contact with House before giving him his PSP
, a most unusual gesture for an autistic child. Upon seeing the reaction of the parent, Wilson gives them a 'ten' on House's scale. The old carpet is laid back down in House's office exposing the blood stain, and Cameron says to House, "All change is bad? It's not true, you know."
her breasts in exam. Cuddy tells House that Ali (Leighton Meester
) is stalking him and that she will call security. Later, House finds Ali sitting on his motorcycle. She continues flirting, undeterred by earlier unanswered calls. However, Cuddy interrupts their exchange again and sends Ali away. Even though House is flattered by Ali's feelings for him, he really is not interested in her, however, he doesn't want to hurt her feelings. Cuddy lies to House, trying to get him away from Ali, but then cracks under House's pressure and reveals that Ali is locked in her office and House should talk her down and send her off for good. House observes Ali crying milky tears. Having recently experienced an earthquake in Fresno
, she likely inhaled a fungal spore - Coccidioides immitis
in her brain, which is typically released during earthquakes. As most of her symptoms developed in her head, it may be that the spores mostly concentrated in her sinuses and resulted in headaches, cough, and her loss of inhibition.
In his final speech to Ali in the episode in an attempt to scare her away, House indirectly quotes the famous romantic speech at the end of Casablanca
. "We will always have Fresno"
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 fiftieth episode overall.
Adam
Adam, who is severely autisticAutism
Autism is a disorder of neural development characterized by impaired social interaction and communication, and by restricted and repetitive behavior. These signs all begin before a child is three years old. Autism affects information processing in the brain by altering how nerve cells and their...
, is learning shapes and words in his backyard. His father, Don, is trying very hard to show Adam words, but Adam seems more interested in drawing lines on his chalkboard. While eating his lunch, Adam gags as if choking, grabs at his chest, and screams loudly.
While House and his team are doing the differential diagnosis for Adam, he notices that the blood-stained carpet in his office has been replaced. He goes to complain to Cuddy, who has no intentions of returning the carpet. As a result, House refuses to return to his office. Cuddy suggests working in the Clinic, but he begins to work in other people's offices during the course of the episode. While House is complaining to Cuddy, the rest of House's team tries to strap Adam down and get him into an MRI machine. It takes time because Adam must first finish a video game, which his father insists that the team does not want to interrupt. After the MRI, Chase and Cameron go to Adam's house to run tests. Foreman tells House that all the tests are negative. House then meets with his team in the clinic and orders his team to get a stool sample. Before the team can take the sample, Adam has another fit and coughs up fluid from his lungs. House moves into Wilson's office after he is evicted from the clinic by Cuddy, and Wilson is not happy. The team finds a heart problem, but House brushes this off and continues with his diagnosis. In the end Foreman is instructed to do a biopsy of his lung.
Foreman consults Wilson, who recommends taking a biopsy of the lymph node
Lymph node
A lymph node is a small ball or an oval-shaped organ of the immune system, distributed widely throughout the body including the armpit and stomach/gut and linked by lymphatic vessels. Lymph nodes are garrisons of B, T, and other immune cells. Lymph nodes are found all through the body, and act as...
under Adam's arm to look for cancer. Foreman tricks Wilson into doing the biopsy in order to avoid dealing with Adam himself. The biopsy finds liver cells under Adam's arm. Another differential in Wilson's office suggests that Adam may have suffered liver damage, leading to its cells flowing into the lymphatic system. House then moves to Cuddy's office for the differential and is discussing the presence of calcium carbonate
Calcium carbonate
Calcium carbonate is a chemical compound with the formula CaCO3. It is a common substance found in rocks in all parts of the world, and is the main component of shells of marine organisms, snails, coal balls, pearls, and eggshells. Calcium carbonate is the active ingredient in agricultural lime,...
in Adam's stool when he is evicted by Cuddy again, with the news that Adam is in a cardiac intensive care unit. Adam is stabilized, and House considers the possibility of pica
Pica (disorder)
Pica is characterized by an appetite for substances largely non-nutritive . For these actions to be considered pica, they must persist for more than one month at an age where eating such objects is considered developmentally inappropriate...
, believing that Adam may have been eating non-food items since calcium carbonate is found in blackboard chalk. He orders his staff to get samples from the house. While searching the backyard, Foreman finds jimson weed and suspects that might be the source of the problem. However, House is skeptical.
When Adam's eyeball moves awkwardly, a surgery is scheduled for a possible tumor. House continues with the differential, this time in the hospital chapel. They decide to do a CT scan of Adam's head for tumors, and to remove the eye if the CT scan doesn't reveal anything.
Sitting amongst Adam's toys, House finally makes a connection. He shows that the boy has roundworms floating in his eye; they have also infested his heart, lungs, and liver. Adam picked up the parasites by eating sand contaminated with raccoon
Raccoon
Procyon is a genus of nocturnal mammals, comprising three species commonly known as raccoons, in the family Procyonidae. The most familiar species, the common raccoon , is often known simply as "the" raccoon, as the two other raccoon species in the genus are native only to the tropics and are...
feces from his sandbox. The lines he kept drawing were actually the worms that blocked his vision. House orders anti-parasitic medication and laser eye therapy to clear up the problems.
Wilson notes that House's apparent interest and connection with his autistic patient indicates a possible diagnosis of Asperger syndrome
Asperger syndrome
Asperger's syndrome that is characterized by significant difficulties in social interaction, alongside restricted and repetitive patterns of behavior and interests. It differs from other autism spectrum disorders by its relative preservation of linguistic and cognitive development...
in House himself, but soon dismisses this idea and concludes that House is simply a jerk.
As Adam and his parents are leaving, House observes them from a nearby seat with Wilson. He comments on their lack of genuine joy, inventing an arbitrary happiness scale and giving them a relatively low score. He reasons that this is because they are dreading the return to their heavily regimented lifestyle with an autistic child. As they stop to thank House, Adam holds eye contact with House before giving him his PSP
PlayStation Portable
The is a handheld game console manufactured and marketed by Sony Corporation Development of the console was announced during E3 2003, and it was unveiled on , 2004, at a Sony press conference before E3 2004...
, a most unusual gesture for an autistic child. Upon seeing the reaction of the parent, Wilson gives them a 'ten' on House's scale. The old carpet is laid back down in House's office exposing the blood stain, and Cameron says to House, "All change is bad? It's not true, you know."
Ali
While House is treating Adam, the seventeen year old daughter of a clinic patient in the last episode has developed a crush on him. She tracks House down by visiting the clinic, flirting heavily with him and exposingExhibitionism
Exhibitionism refers to a desire or compulsion to expose parts of one's body – specifically the genitals or buttocks of a man or woman, or the breasts of a woman – in a public or semi-public circumstance, in crowds or groups of friends or acquaintances, or to strangers...
her breasts in exam. Cuddy tells House that Ali (Leighton Meester
Leighton Meester
Leighton Marissa Meester is an American actress and singer. Meester first garnered attention for playing Blair Waldorf in the CW television series Gossip Girl...
) is stalking him and that she will call security. Later, House finds Ali sitting on his motorcycle. She continues flirting, undeterred by earlier unanswered calls. However, Cuddy interrupts their exchange again and sends Ali away. Even though House is flattered by Ali's feelings for him, he really is not interested in her, however, he doesn't want to hurt her feelings. Cuddy lies to House, trying to get him away from Ali, but then cracks under House's pressure and reveals that Ali is locked in her office and House should talk her down and send her off for good. House observes Ali crying milky tears. Having recently experienced an earthquake in Fresno
Fresno, California
Fresno is a city in central California, United States, the county seat of Fresno County. As of the 2010 census, the city's population was 510,365, making it the fifth largest city in California, the largest inland city in California, and the 34th largest in the nation...
, she likely inhaled a fungal spore - Coccidioides immitis
Coccidioides immitis
Coccidioides immitis is a pathogenic fungus that resides in the soil in certain parts of the southwestern United States, northern Mexico, and a few other areas in the Western Hemisphere....
in her brain, which is typically released during earthquakes. As most of her symptoms developed in her head, it may be that the spores mostly concentrated in her sinuses and resulted in headaches, cough, and her loss of inhibition.
In his final speech to Ali in the episode in an attempt to scare her away, House indirectly quotes the famous romantic speech at the end of Casablanca
Casablanca (film)
Casablanca is a 1942 American romantic drama film directed by Michael Curtiz, starring Humphrey Bogart, Ingrid Bergman and Paul Henreid, and featuring Claude Rains, Conrad Veidt, Sydney Greenstreet, Peter Lorre and Dooley Wilson. Set during World War II, it focuses on a man torn between, in...
. "We will always have Fresno"