Needle in a Haystack (House)
Encyclopedia
"Needle in a Haystack" is the thirteenth episode of the third season of House
and the fifty-ninth episode overall.
The patient, teenage Stevie Lipa, has a respiratory attack while kissing his girlfriend. The ER workup reveals a bloody pleural effusion
. Chase suspects drugs, but House doesn't think so. House orders them to do a venogram to find the "low pressure leak", and orders Chase and Cameron to break into his house. Foreman tries to contact the boy's parents to get consent in order to carry out the venogram. When neither parent can be reached, Foreman does the venogram anyway. Meanwhile, Cameron and Chase, while breaking into his house, find that the patient has been lying about everything and that he is a Romani, and doesn't want to share his personal information or medical history with outsiders. After a consultation with House, Foreman tries to find a deep-vein thrombosis by carrying out an arteriogram, although House suggests thinning his blood and redoing the venogram. Foreman discovers his liver is failing, after which House suggests doing a CT
scan, MRI
, and other tests. After the MRI, they find a granuloma
, and believe he has Wegener's Disease
; House suggests immediate treatment since a liver biopsy
to confirm Wegener's would take too long to obtain results. The treatment improved his liver, but causes a hemorrhage in his bladder, so they switch to an experimental treatment, FT28. While Foreman tries to convince his patient to take the medicine, his spleen
bursts. The exchange between the patient's father and Foreman reveals that the father is comparing the experimental treatment to the Porajmos
. Foreman replies citing his people's slavery. During surgery, House looks and finds there are no granulomas, so the diagnosis can not be Wegener's. House then orders a colonoscopy
, at which point his team finds a toothpick stuck in his colon. They conclude that he must have accidentally swallowed the toothpick and folded awkwardly while making out with his girlfriend, causing the toothpick to pierce his intestines and infect the rest of his organ system.
Throughout Stevie's stay at the hospital, he displays a deep curiosity and interest in science and medical knowledge. After the toothpick is removed, Foreman offers Stevie a chance to become a paid intern at the lab. However, Stevie refuses because of his attachment to his life and family as it is, and because he doesn't want to become "alone", as he admits to seeing Foreman and the other doctors.
Near the end of the episode, House approaches Cuddy and asks about the bet concerning the wheelchair; she reveals she was not going to give House the parking space. Hoping to make her feel guilty about lying to him, he says to her, "Don't make commitments you can't keep." Cuddy feels guilty about misleading House, but in truth, House planned on making Cuddy feel guilty to get his parking space back. The end of the episode shows first Stevie being discharged from the hospital with his family, giving a nod to Foreman. It then shows a man writing House's name on the parking space and House smiling.
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 fifty-ninth episode overall.
Plot
House arrives at the hospital to discover a wheelchair-accessible van in his usual parking space. He seeks out the van's owner, who turns out to be the hospital's new researcher, Julie Whitner, who is paralyzed from the waist down. She and House exchange some sardonic banter, following which House begins using a wheelchair himself (with a bumper sticker on the back which says "I'd rather be walking") in a bet with Cuddy to get his parking space back.The patient, teenage Stevie Lipa, has a respiratory attack while kissing his girlfriend. The ER workup reveals a bloody pleural effusion
Pleural effusion
Pleural effusion is excess fluid that accumulates between the two pleural layers, the fluid-filled space that surrounds the lungs. Excessive amounts of such fluid can impair breathing by limiting the expansion of the lungs during ventilation.-Pathophysiology:...
. Chase suspects drugs, but House doesn't think so. House orders them to do a venogram to find the "low pressure leak", and orders Chase and Cameron to break into his house. Foreman tries to contact the boy's parents to get consent in order to carry out the venogram. When neither parent can be reached, Foreman does the venogram anyway. Meanwhile, Cameron and Chase, while breaking into his house, find that the patient has been lying about everything and that he is a Romani, and doesn't want to share his personal information or medical history with outsiders. After a consultation with House, Foreman tries to find a deep-vein thrombosis by carrying out an arteriogram, although House suggests thinning his blood and redoing the venogram. Foreman discovers his liver is failing, after which House suggests doing a CT
Computed tomography
X-ray computed tomography or Computer tomography , is a medical imaging method employing tomography created by computer processing...
scan, MRI
Magnetic resonance imaging
Magnetic resonance imaging , nuclear magnetic resonance imaging , or magnetic resonance tomography is a medical imaging technique used in radiology to visualize detailed internal structures...
, and other tests. After the MRI, they find a granuloma
Granuloma
Granuloma is a medical term for a tiny collection of immune cells known as macrophages. Granulomas form when the immune system attempts to wall off substances that it perceives as foreign but is unable to eliminate. Such substances include infectious organisms such as bacteria and fungi as well as...
, and believe he has Wegener's Disease
Wegener's granulomatosis
Wegener's granulomatosis , more recently granulomatosis with polyangiitis , is an incurable form of vasculitis that affects the nose, lungs, kidneys and other organs. Due to its end-organ damage, it is life-threatening and requires long-term immunosuppression...
; House suggests immediate treatment since a liver biopsy
Liver biopsy
Liver biopsy is the biopsy from the liver. It is a medical test that is done to aid diagnosis of liver disease, to assess the severity of known liver disease, and to monitor the progress of treatment.-History:...
to confirm Wegener's would take too long to obtain results. The treatment improved his liver, but causes a hemorrhage in his bladder, so they switch to an experimental treatment, FT28. While Foreman tries to convince his patient to take the medicine, his spleen
Spleen
The spleen is an organ found in virtually all vertebrate animals with important roles in regard to red blood cells and the immune system. In humans, it is located in the left upper quadrant of the abdomen. It removes old red blood cells and holds a reserve of blood in case of hemorrhagic shock...
bursts. The exchange between the patient's father and Foreman reveals that the father is comparing the experimental treatment to the Porajmos
Porajmos
The Porajmos was the attempt made by Nazi Germany, the Independent State of Croatia, Horthy's Hungary and their allies to exterminate the Romani people of Europe during World War II...
. Foreman replies citing his people's slavery. During surgery, House looks and finds there are no granulomas, so the diagnosis can not be Wegener's. House then orders a colonoscopy
Colonoscopy
Colonoscopy is the endoscopic examination of the large bowel and the distal part of the small bowel with a CCD camera or a fiber optic camera on a flexible tube passed through the anus. It may provide a visual diagnosis and grants the opportunity for biopsy or removal of suspected...
, at which point his team finds a toothpick stuck in his colon. They conclude that he must have accidentally swallowed the toothpick and folded awkwardly while making out with his girlfriend, causing the toothpick to pierce his intestines and infect the rest of his organ system.
Throughout Stevie's stay at the hospital, he displays a deep curiosity and interest in science and medical knowledge. After the toothpick is removed, Foreman offers Stevie a chance to become a paid intern at the lab. However, Stevie refuses because of his attachment to his life and family as it is, and because he doesn't want to become "alone", as he admits to seeing Foreman and the other doctors.
Near the end of the episode, House approaches Cuddy and asks about the bet concerning the wheelchair; she reveals she was not going to give House the parking space. Hoping to make her feel guilty about lying to him, he says to her, "Don't make commitments you can't keep." Cuddy feels guilty about misleading House, but in truth, House planned on making Cuddy feel guilty to get his parking space back. The end of the episode shows first Stevie being discharged from the hospital with his family, giving a nod to Foreman. It then shows a man writing House's name on the parking space and House smiling.