Special needs children – kids with autism, Asperger’s, ADHD, and other neurological brain disorders – require extra attention in the classroom. A teacher to patiently answer their questions and assuage their fears. A teacher to celebrate their achievements and complement beautiful (if not slightly unusual) art projects. A teacher to comfort her students who have “accidents” in class, a teacher to spit up blood all over the little darlings... Okay, that last part is way too much special attention. When such a teacher scares the hell out of her kids and keels over, she becomes House’s next patient.
Cameron introduces the file to House on her first full day as Cuddy-Clone. He is definitely aroused by her new position and the sparks fly right back – what man doesn’t get off on the idea of being with twins? Though how alike Cam and Cuddy are is still left to be seen. Kutner fears for Cam’s safety and sanity, but Foreman thinks the opposite: she’ll have too much to prove, overcompensate on the job, and thus destroy House. Taub either welcomes the eventual fall-out or doesn’t care one lick – he brings the team back to the case and suggests a bleeding ulcer. Thirteen notes that a scope revealed nothing in the stomach or lungs to account for the bleeding. When Foreman proposes a blood abnormality and Thirteen disagrees, House uses their exchange as an excuse to out their newfound relationship to the rest of the crew. Then he tells them to go run a bleeding time test.
During the blood test, Thirteen and Kutner become enamored with their new sweet-natured patient who goes to her “happy place” despite all the needles, bleeding, and open-backed hospital gowns. Special Edna’s practically a saint, talking joyfully about her students and quietly accepting all that’s happening to her. Thirteen and Kutner plot to protect her from House’s taint. The test reveals reduced coagulation.
Someone who’s proving less than sweet is Cuddy. After all the emotional crap she’s gone through to try and get laid, to try and get pregnant, and to try and adopt, now she can’t dredge up any maternal bond with baby Joy II. I’m liking this twist. I truly hated the sappy “happily ever after” overtone to the end of episode 11 (“Joy to the World”), so to have her struggle to become a mother after becoming a mother is pretty great. Wilson is the only person to whom Cuddy can confess this flaw.
Foreman and Thirteen tell House there appears to be a problem with Special Edna’s platelets. Taub suggests lymphoma. Kutner thinks a better guess would be ITP (idiopathic thrombocytopenic purpura, an autoimmune disorder characterized by bruising and bleeding) and proposes starting her on methotrexate. House agrees and also orders total body irradiation. The team balks; TBI will promote cancers and kill her digestive tract, but House counters that it will also stop bleeding in her brain. He goes to Cuddy-Clone for permission and she…consents.
Good thing House never intended on doing the TBI; he just wanted to give something crazy to Cameron to shoot down now so he could get her to agree to more reasonable procedures later. So, how to keep up the farce? Thirteen suggests going through the motions without actually irradiating the patient. House likes it. Since the methotrexate doesn’t seem to be working, he tells the team to double Special Edna’s dosage and add prednisone.
Taub and Thirteen oversee the fake TBI. Special Edna asks them if she can go pee before the procedure begins. As she’s getting up from the table, she collapses and goes into cardiac arrest. Taub and Thirteen shock her back to life, and then run to tell the rest of the team that it isn’t ITP. While reviewing echocardiogram images of the patient’s heart, the team contemplates different possible causes for the sudden problems; Kutner and Taub suggest external poisons – heavy metal toxicity and drugs or alcohol, respectively. Thirteen comes up with an internal toxin: cold agglutinins produced by Special Edna’s own body in response to cold temperatures, such as the cold metal table in the procedure room and her chilly classroom with the broken heater. House tells them to immerse Edna in an ice bath to confirm the diagnosis.
Before the team can put the patient on ice, House must get permission to perform yet another risky procedure. This time, his fantasies come true as he interrupts Cuddy and Cameron fighting over him. Well, arguing over why Cam let him do the TBI. He tries to force Cuddy out of the office by revealing Wilson spilled her secret, even telling her it’s not too late to give the unlovable kid back. Cameron is disgusted but consents to the ice bath. Only after he gets a blood test to confirm the cold clotting first.
Kutner gets a blood sample from Saint Special Edna as she works from her hospital bed with Johnny, a young autistic boy who crushes on his teacher and won’t speak to anyone but her. In the lab, Foreman and Thirteen cool the vial and determine that House was right. When Thirteen has butterfingers with some equipment, Foreman feels guilty and almost tells her he found out she’s only on the Huntingdon’s trial placebo. But the good lovin’ he’s been giving her has her in such a good mood, he changes his mind. For now.
The team places Special Edna in an ice bath. To fight the excruciating cold, she chats with Kutner, an annoying thing for House to listen to but it provides some seemingly mundane information that turns out to be sort of important: six years ago she mixed up a room number, transposing two of the digits. House thinks she might have a lesion in the brain or multiple sclerosis and he recommends a brain biopsy. Kutner thinks her symptoms point more towards a pancreatic tumor. But if it’s MS, her lungs will be the next to go. They take their disagreement to Cameron who orders them to do an MRI instead.
The MRI doesn’t reveal any plaque in Special Edna’s brain, so House calls off the biopsy and instead gives the go-ahead for an ERCP (endoscopic test). During the endoscopy, Edna’s O2 stats drop, proving House kinda right. It’s in the lungs, but it’s not MS. House tells the team that a picorna virus can cause MS-like symptoms without detection on an MRI. To find dead portions of the brain, they’ll need to cut off her skull and perform a nerve conduction study. He goes to Cameron for permission, but this time she refuses his request unless he gets better evidence.
House sends Thirteen and Foreman to Special Edna’s classroom to search for evidence. Instead of evidence, Thirteen finds her homely, hetero side and decides she wants to settle down and have kids. Back at PPH, House dumps some dead fruit flies on Cam’s desk along with a report on a student’s head cold. Pretty weak, at best. But she gives in!
Kutner strongly objects to the nerve conduction test and insists on a splenectomy. House ignores him and moves forward with cutting off Edna’s skull. During the test, Kutner tattles on House and calls Cuddy at home. Over the OR’s overhead speaker, Cuddy begins to chew out House until Joy II starts to cry. And cry. Then scream and wail. Special Edna’s no saint anymore when she tells the team to shut the brat up. Her blood pressure drops while Cuddy’s rises. Cud snaps and yells at the baby to tell her what she wants. They lock eyes and Joy II stops crying. Mommie Dearest shares a bonding moment with her baby for the first time.
House is at a loss as to why Special Edna’s blood pressure dropped while under apparent stress. Cuddy visits his office with Joy II to tell him that she’s changed her mind about throwing the baby out with the bathwater, literally. House’s eureka moment is brought on by baby vomit and a contemplation on women’s childbearing hips. Special Edna has a congenital heart defect called patent ductus arteriosus (PDA). While a fetus, blood bypasses the lungs since they’re not in use. After a newborn takes her first breath, the ductus arteriosus is supposed to close within a few days but in some cases it remains open. When Edna undergoes stress, the increased BP forces her ductus open and sends blood away from the left side of the brain, making her “un-stressed.” And thus gives her the patience of a phony saint. Johnny and the other kids still love her anyway. Question is: will she still love them?
Cameron decides that she isn’t cut out to babysit House, which leaves Cuddy as the only one qualified. Just when she’s learned to love her child, she’s got to leave her with the nanny and return to the trenches.
Speaking of learning to love, Foreman can’t let Thirteen die with placebo in her veins. So he switches her drugs!
Next Week: The 100th episode is marred by over-the-top, cartoonish melodrama as Foreman fights to save Thirteen’s life and his career.
