A seemingly sleep-deprived single dad can’t seem to get a grip on reality and keeps leaping forward in time. Previous doctors have already ruled out drugs and alcohol, and his EEG and CT scans are clean. House overlooks the interesting case to whine about what a mistake Cuddy’s impending adoption is. However, she’s still very much excited about meeting the birth mother, a former meth user who’s due in a couple of weeks.
During an initial diagnostic differential, Thirteen says the recurring blackouts might be due to post-concussion syndrome, which would probably make sense if he’d gotten knocked upside the head in the first place. Since the absent-minded patient works as an at-home product tester, Thirteen switches up and thinks he may have been exposed to some kind of toxin. Taub proposes a mini stroke and Kutner throws out cavernous sinus thrombosis as a source of memory loss. House drops the doc from his list of talents and picks up bookie instead as he starts taking bets on how long Cuddy will take to change her mind about the baby (Kutner places a wager on 7-14 days; House bets it’ll take less than a week). Oh, yeah – this is a hospital, not the OTB. House orders the team to check the patient’s home for toxins and scan his sinuses for blood clots.
At the patient’s apartment, Taub suggests caffeine overload when he finds tons of coffee he’s been sampling. But Thirteen tells him the tester didn’t taste it, he only smelled it. The apartment is particularly bare and doesn’t seem lived in; even the view is dismal. Well, maybe the apt isn’t quite empty – they discover mold behind a baseboard so they take a swab and return to the hospital.
At Princeton Plainsboro, Thirteen spends some quality time with the patient’s pre-teen daughter while testing her for mold infection. The young girl informs her that her dad has no life and neither does her mom who died in a car accident when she was 4. She’s surprisingly cold when discussing her mother’s death. Let me guess, a symptom?
While creeped-out Thirteen is talking to Foreman in the hall, they notice that the father is fully clothed and about to step onto an elevator. When they stop him, he robotically tells them that he has an appointment. Foreman shines a penlight in his eyes and from the reaction of his pupils he can tell that the guy’s fast asleep on his feet.
Taub suggests stress-induced insomnia and Kutner guesses narcolepsy. House thinks they should let Cat Nap keep his “appointment” next time to see where he really wanders all day.
Cuddy meets her Baby Mama at a diner for the face-to-face interview. The girl’s first question is a simple one: what will you name her? A baby’s name is #2 priority over 10 fingers and 10 toes, but Cuddy hesitates. She really hasn’t thought about it but it might be Joy. For someone who’s been obsessing over breeding for three years, it seems odd for her not to have chosen names – even I’ve had names picked out since I was 5!
Cuddy’s question to the girl: since the adoption agency website is filled with photos and descriptions of so many wonderful couples, why did she select a single woman to become the mother of her unborn child? Baby Mama explains that her granny and her mother were involved with awful men who treated them like crap, so she doesn’t want her baby girl raised by yet another loser leaf on the family tree. While listening to Mama relate her adoption motives, Cuddy spies a nasty rash on the inside of her left arm. Uh-oh. She brings the girl back to the hospital for testing.
Thirteen and Taub return to Cat Nap’s apartment to observe him in his own environment and monitor his brain wave patterns. The monitors signal when he is asleep, but there is no apparent change in his physical demeanor or motor functions. He grabs his jacket and heads to the door, so they follow him. OMG! He’s driving! You know there have got to be some sleep-driving people on the road right now! How scary! Thirteen and Taub give chase through the streets of Jersey and watch as he pulls over beside a shady-looking woman. But she’s not a hooker – Thirteen races on foot to his parked car and finds out he scored drugs instead of sex.
Cameron examines Baby Mama’s rash at Cuddy’s request but disagrees that it could be Fifth disease, a contagious viral infection that typically strikes children and pregnant women within the first 20 weeks of gestation (she’s already 38 weeks along). Cuddy thinks Mama’s immune system is compromised due to her prior drug use and insists that they admit her. Cameron, forget the heat rash theory – when the Dean of Medicine freaks out about her almost unborn baby, you always listen.
When Cuddy tells House about her irrational fears, his natural reaction is to throw a cup of baby vomit at her. Point taken, I guess. Babies spit up, cry, and poop, so Cuddy better change her mind about the adoption…? (By the way, if I were Cuddy I’d fire the maternity nurse who provided House with the hot cup o’ vomit.) She asks him an excellent question: why does he care? Wish she’d ask the same of me. ‘Cause I don’t right now. A couple of seasons ago, I would’ve appreciated the story arc more. But this sudden appearance of insta-baby leaves me empty and disinvested.
The team tries to determine which came first: the sleepwalk or the coke? Thirteen’s pretty sure Cat Nap lied about his conscious substance abuse, but House believes he could’ve forgotten he ever used in the first place. Cocaine explains narcolepsy, narcolepsy explains sleepwalking, and whatever else was in the cocaine explains the memory loss. House tells them to go get a sample of the product. Wait a minute, what happened to the drugs Thirteen and Taub found on Cat Nap? If he’d already snorted it, why don’t they just blood test him rather than risk 3 to 5 on felony possession?
Cameron performs an ultrasound on Baby Mama. All looks wonderful until the blood drains from Cam’s face: she detects highly under-developed lungs. To try and save both mother and child, the staff will need to prevent labor and administer steroids for lung development. Let me guess: this chick’s going into early labor.
Thirteen and Taub track down Cat Nap’s dealer and politely request some cocaine. Thirteen samples the stuff and hands it back ‘cause it’s too good – she wants the lower-grade snow that Cat Nap’s been taking as a regular.
I won’t even bother going into detail about the next very annoying exchange between Cuddy and House over how it’s a blessing in disguise that the baby is sick.
Taub tells House they discovered the poor man’s coke was cut with milk powder. House orders them to test for lactose intolerance. I can tell you right now, it’s not lactose intolerance; I know all about bubbly gut and there’s definitely no sleep-snorting involved.
Cuddy checks on Baby Mama who goes into distress – her cardiac rhythm becomes erratic and she starts hemorrhaging vaginally. She’s in the process of a Stage II placental abruption (a separation of the placenta from the uterine lining that can deprive the unborn fetus of oxygen and nutrients). They’ll have to risk the life of the baby by delivering her with lungs 10 weeks premature if they hope to save the mother. At first, House reminds her that the choice isn’t hers yet, but then advises her to deliver now. When she agrees, he flips on her and tells her his advice was just a test – her response is an indication that deep down she doesn’t really want the child.
House visits his conscience to sort through his feelings about Cuddy and the adoption. Wilson tells him that he’s threatened because Cuddy’s growing up and he’s still living in arrested development. More about his fear of change.
Taub checks on Cat Nap and he appears to be recovering after treatment for a milk allergy. Until, of course, he starts sweating blood. Kutner suggests Ebola virus, but Thirteen tells him the white blood cell count is normal. Taub proposes leukemia and House orders a bone marrow biopsy. During the painful procedure, Taub and Kutner notice a “tan” on one of his legs – it’s not leukemia; might’ve been nice to figure that out before jamming a mammoth needle in the poor guy’s hip.
Baby Mama’s not as dumb as she looks – when Cuddy approaches her with the suggestion to wait on delivery, she refuses to continue risking her life for a baby she’s not even going to keep. Mama wants to deliver now, so she’s wheeled into surgery for an emergency C-section.
A chem panel shows that Cat Nap’s in the end stage of kidney failure. House tells the team to test for vasculitis, but Kutner points out the obvious: the patient is still going to need a transplant. House says the daughter will be a good candidate; but since the girl is a minor and the father has a conflict of interest, Cuddy will need to sign-off.
However, she’s up to her elbows in premature baby. House enters the sterile operating room to demand her attention but she ignores him until after Joy’s limp, silent body is pulled from the womb. Come on, cry. Cry, Joy. Cry! And finally she does. Okay, I’m a little bit touched.
Back in her office, Cuddy explains the risks of surgery to Cat Nap’s young daughter and she robotically agrees to it. House takes a closer look at her and realizes that, just like dear old dad, the girl is sleepwalking (-talking, -living) too. Oh, and she starts sweating blood as well. The only factors that would link the two cases are toxins, infections, and genetic disorders. Since the team has already ruled out the first two, they’re left with millions of genetic causes for their symptoms. Another visit to Wilson provides House with the Eureka! moment he needs.
House enters the patients’ room and announces that he knows what’s wrong with them and they’ll be fine – neither of them exhibits any emotional response. House tells them that they’re anhedonic (incapable of experiencing pleasure) due to something messing with their dopamine receptors. This explains the boring apartment, the lack of sustained relationships, and even the unconscious drug use. Foreman points out that the most common cause of anhedonia is schizophrenia, but House says that would only be the case for Caucasians. Huh? Cat Nap and kid are actually Iraqi passing as white. They are suffering with Familial Mediterranean Fever, a genetic disease common in people of Armenian, Turkish, Sephardi Jewish, and Arab descent. Doses of colchicine and melphalan make them smile again.
Cuddy finishes painting her nursery and readies herself to take Joy home. However, the experience of childbirth does a number on Baby Mama and she changes her mind. Heartbroken, Cuddy returns home to grieve. There’s a knock at the door. It’s House. He’s remorseful. He tells her she would’ve made a wonderful mother. Cuddy’s pissed at his games and asks why he has to negate everything. House honestly doesn’t know. Or maybe he does. The air is electric. They kiss! Awkwardly, but it’s still a big deal. Congratulations, Cuddy. It’s a man!
In Two Weeks: Sloppy smooch backlash and it looks like Wilson wants in on the fun. Plus, the team struggles to save the life of a shut-in.
