I haven’t had a kid yet, but I imagine having my first should be pretty scary. There are so many things that can go wrong when having a child: Down’s syndrome, a heart defect, cleft palate, freckles (no offense, I love my spotty brothers and sisters; I’m just glad it ain’t me). Most parents just hope and pray for the best, then count fingers and toes when their little one pops out. Unfortunately, the couple on tonight’s episode of House receive news a little more serious than a skin condition. A flashback scene shows them in a hospital room, mom cradling her newborn baby. Congratulations! It’s a…? A doctor tells them that they got a two-for-one special in their bundle of joy: their child is a genetic mosaic, born with both male and female DNA. Surgery can “correct” the ambiguous genitalia, but they need to decide whether they like pink or blue.
Fast-forward thirteen years and the same parents are watching their son play basketball. He fakes left, fakes right, dribbles to the basket…then chickens out and passes to another team member. The ball makes its way around the court and finally back to his waiting hands. The clock is running down, the kid swallows and shoots. And he scores! Right after sinking the game winning basket, our hero/heroine winces in pain and collapses in the middle of the court.
Cuddy finds House in the cafeteria with Wilson, politely requesting a bite of his friend’s food. Wait a minute. Politely? Asking permission for food and not just snatching it from Wilson’s plate? Huh. Must have a fever. Whatever, back to the case.
Foreman thinks the pelvic pain could be simple dehydration. Taub believes it’s probably much more complicated than dry mouth; intersex children can present with far more serious issues such as congenital adrenal hyperplasia (a genetic defect of the adrenal glands) or Persistent Müllerian Duct Syndrome (or PMDS, a congenital disorder resulting in the presence of an underdeveloped uterus in males). Kutner corrects them both: the ER already treated Baby Boy George for dehydration and the aforementioned intersex disorders wouldn’t occur in a young patient with both XX and XY chromosomes. The vitamin regimen the teen recently started is the most likely culprit. And “vitamin” used here is code for testosterone – the parents haven’t bothered to tell their baby boy he’s a she, sort of.
Thirteen proposes they perform an MRI to look for a blind uterus hidden in the abdomen but Foreman disagrees, to put it mildly. His response is cutting and overly sarcastic. Who is he trying to fool? You don’t play heartbroken ex by overcompensating with nasty remarks, especially when you don’t have much of a personality to begin with. Obviously he and Thirteen are trying to hide the fact that they’ve kissed and made up, but House doesn’t seem to notice. Huh. Polite and oblivious. Maybe it’s indigestion. Whatever, back to the case.
Foreman suggests complications from the surgeries Baby Boy George has had on his penis. Just as House is agreeing that the MRI would be a waste of time, the patient’s parents enter the office. The mother says that she and her husband have done some online research, think their son could have a blind uterus, and they think he should get an MRI. And House gives in! Damn you, Web MD!
A contrast MRI doesn’t reveal a blind uterus, so the team must resort to House’s original suggestion: shove a scope up the poor kid’s penis, fill his bladder with saline, and examine the urethra for narrow spots. Ouch! During the really uncomfortable exam, Baby Boy George starts to complain of tightness in his chest and difficulty breathing. Leaking exudate is filling his pericardial sac and strangling his heart. Thirteen drains the excess fluid and the patient’s vitals stabilize. Problems with the pelvis and heart don’t fit any known intersex disorders so the team is forced to move on to other diagnoses that have nothing to do with him being a girl trapped in a boy’s body. Aw, too bad. But House seems fine with that. Okay, this is getting scary…
Kutner is concerned by House’s actions, especially humoring Baby Boy George’s parents with the MRI, so he goes to Wilson to tell him something’s wrong. Wilson tells him to just enjoy the good mood while it lasts, but even he isn’t totally convinced there isn’t something very peculiar about House’s character of late. Saying “please” and “thank you.” Taking a shower and using deodorant. Speaking in his inside voice. Wow! Why didn’t he think of this before? House got laid! By a real woman! Who didn’t cost him a dime! Wilson runs to Cuddy’s office and confronts her about sleeping with House, but she denies it ever happened. Her flat affect isn’t very convincing, but apparently it’s true: no hoochie-coochie went down between the two love birds. At least, not yet.
Foreman thinks that drugs, toxins or an infection could be Baby Boy George’s problem, but Thirteen offers the idea that the “vitamins” the kid has been on could cause a host of autoimmune disorders. House orders corticosteroids for the autoimmune symptoms and finasteride to block the testosterone. Thirteen is charged with telling the parents about the need to cut the testosterone treatment. The mother is afraid her son won’t develop into the man they decided he was going to be a long time ago; did they really make the right decision to fashion a wee-wee out of their baby’s misshapen hoo-hah? Both parents agree to give Georgie the meds but don’t want the docs to reveal anything about his genetic status.
Cuddy decides to test Kutner and Wilson’s theory that House is in a strangely good mood by assigning him an idiot to treat during clinic duty. Some moron walks in and claims his left arm and both legs hurt whenever he presses them with his right index finger. Instead of insulting or outright killing him, House sets the guy’s broken finger and sends him off with a grateful smile. Huh. That’s it, Cuddy’s convinced.
Thirteen starts Baby Boy George on the corticosteroids and finasteride. They bond a little through conversation about basketball and overbearing parents. We find out that Georgie’s dad is cool with his son being whoever he wants to be, but Mom is ultra-sensitive when it comes to stereotypically gender-specific activities: when she first heard her kid liked to dance, she forbade him from performing any pirouettes and forced him to choose between hockey and basketball. During their chat, Thirteen notices that the kid’s palms have turned red. Lab tests confirm liver and kidney dysfunction, knocking out autoimmune disorders.
Cuddy and Wilson decide to approach House about his mood and find out what’s really going on. They find him asleep in his office and try to nudge him awake. His head falls heavily to the side and they quickly realize something’s really, really wrong. He’s not breathing and has a weak pulse. Everyone jumps into action checking his stats and squeezing his nipples. Squeezing his nipples?! Who knew purple nurples were an effective resuscitation technique? Well, Foreman did and it immediately wakes House up and gets him breathing again.
While he recovers, House claims that his episode must have just been a Vicodin overdose but no one can remember seeing him take any pills for hours. Maybe days! He deflects back to the case and suggests amyloidosis, but Thirteen tells him protein levels are normal. She thinks he might be depressed and self-medicating with drugs or alcohol. House sends the team to search the kid’s school and home. After everyone leaves the office, Wilson turns to Cuddy and announces that House has graduated to something much more hard-core than Vicodin: House is on heroin!
Thirteen and Foreman search Baby Boy George’s bedroom where they discuss their relationship (are they gonna do this every episode?). Foreman tells her that Kutner suggested they might be better off without each other because she eventually would’ve left him for another woman. Thirteen confesses that Taub was mocking Foreman, calling him a robot incapable of love and not good enough for her. The pair realizes their co-workers were trying to get a rise out of them because they know they’re still together. And if they know, then House has to know. At first it doesn’t look good, but then Foreman recognizes there are only two alternatives for House in this situation: fire them both or continue to jerk them around. Since they both still have their jobs, it seems like House has chosen the latter. Okay, everything’s all good. Not all good, especially when Thirteen finds a suicide-themed poem in Georgie’s desk drawer.
Back at PPH, Taub announces that a swab of the kid’s water bottle in his school gym locker revealed the presence of toxoplasmosis. When approaching the patient’s parents for permission to start him on antibiotics, Thirteen takes the opportunity to show them the poem. Dad asks for the name of a good therapist, but Thirteen insists it would be best for the parents to talk to their son. Mom ignores them both. She okays the use of the antibiotics and orders the docs to start her son on testosterone again. Thirteen complies but the astute kid notices the injection looks a lot like his “vitamins.” Thirteen refuses to lie anymore and confesses that he’s not being given vitamin shots.
Foreman confronts Kutner and Taub who’ve been in a bet against each other regarding the existence of his and Thirteen’s relationship. Kutner wins because he noticed a while ago that Foreman was coming to work smelling suspiciously like Thirteen’s soap. Foreman is shocked that Kutner figured it out but House may not have. It clicks and he calls Wilson: House is on heroin! But Wils can’t talk because he’s out to dinner with House. He decides to perform a makeshift tox screen on his pal: he orders him a shot of bourbon. Nice! However, booze isn’t quite so nice if H. is on H. One little sip on top of narcotics will suppress his respiratory system again and most likely kill him. House sees through his scheme and calls his bluff. Then he goes outside to throw it all up. Wilson catches him and is angry, but it turns out his anger is for the wrong reasons. House isn’t on heroin; he’s on methadone. The high with a lower case “h” has been working brilliantly at eliminating his leg pain. So brilliantly, in fact, that he may be starting to like life a little and he absolutely doesn’t need his cane.
When Mom finds out that Thirteen told her kid he isn’t on vitamins, she demands she be removed from the case. Cuddy refuses. Thirteen hasn’t told Baby Boy George that he’s a she-male; that’s now the responsibility of the parents. When they do, it blows up in their faces. Georgie refuses to see or speak to them. He allows Thirteen in his room to treat and comfort him. She tells him that she found his poem and tries to dissuade him from suicide. Georgie tells her that it was just a class assignment to write a poem in the style of Sylvia Plath. He never wanted to die. At least, not until today. Good job, Thirteen. Well, make yourself useful and pass the poor kid a bucket; he’s not feeling well. Ewww, he just threw up blood!
Cuddy finds House hiding out in the bathroom reading. She tells him she knows about the methadone and can’t condone its usage. Since it works so well for him, better than anything he’s ever tried before, he refuses to stop taking it. When she gives him a half-hearted ultimatum, he quits!
In House’s absence, Foreman takes charge of the team. Surgery reveals that the bloody vomit was the result of a gastric fistula (an abnormal connection between vessels or tissues in the stomach) caused by necrotizing pancreatitis. Taub suggests systemic scleroderma (hardening of the body’s tissues) but Thirteen doesn’t want to give the kid a death sentence. Out of guilt she insists Zollinger-Ellison syndrome (excess hydrochloric acid in the stomach) is a better fit, but it’s not. Foreman orders them to put Georgie on proton pump inhibitors – if he gets better, then it’s Zollinger-Ellison; if not, then it’s scleroderma.
After catching wind of House’s resignation, Wilson visits his friend’s apartment and finds a lady of the evening leaving his pad. Whew, he’s back to normal! Not quite. House only hired the prostitute to watch him sleep in case he stopped breathing again. What is this, The Twilight Zone?! House is clean shaven in a crisp, new suit on his way to an interview. He’s hiring hookers to do something other than bend over backwards. He’s calm, friendly, charming, and hap…, happy? Yes, that’s it. He’s finally feeling as close to happy as he’s ever been. Wilson returns to PPH to tell Cuddy to leave him on his methadone and hire him back.
Baby Boy George, unfortunately, doesn’t respond to the proton pump inhibitors so it must be scleroderma. Thirteen is crushed and so is Georgie’s mom; she lashes out at Thirteen for ruining their happy, ignorant little family but Cuddy steps in and tells her to just go be with her son. After the docs switch to scleroderma drugs, Foreman tries to cheer up Thirteen by telling her about Georgie’s progress. However, they realize that the AST levels shouldn’t be picking up the way they are if it were scleroderma. Another wrong diagnosis and the kid’s gonna live!
Cuddy invites House to her office. He arrives ready to pick up his letter of recommendation but she presents him with a list of requirements for his methadone regimen. He accepts his job back and immediately loosens his tie. By the time he returns to his office, it takes a record ten seconds for him to have his eureka! Just as Foreman had originally said, Georgie really did have dehydration. But he also had a sports drink addiction that strained his kidneys. Before he had enough time to rebound, his idiotic mom insisted on an MRI to search for something that wasn’t there. With weakened kidneys, Georgie hasn’t been able to filter the MRI contrast material from his system, causing all kinds of issues with his organs. A couple of weeks of dialysis should fix the problem. How deceptively simple. I wish the kid was pregnant instead.
Cuddy visits House’s office with his first dose of happy juice. House tells her that the methadone stripped him of his ability to be a good doctor. If he had been a little more miserable, he wouldn’t have done the MRI and Baby Boy George could’ve gone home days ago, none the wiser. With much regret, he refuses the meds.
**Note to readers: For those paying attention, yes, I did steal this week’s nickname from the House script. Well, House actually called him “Little Boy George” and I chuckled. And couldn’t get it out of my head. So “Baby Boy George” was born. I’ll try to be original next time, but give me a break. Trust me, these nicknames get harder and harder to come up with. Okay, I’m done bitchin’ – see you next week!
Next Week: There’s only room for one! A patient’s condition makes him act a lot like House.
