Failure to Communicate

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Cameron: "How are you holding up? I know what you just heard is scary as hell, but..."

Stone: "Couldn't tackle the bear! Couldn't tackle the bear! They took my stain!"

―Failure to Communicate

Failure to Communicate is the tenth episode of the second season of House which first aired on January 10, 2006. A famous writer finds himself literally at a loss for words when he starts suffering from aphasia. Meanwhile, House and Stacy are stranded in Baltimore and they share a kiss.

Recap[]

A famous journalist collapses while giving a farewell speech about his editor to his co-workers. When he regains consciousness nothing he says makes sense although he is using English words and the inflection of his sentences remains correct. The editor rushes to call 911.

Cuddy asks Foreman who has the best diagnostic department nearby as House is not in town. When Cuddy says aphasia is one of the symptoms, Foreman asks for the case because the cause is most likely neurological. Cuddy finally agrees.

Foreman examines the journalist and takes a medical history. The patient thinks he is speaking correctly. The patient can't write or draw pictures either. He can understand the doctors and put together an appropriate one word response. He did hit his head when he fell. The editor comes in and tells the doctors the patient didn't trip, he fell.

Meanwhile, Stacy and House are at the Medicaid offices in Baltimore trying to justify some of House's medical billing. All of his cases were rated the maximum on the complexity scale.

The team starts arguing about who should have authority while House is away. Despite Foreman's attempt to take charge, they all agree to work together.

The Medicaid adjuster starts taking issue with some of House's cases. For example, House prescribed Viagra for a female patient's heart problem when she couldn't take Nitroglycerine because of her blood pressure. House offers the adjuster the cost of the pills, but Stacy knows the adjuster is retiring in three weeks and is reconciliatory. The adjuster agrees to wrap things up early.

Stacy and House finish up their insurance business and discuss what to do before they fly back. Stacy has deliberately booked a different flight. House wonders why Stacy isn't wearing the crucifix she always wears. She says it's out for cleaning.

The team starts treating the patient, but he starts coughing and his O₂ stats start failing. The patient has pulmonary edema. They intubate the patient and start a new differential. Chase comes back with a positive test for amphetamines and reminds everyone that smoking them could cause all the symptoms.

House calls Wilson because Cuddy called him about the journalist. House is waiting at the airport for his flight. It turns out the patient is now running a fever, which would appear to rule out amphetamines as the cause. House doesn't think his team has it right.

The team is still doing a differential diagnosis when House calls them. He tells to start antibiotics and antivirals then to get an MRI and a better medical history and that he will be back in a few hours. House taking over the case further undermines the rest of the team's view of Foreman's authority.

The team start talking to the journalist's wife and editor about his drug use, and the journalist is answering yes and no questions. A picture appears of a thrill-seeking journalist who settled down when he met his wife. The editor puts down the drug use to insomnia.

The patient tries to tell Chase something, but Chase just thinks he's worried they're going to tell his wife about the drugs. The MRI shows edema in his brain. There is scarring, but it doesn't affect the speech centres. The patient denies a prior injury or prior symptoms.

In the meantime, Stacy and House find themselves in the same waiting room at the airport. House buys Stacy a coffee, but she isn't speaking to him.

The team still can't figure out a definitive diagnosis. They can't reach House on the phone and there are no more tests to try and a lumbar puncture is too dangerous. They decide to try an environmental scan. Cuddy tries to pin the team down but they dodge her.

Meanwhile, House is entertaining Stacy by diagnosing all the people in the waiting room. Then he asks Stacy again why she isn't wearing her omnipresent cross. Stacy refuses to answer and they stop talking again.

The team checks out the journalist's home, but although they find anticonvulsive drugs, they don't explain the symptoms. Chase is challenging Foreman for his lack of confidence in his opinions, figuring that Foreman's former confidence was the result of having House to fall back on.

House is pressing Stacy about the cross and rejects Stacy's explanations about why she isn't wearing it.

Meanwhile, the patient is in pain. He finally communicates he has a metallic taste in his mouth.

Stacy finally admits that she had a fight with Mark and didn't want to go back to get her cross after she realized she forgot it. Not only that, the fight was about something totally trivial. Stacy is afraid that Mark is pushing her away. Finally, Wilson gets through to Stacy who hands her phone to House. Wilson tells House about the new symptoms.

House calls the team while Cuddy is there - Cuddy is furious that the patient is getting worse with three failing organ systems. House tells the team to tell the patient he is going to die so he won't hold back on any bad behavior. Foreman and Chase tell the patient he's going to die, but Cameron tells the patient that they are doing as much as they can. At that point, the patient breaks down and starts talking to Cameron, but the patient still isn't making any sense.

House and Stacy's flights are delayed, so they go to the airport hotel Stacy has booked well in advance just in case her flight was cancelled. When they get to the room, House asks what's up. They start talking about their relationship. Stacy admits that she has had enough of him, but later realized how much she missed him. She equates the effect House has on her to a Vindaloo curry - hot and painful but after a while you come back for more. They kiss. When House pulls back, Stacy presses the matter. However, at that moment the phone rings for House. The team tells him that the lumbar puncture was inconclusive and that the patient's organs are still failing. Cameron tells House the patient's message: he "Couldn't tackle the bear," and "They took my stain." House excuses himself, tells the team to keep the patient talking and write down everything he says.

The team start interrogating the patient, and his wife is getting frustrated by the lack of progress. House passes the time by bounding a ball against a wall in the airport which he is using as a whiteboard by using Stacy's make-up. Stacy comes down to meet him.

When House calls back, the team can't provide him with any more information. Cameron notes that the patient previously used the word "stain". They realize the patient won't talk when his wife is in the room. The team calls Cuddy back to the hospital to get her out of the room.

Meanwhile, House calls the patient directly while his wife is out of the room. House finally realizes the word "stain" substitutes for "brain" and "bear" is substituting for "polar" - the patient has bipolar disorder and kept it secret, but confirms it. That explains his current use of sleeping pills and stimulants and risk-taking behavior as a journalist. When he met his wife, he decided he didn't want the ups and downs and underwent experimental surgery. During that surgery (which explains the scarring), which isn't performed in the United States, he must have contracted malaria, which would explain all his symptoms. The patient's wife returns and realizes that he's been lying to her. He tells the team to actually look at the patient's blood through a microscope instead of running it through a machine. The team does so and instantly sees the malaria parasites.

The patient's editor tells him that his wife will come back when she misses him.

Finally, Stacy and House head for their flight home, and they discuss how difficult it is for people to change, even when they want to.

Major Events[]

While stranded in Baltimore due to a snowstorm, House and Stacy share a brief kiss.

Zebra Factor 5/10[]

Malaria is still endemic in many parts of the world, and travellers frequently become infected when they travel to such areas. Malaria patients present with obvious symptoms like cyclic fever, low platelets and the asexual stage would be easily detected in the patients blood. The parasite under the microscope was incorrectly shown; they are intracellular in red blood cells and they have a round shape. The episode, however, depicted them more like bacteria or free-living parasitic worms.

Title[]

This episode's title, Failure to Communicate, refers to the patient's inability to communicate properly due to aphasia, and to House being stranded in the airport, unable to speak with his team personally.

Goofs[]

In the scene at the airport where House chats with Stacy while she is using her laptop, we first see a pen in her mouth, then it appears behind her left ear. It then appears and disappears behind her ear two more times, before disappearing for good.

Trivia and Cultural References[]

The title to episode draws from a famous quote in the movie Cool Hand Luke – "What we have here is a failure to communicate."
When Stacy doesn't want to engage House in conversation, she pointedly asks him if he didn't bring a book to read. In their next scene together, House has bought the book Lesbian Prison Stories.
Vindaloo Curry is a regional curry recipe in the western part of India. It is one of the usual curries found in British curry establishments.
When looking at the patient's lungs' x-ray, Foreman says "And then there were two," to which Chase replies "...And then there was one." Agatha Christie's novel And Then There Were None is about a group of people trapped in an island who get killed one at a time, analogous to when the team is in a differential ruling out conditions one at a time.
The riddle House gives his team where the room has an all southern view is one of the many homages to Sherlock Holmes seen in the series as Holmes gives Watson exactly the same riddle.

"You know, this guy goes to his psychiatrist and says, "Doc, my brother's crazy. He thinks he's a chicken." And the doctor says, "Well why don't you turn him in?" The guy says, "I would, but I need the eggs." Well, I guess that's pretty much now how I feel about relationships– you know, they're totally irrational and crazy and absurd, but, I guess we keep going through it because most of us need the eggs"

―Woody Allen

The quote becomes the title for the Season 8 episode We Need the Eggs, where the characters assess their ability to form a relationship.

Stacy's quote about the need for relationships draws from a joke in Woody Allen's Annie Hall.

Cast[]

Previous episode:
Deception

Failure to Communicate

Next episode:
Need to Know