Amber Volakis
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Amber Volakis, usually referred to by the other characters by her first name, but by House by the affectionate "Cutthroat Bitch," was one of the final four applicants for the fellowship positions that opened up in Season 4. She is portrayed by actress Anne Dudek.
Amber was quickly identified as the most ambitious candidate in "The Right Stuff" when she was assigned along with nine other candidates to wash House's car while twenty others were running tests. She quickly mutinied and took eight others with her with only Cole staying behind to do the work. However, she returned fifteen minutes later to rejoin Cole and took the car to a car wash. She made it to the final ten.
She secured her employment, at least for a time, in "97 Seconds" when House paged her just before he electrocuted himself into a cardiac arrest just to prove a point. He realized Amber would be the best choice because she wanted the job the most and wouldn't let him die. She justified House's faith in her in "Guardian Angels" by finding the correct diagnosis for the patient. However, she learned the full truth about working for House -- when she tried to get out of a grave robbing assignment by sucking up to Cuddy and offering to do clinic duty, Cuddy made it clear that whatever she was trying to get out of doing for House was only the tip of the iceberg compared to what she would have to do if she were hired.
Amber's ambitious personality was easily seen by the mirror patient in "Mirror Mirror" when he commented that he (as her) was always right and had to be. Amber tried to laugh it off, but was taken aback when he added "If they don't like you, you gotta be right -- or you're not worth anything."
When House suggested in "You Don't Want to Know" that the person who stole Cuddy's thong would get to stay another week, the rest of the applicants were reluctant until they realized that Amber was going to try to do it. However, Cole succeeded in the challenge and picked Amber as one of the two people House would have to choose to fire. However, she was saved for another week when House realized that Cuddy had given her thong to Cole in an attempt to influence his choices. He fired Cole instead.
However, when the endgame came up in "Games," House decided that Amber had to be the last to be fired. Although he admired Amber's ambition and her ability to play the game, her "win at all costs" attitude wasn't compatible with the job; House said that when one works for him, one had to be able to lose. She drifted into the room where their patient (a drug addict she had expressed contempt for) was recovering, saying she was trying not to care.
In "Frozen," House was sure that Wilson was not only dating someone, but was dating someone he knew. He was hurt Wilson didn't want him to know. He cornered Wilson in a fancy restaurant and was shocked when Amber showed up.
House: Cutthroat Bitch?!
Wilson: I call her Amber. Was she on your list?
Despite her dominating personality easily overshadowing Wilson's she seemed to genuinely care for him, telling House that for the first time in her life she had both love and respect and didn't have to choose. House and Amber quickly developed an adversarial relationship, bickering over 'shared custody' of Wilson.
In "House's Head," House is tormented by broken memories after a bus crash where he saw symptoms of an unknown disease. At the very end of the episode, following a period of cardiac arrest induced by Alzheimer's medication, it is revealed that Amber was the patient he had seen dying. House had been drunk at a bar and called Wilson to pick him up, but Amber was the one who answered the call and followed him onto the bus.
Amber becomes the patient in "Wilson's Heart," where she experiences multiple organ failures as the disease progresses. The cause is revealed to be amantadine poisoning, as her kidneys were destroyed by the crash and she was unable to process the medication she was taking for the flu. The amantadine could not be purged from her system, meaning the organ failure could not be repaired. In the end of the episode, she died in Wilson's arms as the machines were shut down.
She appeared one last time in a dream House experienced while in a coma, a result of deep brain stimulation which led to a seizure and a brain bleed. On a bus surrounded by white light, she acknowledged she was dead and told House to get off the bus.
House: You're dead.
Amber: Everybody dies.
House, in a rare crack in the armor, admitted he didn't think he was able to face Wilson or want to go back to the pain and misery of his life. Amber smiled sadly and said "Well, you can't always get what you want." House, after a moment, nodded and walked away.
Amber's death is the first death of a main or recurring character in the show who is not a patient. The impact of her death on the other characters, as well as on Wilson and House's friendship, formed a major plot point in the 5th season. In the 21st episode, "Saviors," Amber appears to House as a hallucination and continued to haunt him in "A House Divided." throughout the episode, House assumes it because he has not slept properly since Kutner died and has insomnia but at the end of the episode after he finally sleeps he sees her again.
Throughout the episode Under My Skin, the hallucinations of Amber become more and more sinister, cruel, and violent. At one point, Amber slices her arm open with a scalpel. When House begins to try and figure out what's wrong with him, Amber begins to mock him and torment him. Amber reminds House that every option will be terrible: Schizophrenia means he can never work again while Multiple Sclerosis or Vicodin overdose will cause him severe pain. House realizes the problem is the Vicodin, and during his withdrawal, Amber constantly tortures him, laughing and telling him he's worthless. However, once the withdrawal period is over and House manages to get some sleep, the hallucination appears to have vanished for good.
However, in the next episode, Both Sides Now, it is revealed that House didn't get off vicodine, and that it was all a hallucination just like Amber herself. Amber and surprisingly, Kutner shows up at the end of the episode, telling House: "So this is the story you made up about who you are. It's a nice one," to which the hallucinated Kutner adds "Too bad it isn't true." This is her last known appearance.
In the episode Brave Heart, Wilson wants House (who has been living with him for a while) to move into the study which is covered in pictures of Amber. While sleeping there, House starts to here whispering, he soon heres it in an air vent and follows it to Wilson's room where he overhears him talking to Amber. When House confronts Wilson about this, he told House that it made him feel better. House trys talking to his dad, he yells at Wilson that he thinks it is stupid. Wilson tells Amber that he has changed.
[edit] Case History
The patient was severely injured in a bus crash and was admitted as a Jane Doe into Princeton General Hospital. Surgery to repair her damaged kidneys and other injuries was successful and the patient was put on dialysis. However, post-op, she failed to regain consciousness and developed persistent tachycardia well after surgery. She was given potassium, adenosine and verapamil with no effect. She was scheduled for a coronary angiotomy, but there were more severely injured patients ahead of her. She was eventually identified when her boyfriend and Dr. House arrived at the hospital looking for her. Her boyfriend posed as her husband and gave consent to transfer her to Princeton-Plainsboro Teaching Hospital because she was hemodynamically stable.
However, on the ambulance trip, the patient had a cardiac arrest. However, instead of defibrillating the patient, she was put into protective hypothermia as keeping her heart beating would result in the release of free radicals into the bloodstream. Dr. House ordered cold saline solution to lower her body temperature.
At Princeton-Plainsboro, the patient was put on heart-lung bypass and her body temperature was lowered to 90 degrees F. She was stabilized.
Dr. House surmised the trauma set off a pre-existing heart condition. Dr. Taub suggested it might be an autoimmune disorder or lead poisoning. Dr. Kutner suggested looking for arterial blockages. However, Dr. Foreman pointed out that most of the tests they run required the patient to have a functioning heart and normal body temperature. Dr. Kutner suggested that Dr. House take physostigmine in order to attempt to recall the symptom that Dr. House believed he saw in Amber before the crash. Dr. House ordered an angiogram as it would work even in the patient's present condition. He also ordered tests for any toxin, drug or heavy metal that would make her heart race.
Dr. Taub asked Dr. House if he had a sexual relationship with the patient, but he denied it. Dr. Taub suggested that in addition to alcohol at the bar they were at, they may have done drugs together. He went to do a tox screen.
Dr. Hadley and Dr. Kutner went to do an environmental scan of the patient's home. They found diet pills. Dr. Hadley expressed reservations about treating a patient they knew.
Dr. House suggested to Dr. Cuddy that he undergo deep brain electrical stimulation to try to revive his memories. However, Dr. Cuddy and Dr. Wilson agreed it was too dangerous.
The patient's brain activity spiked, but Dr. House put it down to a random event. The coronary angiogram was normal and the tox screen showed no drugs. Dr. Wilson denied that the patient took drugs. However, he was told that the patient hid her diet pills in a vitamin bottle. Too many diet pills might have damaged her mitral valve. Dr. Foreman suggested returning her body temperature to normal and doing a CT Scan to confirm the diagnosis. However, Dr. Wilson objected. Dr. House instead instructed the team to do exploratory surgery and inspect the valve manually. Dr. Foreman objected, but Dr. House insisted. Dr. House also admonished Dr. Hadley for her lack of objectivity on the case.
However, as they took the patient to surgery and prepared to inspect her mitral valve, they noticed the patient was jaundiced. Diet pills would not have damaged her liver, so they returned the patient to intensive care.
It was clear that whatever the patient had it was spreading despite the hypothermia. Dr. Hadley suggested anti-trypsamise deficiency. Dr. Foreman suggested a liver biopsy, but Dr. Taub noted that anacardia would also explain the symptoms, buf if it were an infection, it would be necessary to bring her body temperature back to normal. Dr. House agreed with Dr. Wilson that the patient had to be made colder and ordered the team to fill the patient's lungs with crushed ice.
Dr. House went to the bar where he and Amber had been, but the bartender only noticed that Amber had been sneezing and had a runny nose. Dr. House believed this meant that Amber probably had an infection.
Dr. Kutner and Dr. Hadley filled the patient's lungs with ice. The patient's body temperature was lowered to 70 degrees F.
Dr. House confirmed that the liver biopsy showed infiltrates and minor inflammation. The most likely diagnosis was hepatitis B. Dr. House ordered interferon. However, he later realized he saw a rash on the patient's back earlier. He confirmed the existence of the rash, which pointed to influenza. However, this would not explain the failure of her organs. Dr. Kutner suggested dermatomyacitis, but this would not have caused tachycardia. Dr. Hadley suggested an allergic reaction to interferon, but Dr. House was convinced he saw the rash prior to the treatment. Dr. House decided to check for abcesses and instructed Dr. Taub to insert a needle into the rash to attempt to detect pus. The fluid was clear. Dr. Foreman suggested rocky mountain spotted fever and Dr. Wilson realized that Amber may have been exposed to ticks on a dog. Dr. House ordered oxycyclene followed by returning her temperature to normal and schocking her heart to get it beating again. However, Dr. Wilson wanted to run blood cultures. Dr. Foreman noted this would be too slow. Dr. House agreed to run the blood cultures. Dr. Foreman objected to this course of action, but Dr. House insisted.
Dr. Foreman approached Dr. Cuddy about Dr. House's actions and Dr. Cuddy ordered Amber's body temperature raised so they could shock her heart back to sinus rhythm. Dr. Wilson arrived when it had reached 80 degrees F and noticed that her EEG activity was lower. He realized the disorder had spread to her brain.
The spread of the disorder to her brain suggested an autoimmune disease. Dr. House ordered a course of prednisone followed by returning her body temperature to normal. Dr. Wilson objected because steroids would make her immunosuppressed allowing any infection to spread. However, Dr. Cuddy reminded Dr. Wilson that Dr. House was the attending physician. Dr. Wilson asked Dr. House to undergo deep brain stimulation to attempt to recall another symptom. Dr. House agreed to the procedure despite the risk to his own life.
Dr. House recalled the events of the previous evening - he had called Dr. Wilson to pick him up at the bar, but Amber arrived instead. House left and got on the bus, but Amber followed him with his cane. She was suffering from the flu and took amantadine just before the crash. After the crash, he gave her first aid for shock and noticed the damage to her kidneys.
It was realized that the amantadine, which is usually filtered by the kidneys, stayed circulating in her bloodstream. This caused an overdose. However, the drug would have bound to her proteins, so dialysis would not clear it from her system. Her case was terminal and there was nothing that could have been done from the moment she suffered the cardiac arrest. A heart transplant was out of the question because too many of her organ systems were damaged irreparably.
At Dr. Cuddy's urging, Dr. Wilson agreed to return her body temperature to normal and wean her off anasthetic. Amber regained consciousness and realized her situation once she was told about the tachycardia, cardiac arrest and liver failure. The patient later became extremely fatigued and asked to be taken off bypass. Dr. Wilson discontinued life support.
[edit] Appearances
- The Right Stuff
- 97 Seconds
- Guardian Angels
- Mirror Mirror
- Whatever It Takes
- Ugly
- You Don't Want to Know
- Games
- Frozen
- Don't Ever Change
- No More Mr. Nice Guy
- Living The Dream
- House's Head
- Wilson's Heart
- Saviors (as hallucination)
- House Divided (as hallucination)
- Under My Skin (as hallucination)
- Both Sides Now (as hallucination)
- Brave Heart (in photo's)
