- Park: "You do know I punched the last person that pissed me off."
- Adams: "Was it Santa?"
- ―Charity Case
Charity Case is a Season 8 episode of House that first aired on October 17, 2011. It is written by Sara Hess and directed by Greg Yaitanes. The episode marks the last regular appearance of Olivia Wilde.
When a philanthropist collapses after making a rare and generous donation, House isn't the only one who believes the man's extreme generosity is a symptom of a deep underlying condition. House reconnects with Jessica Adams by convincing her to donate her time and expertise to the case. In addition, House manages to drag Thirteen back, but when House tries to enlist her help as well, he finds out he's not the only one who has considered a career change in the last year. However, as the patient gets worse, he becomes determined to sacrifice his own life to save someone else, and the team must race to find out what is wrong with him before he ends his own life. Meanwhile, Adams and Park test each other's outlook about generosity. Thirteen tries to determine whether her own happiness should mean that she should throw away her medical career.
Plummers is toxic multi-nodular goiter!. It means you can either see an enlarged thyroid or feel it during physical. It is the 2nd most common cause of hyperthyroidism which would show on thyroid function test. (increased T4, decreased TSH). Furthermore he had tremors, arrhythmia, syncope in the first 20 minutes. All of it is explained by hyperthyroidism. That being said it is an easy diagnosis that should have been solved in 15 minutes to the episode. Very Disappointing.
A social worker is talking to Benjamin about how her agency can help him get a job. He asks about the availability of child care, and she says that unfortunately, they can’t make such arrangements although there is a lot of demand for it. She has to take a phone call and Benjamin thanks her and starts to leave. However, when the social worker turns back to see him go, she notices an envelope left on the table. She opens it and finds a check for $1 million. She runs after Benjamin, and she sees him collapse on the street. She calls for an ambulance.
House grabs his beard trimmer and decides to go back to his heavily stubbled look. He then takes the trimmer to his hair as well to go back to his shorter cut. Park asks him why she’s there to watch him cut his hair, and he says it's because she’s the one who has to clean up. However, when she presses why he did it, he said he needs a new look to start his new life. Then they start talking about Benjamin’s case. Park thinks it’s routine - a man who skipped breakfast and was on his feet all day collapsed in the heat. The emergency room couldn’t find anything wrong with him. House admits he knows the patient is rich, but took the case because no one could find anything wrong with him.
They proceed to House’s office where they find Jessica Adams. He tells Park to give her the file because he has to work with a “team”, and that means more than one person. Park reminds him he can’t afford a team, but House reassures her that Adams will be working for free. He introduces them. Adams reminds House that she thought they were meeting for coffee. House says he said they were meeting to talk, and he wants to talk about his new case. She says she’s looking for a paying job, and he counters that she must be doing work for free and that this is a better option than a free clinic. Park chimes in that she doesn’t think it’s much of a case, just dehydration. House reminds Adams that the last time she listened to him, she saved a patient’s life.
Adams agrees to help with the ultrasound and tells Benjamin that the collapse could indicate something serious. Park tells the patient it's probably something simple and tells him he should drop his undercover act the next time. However, he says if he goes in as a rich guy, they put their best foot forward. He describes how he’s trying to give away his fortune because it’s more fulfilling than changing the plants on his estate.
Park comes back and says that the patient must be nuts for giving away all his money, but Adams thinks he’s just generous. Foreman comes in and asks what House’s evil plan is. Foreman thinks he’s angling for a donation. He tells him to get used to his new reality and the noise from the orthopedic area next door. However, House has finally gotten in touch with Chase and Taub - they’re willing to return. Foreman asks about Thirteen, but House dismisses the suggestion on the grounds that any return would be short term. Foreman guesses that the actual reason is that Thirteen hasn’t returned his calls and tells him to discharge Benjamin. House argues that it’s a bad idea to discharge someone who suffered an unexplained lapse in consciousness. Foreman notes Benjamin got better on fluids, now feels fine, and all the other tests were fine as well. He orders Benjamin discharged. However, Park argues that his extreme altruism is a symptom. Foreman tells House he can either send Benjamin home or, if he thinks altruism is a symptom, he can’t ethically take his money. House orders Benjamin discharged and tells his team to check admitting for the net worth of all new patients.
Thirteen shows up at the hospital and tells House she’s not coming back, although she’s flattered by the seventeen messages he left. She wants him to stop calling. She has figured that the reason he hasn’t come to her apartment is because of his ankle monitor. She says she’s not a doctor any more. House starts to figure out why she’s not practicing anymore, and figures she’s fallen in love with someone whom she’s moving away with. She confirms she’s met a woman and they’re going to Greece. She once again asks him to stop calling her, but he refuses.
Although they’re discharging the patient, Park wants to do one more test of his muscles. Adams admits to the patient that his altruism makes her own wanting to do charity work seem feeble, but Park says he just makes Adams feel guilty. Park completes her test and the results are normal. However, Benjamin complains that his chest hurts and Park realizes he’s tachycardic. They call a code.
Park reports the tachycardia, which would seem to indicate there is something wrong with the patient. House starts thinking about arythmia. Adams brings a coffee for Park. Park wants to pay for it, but Adams won’t take her money. Park is still arguing that the altruism is a symptom, but Adams thinks it is just Long QT syndrome brought on by antihistamines. House agrees and orders saline to clean the drugs followed by an EKG. He then decides to do the procedure himself. He then tells Adams to stop fighting with Park about who pays for the coffee.
House tells the patient how he lost his department. The patient offers a donation of $1 million. House tells him that he just fell for a sob story given by an opportunistic ex-con.
House goes to see Wilson about his ethical problems. Wilson tells him he can’t take money from the patient under any circumstances. Wilson has to run off to deal with a patient who probably needs a kidney transplant. House agrees that the patient probably just has Long QT and is just really generous.
Park asks Benjamin if he wants to call anyone, and he says the only person he wants to call won’t listen to him - his wife. The relationship ended when he started giving away his money. He’s also alienated from his sons. He discusses with Park whether family comes first. He says his sons get plenty of financial support. Park notices the patient’s hands are trembling, but he‘s not in pain. This rules out Long QT.
House meets Park and Adams in the cafeteria. Park and Adams start fighting over who pays for coffee again and then start arguing about whether the patient’s altruism is a symptom. They finally settle on a diagnosis of echovirus.
House calls Thirteen for help using the hospital’s computer system. She agrees to help, then admits that she doesn’t want to work for him anymore because they became friends when he was there for her when she got out of prison. However, she admits she still wants House in her life. House complains his computer screen has gone completely blue and she agrees to come in. House gets her to pick up Chinese food on the way.
Adams tries to give Park a pair of shoes she got for free in a 2 for 1 sale. Park reluctantly takes them, but reminds her she punched the last person who ticked her off. Adams asks if it was Santa.
When House comes in the next day, Wilson asks him how his patient is. House assures him that he’s getting better and they plan to discharge him. House wonders why he’s so pleased with the news. Wilson tells him Benjamin just agreed to donate a kidney to Wilson‘s patient. House reminds Wilson that he said it was unethical to take things from patients. Wilson says he changed his mind. House realizes that the altruism may be a symptom, and it may be getting worse.
House and Wilson argue about the matter with Foreman. Foreman goes to see the patient to ask why he’s donating a kidney. Benjamin says it’s because over 60,000 people a year who need one don’t get one. When House makes a sarcastic remark, Benjamin promises to make good on his $1 million donation, but this just convinces House that he’s right about the altruism. However, Foreman notes that the altruism is the only evidence House has that there is anything wrong with Benjamin and allows the transplant to go forward. Benjamin assures House it isn’t a symptom and that he will make good on his donation. House doubts it.
House tells Park they have time for one more test. The patient got better on echovirus treatment, so they have to think of something else that just affects his mental status. Park is still pressing for Whipple's disease, but House notes there is no joint pain. He asks about Adams, but she has left for a job interview. House finds Thirteen in his office. She has come up with Whipple’s too, and notes that joint pain doesn’t always occur. House gives in and orders tests, noting to Park that being right doesn't matter much if she can't defend her idea. He argues with Thirteen about why she’s back.
The small intestine was normal, but Park is still running the tests. House gives Park a gift he found in his office. He realizes Park got Adams the job interview and was hoping the gift giving would stop. House realizes either that Park is so insecure she doesn’t want to feel like anyone has the upper hand, or she’s so arrogant that she’s insulted whenever someone does her a favor. She just says it makes her feel weird when people do things for her. House says she really needs to analyze that. The tests come back negative for Whipple’s. They realize the kidney transplant will proceed.
Wilson is preparing Benjamin for surgery and they put him under anesthetic. However, once he’s under, his heart rate goes up and his blood pressure drops. Dr. Simpson orders adenosine, but they can’t stabilize him and they have to cancel the surgery.
They start discussing new diagnoses when Foreman comes in. House reminds him that he was right. Foreman takes him off the case, accusing House of dosing Benjamin to get him to crash under anesthetic. Park chimes in that it would have been idiotic for House to try something like that with two lives in the balance. Foreman counters that when symptoms show up just when House needs them to, it's usually because he’s tried something. House counters that Foreman is suspicious and micromanaging. Foreman asks House what he did, and House denies responsibility and says the right thing to do would be to keep him on the case. Foreman takes him off the case anyway. When he leaves, House admits Foreman was right.
Adams approaches House and asks if he dosed the patient because he was certain he was sick. House dodges the question and asks Adams what her problem with Park is. Adams admits that she found it interesting Park wouldn’t accept a coffee and wanted to see how deep the problem went. However, now that she’s committed, she just wants to show Park up. House tells her if she wants to win, she has to pick something that Park can’t reciprocate and where turning it down will make even Park think she’s crazy. House sees something and calls Thirteen.
Thirteen arrives and finds Benjamin’s wife Kate outside his room. However, she doesn’t want to see him unless she and their sons mean more to him than other people do. She leaves. Thirteen then goes to see Benjamin to ask about the kidney. She claims she needs a transplant too. She goes to leave, but Benjamin says he will give her the other kidney. She reminds him he will die, but he says he can go on dialysis and save even more lives when he dies and donates his other organs. Thirteen reports to House.
Even Adams now believes the generosity is a symptom. The best they can come up with is acute intermittent porphyria. House finally has had enough of people sawing off casts in the next room and sabotages their equipment. Adams wants to start Benjamin on hematin, but Thirteen says she will do it. House follows her and asks if she’s on the team. She says she’s undecided, but admits she feels guilty for giving up the practice of medicine just to have fun.
Wilson’s kidney patient has died. House tells him that Thirteen is coming back, and Wilson says it’s amazing what he can do without a department or money. All of a sudden, House realizes that one of the tests he did used iodine contrast. He realizes Thirteen was right about it being his thyroid and that it’s Plummer’s disease. It wouldn’t show up on thyroid function tests, would explain the brain issues with generosity, and makes him susceptible to overheating. The iodine sent him into thyrotoxicosis. However, once they remove the nodule, he will be fine.
The patient recovers from his surgery. House asks about the money. The patient counters that House made him sick. House tells him he was sick when he arrived, but agrees his treatment made him much worse. House realizes that the altruism was a symptom and he’s not getting the money. The patient is more concerned about his family now.
Park confronts Adams about paying her $4,500 car repair bill. Adams tells her to say thank you, or else she outfits the car with GPS too. Park tells her she’s won and thanks her. However, Park then goes to House and tells him Adams fell for his trick and has unwittingly paid to have House‘s Dynasty fixed instead. Park says she’s glad it’s over. House tells her nothing is ever over.
House sees Thirteen embrace her girlfriend and calls her over. He fires her, saying he can’t work with people who are there just out of guilt. However, Thirteen realizes House is trying to save her, but he denies it. She agrees to go.
The patient is a young boy who has an itchy rash on his hands and is having trouble holding on to pencils. The only thing that has changed in his life is that the neighbors have a new pool. House notes the scent of lilac on him. He realizes that he’s allergic to his mother's hand cream, which he’s been using when he has been masturbating to the women swimming in the pool. He gives the boy a tube of lubricant.
- Adams comes to work for House for free while she looks for another job.
- Adams and Park fight about generosity, which leads Adams to buy increasingly valuable presents for Park to test how far it will go.
- Thirteen agrees to come back to work for House as well, but House finally sends her on her way so she can be with her girlfriend.
Trivia & Cultural ReferencesEdit
- This is the only episode in the entire series where House's diagnostic team consists entirely of female doctors. However, it should be noted that while Drs. Jessica Adams and Remy Hadley worked on the case, only Dr. Chi Park was an official member of the team at the time. Adams was just killing time and working for free while looking elsewhere, while Thirteen was testing the waters to see if she was interested in returning to the team.
- The Phoenix foundation is also the agency employing Mac Gyver.
- The title is the term for a person a hospital treats at no charge. Many hospitals have to treat a certain number of persons without the ability to pay either as part of their mission or to meet legal requirements.
- House’s crack about “What is this, Canada?!” is a reference to the fact that Canada has a universal health care system and gets next to no income from patients or their insurance companies, while hospitals like PPTH get almost all of their money from patients and insurance companies, not the government.
- House’s crack about Clancy’s eyesight is from the old myth that masturbation causes blindness.
- Charlie’s Angels was a television series that ran from 1976-1981 about a mysterious benefactor who had three beautiful women working for him as private detectives. It spawned two “reboot” series and two movies.
- House's remark "We're putting the band back together" to Thirteen is a reference to the movie The Blues Brothers
- The cricket ball, an oblique reference to Hugh Laurie’s country of birth, makes a reappearance on House’s desk.
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