DNR
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DNR is a first season episode of House which first aired on February 1, 2005.
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[edit] Recap
While at a rare session, a legendary jazz musician with amyotrophic lateral sclerosis (Lou Gehrig's Disease) starts to have trouble breathing.
The patient is taken to Princeton-Plainsboro. House asks to be assigned to the patient. He thinks the paralysis has an undiagnosed cause. Cuddy thinks the patient has only developed pneumonia. However, Foreman had previously worked with the patient's regular doctor and has already been assigned to the case.
Foreman takes charge of the team, but House isn't taking him seriously. House asks about the paralysis, but Foreman points to the ALS diagnosis. However, House points out there is no definitive diagnostic test for it, and it is incurable. House starts a differential anyway, but Foreman shoots down the proposal because no other possible cause fits. House points out it's a death sentence, but Foreman says that doesn't make it wrong.
Foreman goes to see the patient, and tells him the pneumonia is probably related to the ALS. The patient learns House is on his case, and the patient asks Foreman for his opinion. Foreman disagrees with House, so the patient doesn't consent to an MRI. The patient also asks for a do not resuscitate order, or DNR. Foreman can't dissuade him.
Foreman tells House about the DNR. Foreman is treating the pneumonia with steroids, but House wants him to treat for other conditions. Foreman starts him on House's suggested treatment, but doesn't tell House or the patient.
The patient goes into respiratory arrest as the result of House's suggested treatment. House comes in and finds the team obeying the DNR order. House starts resuscitating him anyway. At that moment, the patient's agent comes in and asks what is going on.
The patient is put on a respirator. Foreman challenges House over the procedure. House says the only reason the patient signed the DNR was because he thought he had ALS; if he doesn't, he wouldn't want to die. Foreman storms out. House starts a differential with Chase and Cameron. However, at that moment, he's served with a restraining order. House orders tests on the remaining blood, and asks Chase to do a lung biopsy and move the patient nearer the clinic so the restraining order won't let him work there.
Cuddy asks House if he needs a lawyer. She's upset, but she has set aside money for legal expenses and she's under budget and she sees no point arguing with House. However, she informs House that the patient's regular doctor is flying in to take charge of the case.
House goes to court over the restraining order. House's lawyer argues that they can't kill the patient because an assault complaint has been laid against him and he needs the patient alive to testify. House tells Wilson he's only going through the process to buy time to diagnose the patient. House impresses the judge by pointing out clubbing in his fingers which indicates a heart condition and tells the judge to seek treatment. The judge turns out to have a family history of the disease, and rules in House's favor. However, House admits to Wilson he was only guessing.
House goes back to Chase and Cameron to ask them to treat the patient. House does it himself in defiance of the court order. He runs into the patient's regular doctor. He tells the other doctor he's treating the patient for Wegner's disease. Foreman has a reunion with the doctor, his old boss. House points out they can't kill the patient, but the patient's doctor points out they have dropped the charges.
They disconnect the patient from the respirator, but he starts breathing on his own. This proves it isn't Wegner's. House admits he was wrong - again.
The patient is stable, but one of his arms is now paralyzed. The progression of paralysis once again confirms ALS. Cameron suggests a stroke. House notes that the restraining order is no longer in place and goes to see the patient. He asks the patient to let him complete a diagnosis. The patient agrees to indulge House's obsession, but he can't play music any more, and that is his reason for living. The patient points out that diagnosis is to House what music is to him. At that point, House takes him to get an MRI.
Foreman is talking to his old boss. He's asked if he enjoys working with House and if he's in a serious relationship. He offers Foreman a partnership at three times the salary.
Foreman points out to his colleagues that he has a contract, but they tell him House wouldn't care if he left. At that moment, Chase finds evidence of a stroke, explaining the paralysis in the arm, but not the legs. They want to treat the patient with blood thinners, despite the risk of bleeding in his lungs, but the patient refuses. Foreman suggests directly removing the clot and the patient agrees. They do the procedure to remove the clot successfully.
Foreman goes to House about the difference between House and his old boss. House isn't impressed with the old boss's humility, but Foreman points out House has been wrong on every step of this case.
The patient's arm function improves. Foreman's old boss congratulates House, but at that moment the patient reports feeling in his leg.
House is glad the patient is getting better, but they have no idea why. The patient's doctor figures it is the previous treatment, but Foreman is skeptical. One treatment is definitely working, but they can't figure out which one. They have to try the medication once at a time, so they have to convince the patient's doctor to discontinue his ongoing treatment. However, the patient's doctor wants to know what medications House has been using. The patient starts getting worse. House orders another MRI and steroids.
Cameron points out that House would have to either let Foreman out of his contract or admit he needs him. Meanwhile, House is talking to Foreman about the job offer.
The new MRI shows a malformed blood vessel on the spine, but previous radiology showed nothing. It turns out the abnormality's swelling hid it from x-rays until they got the swelling down. If they remove it, he will get better.
The patient is treated and starts walking again. The patient thanks House, but guesses House's personality was still bad before House's leg got bad. The patient gives House his instrument, but asks how many pills he takes. When House says he's in pain, the patient reminds him they all are.
House sees Foreman, and addresses him by his first name for the first time in an attempt to be more friendly.
[edit] Clinic Patient
A middle-age man comes in for Viagra. House figures out the patient has diabetes and that he has not been managing his condition. He tells him his impotence will go away if he manages his blood sugar. However, he gives him Viagra anyway.
[edit] Major Events
- Foreman's former boss, Dr. Marty Hamilton comes to PPTH to help overcome the treatment of House's latest patient, John Henry Giles.
- Foreman is offered a new job by Hamilton but politely declines.
- As thanks for saving his life, Giles gives House his trumpet as a gift.
[edit] Starring
- Jesse Spencer as Dr. Robert Chase
- Jennifer Morrison as Dr. Allison Cameron
- Robert Sean Leonard as Dr. James Wilson
- Hugh Laurie as Dr. Gregory House
- Omar Epps as Dr. Eric Foreman
- Lisa Edelstein as Dr. Lisa Cuddy
| Previous episode: Poison | DNR | Next episode: Histories |
