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Distractions

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Distractions
Distractons
Director(s)
Airdate
February 14, 2006
Episode Number
2.12
TV.com Rating
8.8/10
Guest Star(s)
Final Diagnosis
Serotonin syndrome
Zebra Factor
9/10
Weber: "The name’s Philip"
House: "My bad. Something to do with your face. I always think your name is Dick."
Weber: "HOUSE!"
— Distractions

Distractions is a second-season episode of House which first aired in the United States on February 14, 2006. A severe burn victim becomes House's patient when he develops tachycardia, but because of his conditions, they can‘t use most of their usual testing procedures. Meanwhile, House plots revenge on a doctor that he went to medical school with by trying to prove that a new migraine prevention medication doesn't work.

RecapEdit

The show opens with a pair of ATV motorists; the teenaged Adam is learning from his father. Adam wants to drive the ATV, but his father refuses, recalling the paperwork they signed promising that Adam would not drive the vehicle. Dad eventually gives in and lets Adam drive the ATV up to 15mph. However, Adam appears to jam the throttle, accelerating to high speeds. The father is thrown from the vehicle, but Adam winds up hitting a pile of large pipes. The ATV’s gas tank explodes and Adam catches on fire. Adam is rushed to the ER.

House is reading a medical article written in Hindi when Foreman brings House the chart and notes that Adam's potassium is low, when it should be high. Foreman suggests that it might be amphetamines and House recommends an EKG. However, once he sees the patient, he realizes there is no skin to attach the EKG. House peers through the window and sees Adam 40% covered in severe burns. House believes he has a good chance of survival unless his heart shuts down.. House tells Foreman and Chase to find a galvanometer.

A nurse enters Cuddy's office and tells her an audio-visual setup is needed for a lecture from a doctor Cuddy has never heard of. Cuddy confronts House as he stands next to a man who has been comatose for two years, whom House has apparently given a migraine. Cuddy is dumbfounded why House is doing it, but House admits he’s the one who forged Cuddy’s signature on the requisition for the doctor.

Cameron explains to the fearful father and mother that the reason Adam's heart is failing is because he may be on amphetamines. The parents admit they allowed him to use marijuana once, and they also let him drink alcohol, but the patient is not a drug user. Foreman and Chase start using the galvanometer. However, Adam suddenly begins to have a seizure, knocking over the machinery.

House and the team brainstorm several diagnoses, including multiple sclerosis, adrenoleukodystrophy, and others. However, radiology and a lumbar puncture are ruled out by the patient‘s condition. House eventually decides on transcranial sonography.

Meanwhile, Cuddy somewhat clumsily introduces a Dr. Weber for a lecture on headaches. Wilson notices House in the audience, disguised in a green coat, sunglasses, and a fishing hat. Wilson deduces that Dr. Weber was the Doctor that got House kicked out of Johns Hopkins for cheating.

In the operating room, Cameron explains that the eyes can be stimulated with imagery which can then be tracked with a sonogram as Chase and Foreman perform the procedure. Foreman spots something in the sub-arachnoid space.

Back at the lecture, Wilson and House are arguing when Foreman walks in and tells House that Adam has a cranial bleed. After an impromptu differential, House just tells Foreman to fix the bleed. Chase manages the procedure even though it’s usually done with a contrast CT Scan.

House finally interrupts Dr. Weber and has a long argument with him regarding the effectiveness of his migraine medication. Weber dismisses House’s objection that the drug didn’t work on a coma patient and tells him that the drug only works on conscious patients.

Adam is in a hyperbaric chamber. Chase and Foreman notice that Adam is awake and Foreman calls for an anesthesiologist. Adam looks like he is in pain, but when Cameron walks in, she realizes it’s something else.

House injects himself with Weber's migraine medicine then, to prove Weber wrong, also injects himself with nitroglycerine, a migraine-inducing drug. Cameron walks into House's office and informs him that Adam wasn't in pain, he actually had an orgasm while in the hyperbaric chamber even though he was unconscious. House is about to reply but is suddenly overcome with a migraine headache, giving him both satisfaction about his correct conclusions and great pain at the same time.

Foreman gives House medicine for his migraine and prompts a differential diagnosis on having an orgasm. House prompts Foreman, who tells the others that some diseases cause the brain to misinterpret sensory information. Cameron notes how stressed Adam's brain must be from all the medication and that he may have an infection that has pushed him over the edge. However, there‘s no way to test him for all the possibilities. House suggests one way they could clean up a skin infection that‘s low risk. Foreman and Chase begin applying maggots to Adam's burned chest to clean out dead skin and bacteria.

Wilson confronts House about taking nitroglycerin to induce a migraine and it being a lose/lose situation. Wilson also deliberately raises his voice and makes noise to put House into more agony. Wilson points out the single failure to prevent a migrane doesn’t disprove Weber’s results.

The next morning, Cameron finds House sleeping on the floor under a table in his office, and gingerly wakes him up to tell him that the maggots didn't fix the problem although they helped the burn. House commands a lumbar puncture at C2 and C3 (technically a cervical puncture) which has a large risk of paralysis but a lesser chance of infection. Consent is granted and Foreman preps for the puncture. During the procedure, however, Adam's blood pressure spikes and has a high risk of stroke. Foreman finishes the procedure just in time.

The tap was negative for MS and infection. House needs to know if the patient was suffering from tingling in his fingers before the crash, so he goes to the burn ward commanding the anesthesiologist to wake up the patient he can speak with him. Adam is woken and is in extreme pain, only stopping yelling just long enough to tell House that he urinated in his pants just prior to the accident, but doesn‘t remember anything after that.

Afterwards, House claims he has to go to his office to "take an aspirin." We see House shower and begin to hallucinate. Cameron walks in and House claims to be "seeing music." Cameron examines him and immediately determines that House has taken something to get himself high.

House re-enters the office cheerfully, claiming Adam is depressed and is on anti-depressant medication, giving him serotonin storm. However, if they treat him for it and he has an excess of dopamine instead, it will kill him.

House speaks to the angry parents and asks to wake Adam up again so he can ask him if he‘s on anti-depressants. However, the parents say that Adam is always open to them, and they are willing to bet Adam's life on the fact that he's not depressed.

House returns to his team to tell them the patient seems to be very happy, but all the other seizure disorders seem to be ruled out. House leaves the room, and goes back to the ward to wake up Adam again. Foreman comes by to try to stop him, but House says if they don’t wake him up, he‘s as good as dead. However, as the two of them struggle, House suddenly notices a small circular burn on Adam’s wrist and nicotine stains on his fingers. He stops struggling with Foreman and goes to talk to the patient.

House asks the parents if Adam smokes. Although his parents are very open minded and supportive to the point of trying marijuana with him, they make it clear to House that they would "kill him" if they ever found out he was smoking. House explains that Adam has been smoking and is trying to quit. It is the "over the internet" anti-depressant drugs which are helping him do so that are slowly killing him. They can now treat him.

Cuddy bursts into House's office asking him if he took LSD. House "hypothetically" admits that he did, and that he also took anti-depressants to short-circuit it. Weber soon storms in as well, complaining that House has ruined him and his clinical trials with his email to the pharmaceutical company saying the anti-migraine drug is a fraud. Weber blames Cuddy for cooperating with House.

Adams parents start to forgive themselves for their son’s injuries. He is soon conscious and smiling at them.

Later, House invites a prostitute named Paula over to his house to "distract" him.

Major Events Edit

  • House attends a lecture held by Doctor Philip Weber, who is revealed to be one of House's former classmates. While at medical school, Weber caught House cheating off of him on a test and had the Dean throw him out. This also cost House an internship at the Mayo Clinic which Weber gained for himself.
  • In an attempt to prove Weber wrong, House injects himself with the experimental anti-migraine drug. His plan eventually works and Weber is forced to shut his trial down.
  • In this episode, House learns a bit of Hindi to confront Philip Weber.

Zebra Factor 9/10Edit

Anti-depressants are one of the most commonly prescribed medications and are generally very safe. Cases like this where the drug’s effect cascades are a one-in-ten-million event.

Quotes Edit

Lisa Cuddy: "You induced a migraine headache in a coma patient?"
House: "Gave him a little headache, similar to the one you're giving me now"
Lisa Cuddy: "Have you even read an ethical guideline?"
— Dr. Cuddy to Dr. House as he induces a migrane headache in a coma patient.(Distractions)

Trivia & Cultural ReferencesEdit

  • Hindi is one of the official languages of India (each state in the country has a different official language, all of which plus English are recognized as official languages by the central government of India), spoken mostly in the north central part of the country.
  • House says "Teri ma ki" in a respectful tone to Weber, to look like a greeting. The phrase is actually an insult in Hindi, roughly equivalent to saying 'Your mom's Vagina'.
  • The title of the Hindi journal that he is reading says "Neuro Science" while the rest of the characters on the cover of the book make up no meaning.
  • More about maggots in medicine
  • ”The Flyers” is a reference to the Philadelphia Flyers, an Ice Hockey team in Philadelphia, Pennsylvania.
  • More about Karma, The Golden Rule, and Rabbi Hillel.

CastEdit


Previous episode:
Need to Know

Distractions
Next episode:
Skin Deep

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