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Frozen

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Frozen
Extra-Frozen-Photos-house-md-14008700-2560-1708
Director(s)
Writer(s)
Airdate
February 3, 2008
Episode Number
4.11
TV.com Rating
9.1/10
Final Diagnosis
Fat embolism from broken toe
Zebra Factor
5/10
Cate: "Stop projecting! You’re anti-social so you assume I’m anti-social?"
House: "How about if I just get naked and you shut up."
Cate: "If I thought I could get you naked I would have led with that. You’d rather show me your soul than your leg"
— Frozen

Frozen is a fourth season episode of House which first aired on February 3, 2008 - a special episode following Super Bowl XLII. This is also the most viewed House episode ever. When one of PPTH’s adjunct faculty members gets sick while stationed at the South Pole, Cuddy enlists House to work out a remote diagnosis when he only has access to the materials on hand at the research station and the patient is the only doctor. Foreman helps out, but the rest of the team is assigned a far more important task with respect to working out something with Cameron. As House treats the patient, he starts getting more and more attracted to her, he realizes that someone who works with the patient will do anything it takes to save her. House also realizes Wilson is seeing someone new, but although it’s obviously someone House already knows, he can’t figure out who.

RecapEdit

A doctor stationed at an Antarctic research station saves a man from bleeding to death from a wound to his femoral artery, but then collapses, clutching her chest.

Cuddy comes to House, who is trying to fix the cable on one of the coma patient’s televisions. She tells House that cable is no longer free to patients. She then tells House about the patient trapped at the South Pole.

House discusses the case with his team. They can't evacuate the patient for two months. They start thinking it might be a struvite kidney stone, but she doesn't have the right medical equipment to treat it. However, Kutner surmises they may have equipment for sound-blasting rocks for geology that might work.

House finds out Cameron is on the budget committee and asks her to reinstate free cable. She refuses because the measure brings in $13,000 a month. He starts destroying other things out of spite, starting with tongue depressors.

They get ready to test the rock breaking equipment on an egg. House is dismayed he can get free internet webcams from Antarctica, but not free cable. The patient introduces herself to House, and House sends his team to find a way to blackmail Cameron into reinstating free cable. The rock breaking equipment breaks the egg, but then shatters the glass container. The patient, a psychiatrist, doesn't think it is a kidney stone. Foreman suggests a kidney function test. House suggests antibiotics in the meantime.

The team tells Cameron they are spying on her and give her a chance to reverse the cable policy. Otherwise, they plan to make her life miserable. She says tolerating House's whims is not her problem any more. When Cameron walks off, Taub suggests paying for it themselves, but Cameron has another idea.

The test shows decreased kidney function, showing House was right about the stone, but she still wants to wait. House realizes that she hasn't given herself antibiotics - she's given them to the injured man and she hasn’t got any to spare for a speculative case. Suddenly, she has trouble breathing. They look at her neck and realize that her lung is collapsing. They instruct her to use a syringe to reinflate the lung. She succeeds, but points out that this means it can't be a kidney stone.

Her kidney function test is still declining. Foreman is wondering why House is letting her sit in on the differential. Foreman turns off the sound and suggests cancer. House breaks the news she may have an abdominal tumor, but there is no way to diagnose it. House tells her to X-ray herself as its the only scanning technology she has. She agrees.

House tells Wilson about the patient's decision to give the antibiotics to someone else. Wilson thinks it shows she has character. They find nodes on her scanned X-rays that could be a tumor from lymphoma, but she would still need a biopsy and a stain. House suggests finding a node close to the surface that she can biopsy herself. House is wondering why Wilson seems happy and is wearing a nice shirt. He gives Wilson orders to look for a staining compound the patient might have at the research station.

House goes to his apartment and starts a long-distance physical of the patient. She's reluctant to take off her clothes in front of him. The patient wonders whether House has insomnia - he admits to drinking bourbon to fall asleep. She also notes the lack of family pictures. He tells her she's avoiding people, but she says he's just the same.

Wilson and Foreman are doing stain tests and are talking about whether House likes the patient. Foreman points out that he insults her all the time - Wilson points out that's courtship to House.

The patient takes time to strip off her layers. House wonders why she hasn't taken off her socks. She reminds him it's cold, and there are no lymph nodes in the feet. He orders her to start palpitating her skin. House starts playing sexy music. As she feels her back, he notes that one lymph node is swollen, giving them a possible biopsy site.

The patient takes an ice cube to numb the site, and Wilson instructs her about how to perform a biopsy. Wilson notes that House has just referred to the patient by name instead of by a nickname. The patient manages the biopsy and House asks if she's okay. Wilson wonders why House is so concerned about her - he's never concerned about patients. Wilson realizes House is following him. House realizes Wilson is going out to lunch and is most likely going to see someone. Wilson seems about to tell House something when he runs away. Cameron confronts House about his team bothering her. She retaliates by resigning from the budget committee, meaning it's not her decision about cable any more.

House meets with his team. He has a plan to torture Cameron to get her to get back on the committee. He suggests getting Cameron to screw up and then fix it so they can blackmail her.

They find red wine will stain the cells. The patient admits that she has been checking up on Wilson. She wonders why someone so nice is House's best friend. She figures he's not as nice as he seems. Wilson realizes why House likes her. Wilson comes to the conclusion from the biopsy that she doesn't have cancer. However, all of a sudden, the patient is in terrible pain.

The patient's kidneys are now both failing. House thinks it is an autoimmune disease and suggests prednisone. However, she thinks House is just guessing and demands proof. Foreman suggests sending her outside for five minutes - if she feels better it means it is autoimmune. House reminds him it’s minus 70 Fahrenheit outside the research station and she already has double kidney failure. Wilson finds out that House has been going through his wallet looking for receipts. Wilson has been at a fancy restaurant for at least a third date. House realizes back before ANA, they tested autoimmune diseases with LE Prep damaging blood cells and seeing if the immune system reacted to them. Wilson realizes that they don‘t need fancy equipment like was used when the test was current, a paper clip will work. She runs the test on her blood, which will take two hours. They discuss why he's spent more time with her than any other patient.

Cuddy finds House in the cafeteria and tells him that Cameron has been fired for screwing up the medication on a patient. House doesn't react and says Cameron has no-one to blame but herself. House tells Foreman that he thinks that Cuddy was lying as part of a conspiracy with his team to punish him for seeking free cable.

The LE Prep is negative. Foreman once again suggests her going outside to see if her kidney pain diminishes. House thinks it is a bad idea and tells her to take prednisone. However, before she can go outside, she collapses.

They manage to get the station mechanic, the injured man seen earlier, to stabilize her. She's now in a coma. House still wants to know who Wilson is dating and is sure that it's someone he already knows. They need another kidney function test, but they can't figure out how to talk the mechanic through it. However, they come up with an alternative - have the mechanic extract the patient’s urine through a catheter, then drink it. The mechanic agrees without hesitation, and House realizes the mechanic is in love with the patient. He tells him he can get him to do anything he wants to save her.

House confronts his team about getting Cameron fired. He tells them they can only say one thing to keep them from being fired. After they tell him that Cameron isn't really fired, Taub thinks the 'right' word is 'I'm sorry', Kutner says 'I love you' to House, Thirteen says she doesn't want to play games any more. House tells them that was the right answer and that he needs them to stand up to him. He then tells them they really have to pay for his cable.

The patient's urine is watery, which means either increased intracranial pressure or a problem with the hypothalamus. They tell the mechanic that he has to drill into her skull to try to relieve the pressure. If that works, they still might be able to figure out what is wrong. If it's the hypothalamus, there is nothing they can do. House convinces the mechanic to drill into her head. He's surprised how easy it was to convince him.

The mechanic prepares for the procedure and starts drilling. He penetrates the skin, but has problem with the skull. Foreman tells him that the skull is harder than wood, and to drill a quarter of an inch. He makes it through and they tell him to let the fluid drain. The patient regains consciousness and asks what's going on.

House gets his team to do a new differential. Taub thinks it might be clots. However, all the causes are ruled out. However, Kutner thinks it is fat blocking her arteries. When House overrules him, Kutner stands up to him and says it might be a fat embolism. House says although it fits perfectly, an embolism can only be caused by a broken bone and he‘s seen her X-rays and her whole body. However, he then realizes something.

House tells the patient to remove her socks. She finds her right big toe is broken. The marrow has been leaking into her bloodstream and causing the fat embolisms. She didn't feel the break because of the cold. The mechanic sets the bone. All she needs now is a splint. The patient thanks House, but he tells her to thank the mechanic for saving her life. The patient and mechanic embrace. House walks out of the room dejected.

Wilson is at a fancy restaurant when he is cornered by House. House has called Wilson’s ex-wives to rule them out as romantic relationships. He notes that none of them hate Wilson although they all should. Wilson reminds that House solved the case because he liked the patient. House notes that letting the patient keep her socks on during the physical exam is what delayed the diagnosis. At that moment, to House's astonishment, Amber shows up and embraces Wilson.

Major Events Edit

  • House learns that the Budget Committee have started charging for cable in patient's rooms.
  • House begins nagging Cameron for cable, but Cameron refuses to give into House's demands -- and tells him that the scheme is bringing in $13,000 a month.
  • In an attempt to change Cameron's mind, House sends his team down to the ER to pester her until she gives in.
  • Cameron resigns from the Budget Committee due to House's constant nagging for cable.
  • House discovers that Wilson is dating someone and tries to find out who it is.
  • To House's horror and disbelief, Wilson's new girlfriend is revealed to be none other than Amber Volakis aka Cutthroat Bitch.

Zebra Factor 5/10 Edit

Embolisms as a result of broken bones are fairly common. In fact, there was a similar case in the episode Love Hurts where it was dead tissue from a broken jaw rather than fat that was leading to arterial blockage. However, broken bones usually present with severe pain which wasn't present in this case due to the patient's exposure to extreme cold.

Trivia & Cultural ReferencesEdit

  • House calling the patients "Team Mcgyver" was a reference to the show McGyver, which is about a secret agent that solves most of his problems with everyday materials avaible. Similar how the patients were told to improvise some medical procedures.
  • The song House plays during Cate’s physical examination was Let’s Get It On by Marvin Gaye. In 1973, it reached #1 on the Billboard singles chart for two weeks.
  • The song playing when Cate's toe is put back in place is Civil Twilight- Human.
  • House's comment, "Just trying to move things along, Bob" is a possible reference to the actor, Robert Sean Leonard who plays James Wilson.
  • House giving his team a box of items they have to work with is a possible reference to the true story of Apollo 13, in which the ground team had to find a way to reverse engineer an oxygen filter using only components the crew had on board, and guiding them through the process of putting it together.

In Real LifeEdit

This episode was inspired by the story of Dr. Jerri Nielsen, a physician who diagnosed herself with breast cancer while on duty at the south pole in 1999. She confirmed the diagnosis by performing a biopsy on herself and using equipment dropped from the air. She treated herself with chemotherapy drugs that were also airlifted. She was finally rescued four months after the diagnosis. However, the cancer eventually returned and she died on June 23 2009, aged 57.

There is also the story about the Russian physician Leonid Rogozov, a member of Soviet south pole exploratory group in 1960s who diagnosed himself with appendicitis and performed the operation (appendectomy) on himself.


Previous episode:
It's a Wonderful Lie

Frozen
Next episode:
Don't Ever Change

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