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Games
-Games-Screencaps-house-md-11334834-852-478
Director(s)
Writer(s)
Airdate
November 27, 2007
Episode Number
4.09
TV.com Rating
8.8/10
Final Diagnosis
Zebra Factor
4/10
House: "I want you to feel guilty. [Amber] thinks the patient’s a loser. [Thirteen] thinks the patient’s a winner, just a regular guy with a regular problem. [Taub] thinks he’s going to be great once he’s all grow’d up and [Kutner] thinks, what did you think?"
Kutner: "Autoimmune."
―Games

Games is a fourth season episode of House which first aired on November 27, 2007. When Cuddy delivers an ultimatum that House must fire all but two of his remaining applicants, he starts searching for a mysterious case to work on. However, the only patient available is a burned out punk rocker who Foreman thinks is merely suffering from years of drug and alcohol abuse. When House tells the applicants the rocker is the final exam, they fall over each other trying to come up with new ideas while House asks for advice on who to keep. In the end, House finds the rocker does have a real illness, and the only way he could have found out was through the help of all four of his new hires. However, Cuddy remains unmoved and House has to finally pull the trigger.

RecapEdit

Some punk musicians are hanging around outside a gig when they get into an argument about one of their instruments. They break it up to go on stage. However, Jimmy Quidd starts coughing up blood and then collapses.

House is watching Prescription Passion when Cuddy comes in. She is bugging him about which fellows he is going to keep. She demands that he decide or the pay overruns will come out of House's salary and his parking space will be moved.

Realizing that Cuddy's not messing around, House goes to Cameron for the sickest patient she has. They come across the punk rocker, but Cameron thinks it's just drug and alcohol abuse. House takes him on as a patient and presents him to the remaining applicants. However, even Foreman thinks it's drugs and booze. However, the applicants pick up when House tells them this is the final test, the one that will decide the lucky three will be picked for his team and the last person who will get the axe. House orders tests, but Foreman quickly overrules him because he believes the tests will be invasive and dangerous. House agrees to one test at a time and starts rating the applicants on a point system. Kutner falls behind early, and Amber is given the first opportunity to test and treat.

Foreman challenges House about making the diagnosis a game. House tells Foreman he doesn't need him. House asks Wilson about Amber, but Wilson is worried about a diagnosis he screwed up - a biopsy was a false positive and the patient is actually fine. House doesn't care.

Thirteen asks Amber why she left the patient(a smoker) alone with an oxygen tank. Suddenly, there is an explosion - the patient was smoking near the tank.

Wilson tells his patient that he doesn't have cancer. The patient is confused. He's sold his house and will be out money he doesn't have for the commission. House is astounded by the patient's reaction too but, thinks the patient's reaction isn't about the money.

Amber drops in last place with 17/100. They are hiding from Foreman. Amber and Thirteen soon begin arguing about who gets to do the next test. House orders a nicotine patch and allows Amber to do an open-lung biopsy.

Chase and Foreman meet - Foreman notes that House is hiding from him. Foreman is following Taub in an attempt to stop the game. Chase notices Foreman has stopped wearing a lab coat. Taub and Amber are struggling with the patient when Foreman comes in and finds that the reason is the patient has put all of his nicotine patches on his left arm and doesn't want them to know. Taub notices that the patient has blood clots. Amber realizes her diagnosis was wrong.

If a clot reaches a vital organ, the patient will die. House has waylaid Taub to keep Foreman away. Thirteen is leading with 100 and thinks it is malaria. Amber thinks it is drugs, but she‘s trailing badly with minus 6. House passes the testing and treatment orb to Thirteen. House asks Amber to come into his office. While they're both in there, he asks her what she has against drug addicts. He also wonders if she is afraid to lose. She says that winners are happy. House notices the patient is happy, and this screws up Amber's world view. Amber gets tired of being psychoanalyzed and says all she wants to do is get the right answer and that will benefit the patient.

Thirteen and Taub argue about whether Taub should care about the patient. He won't say why he wants the job. They find the patient is missing.

Wilson finds House in his office listening to the patient's music. House wants to know why Wilson has a release and a checkbook - he thinks that Wilson is going to pay the patient's lost money even though Wilson did nothing remotely incorrect. Taub and Thirteen come in and admit they lost the patient. House talks to Thirteen about why she likes drug addicts. She says he's worth saving. After discussing it some more, Thirteen leaves, but House increases her score to 102 and first place.

Taub asks Thirteen why she wants the job since she likes patients and House couldn't care less. They find the patient in the pediatric ward entertaining the kids. However, he soon collapses. Thirteen checks his vital signs, which are still strong.

Cuddy finds House playing the piano and tells him to control his patient. House asks Cuddy if she has a preference for fellows. He admits that she makes good personnel decisions despite her shortcomings. She thinks Taub will stand up to House, and Kutner shares House's medical philosophy and would make a good match. Kutner and Thirteen come in and say the patient was negative for malaria, but they found blood fragments. House goes to see the patient. He finds the patient's band mates. He sees one with a needle mark and finds a hypodermic. He realizes they have been sharing needles, which explains the blood fragments. He orders all the tests redone. The patient collapses again with respiratory failure, but House realizes it can’t be from drugs.

House realizes the clots were drug related, but the coughing up blood and respiratory arrest weren‘t. Foreman finally catches up with them. The lumbar puncture was clear - Thirteen secretly did one as she thought it was bacterial meningitis. Kutner thinks it is an embolism. House gives Kutner the right to run tests, but Amber points out that Kutner knows it can't be an embolism, and only wants the chance to run several tests and come up with a guess like Thirteen did. House gives Amber points and asks Foreman to do the tests. Foreman doesn't want to encourage the game and walks away.

House goes to perform the tests on the patient. The patient says he only plays music for himself, but House asks why he plays on stage. He admits some people like the music, but most can't stand it. What he can't take is people who tell him he's wasting his life. House finds some curious masses near the patient’s heart. He realizes the patient doesn't care if he lives, but does care if people appreciate his music.

Wilson is apologizing to his patient about the lost broker fee and gives him a check. However, the patient is looking for more money because the diagnosis that he didn't have cancer has taken away the happiness he got knowing that he was going to die.

Kutner is now leading with 87 points. Taub thinks the echocardiogram is blurry because the patient is in withdrawal and is shaking. Kutner wants to give the patient a sedative to do it again, but House thinks that might be fatal. Taub wants to test to see if a blood vessel has wrapped around the patient's trachea. However, he keeps losing points because he can't suggest a way to test for it. House suggests exploratory surgery. They try to talk Chase into doing it. House asks Chase who he should hire. Taub tells Chase to do the surgery or if the patient dies, people will blame him. Chase prefers Taub and Amber, and agrees to the surgery. They find abnormally large lymph nodes, but the patient's vital signs go into distress during the surgery.

Kutner leads with 72, but House agrees to stop the game, but Foreman knows whoever gets the right answer will stay. He tells House to fire someone - it's the only way to end the game. House tries to fire Kutner and Thirteen, but they come up with more ideas. They think that the enlarged lymph nodes are due to impurities in street drugs. House admits they weren't fired. They think the patient might have heavy metal poisoning from tainted drugs and House orders treatment. He tells Foreman competition works.

The patient won't tell Amber who sells him drugs. He says he doesn't care if he dies. He says he never wanted to be an adult, or grow old. Amber is astounded that he has no regrets about the drugs, drinking and fighting, just everything else. Amber admits she hates the patient, but he says he doesn't care. She asks what it's like. He says it means having no regrets.

House continues to listen to the patient's music despite the fact he hates it. Wilson tells House about the cancer patient wanting more money and he thinks House may have told the patient to ask for more money so that he wouldn‘t take the $6,000 Wilson offered. House admits that he did it to keep Wilson in funds and teach him a lesson. They start arguing and Wilson finally blurts that House is like his patient - he's afraid to live. Kutner comes in and says that the treatment isn't working, but points out that despite his reputation, the patient works with orphans. House doesn't think it is medically relevant.

House "fires" Taub and Amber to get more ideas. When they don't play along, he fires the other two. Foreman still thinks it is drugs. House asks who will tell the patient he's dying. When no-one volunteers, he suggests a little kid do it, the patient gets along with little kids. Suddenly, House believes the fact the patient works with orphans might be medically relevant. He goes to Cuddy to ask for a brain biopsy. Cuddy refuses unless he can show neurological symptoms that would justify it. Cuddy wonders why he brought along the applicants. House says he wouldn't be where he is now unless he had all of them: Amber thinks the patient is a loser, Thirteen thinks he is a regular guy with problems, Taub thinks the patient will be fine once he matures, and Kutner thinks it is an autoimmune disease. However, they were all wrong and House realized why - the patient just has measles from the kids he is always hanging around. He's not having normal symptoms because the patient's immune system is shot from drug abuse. Cuddy is intrigued, but needs a neurological symptom. Amber has noticed that the patient keeps swallowing and thinks it might be a partial seizure. Cuddy tells them they can to the biopsy if they can induce a seizure. House tries playing the patient his own music, and it works. They schedule the biopsy and a meeting back in the lecture hall.

House comes in with the results. He start playing back a mellow vinyl record, recorded by the patient before he became a punk rocker. He tells Amber she played a good game, but for the wrong reasons. He tells her that results don't always count - to work for him she would have to be willing to lose. He fires her. He turns to Thirteen next and fires her too. He tells her he would keep her if he had three spots.

Amber goes to tell the patient he has measles and will live a long life. She tells the patient she got fired. She's with the patient trying not to care about it. He admits it isn't easy.

Cuddy comes in and tells House he screwed up and he can't have three male fellows. She told him to hire Taub and Kutner because she thought House would do the opposite. She tells him he can hire Thirteen too because unlike Amber, Thirteen actually cares about the patients. Suddenly, she realizes House planned it that way, so she would have to agree to let him hire three people.

Major Events Edit

  • It's revealed that two months have passed since House began searching for new applicants to become members of his diagnostic team.
  • When asked who they would pick for House's team, Cuddy suggests Taub and Kutner while Chase's choices are Taub and Amber. Cameron declines to give an opinion figuring House would fire her choices.
  • Wilson reveals that he has misdiagnosed a patient. Later House learns of Wilson's intentions to give his patient money to make up for the mistakes he made during the diagnosis process.
  • Amber Volakis is fired along with Thirteen.
  • Cuddy confronts House over his decision and soon learns that he was manipulating her all along.
  • Thirteen is hired again.
  • With the games over, Chris Taub, Lawrence Kutner and Thirteen are hired and as such, officially become House's new diagnostics team, replacing Robert Chase, Eric Foreman and Allison Cameron.

Zebra Factor 4/10Edit

Measles used to be very common but is getting increasingly rare due to widespread vaccination. It still infects a few thousand people a year, generally children who have not been vaccinated.

TriviaEdit

  • Punk Rock is a form of rock music that developed in the 1970s in the United States, England and Australia that stressed simple band setup, lyrics and chord progressions with very little in the way of production values. Elvis Costello and Talking Heads are two still active artists who developed their music during this period of time.
  • Titus Flavius Vespanianus was a Roman Emperor in the 1st century AD.
  • The reference to the viper head on a staff is a description of the Rod of Asclepius, a symbol of the medical profession that dates back to Ancient Greece.
  • One of the rare episodes when House puts on a lab coat, but Chase also notes that Foreman has stopped wearing his lab coat.
  • The scoreboard for the Game reads “Bitch Kutner 13 Taub”.
  • Perry Como was a popular singer in the 1950s and 1960’s whose easy listening music and relaxed style were often parodied by later artists.
  • House's remark that Cuddy's is "the face that launched a thousand long faces" is a refrence to Helen of Troy having "the face that launched a thousand ships" and started the Trojan War
  • Thelonious Monk was a jazz pianist and composer.
  • House mentions that the guitar song being played in the background during the final firing process to choose his team was composed by Jim Moskowitz, who later came to be known as Jimmy Quidd, the rock star patient they just diagnosed. In fact, it was Hugh Laurie himself who composed and played the entire song.
  • The final song played when House is talking to Cuddy is "Spirit in the Sky" by Norman Greenbaum. The track was cut and pasted so that the intro segued directly into the outro. It was later covered by a band called Doctor and the Medics, a trivial reference to House and his new team.

GoofsEdit

  • When House is playing loud music to Jimmy in order to induce a seizure, you can still hear him clearly when he asks Jimmy what his influences are. This is an example of a dramatic convention known as Acoustic License

CastEdit

LinksEdit


Previous episode:
You Don't Want to Know

Games
Next episode:
It's a Wonderful Lie

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