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House Divided
A House Divided
Director(s)
Airdate
April 27, 2009
Episode Number
5.22 (108)
TV.com Rating
8.8/10
Final Diagnosis
Zebra Factor
5/10
Wilson: "You’re okay with this?"
Foreman: "I paid fifty bucks for this!"
―House Divided

House Divided is a 5th season episode of House which first aired on April 27, 2009. House takes the case of a deaf teenager who starts hearing explosions. However, House is distracted by a visual manifestation of his own subconscious in the form of Amber Volakis, Wilson’s deceased girlfriend. He also has to make plans for Chase’s bachelor party which “Amber” is more than happy to make suggestions for. While House is looking for the patient’s problem, he decides to proceed with an unauthorized cochlear implant which enrages the patient but, House finds an unlikely ally in the patient’s mother. However, an unfortunate incident at Chase’s bachelor party makes House realize that “Amber” is acting in a malevolent manner, and as he tries to rid himself of the visions, his team is left alone to see if they can find out what is making the patient worse.


RecapEdit

Seth Miller, a 14-year-old wrestler, is going into the ring. His girlfriend and translator Laura encourages him. His mother, Ellie, is wearing a deaf pride shirt and cheering him from the sidelines. He takes on his opponent but clutches at his head when he suddenly "hears" loud explosions.

House is at home trying to sleep but his hallucination of Amber is keeping him awake. He insists she's brought on by insomnia, but she asks why he's hallucinating about her instead of someone else. She suggests it might be guilt over Kutner's suicide and her death. Before he can get back to sleep, he gets a page. Later, House staggers into the conference room and the team brings him up to speed on Seth's case - he has exploding head syndrome, showing his brain can hear but his ears don't work. Seth went deaf at age 4 due to meningitis, and the Amber hallucination wonders why he doesn't have cochlear implants. Seth was also the product of artificial insemination and has only one parent. House suspects a seizure and has them run tests, even though Amber, representing his subconscious, doesn't agree with him and talks about the limp leading the blind.

House goes to get a prescription for sleeping pills from Wilson, and finds him with Cameron. Wilson hastily closes the file they're reviewing and the Amber hallucination notices it. She also notices Wilson gave him the sleeping pill prescription without a lecture. House knocks over a cup and grabs the file, and discovers it contains flyers for bars. Cameron admits she asked Wilson to plan a bachelor party for Chase. House cheerfully volunteers to do it over Cameron's objections. The Amber hallucination asks if she gets to help.

Thirteen and Foreman do the seizure tests and Thirteen notes that it's admirable that Seth doesn't want cochlear implants as a matter of pride and culture. Foreman doesn't buy it, and also wonders why House didn‘t mock the patient about it. They're interrupted when Ellie informs them that Seth has gone blind in one eye.

House remembers Amber's early comment. The team suggests a variety of tests and House tells them to go ahead. He grabs his sleeping pills and goes into an exam room, then wonders how the Amber hallucination knew the patient would go blind. The hallucination explains how the stress of the seizure test would cause inflammation, causing the blindness. House realizes the hallucination can remember thing’s he’s consciously forgotten. The hallucination then suggests he play loud music to the patient. House takes a boom box to Seth's room and to his team’s annoyance and the patient's amusement puts it on Seth’s chest. Seth admits he can't feel the vibrations in his hands but can feel them in his abdomen, indicating neuropathy. House tosses the sleeping pills away, admitting to the hallucination that the case just got interesting.

Foreman wonders how House knew about the neuropathy, and Amber reminds him with bowling pins and House remembers that Seth was "pinned" in his last three matches, indicating he might be losing his sense of balance. Foreman suggests that it might be increased ICP from a brain tumor and Amber agrees. House backtracks and suggests slow acting NF2 cancer may have caused Seth's deafness. House tells Taub to run an MRI and then has Thirteen and Foreman check out a strip club for him. As Thirteen slips a stripper some money, Foreman wonders why House is so insistent on doing the bachelor party. Foreman suspects that House is trying to get Chase to cheat with another woman to break up his relationship with Cameron.

Taub explains that if it is NF2 cancer they can remove the tumor and restore Seth's hearing. Seth wants them to remove the tumor but leave him deaf. Seth doesn't want to lose his school and his girlfriend, but Laura and Ellie point out he has no choice. However, the tests show no cancer. House does notice a slight bowing of the fourth ventricle that might indicate a tumor. Thirteen and Foreman come back and House tells Thirteen she can’t come to Chase’s party. She gets back on the guest list by suggesting if she’s drunk enough, she would start coming on to the strippers. Taub doesn't agree and the only way to confirm is to drill into his brain for a biopsy, and House wants to proceed. House turns down one of the strippers because she suggested House invest with Bernie Madoff. However, Amber suggests they look at Seth's old x-rays from when he broke his nose and House suggests that course of action to his team.

Wilson is explaining to Chase how he and his third wife eloped to avoid House's bachelor party for him when House arrives with the old x-rays. As Wilson examines them, House suggests that a bachelor party is a test of Chase's commitment. Wilson confirms the bowing of the ventricle is new, which means they still need a brain biopsy to confirm. Wilson tells House he won't go to the bachelor party because he always gets embarrassed at them. House says it's okay and leaves, but Amber thinks it’s not okay that he’s going.

Chase performs the brain biopsy while House and Amber watch. Amber suggests they get the stripper from Wilson's party because she might bond with Chase - they both like cats. Chase wonders who House is talking to, and then tells House there's no sign of cancer in the biopsy. Amber goads House into telling Chase to put in a cochlear implant. Chase wants to wait for the paperwork but House points out putting in an implant wouldn't help him diagnose Seth, so he can't be lying.

Later, Chase checks the implant while Seth tries to deal with all the new noise. When Ellie goes to Cuddy to complain, House warns they can't remove it so soon after brain surgery. Amber points out that Ellie is taking the news calmly and House concludes that she wanted Seth to hear, but didn't have the guts to make the call herself and confronts her about it. She insists it be removed once Seth is stable. Once the mother leaves, House tells Cuddy that Seth is opting into a handicap and that's why he told Chase to put in the implant. Cuddy puts Foreman in charge of the case and House accepts it and leaves.

House begins to wonder to Amber why he did the implant. He puts a Bluetooth headset into his ear so it won’t look like he’s talking to himself when he talks to Amber. Back in differential, the team finds out that Seth is suffering from a fever. Meanwhile, Amber tries different candy in an attempt to get House to remember the name of Wilson's stripper. They wonder if Laura gave Seth Epstein-Barr and Foreman orders tests. House goes to see Wilson, who feels that House ordered the implant because he was trying to be nice. Amber doesn't believe that Wilson is saying. When Wilson insists he isn't going to the bachelor party, House just says he has no control over Wilson and leaves.

Seth argues with Ellie about removing the implant, but reconsiders once he hears her say his name. Taub comes in to run the test for Epstein-Barr and Seth urinates uncontrollably onto the bed.

The patient is dehydrated, but stable. The next morning, House has everyone try alcohol-infused ice cream samples for the bachelor party. Taub suggest sarcoidosis but Foreman notes the symptoms came on too fast. Amber reminds House of a med school case about a wrestler with damaged kidneys brought on by steroids. The team's voices start to fade out as Amber notes that the kidneys failed when the patient was laying down, at night. House tells the team it's Seth's heart and orders tests to confirm.

In his office, Amber explains that House's attention is fading because he's getting better at ignoring everything that doesn't matter. Chase comes in and tells House to kidnap him for the bachelor party. As House tosses Chase some alcohol ice cream, he finally remembers the stripper's name was Karamel.

Laura talks to Seth and says how great it is that he can hear, and wishes she could have one. Seth insists nobody needs one, but Laura says it will open up a new world for him. Seth doesn't agree. Laura asks where the bathroom is, and Seth notices how she sounds for the first time. Thirteen says it'll take time for voices to sound better.

House is guzzling energy drinks when Taub and Foreman tell him that all the tests show Seth's heart is fine. Amber insists it isn't, and that the arrhythmia is hiding. House suggests they put Seth on a treadmill, but Foreman refuses because of the possibility of bleeding of the brain. Foreman has Taub and Thirteen run a thyroid panel. Once they're gone, House tries to figure out how to run the stress test on Seth. Amber suggests asthma meds to make the heart beat faster, revealing the arrhythmia. However, as House prepares the shot, Seth screams in pain after he deliberately rips out the implants. The stress of the pain reveals that he does have an arrhythmia.

House takes over again as they try to figure out what would account for the arrhythmia. Amber holds up a lit lighter when Foreman suggests a VQ scan for embolisms and House agrees to the test. House goes to the morgue to practice his alcohol lighting routine. He sets a corpse on fire by accident. Amber suggests that all of the symptoms have one thing in common: heat. House calls Foreman and tells him he has Uhthoff’s phenomenon, indicating MS. He orders interferon.

As Foreman, Cameron, and Chase leave, two immigration officers arrive to arrest Chase because his work permit has expired. Cameron quickly realizes what's going on and tells Foreman to keep Chase out of trouble.

The bachelor party goes off, with House's flaming drinks and strippers. Wilson comes home to discover that House is using his apartment for the party. Karamel the stripper comes over to tell Wilson she remembers him and asks how his wife is doing as she hugs him. Wilson and Thirteen are soon taking shots off of Karamel. House is drinking in the tub and Amber joins him. She points out that he works better alone and congratulates him on the diagnosis. In the main room, Foreman and Taub get Chase to take a shot off of Karamel. He tastes strawberries and goes into anaphylactic shock. Foreman calls out to House that a resident had an Epipen to stabilize him, and the others are planning on taking him to the hospital. House realizes that he knew Chase was allergic to strawberries. He also knew Karamel used strawberry body butter. He wonders if Amber was trying to kill Chase, which means he was trying to kill Chase. Amber points out he's not a big fan of other people's happiness. He's interrupted when the hospital staff call to tell him that Seth is dying of lung failure, meaning that MS isn't the problem.

As the team arrives at the hospital with Chase (who is staring to recover), Cuddy hands them Seth‘s file and realizes they have all been drinking. House goes to his apartment to get some sleep. House believes that Amber is dangerous, but answers the phone. It's Cuddy, who wants House to help treat Seth. She’s hooked up House’s entire team to intravenous lines to try to sober them up. Amber suggests eosinophilic pneumonitis but House dismisses it out loud, and then says he's going to bed and hangs up. Foreman wonders if it makes sense, but Thirteen notes that House ruled it out because it would make the patient's larynx hoarse, but they wouldn't notice that in a deaf person who rarely speaks. Before they go to see the patient, Cuddy hands out breath mints.

Foreman and Thirteen go to Seth and remove the breathing tube. His larynx is clean, but as Foreman goes to suction out the throat, notices tobacco stains on Seth’s teeth. Seth admits he used chewing tobacco to cut weight for wrestling. Foreman realizes that Taub was right: it's sarcoidosis. The chewing tobacco's toxins held his immune system at bay until he stopped using it. Once he did, the sarcoidosis, which had been lying dormant, asserted itself quickly, fooling them into thinking it was fast-progressing condition. They order treatment so Seth will recover.

House goes to see Cuddy to get sleeping pills because he can‘t find Wilson. She notes that the police arrested Wilson when he was discovered wandering the streets drunk, and not wearing pants. Cuddy gives House the pills, tells him his team solved the case, and asks for an explanation. House admits he hasn't gotten a full night's sleep since Kutner killed himself, and then leaves.

Ellie tells Seth she's going to have the doctors repair the implant. When Seth refuses, Ellie insists she's his mother and it's her call.

House wakes up after a good night's sleep. He figures he's over his insomnia, goes to the bathroom to wash up… and discovers that he's still hallucinating Amber.

Major Events Edit

  • It is revealed that Amber is in fact part of House's subconscious triggered by lack of sleep and his own guilt over Kutner's death and her death as well.
  • House plans Chase's bachelor party.
  • Chase is revealed to be allergic to strawberries.
  • House takes a sleeping pill to cure his insomnia but learns the next morning that he's still seeing Amber.

Zebra Factor 5/10Edit

Sarcoidosis affects about one in ten thousand people. Although it usually has it’s onset between the ages of 20 and 29, it usually affects people under the age of 40 and less often thereafter. The team is right that the incidence of the disease is lower in people who smoke or use tobacco.

Trivia and Cultural References Edit

  • The title for this episode comes from a line from Abraham Lincoln's House Divided Speech. It also refers to House's current state of mind.
  • More about Deaf Culture.
  • Laura is seen waving her hands in the stands. As deaf people can’t hear applause, they prefer it when the audience waves their hands in this manner as it is easier to see in a crowd.
  • The song on the boom box was Fight the Power, a 1989 song by Public Enemy that was released as part of soundtrack of Do The Right Thing. It reached #1 on the Hot Rap Singles chart.
  • Bernie Madoff was the architect of the largest investment fraud in history, resulting in losses to investors of about $18 billion.
  • Caligula was a 1979 film about the Roman emperor of the same name. It is notable for mixing first class actors in a film with explicit sex scenes, but it is widely regarded as being one of the worst films ever made. Among the actors who appeared in it were Malcolm McDowell, John Gielguid, Peter O’Toole and Helen Mirren.
  • Evita is a musical about the life of Eva Perón written by Andrew Lloyd Webber and Tim Rice.
  • Waltzing Matilda is a famous Australian folk song.
  • The NAACP is a civil rights organization that works for political equality of all races, but is generally associated with African-American rights.
  • Holding up a lit lighter is a common way to express a “tribute” during a rock concert.
  • Sambuca is an Italian liqueur flavoured with anise seed. It is commonly served by setting it on fire for a few seconds to bring out its flavor.
  • "By the power of Greyskull" is a line from a 1980s cartoon, "He-Man and the Masters of the Universe", which promoted a line of toys from Mattel. Prince Adam would say these words while holding his sword above him to turn into He-Man.

CastEdit

Confusing Edit

In Adverse Events, Chase says he won’t let Cameron have a cat because it will get hairballs.  Chase also denies owning a cat in You Must Remember This.  Hoewever in this episode, it’s suggested Chase owns a cat himself.

GoofsEdit

There is a time gap between when a cochlear implant is implanted and when it is activated. As such, Seth would not have had any cochlear hearing immediately following the surgery.

The listed dosage for Zolpidem in the episode is 200 mg, which is 20 times the normal prescribed dose.

End Credits MessageEdit

Male Announcer: This is the hour that will stop the clock. 24 is next.


Previous episode:
Saviors

House Divided
Next episode:
Under My Skin

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