Irene is a one-time character on House, that appeared only in the episode Guardian Angels, the fourth episode of the fourth season. She is a Ukranian funeral home cosmetologist suffering from vivid hallucinations and Delusions.
She was portrayed by actress Azura Skye.
Irene was brought to Princeton-Plainsboro Teaching Hospital when her co-worker Martin at the funeral home found her collapsed on the floor near her work area having a seizure. Emergency room attending Dr. Cameron referred the case to Dr. House who brought the case to his remaining fellowship applicants. Mr. Dobson presented the charts to his colleagues. The patient had suffered a grand mal seizure and had a hallucination that she was being raped by one of the dead bodies. The seizure ruled out mental illness, and she had no history of epilepsy, head trauma or drug use. Dr. Volakis thought it might be a tumor on the temporal lobe, but the CT scan was normal. Dr. Volakis countered that the ER doctors might have missed it because they weren't looking for it. Dr. Taub noted that funeral homes are full of toxins, and Mr. Dobson noted that she might have gotten something from one of the cadavers, like a parasite or an STD. Dr. House ordered Dr. Cole, Mr. Dobson and Mr. Kutner to do an environmental scan. He ordered the other applicants to do an MRI with contrast, an EEG, a lumbar puncture and a blood panel.
Irene was a little concerned about the confined area of the MRI, but Dr. Taub told her she would feel more relaxed once the Valium they gave her took effect.
The environmental scan was clean. The cadavers had no communicable diseases, and her food was all organic. Dr. Cole suggested it might be the embalming fluid, but Dr. House pointed out that the emergency room had ruled that out already. Mr. Dobson had reviewed the funeral homes record and found a 48-year old male who supposedly died of pneumonia, but the symptoms and autopsy report didn't fit. The memory loss and depression suggested mad cow disease. Dr. Cole pointed out that Irene is a vegetarian, but Mr. Dobson pointed out that she may have come in contact with his brain tissue, which can also spread the disease. Dr. Brennan opposed doing a brain biopsy on the patient, but instead Dr. House instructed the applicants to get a sample from the brain of the deceased 48-year old.
The applicants exhumed the body, but it was negative for mad cow disease. Dr. House started a new differential and the applicants restarted the tests. Irene was frustrated and wanted to be discharged as she was feeling much better. She promised to return if the symptoms came back. All of a sudden, the patient stated that someone in the room could drive her home and Dr. Hadley asked her who was going to drive her home. The patient said her mother would and pointed to an empty chair across the room. They realized the patient was still hallucinating.
Dr. House admonished the applications for not noticing the hallucinations earlier. He dismissed Dr. Taub's explanation that the patient had never mentioned it. Mr. Dobson noted that this was a new symptom - not knowing her mother was dead was a delusion, not a hallucination. Dr. Taub suggested carbon monoxide poisoning, but Mr. Dobson noted there was no headache or tachycardia. Dr. Hadley thought it might be a geneticdisorder - the patient's mother had died when she was about the same age. Dr. House instructed them to test for genetic diseases that fit the symptoms. Dr. Taub pointed out there had to be dozens, but Dr. House told him to start with amyloidosis and keep going until they got to zamyloidosis.
Dr. Volakis told the patient they could narrow down the diagnosis if they found out what her mother died of, but the patient denied her mother was dead. When Dr. Volakis asked why they would lie, the patient rationalized that they were just being mean and incompetent.
The initial tests were all negative. Dr. House also dismissed reports that the patient has a hallucination of Thomas Stark, the patient Dr. Hadley mishandled, thinking it had to be something the patient overheard. He told the applicants to keep testing her. Mr. Dobson suggested something else - ask the patient's mother how she died. Dr. House was intrigued and went to see the patient. He asked to speak to her mother. The patient said she saw an older man who looked like Dr. House standing behind him. Dr. House played along and said it was his grandfather. The patient called the grandfather "Walter" and Dr. House looked shocked and left the room. However, the patient got it wrong and he was just trying to build a rapport with the patient. He came in later, suitably spooked, and asked to speak to her mother again. He asked if the mother was sick when Irene was 4 or 5 years old. She said the mother wasn't in pain, but was tired a lot, sometimes staying in bed all day. The mother also fell down from time to time, including once when she fell against the bathroom sink and bled over the floor. She also remember that she would walk bent over, and that her hands would shiver sometimes when she was cold. Dr. House instructed his team to start her on L-Dopa and bromocriptine for Parkinson's disease.
However, the patient a nightmare - that Dr. Kutner and Dr. Hadley were holding her down and poking her with a large needle. When she woke up, she complained her arm was bleeding, and when Dr. Hadley looked down she saw several small bleeding lesions on Irene's right arm.
Dr. Volakis noted the lesions ruled out Parkinson's. Mr. Dobson suggested vasculitis, but Dr. Taub noted the MRI showed no cerebral ischemia. Mr. Dobson noted that she did have focal weakness and urinary retention. Dr. Taub noted that vasulitis wouldn't explain the hallucinations. Mr. Dobson countered that vasulitis in the retina could. Dr. Taub insisted the hallucinations had to indicate a neurological problem, not a vasular one. However, Mr. Dobson countered that if the nerves didn't receive blood, they would malfunction. Dr. Taub thought porphyria was a better diagnosis, but Mr. Dobson pointed out that if they treated her for it and they were wrong, she would suffer Kidney failure. Mr. Dobson pointed out that the treatment for vasculitis, steroids was less likely to have negative side effects. Dr. House agreed, ordered steroids, and told them to test for both vasculitis and porphyria.
Dr. Hadley and Dr. Volakis tested the conduction of electrical signals from the retina to the brain with special lenses. All of a sudden the patient complained of abominal pain and vomited blood. Dr. Hadly attempted to perform an aspiration, but the patient complained that it hurt too much.
Irene was rushed into surgery, where Dr. Chase started tracking down and stopping the bleeding, assisted by Dr. Cole. The bleeding was traced to the liver, which had deteriorated from the inside, and her spleen was enlarged.
Dr. Taub insisted that the liver failure and enlarged spleen pointed to porphyria. However, Mr. Dobson pointed out the porphyria test was negative. Dr. Taub countered that a negative test is only conclusive if it is taken during an attack. Dr. House admonished both of them for being so concerned about which one of them was right and forgetting about the patient. Although the steroids had no effect, Mr. Dobson still felt something was cutting off blood flow, only now it was to the liver and spleen. Dr. House wanted to do an angiogram.
Dr. Cole started the procedure and tried to comfort the patient by praying to her (he saw a cross on a necklace), but the patient interrupted it by reached for his crotch and became agitated. She was having convulsions, was in a delerium and was hypersalivating. She had to be sedated with Lorazepam. Her reaction seemed to rule out any vascular problem.
Dr. House was leaning particularly hard on Dr. Cole, noting that religion had treated other medical problems like epilepsy and magic mushrooms like witchcraft. All of a sudden, Dr. Volakis realized there were other medical problems that was treated like witchcraft - jimson weed, belladonna, mandrake root and ergot poisoning. The symptoms fit ergot poisoning and she could have been exposed to the ergot fungus by eating organic rye bread. It also explained why she got worse on bromocryptine - it's derived from ergot as well. The patient had also kept asking for milk, which counteracts the effect of the fungus. Ergot also constricts blood vessels, which explained the liver necrosis.
They started treating the patient and told her the effect was like LSD, which is also extracted from ergot. The patient realized her mother wasn't there and they told her that was a sign of improvement.