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Out of the Chute

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Out of the Chute
House-7x16-Out-Of-The-Chute-Promotional-Photos-house-md-19770340-434-653
Director(s)
Airdate
March 14, 2011
Episode Number
7.16
TV.com Rating
8.8/10
Guest Star(s)
Final Diagnosis
Zebra Factor
2/10
House: "Really? No reason? None at all? I was planning on cracking open his chest, blowing up his heart what, to pad his bill? Or you think that since you broke my heart I want to break his."
Cuddy: "I don’t know. I think maybe you‘re looking for something that can excite you. Fill a void. And, it‘s affecting your judgment"
House: "You’re right. I am. But my damaged, depressed drug-addled judgment is still better than yours or any other doctor in this hospital. Now, my team is going to do this procedure and save his life, so you can either have security arrest me and my team, or you can get the hell out of my way….And...she caves."
— Out of the Chute

Out of the Chute is a 7th season episode of House which first aired on March 14, 2011. It is directed by Sanford Bookstaver and written by Lawrence Kaplow and Thomas L. Moran.

Huddy may be over, but nothing gets in the way of Hilson. House has to deal with both his breakup with Cuddy and his return to his Vicodin habit, both of which quickly become known to his team. He deals with his problem by checking into a hotel and ordering a steady stream of booze, Vicodin and prostitutes. Wilson tries to pick up the pieces and once again suggests they start living together. The team is left alone to treat the victim of a rodeo accident who also has an underlying neurological problem. Foreman once again tries to assert his authority over the other fellows, only to see Chase once again push back. Masters has to come to terms with both her astonishment that House is openly allowed to use narcotics while working at the hospital and her sexual attraction to the patient.

RecapEdit

A rodeo bull rider gets ready for his ride. The ride is going well for him as he thinks he way through it. The buzzer goes showing a successful ride and after being thrown from the bull he jumps up in triumph. However, the bull is still loose and has evaded the rodeo clowns and manages to knock him to the ground and trample him. The clowns manage to get the bull under control. The bull rider is conscious but dazed, but the clowns wonder how he let himself be hurt like that.

House is telling Wilson he’s fine, but he admits he’s back on Vicodin. However, House has emptied his bank account and checked into an expensive hotel. House says his pain has gotten worse. House grabs a large bill and welcomes in room service. House jokes about killing Wilson and the bellhop says he will cancel maid service for the room that morning.

House and Wilson enjoy a massage and they discuss how far the bellhop will go. House says he has already arranged a prostitute.

The bull rider has been patched back together, but is still sick. He’s got metal plates everywhere from ten years of serious injuries, ruling out an MRI and making X-rays nearly useless. Taub figures House has bailed on them because Cuddy has told them that she broke up with him. Foreman says they can work without House, and Chase accused him of using any opportunity to seize control of the team. Masters wants to know why they mentioned Vicodin along with booze and hookers, and Foreman breaks the news that House is a Vicodin addict (although he had been clean for nearly two years), and he used Vicodin at work. Foreman returns to the case and points out several symptoms can be explained by the trauma, but some can’t. Masters thinks the hearing loss may just be the symptom of an inner ear problem and suggests testing the patient’s balance. Foreman agrees and orders the test.

Wilson confronts Cuddy about breaking up with House for using Vicodin. She says she’s thought about it and she hasn’t changed her mind. Wilson reminds her House thought she was going to die and that he deserves another chance. Cuddy agrees that House needs another chance, but it isn’t about that - House never steps up when he gets the chance. Wilson breaks the news that House is back using Vicodin.

The balance test is fine and they reach House in the hotel with a woman. House agrees that it’s probably the inner ear, but he reminds them that a world champion bull rider has excellent balance and needs a more challenging test. As he hangs up, he tells Cuddy not to spy on him. We see her in the room with the team.

They step up the balance test and Masters is correcting the patient’s English. They make the patient balance blindfolded on one foot. Once again he aces it and Masters compliments him on how well he’s doing. Foreman figures the problem is in the brain. The patient complains about the water being brown and Foreman realizes it’s not the water, it’s blood leaking from the patient’s mouth.

House is in bed with another woman when the team calls him. He realizes the team is fighting over who’s in charge. House tells them no one is in charge as long as they have phone contact and orders a scope of the digestive tract and a biopsy of the salivary glands. Masters asks House if he is on Vicodin and he denies it.

Masters is worried about House’s Vicodin use, but Taub says that they should not worry unless he orders something crazy. Taub asks Masters why she’s attracted to the patient, but she suddenly spots that the patient is showing signs of jaundice.

The X-ray shows a mass on the liver, but a metal rod is blocking their view. House is with another prostitute who plays the hurdy-gurdy. House tells them to perform exploratory surgery.

Chase does the surgery with Taub and Masters assisting, but they can’t find the mass they saw on the X-rays. They go to House’s hotel room, where he is entertaining another prostitute. The team rules out House’s suggestions until he comes up with a swollen lymph node, which would fit. A lumbar puncture is too dangerous so Chase suggests a ventricular puncture and House agrees.

The patient wonders why they want to drill into his skull. Masters asks if he has family nearby, then places her hand on his pillow. They start the procedure and Masters admits to Taub she’s attracted to the patient, but can’t figure out why. However, the patient’s oxygen stats start to plummet. Taub tries intubation unsuccessfully, and they realize they have to do a tracheotomy. It’s successful and the patient is stabilized. One of the nurses smells something and Masters thinks the patient may have lost control of his bowels, but they don’t see anything. However, on closer inspection, the smell is coming from the patient’s feet.

House is playing William Tell with another hooker, but the bellhop is trying to intervene. His team calls and House points out that smelly feet point to diabetes mellitus, athlete's foot or gangrene, but none of those explain the other problems. They finally decide that a fungal infection is causing the problem and they decide to MRI the patient’s heart despite the pain the rod in his chest will cause. House shoots the arrow at the hooker and appears to hit her in the abdomen. The bellhop freaks out, but the arrow and blood are fake and the hooker starts laughing. Wilson shows up.

Taub and Masters explain the risk of the procedure and tell him they are injecting ice water into his abdomen to lessen the heat the metal will give off. Masters stumbles over her words with the patient and she admits to Taub that she finds the patient attractive and because he’s likely to have strong children, her prefrontal cortex is telling her to have sex with him. However, she realizes the patient is an idiot.

Wilson takes House down to the bar and asks him why he’s acting so stupid. He asks House if he wants to move back in with him. House doesn’t want to talk about it, but Wilson insists. House just walks off.

The patient is suffering through the MRI as the temperature of his chest keeps rising. He starts smoking. Masters wants to shut off the machine, but Taub won’t let her. As the test ends, Masters rushes to him to place an ice pack on him. Taub reports that the images show no abnormalities.

Wilson goes to see Cuddy again and tells her she will have to talk to House. Cuddy says she loves House and she knows he loves her. However, she doesn’t think she can fix his problem, because she’s his problem.

The team meets House by the pool, and he’s with a new hooker. He tells them the infection must be in the brain. They can’t do a CT Scan because of the plates in his skull, so House suggests removing them. Taub says that’s impossible, he has multiple hairline fractures. House wonders if the patient is slow answering questions, and Masters says he’s right. House thinks the patient is suffering from something like a partial complex seizure, but Chase says the EEG is normal. House proposes another test.

They ask the patient to sing. They say if he can’t sing normally, he’s having mini-blackouts and they will have to open his skull. House sets a metronome. The patient starts singing normally, but he pauses between some of the lines. However, he thinks he’s singing fine. Masters tells House how brilliant he is, but House just shrugs it off.

House and Wilson are back at the hotel. Wilson thinks House is worried because nothing seems to excite him. He tells House the feeling will pass. Another prostitute comes out with House’s phone. Foreman tells House the patient’s brain was clean too. House realizes they will have to stress the patient’s heart.

House returns to the hospital, and Foreman tells him that further tests on the heart would be pointless - all the tests are normal. House says they have to stress the aorta until it bursts. They can repair it after it does. If it bursts from the infection they think he has, he will bleed to death. Chase thinks it’s too dangerous, but House goes to get the patient’s consent.

House tells the patient he might have an aneurysm in his aorta and they have to increase the pressure to break it open. The patient has no questions. House wants to know why the patient isn’t concerned that he may never be able to ride bulls again. The patient admits he loves bull riding, but he says he can always find something else to love. Cuddy comes in to talk to House.

Cuddy tells House he can’t try to blow up the patient’s aorta because he has no reason to think the test will save the patient’s life. She claims House is just trying to fill a void and the break-up is affecting his judgment. House admits his judgement probably is compromised, but he says he’s still the best doctor in the hospital despite that. He tells her to arrest him or get out of his way. She does nothing and House walks away in triumph.

They open the patient’s chest and start upping the pressure on his heart. Masters admits she squealed to Cuddy because she thought his judgment was compromised. House tells his team to pick up the pace. They start the procedure and the aorta starts leaking. Masters admits she was wrong to doubt House. However, the procedure starts to go badly, with blood spurting everywhere. Chase manages to stop it and the patient is stabilized. The procedure has worked.

The patient is taken to recover in intensive care as Masters looks over him. He finally wakes up. Masters warns him to keep his heart rate down for a while. Masters asks him for a date, but when the patient hesitates, she realizes she acted inappropriately and apologizes.

House goes back to the hotel bar and sees some of the younger patrons celebrating a sports team win. The bartender says he wishes he were young enough to act like that. House finishes his scotch. He goes back to his room and starts rubbing his leg. He reaches for his Vicodin and takes some. Wilson comes to the bar looking for him. House goes to his balcony and climbs on the railing. Wilson is outside the bar and sees House on the railing with other people looking at him as well. House jumps off into the hotel pool while Wilson looks on. House rises to the surface smiling as the onlookers jump into the pool with him. Wilson asks House what he’s doing, but House ignores him and grabs a beer from one of the partiers. Wilson walks away.

Major EventsEdit

  • House goes on a binge of hookers, booze and Vicodin in response to his break-up.
  • Masters develops a crush on the patient and asks him for a date before immediately regretting doing so.
  • House jumps from a hotel balcony into the pool to prove to himself he can still have fun.

Zebra Factor 2/10Edit

Bartonella is not a rare infection. However, it usually is opportunistic, entering through an existing break in the skin. Illegal intravenous drug users are at particularly high risk. In addition, this presentation was rather unusual, although the infection can cause a large number of symptoms.

Trivia & Cultural FactorsEdit

  • Rodeo is a competitive sport involving the handling of dangerous animals. It was first developed in Spain, spread to Mexico, and then into the rest of the Americas and Australia.
  • The Hurdy gurdy is a stringed instrument where a rosin-covered wheel driven by a crank rubs against the strings. Different notes are played by pressing keys which press wedges against the strings.
  • Free Bird was a hit song for Lynyrd Skynyrd in 1974. It has since been extensively covered. The full version lasts 14 minutes.
  • House asks the bellhop to bring him General Patton's Colt .45, "the one with the two notches." He is referring to a famous incident which occurred during the Punitive Expedition of 1916 in which Patton personally killed two of Pancho Villa's lieutenants using his silver-plated Peacemaker. He had them strapped to his command car's fenders in a manner similar to the one used to show off trophy deer. Both the .45 and the Smith & Wesson .357 Patton occasionally wore are currently on display at the Patton Museum in Fort Knox, Kentucky, making Carnell's acquisition of it problematic at best.
  • My Bonnie Lies over the Ocean is a Scottish folk song. It was famously covered by Tony Sheridan in 1961 working with Paul McCartney, John Lennon, George Harrison and Pete Best.
  • In the scene were House tries to shoot a hooker with a bow, a famous musical piece can be heard : "In the hall of the mountain king", from Edvard Grieg's incidental music for Ibsen's play, Peer Gynt (1876) .
  • House addressing his team by the pool with the sentence "You're in my sun"  probably alludes to the similar one allegedly aimed by the cynic philosopher Diogenes of Sinope (5th-4th century BC) at Alexander the Great.
  • Wilson's trick of breaking into House's thoughts on the balcony mirrors Sherlock Holmes's predilection for doing the same to Dr. Watson, as in "The Adventure of the Cardboard Box," when Holmes famously follows Watson's thoughts to their logical conclusion, that the American Civil War was a silly waste of time.

Cast Edit

VideoEdit

1 Chute01:00

1 Chute

Differential






2 Chute00:34

2 Chute

Reason v. Evolution








Preview00:46

Preview

A good friend


Previous episode:
Bombshells

Out of the Chute
Next episode:
Fall From Grace

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