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Post Mortem

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Post Mortem
H4
Director(s)
Airdate
May 7, 2012
Episode Number
8.19
TV.com Rating
9.2/10
Guest Star(s)
Final Diagnosis
Hypothyroidism induced by combination of triclosan and caffeine.
Zebra Factor
10/10
Wilson: "I want a threesome."
House: "Shouldn't we try a twosome first?"
— Post Mortem


Post Mortem is an 8th season episode of House which first aired on May 7, 2012. In an episode directed by and guest-starring Peter Weller (Dexter, RoboCop), the team takes on the case of Dr. Peter Treiber (guest star Jamie Elman), a pathologist at Princeton-Plainsboro Teaching Hospital who knows too much about the hospital staff to trust any of the physicians. The only person he does respect is House. Wilson has decided not to wait around Princeton-Plainsboro for his test results. He buys a new car and convinces House, by threatening to drug him and take him along anyway, to go on an unannounced road trip with him. Leaving their phones behind, this results in House's "mysterious" disappearance. House decides to take advantage of Wilson's condition to get some sympathy from the people they meet. With House in absentia, the team has to figure out how to treat Treiber while making him believe that House is calling all the shots. It becomes even more difficult when it turns out that the patient has a grudge against Chase, and this just forces Chase to confront his own choices in life.

RecapEdit

A doctor unsuccessfully attempts to defibrillate a young woman. He realizes it is hopeless and calls time of death. Orderlies prepare to take the body to the morgue. A young pathologist starts the autopsy and quickly figures out the attending physician misdiagnosed the young woman. He notes that it’s the third time in the past year he’s asked the hospital to look into the competence of this particular doctor. He goes to make an incision to examine the young woman’s brain, but instead takes the scalpel and inexplicably performs the incision on his own head. Luckily, an orderly comes in looking for him and finds him bleeding profusely and complaining he is cold.

House arrives at work on his motorcycle and watches a brand new, poorly driven Corvette pull into a handicapped parking spot. House sees Wilson is driving it. Wilson gets out and says to House that he knows what he’s going to say and admits both that he can’t drive a stick shift and that he doesn’t care he’s in a handicapped space. He says he’s ready to be indifferent, selfish and shallow. He then shows he can’t figure out how to use the locking mechanism on the key chain either. House mentions that Wilson’s check-up for his thymoma is in three days and he hopes he’s not just killing time. Wilson then announces he’s driving to Cleveland to see his boyhood crush - the actress Julie Christie. House thinks he’s going to back down, but Wilson makes his point by deliberately closing the elevator door on someone running towards it.

Foreman presents the case of the self-cutting pathologist to House. House thinks it is a form of mental illness and passes. However, Foreman notes the patient has no history of mental illness and all the obvious diagnoses have been ruled out. He then tells House the patient won’t let any other doctor get close to him. House agrees to take on the case. Park asks about Wilson and although it’s clear the team is concerned, House’s attitude is that there is nothing they can do until the results come back in three days. They start a differential, and House soon finds out that the patient harbors a deep dislike of Chase. Taub notes the patient hates all the doctors in the hospital and most of the doctors dislike the patient as well. However, Park notes that the patient only hates doctors who screw up and the other doctors don’t like the patient because he points out their mistakes. Taub argues that it’s a lot easier to come to the right diagnosis during autopsy than with a living patient. They finally decide that it might be a toxin from an interaction from the dead woman’s medication or a clotting problem. House orders the necessary tests.

The patient is aware that House rarely sees patients, but figured he would make an exception for another doctor. Chase and Adams reassure him that they are just following House’s orders. The patient has memorized House’s error rate, and it’s half the average of the rest of the hospital. The ultrasound shows no clots.

Park and Taub are in the morgue in isolation suits. Park is impressed that the patient has coded every physician’s competence, but Taub merely finds it unsettling. The test for toxins in the dead woman’s blood is negative. Park decides to look for other sources of toxic exposure because she’s noticed the patient uses his own instruments and might have brought in his own supplies. However, all they find is large amounts of energy drinks.

1 Post Mortem(00:53)
Road trip!
SteveHFisyhAdded by SteveHFisyh

Wilson comes in to invite House to go with him. House tries to beg off, but Wilson threatens to drug him and take him along anyway. He tells House they’re leaving at eight the next morning. The team comes in to report the huge amounts of caffeine the patient has been ingesting, and House thinks it’s probably stimulant psychosis. The patient just needs fluids and 24 hours of observation. House tells Chase he can pretend he came up with the idea.

However, the patient is soon complaining of abdominal pain. Park tries to convince him that it’s just withdrawal, but the patient shows his abdomen is distended.

Chase realizes they were wrong about stimulant psychosis. Park notes that her examination showed no masses and no bowel sounds. Taub comes in and asks about House, but the team notes he hasn’t come in yet and they can’t reach him on the phone. They soon run out of ideas and try to reach House again. They hear House’s phone ringing and trace it to its source - Wilson’s office. It’s inside a desk with Wilson’s phone.

Wilson is driving House down the highway and is refusing to let House either plan the itinerary or drive the car. House thinks Wilson wants to talk about his cancer, but Wilson says he doesn’t want to talk about it. Wilson says he doesn’t want to be himself and he now wants to go by the name Kyle Calloway, because Kyle is roguish, carefree and has nothing in common with James Wilson. He can also drive a stick shift.

The team realizes the patient won’t let him go near him, but they continue the differential. Chase thinks the lack of bowel sounds points to an intussuception and cancer. Chase wants to do an x-ray and notes that as long as the patient thinks House ordered the test, he will allow it.

2 - Post Mortem(00:53)
What is "The Big One"?
SteveHFisyhAdded by SteveHFisyh

House and Wilson stop at a roadside restaurant. Wilson orders an 80 ounce steak that’s free if he finishes it within an hour. The rest of the restaurant patrons get interested.

The patient’s x-ray is normal. The patient believes House is convinced there is an intussuception and wants exploratory surgery to examine his bowel. Taub and Chase try to talk him out of it, but the patient refuses any other treatment until they find the intussuception. Chase finally agrees, and the patient insists Chase do the surgery because the statistics show he’s the best.

With 26 seconds left, Wilson only has a few bites to go. He finishes the steak just in time and House and the rest of the restaurant patrons go wild. Wilson then vomits. House asks if it still counts.

3 - Post Mortem(00:50)
Wasted opportunities
SteveHFisyhAdded by SteveHFisyh

They take the patient to the operating room. The patient asks Chase if he has any hard feelings about him. Chase asks why the patient treats him like an idiot. The patient admits Chase is talented, but is upset Chase has wasted his talents. The patient says he applied for the fellowship position with House that Chase received. The patient figures if he had got the fellowship, he would be a lot farther ahead than he is now, but Chase hasn’t done anything with the opportunity he was denied.

Wilson and House wash up. Wilson says it felt good to be a hero, even for a group of people he will never see again. He then goes back to have dessert.

Chase operates on the patient. He asks Taub what he will do when he leaves House. Taub says he will work for House as long as he lets him. Chase notes that when House went to prison, Taub got a good job doing plastic surgery while he went surfing. Taub says that as a father with spousal support payments to make, surfing wasn’t an option. Chase notes that fellowships are supposed to prepare you to work for yourself, and Foreman is now Dean of Medicine and Cameron is now head of emergency medicine at a hospital in Chicago. Taub notes Lawrence Kutner is dead and Thirteen is having lesbian sex on a Greek island. They finally find something in the patient’s bowel.

The team still can’t reach House. Park wants to tell Foreman or the police, but Chase says they shouldn’t tell anyone. Chase thinks it’s porphyria and wants to treat, but Adams says that the patient will eventually find out House isn’t in charge and all hell will break loose. Chase says that will only be an issue if they’re wrong. Adams notes the treatment for porphyria isn’t like an x-ray or even exploratory surgery - if they’re wrong the drug will cause severe damage. Chase isn‘t swayed.

Wilson and House are back on the road. Wilson wants to have sex with two women. House tries to talk him out of it, but finally agrees if Wilson will do exactly what he tells him to do.

Chase explains the diagnosis to the patient and tells him they have to start treatment right away. He says House feels very strongly about it. The patient agrees.

House has fit Wilson with a fake bald wig and is disappointed Wilson wouldn’t shave off his hair. House says that it’s Wednesday afternoon and the women are sober, so pity is the only way to arrange the threesome. House spots a prostitute in the bar. Wilson says he’s never paid for sex and isn’t about to start, but House offers to pay. The waitress comes over and House tells her Wilson is dying. He then makes a veiled reference to sex and asks when she gets off work.

The patient develops a pleural effusion, which rules out porphyria. The patient demands to see House. Chase finally admits they don’t know where he is.

The next morning, House is sleeping in Wilson’s car when Wilson comes out of a motel room. He says the experience wasn’t all that terrific, but it’s exactly what he needed. However, one of the women he was with stole his wallet.

Foreman is furious with the team. The patient is getting worse and has agreed to let Foreman take over the case. Chase is told to have no further contact with the patient. Chase goes to leave, but Foreman tells him to sit down - he needs him for the differential. Foreman has done a cardiac MRI which shows an enlargement of the left ventricle typical of infiltrative diseases. Taub suggests sarcoidosis and Foreman wants to order a cardiac biopsy and steroids, but Chase objects. He thinks the nervous system involvement is what they should be looking at. He thinks it’s a prion disease and they need to do a brain biopsy. Foreman says the patient is too weak for it, so Chase suggests that they re-test the brains in the morgue to find out if he could have been exposed. Foreman says there are too many samples to test, but Chase points out there are four doctors to do the work. He wants to start the patient on amphoteracin as well. However, Taub notes that the contrast together with amphotericin will destroy the patient’s kidneys. They can’t do both. Foreman decides on the heart biopsy.

With Wilson’s wallet gone, the pair is down to twenty dollars in cash. House can’t use his credit cards because of his probation - he can’t leave proof he’s been out of the state. House realizes they can’t even buy gas to get home, but Wilson says they can still get to see Julie Christie and he doesn’t care what happens after that. House says he’s worried Wilson will come back because he likes Kyle Calloway.

Chase heads down to the morgue. He finds the brain samples and picks one at random.

Wilson comes to a road and traffic is blocked off. He looks at his watch, but they then see that traffic is being held back for a funeral procession. Wilson guns his engine, rushes past the man holding back traffic, and rushes past the procession. He then runs the car off the road, through a fence, and into a field. The damaged car stops and Wilson is fine, but he sees House slumped over in his seat. He quickly gets out of his seat belt and rushes over to House. House is a bit shaken up, but seems fine. Wilson tells him to hurry up because they still have eleven miles to go.

Chase is still examining brains when Park comes by to ask why he’s not answering pages. Park reports the heart biopsy showed fibrosis. Chase notes that this also rules out prion diseases. Park says Foreman wants them in House’s office. Chase thinks Foreman will just say it’s an infection. He wants to concentrate on the morgue. He thinks the patient always acts like he’s perfect, but he’s not and the answer must be there. Park asks if he’s trying to cure the patient or discredit him. Chase says he’s tired of both Foreman and the patient seeing him as “not House”, even if they’re probably right about that. Chase announces that not only will he not be joining the differential, but he’s quitting after the case is over.

Foreman is incredulous that Chase plans to quit, but Park has found out that Chase is even looking for another job. Foreman says Chase is just upset about the patient and he will get over it. When Foreman suggests an infection, Park points out that Chase guessed Foreman would say that. Adams says she will test the biopsy sample for viruses and start the patient on anti-virals. Taub asks Foreman if he’s going to speak to Chase, but Foreman says he’s not worried. Taub tells him that if he’s wrong, he’s losing a good doctor.

House and Wilson are at a bus stop, but House thinks it’s not in use. Wilson turns to the woman who is waiting with them, and it starts to become clear to him that she has dementia. However, a cab comes by and House realizes they have just enough cash and just enough time. However, the woman won’t budge and Wilson refuses to leave her until the police arrive to take care of her. House says goodbye to Kyle Calloway.

Chase is busy at the whiteboard when Foreman comes by and asks if he’s found anything. Chase responds “not yet”. Foreman says his co-workers are worried about him quitting. Chase asks if he’s there as a boss or a friend. Foreman says the boss would have suspended him already. Chase says he’s learned a lot and is ready for a team of his own. However, he admits he’s felt that way every year for the past two years. Foreman thinks there’s a reason he hasn’t left - he needs structure, support or someone else calling the shots. Chase says that Foreman is now acting like House - insulting him to get him to make a decision. Foreman says it’s always been effective in the past. He notes that either Chase will rise to the challenge and quit, or stay on as a team member.

The patient becomes unresponsive. He slips into a coma.

The team and Foreman finally join Chase in the morgue. However, Chase admits he was wrong about the source being in the morgue. He admits the patient’s methods and reports are fastidious. As the rest trade ideas, Chase goes to wash his hands and suddenly realizes something about the soap. He rushes out of the morgue.

Wilson and House are on a bus back to Princeton. Wilson is bashing himself about not even being able to maintain meaningless fun for a period of three days. He also admits he never even had a crush on Julie Christie, just another girl who looked like her. He spent a lot of time with her, but she was dating a guy who had a car and was in a band. House guesses that Kyle Calloway was the guy his crush was dating. Wilson admits his crush asked him if he would mind if she went to the prom with Kyle. Wilson lied and said he didn’t mind, and that ended the relationship. He admits he doesn’t want to go back and find out the results of his scans. House notes that Kyle probably would have ditched him a long time ago. House says he can live without Kyle.

The patient regains consciousness to see Chase hovering over him. Chase tells him the industrial strength antibacterial soap he was using contained triclosan, which, although it is very effective against MRSA, also affects thyroid function. Combined with the caffeine in his energy drinks, it induced hypothyroidism. When the emergency room put him on sedatives for his psychosis, it set off a myxedema crisis. The patient admits he never would have thought of that. Chase tells him that House trains them to look for irony. As Chase goes to leave, the patient reminds him that House didn’t come up with this diagnosis.

Chase goes to Foreman’s office and throws him his locker key. Foreman offers Chase his own team, but Chase says it’s time to step out of House’s shadow. Foreman says it’s about time and gives him a hug.

House is giving Wilson his scan. Chase joins House, who says they don’t have the results yet. House wants to know if he wants Chase to talk him out of leaving, but Chase is just there to thank him. House say’s its been fun and when Chase questions him, he says its better than saying they’ve been in a variety of different situations. Chase asks House to let him know about Wilson. When Chase leaves, Wilson asks why House let him go. House reminds Wilson slavery was outlawed. But when he suggests that Lincoln's undesirable social policies lurked beneath his top hat, he falls silent. Wilson calls for him, but House doesn’t respond. House stares at the monitor.

Major EventsEdit

  • Wilson buys a Corvette, but crashes it.
  • Wilson and House take an unannounced road trip to Cleveland.
  • Chase decides to leave the hospital.

Zebra Factor 10/10Edit

Although triclosan has been linked to thyroid hormones in lab tests, there has never been a human case where thyroid function was actually affected by the chemical.

Trivia & Cultural ReferencesEdit

  • A Corvette was also featured in the Season 1 episode Mob Rules
  • Cleveland is the second largest city in Ohio, but sits in the middle of the most populous county in Ohio.
  • Cleveland is about a nine hour drive from Princeton in normal traffic. The best route is to take U.S. Route 206 to U.S. Route 22 to Interstate 78, then Pennsylvania State Route 33 to Interstate 80. I-80 takes you all the way to the outskirts of Cleveland.
  • David Cassidy, together with his step-mother Shirley Jones, made up The Partridge Family, one of the most popular pop music groups in the 1970s.
  • Julie Christie is an Indian born Academy Award winning British actress.
  • The Wannsee Conference was a secret meeting of senior officials of Nazi Germany in 1942 that worked out and started to implement the Holocaust.
  • Big Brother is the dictator in George Orwell’s 1984.
  • Allentown is the third largest city in Pennsylvania.
  • An “Ear in the mail” is a reference to Vincent van Gogh, who lost a piece of his ear in a fight with his friend Paul Gaugin and, as legend would have it, mailed it to the woman they were fighting over.
  • Interstate 78 joins New York City to Harrisburg, Pennsylvania and passes Allentown.
  • “You magnificent bastard” is how George S. Patton describes his rival Erwin Rommel in the 1970 movie Patton.
  • A Sno Ball is a cream filled chocolate cake, covered with marshmallow frosting and shredded coconut. They were formerly made by Hostess, which went out of business in 2012.
  • The Thirteenth Amendment outlawed slavery and involuntary servitude.
Previous episode:
The C Word

Post Mortem
Next episode:
Holding On
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