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Sleeping Dogs Lie

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Sleeping Dogs Lie
249700
Director(s)
Writer(s)
Airdate
April 18, 2006
Episode Number
2.18
TV.com Rating
8.6/10
Final Diagnosis
Zebra Factor
9/10
Cameron: "We’re withholding information relevant to her decision to risk her life. How is that not an ethical dilemma?"
House: "It’s not medical information."
Cameron: "Who cares?"
— Sleeping Dogs Lie

Sleeping Dogs Lie is a 2nd season episode of House which first aired on April 18, 2006. A woman with a life threatening case of insomnia comes to the hospital after swallowing a whole bottle of sleeping pills. The team soon learn that she is planning on leaving her girlfriend, Max. When her liver fails Max offers to donate hers and the team are faced with an ethical dilemma. Meanwhile, Cameron accuses Foreman of plagiarism because they both wrote an article about the same patient.

RecapEdit

Hannah, a woman who has not slept in ten days takes a whole bottle of sleeping pills and her partner calls an ambulance. She is taken to Princeton-Plainsboro.

Meanwhile, House is taking the opportunity to catch a nap while on clinic duty. Cuddy comes to him with the patient's case, but House thinks its a psychiatric problem and explains the insomnia as a lie. However, House is intrigued that the patient took a whole bottle of sleeping pills and still couldn't sleep.

He finds Foreman and Cameron arguing about Foreman stealing an article from Cameron (about the case in Autopsy). While Cameron and Foreman argue about the dilemma, House admits he signed Foreman's article, but didn't read it. House thinks it is an optic nerve disease that is interfering with Hannah's light exposure cues.

Foreman and Cameron go to examine the patient's retina and optical pressure, and notice that she is sleeping for very short periods. Since the tests show no problems, House orders that they keep Hannah awake by putting her under stress, therefore making her sicker. The patient doesn't realize when she's asleep. Suddenly, the patient develops rectal bleeding.

Cameron and Chase do a colonoscopy on the patient without an anesthetic in order to keep her awake and test for a tumor in her colon. The patient goes into respiratory arrest and starts bleeding from her nose.

The team starts discussing what could cause such a massive nosebleed and the nasal epithelium in her large intestine. The possibility of Hannah being exposed to poison ivy arises. House suspects Wegener's disease. He orders corticosteroids and tests.

Cameron confronts House about allowing Foreman to scoop her on the article. House tells her that Foreman just did what was best for him.

Chase starts a biopsy of the patient's nasal tissues. All of a sudden, the patients eyes go into rapid-eye-movement, such as occurs during sleep, even though her eyes were open and she was sitting up. House thinks it is a movement disorder. Chase suggests rabies, but there doesn't seem to be any exposure source. Hannah and Max did have a dog for a week, and House realizes Hannah wants to leave her girlfriend because having the dog would indicate a long term relationship. The patient obviously lied about being allergic to the dog, because the drugs for her poison ivy would have taken care of the allergies as well. House agrees to an allergy scratch test.

During the test, the patient admits that she wants to break up with Max. Cameron then notices the patient has a large contusion. They concentrate on the sleep disorder and the internal bleeding. Foreman enters the patient's room and tells the couple that Hannah's liver is failing. She is in need of a transplant, but she can't get one without a diagnosis of what caused the liver failure. Furthermore, the medical team can‘t test for anything in the approximate six hours Hannah has left to live. House realizes the girlfriend could donate her liver (they are the same blood type), but the team is opposed based on the fact the patient wants to break up the relationship.

House tells the patient her liver is failing. The girlfriend agrees to donate a part of hers. However, this will only give them an extra 36 hours. Allergies have been ruled out. House orders as many relevant tests as possible, and warns Cameron not to tell the girlfriend.

However, House goes to Cuddy to tell them the patient and girlfriend have differing interests. Cuddy agrees not to press House about what the interests are, and agrees to advise the girlfriend about the risks of the procedure. Cuddy does so, and the girlfriend still wants to proceed.

Cameron proceeds with the testing, and asks the patient how she can proceed with the transplant without telling her girlfriend how she feels. The patient asks Cameron if she were in the same situation, whether she would tell if it meant she would die.

Wilson comes to House over Foreman's article. Wilson tells him that he has to deal with these problems, or else his team will be at each other's throats. However, House tells Wilson that Foreman would have done it anyway.

The transplant is ready to go ahead, but the tests on the patient are all turning out negative. House realizes Cameron is alone with the patient and the girlfriend. Just before the patient is about to confess to the girlfriend, House anesthetizes her.

The transplant proceeds. Cuddy asks Cameron what the secret is. Cameron changes the subject and tells Cuddy about Foreman stealing her article. Cuddy tells her to write another article, and wait to get back at Foreman when he needs a reference. The girlfriend goes into cardiac arrest, but is revived. House finds Cuddy and Cameron together and tells Cameron to get back to the patient's case.

After the successful transplant, the team goes back to the differential. House realizes they have to stop the patient's immuno-suppressive drugs in order to do a proper cancer work up. He orders that the immunosuppressants be discontinued so they can take new blood tests. Her white blood cell count turns out to be normal, when it should be low. They realize it's an infection, which is raising the white blood cell count. House thinks it might be something exotic, but the patient hasn't been out of the state. However, House realizes their dog had been out of the state. He looks at the patient's armpits, which show newly formed buboes, a sign of bubonic plague. Hannah caught the plague off of the fleas from the dog, which had been to the Southwest U.S., where the plague is an endemic among prairie dogs. House orders broad spectrum antibiotics, and Foreman is sent to find out what happened to the dog.

Cameron tells Max the diagnosis. She knew all along that Hannah was going to leave her, but she donated her liver to keep her girlfriend from leaving.

Cameron seeks to reconcile with Foreman about the article. However, Foreman is not magnanimous, and claims that they are only colleagues, not friends, and refuses to apologize.

Clinic Patient Edit

An older Chinese speaking woman comes in with her teenage daughter, who explains that her mother needs birth control pills for her PMS. However, House thinks the mother has a cold. House tells the daughter she can get contraception at any clinic in New Jersey, but gives her a prescription for birth control pills anyway.

The mother comes back, and complains that her breasts have grown. House realizes the daughter mixed up the medications. The daughter tries to blame House. House, however, can understand and speak Mandarin Chinese, and lets it slip, falsely, that the daughter is pregnant. He leaves the two of them to sort it out.

Zebra Factor 9/10Edit

Bubonic plague is not unknown in the United States, but House is correct that it is generally restricted to the south-west.

Major Events Edit

  • Cameron and Foreman get into an argument over an article they both wrote about Andie, the nine year old girl with terminal cancer.
  • It is revealed that House knows Mandarin Chinese
  • When Cameron goes to apologize, Foreman tells her they're colleagues, not friends.

Trivia and Cultural References Edit

  • The title of this episode comes from the old saying "let sleeping dogs lie", in the sense of "leave people or situations alone", because if you wake a sleeping dog, he may bite you. The episode's title is a pun on several arcs in the story:
    • The primary patient's disrupted sleep patterns causes her to doze off repeatedly. So she is constantly "sleeping"; her illness had been caused by a "dog"; and she "lies" to her girlfriend.
    • Cameron refuses to allow Foreman's backstabbing pass.
    • At both the beginning and the end of the episode, House is seen sleeping
  • Dodgeball is a ball game where the object is to hit players on the opposing team with the ball without letting them catch it.
  • More about the Blue Barrel Cactus

CastEdit

LinksEdit


Previous episode:
All In

Sleeping Dogs Lie
Next episode:
House vs. God

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