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The Softer Side

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The Softer Side
1252038
Director(s)
Writer(s)
Airdate
February 23, 2009
Episode Number
5.15
TV.com Rating
8.6/10
Guest Star(s)
Final Diagnosis
Dehydration complicating adverse reaction to MRI contrast material due to poor kidney function
Zebra Factor
1/10
Wilson: "I’ll run some tests and I’ll let you know"
Foreman: "[House is] there isn’t he?"
Wilson: "Well that would certainly explain the inappropriate responses. I gotta go. Okay. Sorry, consult."
— The Softer Side

The Softer Side is a 5th season episode of House which first aired on February 23, 2009.

The team encounters a teenage boy who collapsed from severe pelvic pain after playing basketball. The parents reveal to House and the team that the boy has genetic mosaicism; both male and female DNA, and that the boy is unaware of his condition. They consciously chose the male gender for him when he was born and raised him accordingly, never telling him about his unique condition. However, when his condition worsens and his life is threatened, the parents wonder whether they made the right decision, particularly when Thirteen starts identifying with patient‘s ambiguity. Meanwhile, Cuddy and Wilson suspect something is wrong with House when he starts acting way too nicely. When they discover the shocking answer, they must face the prospect that House may be changed forever.

RecapEdit

In a flashback, we find a family dealing with their baby, who has both male and female DNA and ambiguous sexual organs - genetic mosaicism.

We come to the present day, where a boy is playing basketball, but is reluctant to take a shot until the last second, when he scores the winning basket. However, he soon grabs his lower right side and collapses on the floor.

Foreman and Thirteen are dressing for work. They are discussing how they faked breaking up to fool House.

House is having breakfast with Wilson when Cuddy comes in with the case and asks House not to reveal the patient's mosaicism to him. House agrees right away and Cuddy wonders why it went so easy.

The team thinks it may be dehydration. Thirteen is worried how they will hide the mosaicism from the patient. Foreman pretends that Thirteen's guess of a blind uterus is a stupid idea. House thinks so too and wants to examine his uethra. The parents come in and House tries to defer them to his team, but the parents think it's a blind uterus too. House orders an MRI, even though he thinks it is a waste of time.

Thirteen and Taub do the MRI. They discuss the "breakup" and Taub insults Foreman as unemotional. They rule out the blind uterus theory.

Kutner comes to tell Wilson that House is not arguing with the patient's parents even though he disagreed with him. Wilson thinks House is just in a good mood and tells Kutner not to worry.

Next, Thirteen and Taub do a procedure where they inject saline into the bladder and examine the urethra with a scope to look for narrow spots . The patient starts to feel tightness in his chest and has trouble breathing. Its a pericardial effusion. Thirteen stabs him with a syringe to draw out the fluid.

They drain the fluid and the patient stabilizes. Kutner wonders why House isn't making fun of the team's guesses. Thirteen thinks it is the patient's testosterone supplements. House orders corticosteroids in case it is an autoimmune disease and a drug to block the testosterone.

Wilson comes in to see Cuddy because House is being nice and thinks he‘s keeping something secret from both of them. Cuddy denies having sex with House and tells Wilson not to worry.

Thirteen tells the parents they may have to discontinue the testosterone. They tell Thirteen to tell the patient the testosterone blockers are something else. The parents resist telling their son the truth.

Thirteen talks to the patient about his basketball. The patient says his mom made him join the team. He says he wanted to take dance lessons, but his mom wouldn't let him. Thirteen notices the patient's palm is red, which means the diagnosis they have is wrong.

Cuddy comes in to tell Wilson that House is in a good mood, and she's worried too.

Kutner and Foreman talk about the "breakup". Kutner is obsessed with her promiscuous bisexuality.

Wilson and Cuddy go to confront House, but he appears to be asleep. However, it turns out he is barely alive, not breathing and barely has a pulse. Foreman manages to resuscitate House by twisting his nipples. Cuddy asks what is going on.

They give House oxygen. Cuddy examines House and can't find anything obviously wrong. His pupils are “equal, round and reactive”, ruling out narcotics. He asks for the patient's test results and claims he probably took too much Vicodin. Thirteen finally tells House the patient’s liver and kidney function is declining. No one remembers House taking any Vicodin that day, or the day before. House orders an environmental scan. Wilson thinks House is on heroin or at least some narcotic stronger than Vicodin because he is not favoring his bad leg. Cuddy wants to know what they should do.

Foreman and Thirteen do the environmental scan and Foreman asks if Thirteen misses sleeping with other women. She says she's does, but she wants to remain monogamous too. She wonders why he wants to know. Foreman admits it's because Kutner brought it up, and Thirteen remembers Taub bringing it up too. They figure out that Taub and Kutner have figured it out or, more likely, House told them and has decided not to fire them.

Thirteen finds a poem - the patient appears to be suicidal and confused. However, House doesn't think its medically relevant. They do find toxoplasmosis in his water bottle and treat him for it with pyrimethamine.

Thirteen confronts the patient's parents about the note. The parents argue about whether to tell him or not. The mother tells Thirteen to restart the testosterone.

Kutner admits to Foreman he's the one who figured out that he was still with Thirteen, and House didn't tell him. Foreman wonders why House didn't figure it out. He calls Wilson and tells him House is on heroin, but Wilson is having dinner with House. House turns down alcohol. He realizes that Wilson thinks that he's on heroin. House downs the shot to show Wilson he's wrong, then leaves the restaurant.

Thirteen gives the patient more testosterone. She tells the patient they aren't vitamins, and tells him to ask his parents.

Wilson goes outside and catches House throwing up. House finally admits he's on methadone. Wilson reminds him how dangerous it is. House denies he’s detoxing or looking to help his pain - he's looking to eliminate his pain. His leg has stopped hurting.

The parents complain to Cuddy about Thirteen. However, Cuddy refuses to remove her from the case unless House is also removed. Cuddy tells Thirteen she better not abandon the patient now as she's probably the only person he will trust.

The parents break the news to the patient. He's angry with them and tells them to leave.

Cuddy finds House in the bathroom and tells him she knows about the methadone. He tells her it's none of her business, it‘s legal, and he has a prescription. She tells him he can't do methadone and work at her hospital. House decides to quit.

Thirteen tells the patient he will have to talk to his parents again sometime. The patient admits to being attracted to other boys and to liking dance more than basketball. Thirteen tells the patient that she found his poem and that suicide is not the answer. The patient says it was just a poem he wrote for his English class in the style of Sylvia Plath and it doesn't reflect his feelings. Thirteen realizes she may have made a mistake. The patient starts to feel nauseous and vomits blood.

House shaves off his beard.

Foreman tells the team he's now in charge because House isn't at work. The team starts a new differential and Foreman orders proton-pump inhibitors. If they don't work, it's scleraderma. Foreman talks to Thirteen about her blaming herself for breaking up the family and tells her it wasn't her fault.

Wilson goes to House's apartment and finds a woman there. She was a prostitute House hired to watch him sleep. Wilson finds a neat apartment, that House has shaved and that's he's picking out a tie. He's going to St. Sebastian's Hospital to look for a new job.

The proton-pump inhibitors don't work and they realize it is scleraderma and that the patient needs steroids, but it also means he doesn't have long to live. The mother confronts Thirteen about not being able to see her son, but Cuddy defends Thirteen and tells the mother to go and see the patient. Thirteen thanks Cuddy, but she says she didn't do it for her.

Wilson thinks they may have been wrong about House, but Cuddy is convinced the methadone will eventually kill him.

Foreman and Thirteen are getting ready for work again. The patient is responding to the steroids, but Thirteen isn't pleased with the news because the patient is still going to die. Foreman tells her to be honest with him. Thirteen wonders why the patient's AST improved so fast. Testosterone would have improved kidney function unless the kidney was damaged by scleraderma, and they realize it isn't scleraderma.

A clean-shaven immaculately dressed House goes to Cuddy for his letter of recommendation, but instead he finds a methadone treatment schedule and an offer of his job back. He asks for terms that Cuddy refuses, but he agrees to start working there again. He thanks Cuddy and leaves.

He goes to see his team. Thirteen comes in with the news it's not scleraderma. House takes off his tie. House asks if the kid likes energy drinks. He goes to see the patient. When he came in, he only had dehydration, but the energy drinks put strain on his kidneys which made him slower to rebound. He would have recovered with normal treatment. When they did the MRI on the parents' request, the contrast material wasn't filtered by the kidneys and diffused through his body, causing all of his other symptoms. He just needs dialysis for a few weeks and he will be fine.

Thirteen goes to see the patient and is pleased to see he is talking to his parents.

Cuddy goes to see House in his office to give him his methadone shot. He tells her that he's going off methadone because he did a procedure that made the patient sick because he was under the influence of the drug. Cuddy confronts him, but House wonders why she cares if he's happy. He throws away the methadone and limps out of his office.

Clinic Patient Edit

The patient complains of pain in one arm and both legs when he puts pressure on them. He demonstrates by poking himself with his right index finger and grimacing in pain. House twists the patient’s right index finger to make him really scream. It is the patient's finger that hurts because it is probably broken. House puts on a splint and Cuddy sees the patient thank House when he leaves.

End Credits MessageEdit

Male Announcer: 24's most gripping season yet, continues next on Fox.

Major Events Edit

  • House starts acting unusually nice to everyone.
  • Wilson reckons that House is using Heroin. This claim is dispelled when House tells him that he's using methadone and that it stops his leg pain.
  • House soon quits the hospital over Cuddy’s opposition to his methadone use and shaves off his beard.
  • House eventually returns to Princeton-Plainsboro and announces that he's going to stop taking methadone.

Zebra Factor 1/10Edit

Nothing out of the ordinary here, and House was right to blame himself for looking for a zebra when there were plenty of horses around. Dehydration from extreme physical exertion is very common, and fluid is the first treatment when a person collapses after exercise. Up to 15% of patients suffer some type of adverse reaction to contrast material, and the incidence goes up both when the patient is dehydrated or if they have a pre-existing kidney problem, and the patient had both. House and his team should have assured the patient was well hydrated before giving him contrast - it’s a common precaution that lowers the risk of adverse reactions.

Trivia & Cultural ReferencesEdit

  • The T1000 and Cyberdyne Systems are references to Terminator 2: Judgement Day
  • The clinic patient with a broken finger is a popular blonde joke:

A brunette goes to the doctor and as she touches each part of her body with her finger she says, "Doctor it hurts everywhere. My leg hurts, my arm hurts, my neck hurts, and even my head hurts!" The docters asks, Did you dye your hair?" Yes,I did," she replies with a frown. The doctor asks, "Were you a Blonde?" "Yes I was. Why do you ask?" The doctor answers, "because your finger is broken!"

  • Sylvia Plath was an American poet who was first published in 1960. She committed suicide in 1963 at the age of 30 but her original work continued to be published well into the late 1990‘s.
  • (Maybe not an allusion) At the beginning of the second scene House asks Wilson for food, Wilson makes a comment about House (who never does) asking for food before taking it - House (assuming that the comment was made about change) response, "Yes we can." A remark about Obama's campaign slogan.
  • When talking about his interview at St. Sebastian's Hospital, Laurie's American accent slips and he uses the British pronunciation of "Sebastian" (Sea-bast-e-an) as opposed to the American one (Sea-bast-chun.)


Previous episode:
Unfaithful

The Softer Side
Next episode:
The Social Contract

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