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Top Secret

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Top Secret
House328
Director(s)
Writer(s)
Airdate
March 27, 2007
Episode Number
3.16
TV.com Rating
8.7/10
Zebra Factor
3/10
House: "Did you find out about any television or other media exposure?"
Cameron: "Do you really care or are you just trying to waste hospital resources to get back at Cuddy for making you take the case?"
House: "Of course I care! What a horrible thing to say. Do a LexisNexis search and get a copy of his credit report."
— Top Secret

Top Secret is a third season episode of House which first aired on March 27, 2007. When House has a dream about being in combat, he wakes up only to have Cuddy assign him the case of an ex-soldier whom House just saw in his dream. Certain that he has seen the man before, he spends more time trying to learn where he could have possibly met him than he does treating the patient. Meanwhile, Cameron and Chase’s sexual relationship starts to get riskier.

RecapEdit

House is having a dream about being in combat during the Desert Storm conflict and being treated for his wounds by a soldier. His right leg is missing below the knee. When he wakes up in his office, Cuddy is there with a file—an ex-Marine who believes he has Gulf War syndrome. House opens the file and sees a picture of the soldier he saw in the dream. Cuddy asks if he knows him, and House says he's never met him before in his life.

House meets Wilson in the washroom to discuss his dream. House is sure he must have seen the patient before. House reveals he isn't urinating.

House discusses the patient with his team. He has fatigue, intermittent rashes, sore throat and sore joints. House dismisses the patient's idea that he has Gulf War Syndrome and Foreman agrees there is no such thing, but Chase believes it may be possible. Cameron sides with Foreman, so Chase gives in. House thinks the patient is a malingerer looking for a disability pension. He orders a full physical, blood tests and a medical history including whether he's ever been on television. House gives an excuse for why he wants to know.

The patient is angry. The doctors don't believe he's fatigued, because he exercises regularly. The patient describes his symptoms and demands to know what is wrong with him.

The team meet to discuss possible diagnoses. House wants to know if the patient has done any modelling, but they didn't ask. The patient isn't currently showing symptoms. House orders more tests, including checking the patient's sleep patterns, a polysomnogram, a LexisNexis search and a credit check.

The patient is taken to the sleep lab and is sleeping well. Cameron starts leave but Chase says if she goes House will complain. She agrees to stay and suggests having sex, but Chase thinks there is no place private. They wind up going into a nearby room and covering up the closed circuit camera.

House is still having trouble urinating. He takes some Vicodin.

Foreman arrives at the sleep lab and finds Cameron and Chase missing and the patient awake and complaining about a bad smell. Foreman finds the source of the smell in the patient's mouth.

House is in the bath reading, looking at the patient’s picture and taking more Vicodin. He gets a phone call from Chase—the patient has bacterial vaginosis in his mouth. However, the patient hasn't had sex in over a year. Foreman thinks it is cancer, and House agrees to let Wilson biopsy the salivary gland. He also tells Chase to find out more about the patient's sexual history.

Wilson does the biopsy and reassures the patient, but the patient believes it may already be too late.

The team wonders if House is wasting their time. Foreman asks where Chase and Cameron were when he found the patient alone in the sleep lab. Cameron admits they were having sex, but Foreman thinks it's a joke. Chase is insulted that Foreman doesn't believe her.

Wilson tells House the biopsy is inconclusive. House asks him for a prescription for Alfuzosin. Wilson asks House if he remembers where he met the patient. House tells Wilson he hasn't urinated in three days. Wilson tells him to stop taking Vicodin, but when he realizes House isn't lying, he writes out the prescription for Alfuzosin.

Foreman confirms that the patient hasn't even had a date in over a year. When Foreman leaves the room, Chase and Cameron talk about their relationship.

Wilson is doing more tests on the patient when he realizes that the patient can‘t hear him. He seeks out House, who is still unable to urinate. Wilson tells House the patient has at least six brain tumors and has lost his hearing.

The tumors appeared in a week, but House doesn't think that they could grow that fast. Wilson suggests that the previous hospital gave them scans from the wrong patient. Cameron and Chase report that everything in the patient's background check corroborates the details the patient gave them. Wilson realizes House is using his team to find out where he previously saw the patient. Wilson takes over the case and tells House to go home and gets some sleep.

House tells Cuddy that the patient is terminal—the previous hospital screwed up. Cuddy points out that both their scans and the previous scans show an image of a surgical pin, therefore they received the correct records. House thinks that the patient was exposed to radiation. House wants Cameron to research the patient more, and snaps at her when she refuses.

Wilson gets ready to drill into the patient's head. Before the procedure begins, Foreman's portable scanner shows the tumors have disappeared.

House realizes the "tumors" aren't tumors. They discuss possible alternatives, but they find out the patient is now paralyzed below the waist. House asks the patient if he has ever been in any pornographic films.

House lists all the symptoms on the whiteboard. Cameron thinks it is an infection, but that wouldn't explain the disease moving around. Although the patient's urine shows evidence of irradiation, there isn't enough to damage the spinal cord. House still can't urinate and asks for Wilson's car so he can drive home instead of using his motorcycle. House leaves the hospital, claiming he needs sleep.

The patient's paralysis and deafness persist and he is afraid he is going to die. The team discuss whether they should try to treat the patient for radiation sickness, despite what House said.

Meanwhile, House is at home using a catheter to drain his bladder, megadosing on Vicodin before prepping himself. He finally gets some relief, and heads off to bed with the catheter bag.

The team starts treating the patient for radiation sickness. Suddenly, the patient's paralysis is spreading upwards from his legs. Luckily, it hasn't restricted his breathing yet.

House is still unable to sleep. After six hours of tossing and turning, he returns to the hospital. He finds Chase and Foreman sleeping in the doctor's lounge. The team discuss the new symptom, but House is furious that they treated him for radiation sickness. House still wants a better medical history. The team is paged by Cuddy who wants to know about the patient's treatment. House believes the patient is suffering from internal bleeding and needs a transfusion. Chase finds urine on the floor, coming from a bag under House's pants leg. House wonders what the fuss is. Foreman tells House he is bleeding and Cuddy starts acting nice to House. House wakes up and realizes he has been dreaming. He also sees the catheter has come out during the night and spilled its contents.

House arrives at the hospital and finds Chase and Foreman in the lounge sleeping. House surprises them with knowledge about some new symptoms. Because of his dream he has had a diagnostic epiphany—the patient suffers from hereditary hemorrhagic telangiectasia. The clue was his grandfather's nosebleeds. House inspects the patient's nostrils and sees no hairs, but cauterization scars. The patient has had his nose cauterized to stop his own nosebleeds. The symptoms of the disease are often dismissed as minor problems, but are the results of the body's capillaries breaking down. The condition can be treated with various surgeries.

House is urinating on his own again. Wilson is shocked when he learns that House catheterized himself. He reminds House the spasm in his urinary sphincter was probably caused by the Vicodin.

House tells Cuddy he now remembers where he saw the patient—he was making out with Cuddy at a hospital fund raiser. He chides her for not telling him in the first place. Cuddy thinks House remembered him only because he made out with Cuddy. Cuddy tells him to get over her.

Chase and Cameron are making out in a supply room when House comes in to supposedly discard some office supplies and catches them. House exits the room, and a slow, sly grin spreads across his face.

Clinic Patient Edit

A patient is discussing her sex life with House and drinking from a large bottle of water. He gets upset when she keeps sloshing her bottle of water around. She tells House she has OCD, but her only symptom is water drinking. He tells her she has diabetes insipidus caused by hitting her head on a balance beam—she has characteristics common among gymnasts. He tells her she only needs hormone supplements.

Major Events Edit

  • House develops a spasm in his urethral sphincter and is unable to urinate.
  • While monitoring a patient, Chase and Cameron sneak into one of the rooms in the Sleep Lab and have sex.
  • House catheterizes himself to relieve his bladder.
  • House eventually realizes that the patient was a man Cuddy had made out with at a hospital fundraiser.
  • House implies that he once had a one night stand with Cuddy.
  • House walks in on Chase and Cameron making out in a supply room.

Zebra Factor 3/10Edit

HHT is a fairly common genetic disease, occurring in about one out of every 5,000 people.

Trivia & Cultural ReferencesEdit

  • ”Top Secret” is a way of classifying sensitive material that is extremely sensitive and should not be discussed with others. It refers both to the military background of the patient and the attempts of Cameron and Chase to keep their sexual relationship private.
  • The Village People were a popular disco group in the late 1970s and early 1980s. When performing “In The Navy”, both Victor Willis (who usually dressed as a police officer) and Alex Briley (who usually dressed as a general infantryman) wore naval uniforms.
  • The radiation danger from depleted uranium is due to alpha particles, which do not travel far through air, and do not penetrate clothing. Thus, the primary concern is internal exposure, due to inhalation, ingestion or shrapnel contamination.  Most studies show that risk of radiological-related illness is very low in relation to depleted uranium.
  • Another reference to a “pine box” as a cheap type of casket.
  • LexisNexis is a computer database service that is still the single largest archive of legal and public records. It was founded in 1970.
  • The classical piece playing while Wilson is testing the patient is the fifth movement from Franz Schubert's Trout Quintet in A major.
  • The patient's character name most likely comes from John C. Kelley, one of the show's writers.

MusicEdit

The song playing at the end is “Superfly” by Curtis Mayfield, released in 1972.

Cast Edit

Previous episode:
Half-Wit

Top Secret
Next episode:
Fetal Position

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