Wilson's Heart

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For other uses of Wilson, see Wilson.

"An incredibly rare neurological symptom is boring? Am I in someone else's subconscious?"

―Wilson’s Heart

Wilson's Heart is the 4th season finale episode of House that first aired on May 19, 2008. It immediately follows the events in the previous episode House‘s Head. Amber is found at Princeton General in rapidly deteriorating condition despite successful surgery to treat her physical injuries. House and Wilson manage to have her transferred by ambulance to Princeton-Plainsboro, but a heart attack along the way results in a decision to put her in protective hypothermia. The key to Amber's condition seems to lie in House's damaged memory as he is sure he saw something before the bus crash that is relevant to her condition. The diagnosis is complicated by House suddenly becoming cautious and Wilson’s lack of objectivity. However, as House begins to recover his memory, he starts to remember something that could end his friendship with Wilson and change both of their lives forever. When faced with the diagnosis, Wilson wonders if he can face Amber for the last time.

Recap

House and Wilson find Amber at nearby Princeton General hospital. Although Amber came through surgery well, just prior to their arrival, her heart started racing at 130 beats per minute. House lies about Wilson being Amber's husband so they can take her by ambulance back to PPTH. However, on the way there, she starts fibrillating. Instead of defibrillating, Wilson comes up with the idea of lowering her body temperature to keep her racing heart from killing her, giving House more time to come up with a diagnosis. House agrees.

Amber is put into protective hypothermia by Chase, and then her heart and lungs are put on bypass, stabilizing her. The team then starts a differential. They are handicapped by the fact that she is on bypass and they can't test her heart. Kutner suggests that House try to restore his memory, but House realizes that, due to very recent events, he can't afford to take any more risks with his own health.

Taub asks House if there is anything else he should know, like if House was sleeping with Amber. House denies it, but admits he can’t remember what happened. He goes to run a tox screen.

Thirteen and Kutner go to Amber's apartment to do an environmental scan. Kutner finds sex videos of Wilson and Amber. Thirteen is reluctant to proceed, thinking their behavior is changing because they know her.

House is in his office trying to think, but he falls asleep and starts dreaming. He starts talking to Amber in his dream. He tries to remember what they were doing together the previous night. Amber suggests they were meeting to have an affair, but House suddenly wakes up and realizes that electricity will stimulate his brain. He goes to Cuddy, but she's dismissive, and Wilson agrees with her. Wilson conforts Amber by talking to her. House gets a page from his team, but all the tests are negative. However, Kutner found SSRIs and amphetamines being prescribed as diet pills, which could explain the racing heart. Foreman wants to restart her heart to test it, but House suggests surgery to look at the pulmonary vein directly.

As Amber's condition deteriorates, Thirteen begins to act strangely, which prompts House to confront her about not participating in the differentials. House tells her to get over whatever her problem is so she can stop hesitating and do her job.

Just as they are about to start surgery, they find Amber is exhibiting jaundice. The liver failure shows that diet pills aren't responsible, so they return her to intensive care.

House saw sherry in his dream with Amber, and Kutner remembers that there is a Sharrie's Bar near the site of the bus crash. Wilson and House go to the bar, and the bartender gives House back his keys. House starts asking about Amber, and the bartender tells him that she sneezed and that they were drinking together. House thinks the sneezing points to an infection.

Kutner tells Thirteen that he went through what Wilson is facing. His parents were killed in a store robbery when he was very young.

House decides that Amber may have had hepatitis and orders interferon. Foreman goes to tell Wilson and tells House to get some sleep. However, House has another dream, and Amber starts speaking to him again, telling him that hepatitis can't be the right diagnosis. She then shows House her back. House wakes up again and tells his team to turn Amber over. They notice a rash on her back that indicates that she might have the flu.

Wilson is wondering exactly how House saw the rash. Once again, House has to confront Thirteen about her hesitance. They think it might be Rocky Mountain Spotted Fever, but after they treat her with antibiotics, they have to warm her back up to test their theory. Wilson objects. House orders blood cultures, but Foreman objects because treatment would be faster. House overrules him.

House goes to see Thirteen again to see why she is screwing up. He thinks it's because of her refusal to deal with the possibility of having Huntington's disease. He tells her to get over it, but she confronts him about his hesitance on Amber‘s case.

Foreman is concerned about Amber, and goes to Cuddy. Cuddy goes in and starts warming Amber up. Wilson objects vehemently as he sees a drop in brain function on the EEG. He accuses Cuddy and Foreman of letting whatever is wrong with her spread to her brain.

House thinks it might be an autoimmune disease. He wants to give her prednisone and warm her back up. Wilson objects again, but Cuddy tells Wilson he's the family, not the attending. House apologizes to Wilson, but agrees with Cuddy. Wilson soon comes back to apologize, but asks House to go through deep electrical brain stimulation to attempt to restore his memory. House realizes he will be risking his own life again, but agrees.

Chase starts the procedure on House. House remembers the bartender taking his keys. He asks for a phone, and realizes he's calling Wilson. However, he reached Amber instead. House asked her to get Wilson, but she came to the bar to get him instead. They argue about leaving, and Amber agrees to stay for one drink. However, House can't remember there being anything wrong with her. He remembers that he saw Amber sneeze, but there is nothing in her mucus to indicate a problem. House realizes he tried to leave the bar without paying, and Amber went back to pay once he insisted on taking the bus home. He also forgot his cane, and Amber ran onto the bus to return it. Amber sneezes again, and says she has the flu. However, House realizes that can't be the whole answer. She reaches for pills - Amantadine. House tells her not to take them, but just after she does, the bus crashes. He realizes that her injured kidneys and the day that passed since she took them, allowed the Amandatine to bind to the proteins in her body and poison her organs. It's too late for dialysis, as she's become terminal. House apologizes to Wilson, and a tear runs down his face. House then suffers a seizure.

House goes into a coma because the seizure worsened his skull fracture. Foreman explains to the others that House was right about Amantadine poisoning. There was nothing they could have done once Amber went into Ventricular fibrillation in the ambulance. She can't qualify for a transplant because all her other organs are damaged.

Wilson wants to call time of death, but Cuddy tells him that Amber would most likely prefer if she was awakened for a few hours so they could say goodbye to each other. Wilson agrees, and waits for Amber to wake up. Amber finally regains consciousness and, as Wilson explains the situation, she realizes that the Amantadine will soon result in her death. They tell each other that they love each other.

Thirteen says that the team should say goodbye. Taub says, "She didn't even like us," to which Kutner replies, "We liked her." Taub then says, "Did we?", and Foreman says, "We do now." Taub asks what they're supposed to say to her, and Kutner says that they don't have to say anything. A fade between the team then happens. Kutner walks up, puts his hand on Wilson's shoulder, and gives a faint smile to Amber and Wilson; Taub blows a kiss to Amber; Foreman stands next to her, with his hand on the bed, and looks at Wilson; Thirteen walks up and gives Amber a hug.

Amber starts to feel fatigued, and realizes her time is short. Wilson wonders why she isn't angry. She says that's not the last feeling she wants to experience. Wilson kisses her, and shuts down her bypass. She then dies in Wilson's arms.

House is still unresponsive. He hallucinates that he is in a brightly lit bus with Amber. He realizes she's dead. She tells him, "Everybody dies." He wonders if he is dead, but she tells him that he isn't yet. He believes that he is the one who should have died. House then realizes Wilson is going to hate him. Amber tells him, "You kind of deserve it." House then says, "He's my best friend," and Amber tells him that she knows. She then asks what to do now, and House says, "I could stay here with you." Instead, Amber tells him to get off the bus. House says, "I can't," and goes on to say, poignantly and almost tearfully, "It doesn't hurt here. I... don't want to be in pain. I don't want to be miserable. I don't want him to hate me." Amber then tells him that, "Well, you can't always get what you want." She raises her eyebrows, and House walks off the bus. Amber smiles and, as she looks outside of the bus, it fades to white. House then finds himself awake in his hospital bed with Cuddy at his side. She tells him to rest after she confirms he can hear her.

We see the result of Thirteen's test for Huntington's. It is positive. Taub goes back home where his wife is sleeping, and he embraces her. Kutner watches television while eating cereal alone. Foreman goes to a bar where he is soon joined by Chase and Cameron.

In the hospital, a red-eyed Wilson visits House while he sleeps, with Cuddy sleeping in a chair nearby. House wakes, and the two stare at each other for several moments. Eventually, Wilson leaves the room. He goes home, to his bedroom and finds a note under the pillow from Amber that she has gone to pick up House, and soon breaks down in tears once again, clutching the note.

The season ends with House still in his hospital bed, and Cuddy, fast asleep in a chair beside him, still holding his hand in the background.

Major Events

The team struggle to find out what's affecting Amber while a distraught Wilson tries to cope with what has happened.
Kutner reveals his biological parents were murdered when he was six.
House confronts Thirteen over her hesitance to treat Amber.
In a final attempt to reclaim his lost memories, House undergoes a Deep Brain Stimulation for Wilson's sake. He soon discovers that Amber was taking flu-pills and figures out that she has amantadine poisoning. He tells a heartbroken Wilson that they can't do anything to save her and offers his friend an apology.
House soon suffers a seizure as a result of the deep brain surgery and ends up in a coma.
Kutner, Taub, Thirteen and Foreman all say their goodbyes to Amber.
Wilson switches off the life-support which results in Amber dying.
House awakens from his coma.
Thirteen learns that her Huntington's test is positive.

Zebra Factor 9/10

Accidental amantadine poisoning of this type is rare, but not unheard of. It is difficult to overdose on the drug because the kidneys filter it quickly. However, if the kidneys aren’t functioning, it will often result in toxic damage.

All you need is a double bypass, pumping the poisonous blood to a healthy person, and use their heathy kidney as a filter. or if the toxicity is already too high, use multiple persons'. its not a very risky treatmeant, if enough volunteers are found.

Trivia & Cultural References

Sherry is a fortified wine made from white grapes that are largely grown near the town of Jerez, Spain. “Sherry” is an Anglicization of “Jerez”.
While Thirteen is in the bathroom crying, a "Change '08!" pamphlet can be seen posted on the wall, referring to Barack Obama's candidacy for president.
In a scene of the episode, a cover of Massive Attack's song Teardrop is played, performed by Jose Gonzalez.
A Cosmopolitan is a cocktail consisting of vodka, triple sec, cranberry juice and lime juice.
The way house gets Thirteen's attention in the restroom is a reference to the Larry Craig scandal. The Republican Senator was accused of engaging in homosexual encounters, solicited by entering a bathroom and sliding one's foot across to the person in the adjacent stall. Craig's initial denials were based on the premise that he had an unusually wide stance while using the toilet.