Family Practice - Recap

Cuddy and her sister Julia go shopping for dresses with their mother Arlene, who can't resist half-seriously insulting her older daughter. However, as she has a glass of champagne, Arlene starts complaining of heart palpitations. Cuddy takes her to the hospital for treatment. Meanwhile, House hides out in the morgue to watch cartoons, and the men explain to Masters that their boss is hiding out from someone, and the odds are on Cuddy. Cuddy finally tracks down her boyfriend and asks him to treat her mother. House warns against it, saying that she should know better because she knows how he is. Cuddy insists and House goes to see Arlene. Arlene doesn’t buy his assurances and insists that he go over her fifteen year’s worth of medical files. House starts to insult her, but Cuddy cuts him off and promises her mother that they’ll do a full series of tests.

House sends Taub and Masters to Arlene’s home to look for environmental causes, and Taub insists that House is just giving them busywork so he can impress Cuddy, and there really is no case. They find photos of Arlene having sex with her landscaping contractor, a muscular Hispanic named Jesus, but Taub is more interested in the bottle of Azracon pills. He brings them to House, who explains to Cuddy that they’re a Mexican herbal treatment used for stomach pains, but they contain lead. He figures that Arlene is suffering from lead poisoning and orders chelation treatment. As Cuddy administers it, Arlene explains that Jesus gave her the pills. Julia knows about Jesus, much to Cuddy’s surprise, and Arlene is surprised that Cuddy expects her to tell her older daughter everything.

Taub moves in with Foreman, and Rachel comes by to drop off his mail. When he tries to take her hand, Rachel tells him that they have to move on, and he suspects that she’s moving on with Phil, her support group fan. She refuses to discuss it and tells Taub that her brother, Jamie, is looking for a part-time medical consultant at his law firm. Taub notes that Jamie punched him in the nose when he learned that Taub was cheating on his sister, but Rachel just gives him her brother’s card and leaves.

Arlene keeps paging House, demanding to see him. When he gives in, she notes that her symptoms predate her taking the pills. House finally tells her that he figures that she’s a hypochondriac. When she tells him that she still has symptoms despite the pills he gave her, House explains that he secretly gave her sugar pills. Cuddy fires him and threatens to leave the hospital, but Cuddy convinces her to stay. Dr. Marty Kaufman of Internal Medicine takes over her treatment, and House insists that he did the right thing. Cuddy isn’t so sure, but they’re interrupted when Kaufman reports that Arlene has gone into a-Fib. Cuddy tells House that he’s still on the case, but Arlene can’t find out that he’s involved.

House approaches Kaufman and asks for the test results, but Kaufman refuses. He figures that House will just muscle in on the case, take his normal approach, and leave Kaufman hanging when the medical board evaluates the treatment. Next, House bugs Arlene’s room and calls in the team to listens. When Masters points out that what he’s doing is illegal, House dismisses her concerns.. Meanwhile, Chase listens to Kaufman discuss the test results and suggests leukemia. House notes that Kaufman has come up with the same diagnosis and he’s probably right. He sends Masters to Admitting to find a new case, and then tells the others that now that they’ve gotten rid of the “narc,” they can discuss Arlene’s case. He irritably proposes alcoholism and wants to give her thiamine vitamin pills to cure her. When Foreman warns him that he’ll have to run it by Cuddy, House says that’s why he’s irritable.

House meets with Cuddy and explains his theory, and disguise the thiamine pills as antacid tablets. He wants Cuddy to give the disguised drug to her mother, but Cuddy wants to ask her mother first. She insists that they’ve been honest with each other since her father died, but House warns that addicts lie. Cuddy goes to see Arlene and accuses her of drinking, but her mother angrily denies it. Julia stands by her mother, and Cuddy says that she believes her... and then gives her the disguised thiamine pills for her stomach pains. Afterward, House finds Cuddy in the lobby and she asks him to handle her mother from now on, because she can’t handle the conflict of interest. She says that House was right as usual and walks away.

Taub goes to see Jamie, who apologizes for hitting him and says that he had a lot of stress in his life. Now he says that he’s getting therapy and he’s doing much better. He wants Taub to do one case on a trial basis, and if he works out then he’ll make $50,000 a year. Taub immediately agrees and starts to go. He notices a MRI on the table and points out what looks like a micro-bleed in the brain. Jamie says that it’s the MRI of his client, a young boy who was hit by a pizza delivery truck. Taub insists it’s a micro-bleed, even though Jamie says that his doctors and the defendant’s didn’t find anything. He tells Taub to drop it so it doesn’t undermine his case, and Taub agrees.

As House prepares to go, Cuddy gets word that Arlene is running a high fever, and the biopsies show negative for leukemia. House takes the team to a coma patient’s room to run differential on the coma patient, insisting that Arlene isn’t their case. He refuses to give any hints or say anything to the team, and Foreman suggests that the coma patient overdosed. Masters figures that House wouldn’t be interested unless it was something more interesting, and offers to test him. House leaves with the others, and then starts running a differential on Arlene. They go to a procedure room and House tells them that Kaufman now believe that it’s auto-immune. He believes that Arlene has endocarditis, but if Kaufman lowers her immune system to treat for his diagnosis, that will leave her even more vulnerable to endocarditis. Kaufman has dismissed endocarditis as the disease, so House wants to treat with prednisone. To do so, they have to substitute Kaufman’s IV bag for one with prednisone. Foreman disagrees, warning that they’re getting into illegal territory and he doesn’t to go to jail for Cuddy’s mother. He warns House that he’s losing his objectivity because he’s involved with Cuddy. When Chase asks if Cuddy knows about House’s theory, he tells them that Cuddy told him not to tell her what was going on. House orders them to make the substitution or they’re fired. Foreman refuses to do it and Taub sides with him, but Chase immediately agrees to write the prescription, saying that he agrees with House that it’s endocarditis.

In the conference room, Foreman and Taub sit and brood, and Taub wonders if he’s doing the right thing. He tells Foreman about the micro-bleed, but Foreman says that it’s none of his business and if he messes up the lawsuit for Jamie, Taub will lose his consulting job. Chase comes in and tells them that he ran into Julia, and she recognized him from a charity event. She met Foreman at the same event, so Taub is the only one that she doesn’t know. He refused to switch in the prednisone, but is called away by Jamie on his tryout case. Foreman asks if he’s really leaving them in the middle of Arlene’s case, and Taub says that he needs the job.

Taub makes a decision and goes to see the plaintiff, Timothy. His mother Kara greets Taub at the door, and initially has no idea why he’s warning her that Timothy has a micro-bleed. Once he explains how he found out, he tells her to take Timothy to a doctor immediately to have an angiogram done, and she agrees.

House finds out the team hasn’t given Arlene the prednisone, and warns them that they longer they take, the more danger she’ll be in. He tells them to wait until Julia leaves, and then switch in the prednisone while Arlene is asleep.

Masters goes to Cuddy’s office and warns her that House is up to something, and he’s got prednisone from the pharmacy. Cuddy calls House in and warns him not to go ahead with his plan, but he points out that she knew he’d do something crazy and unethical, and that’s why she didn’t want him telling her anything. She wants his assurance that he’s 100% right, but House warns that it’s impossible. All they can do is the best they can with the best diagnosis they have... and then asks Cuddy to give Arlene the prednisone.

Cuddy puts in the prednisone IV bag and Arlene tells her that Julia left to be with her family, and points out that Cuddy doesn’t have a real family. Cuddy complains that her mother has always been tougher on her than on Julia, and Arlene says that she loves them both, but she likes Julia more.

Taub returns to the apartment and discovers that Foreman has been trying to call him. Foreman informs him that the angiogram shows that the supposed micro-bleed was a skull abnormality next to a blood vessel, and Taub was wrong.

Arlene has breathing problems due to an allergic reaction, and Kaufman doesn’t know why. Cuddy calls House and his team into her office and warns them that they’re in trouble. Kaufman now believes that Arlene has endocarditis, but if he treats her with the prednisone then he’ll kill her. House figures that he’s right, but that Arlene has a fungal version of endocarditis. They need to administer amphotericin B, but Foreman warns that it’s a highly dangerous drug that literally burns the fungus out. Cuddy refuses to let them do it, and House tells her that it’s her fault for letting Arlene fire him. The others agree with Cuddy and leave, and House tells Cuddy that he is right. She gives in... and Masters comes in and overhears them. She agrees with the treatment, but insists that they have to tell Arlene first so she knows the risk, and that the patient is the highest priority. House asks Cuddy to leave, and then tells Masters that if she reveals what she knows, he’ll have her thrown off of his team and out of medical school. She figures that no one will believe House, but he explains that the coma patient had a form forbidding treatment in his file. When she tested him and took blood, she committed assault on the patient. If Masters goes public about Arlene’s treatment, House will tell the authorities. When Masters asked why House set her up, he says it’s because the patient is the highest priority. Masters runs out of the room and goes to the bathroom to vomit.

Taub is in the restroom at his brother’s office when Jamie comes in and slams his head into the urinal. He tells Taub that Kara has scuttled the settlement and reported him to the bar for concealing her son’s condition. Jamie tells Taub that he’s going to sue him for defamation and slander, and destroy his life. He also passes on a message from Rachel saying she wants Taub to stay out of her life.

Masters goes to Kaufman and Arlene and tells her what House has been doing. Kaufman calls in House and Cuddy and threatens to report House to the board. Arlene tells them that she’s going to a different hospital for treatment. When Cuddy objects, Arlene points out that she lied to her and that she doesn’t care what she has to say anymore.

Later, House meets Cuddy in her office and he blames her for Arlene’s inevitable death. Cuddy is the one who can’t control her mother, and she needs to. He warns her that now that she’s put it on him, she’ll eventually blame him for killing Arlene, ruining their relationship, and asks her to get his patient back. Cuddy runs out to the ambulance and orders Julia out, and then tells her mother that the reason she’s always been hard on her is because she expected more from her. If Arlene values her medical judgment, then she has to respect it now and stay at the hospital so House can treat her.

Arlene agrees to return to the hospital, and House checks on her. She comments on something House said earlier about how he no longer runs his department, and takes him literally. When House realizes that she can no longer understand sarcasm, he realizes that her brain is showing symptoms, indicating CNS involvement. As Arlene’s heart accelerates, House focuses on working out the case and then cuts open her thigh. She has black muscle tissue brought on by metallosis: Arlene has a defective cobalt hip joint, which is the source of her illness. When they stopped the earlier chelation treatment, her conditions got worse. House orders her into surgery to remove the hip joint and cure her.

Rachel comes to see Taub in his room and says that Foreman told her what happened. When she told Jamie that she didn’t want to see Taub again, she didn’t know that he was trying to save Timothy. Rachel tells him that she’ll kill Jamie if he threatens Taub, and says that no matter how bad a husband he was, he was always a good person. The two of them hug.

Masters is preparing to leave when House visits her and says that he’s hiring her back. He reluctantly admits that he’s impressed that she stood by her principles even when he threatened her. When Masters wonders why he wants her there, House explains that he needs Masters as his conscience because Cuddy will protect her boyfriend instead of her doctor, and the hospital will call her on it. As House leaves, Masters starts unpacking.

Cuddy visits Arlene, who can’t help pointing out that she was right about insisting she had lead poisoning symptoms... but she takes Cuddy’s hand.

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