Joy to the World - Recap

Natalie and several other older students are off-stage waiting to go on at their school’s Christmas pageant. One of them, Sarah, says they need to make a statement and prods another girl, Natalie Soellner, into insulting a teacher in the middle of their song. They go out and sing and Natalie starts to hallucinating. She blurts out the teacher’s name but the other students don’t leaving her embarrassed. She starts vomiting and collapses to the stage.

Natalie brings the case to House and her team and explains that Natalie’s liver is failing. House is more interested in why Cuddy is there and suggests she’s doing so because she’s sexually interested in him. She casually dismisses his accusation and leaves, and Taub finds a Christmas present for House. House immediately throws it away but Taub takes it out and discovers it’s an antique medical text. House throws it away again and tells them to forget it, and wants to know why the girls picked on Natalie. He wonders if they slipped Natalie something. Kutner and Chase talk to the students and they eventually admit they slipped Natalie some mushrooms. One of the boys, Simon, has them in the locker but claims he didn’t give them to Natalie. He doesn’t think they’re dangerous but Chase notes that they can be if not dried properly.

Foreman is checking Thirteen, who asks about Janice, the other patient. Foreman says she dropped out and didn’t ask why, and notes that Thirteen is improving. She leaves him a gift certificate as a Christmas present along with a thank-you note.

Kutner and Taub get the mushrooms from Simon’s locker at school, while they wonder if House is something up to or if the present is legitimate. They also check out Natalie’s locker and find a bottle of painkillers. They give it to Natalie who talks to Natalie. The girl claims she takes them for headaches and asks Cuddy if she has any kids. Cuddy says she knows what Natalie is going through but Natalie says she’s fat and they hate her. Cuddy tells her to forget them and to focus on making her better, but Natalie wonders what’s the point. Cuddy talks to Natalie’s parents, who initially insists she didn’t overdose on the painkillers. However, Mrs. Soellner admits her daughter has changed in the last year since she hit puberty and gives Cuddy the okay to treat her.

Kutner and Taub go to Wilson to ask him about the present. When they describe the note and the present, he claims to recognize it and claims it came from Irene Adler, a patient House fell in love with. Then he tells them he’s lying and says it’s the same present that he gave to House a year ago. Taub and Kutner are called away to where Natalie is having heart problems and increased blood pressure, disproving the painkiller overdose theory.

Back in differential, Cuddy is attending again and House notes she’s still there. Thirteen and Foreman are busy so Taub and Kutner called her in. Once she gives them the update, Cuddy leaves. The team tosses out theories but Taub plays along with House’s prank and suggests Cuddy really loves him and House should tell her how he feels. House figures out they’re onto him and goes back to the case, remembering Natalie works at a soup kitchen. He tells Taub to do the anal-swabbing of the men at the soup kitchen and sends the others to check out Natalie’s house and school.

House confronts Wilson in the cafeteria about setting him up. Wilson is puzzled as to why House waited a year to open his present and figures that House creates the appearance of a gift because he can’t get along with anyone. Wilson kind of goads him into being nice to his patients but insists it won’t work. House admits he has to stop being a jerk… and then steals Wilson’s ice cream.

Thirteen goes to see Janice who explains that she quit because the injections were making her nauseous and when she complained to Foreman, he told her to get over it. Janice says she doesn’t have a long time and she refuses to spend her remaining time being Foreman’s guinea pig.

Taub talks to House and says it’s tuberculosis: one homeless man had it at the soup kitchen and Natalie was exposed to him constantly. The symptoms fit and House orders a standard regimen. He then goes in for clinic duty and starts being nice with his first patient, Whitney. She complains about a headache and he quickly determines she’s pregnant. Whitney had no idea she was pregnant and claims she and her fiancé are virgins. House doesn’t believe it and leaves, giving up on being nice.

Natalie has a seizure and Cuddy doesn’t know what it is. Back in the differential, they add brain issues to the diagnosis and House notes Cuddy keeps showing up and leaving. Cuddy insists she wants to make sure Natalie is okay, but House speculates that Natalie is making her think of her adopted baby Joy. Kutner suggests the mushrooms caused an anti-fungal infection and House orders a prick test and antifungals.

Thirteen talks to Foreman, who thanks her for the gift. She asks him about Janice and he admits that he did tell her to get over it. Thirteen suggests he apologize but he refuses. She accuses him of acting like House, but he says he’s not trying to be cruel or manipulative like House. Thirteen points out that Janice is dying and Foreman notes he sympathizes with what Thirteen sees as her future, but she isn’t buying it.

Whitney brings her fiancé Geoff in to get an explanation for House. He spins a story of a Civil War soldier who impregnated a woman by remote, then gives it up and says she cheated. Whitney insists otherwise and agrees with Geoff that they should get a paternity test.

Natalie tests negative for fungal infection and Kutner offers her some advice, but she says she’s feeling better and that the male student, Simon, brought her her homework. Kutner doesn’t believe it and has security hold Simon so he can confront him. Kutner angrily accuses Simon of doing something but Taub says Simon didn’t do anything and thinks Kutner was bullied in high school. Simon explains that he used to be friends with Natalie but he broke off with her when the other students made fun of him. He explains that he used to get Natalie a couple of bottles of vodka a week with a fake ID, but eventually she stopped when she claimed she had her own ID. They let Simon go and figure that Natalie is an alcoholic.

Cuddy confronts Natalie, who denies drinking now. Cuddy warns can’t get her a liver transplant if they can’t identify the reason for her liver failure. Natalie says she only bought the vodka so she could talk with Simon, but can’t explain why she broke it off by saying she had her own ID. Cuddy explains that she was lousy at life and screwed up every relationship she ever had. She didn’t want a child then, but got older and that feeling passed and she wanted a child. Natalie says her life is already screwed up.

House tries being nice with another patient, Anna, who is having asthma problems. She says she’s using her asthma inhaler and demonstrates by spraying it on the outside of her neck. He tells her off and she leaves. Cuddy arrives and tells House that the parents have vetoed treatment for alcoholism and Natalie either wants to die or wants the attention. House tells Cuddy to have Kutner order the same treatment for the seizures. He then talks to Geoff and Whitney about the paternity test. He looks at it and then, shocked, tells them to wait and walks out.

Foreman is going over the files and talks to his partner, Dr. Schmidt. She tells him not to try and get Janice back, and that they’re not people. She says he has to view the patients as numbers, and it’s a double-blind so that their personal relationships won’t affect the study. She thought Foreman knew that: she hired him because he worked for House.

Natalie’s heartbeat slows down due to bradycardia and the team tries to revive her. Meanwhile, House returns to Geoff and Whitney and explains that Whitney didn’t cheat on him. He explains that through an incredibly rare freak of parthenogenesis, one of Whitney’s eggs had two gene mutations and a spontaneous calcium spike fertilized the egg without sperm. The fetus only has Whitney’s DNA and in seven months she will have a virgin birth. He wishes them a Merry Christmas and leaves.

The team goes back into differential and House starts to tell them about his patient. However, Cuddy says that Natalie’s liver is continuing to fail and her heart is slowing down. Alcoholism would cause the heart to speed up. Her Alk phos is too high, suggesting leukemia. They go to Wilson who admits it’s possible and orders chemo, while House orders a bone biopsy. Cuddy thinks they can save Natalie but House leaves it up to her and leaves. Wilson warns that even if they eliminate all of the bone cancer, she’ll still die: House is sparing her the pain. Cuddy agrees to authorize the biopsy.

Foreman goes to see Janice and says they’re conducting another trial with a drug that will cause less nausea. He offers to get her in and leaves the forms for her.

An increasingly upset Cuddy goes to House and starts second-guessing their diagnosis. He notes that she can’t possibly get worked up about every patient and questions her personal involvement. He finds a present on his desk and explains to Cuddy that he got it from Whitney after saving her marriage. He claimed her pregnancy was the result of parthenogenesis, but Cuddy notes the cycler’s broken and he couldn’t have checked it. He admits the paternity test showed she cheated and he lied to help her. He tosses the present to Wilson, since it proves he was nice to a patient, and declares that he’s won. He admits that he could simply have lied about the paternity test, but decided to give the couple a Christmas miracle as a present. Cuddy realize that Natalie’s symptoms don’t indicate leukemia, but eclampsia. They have two patients… and the fetus must be dead.

Cuddy confronts Natalie and her parents and explains that she has eclampsia, and that someone can get it a month after giving birth. The baby was premature and Natalie hid her pregnancy with loose clothing. When she realized she was pregnant, Natalie stopped drinking. Natalie admits that Simon was the father and they never told anyone, and he doesn’t even know about it. Natalie planned to give it away but didn’t want them to find out at school. The baby stopped breathing and she tried to help it, but it died and she left it at an empty house near the soup kitchen, putting her coat over it. Cuddy informs them that the heart and liver damage are permanent and Natalie is going to die.

Cuddy goes to the house and finds a squatter couple living there. The man tells her to get out but the woman is holding a living baby. Cuddy says it’s not her baby but it’s sick due to a partially blocked airway. Cuddy offers to get it help and notes the woman saved the baby’s life, but now she has to let it go. She brings it back to the hospital and gives it to Natalie. Simon arrives and Kutner lets him go in to be with his daughter.

Kutner goes to the hospital’s Christmas party and informs them that they appealed the transplant refusal but Natalie’s too sick and she only has a couple of days. The baby seems healthy and is being kept for observation. Kutner says he has to go and travels to an apartment. He knocks on the door and talks to a man, Jonathan, and apologizes for bullying him in high school.

Cuddy is watching the baby as House comes in. She explains that the grandparents are putting the baby up for adoption. Cuddy’s going to become a foster parent and adopt the girl. House wishes her a Merry Christmas.

Thirteen visits Foreman in his office and says she knows Janice is coming back. She apologizes for accusing him of being like House. She says they should go to the party and he agrees… and they kiss.

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