Euphoria, Part 2
Encyclopedia
"Euphoria" is the twenty-first episode of the second season of House
, which premiered on the Fox
network on May 3, 2006. This is the conclusion to the House two-episode story arc, the first part being "Euphoria (Part 1)".
on Joe, in order to find out which disease killed him. However, because the disease is contagious
and has now killed one human, the situation has elevated to a Biohazard Level-3, which means no one other than CDC
officials can perform an autopsy on Joe. As it will take at least 3 days for them to arrive, Foreman will be long dead before any such autopsy can be performed.
House then goads Foreman into performing the autopsy himself via a transorbital lobotomy
, known as an ice pick lobotomy, as Foreman will not be prosecuted if he's dead and is already infected. Cuddy arrives and tries to dissuade Foreman, but he attempts it anyway, only for his newest symptom to develop: Anton–Babinski syndrome, same as Joe, which prevents him from performing the operation correctly. With the autopsy plan ruined, the team attempts another differential diagnosis. House, desperate, orders treatment for Foreman, treating everything: viruses, fungi, bacteria, parasites, etc. Foreman, also increasingly desperate, takes the drug cocktail. House then comes up with another plan: taking his pet rat, Steve McQueen, to Joe's apartment, House has Steve retrace all of Foreman's steps, in hopes that it will catch the disease so House can perform a necropsy. Foreman then calls his estranged father, telling him he is sick and they should probably meet.
The drug cocktail successfully treats the disease that is killing Foreman, but the toxic combination also causes pancreatitis
. Foreman wants to continue the treatment, preferring the pancreatitis over the blindness and hyperalgesia
, but as he will die much sooner from the pancreatitis than from the unknown affliction, he finally agrees to stop treatment. Rodney Foreman, his father, then arrives, and House, realizing his opportunity, attempts to use him to guilt Cuddy into allowing the autopsy, but fails.
As Foreman makes up with his dad, the team discovers that Foreman is dying much quicker than Joe did. Trying to come up with reasons for why this is, House realizes it's because Foreman was completely healthy when he was infected. Cuddy then visits Foreman, offering her apologies, but though they are accepted, Foreman is furious, stating that even if she has to serve a prison sentence, her highest priority should be saving his life. ("And the punishment for violating those regulations? Is it death? Hmm? Because frankly, I'm ok if you get a fine, a suspension, hell, you can spend a couple years in jail if it saves my life!") As he is yelling at her, House arrives with a vial
of Legionella
, explaining that while Foreman was completely healthy when he was infected, Joe had legionnaire's disease. For some unknown reason, the legionnaire's disease slowed down the unknown disease. House then proceeds to purposely infect Foreman by shattering the vial of Legionella in the isolation chamber.
Back with the team, House then states that it's possible that an unknown infection is the culprit, which was not recognized by the body. However, the body was then infected with Legionella, which it recognized, causing an immune reaction. Putting together a disease that affects humans but not rats (as the rat failed to exhibit symptoms of the unknown disease) and a disease that the human body would not recognize, House postulates the unknown disease is Listeriosis. However, Foreman initially refuses treatment, as it will definitely cure the legionnaire's disease but not necessarily the unknown disease, which means the pain will return. Treatment doesn't work, and Foreman, in increasing pain, asks Cameron to be his medical proxy. Because of the increasing pain, the team has no choice but to put Foreman into a coma, similar to Joe. Everyone knows there is a good chance Foreman will never wake up.
After Foreman has been put into a coma, Cameron, now his medical proxy, obliges his request and decides to perform a white-matter brain biopsy
, a dangerous operation which could leave Foreman paralyzed, brain damaged, or killed. House, desperate to save Foreman without endangering his brain, decides to return to Joe's apartment, even without hazmat protection, to find another infected animal on which he can perform a necropsy.
As House is investigating Joe's apartment, the medical team is simultaneously preparing Foreman for the operation. After following an apparently infected pigeon, House eventually discovers that Joe had an illegal well of rain water on his roof, which was contaminated by Naegleria fowleri
. Foreman came through as it was spraying the plants in the greenhouse and was thus infected. House and Cameron came through hours later after the plants were watered and thus were not exposed. House calls and informs Cameron of this revelation, but Cameron has already performed the biopsy, and both teams have simultaneously discovered the true disease, primary amoebic meningoencephalitis
. The Legionella had attacked the parasites which is what had been slowing the disease when Joe and Foreman were infected with that. A later CDC autopsy on Joe also confirms it.
As Foreman wakes up from his coma, House performs a checkup of his brain function. House and Cameron then realize Foreman's lobes are crossed when he attempts to lift his right arm, but his left arm moves instead.
House (TV series)
House is an American television medical drama that debuted on the Fox network on November 16, 2004. The show's central character is Dr. Gregory House , an unconventional and misanthropic medical genius who heads a team of diagnosticians at the fictional Princeton-Plainsboro Teaching Hospital in...
, which premiered on the Fox
Fox Broadcasting Company
Fox Broadcasting Company, commonly referred to as Fox Network or simply Fox , is an American commercial broadcasting television network owned by Fox Entertainment Group, part of Rupert Murdoch's News Corporation. Launched on October 9, 1986, Fox was the highest-rated broadcast network in the...
network on May 3, 2006. This is the conclusion to the House two-episode story arc, the first part being "Euphoria (Part 1)".
Plot
The episode begins with House desperately trying to perform an autopsyAutopsy
An autopsy—also known as a post-mortem examination, necropsy , autopsia cadaverum, or obduction—is a highly specialized surgical procedure that consists of a thorough examination of a corpse to determine the cause and manner of death and to evaluate any disease or injury that may be present...
on Joe, in order to find out which disease killed him. However, because the disease is contagious
Contagious disease
A contagious disease is a subset category of infectious diseases , which are easily transmitted by physical contact with the person suffering the disease, or by their secretions or objects touched by them....
and has now killed one human, the situation has elevated to a Biohazard Level-3, which means no one other than CDC
Centers for Disease Control and Prevention
The Centers for Disease Control and Prevention are a United States federal agency under the Department of Health and Human Services headquartered in Druid Hills, unincorporated DeKalb County, Georgia, in Greater Atlanta...
officials can perform an autopsy on Joe. As it will take at least 3 days for them to arrive, Foreman will be long dead before any such autopsy can be performed.
House then goads Foreman into performing the autopsy himself via a transorbital lobotomy
Lobotomy
Lobotomy "; τομή – tomē: "cut/slice") is a neurosurgical procedure, a form of psychosurgery, also known as a leukotomy or leucotomy . It consists of cutting the connections to and from the prefrontal cortex, the anterior part of the frontal lobes of the brain...
, known as an ice pick lobotomy, as Foreman will not be prosecuted if he's dead and is already infected. Cuddy arrives and tries to dissuade Foreman, but he attempts it anyway, only for his newest symptom to develop: Anton–Babinski syndrome, same as Joe, which prevents him from performing the operation correctly. With the autopsy plan ruined, the team attempts another differential diagnosis. House, desperate, orders treatment for Foreman, treating everything: viruses, fungi, bacteria, parasites, etc. Foreman, also increasingly desperate, takes the drug cocktail. House then comes up with another plan: taking his pet rat, Steve McQueen, to Joe's apartment, House has Steve retrace all of Foreman's steps, in hopes that it will catch the disease so House can perform a necropsy. Foreman then calls his estranged father, telling him he is sick and they should probably meet.
The drug cocktail successfully treats the disease that is killing Foreman, but the toxic combination also causes pancreatitis
Pancreatitis
Pancreatitis is inflammation of the pancreas. It occurs when pancreatic enzymes that digest food are activated in the pancreas instead of the small intestine. It may be acute – beginning suddenly and lasting a few days, or chronic – occurring over many years...
. Foreman wants to continue the treatment, preferring the pancreatitis over the blindness and hyperalgesia
Hyperalgesia
Hyperalgesia is an increased sensitivity to pain, which may be caused by damage to nociceptors or peripheral nerves. Temporary increased sensitivity to pain also occurs as part of sickness behavior, the evolved response to infection.-Types:...
, but as he will die much sooner from the pancreatitis than from the unknown affliction, he finally agrees to stop treatment. Rodney Foreman, his father, then arrives, and House, realizing his opportunity, attempts to use him to guilt Cuddy into allowing the autopsy, but fails.
As Foreman makes up with his dad, the team discovers that Foreman is dying much quicker than Joe did. Trying to come up with reasons for why this is, House realizes it's because Foreman was completely healthy when he was infected. Cuddy then visits Foreman, offering her apologies, but though they are accepted, Foreman is furious, stating that even if she has to serve a prison sentence, her highest priority should be saving his life. ("And the punishment for violating those regulations? Is it death? Hmm? Because frankly, I'm ok if you get a fine, a suspension, hell, you can spend a couple years in jail if it saves my life!") As he is yelling at her, House arrives with a vial
Vial
A vial is a relatively small glass vessel or bottle, especially used to store medication as liquids, powders or in other forms like capsules. They can also be sample vessels; e.g., for use in autosampler devices in analytical chromatography.The glass can be colourless or coloured, clear or amber...
of Legionella
Legionella
Legionella is a pathogenic Gram negative bacterium, including species that cause legionellosis or Legionnaires' disease, most notably L. pneumophila. It may be readily visualized with a silver stain....
, explaining that while Foreman was completely healthy when he was infected, Joe had legionnaire's disease. For some unknown reason, the legionnaire's disease slowed down the unknown disease. House then proceeds to purposely infect Foreman by shattering the vial of Legionella in the isolation chamber.
Back with the team, House then states that it's possible that an unknown infection is the culprit, which was not recognized by the body. However, the body was then infected with Legionella, which it recognized, causing an immune reaction. Putting together a disease that affects humans but not rats (as the rat failed to exhibit symptoms of the unknown disease) and a disease that the human body would not recognize, House postulates the unknown disease is Listeriosis. However, Foreman initially refuses treatment, as it will definitely cure the legionnaire's disease but not necessarily the unknown disease, which means the pain will return. Treatment doesn't work, and Foreman, in increasing pain, asks Cameron to be his medical proxy. Because of the increasing pain, the team has no choice but to put Foreman into a coma, similar to Joe. Everyone knows there is a good chance Foreman will never wake up.
After Foreman has been put into a coma, Cameron, now his medical proxy, obliges his request and decides to perform a white-matter brain biopsy
Brain biopsy
Brain biopsy is the removal of a small piece of brain tissue for the diagnosis of abnormalities of the brain. It is used to diagnose Alzheimer's disease, tumors, infection, inflammation, and other brain disorders....
, a dangerous operation which could leave Foreman paralyzed, brain damaged, or killed. House, desperate to save Foreman without endangering his brain, decides to return to Joe's apartment, even without hazmat protection, to find another infected animal on which he can perform a necropsy.
As House is investigating Joe's apartment, the medical team is simultaneously preparing Foreman for the operation. After following an apparently infected pigeon, House eventually discovers that Joe had an illegal well of rain water on his roof, which was contaminated by Naegleria fowleri
Naegleria fowleri
Naegleria fowleri is a free-living excavate form of protist typically found in warm bodies of fresh water, such as ponds, lakes, rivers, and hot springs. It is also found in soil, near warm-water discharges of industrial plants, and unchlorinated swimming pools in an amoeboid or temporary...
. Foreman came through as it was spraying the plants in the greenhouse and was thus infected. House and Cameron came through hours later after the plants were watered and thus were not exposed. House calls and informs Cameron of this revelation, but Cameron has already performed the biopsy, and both teams have simultaneously discovered the true disease, primary amoebic meningoencephalitis
Primary amoebic meningoencephalitis
Primary amoebic meningoencephalitis is a disease of the central nervous system caused by infection from Naegleria fowleri.-Presentation:...
. The Legionella had attacked the parasites which is what had been slowing the disease when Joe and Foreman were infected with that. A later CDC autopsy on Joe also confirms it.
As Foreman wakes up from his coma, House performs a checkup of his brain function. House and Cameron then realize Foreman's lobes are crossed when he attempts to lift his right arm, but his left arm moves instead.
External links
- "Euphoria (Part 2)" at Fox.com