- House: "You sold it to Sir William?"
- Apothecary: "No. To the king."
- House: "It’s the only part of the environment you didn’t check - the people living in it."
- — Knight Fall
Knight Fall is a sixth season episode of the American medical drama House and it is the 128th episode overall. It first aired on April 19, 2010. It was directed by Juan J. Campanella.
A knight at a Rennaissance fair has bloody sclera after winning a sword fight. House has to deal with the tightly knit community of the fair while diagnosing the patient’s increasingly severe symptoms. Meanwhile, Wilson sets out to date his first ex-wife, which makes House try and break them up. On the other hand, Thirteen notices that someone wants to get much closer to the patient.
At a medieval re-enactment community, modern-day people live life like centuries before. Knights gather on the jousting field as King Miles informs them that the queen will choose their champion from those who will battle for her honor and a title. They must defeat the captain of his guard, Sir Horace the Black. The queen walks among them and asks if Sir William will fight for her honor, and he vows to fight to the death for her. She chooses Sir William, and gives him advice on Horace's weakness while King Miles looks on suspiciously. He questions her choice but she insists, and the fight begins. Horace disarms William and knocks him to the ground, but as Horace plays to the crowd, William returns to his feet, recovers his sword, and finally drops Horace with a series of blows to Horace's injured shoulder. The captain of the guards collapses and the crowd cheers William on. As the queen approaches her chosen knight, William staggers and clutches at his helmet, the whites of his eyes tinged red with blood. Miles takes out a cell phone and calls an ambulance.
At the condo, House is taking Ibuprofen in the nude when Wilson's ex-wife Sam Carr comes in and says that Wilson was called off to work. She's initially surprised but soon recovers and introduces herself and asks House to put on an apron. She thought House was in New York City and asks that they pretend it never happened.
At Princeton-Plainsboro, the team is considering cases when they see House coming in with a sword. He informs them that they'll be taking William's case and explains that he's part of a troupe that re-enact the medieval era. William has been camping out at the Camden fairground for a month. Foreman believes it's a concussion, but Chase notes that the ER wouldn't have consulted House if it were that simple. Taub thinks it might be a sub-dural hematoma. House describes the bloody eyes, leading Thirteen to believe it might be an allergic reaction. House sends Taub and Chase to do an MRI to test for concussion while Foreman and Thirteen go to the fairground to take samples.
First, House stops off to ask Wilson about his new date. He soon realizes that Sam is Wilson's first wife, the "soulless harpy" House has never met. Wilson insists he has everything under control and doesn't want House to interfere. House says he'll soon be back to say "I told you so."
Chase and Taub test for a hematoma, find nothing, and discuss William's case. He hears them and insists that he's not “pretending” to be a knight. William explains that it's a lifestyle and he and the others live by a code of loyalty and courage, and beat each other up for fun. He complains of nausea and starts vomiting, and they rush to get him out before he aspirates.
Foreman and Thirteen take environmental samples at the fair, but the recreationists can't resist pointing out Foreman's strange garb. Thirteen tells him to relax and play along, but Foreman would rather focus on the potential for food contamination. Thirteen drops the turkey drumstick she was munching on. King Miles and Queen Shannon come over and ask how William is doing, and the doctors ask to see William's tent. Foreman notices a vomit-covered cow's eye. Miles explains that it's part of an eating ritual he makes the knights perform. Due to the vomiting, both Taub and Foreman think it’s food poisoning. Miles said William didn't tell them because he swore an oath of secrecy and takes his role seriously.
Back at the hospital, Chase wants to do a lumbar puncture, but House dismisses their theory of food poisoning, noting no one else was sick. He tells them to run scratch tests for allergies and to treat him with epinephrine in the meantime. As Foreman administers the epinephrine and runs the test, Shannon visits William, interrupting the preparations for her wedding to Miles. However, William's heart rate speeds up and Foreman realizes he is suffering from tachycardia. He gets the defibrillator paddles. As they go to shock him back into sinus rhythm, they discover red blisters on his chest.
Dr. Foreman doesn't think it is an allergy, or the epinephrine would have helped. However, House believes the blisters suggest an allergy to the preservative in epinephrine, sodium bisulphite and something else. Taub suggests Wolf-Parkinson-White syndrome, which would explain the blisters and red eyes, but wouldn't cause the blisters. However, Thirteen suggests drug resistant staphylococcus that may have spread to Foreman when he shocked William without gloves, and could potentially spread throughout the hospital. House tells them to test for it and to isolate William and start him on narrow spectrum antibiotics.
House then goes to see Cuddy to talk about Wilson. Cuddy already knows about it and House is surprised Wilson was able to keep it a secret so long. He wants her to break them up before Sam turns harpy again, warning that Wilson was a wreck afterward. House figures that she'd had the most experience in dating losers, but she's not interested in helping out. Cuddy warns that if House forces Wilson to choose, he might not like the answer.
Thirteen checks on William, who seems to be in less pain. He asks Shannon to go get him some pop. Once she's gone, William explains that the pain isn't getting better. Thirteen figures he's in love with Shannon but he won't tell her because he doesn't want to break up her relationship with her fiancée, Miles. He prefers to live like a knight with honor, not a bride stealer. She tells him he's just a guy, but he says he wants to be more. However, he complains that the pain feels like a knife in his back.
Taub and Chase go over William's test results and confirm it's not MRSA but something like clostridium. They discuss possibilities. Chase admits he's impressed by William's bravery. Taub disagrees, and Chase figures he thinks that way because he never won a fight. House arrives to inform them that the blisters are caused by poison ivy, both physical contact and breathing in fumes, and confirms it by revealing he got a poison ivy rash from handling William's sword. They get paged and find that William now has bradycardia. Chase manages to revive him using epinephrine, overriding Taub's objections.
With MRSA eliminated, poison ivy being unable to explain the bradycardia, and clostridium being everywhere in the environment, House concludes there must be some other environmental toxin. House agrees with Chase that it might be trichinosis and orders treatment and a muscle biopsy to confirm.
House then goes to see Wilson, who explains that Sam wants to know House better. Wilson reluctantly agreed because she thinks Wilson was hiding House from her. He was, but he doesn't want Sam to know it. House agrees and Wilson notes that House is worried about him. However, Wilson insists that he doesn't want House's help, and tells him to just come and be his usual selfish stuff.
Shannon comes to see William again, and he says that he doesn't want Miles to see him. He's fine with her seeing him, and Thirteen hastily explains that it's a guy thing so Shannon won't suspect William's feelings. Once Shannon leaves, Thirteen starts the muscle biopsy and suggests that she's waiting for William to make the first move. She tells him to take what is his, but William says that Shannon isn't his.
Wilson and Sam wait for House to arrive. They're surprised to see House arrive with a transvestite prostitute, Sarah.
Thirteen and Foreman check the muscle biopsy and confirm that it's not trichinosis. They wonder what they missed at the fairground, and Foreman suggests it's a fungal infection because it fits the symptoms. Thirteen protests it will take all night Foreman figures that House is suffering from extra pain, making him extra cranky, and they'll have to go to extra lengths to prove it's not environmental.
House’s plan backfires when Sarah starts bonding with Sam and Wilson because Sarah and Sam are both from Bloomington, Indiana.
William has sudden shooting pains in his legs. They check and discover that the legs are swelling with blood and feel like they are on fire, indicating rhabdomyolysis and kidney failure.
Taub suggests cancer and Foreman insists it can't be environmental. House insists it must be environmental and irritably tells them to check William's apartment, despite the fact William hasn't been there in weeks. Chase and Thirteen do it while Foreman and Taub check William's liver with an ultrasound to look for cancer.
Cuddy talks to Wilson in the cafeteria and he describe what happened at dinner and at the condo. When she doesn't react, Wilson wonders if House said something to him but she denies it. He persists and tries to discuss his relationship, explaining that Sam is less competitive than she was when they were married. Wilson asks Cuddy if he's out of his mind, but she remains non-committal, saying he might as well give it a chance. He smiles and agrees.
Foreman and Taub confirm that William's liver is filled with what appear to be dozens of tumors. However, when they magnify them on the scanner, they realize that while they can't identify what it is, it's definitely not cancer.
Thirteen and Chase check out William's apartment, which contains medieval model landscapes with miniature figures. They find a locked door and Chase tries to break it down without much success. Thirteen gets it open when she finds the key under the mat. Inside they find a sanctum dedicated to witchcraft.
Thirteen and Chase bring William's books and potions back to the hospital, but confirm the potions aren't poisonous. Taub suggests the black spots in the liver are blood lesions that are slowly releasing poison into his system. House notices that the figures from the model are lead and proposes lead poisoning as a diagnosis. He orders biopsies of the liver cysts to confirm the presence of lead.
Wilson and Sam return to the condo. They had planned to go to a movie, but she'd rather stay in for sex rather than make the show. However, they hear House singing and discover that he's cooking. He explains that he made dinner for them and his team will handle William. Wilson figures that he's up to something but House insists that he's trying to be nice. He apologizes for bringing Sarah and seems sincere. They have dinner together and things seem to go well. Wilson needs to go the bathroom, but worries that it might be dangerous to leave them alone. Sam and House assure him they'll be fine. Once he leaves, House tells Sam she's a cold-hearted bitch that left Wilson damaged for years, and he doesn't plan to let her do it again. He admits he made dinner to get to know the enemy, and they agree to dislike each other as long as Wilson isn't around. Wilson returns and they go back to pretending to like each other.
The next morning, House returns to his office and the team tells him there's no sign of lead poisoning, but William's heart and BP are growing more erratic and he had to be shocked back into rhythm twice. House decides that he and Thirteen need to go to the fair, in appropriate dress, so they can find whatever is causing William's symptoms. He can't resist discussing Wilson's relationship with Sam, and Thirteen figures that he'll eventually be fine. House warns her that Wilson is actually a nice guy (i.e., a sucker), and they have to watch out for him. House smells something from the apothecary shop and goes to investigate even though Thirteen tells him she and Foreman already checked it out. The apothecary is an apprentice and doesn't know much about what's in the shop. House finds hemlock and confirms that the apprentice sold it to King Miles. House realizes that they checked the environment, but not the people living in it.
Back at the hospital, House confronts Miles and accuses him of poisoning William. Miles denies it at first, and then claims that he bought it for the food challenge because he thought it was wild carrots. When House wonders what Miles' motive is, Thirteen points out that he has one reason. Shannon tells him to tell the truth, but Miles insists that he didn't do it. Tests confirm that William has hemlock poisoning, and House tells William that Miles poisoned him. William insists that Miles didn't poison him because he's never known him to lie. House tells him that Miles is a jealous idiot. However, Taub notes that the treatment isn't working and William is still getting worse. Either William would be dead by now, or the treatment would be working. Taub agreed he had hemlock in his system, but it wasn't what was killing him.
Lucas brings House a report on Sam. It shows that she has a typical life with nothing suspicious in her background. She's been successful at everything except marriage. Lucas admits that he didn't read her psychiatrist's notes, even though he stole them. Sam comes in and asks to talk to House privately. Once Lucas leaves, Sam says that she understands why House suspects her. House isn't impressed, but Sam says that they need to work together to make Wilson happy. She'd like a chance to find out if she can make a new relationship with Wilson. House doesn't have an answer for her and she leaves. As she leaves, House contemplates William's sword and gets an idea.
House tells the team that the lesions are peliosis hepatis lesions, which indicate infection on his heart that in turn indicate steroid abuse, which is also consistent with the rhabdo. The hemlock accelerated the affect of the steroids. House orders treatment. They treat William and Thirteen goes to see him. She wonders why he compromised his ideals for a fight, but not for Shannon. William explains that the fight was a game, but his feelings were real. Thirteen tells him that Shannon takes it seriously, and advises him to tell her how he feels. William explains that Miles is a great guy and Shannon will have a great life with him. However, William can't offer her anything, and he'd rather she be happy. Thirteen tells him that he's an idiot.
Later, House considers Sam's psychiatric files, goes to open them, and then throws them away. He then takes more Ibuprofen for the pain.
Zebra Factor 10/10
Although poison ivy is a common malady, and steroid abuse isn’t all that rare, hemlock poisoning is.
- Sam Carr, Wilson's first ex-wife, is seen in person for the first time.
Trivia & Cultural References
- Read more about Renaissance Fairs
- Well, Chase doesn’t know who Frodo is, but he and Gollum are of course from The Lord of the Rings, which also explain‘s House‘s reference to Middle Earth.
- A Transvestite or Cross-Dresser is a person who dresses up in clothing usually worn by the opposite sex. They should not automatically be assumed to be homosexual, and often accept their gender assignment as well.
- In addition to hemlock, House identifies Rose hips (which contain several vitamins) and Black cohosh (which has several medicinal uses).
- House knows his Shakespeare! He also loves his metaphors. An “embossed carbuncle” is a term used in King Lear to compare someone to a boil that has risen well above the level of the skin.
- When Lucas finds House with a sword, House says “it was just sitting in a stone”, a reference to Excalibur, the sword of King Arthur that he drew from the stone to show he was the rightful king.
- In William's 'Sanctum', he has two sets of symbols relating to 'witchcraft' that are actually opposed to each other - a Pentagram necklace and a copy of the Necronomicon, both associated with Black Magic, but he has Pentacles painted on his wall, which are symbols of protection.
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