Acceptance

Episodes • 1 • 2 • 3 • 4 • 5 • 6 • 7 • 8

House and Foreman engage in the Socratic Method:

House: "Good question. What makes a person deserving? Is as man who cheats on his wife more deserving than a man who kills his wife?"

Foreman: "Yeah, actually, he is."

House: "What about a child molestor? Certainly not a good guy, but he didn’t kill anybody. Maybe he can get antibiotics, but no MRIs. What medical care should you be denied for being a car thief? Tell ya what, the three of you work on a list - what medical treatments a person loses based on the crime they committed. I’ll review it when I get back"

— Acceptance

Acceptance is the premier episode of the 2nd season of House which first aired on September 13, 2005. When a death row inmate takes ill, House tricks Stacy into getting him released to the hospital so he can figure out what is wrong with him. When the prisoner improves, Cuddy tries to get rid of him, only to have more serious symptoms appear. Meanwhile, Cameron deals with a clinic patient’s terminal diagnosis by trying to prove everyone wrong, and when the diagnosis seems to be confirmed at each step, she gets more and more desperate to save her patient while wondering why House only cares about a murderer.

Recap

A death row inmate is in the exercise yard when he starts hallucinating about the people he killed and he collapses.

Despite the efforts of Cuddy’s new assistant, House interrupts Cuddy and Stacy in a meeting. Stacy realizes House wants her to leave, so she leaves and House asks to take the inmate's case. Cuddy finds out that House has stolen her computer password. The patient's heart is beating too fast to pump blood, and House argues the cardiologist, Dr. Nolo couldn't possibly have any diagnoses for that. Cuddy gives House the case in exchange for more clinic duty.

House runs into his team, who are wondering about the ethics of treating a death row inmate. He sends Cameron to cover his extra clinic duty. House shoots them down for failure to want to treat the patient by saying medical care shouldn't be contingent on past good behavior. He then goes to work on the case alone.

House goes to the prison to see the patient. He's turning blue from lack of oxygen. The patient needs intubation and a respirator, but prison doesn't have one and the warden won't let the patient leave. House gets Stacy to get a court order to take the patient to the hospital, but Stacy finds out that Cuddy didn't clear it. House points out that the court order orders him to make the patient better.

House starts a differential on the inmate. Cameron wants to work on her clinic patient instead. Foreman objects to treating a death row inmate. The obvious thing to check for is drugs, so House orders tests.

The team has a discussion about the death penalty. They go to see the patient, but he is agitated and struggling with them even though he‘s restrained. He tears apart his bed, pulls out his feeding tube, and asks for water.

The patient’s thirst goes away when they give him more saline. There are no traces of drugs in his system. They argue again whether they should figure out his underlying condition or just treat his symptoms. House orders tests of his blood gasses. Stacy is waiting outside and confronts House about lying to her. She wants to know if she can trust House. House points out that he lied to help the patient. Stacy accepts that answer.

The patient notices Foreman has a gang tattoo. The test shows that the patient has anion gap acidosis. Foreman guesses that the patient may have taken a drug they don't usually test for. Chase is sent to the prison to look for cut up INH the patient may have mistaken for narcotics.

Wilson finds House in the coma ward watching Prescription Passion. He talks about House’s intentions about Stacy.

However, the patient's vital signs drop. House gives him a stimulant to raise his heart rate. He calls Chase, who is searching the patient's cell. Chase mentions that the cell contains copier fluid.

House goes to the patient's room and offers him some booze. They have several drinks together. Cameron comes in and catches them. House admits he could have had her, and the patient thinks House is crazy for passing her up. House tells the patient he's figured out the patient drank copier fluid in a suicide attempt. The patient says the impulse to do it just came on suddenly. He tells the patient that although he drank enough methanol to kill himself, the ethanol in the booze is binding to the formic acid from the methanol in the copier fluid so that it can pass harmlessly through his kidneys.

House comes in the next morning with a hangover. Stacy is there to meet him to tell him to send the patient back to prison. However, House still thinks the patient is sick despite the treatment for the poisoning. He asks Stacy not to tell anyone. He goes back to the team to ask them why a healthy man would attempt suicide. House notes that the patient's heart was in tachycardia before he drank copier fluid. He orders a full workup.

Foreman starts a more thorough examination. The patient wonders why they care about him. Foreman performs a lumbar puncture. The patient starts talking about his younger brother, who he hasn't seen since he went to prison.

The tests are all turning out normal. Chase realizes that the patient is getting to Foreman by reminding him about his background.

Cuddy finds out the patient is still in the hospital. She decides to discharge the patient. However, the patient is having abdominal pain. Cuddy thinks he is faking, but House finds blood coming out of his anus.

House goes to Stacy about ratting him out. However, he isn't angry, although he did point out that he trusted her. She tells him that she did what she thought was right. House reminds her that's the only reason people ever do things.

The patient has part of his necrotic bowel removed, and House starts wondering why the patient killed his fourth victim. The first three had an obvious motive, but the fourth one didn't. House asks the patient, who responds that he just got very nervous and when he saw the other inmate looking at him, he went into a rage.

The team looks at the patient's rage. House thinks it is an adrenal gland tumor - a pheochromocytoma - it releases adrenaline at random intervals, like the time he ripped the bed apart. They have to do an MRI to find it, but the patient has tattoos with metallic inks, and the MRI will rip out the ink. They proceed, but the patient is in pain. They find the tumor and schedule surgery to remove it.

Foreman goes to see House. He thinks that the patient should appeal on the basis that his tumor gave him random rage. However, House is more sanguine - many other people have such rage attacks and don't commit crimes. The episode ends with with Cameron telling her clinic patient that she is terminal, and then comforting her, and Foreman watching on as death row inmate is taken away.

Clinic Patient

Cameron is filling in for House at the clinic when she meets a young woman with anemia and a cough. She has no surviving family, and a family history of cancer and heart disease. The patient is there for a routine health clearance before starting work. The tests have already come back and Cameron looks at the x-rays and see the patient may have cancer. She seeks out Wilson for a consult but he thinks it's obviously cancer.

Cameron looks to House for a consult, but he agrees with Wilson - it's lung cancer with a prognosis of six months. Cameron has alternative diagnoses, but House knows they have to be wrong. She asks for a differential diagnosis, but instead House draws the five stages of dying on the whiteboard. He orders Cameron to tell the patient she's dying.

However, Cameron tells the patient the tests are inconclusive. She is testing for unlikely but possible diagnoses. The patient asks if she should be worried, but Cameron reassures her.

House finds Cameron doing a differential on her patient with the team. She still wants to confirm the diagnosis.

She asks House to do a lavage to look for infections. House suggests a biopsy, which would be conclusive. She can't understand why House doesn't care about her patient. He points out that Cameron is going through the five stages of impending death instead of her patient. He agrees to the one procedure if Cameron will do two more of his clinic hours.

However, the lavage shows no infection - Cameron has to do a biopsy.

The biopsy is positive, but Wilson finds out that Cameron still hasn't told her patient. Cameron has been spending time being friendly with her patient. Cameron is upset that she's alone. Wilson tells her that it's not worth it to get emotionally involved with terminal patients; the patient feels good for their last few days, but the doctor isn't the same, maybe for years. She tells Wilson about how her late husband would have died alone if she hadn't married him and that when a good person dies, there should be an impact. Wilson appears to understand.

Zebra Factor 8/10

Pheochromocytomas are very rare, but the symptoms (particularly sudden rage, which was put down to the patient’s personality) did point in that direction.

Major Events

Stacy Warner starts working at the hospital, having been appointed General Counsel.
Stacy reveals that she met Mark Warner at a fundraiser. To tease House, she goes along with his suggestion that it was at a strip club by saying Mark was one of the strippers.
Cuddy’s network password is “partypants”

Trivia & Cultural References

The title of the episode is the last stage in dealing with imminent death.
At one point in the episode House (while speaking with Wilson about House's ex, Stacy) says:

I know you're friends with her, but there is a code...bros before hoes, man.

Robert Sean Leonard, who plays Wilson in the show found this so hilarious that he laughed aloud, although this was not actually scripted.

“Dead man dying”, which is how House describes the patient on the whiteboard, is a play on the phrase “Dead man walking”, a term used to describe a person who is currently alive but facing imminent death, such as a death row inmate.
More about Capital punishment in the United States’
Elizabeth Kubler-Ross was a Swiss-born psychiatrist who was one of the first physicians to study the effect of imminent death on patients. She developed the “five stages of grief”, which is officially known as the Kubler-Ross model
More about Hitler, Ghandi, and Pol Pot

Links

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Honeymoon

Acceptance

Next episode:
Autopsy