- "Ladies and gentlemen. We have a passenger with a confirmed case of bacterial meningitis. Even if we land as soon as possible, the passenger will not survive. It’s very likely that some of you have been infected as well. As soon as you start feeling symptoms, we need to isolate you in the first-class cabin. Fever, rash, nausea and in the late stages, tremor in the left hand."
"Airborne" is a third-season House episode that first aired on April 10, 2007. On a trans-polar flight from Singapore to New York, House and Cuddy face a “Flight Into Danger” as the passengers around them keep getting sick and even Cuddy seems to be affected. Meanwhile, back in Princeton, Wilson leads House’s team when a middle-aged woman seems to be suffering from her recent decision to live life to its fullest.
An older woman welcomes a beautiful young woman who offers to perform sexual favors for a fee. The older woman grabs a packet of several $100 bills and looks upon the now scantily-clad young woman before suddenly passing out on the floor. The young woman calls 911.
The older woman is transported to Princeton-Plainsboro Teaching Hospital, where she is examined by Wilson. He is quick to note the motion sickness patch that she left attached—it could have caused her collapse. The young woman wishes to leave to see another client, but Wilson urges her to stay with the older woman just in case she suffers a relapse. The patient wants to let the woman go, but she then falls to the floor with a seizure that can‘t be explained by the motion sickness patch. Wilson wonders where House is.
Meanwhile, House and Cuddy are in an airport gate in Singapore, boarding the plane for a flight back to New York. Cuddy notes how House has racked up over $500 in room service expenses during the trip. The airline hostess welcomes House to first class but tells Cuddy her seat is in coach. House says he solved the expense problem by downgrading her seat.
Back at the hospital, Wilson sits with the patient and asks her about recent activity that might have contributed to her blackouts. The woman regretfully tells Wilson that she went to Venezuela where she had probably consumed unsanitary water and food, drank dangerous alcohol mixtures, engaged in unprotected sex, and inhaled cocaine. She assures Dr. Wilson this is not her typical behavior, and she is afraid that her trip is why she is ill.
House is given a steak dinner as he notes a Korean man moaning a few seats down. When he regurgitates a pink liquid, House tells the flight attendant that he's drunk. When the attendant asks if there's a doctor on the plane, House offers to "go get her" and "kindly" relieves Cuddy of an uncomfortable seat in coach.
Wilson start discussing the case with House's team. He politely orders several tests done to determine the disease while Foreman notes that Chase's suggestions are most likely based solely on the fact that Cameron suggested them.
On the flight, an angry Cuddy returns to House, noting that the vomiting and moaning man may likely have meningococcus, a highly contagious form of bacterial meningitis. Cuddy is concerned that if this is the case and they do not order the plane turned around, their route over the North Pole will leave them with no opportunity to land the plane for fifteen hours, and not only the sick man, but anyone who had been infected by him, would be dead before they land. House is convinced that it is not meningococcus and that she shouldn't induce hysteria.
Chase and Cameron are sent to scan the old woman's house for toxins. Cameron thinks Chase is agreeing with her because they're having sex. Cameron coerces Chase into having sex on the patient's bed. Chase is reluctant at first because the patient's cat is watching them from atop a chest of drawers. Cameron removes his pants and he changes his mind.
A girl in the seat in front of House has overheard their conversation and soon proceeds to vomit. Cuddy still believes that it's meningococcus and that immediate action needs to be taken. House is dismissive until he sees a rash on the woman's back—the same symptom the Korean man had.
House creates an ersatz differential team by asking a young boy if he can say “Crikey, mate” and then to agree with everything he says (imitating Chase), telling a foreign man to disagree with everything he says (imitating Foreman), and directing an annoyed middle-aged woman to get mad at him for everything he says (imitating Cameron). The number of sick passengers is increasing, House begins to scribble on the projector screen in coach as though it were the whiteboard. He comes to the conclusion that the sea bass served for dinner contained a toxin. House makes an announcement on the loudspeaker that a man has ingested a food-borne toxin and that anyone who had a seafood dish should proceed to the restrooms and vomit as soon as possible. Most of the passengers immediately rush to the restrooms. House hesitantly agrees with Cuddy that meningococcus would also explain the symptoms.
The team meets with Wilson at the hospital. Chase notes the tox screen was a waste of time, as was Foreman's brain scan and tests. Wilson theorizes that the woman has breast cancer and they prepares her for a mammogram.
More passengers start feeling sick and Cuddy insists that it is meningococcus. The Korean man is feeling worse. House gets the patient to stand up to prove he doesn’t have the ataxia typical of meningococcus, but he collapses.
Wilson approaches the young woman, who is leaving, and asks her to stay with the older woman for moral support as she has no other friends or family. The mammogram is completed without event, but as Cameron helps the woman away from the machine, she begins to complain of eye pain. This, as well as a spotless mammogram, debunks the cancer diagnosis.
House is still trying to determine what is wrong with the Korean man. He guesses radiation sickness. He thinks the blonde woman with the rash is pregnant. Cuddy dismisses House for coming up with two different diagnoses. Right then, Cuddy starts having the same symptoms. Cuddy tells House "I told you so" while he examines her. House informs the attendant that there is something to worry about, but to tell the passengers otherwise. More passengers get sick. They realize they need medication.
Wilson talks to the young woman, who admits she just met the patient. Wilson says she can go. She reluctantly leaves, but gives Wilson her phone number and asks to be informed about how things turn out with the patient.
The patient is transferred to a testing lab, told to cover her eye, and made to stare at a spiraling screen to help induce seizure. This tactic also fails when the woman's brain activity plummets as she goes comatose.
House parades up and down the aisles, collecting medication from reluctant passengers. He diagnoses a Businesswoman with herpes, and finds her male companion with the pills to treat it. He makes an announcement that unless the passengers give up their meds, it's likely that some of them will be de-planing in body bags. Pill bottles immediately come out of pockets across the plane.
Back at Princeton, Foreman is theorizing that the patient has an intercranial bleed that the tests missed and advises drilling into the patient's skull to releive the pressure. Cameron disagrees and Chase follows her lead, which doesn't surprise Foreman. Wilson orders a lumbar puncture first to play it safe.
They only find a few antibiotics, and the Korean man is allergic to penicillin. Cuddy tells House to do a lumbar puncture on the Korean and give him the antibiotics if the fluid is cloudy. House thinks its foolhardy to do a lumbar puncture due to the lack of equipment and turbulence, but agrees when Cuddy mockingly suggests they just let the patient die.
At the same time, in the hospital, the older woman is prepared for a lumbar puncture.
House jerry-rigs instruments to perform the procedure, which shows that the liquid is clear. House makes another broadcast informing all passengers that they will need to be isolated when they start exhibiting symptoms such as fever and tremors in the left hand. When several passengers' hands begin to shake uncontrollably, House notes that none of the passengers have bacterial meningitis, but rather are exhibiting mass hysteria, and that if they all relax their symptoms will soon go away. To prove his point, he reminds Cuddy left-hand tremor is not a symptom of meningitis, or anything else for that matter. The fluid from the lumbar shows no evidence of infection, and even the rashes are psychosomatic. He suggests "drinks all around" at the expense of the airline as the perfect solution. Cuddy starts feeling better almost immediately. However, the Korean man is still sick and House has no idea why.
House goes back to his "whiteboard" and his "team". When Cuddy mentions condoms, House concludes that the Korean man may be acting as a drug mule, and the cocaine in condoms he swallowed may have burst, setting up the conditions for an overdose. They will have to operate. "New Chase" thinks it's a cool idea.
With the elderly woman's lumbar puncture results unhelpful, Foreman concludes the only logical step at this point is to drill into the older woman's head. Chase wonders if his sexual relationship with Cameron is affecting his work. As they prep for surgery, Chase questions why the woman's cat wasn't eating any of its food and realizes the patient has no appetite either.
House preps the Korean man for emergency surgery by having him consume alcohol and having his "team" hold him down on the floor.
As they prepare her for surgery, Chase rushes to the older woman's house wearing a gas mask to scan for toxins a second time. He notices that the woman's cat has died atop the chest of drawers, the highest point in the room, and that its food remains untouched. He follows a pipeline outside, eventually leading to a house that was being fumigated with methyl bromide, a powerful insecticide that is poisonous to everything. He quickly calls Cameron, who alerts the surgeons just moments before the drilling has commenced.
House is just about to make the abdominal incision when the young boy accidentally lets go of the Korean man's shoulder, then quickly holds it back down again, causing the man to moan in pain then fall silent. House realizes that pressure on his joints relieve his pain. Checking the man's wallet, he notes a receipt for a scuba-diving session the previous day. Cuddy orders the flight attendant to drop from 38,000 feet to below 5,000 feet; the man has the bends from surfacing too quickly from a deep dive the previous day and then moving to an airplane environment pressurized to only 8,000 feet. House also orders pure oxygen to flush the nitrogen out of his system, and takes a hit of it himself.
Wilson and Chase tell the patient what happened: an old electrical service ran from the fumigated house to her house, which were once joined as a single estate. The motion sickness patch temporarily masked the effects of the poison. She feels better knowing it wasn't her trip that nearly killed her, it was coming home.
The flight attendant thanks House for his aid, and lets him know she’s in New York every Monday. He asks if she’s handicap accessible.
Wilson calls the young woman to tell her that the older woman will be okay, and thanks her for standing by her side. Wilson asks the young woman if she’s coming back to visit.
Chase tells Cameron that he wants more than just a "Friends with Benefits" relationship, but she tells Chase that he’s breaking the rules of the relationship, so it was fun but now it's over.
- House and Cuddy return home from a conference held in Singapore.
- With House out of the country, Wilson temporarily takes over as the head of the Diagnostics team.
- Chase and Cameron break into the patient's home to search for clues but end up having sex instead.
- What appears to be a deadly illness breaks out on the flight back from Singapore, leaving House and Cuddy to find out what's going. Cuddy falls ill as well, forcing House to handle the whole case himself.
- In the end, most of the passengers are diagnosed with mass hysteria while the Korean just has the bends from scuba-diving the previous day.
- Cameron breaks off the friends-with-benefits relationship with Chase when he says he wants "more".
- For a change, instead of finding out the random languages House does speak, it is revealed that he does not speak Korean.
Two different ones for this episode. Methyl bromide poisoning scores a 10/10 as it is very rare because of the precautions taken with the substance to prevent accidental poisoning.
The decompression sickness scores a 1/10 in this case, at least after the receipt was found. It is very common among scuba divers and those who work in compressed air environments, such as tunnel diggers. What complicated the diagnosis was the mass hysteria causing people in the plane to unconsciously mimic the symptoms, making it look like a contagious disease.
Trivia & Cultural References
- The title refers to both the airplane where the plot with Cuddy and House takes place, and the airborne toxin that afflicted the patient in Princeton.
- At the time this episode aired, the Singapore-Newark flight depicted was the longest commercial flight in the world. It takes around 18 hours to fly from Singapore to New York Newark. However, on November 25, 2013, the route was cancelled due to the global economic recession and rising fuel costs. In contrast to the packed flight shown in the film, the actual route was flown by an Airbus A340-500 which had only 100 business class seats. The flight was reinstated by Singapore Airlines in 2018, once again with no economy seating.
- Singapore is a small nation on an island at the tip of the Malay Peninsula in south east Asia. Patient Peng who suffered from decompression sickness had a receipt for "Tekong Scuba Rental", referring to Tekong Island in Singapore. However, it is a military installation, and civilians are not allowed on it.
- The scene at the airbridge shows the airport as Serapong International Airport. Serapong is located in Melaka, Malaysia, and does not have an airport of its own. Factually, Singapore's only international airport is called Changi International Airport.
- Zinfandel is an American wine, the grapes for which are largely grown in California.
- WHO is the acronym for the World Health Organization.
- “El Gordo” is Spanish for “The Fat One” or “The Big One”.
- The plane House and Cuddy flew on from Singapore to New York was probably a Boeing 767-200. However this would be impossible as no 767 model is capable of a such range.
- House's thought that eating the seafood meal had made the flight passengers ill, is borrowed from the film Airplane!, a 1980 comedy in which everyone on the flight who ate the fish (including all three members of the flight crew) becomes ill and the plane has to be landed by a passenger, an ex-pilot with a "drinking problem". The plot of Airplane! was based on a dramatic film from 1958, Zero Hour! which in turn was based on a 1956 Canadian television movie, Flight into Danger which featured a very young James Doohan and Kate Reid.
- Pej Vahdat, the actor who portrays Arastoo on Bones, appears as a member of House's improvised diagnostic team on the airplane. He is the one who cannot speak English very well.
- ”Crikey, mate” is a reference to Steve Irwin, the noted Australian wildlife enthusiast.
- The flight attendant clearly asking "Malalagnat ka ba?" to the Korean passenger after he first vomits when it should be "Nilalagnat ka ba?". It means "Do you have a fever?" in Tagalog.
Cases such as Peng's are not unheard of, and frequently happen on flights away from major scuba destinations, such as Hawaii. It is dangerous to scuba dive and fly within a short period of time because, although the air pressure on a diving ascent is carefully controlled to prevent decompression sickness, the air pressure on a plane drops far more rapidly and residual nitrogen in the bloodstream may bubble out of solution.
- Hugh Laurie as Gregory House
- Lisa Edelstein as Lisa Cuddy
- Omar Epps as Eric Foreman
- Robert Sean Leonard as James Wilson
- Jennifer Morrison as Allison Cameron
- Jesse Spencer as Robert Chase
- Jenny O'Hara as Fran
- Meta Golding as Robin
- Krista Kalmus as Joy the Blonde
- Tess Lina as Keo
- Jamison Yang as Peng
- Melissa Kite as Sour Faced Woman
- Pej Vahdat as Hamid
- Connor Webb as 12-Year-Old Boy
- Ben Carroll as Businessman
- Gayla Goehl as Businesswoman
- Karla Droege as Mother
- Savannah Paige Rae as Crying Child
- Victor Buno as Passenger One
- Donna Silverberg as Passenger Two
- Bobbin Bergstrom as Nurse
- Kal Parekh as Passenger Three
- Episode page at IMDB
- Episode article at Wikipedia
- Episode page at House MD Guide
- Episode transcript at Clinic Duty
- Episode quotes at House MD Quotes
- Episode page at TV.com
- Episode article at TVIV
- Episode preview at The House of Fan
- Episode recap at Buddy TV
- Quotes at Dr Greg House.com
- Episode review at Blogcritics
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