Babies & Bathwater

Babies & Bathwater
Director(s)	Bill Johnson
Writer(s)	David Shore, Peter Blake
Airdate	April 19, 2005
Episode number	1.18
TV.com rating	8.8/10
Guest star(s)	Chi McBride
Final diagnosis	Small-cell lung cancer
Zebra Factor	1/10

Season One Episodes: Pilot Paternity Occam's Razor Maternity Damned If You Do The Socratic Method Fidelity Poison DNR Histories Detox Sports Medicine Cursed Control Mob Rules Heavy Role Model Babies & Bathwater Kids Love Hurts Three Stories Honeymoon Episodes • 1 • 2 • 3 • 4 • 5 • 6 • 7 • 8

House: "Thank goodness you were here to save all those lives!"

Vogler: "The Board’s meeting again this evening. Why don’t you settle down? Play some GameBoy. Why don’t you watch your soap? I hear they’re firing the handsome doctor today. Oh, that should be a good one."

―Babies & Bathwater

Babies & Bathwater is a 1st season episode of House, M.D., which first aired on April 19, 2005. House quickly diagnoses a pregnant woman, but she resists treatment because of the risk to her unborn baby. When House tries to bend the rules to get her into a clinical trial, he finds Vogler standing in his way. The dispute between them leads to a showdown before the Board of Directors, and Wilson gets caught in the crossfire. However, when House once again pulls off the impossible, Cuddy has to decide whether to risk her own career.

This is the last episode in the series to feature Edward Vogler.

Recap

A pregnant woman, Naomi, is driving her drunk husband home when she briefly blacks out, and they narrowly escape a collision. A policeman pulls them over and, mistakenly suspecting that she is also intoxicated, tells Naomi to step out of the car to undergo a sobriety test. When she does so, she collapses in the street.

Foreman performs some tests and finds that Naomi's kidney and liver function are off. Naomi reveals that she has miscarried several times and is fearful for the life of her unborn baby.

In the following scene, House is diagnosing Vogler with Stage 4 cancer when he hears Foreman's voice—he has been dreaming—and startles awake. House is hiding from Vogler. Foreman introduces Naomi's case and explains that she has lost coordination but has normal blood pressure, to which House responds that she might have an autoimmune disease. He then breaks the news that Cameron has quit. Foreman and Chase think this is House's fault, and they have a spirited disagreement about what they should do.

Chase and Foreman visit Naomi, who suddenly begins choking on a morsel of soft pear. After they stabilize her, she frantically tells them she can't swallow.

Foreman and Chase run tests on Naomi for vasculitis, during which she appears to go into premature labor.

Vogler finally catches House in the diagnostics office. House announces that he has fired Cameron, hoping this will make up for the embarrassing remarks he made during a speech Vogler bullied him into giving (see previous episode). Vogler menacingly demands House's resignation as well as a public apology, and threatens to "destroy" him if he refuses.

As the team discusses Naomi's case, House expresses regret at letting Cameron go (because, he says, she would know where the sugar for the coffee is kept). He also wonders why Naomi choked on soft food. At this point, Wilson arrives and tells House that there is an imminent board meeting to revoke House's tenure. He reminds House that even though he cannot be fired without unanimous board consent, his contract gives Vogler plenty of wiggle room to make his life miserable.

On House's advice, Foreman and Chase check Naomi's eyelids. They discover that one is drooping, and also that her esophagus is swelling. Over her objections (because of her pregnancy), they order X-rays, which reveal a mass pressing against her esophagus. She has aggressive small-cell lung cancer, and it is inoperable. Her other symptoms are the result of paraneoplastic syndrome.

The team wants to use radiation and chemotherapy to treat the cancer. However, chemotherapy would endanger Naomi's baby, so she must have a Cesarean section before starting treatment. The baby, at 28 weeks' gestation, has an 80% chance of surviving, but that isn't high enough for Naomi. She begs to wait one more week, to improve the baby's chances to 90%, but the team strongly objects, noting that her form of cancer is so aggressive that even a week's delay will hurt her prognosis. Her husband, though grieved at the prospect of losing his unborn child, is even more desperate for his wife's survival. Still, she refuses the treatment.

At the board meeting, Vogler begins itemizing the "indiscretions" in House's record. Dr. Simpson tells him that everyone makes mistakes, but Vogler reminds him that these are just the ones House has made in the last three months. Wilson defends House, and Vogler threatens to leave with his $100 million donation if House isn't fired. He calls for a vote. Cuddy votes in favor of dismissal, presumably due to financial considerations. Everyone but Wilson votes to revoke House‘s tenure, but because the vote needs to be unanimous, the motion fails. Glaring at Wilson, Vogler calls for another vote—this time to remove Wilson from the board. He sends Wilson out of the room.

House isn't happy with Naomi's decision to delay treatment and seeks a way to increase her odds of survival, thinking that will change her calculus. Needing an oncology consult, he searches for Wilson—only to find that Wilson has been dismissed from the board for defending House, and that House will most likely be fired the next day when the board can reconsider the motion. Wilson says Vogler gave him the option to resign from the hospital, and he took it. He is angry that House didn't value their friendship enough to give the speech Vogler wanted. However, he agrees to try to find some drugs from Vogler's clinical trials to help Naomi.

House finds Cuddy with a hemorrhoid patient and confronts her about letting Vogler fire Wilson. Cuddy responds that House is a good doctor, but he's not worth $100 million.

House goes to the doctor in charge of a clinical trial and tells him Naomi can start in two days. He schedules Naomi for a Cesarean section, infuriating Chase and Foreman, because he is not only risking the patient's life but also breaking the clinical trial's protocol, which calls for a 30-day waiting period after major surgery. Naomi still refuses to have the Cesarean section and starts arguing with her husband, who agrees with House. House sends the husband out of the room and asks Naomi about her incontinence. He deduces that she has had a child before, and that her husband doesn‘t know. She admits that she got pregnant at 18, and that her child had infantile Alexander's disease[1] and died before the age of 2. She left her first husband and started a new life. House says that's a moving story, but calls her selfish. Naomi defends herself, saying she wants to die to save her child, but House says that is what she wants; she's not thinking about her husband, who clearly wants her to accept treatment. Naomi claims that he doesn't understand, but House loses patience and asks her who does. He says tragedies happen, and tells her to get over it and save her own life. He adds coldly that if she wants to protect her baby from all the "crap" in the world, she can die happy, but it doesn't make her a hero. She agrees to the Cesarean section.

The surgical team anesthetizes Naomi but is interrupted: Vogler has called off the surgery. Furious, House confronts Vogler, who says that House has broken protocol and that, consequently, Naomi has been removed from the clinical trial. Cuddy oversees nearby, silently shocked by the fury House is showing. Vogler tells House that he's going to be fired later that day.

The team informs Naomi that she can still start the clinical trial in 30 days, but as they discuss her options, she develops respiratory distress from a pulmonary embolism. As she is rushed into the operating room, they tell her husband that she must have surgery for the embolism. Only a Cesarean section can protect the baby from brain damage, but a C-section will kill Naomi in her weakened state. The husband's concern for his wife again supersedes his concern for her pregnancy, and he forbids the Cesarean section.

The doctors manage to remove the embolism, but Naomi's blood pressure suddenly drops, and House realizes she is bleeding irreversibly into her abdomen. He tells the team to keep Naomi as stable as possible while he talks to her husband. He tells the husband that she has had a trauma and there is nothing they can do to save her, but he has to permit the C-section or the baby will die as well. The husband doesn't want to, but House reminds him that the decision is easy: Naomi is going to die either way, but he can still save the baby. The husband finally agrees. Although Naomi dies, the team manages to deliver the baby and get it breathing despite the premature birth.

The board meets again on the motion to fire House. This time, Cuddy—whom House has just informed about the fate of Naomi’s baby and a clinic patient—opposes it. She and Vogler argue about who is more out of control: House or Vogler. Vogler calls for a vote to remove Cuddy from the board. Before leaving the room, Cuddy tells the board that if they vote to keep Vogler and his money, he will own them, and their decision to vote her off the board will be the last "free" decision they ever make.

The board votes to retain Cuddy. Wilson is reinstated, and Vogler is dismissed. The team celebrates, although Cuddy isn't happy about the lost $100 million. She reminds House of the good that money could have done, and notes that none of this would have happened if he had just tried to please Vogler.

Clinic patient

House tells parents Joel and Rachel that their baby has pneumonia and is malnourished. The parents say they have been feeding her a vegan diet, and House says she isn't getting enough fat and protein. He admits the baby.

The baby starts improving on antibiotics, and House gets ready to send her home with stern instructions to the parents to give her "human food", but then the police and a social worker arrive to arrest the parents. House goes to Cuddy, railing against Vogler, but Cuddy says Vogler didn't call the police—she did it to stop House from giving Vogler an excuse to fire him. House is furious, telling Cuddy the parents were stupid, not abusive.

The parents are released on bail and return to the hospital, where they tell House that they followed the advice of the mother's uncle, a college-educated nutritionist. House orders a CT scan of the baby.

Just before Cuddy goes to the final board meeting, House tells her the results of the scan. The baby wasn't malnourished after all; she was underweight because of a problem with her thymus gland. Cuddy promises to have the charges against the parents withdrawn, and House gives her instructions on how to treat the baby, assuming he won't be around to do it.

Major events

• Chase and Foreman learn that Cameron has resigned from the team.
• Vogler tries to get House fired, but the vote is defeated.
• Wilson is dismissed from the board when he supports House, and agrees to resign from his job. However, in the end, he is rehired.
• When Cuddy supports House on the second vote, Vogler tries to have her removed from the board, but fails. Vogler is voted off the board instead.

Trivia and cultural references

• Although credited, Jennifer Morrison does not appear in this episode.
• The title of the episode is from the saying “Throwing out the baby with the bathwater”, a metaphor for throwing out the useful to get rid of the useless. As a result, it doesn't work in many other languages. In Spanish, it is alternatively titled "Prioridades" (Priorities), "Cuestión de muerte o muerte" (A Death or Death Issue—a play on the phrase "a life-or-death issue"), or "Morir por amor" (Dying for Love).
• House calls Cuddy "Quisling"—a reference to Vidkun Quisling, who ruled Norway when the country was occupied by the Nazis during World War II. He was executed for high treason after the war, and his name is now synonymous with “traitor” or “collaborator”.
• The outcome of the battle with Vogler has been cited as an example of the As Long As There Is One Man trope. In turn, House, Wilson, and (eventually) Cuddy stand alone against Vogler.
• Vogler ends up revealing is true, profit concerned self. He cares nothing actually medicine, only if he can make money off of it

Zebra Factor: 1/10

Small-cell lung cancer is common in the American population, even among young people and non-smokers.

Cast

• Hugh Laurie as Dr. Gregory House
• Lisa Edelstein as Dr. Lisa Cuddy
• Omar Epps as Dr. Eric Foreman
• Robert Sean Leonard as Dr. James Wilson
• Jennifer Morrison as Dr. Allison Cameron (credit only)
• Jesse Spencer as Dr. Robert Chase
• Marin Hinkle as Naomi Randolph
• Michael Goorjian as Sean Randolph
• Michael Simpson as Joel Kaplan
• Natalie Shaw as Rachel Kaplan
• Ron Perkins as Dr. Ron Simpson
• Kenneth Choi as Dr. Lim
• Chi McBride as Edward Vogler
• John Berg as Dr. Prather
• S.E. Perry as Officer Davis
• Guy Camilleri as Hayden Brown
• Kevin Brief as Officer Angle
• Diane Sellers as Gail Friedman
• Veronica Brown as Female board member
• Reggie Jordan as Anesthesiologist
• Anna Drumm as Teen Mother
• Olive Kaplan

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