- Adams: "..and if we start you on treatment now, get you off Vicodin"
- House: "What's the opposite of 'Thank you'? I'm pretty sure it ends in 'you'. I know my body, I‘m fine."
- ―Blowing the Whistle
Blowing the Whistle is a 8th season episode of House which first aired on April 2, 2012. House treats a sick soldier who is under heavy guard because he has leaked a video of a military massacre. Meanwhile, Wilson and the team start to believe House's Vicodin use has caused permanent damage and wonder whether Foreman should be told.
An army captain and his family are awaiting the arrival of his brother, a private, at the airport. However, when the brother arrives, he is surrounded by military police who tell the captain the brother has been charged with treason. However, as the military police lead him through the airport, the private loses his balance. They try to put him back on his feet, but he keeps collapsing, eventually going into a seizure.
The team is watching a military video. Adams tells them the army killed 34 civilians, including six children, who they thought were insurgents. Foreman tells the team that the patient will be constantly surrounded by military personnel and to make sure their identification badges are in full sight. He also tells them the army doctors couldn’t find anything wrong with their patient. Foreman leaves and the team starts a differential, but Park doesn’t want to treat the patient because he anonymously downloaded the video to the press. She thinks he’s faking it. House agrees to pretend to treat him.
Adams is worried about House. To test him, she stole his mug and wore the same outfit two days in a row, but he didn’t notice. She thinks he’s suffering an attention deficit. However, she can’t get the others concerned. Chase thinks that House is acting this way deliberately to try to make Adams think he is sick.
They give the patient a placebo and tell him he developed a deep vein thrombosis to see if he will fake another symptom. Park questions him about what he did. The patient and his brother get into an argument. However, the patient says his leg is numb. Adams realizes Park was right and goes to get the discharge papers. However, when the doctors reveal the deception, the brother stands up for him, saying he would never fake anything. The patient starts complaining about stomach pain too. Adams examines him and finds a large rash on his abdomen. She realizes he wasn’t faking.
However, the rest of the team isn’t convinced. Adams points out that the patient was ready to plead guilty to treason, so there’s no reason for him to lie about symptoms. They start a differential, but House wants to talk about honor. Taub agrees with Chase that it’s probably pancreatitis from gallstones and goes to do an ultrasound. Adams stays behind to get House to do a written order for the ultrasound so all the paperwork will be in order. House wants to know why she didn’t get one before and why she doesn’t just forge one. She says they didn’t really treat the patient before and that she needs to know what his signature looks like.
Wilson is in the clinic when Adams comes to see him. He diagnoses the patient as a nose picker and his girlfriend breaks up with him. Adams asks Wilson to compare two of House’s signatures done six months apart. She has noted his hands are shaky and she thinks it’s hepatic encephalopathy from Vicodin abuse. She also says House has been forgetful and inattentive. Wilson thinks it’s just Dominika’s cooking combined with too little sleep and too much caffeine. Adams argues if she’s right, House needs immediate treatment. Wilson says she’s been working for House too long and is seeing zebras where they don’t exist. He reassures her that House is fine.
However, Wilson goes to confront House in the clinic. He finds him asleep in a room with the lights off. A sedated patient is sleeping nearby. Wilson tells House that he thinks he has hepatic encephalopathy, notes his reflexes are slow, and that he forgot about lunch. Wilson wants to run tests, but House won’t go for it.
They give the patient an ultrasound. He says he joined the Army to find out what really happened to his father - two pages were missing from his service record when he died. Chase wants to know why he released the video if that were the case. He says it’s because he spent time with civilians and wants to protect them. Park notices the patient’s spleen is enlarged. She wants to do a biopsy, but Chase notices that there is blood in his urine as well. They examine him further and find other bleeding as well. They call for units of whole blood for a transfusion as they realize that the patient’s platelets are all in the spleen and no-where else. They realize they don’t have time for a transfusion and need to squeeze his spleen to release them and Chase calls for an operating room.
Chase operates with the assistance of Taub as the patient’s vital signs get worse. Chase manages to get in and get the spleen. The patient stabilizes, but Chase has noticed the patient’s spleen has lumps.
A CT scan confirms nodules on the spleen. They start a new differential. House is trying to get Taub to lose the video game they’re playing and pressures him to come up with ideas. However, it backfires - Taub gets inspired and realizes the nodules might be granulomas from sarcoidosis. None of the other fellows can give a reason why Taub is wrong. Taub then blows House’s character off the screen. House orders steroids and then tells them to come back so he can beat them at the videogame.
Adams is even more worried - House never loses videogames. Taub is too busy basking in the glow of victory to take her seriously. However, Park starts to agree with Adams and says they have to tell Foreman. Taub is opposed because they have no evidence that it’s affecting House’s work. Chase is still sceptical - he thinks its too much of a coincidence that they are treating a whistleblower and they are discussing blowing the whistle on House. He thinks House is faking.
The patient refuses steroids until he gets a live television interview. Taub tells him it won’t make a difference.
The major comes out of Foreman’s office - they’re refusing the interview. Taub says that the public will think it was a deliberate act by the military, but the major told Foreman that would still be less damaging than letting the patient talk publicly. They discuss their options and decide to get a court order that the patient isn’t mentally competent. However, the brother refuses to co-operate with the plan.
The team are discussing the matter. When Taub comes back from the bathroom, House wants to know why he’s coming from the wrong direction. Taub says the nearest bathroom has been out of order, and House gets up to say he’s going to fix it. They discuss how they could treat the patient without letting him know, but House thinks about giving the patient a better reason to accept treatment. He also leaves a little something in the broken restroom in order to compel the hospital to fix it. He also suggests getting something to compel the patient to accept treatment.
They get the major to agree to release the missing pages from the patient’s father’s file, but it will take two days. The brother tells the patient that he will make sure the Army follows through on their promise.
Chase is disappointed that the patient is more interested in his father than the truth. Taub heads back to the broken restroom to get a stool sample.
The tests on House’s stool show signs of liver failure. The team is reviewing the results when their pagers go off. The patient is suffering from severe cyanosis in one of his feet. They realize it can’t be sarcoidosis.
The team confront House with the results of their tests, but he focusses on the differential for their patient. Even Chase wants to discuss House’s issues, but although House agrees the test results are probably right, their diagnosis is wrong. To get them off the subject of his health, House agrees to Park’s diagnosis of DIC and orders heparin.
The team argues about whether to tell Foreman. Chase convinces them not to.
House and Wilson get into an argument about his condition. To get away from Wilson, he goes to see the patient - Wilson’s not allowed in the room. Wilson says he will just keep after him.
House is obviously just killing time, so he and the patient get into a conversation about honor. House asks if it was worth it. The patient says that it was his job to log the tape and when he watched it over and over, he just couldn’t believe the official story that the soldiers had mistaken a shovel for a gun. He couldn’t sleep or eat, and his hair started to turn grey. He said he had to do it to make sure it didn’t happen again. House is interested in his grey hair.
House goes back to the team and tells them loss of hair color points to an autoimmune condition, most likely Grave’s disease, which explains the coagulopathy. However, his team is sceptical and points out if he’s wrong, the patient will die in his current condition. House orders anti-thyroids.
Park is worried that House has gone from genius to “just really smart”. Chase suggests they shouldn’t follow House’s orders, and they agree.
House finds out that they didn’t treat with anti-thyroids, and Taub says they’re acting that way because they don’t trust his judgment. In addition, the team has already ruled out Grave’s disease. Foreman comes in and asks to speak to House in private, but House realizes he’s there to address his team’s concerns and says he can talk in front of everyone. Foreman says that until House gets examined, Foreman will have to approve all treatment orders. Adams turns back to infections, which were eliminated earlier because the patient’s white blood cell count was normal. However, House keeps talking about how he was stabbed in the back by his team. However, he finally hits upon drug-resistant malaria and Foreman agrees.
However, the patient is once again refusing treatment because his father’s file is overdue. His brother assures him it will come, but the patient has stopped trusting the Army.
As the team discusses whether it is worth treating the patient, the brother comes forward and agrees to co-operate with being appointed the patient’s medical proxy. Taub says he will get the paperwork done.
However, Adams can’t figure out why the brother changed his mind - the patient was also close to death the last time they asked him to say his brother was incompetent. Adams convinces Taub that it’s strange the brother’s code of honor has been abandoned so easily.
Taub goes to confront the brother. Taub has found out that the army did release the file like they promised, only they released it to the brother who hasn’t shown it to the patient. The brother says he had a good excuse for not telling the patient. Taub has read the file too and knows the reason, and says he’s going to go and treat the patient.
When Taub goes to see the patient, the patient thinks he was right that the army is covering something up. However, the brother comes in and tells the patient he’s responsible for the cover up. He tells the patient his father died while driving drunk, and killed a pedestrian in the process. The brother was the one who asked someone to remove the pages. Taub asks to begin treatment, and the patient agrees.
However, the patient doesn’t improve. They start a new differential. All of a sudden, Chase realizes something - House has a bigger cup today that he uses to steal candy. There’s no reason he couldn’t have used a bigger cup the previous day when he stole candy, so he must have been using it to help fake symptoms. House admits to the deception - he took herbal remedies to fake how his body processes acetaminophen. Just as House says he’s already figured who ratted him out, he thinks of something.
House has remembered that the patient spent a lot of time with Afghani civilians, and rat lice can harbor typhus. They ruled it out earlier because people without hair usually don‘t harbor lice. Not only does it explain all the symptoms, it could also explain why he leaked the video as it can cause psychiatric issues as well. The patient is reluctant because he thinks pleading insanity will undermine all he did. House reminds him that he’s just trying to please his dead father, and the honor he’s trying to uphold never existed.
House goes to call Wilson a traitor because he’s been avoiding him ever since he went into the patient’s room to get away from him. He thinks Wilson turned him in to Foreman. Wilson says he’s been avoiding House because he’s an ass. House points out that’s never driven Wilson away before, and that if Wilson wasn’t the one, he has to abuse his whole team until one of them confesses. As he turns to leave, he realizes Wilson hasn’t “real confessed” or “pretend confessed” and it probably wasn’t him. However, as he talks about confessions, he realizes something else.
The patient is about to be discharged. As he leaves, the brother salutes him. Chase is standing by watching when he sees a rat. House is right behind the rat, saying it’s name is “Little Chase”. House figures Taub confessed to ratting him out to protect the patient, and Adams did it to protect Taub. However, Chase’s confession was superfluous. However, Chase doesn’t think House will punish him because he wanted Chase to tell Foreman. It was the only way that House could ensure someone would step up to the plate if House ever did lose his skills. House points out that if that were the case, there wouldn’t be a whole bunch of rats in Chase’s apartment right now.
House is treating a patient who is clearly drunk, which accounts for all his symptoms. However, the patient insists that there must be something else wrong because he’s only had eight beers and has been building up his tolerance to alcohol to play beer pong. House gets him to hop up and down on one leg while singing. After the patient does it for a while, House agrees that the patient has an intolerance to the green dye in the green beer he’s been drinking. He tells the patient he will be fine in a couple of days.
- House fools the team into thinking he’s starting to suffer from liver failure just to see if any of them will rat him out to Foreman.
- Chase is the one who rats House out, even though he initially thought House was faking liver failure.
- House punishes Chase by releasing rats in his apartment.
Zebra Factor 8/10
Even where it is endemic, typhus is extremely rare. It certainly wasn’t a stretch here because the patient had admitted to travel in Afghanistan and it was the first disease Chase suggested in the differential.
Trivia & Cultural References
- “Blowing the Whistle” is a reference to Whistleblowing, an act where a person in an organization who reasonably believes there is corruption or illegal activities going on in the organization reports it to law enforcement authorities. In the episode, it refers both to the patient’s release of classified information and Chase telling Foreman about his concerns about House.
- The episode is loosely based on events surrounding Bradley Manning, a U.S. Army private who released several hundred thousand classified diplomatic documents to Wikileaks and the Kandahar massacre, an incident where a U.S. Army staff sergeant murdered seventeen people and wounded five others.
- Treason is a crime which includes assisting an enemy combatant against one’s own country.
- The Battle of Tora Bora was a 2001 battle between U.S. forces and supporters of al-Qaeda in Afghanistan near the border with Pakistan. It was believed Osama bin Ladin was hiding there.
- Kunar province is one of the most easterly parts of Afghanistan and borders Pakistan as well.
- In the videogame, Taub chooses the nickname “Taubinator”, while House goes with “Occam’s Chainsaw”.
- iCarly is a popular teen sitcom about a young girl who has her own web broadcast.
- Yet another reference to Judas Iscariot and his thirty pieces of silver
- Spartacus was a gladiator who led an unsuccessful slave revolt against the Roman Empire. In the movie version, when Spartacus and his men are captured, they refuse to tell the Romans which man is Spartacus - instead they all say they are Spartacus.
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