Medical History
Clarence was a death row inmate that started to hallucinate about the people that he killed. Clarence screams to be let out of the room and then collapses on the floor. House is intrigued to hear that the patient’s heart was beating so quickly that it pumped air instead of blood. Cuddy gives him the case in exchange for two clinic hours.
House diagnoses Clarence as hypoxic with fluid in his lungs. He will die in an hour without a respirator. House calls for an ambulance. The warden insists that no death row inmate leave through the front doors. House has Stacy acquire a legal injunction and angers Cuddy. Foreman thinks heroin might be the cause of Clarence’s tachycardia and pulmonary edema, so House orders a drug test. The test results come back with no sign of opiates in Clarence’s system.
Foreman draws blood from Clarence’s femoral artery. The tests results indicate an anion gap acidosis, a new symptom. The team mulls over the causes of anion gap acidosis, and Cameron suggests INH, the drug for tuberculosis. House sends Chase to the prison to find Clarence’s heroin stash, but he only finds boxes of office supplies. House figures out that Clarence drank copier fluid to kill himself, and cures him with several shots of alcohol, which should bind to the methanol in the copier fluid and neutralize it. Clarence's return to health means he should go back to prison, but House asks Stacy to cover for him, thinking something else is wrong with Clarence. Stacy tells Cuddy, and when she tries send Clarence back to prison, Clarence complains of tremendous stomach pain. House pulls back Clarence’s sheets, revealing a large pool of blood on the bed.
The surgeons remove almost a foot of necrotic bowel from Clarence. House asks Clarence about why he killed his fourth victim, the only case that didn't fit or have an apparent motive. Clarence says that he felt like the guy could stare straight through him. House, Foreman and Chase ponder the sudden cause of this rage. Chase suggests adrenaline, which leads House to think about pheochromocytoma which sits on top of the adrenal gland and randomly dumps the system with adrenaline. Although extremely rare, it is the best explanation. The diagnosis is confirmed, and Clarence is cured. Afterwards, Foreman plans to testify at Clarence’s appeal hearing.
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