- House: "...so let’s get to the point - you don’t like me. I’m pretty sure I’m not going to like you. It’s nothing personal, I don’t like anybody. But none of that really matters does it, because you’ve got money, and I’ve got tenure. You need full board approval to get rid of me. I’ve got Cuddy...and Wilson. So as long as we’re stuck with each other, we might as well ignore each other...(accidentally plays “Hava Nagila” over his iPod speakers). That wasn’t nearly as dramatic as I was hoping."
- Vogler: "I looked into that tenure thing, and you’re right. It’s actually easier for me to get rid of a board member like Cuddy or Wilson than to get rid of a doctor. That’s interesting isn’t it?"
A young, high powered CEO of a cosmetic company starts to suffer intense pain. House quickly diagnoses the problem, but realizes revealing the truth about it will mean the patient’s certain death. Instead, he risks his own career to hide the truth and get her the treatment she needs. During all this, Princeton-Plainsboro takes on a rich new chairman of the board who has just offered a $100,000,000 donation. He immediately sees House as dead weight and decides to infiltrate House’s team to get ammunition against him.
During a presentation, a powerful 32 year old woman CEO starts suffering headaches and leg pain. She cuts the meeting short because she can no longer move her leg and messages her assistant. She asks the assistant to get her a doctor.
House explains the case to the team. The patient has paralysis intense pain in her leg, which prevents her from moving it. Cameron immediately thinks leg infarction, the exact condition House suffered from. When Cameron starts being assertive, House realizes she has been reading negotiating books. House orders blood thinners and tests.
Cuddy is busy introducing Edward Vogler to the rest of the board of directors. He has donated $100 million to the hospital on the condition he be chairman of the Board of Directors to have a say in how it is spent. Vogler tells the story about how he became a billionaire, his relationship with his father and how his father became incapacitated with Alzheimer's disease. He says he wants to help cure diseases like Alzheimer’s and cancer.
Vogler tells Cuddy the hospital should be run like a business. He then sees House playing with a yo-yo. He starts asking about him and how he doesn‘t wear a lab coat. Cuddy assures Vogler that House is a good doctor.
Cuddy goes to House to tell him to wear a lab coat. House tells Cuddy that Vogler is only interested in using the hospital's patients to run clinical trials. Cuddy defends the practice but House points out that it is incompatible with the hospital's purpose - with a pharmaceutical company behind them, they will probably pressure patients into getting into clinical trials. Cuddy notes that House has ethical lapses all the time. House wonders why this particular ethical lapse isn’t bothering her.
The team starts discussing Vogler. They then get back to the patient. The angiogram, muscle biopsy and other tests were all negative. Cameron goes back to using her new-found negotiating skills and convinces House the patient might have cancer.
Wilson suggests bone cancer and discusses Vogler's plans to do clinical trials. House thinks Vogler bought the hospital to get laid. House is not worried about Vogler (having survived three previous administration changes), and rejects Wilson's suggestion to put on a lab coat.
Wilson meets with the patient, who is meeting with her assistant. She knows he's an oncologist. Wilson thinks it might be colon cancer and suggests a colonoscopy and tells her it can be treated. The patient's mother died of the disease. She refuses the test. Wilson suggests they do a CT Scan instead - more expensive, but less invasive. She agrees.
However, the virtual colonoscopy is clean. Wilson and House discuss the patient's reluctance to have intimate tests. House reviews the patient's angiogram, which was clean, but shows that the left foot was scaned twice. House finds out Chase didn't do the angiogram himself and is enraged by the screw-up. He orders it to be repeated, this time by Foreman. Despite the patient’s vitals being strong, she starts having trouble breathing. She goes into respiratory arrest from pulmonary edema. Foreman treats the edema and sends a sample to the lab. However, the second angiogram also comes up normal.
House erases the whiteboard and starts listing psychological symptoms on the board - withholding pain, control, and shame. He examines the patient and finds fine cuts on her body. He realizes that she needs a heart transplant. He goes to Wilson to tell him, but can't tell Wilson why she needs a new heart because he is on the transplant committee. The team comes to tell House, who already knows, that the tests show she needs a transplant because she has severe congestive heart failure.
Vogler starts asking Cuddy about the department of diagnostic medicine. He notes that the department only takes on one patient a week. He asks Cuddy if she ever slept with House. She refuses to answer, and tells Vogler she respects House and that he saves one patient a week. Vogler is wondering why House still isn’t wearing a lab coat.
House goes to the patient about the transplant, and confronts her about cutting herself. He realizes she is a bulimic, but she has managed to hide the usual physical signs of the disease by using an emetic, Ipecac, which also causes muscle damage if used regularly - the pain in her leg and the damage to her heart. She admits to taking it three times a week. House tells her that he is ethically obliged to tell the committee about her bulemia, which will mean she will not get a new heart. However, he is willing to lie about it even though this would risk his medical license. He wants to know if she wants to live, because he's not sure if her own life is important to her. She stops him from leaving and tells him she doesn't want to die.
House goes to the committee and tells them that she has severe congestive heart failure. House says he put her on the transplant list because he had a hunch before the tests were in. Cuddy is sceptical about the “hunch”, but House alibis himself. Vogler sits in on the meeting. House denies there are any reasons to deny her a transplant. Cuddy warns him about misleading the committee and asks straight out if there is anything that would disqualify the patient. House still denies that the patient should be disqualified from getting a new heart.
Wilson asks House if he lied. House asks Wilson why he voted for the transplant if he thought House was lying. The transplant goes forward.
The team discuss what House will do to Chase for screwing up the angiogram. He wonders why House knew the patient needed a transplant before the tests were in, and why he isn't gloating about beating them to the punch again. Chase starts looking through the patient's belongings and finds the Ipecac.
House tells Cameron he wants Chase scared about being fired, but isn't going to fire him. Cameron keeps up with the negotiating skills until House tells her that everyone likes her and they don't dismiss her just because of her gender and good looks. She asks House if he likes her, but he denies that he does.
The transplant is successful. House brings a fried chicken dinner to the patient. She asks why he fought for her. House just says that she's his patient. He also tells her not to screw it up.
Vogler comes to see House, who is listening to, and enjoying, "Baba O'Riley" by "The Who". Vogler turns off the music. He tells House that a nurse found Ipecac, and House acts shocked. House points out that they are not going to like each other, but although Vogler has money, House has tenure and Cuddy and Wilson to support him. He then starts playing "Hava Nagila", cutting it off when he realizes it's not dramatic enough. Vogler intimates that he can get rid of Cuddy or Wilson from the board.
House talks to the surgeon about the surgery. The surgeon says the surgery was uneventful.
The father returns and House explains that his vocal cords were damaged when he was intubated during surgery causing spastic dysphonia - a rare complication. He gave him botox, which loosened the vocal cords. He realizes the patient is scared that he is going to lose his settlement of $1,000,000. House assures him that he‘s not going to rat him out because the hospital has just come into a lot of money. The patient admits by blinking twice that he can talk.
Trivia & Cultural References
- The title is a play on several themes in the episode:
- Control of corporations, such as that exerted by Carly and Vogler.
- Control of the doctors, with Cuddy and Vogler asserting control and House resisting it.
- Control of one’s own body, with Carly and House using drugs to deal with their problems.
- The title of the episode did not translate well into Spanish. Part of the problem is that several Spanish words cover the ranges of "control" that appear in the episode. As such, the title concentrates on Vogler - El Nuevo Jefe del Consejo (The New Chief Counsel).
- Getting to YES is a well known book on negotiation and argument that was first published in 1981. It is considered to be one of the classics of the genre.
- Conn’s Current Therapy is a frequently updated medical text that advises doctors on the proper treatment of the most common medical problems.
- Oddly enough, Carly didn't say anything to the medical staff about the wrong leg being x-rayed. She could have deduced that the leg with pain should have been x-rayed over the leg that is fine.
- House's reluctance to wear a lab coat is explained in the Pilot, during which he explains that he doesn't want people to think he is a doctor, because people do not want a sick doctor.
- The character of Carly Forlano may be based on Karen Carpenter, one of the most popular recording artists of the 1970s, who died at the age of 33 of a heart attack. It was revealed after her death that she had been suffering from anorexia nervosa for most of her adult life. The autopsy revealed heart damage typical of ipecac abuse although her family insisted that although she had abused laxatives, she had never abused ipecac.
Zebra Factor 7/10
Congestive heart failure is not rare, but it is rare in women in their 30’s.
- After donating one hundred million dollars to the hospital board, Edward Vogler becomes Chairman of the Board.
- Wilson and Cuddy try to encourage House to start wearing his lab coat.
- It is revealed that House’s department has a budget of $3 million a year.
- Worried about losing his job, Chase finds out about the patient’s deception and reports it to Vogler.
- Vogler and House meet each other for the first time.
- Jesse Spencer as Dr. Robert Chase
- Jennifer Morrison as Dr. Allison Cameron
- Robert Sean Leonard as Dr. James Wilson
- Hugh Laurie as Dr. Gregory House
- Omar Epps as Dr. Eric Foreman
- Lisa Edelstein as Dr. Lisa Cuddy
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