- Mary Eucharist: "They say you have a gift...you hide behind your intelligence...and you make jokes because you’re afraid to take anything seriously, because if you take things seriously, they matter, and if they matter..."
- House: "...then when things go wrong, I get hurt. I’m not tough, I’m vulnerable."
- Mary Eucharist: "I barely know you. And I don’t know if I’m right, I just hope I am, because the alternative is, you’re really are as miserable as you seem to be."
- — Damned If You Do
Damned If You Do is a 1st season episode of House which first aired on December 14, 2004. It is a Christmas episode. When a nun comes in to the clinic with bleeding hands, House gives her an antihistamine which appears to set off an allergic attack. However, when the nun gets tachycardia from the epinephrine House gives her to treat it, Cuddy concludes he gave her ten times the appropriate dose. When House insists he gave her the proper dose, Cuddy gives him 24 hours to prove the nun has another condition before she calls the malpractice lawyers. Although House finally vindicates himself, the answer doesn’t help the patient, who continues to get worse no matter what steps they take.
House is hanging out with Wilson in the clinic trying to catch up on his charts when Cuddy insists that he see a patient. He walks in on three nuns, one of whom is suffering the symptoms of an allergic reaction on her hands which the other sisters think is stigmata. House thinks it's probably a reaction to dish soap and gives her an antihistamine, but after he leaves, the patient has an asthma attack. House administers adrenaline, which stops the asthma but the patient's heart starts racing. House calls for a nurse as the patient goes into cardiac arrest.
Cuddy and House start arguing about whether House gave her too much adrenaline, but he denies it. Cuddy allows House 24 hours to look for an underlying cause for the heart attack, otherwise she will have to report the matter to the hospital's attorneys for a malpractice case, and they will report it to the discipline board.
The team starts a differential. House thinks it is Churg-Strauss syndrome, a potentially fatal condition which would explain her symptoms. Foreman thinks House gave her too much adrenaline. House orders treatment for Churg-Strauss. When Chase finds out the patient is a nun, he mentions that he hates them.
The tests show the patient is immunocompromised. Cuddy believes that it was the prednisone that House gave her, but Cameron points out that she only got two doses. They still think it might be an immune disorder - mixed connective tissue disease, so House orders the prednisone discontinued, and that they put her in a hyperbaric chamber. Foreman points out that it could cause oxygen toxicity and they are not sure it is an immune disorder. Foreman goes to Cuddy about House's decision.
Another nun catches House in the chapel watching TV. She tells House that the patient is a hypochondriac. The patient is often let off work detail for her imagined illnesses. They sit there psychoanalyzing each other.
House and Cuddy are still arguing about whether he was at fault and Cuddy finally pulls House of the case on the grounds it will keep him from killing the patient.
Cuddy decides to treat the symptoms because there isn't an underlying cause - she blames House's care. Foreman defends his decision to go to Cuddy, but the rest of the team doesn't care.
House starts showing signs of doubt about the adrenaline syringe. House decides to go through the clinic records to see if there was another syringe with more than the recommended dose of adrenaline. Wilson points out that House can't trust his own records.
House goes to Chase to ask him about the patient. He tells House to speak to the patient's superior. House goes to the Mother Superior and finds out the patient lived in foster care before she became a nun. House notes that the patient has a tattoo, and again asks the mother superior to tell her about the patient before she became a nun. The mother superior tells him that the patient had a self-induced abortion. House admits that this information is irrelevant to the case. However, the tea he is served twigs a memory.
House comes back to Cuddy and tells her he's going to stop her from killing the patient. He tells her that the patient drank figwort tea that made her ultrasensitive to adrenaline, which caused her to go into cardiac arrest. Cuddy and the rest of the team realize that House didn't make a mistake after all, and the other symptoms can be explained by a long term allergy. He gets the case back and they start talking about what she might be allergic to.
They put the patient in a clean room. Chase tells the patient that he went to seminary school, but his faith wavered. Incredibly, the patient goes into anaphylactic shock in the clean room. They eliminate the possibility that she was allergic to anything that was in the room.
The patient wants to return to her monastery despite medical advice. She says she's convinced the illness is a test of her faith. House thinks that she's running away from her problems like she always has. They have a philosophical discussion. She tells House she was on several types of contraception when she was 15, but still got pregnant. When she got pregnant, she blamed God, but then realized that she couldn't blame God. House finally realizes the source of the allergy might be inside her. The team do a full body scan and find a copper cross IUD. She remembers she got a rash from washing copper cookware. They schedule surgery to remove the IUD.
The patient recovers quickly after surgery, and House points out that he gave her the right dose of adrenaline. Wilson points out the hyperbaric chamber would eventually have killed her if Cuddy hadn‘t taken House off the case. Cuddy comes around to wish them a Merry Christmas.
House meets with a patient who is suffering from inflammatory bowel disease. He‘s a department store Santa and is afraid he is going to lose his job. None of the drugs he has taken have helped.. House prescribes cigarettes twice a day as there is evidence that smokers are less likely to suffer from the disease.
- Chase reveals that he hates nuns and also that he studied at a seminary with the intention of going into the priesthood but quit after failing his own test of faith.
- Cameron states that she is an atheist.
- It's shown that Wilson is left-handed.
- House watches another episode of Prescription Passion.
- Chase reveals his mother died ten years ago.
The title of the episode comes from the old adage "damned if you do, damned if you don't", which also comments on the religious concept of damnation within the context of the episode. It is also quoted by Chase within the episode when House praises Foreman for ratting him out to Cuddy, but chastises Cameron for coming up with the right diagnosis early but not sticking to her guns about it.
The title also posed a problem for international versions of the episode as the adage doesn’t always have an equivalent in another language. For example, the German title of the episode translates to “Only the Bride of Christ?”. In Spanish, it is titled either "Si lo haces, malo, y si no, peor" (roughly - If you do, it's bad, and if not, it's worse), "Buenas intenciones" (Good Intentions) or "Fe" (an ambiguous term that can mean Faith, Belief, Inspiration or Creed).
Zebra Factor 3/10
Severe allergies that can cause anaphylaxis are fairly common. The only question here was the environmental source.
Cuddy to House before he removes her from the case; House to Cuddy when he figures out what caused the patient’s tachycardia:
- "I’m going to do you the biggest favor one doctor can do for another. I’m going to stop you from killing your patient."
- ―Damned If You Do
- "Candy canes? Are you trying to mock me?"
- ―Damned If You Do
Trivia & Cultural References
- In Italy a dialogue between House and Chase in the episode (broadcasted from Mediaset Italia 1) was at first partially censored because of some of House's negative remarks about Catholic religion.
- ”I want her going out the front door and not the back” is hospital slang - the “front door” is the main entrance that living patients enter and leave from. The “back door” is the one leading to the morgue.
- House prescribing cigarettes could be a throwback to A Bit of Fry and Laurie. In the third episode of the first series, Hugh Laurie's character is prescribed cigarettes by Stephen Fry's character.Not the case after the episide :
- 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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