- Foreman: "He’s not dead or sentimental, and somebody needs to do it."
- Cuddy: "Not necessarily. Departments of diagnostic medicine don’t exist. The only reason we have one is because of House."
- Foreman: "You reassigned us. Kept us on payroll for three months. You might as well give me a chance."
- — Epic Fail
Epic Fail is a sixth season episode of House which first aired on September 28, 2009.
House returns home to Princeton-Plainsboro where he continues to focus on his recovery by announcing he's going to quit and go into research. However, as his boredom grows, he is tempted to start taking Vicodin again. He starts taking up a hobby, cooking, at the advice of Dr. Nolan, in order to keep himself busy. He tags along with Wilson to a cooking class.
Meanwhile, what is now Foreman’s team is unable to diagnose a loud-mouthed video game creator who posts each new symptom on the internet and opts for treatments suggested by the online community rather than by his doctors. Foreman angles for House’s job, but Taub leaves to pursue more lucrative offers and the pressure to solve the case creates tension in his relationship with Thirteen.
This episode marks the return of Lisa Cuddy, Eric Foreman, Allison Chase, Robert Chase, Thirteen and Chris Taub after they were all absent from the previous episode and only House and Wilson were seen. Andre Braugher returns as Dr. Nolan.
However, House is in Cuddy's office with Eric Foreman. House wants to resign from the department and look for a research job instead to take the pressure off of him. He apologizes to Cuddy and Foreman for putting so much on them. Cuddy reluctantly agrees. When House leaves, Foreman pushes for his job. He points out that she must have kept the team on salary for a reason. She gives Foreman one shot.
Foreman meets with Thirteen and Chris Taub. They decide that it might be CRPS and Foreman orders a spinal stimulation. Thirteen and Taub go to see the patient, who thinks he has mercury poisoning from eating too much fish. He's also researching his case on the internet and asks for a blood test to rule out the diagnosis.
Foreman goes to House's office and starts taking the covers off the furniture. He finds the B.O.U.O.. Cameron comes in to congratulate him. She asks about House, and Foreman tells her he's being honest. He finds out that Thirteen and Taub didn't take the case to the CT Scan. He finds them in the lab testing the patient's blood. The test is negative and Foreman goes to see the patient.
House goes to see Dr. Nolan. He's complaining that his leg pain is getting worse and that the ibuprofen he has been taking is barely affecting it. Dr. Nolan thinks he needs a hobby to keep his mind off of it.
Foreman comes to the patient telling him his mercury is elevated, but not enough for chelation therapy. The patient demands chelation anyway. Foreman refuses and threatens to drop the case. The patient agrees to the spinal stimulation.
The fluid shows that Vince has a thickened left ventricle. Although he didn't have CRPS, they were lucky enough that it showed another symptom. Foreman wants to ask the patient about drug use.
House goes along with Wilson to his cooking classes. House can't stop making jokes. When Wilson burns his meatballs on one side, House suggests using vinegar to slow down the process.
Foreman apologizes to the patient about the poor result from the spinal stimulation. The patient insults Foreman. The patient denies using drugs for the past 12 years, after his roommate suffered an overdose. Foreman orders an environmental scan of his office just to be sure. Thirteen tells Foreman to stop thinking like House and to be himself. He thanks her and asks her to dinner, but Thirteen is surprised that he's already made reservations.
Cuddy goes to visit House and finds him with Cecile. She speaks Mandarin with House so they can talk about Cuddy to keep her in the dark. Cuddy wants to know if House left his job because of her, but he denies it. When Cuddy hangs around, Cecile takes the opportunity, in English, to tell her to kiss him or leave.
Taub and Thirteen talk about having to work for Foreman. She's upset that Foreman told her to go to dinner rather than asking her. They relax by playing the videogame. Thirteen comes up with an idea.
The patient needed a surgical shunt to relieve his erection. Foreman is upset Thirteen missed dinner. They discuss diagnoses and Foreman decides on thrombocytosis. Foreman and Thirteen discuss the missed dinner and wonder who is in the patient's room. Vince has called other doctors and posted his symptoms on the internet. Foreman tells them to leave because they don't have hospital privileges. One of the doctors stays around and thinks the patient needs an MRI for a brain tumor. Vince asks Thirteen who doesn't take sides because she thought it was a tumor too. However, Vince figures out she agrees with the other doctor and insists on an MRI.
House has been up all night cooking and Wilson comes him and finds him. He keeps getting Wilson to taste. He then admits he couldn't sleep because of leg pain. However, House's cooking is excellent anyway.
Foreman and Thirteen argue about what she should have done when the patient asked for her opinion. Foreman does the MRI, it's clean, and he orders treatment for thrombocytosis.
Thirteen comes to see House. He knows she's there to complain about Foreman. She says she's there to talk about the case. He tells her to stop being a coward - she has to learn to give in sometime. She thinks he's an amazing cook. He tells her his leg hurts.
Foreman talks to Chase about Thirteen. He suggests firing her.
Wilson finds House relaxing in front of the TV watching The Biggest Loser. He complains that his leg still hurts and he's afraid he will take drugs for it again.
House goes to see Dr. Nolan, who suggests trying another hobby. He thinks that he will eventually find something that will work.
Foreman brings Thirteen a donut as a peace offering. They apologize to each other. However, as they start making out, Foreman gets paged. The patient's lymph nodes are swollen, which rules out thrombocytosis. The patient has posted a reward for the cure.
House goes back home and finds his place empty. He finds an old bottle of Vicodin in a sneaker.
Steroids reduce the patient’s facial swelling, but the team is inundated with calls, faxes and e-mails from reward seekers. The team go through all the theories and eliminate them one by one. The patient wants to be tested for amyloidosis because that's what the majority wanted. Foreman agrees to the test if, once it's negative, he retracts the reward.
House realizes Wilson has come home early to check up on him. House has done the laundry and says he is fine.
The test for amyloidosis was positive and Taub starts him on the treatment. He comes in tells Foreman he's joining a plastic surgery practice. He started looking when he found out House wasn't coming back. Thirteen tells Foreman that they will get along fine without him. She tells him the case got solved, but he feels he might not be ready. She cheers him up by telling him about her and a cheerleader from Iowa.
Wilson has been surreptitiously testing House's urine, and finds House substituted dog urine. He talks to Cuddy, tells her that House is not limping, and they think he's been using drugs.
Thirteen finds Vince in the hallway having hallucinations. Foreman manages to calm him down, but the patient starts hallucinating again. Foreman realizes he has a high fever and amyloidosis wouldn't cause that.
The anti-pyretics didn't work, and they put him in a cold bath to try to reduce his body temperature. They think it might be LCDD, which would also cause protein to build up in his organs. The problem is there is no test for it and the only treatment is high dose chemotherapy, which is dangerous. The patient agrees to the treatment.
House denies to Cuddy and Wilson that he is using Vicodin. He offers up another urine sample for testing.
The next day, Foreman rushes in - he has a new diagnosis of Fabry disease. The patient's fingertips didn't swell up in the water. However, Thirteen is already on it - she's discontinued chemotherapy and started the proper treatment. He didn't have proteins in his organs, but fat. It's a chronic but treatable condition. Foreman asks her how she did it. She starts by explaining the swollen lymph nodes were most likely iodine mumps from the contrast, and that without that symptom, Fabry was likely. However, she finally admits she went through the internet responses.
Cuddy appoints Foreman the new head of the diagnostics department. Thirteen comes to congratulate him. She realizes he's angry, but he admits he shouldn't be. He realizes Thirteen was just afraid to confront him openly. He is afraid it's going to affect her relationship. However, he doesn't want to break up with her and realizes he has to fire her.
House comes to Dr. Nolan and tells him he slipped, but not in the way he thought. He started doing diagnostic medicine again. It was House who posted Fabry disease - he shows the reward check to Dr. Nolan. However, it made his pain go away. He's afraid to go back because he might go back on drugs. However, Dr. Nolan realizes that he may have to go back. House agrees.
Zebra Factor 9/10
Fabry disease is very rare, with an occurrence in the general population of about 1 in 120,000. That works out to about 2,650 cases in the entire United States. It is possible, but not likely, that House would see a case. Even specialists in genetic disease and neurology would be unlikely to see a case in their lifetime. However, its symptoms are very non-specific and many Fabry sufferers are not diagnosed until early adulthood even though the disease affects even young patients. Moreover, Fabry can be fatal if untreated and often kills without warning.
- House returns to Princeton-Plainsboro Teaching Hospital, but announces that he is resigning as the head of diagnostic medicine so that he can stay healthy and not fall into his old habits.
- As a result of House's resignation, Foreman becomes the acting head of diagnostic medicine.
- House later takes up cooking and it's revealed that he's fantastic at it.
- Taub resigns as he only started working at PPTH to work with House.
- It's revealed that Thirteen went to Sarah Lawrence College.
- After the case, Foreman becomes the permanent head of the department.
- Thirteen is fired, leaving Foreman (temporarily) as the lone soldier in the diagnostics department.
- In December 2008 actor Jeremy Piven withdrew from the Broadway revival of "Speed-the-Plow", citing mercury poisoning from consuming fish twice daily for 20 years; Thirteen obliquely refers to this in response to the patient's suggestion of sushi causing mercury poisoning, then saying "Google it."
- This episode had one of the biggest uses of CGI of the series to create the virtual-reality in the video game the patient was working on.
- The video game reappears a number of times throughout the rest of the show's run; mainly in season 7. It is later revealed to be named "Savagescape."
- The title of this episode comes from the internet culture slang “epic fail", somewhat referencing the extensive featuring of internet and video game culture in this episode.
- The friends of the patient are called "Lee" and "Roy" which refers to the Leeroy Jenkins internet meme.
- Jake Gyllenhaal is an American actor who has moved from troubled teen roles into action roles.
- Marcus Webley is a play on Marcus Welby, a doctor in a television series of the same name that ran in the early 1970s.
- Tom Brady’s backup for the 2008 season where he was injured was Matt Cassel, who did indeed make over $10 million a season from 2009 onward. Cassel retired from professional play after the 2018 season.
- The Biggest Loser is a reality television series where contestants compete to lose the most weight.
- Actually, Legion is a group of demons in the bible, although it does refer to itself as a single person (“I am Legion“). The herd of pigs falling off a cliff is a reference to the location of the miracle at issue, which took place near a steep slope.
- "Going up to eleven" is an idiom coined from This Is Spinal Tap and refers to how amplifiers only go to a maximum volume setting of ten.
- Itzkoff, Dave. "Arbitrator Rules in Favor of Jeremy Piven in ‘Speed-the-Plow’ Dispute", New York Times, 2009-08-27. Retrieved on 2020-08-26.