Holding On

Holding On
Director(s)	Miguel Sapochnik
Writer(s)	David Foster, Russel Friend, Garrett Lerner
Airdate	May 14, 2012
Episode number	8.21
TV.com rating	9.8/10
Guest star(s)	Olivia Wilde, Skylar Astin
Final diagnosis	Persistent stapedial artery
Zebra Factor	4/10

Season Eight Episodes: Twenty Vicodin Transplant Charity Case Risky Business The Confession Parents Dead & Buried Perils of Paranoia Better Half Runaways Nobody's Fault Chase Man of the House Love is Blind Blowing the Whistle Gut Check We Need the Eggs Body and Soul The C Word Post Mortem Holding On Swan Song and Everybody Dies Episodes • 1 • 2 • 3 • 4 • 5 • 6 • 7 • 8

House’s enraged response to Dr. Taub’s view on House's decision to leave Wilson alone with his cancer;

Dr. Taub: "You can't just give up on Wilson. You know he needs you, you know he's making an impossible choice. He just doesn't want to live a life in pain..."

House: "Life is pain! I wake up every morning I'm in pain! I go to work in pain! You know how many times I've thought about giving up? How many times I've thought about ending it?"

— Holding On

Holding On is an 8th season episode of House which first aired on May 14, 2012. Former Princeton-Plainsboro colleague Thirteen (Olivia Wilde) returns in an all-new episode; she's there both to provide support to Wilson and to confront House about his behavior.

The team takes on the case of Derrick (guest star Skylar Astin), a 19-year-old college student who had a mysterious nose bleed during cheerleading practice, and discovers that his health issues are likely both physiological and psychological. Possibly suffering from schizophrenia, Derrick claims to hear his deceased brother’s voice in his head. Wilson becomes resigned to his fate, but House does not. Meanwhile, Foreman tries a different approach with House. All this results in House showing atypical behavior, even for him.

Recap

1 Holding On

Resignation

Wilson wakes up to his alarm at 6:30 a.m. He heads on over to 221B Baker Street where House is awake and ready to see him. However, Wilson announces he’s not going to agree to more chemotherapy. House reminds him that without treatment, he will be dead in five months. Wilson says he would rather have five decent months than a year in hospital in pain. House says he’s underestimating his chances. On a decent chemotherapy regimen, he might last as long as three years. Wilson apologizes and leaves. House calls out to him that he’s not going to just let him die.

House arrives at the hospital where Foreman greets him with a season ticket for a seat next to him so they can come up with good ideas together. House notices that the first game is for just after Wilson’s likely date of death. He accuses Foreman of trying to be Wilson’s replacement. Foreman says it’s because people other than Wilson care about him. House tells Foreman he will be fine.

2 - Holding On

There's no such thing

The team is watching a video of their newest patient, a 19 year old college cheerleader. However, House wants to talk about Wilson. Taub describes the patient’s symptoms - a persistent nosebleed and dizziness. The team talks about the case while House talks about Wilson’s refusal to get treatment. Adams tells him Wilson just wants to die with dignity, but House says there’s no such thing. Adams tells him he can either accept Wilson’s diagnosis or be miserable. House thinks the patient has a mid-line granuloma and orders a PET scan.

Taub and Park do the scan. Park says that she thinks House should be off the case. The patient’s brain reacts and Taub thinks they were overheard, but Park assures Taub the microphone is off. Taub says the brain’s region controlling hearing sound is all lit up - he must be hearing something.

House comes into Wilson’s office through the balcony with an intravenous set up and accuses Wilson of calling Foreman to get him to agree to the season’s tickets. Wilson goes to deny it, but he realizes he’s been drugged. House tells him that if he’s still alive in six months, they get to go to the game together. Wilson collapses and House hooks him up to the intravenous line. The team comes into Wilson’s office looking for House. Trying not to look at Wilson, they tell House they think the patient is hearing voices. House doesn’t want to be bothered and as the team continues, he realizes they already have ideas that are safe to test and explain all the symptoms. He directs them to do an environmental scan.

3 - Holding On

Creepy

Taub and Adams arrive at the patient’s dorm and find his roommate smoking marijuana and complaining about the intrusion. They ask the roommate what drugs the patient uses, but the roommate says the patient doesn’t party. Adams looks through the patient’s belongings and finds a photograph of a young boy in a bathing suit.

They go to see the patient to ask about the picture. He says it’s nobody, but the doctors ask why he had it hidden. The patient’s girlfriend wants to know too. The patient finally admits it’s his brother, who died about ten years ago. Adams asks if that’s the voice he hears.

Wilson wakes up and finds himself on the couch. He sees House at his desk and asks if his hair is going to fall out. House says he didn’t give Wilson chemotherapy, he just wanted to show him what it’s like to be dead. They argue about whether unconsciousness is anything like death. House starts to think that Wilson believes in the afterlife, but Wilson won’t talk about it. He tells House to leave. However, as House is about to step out the door, Wilson admits that he’s seen death so many times that he can’t just believe that humans are “bags of chemicals”.

Back at House’s conference room, House is in his office ignoring the team and Park insists on talking about the patient. They start a differential and get nowhere. Park wants to invite House to join the differential, but won’t go in without Adams. She agrees, but Taub points out that although House will listen to their medical ideas, he never listens to any personal advice. Taub thinks the patient has temporal lobe epilepsy and leaves to do tests.

Taub and Adams come in and find the patient arguing with his girlfriend. When the doctors say she can stay until he gets back from tests, the patient tells her she can leave and not come back.

Adams tries to set off a seizure or other reaction, but the patient has no adverse reaction to the flashing lights. The EEG is normal too. Adams wonders why he wouldn’t tell his doctors or his girlfriends about hearing his dead brother’s voice. The patient says he was brought up not to discuss his brother. Adams tells him her boss is the same way - his best friend is dying and he can’t talk about it because he thinks the problem can be fixed. The patient starts talking about how his father became an alcoholic after his brother died, but all of a sudden he starts rubbing his right eye. After a moment, he starts telling Dr. Adams that his father left the family and when he and his mother moved away, they got rid of all of his brother’s photographs and never talked about him. He says that worked. He gets back to the subject of his right eye - he was seeing spots and now he can’t see anything. The patient thinks it was from the test but Adams examines him, then starts vigorously rubbing his eye. He tests the patient’s vision, which is there but blurry. Adams has broken up a clot that she spotted. However, she has no idea what caused it.

House meets Wilson in the cafeteria. He starts discussing one of Wilson’s old cases where they wanted to take out a six year old’s eyes to keep a retinal blastoma from spreading to the brain. Wilson fought against the procedure because he wanted to try experimental radiation therapy. Wilson was right and saved the patient’s vision and his life. Wilson remembers the patient, Mikey Campbell. A young man speaks up and says he prefers to be called “Michael” now. They sit down and the patient says he’s graduating high school next month, is going to Princeton University, and wants to become a doctor. Michael knows about Wilson’s cancer and urges him to get treatment. House shouts out and asks if anyone else in the cafeteria is alive today because of Wilson. Just about everyone in the cafeteria stands up. The patients start thanking him, then start applauding. House tells him seventy-four children are alive today that never would have been born otherwise, not to mention fourteen grandchildren. However, Wilson is suspicious. He realizes the person who greeted him would have graduated a year earlier. “Michael” says he flunked a year, but the jig is up and everyone admits they’re not really a patient. House says it doesn’t matter, but Wilson leaves.

Taub goes to see Foreman and asks for a letter of recommendation. Foreman thinks Taub is jumping the gun, but all of a sudden, Foreman sees water gushing out of his washroom.

Foreman chases down House and blames him for the plumbing mishap. House denies responsibility, but tells him if someone did flush a pair of season tickets down his toilet, that’s exactly the sort of prank he would play on Wilson.

Wilson is drinking at a diner when Thirteen walks in. He apologizes for drinking the three beers he bought for her. Thirteen thanks him for telling her about his cancer, but he admits he just wanted to ask someone what it’s like when you know you’re going to die. He wants to know when it stops being surreal. She tells him it will stop about the same time he’s expected to die. Wilson tells Thirteen that one of his patients couldn’t stop crying when she found out about Wilson’s terminal diagnosis. Thirteen says the only two possible responses will be to be overly sentimental or to ignore it altogether. Wilson asks why they can’t say something that will make him feel better, but Thirteen asks what that would be. Wilson is stumped. Thirteen asks about his treatment schedule, but he admits he’s not going to take treatment. He says he wants to spend time with friends. Thirteen asks if he means friends or friend.

House is on his cell phone with Wilson’s mom, urging her to call him back. He’s on his way to the bathroom. The team is talking about whether the patient’s avoidance of his brother’s death, or bringing it up, could be bringing on his symptoms. House wants to focus on the physical symptoms. Adams suggests DIC. They arrive at the bathroom and wonder why House isn’t going in. All of a sudden, a janitor runs out of the bathroom calling for more mops.

Park performs a lumbar puncture on the patient looking for blood in the cerebro-spinal fluid. She asks what the brother says to him. She tells the patient it might be because he wasn’t allowed to properly grieve for his brother, and he can get help with that. As soon as the lumbar puncture starts, Park realizes the pressure of the fluid is very elevated.

House is hanging out outside the chemotherapy suite when Thirteen comes to see him. They start arguing about Wilson. Thirteen points out that House can be selfless. When he fired Thirteen, it forced her to do what she wanted to do rather than what she felt she had to do.

House goes to Wilson’s office waving a white flag. He apologizes for being a disloyal, disrespectful jerk. Wilson says he’s still not going to let his parents call him back. He invites Wilson to dinner and promises no more tricks.

The patient’s mother shows up. Dr. Adams tells her that it’s most likely increased fluid pressure from a severe migraine, but it’s treatable. Dr. Adams also tells the mother that the patient has been hearing his dead brother’s voice for the past ten years and the suppression of grief over his death may be the underlying cause of his symptoms. The patient says he’s not even sure what he’s hearing - he has nothing to compare his memories to. He wants to know more about him. His mother apologizes, says she’s tired and leaves the room.

House and Wilson are having a nice dinner, and House serves Wilson Oreo cookies for dessert. They remember when they went camping, a bear ate all their food except for Oreos, and they had to hike back with nothing else to eat, and Wilson wouldn‘t even eat the cookie part. Wilson starts talking about treatment, but House stops him. Wilson says he thinks he should try it for a while, and House agrees it’s a good idea. All of a sudden, Wilson thinks he’s being conned. House insists his intent was not to deceive, but admits he wants Wilson around as long as possible because he doesn‘t know what he‘s going to do without him. Wilson tells him he doesn’t owe him anything, says his death isn’t about House, and leaves.

Wilson is outside in his car crying when House joins him. Wilson says he did try to stay alive, but House implies he gave up too easily and he has more fighting to do. Wilson tells him to get out of the car. House says he doesn’t have to accept this. Wilson says he has five months to live and House is making him go through it alone. He says he needs a friend and he needs to know that House will be there, that his life was worthwhile, and he loves him. House says he can’t tell him that unless he fights to stay alive, then gets out of the car.

They do an MRI on the patient, but find no blood vessel abnormalities that would indicate a migraine. The patient complains he doesn’t feel well. He turns to Park and calls her “Dr. Adams”. All of a sudden, Park feels a drop of water. She looks up to the ceiling. They hear a large creaking sound and, all of a sudden, the ceiling collapses and covers them all in plaster and water.

House arrives at the hospital to find the fire department cleaning up a huge spill of water. The main power for the hospital has failed and they are on emergency lights. Taub is treating Adams’ and Park’s injuries. House wants to discuss the case, but Adams is furious with him for ruining the MRI, wrecking the hospital and injuring his team. Taub realizes House has returned because something is going on with Wilson. House says he’s finished with Wilson. House focuses on the patient, and Park tells him the patient mistook her for Adams. House grabs a hypodermic needle and tells his team to follow him.

He gets to the patient’s room and asks them what they think will happen when he pierces the patient’s eardrum. Adams thinks the patient will scream in pain. House tells her not to worry and asks what will come out when he pulls back the plunger. Park says it has to be air, but House shows them it’s blood. The patient has persistent stapedial artery - an artery that should have disappeared while he was an embryo. It pressed against the temporal lobe causing his hallucinations and dizziness. The patient realizes his brother’s voice is going to disappear.

Taub follows House out of the room and confronts him about the way he’s treating Wilson just because he wants to avoid the pain of treatment. House lashes out in a rage. He screams he’s been living with pain every day for years. He asks Taub if he doesn’t think he’s considered ending it all to end the pain. He regains his composure and walks off.

House arrives the next morning to see Park waiting for him. He asks if she’s going to scream at him or be overly nice. Park tells House they had to put off surgery because the patient attempted suicide by drinking ammonia. House heads to the patient’s room. He asks the patient if he can’t wait to die and starts choking him. The patient fights back and the patient’s mother and Park try to pull House away. House says the patient is fighting back because he knows it’s natural to want to stay alive. Park finally has to hit House with his own cane in order to stop him. She shouts at him that he’s spent his whole life looking for the truth, but sometimes, the truth sucks.

Wilson is telling Foreman he will be leaving within the next couple of days. Foreman wants to know why. Wilson says he can’t be responsible for House’s happiness. Foreman promises to help out, but then tells Wilson he is responsible for House. He reminds Wilson in the past twenty years he’s had three wives, hundreds of colleagues and thousands of patients, but only one best friend. Wilson says he doesn’t want to suffer for House. Foreman says it’s not about the chemotherapy, it’s about the caring. He tells him that enduring pain for someone else is what life is all about.

House is treating Park’s cane strike with an ice pack. He takes some Vicodin and starts playing the piano. Wilson is at home and grabs a glass of wine. The patient asks his mother if she took the picture of his brother. She says she did. He asks if she threw it out, and she didn’t. The patient agrees to surgery if she brings the picture back. The surgery goes well.

House hears a knock at his door. He shouts he’s not home, but hears Wilson calling for him. He says he’s ready to start chemotherapy. House asks why. Wilson says it’s because House needs him, and he doesn’t think that’s a bad thing. However, House resists. House says Wilson is the only person he listens to. When he stopped listening to Wilson, he nearly killed his patient. House says he has to admit that Wilson is smarter than he is. Wilson asks if House is okay with the fact that they only have five months left. House admits he isn’t, but it’s better than nothing. Wilson doesn’t know where to go from there. House says he isn’t going to tell him he loves him. Wilson is relieved and asks for Oreos.

The patient awakes after surgery. He’s stopped hearing voices. His mother gives him back the photograph of his brother. She has some more of them to show him. They start going through them and crying.

Wilson and House are planning to climb a 8,000 foot mountain. Foreman comes in with a lawyer. He’s holding ticket stubs that have House’s name and fingerprints on them. They were found in the sewage outflow pipe and caused the sewage backup. Foreman tells House that the firefighters had already given the tickets to the police, who referred it to House’s parole officer. His parole is being revoked and he has to go back to jail for six months. House and Wilson are aghast at this development, as Wilson will in all likelihood not survive that long.

Major Events

• Wilson decides to stop treatment for his thymoma. House employs multiple methods to convince him to continue chemotherapy.
• Foreman gives House season tickets, but House goes against Foreman by flushing them down the toilet. This results in a major flood that damages one MRI machine and one wing of the hospital.
• It's revealed that Wilson is forty-six years old.
• Thirteen returns to visit Wilson and House, separately.
• Park assaults her second supervisor.
• House's tickets are found in the sewer pipe, and as a result, House's parole officer is contacted.
• Foreman announces to House that he'll have to serve the rest of his prison sentence. The remaining sentence is six months, and Wilson's life expectancy is only five.

Zebra Factor 4/10

Persistent stapedial artery is uncommon, but not rare. However, they are often asymptomatic.

Trivia & Cultural References

• Jesse Spencer does not appear in this episode, since his character left the hospital in Post Mortem. However, Chase is mentioned by House.
• It’s unknown what team House got season tickets to if the first home game was on October 8, 2012. Football starts in early September. Hockey starts in late September. Basketball doesn’t start until November, and the NBA had not set its schedule by May 2012. The pamphlet says "Hockey Season starts now."
  • Most likely the New Jersey Devils. The NHL season starts early October, but due to the 2012 NHL Lockout, the season did not start on time. The 2013 home schedule started on Oct. 4th.

• Thirteen’s reference to being the “prodigal daughter” is a reference to the Parable of the Prodigal Son from the Book of Luke.
• The use of a white flag to signify a surrender dates back to 1st century China and is currently the standard signal to request for a truce under the Geneva Conventions.
• Niccolo Machiavelli was a 15th and 16th century writer whose most famous work, The Prince, is a treatise on maintaining political power and coined the phrase “the ends justify the means”.
• Oreos are a sandwich cookie currently produced by the Nabisco division of Kraft foods. They celebrated their 100th anniversary in 2012.

Previous episode: Post Mortem

Holding On

Next episode: Everybody Dies