- Wilson: "Is he asking for a spinal nerve?"
- Cameron: "How did you know?"
- Wilson: "Give us a minute."
- — Insensitive
Insensitive is a third season episode of House which first aired on February 13, 2007. House wants to treat a patient who cannot feel pain, and may have his own agenda in order to treat his own pain. Cuddy meets a new man, only to have House track their every move and run interference.
A mother is driving her daughter, Hannah, to the hospital after she has fallen on the ice, but they get into an accident. The mother is unconscious, but the daughter is conscious and calls an ambulance. However, although she says she is all right, we see a piece of jagged metal sticking out of her leg.
Mother and daughter are taken to the emergency room at Princeton-Plainsboro. Foreman treats the daughter and House comes looking for him. House observes as Forman tells the girl what he's doing could hurt. When he touches the bandage to her injury, she whimpers. She asks if they can hurry it up because she wants to see her mom. House tells Forman to take his time. As she winces, House diagnoses the daughter with CIPA, a condition that makes the patient insensitive to pain, but she denies it.
Foreman argues saying that it's one of the rarest conditions in the world. House agrees then tells Foreman he has several reasons for thinking so, primarily that the patient didn't ask what CIPA was. Another main reason is that when Forman was cleaning the wound, she flexed towards the supposed pain. Foreman begins to argue again, House hits her with his cane and she doesn't react. He tells Foreman to do a full work up.
House asks Cuddy to work on the daughter. Cuddy feels that he only wants to work on her because she doesn't feel pain and he always does. He surmises Cuddy has a blind date. Cuddy allows him to do tests, but no nerve biopsy because of the risk of paralysis. She agrees to discuss it further if there is a problem with the EEG.
However, the patient resists being tested. They can't sedate her without her mother's permission, and the mother is still unconscious. House suggests breaking her arm if they have to; after all, it won't hurt her. The patient is demanding to see her mother when House comes in. They have a debate about who has it worse. While she tries to top him by showing him a burn mark on her posterior, he injects her with a sedative so she can be tested.
They rule out an infection as a cause of the fever. House still wants to biopsy a spinal nerve. The team hopes that Cuddy will withhold permission. The team discusses how they should proceed, and Chase realizes that her lack of pain is what is preventing them from having a diagnostic clue. He suggests trying to stimulate her pain response until she feels something.
House finds Cuddy with her blind date to ask for the nerve biopsy. House starts giving the blind date the third degree, but he defends himself quite well. Cuddy gives permission for the biopsy.
They test the patient by having her stick her hand alternately in warm and hot water. However, she leaves her hand in the hot water too long and gets badly burned. The patient is more concerned about her mother's surgery. Next, they drill into her head and inject extra nerve transmitters. The patient discloses she's been arrested three times for fighting because she doesn't know when to stop. Suddenly, the patient starts screaming. They stop the procedure, but once they remove the drill guide, she smiles and runs out of the examination room with Foreman on her heels.
Wilson confronts House about the nerve biopsy. He knows House wants to do it to treat his condition, not hers. Foreman runs in to tell House the patient wants to jump off the balcony railing. Cameron realizes she’s having a paranoid delusion. The patient loses her balance after complaining she has no feeling in her legs and falls off the railing 15 feet to the floor.
The patient survives with several broken bones and a concussion, but she feels fine. Her paranoia has disappeared, but her organ systems are failing. House still wants to do a nerve biopsy. Cameron thinks it might be a thyroid storm. House goes to Cuddy's house for a consult because she's an endocrinologist, even though there is a specialist on duty. He finds her with her date. Cuddy rules out thyroid storm. Cuddy has suspicions about why House keeps dropping in on her and asks House if he likes her. He says his motive is just to mess with her happiness.
Cuddy goes back to her date, who is getting ready to leave. He notices that that Cuddy is at her most vibrant when she is sparring with House, when they are discussing medicine. Don wants to date a woman who is that way in response to him, and his interests.
The team is still resisting the nerve biopsy because of the risk of paralysis. Wilson hears about it, and once again confronts House on the theory he is trying to grow pain free nerves from his patient. He accuses House of risking his patient's life to improve his own and accuses him of a conflict of interest. House tells the team to biopsy a less vital nerve.
Foreman and Cameron discuss relationships. Foreman notes that Cameron knew when she got married that it would only last a few months. He believes commitment is only important when it has no end date. However, he admits that people who avoid commitment know how important it is.
The nerve biopsy shows a systemic disease, not a nerve disease. Cameron goes to check on the patient's mother. However, House chases after her to get Cameron to help with the diagnosis. Cameron goes to take the patient to her mother, who has just come back to consciousness. The mother apologizes for getting into a car accident and is more worried about her daughter than herself. The daughter apologizes for going on the ice and risking injury. The mother has to be taken back to surgery. Cameron notices the daughter is crying and has a terrible headache.
Unfortunately, the pain was emotional, not physical. House asks what condition can cause guilt, and points out B-12 deficiency can cause that. However, the patient was given standard Vitamin B-12 supplements after being admitted.
House goes to Wilson with the problem, and says if it isn't B-12, it is probably leukemia. While House is munching on Wilson's sandwich Wilson remarks that House must get a thrill out of "beating other hunters" to the food. House has his diagnostic epiphany and he runs out to see the patient, who is about to be given nitrous oxide. House says the last time she got nitrous (during her EEG), she got the symptoms. When the patient gets paranoid again, House rushes her into an operating room. The patient is screaming that they are about to kill her, and House grabs a scalpel and starts slicing into her abdomen, shocking everyone in the operating room. She screams, but House figures she is faking. House finds a huge tapeworm in her abdomen and removes it. The tapeworm was sucking out the B-12 as soon as she consumed it, causing her deficiency. Had she not had CIPA, she would have been in tremendous pain because of the tapeworm. House is also disappointed that it didn't beat the record for longest tapeworm.
Chase brings the patient to meet with her mother, who is recovering from her second surgery.
Foreman meets with his girlfriend and tells her he got her an interview for an important job in Boston. She realizes he wants to break up with her. He thinks she's angry, but she's upset because she cares about him.
Cuddy is sleeping alone. The patient and her mother are recovering. Wilson tells House to ask the patient for the spinal nerve, but he points out she has no reason to give it to him. Wilson invites House to breakfast.
It's Valentine's Day, and Cameron asks Chase if he's interested in having sex with her on a "friends with benefits" basis because she figures she won't fall in love with him, and they have already had sex.
- Foreman's girlfriend, Wendy, makes another appearance.
- House gatecrashes Cuddy's date with a man named Don Herrick (twice).
- Cuddy asks House straight out if he likes her. House denies it.
- Foreman and Wendy break up.
Zebra Factor 8/10
Although tapeworm infections aren’t uncommon worldwide, they are increasingly common in the United States due to food processing and cooking methods. Anyway, it's a really rare case as people affected by CIPA are very few and, moreover, a case like Hanna's would be even more rare, because people affected by CIPA usually die out of untreated illnesses before 5 years of age, while Hannah managed to reach teenage years.
Trivia & Cultural References
- “Insensitive” refers both to the patient’s insensitivity to pain and House’s insensitivity to social conventions. It also refers to Foreman's insensitivity while breaking up with his girlfriend. His attitude mirrors House's.
- [SPOILER] The scene in the locker room where Foreman breaks things off with Wendy shows Foreman's reflection in a broken mirror in his locker. It could be foreshadowing not only his and Wendy's breakup, but his future bad luck in his relationship with Thirteen.
- Kingston is an unincorporated area on the outskirts of Princeton.
- The Ashkenazi are Jews descended from those who lived in Jewish communities along the Rhine River in Germany in medieval times. Most of their descendants moved eastward to make up the Jewish communities in Eastern Europe prior to World War II. About 80% of the world’s Jews have such descent.
- All of Wilson and House’s talk about curiosity and cats is from the saying Curiosity killed the cat, which warns about being too curious.
- When House says, "Come on, let's go break her arm," it might be a reference to the movie "Henry Fool."
- House incorrectly states that the longest tapeworm on record is 60 feet. In actuality the longest tapeworm on record is only approximately 28 feet long. It is preserved in the Meguro Museum of Tokyo, Japan, according to Atlas Obscura.
- When House goes to Cuddy's house for a consult and realizes that her blind date is there, she says, "I like him and I like sex. Do I need to stitch a letter onto my top?" This is a reference to Nathaniel Hawthorne's The Scarlet Letter, in which the protagonist is forced to stitch a scarlet "A" into her clothes after being found guilty of adultery.
- Hugh Laurie as Gregory House
- Lisa Edelstein as Lisa Cuddy
- Omar Epps as Eric Foreman
- Robert Sean Leonard as James Wilson
- Jennifer Morrison as Allison Cameron
- Jesse Spencer as Robert Chase
- Mika Boorem as Hannah Morgenthal
- Josh Stamberg as Don Herrick
- Jenny Robertson as Abby Morgenthal
- Kimberly Quinn as Nurse Wendy
- Ingrid Sanai Buron as Nurse Bev
- Ruth Silveira as Female Surgeon
- Cindy Lu as Nurse
- Aulani Rhea as Nurse
- Bobbin Bergstrom as Nurse
- Episode article at Wikipedia
- Episode page at IMDB
- A review of the medicine at Polite Dissent
- Episode page at TV.com
- Episode page at House MD Guide
- Episode transcript at Clinic Duty
- Episode page at Aceshowbiz
- Episode article at the TV IV
- Episode quotes at Dr Greg House
Needle in a Haystack