Dr. Richardson is a neurosurgeon at Princeton-Plainsboro Teaching Hospital. Due to the retirement of one neurosurgeon and another’s vacation, he was the only on-call neurosurgeon at the hospital, and a neurosurgeon is required to keep a hospital’s status as a level 1 trauma center. He had to stay on the hospital premises at all times. Otherwise, the hospital had to shut down it’s emergency room and transfer all of its intensive care patients to other hospitals. He is portrayed by actor George Wyner.
Medical History
Dr. Richardson had been on the hospital premises continually for almost one week. He had threatened to quit. Although he developed symptoms, none of the other personnel or patients at the hospital had the same symptoms, which appeared to rule out an environmental cause.
Case History
Dr. Richardson was in the operating room when he vomitted. Dr. Cuddy’s assistant tried to reach her, but was only able to reach the "nanny" (who was actually House), but he told him that Dr. Cuddy gave instructions to send Dr. Richardson home and sterilize the operating room.
After looking for a replacement, the assistant informed the Department of Public Hospitals that they had no neurosurgeon on site. When Dr. House’s team found out about the problem, Dr. Hadley suggested that although Dr. House was away, they try to diagnose Richardson and treat him.
Dr. Hadley and Dr. Chase found Dr. Richardson at his home clinging to his toilet with severe nausea. They asked him to return to the hospital, but he refused. Dr. Chase offered promethazine to deal with the nausea, but Dr. Richardson had already tried it and trimethobenzamide and they had no effect. Dr. Hadley realized the ineffectiveness of these drugs seemed to rule out food poisoning, and Dr. Chase realized that the problem was that the lining of the stomach was damaged. Unless the lining was repaired, it was unlikely the symptoms would improve. Dr. Hadley suggested ondansetron and prostaglandins even though they would not treat any underlying conditions. They would, however, relieve his symptoms. Dr. Hadley convinced Dr. Richardson to take the drugs despite the risk of side effects by telling him that he would at least not feel as miserable as he was now.
Dr. Chase warned that Richardson’s blood pressure could crash with the treatment, but it did not appear that Dr. Richardson was going to collapse. Dr. Chase was worried the treatment would worsen Richardson’s condition, but Dr. Hadley assured him they could run tests as soon as Richardson was back at the hospital. Richardson started feeling much better and agreed to return to the hospital. However, he started commenting on how shiny everything was.
However, at the hospital, it was clear that Dr. Richardson was in no condition to perform surgery. The assistant wanted to know what was wrong and Dr. Taub assured him it was just high blood sugar and he would be fine once he was re-hydrated. However, once the assistant left, Dr. Hadley told Dr. Taub the leading contenders were hepatitis and peptic ulcer disease and that Dr. Chase was doing the lab work.
The inspector from the Department of Public Hospitals came to see Dr. Richardson and Dr. Chase waylaid him by claiming that Dr. Richardson was in the scrub room getting ready for surgery and that he would have to re-scrub if he came out. The inspector was about to leave when Dr. Richardson came running out of the prep area complaining it was too hot. He then removed his scrubs and walked around the hallway wearing only his undershorts. Despite Dr. Chase’s assurances that Dr. Richardson was not high, the inspector didn’t want to hear it and revoked the hospital’s class 1 status and ordered the intensive care unit evacuated of stable patients and the emergency room closed.
However, the team kept working on Dr. Richardson’s case. All the lab results were negative, leading Dr. Chase to believe one of the results was wrong. Dr. Richardson was still high, but Dr. Chase wondered why - he should be coming back to normal after so much time. Dr. Foreman suggested his behavior may be a symptom and not a side effect of the ondanzatron. They focused on what diseases cause both delerium and nausea. Dr. Taub realized that it couldn’t be environmental because no one else in the hospital had the same symptoms and Richardson had not been outside the hospital. However, Dr. Richardson admitted that he sneaked out of the hospital to go to a seafood festival at a nearby convention center. Dr. Hadley was dismayed because the number of possibilities were nearly endless as seafood could come from anywhere. Dr. Richardson said he ate just about everything there. Suddenly, Dr. Hadley asked if he had eaten any roe (fish eggs). Dr. Richardson couldn’t remember, but said it was a possibility. Dr. Hadley realized toad egg poisoning could cause both nausea and euphoria. Not only that, the treatment was fast acting.
They administered the antidote and kept Dr. Richardson from undressing again. He was soon back on his feet and fully dressed. He met the inspector and passed a sobriety test and correctly described how to treat a cerebral contusion. The inspector restored the hospital’s status.