- Chase: "Patients lying never bothered you before."
- Taub: "Patients weren’t lying about their sexual orientation before."
- Chase: "So you’re only judgmental when it gets personal."
- — The Choice
The Choice is a 6th season episode of House which first aired on May 3, 2010.
The team takes on the case of an ailing groom-to-be who harbors undisclosed secrets from a previous relationship. As his fiancée (guest star Amurri) tries to get answers to her many questions, a frustrated team winnows down the possibilities. Meanwhile, House spends extra-curricular time with his Princeton Plainsboro colleagues; dinner with Taub’s wife, a night at a lesbian bar, and performing a karaoke rendition of a Gladys Knight & The Pips classic with Foreman and Chase.
As a young couple is getting married, the groom, Ted, suddenly finds himself unable to speak. He then starts clutching at his throat and collapses.
Wilson wakes up next to Sam. Luckily, House is dead to the world in bed, although he starts getting up. He finds himself mysteriously in a young boy's bedroom. He next finds himself in the hands of police asking Wilson if they know him.
House reaches the hospital and finds Cuddy looking for another personal assistant. House admits he has been sleepwalking and was drunk enough to have woken up on the wrong bed. House and Nurse Jeffrey exchange insults and Jeffrey heads off to human resources. Cuddy sends him to clinic duty, but Chase intercepts him with Ted's case.
House goes to meet Ted in the emergency room. They say they have ruled out anything that could cause speechlessness and fainting. House asks the patient to turn over and sticks him with a needle. Ted screams, showing he was faking. He claims he wasn't faking, and his fiancée believes him.
Taub thinks the patient's symptoms were real, but House dismisses him and also tells him he thinks he's been cheating again because he can't give up the opportunity. Taub says he's already given up his plastic surgery practice, and House tells him he's compensating with sex. He asks House to dinner, but House won't go unless his wife goes too. Taub agrees.
Ted's fiancée assures him that she believes him. He tells her that he's ready to get married again. However, when he laughs he starts coughing and collapses again.
House thinks he's faking again, but Foreman has found a pleural effusion. He's obviously not faking this time. However, House wonders why the other two symptoms went away on their own without treatment if they were real. Foreman suggests a systemic disease. House thinks it might be medication. House wants to re-run the tests to make sure the ER did them right and also wants an environmental scan of the patient's old residence and current residence.
Thirteen breaks into the old residence and tells Taub that she realizes that he's been with Maya. Thirteen notes the ceiling is suspended and looks above and finds what could be asbestos tiles. Asbestosis would explain the symptoms. Suddenly, the current occupant returns. They reassure him and tell him they're there about Ted. The occupant knows him and wants to know what it's all about. He assures him he had the tiles checked and they have no asbestos. The current occupant tells him that Ted was his boyfriend for three years.
House confronts the patient, who denies he is gay. He says that the guy he met is gay and had a crush on him. Thirteen asks him why they spent three years together. The patient still denies it was sexual. Taub tells him that the new infection tests turned up mononucleosis. It is rare in 27 year olds unless they are immunocompromised. They need to test him for HIV. When they threaten to test his fiancée, he breaks down and said he may have had sexual contact with his old roommate but he's not gay. He agrees to the test as long as they don't tell the fiancée.
Chase and Thirteen discuss Ted's decision to marry a woman. Thirteen thinks its a bad idea and wants to tell the fiancée. The HIV test is negative. Although being gay didn't get him sick, Thirteen wonders if trying to be straight did.
Thirteen goes to see the patient and asks him how he gave up being gay. She realizes she's been through a 'treatment' - conversion therapy, which constitutes giving him emetics while he watches gay porn. He wasn't told which one of the many emetics available was given to him. When that didn't work, they injected him with male hormones and used electro-convulsive therapy. This would explain all of his symptoms. House orders an EEG to see how bad the damage was.
Taub shows up for his dinner with House without Rachel, explaining that she's at a ceramics class. House has already texted her and she shows up. He tells Taub that he still thinks that he's involved with Maya. Taub admits it and begs House not to tell Rachel. When she arrives, House leaves, but gives Taub a Friday night alibi, a ceramics class, and invites his wife to come along.
They discuss the possibilities for a heart attack. Taub says he has joined a "full" ceramics class so his wife couldn't come along. Foreman suggests an angiogram and House agrees. Thirteen invites House to a lesbian bar.
House goes to see Wilson. He's realizes that Wilson is getting his team to socialize with him, partly so he can have more time with Sam. Wilson admits he's paying House’s team and he's worried about House's drinking and his own relationship with Sam. House agrees to try it.
Ted finally regains consciousness. He lies to Nicole about a previous head trauma. They prep Ted for his angiogram, but he suddenly falls back on his bed. He wakes up again, then falls back down. House quickly diagnoses him with POTS. His blood pressure falls precipitously whenever he sits up, causing him to faint, which returns his blood pressure to normal. They hadn't noticed it because they took his blood pressure lying down, when it was normal. However, high blood pressure would explain the heart attack and fainting. House orders fludrocortisone as mononucleosis is a cause.
The old roommate comes to visit, explaining he's an old friend. Ted is still unconscious. He meets the fiancée and tells her they had a falling out. He tells her they were roommates for three years after college. When he touches Ted's hand tenderly, the fiancée asks him to leave.
Ted starts to improve and regains consciousness again. The fiancée tells him about the roommate and asks who he is. He tells her they just shared a house. However, he finally admits he got drunk one night and he and the roommate had sex. He says it was a mistake - the thought he was gay, but he realized he wasn't. He tells her he was cured and that's what caused the head trauma. However, he starts complaining of a headache.
House goes to the lesbian bar with Thirteen. She's flirting with the other patrons. House asks about the bartender, but Thirteen says that the bartender isn’t straight. House reminds her she was wrong about the patient. She says its because he came in with a woman. She believes he loves his fiancée, but will still want to have sex with men. When House points out Taub wants to have sex with other women, Thirteen says that's different. House gets a call that the lumber puncture was negative, but the headaches are getting worse. This seems to rule out POTS. However, House puts the worsening headaches down to leaking CSF from the lumbar puncture. Chase says that wouldn't explain the original headache. However, if he had too little CSF to begin with, it would cause both POTS and a headache. He orders them to find the lead and transfuse CSF.
The new symptom clearly rules out POTS and a transient ischemic attack is ruled out, as is sarcoidosis. House figures the answer must be somewhere in the medical history, which is untrustworthy. He wants to get Ted, his fiancée, and the roommate in the same room to question them. Taub is opposed but House figures its the only way to get at the truth. Chase asks House to go out with him and Foreman. Neither Chase or Foreman wants to do it, but they have both taken money from Wilson. House agrees to go.
Thirteen starts the medical history. When they start talking about blackouts, the boyfriend tells of one that Ted had that Ted put down to being drunk. The fiancée admits that Ted has occasional erectile dysfunction, but Ted thinks that's normal. However, the roommate says it was never a problem. However, the erectile dysfunction could be a vascular problem. The patient agrees to a test that measures blood flow through the penis. They offer him a choice of gay or straight porn and threaten to give him a shot if he doesn't get an erection on his own. The patient wants the shot.
Chase is singing karaoke, with Foreman and House accompanying. No one wants to follow them and they make a toast to Wilson.
The patient's test goes fine, but he feels like he is sweating. However, he's really lactating.
The lactation indicates a problem with his thyroid. It is unlikely to be the hormones he received as male hormones don't cause lactation and he hasn't received any hormone shots in the last three months. Taub thinks it might be a pituitary adenoma. House orders a test of Ted's prolactin level and an MRI of his pituitary.
Wilson asks if House had fun, and he said he realized Chase and Foreman could be his friends, but then he sobered up. When Wilson starts talking about change, House realizes something.
The pituitary MRI was normal, but House already knew that. House puts pressure on Ted's neck, and he feels relief, until House releases the pressure. House realizes the patient has a Arnold-Chiari malformation, a congenital narrowing at the base of the skull that cut off CSF flow. It wasn't a problem until the electro-convulsive therapy caused his brain to swell just enough to cut off the opening. The brain also pressed against his pituitary, causing the other symptoms. Treating him for POTS actually made it worse. He just needs surgery to correct it.
The roommate comes to visit again. Ted tells him he's not coming back to him, but the roommate is more concerned about the fiancée. He leaves and wishes Ted luck. The fiancée sees him leave. Ted starts talking about the wedding again, but she is now harboring doubts even though she still loves him. He tells her love is all that matters, but she still thinks he loves his old roommate. Ted says he's not gay and has made his choice, but fiancée says she has to make a choice as well. She kisses him and leaves despite Ted‘s entreaties that he wants to marry her.
House finds Taub, who gives House the napkin rings he bought to try to fake the ceramic class. He goes back to patch things up with his wife.
Cuddy tells House she has a new personal assistant. She congratulates House on his diagnosis, but House says the patient has no home to return to. Cuddy invites House out. She denies Wilson is involved, and points out Lucas is working late. House says no, but Cuddy says she just wants to be friends. House says that's the last thing he wants them to be. After Cuddy leaves, he rubs his leg and looks at his ibuprofen. Instead, he grabs a bottle of whiskey from his desk and proceeds to pour it into his red mug and drink from it..
- House gets so drunk he wakes up in a neighbor’s bedroom.
- Wilson bribes House’s team to get them to spend time with House so Wilson can spend time with Sam.
- Cuddy asks House to dinner and he tells her that he doesn’t want to be just friends.
Zebra Factor 2/10
Arnold-Chiari malformations aren’t rare, occurring in about 1 to 5 out of every 5,000 people. They are generally congenital, but can be associated with other diseases.
The title refers to the belief that a person’s sexual orientation is a choice rather than an inborn preference. The reference to an “Overbearing mother” is a since discarded theory that a homosexual orientation could be traced to maternal behavior.
Trivia & Cultural References
- "Cryo podia" translates to "cold feet." House said it meant "duh" due to the fact that the symptoms (which at the time, House thought were being faked) all pointed to Ted getting cold feet and inventing a way to back out of the wedding.
- "Born this way" is a song by Lady Gaga about accepting (among other things) one's sexual orientation.
- Liberace was a flamboyant, popular and successful Polish-American pianist who was a closeted gay man for his entire life. From the 1950s to the 1970s, he was the best paid entertainer in the world. His sexual orientation was finally revealed after his death in 1987.
- Playing online poker, House asks if he should call or raise with a “double gutshot draw.” In fact, a “gutshot straight draw” is a hand where there are two cards that would complete one of two inside straights (i.e., if you hold a 5 and 7 with a 3, 6 and 9 on the board, either a 4 or 8 will create a straight. It is the functional equivalent of an open-ended straight draw, even though there is no open ended draw available. In fact, House only has an inside straight draw (only an 8 will help), which should generally not result in a call unless the pot odds are better than 13 to 1, the chance of making a straight. A raise would be a semi-bluff.
- Gaydar is a colloquial term for a person’s supposed ability to determine another person’s sexual orientation and is a play on the word radar.
- House’s auction registration ID is “kissmyasthma99.”
- Midnight Train to Georgia was a #1 hit for Gladys Knight and the Pips in 1973.
- House’s quote when he gets his revelation is a play on the Serenity Prayer - God, grant me the serenity to accept the things I cannot change, Courage to change the things I can, And wisdom to know the difference.
- Christopher Walken is a prolific Academy Award winning American actor, whose distinct vocal cadence is often parodied and imitated.
- The name of the lesbian bar is Foxhole.
- 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
- Peter Jacobson as Chris Taub
- Olivia Wilde as Remy Hadley
- Cynthia Watros as Sam Carr
- Adam Garcia as Theodore Philip Taylor
- Eva Amurri as Nicole Margaret Murray
- Jennifer Crystal Foley as Rachel Taub
- Johnathan Murphy as Cotter Macklin
- Patrick Price as Jeffrey Sparkman
- F. William Parker as Reverend Bowden
- Gregory Franklin as Henry Murray
- Elijah Long as Cop One
- Tyler Scott Gilmour as Esteban
- Bobbin Bergstrom as Nurse
- Richard Bernard as Ted's Father
Open and Shut