Unwritten is a 7th season episode of House which first aired on October 4, 2010. When Alice Tanner (Amy Irving), the author of a popular children's book series, inexplicably suffers from a seizure moments before an attempt to take her own life, the Princeton-Plainsboro team faces the challenges of evaluating both her underlying medical conditions, as well as her unstable psychological state. Unable to diagnose Alice, House becomes particularly motivated, as he's a fan of her books, and is convinced that the key to unlocking the mysteries of Alice's condition lies in the pages of her most recent novel. Meanwhile, House takes Cuddy on a double date with Wilson and his girlfriend, Sam (guest star Cynthia Watros), and makes a discovery that proves that life imitates art as the couple continues to make compromises in order to make their relationship work.
Alice Tanner is busy at her typewriter. She types “The End” when Jack asks her when she will get a computer. She tells him she’s finished. He’s pleased and wants to know how it ends and how he can help with the next book. She tells him there isn’t going to be a next book because she just can’t do it any more. He wonders what she’s going to do with her life, but she picks up a gun and points it at her head. He threatens to stop her, but she tells him he can’t - he’s a hallucination. However, she suffers a seizure as she pulls the trigger and the bullet merely glances her cheek before she collapses. Her housekeeper comes in and finds her on the floor.
House is stealing chocolates from a coma patient, but doesn’t like them and spits them out. Wilson finds him trying to find something to steal for Cuddy. House assures Wilson Cuddy isn’t mad at him, and he’s happy too. He decides to take flowers. However, he’s worried that they are still in the “honeymoon” phase of their relationship and that she will lose interest in him because they have nothing in common. Wilson tells him not to worry, but House says it may take a while, but it’s inevitable. House says that he needs to find something they both like. He can’t tell Cuddy or she will pretend to like things to keep the relationship together. When House asks why Wilson is following him, Wilson tells him he won’t believe who is in the emergency room.
Alice is trying to leave when House shows up. He tells her he’s a huge fan of her work. She’s surprised because most of her fans are teenage girls. House does a preliminary examination. He asks her about the new book, but she agrees to answer any one question if he finishes his examination. House agrees, but then asks her why she tried to kill herself - he noticed the gunpowder burn. She goes to leave but he reminds her of their deal. He then tells the staff that she’s on a 72 hour psychiatric observation and to sedate her if she tries to leave.
House calls his team back to the hospital and tells them that Alice had a seizure while trying to commit suicide. However, the team thinks they’re on the case because House is a fan of hers. He orders a full workup and observation to see if there is another seizure. However, he lets Chase go because he sees his hot date waiting for him.
House goes to pick up Cuddy for dinner, but takes her to Alice’s house to read her latest manuscript. Cuddy figures out what’s up - they’re on a case. The housekeeper confronts them.
Alice admits to Foreman that she hasn’t had a medical examination in some time. She denies having previous seizures. They realize that she’s evading questions. She admits to the suicide attempt. She then insists on a woman doctor, which Taub realizes is another evasion. They agree to step into the observation area.
Cuddy talks the housekeeper into not calling the police, and the housekeeper admits that Alice threatened to fire her if she told anyone about the gun. She says she might be depressed. House asks to see her latest manuscript, but it‘s locked up. Cuddy asks about symptoms, and the housekeeper mentions pain in her back and hands, and that she cries at night. House realizes that the typewriter uses a ribbon, and removes it for examination. He also finds an empty can of tuna, and the housekeeper says she eats two or three cans a day.
Chase finds a tired Taub and Foreman. The leading candidate is mercury poisoning, but the urine and blood samples were clean. House wants to start chelation therapy, but Alice is still insisting on a woman doctor.
House goes to speak to Cuddy, who is mad about the trip to Alice’s. House offers a stuffed penguin as a peace offering, but she realizes it’s stolen. House asks her to speak to Alice about allowing one of his team to work on her, but Cuddy won’t unless House promises to hire a woman for his team.
Cuddy goes to speak to Alice, who agrees to treat her herself, but tells Alice that House’s team is the best. However, Alice smelled Cuddy’s perfume on House and realizes they’re a couple. She also realizes her housekeeper, who is visiting, has also been near Cuddy lately. She admits to talking to House and Cuddy, but Alice fires her. Cuddy tells her lashing out is not the answer, treatment is. Alice agrees to be treated by House’s team.
Meanwhile, House is reviewing the typewriter ribbon. Wilson is telling him he can’t do it, but tells him the fact that Cuddy is going along with it is a good sign for their relationship. They’re both trying to find things they have in common.
Alice hallucinates about Jack again. Taub and Chase see her talking to someone and realize that she may be hallucinating. She say’s she’s just imagining someone. She sums up Chase immediately and tells her how she figured it out. Chase asks her to sum up Taub, and she does a good job with him as well - he pegs him as a cheater. However, she grabs her forehead in pain and her blood pressure shoots up. Chase thinks it is an allergy to the chelating agent, but Taub hasn’t given it to her yet.
The team has ruled out mercury poisoning. House is still trying to decipher the tape. House asks what set off the spike, and they say she was talking about her cheating ex-husband. House notices the first seizure was set off by a gun pointed at her head. He thinks it might be a pheochromocytoma resulting in an excess of adrenaline. When the team returns to its lunch, House sweeps off the table and tells them to go to the MRI immediately.
Alice says she is claustrophbic. When they get her close to the MRI machine, she starts screaming in pain and sparks start shooting from her leg. An x-ray indicates three screws in her leg from a previous skiing accident she didn’t mention. She suffered third-degree burns. Taub says it wasn’t their fault, but for emphasis House writes Everybody lies on Taub’s lab coat and reminds them that the patient wants to die. They realize that finding a pheochromocytoma without an MRI will take more time than they have on her psych hold. House realizes that they need her cooperation.
He goes to Alice and tells her he wants her to write more books. He tells her about how morphine will make it much easier. He gives her a choice - cooperate so they can find out what’s wrong with her, or inject herself with the morphine. She wonders why he cares and he tells her he knows all about pain. He assures her that they can make her pain free and gives her the syringe in case they fail. However, she injects herself with it.
However, Alice soon wakes up - it was only a mild sedative. She realizes she’s been tricked, but says her lawyer will have her out of there in 24 hours. House gives her the bad news - because she thought it was morphine, he was able to extend her psych hold. When she asks him if he wants to know about the book, House agrees, and she tells him the main character dies. House is shocked.
The team has tested for the pheochromocytoma with a PET scan and blood tests for adrenaline, but they are all normal. House still thinks the answer is in the new manuscript. House orders an ultrasound.
House calls Sam Carr for an emergency consult, and she’s angry when she realizes its about the typewriter ribbon. Wilson bursts in and tells Sam not to cooperate, and House admonishes her for tattling. However when Sam realizes the patient is Alice Tanner, it turns out she’s a fan too. She comes up with an idea and she manages to get text off the ribbon.
Cuddy goes to House to tell him that Wilson has invited them on a double date with Sam. Cuddy realizes what he did with the MRI. As his girlfriend she’s impressed, but as his boss she thinks he’s a jackass. She gives him more clinic hours, and tells him he can decide where they go.
The ultrasound finds a small tumor encased around her heart. She’s developed a pericardial effusion, but they find no sign of a pheochromocytoma. A virus or cancer seems more likely. However, House has read the book. He’s dismayed that nothing gets resolved, even though its supposed to be the last in a series. However, he has also noted that the character that’s probably based on Alice herself has a mysterious illness too. He lists the character’s symptoms and tells them the character commits suicide in the book. If the symptoms in the book are accurate, lupus is the most likely diagnosis. However, House realizes although it’s treatable, they can’t do anything to remove the pain, and that’s why she’s trying to kill herself. He looks for another answer, but orders tests to see if they can confirm lupus.
House calls Cuddy’s mom to find out what she likes and they all go go-karting. However, Cuddy says she hasn’t liked them since she was 12. However, once they all start racing, they get into it. Wilson spins out when Sam bumps him off the track. Cuddy wonders why Sam is like that, and House jokes that Sam hates Jews. Cuddy decides to take her on. She catches up and Sam starts driving aggressively again. Cuddy passes her, but Sam bumps her off the track too. House decides to challenge Sam as well, and gets ahead. He uses his cane to disconnect her battery and leaves her behind. The staff ban House from the premises and throw them all out. However, Cuddy’s hurt her neck and she’s angry. When Wilson assures him Cuddy will be okay, she’s just in pain, House realizes something.
House realizes Alice hurt her leg in a car crash, not a skiing accident. He realizes as well that she probably damaged her thyroid gland and that it’s curable. She tries to send him away. He tells her he read the book. She doesn’t believe him until he tells her plot points. He tells her she has hypothyroidism and that the main character in the book deserves a better ending. When she confronts him about the book, she has another seizure and complains about paralysis.
The paralysis seems to rule out hypothyroidism, even though it fits all the earlier symptoms. He concentrates on the accident again. However, Taub has another suggestion that fits an accident - post traumatic syringomyelia. They just need her old medical records to pinpoint the location.
However, the team comes back to report both that they couldn’t find the medical records for the car crash and that Alice is refusing treatment. House wonders why she lied about the car accident being a skiing accident. House goes to see Cuddy, who has been trying to find a legal way of doing the surgery without the patient’s permission. She’s had no luck. House looks back at Alice’s attempts to die and realizes she’s trying to punish herself. When House tells Cuddy he can’t find her medical records, Cuddy realizes that “Alice Tanner” might just be a pen name and her records are kept under another name - the accident happened before she was famous. Cuddy goes to look through the national database.
House goes to see the patient and tells her he knows that her main character was based on her late son, who died in the car crash. The character based on her has her real name, Helen. She says she wants to die in peace, but House realizes she hasn’t been at peace since the accident. She says she was at fault because she let him drive in dangerous conditions. House tells her she doesn’t deserve to die. He says he’s also reviewed the autopsy results and the crash didn’t kill him - it was a brain aneurysm. The autopsy didn’t find it because they concentrated on the crash, but he found the characteristic build up of blood in a post-mortem x-ray.
Alice agrees to surgery, and Cuddy realizes House lied to her. House admits it and says he only did it to save the main character. Cuddy says she’s started to read the books too. House doesn’t believe her because he never gave her the books like he said he did. He realizes Wilson told her he was looking for something they had in common. Cuddy says she doesn’t care about having things in common - common is boring. She just likes being with him - he’s uncommon, and she’s happy.
Alice recovers from surgery. She’s hired back her housekeeper. She thanks House, but tells him she’s not going to write any more books in the series - she’s starting to write books for adults. House protests that she can’t leave it on a cliffhanger, but she says she’s not going to change her mind. He goes to tell her how her son really died, but changes his mind when he sees Cuddy looking on. Cuddy goes to praise House for being kind, but he tells her to shut up.
Zebra Factor 3/10
Syringomyelia occurs in about 8 out of every 100,000 people.
Trivia & Cultural References
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