House Season1 EP16

Heavy

Episode 116 : 2005-03-28

Ten-year old Jessica Simms tells her mother that she isn't feeling good and doesn't want to go to school. She admits that she thinks the kids at school hate her. At school that day, Jessica is jumping rope in gym class when she complains that her chest hurts. The teacher pushes her to finish, but Jessica collapses. Her heart stops beating.

At the hospital, Cuddy asks House if he's made a decision on who to fire per Vogler's order. House wants to stall as long as possible, and she grants him a week. In the elevator, Cameron brings House up to date on Jessica. The team can't believe a 10-year old would have a heart attack but six tests proved it true. Chase thinks it's a simple case of Jessica being too obese and depressed. House though believes that Jessica's legion of previous doctors have missed something. Foreman wonders about a genetic condition. Cameron suggests Metabolic Syndrome X, which could cause a heart attack with high enough blood pressure. House orders a hyperinsulinemic euglycemic clamp. But before dispatching his staff, he informs them that he'll have to cut one of them by the end of the week. They're all shocked, and Cameron and Foreman think they need to stick together through this.

Cameron explains MS-X to Jessica's mother and says it can be controlled through diet and exercise. Mrs. Simms complains that doctors never see past Jessica's weight. Chase and Foreman try to cajole Jessica onto a scale as part of their standard tests. Afterwards, Chase is upset that Foreman told the little girl that she will probably grow into her body. He is also annoyed that Cameron tries to sugarcoat body image. Foreman counters that Chase is probably uptight because he knows he's the one who will be cut.

House's team conducts the HEC test on Jessica, who freaks out and tries to rip out the IV. The doctors and Mrs. Simms all struggle to restrain her. After sedating Jessica, Foreman explains to Mrs. Simms that psychosis brought on by hypoglycemia is common during HEC tests.

From the results, House declares that Jessica isn't hypoglycemic so her psychosis was caused by something else. Chase suggests blood clots, which Cameron shoots down. Yet it could have been brought on by liposuction, which isn't in Jessica's medical file. House considers other weight treatments like diet pills, which wouldn't show up in toxicology screenings. He orders the patient to be put on heparin and warfarin to prevent further clotting, placing Foreman in charge of locating the diet pills. Foreman chides House for pitting the doctors against each other. House asks Foreman whom he would cut. Foreman nominates Chase because he believes he doesn't appreciate the job. House says he's surprised that Foreman would have named anybody.

Vogler questions Cuddy on House's staff cut and what he has been telling the team. Vogler offers to help if Cameron is the one who's let go.

Foreman asks Jessica's schoolteacher if she ever saw Jessica with pills. He learns that Jessica doesn't have any friends at school, so the teacher directs him to Jessica's assigned 6th grade "buddy." The buddy tells him that Jessica always runs laps at recess because nobody will play with her. The girl says that she totally busted Jessica taking drugs one day.

Although Mrs. Simms adamantly denies giving her daughter diet pills, Jessica admits to taking them on her own. Jessica breaks down in tears and says she took them because she feels ugly and disgusting. The pills seem to explain all of her symptoms. Yet the doctors later find Jessica with huge, bleeding sores on her body. In the office, House thinks the warfarin they gave Jessica led to skin necrosis, but Cameron says they started heparin first. House asks if anybody actually saw Cameron administer the heparin. When there's no answer, he has the team give Jessica an unfractionated IV heparin and low molecular weight heparin by subcutaneous injection right away. Out in the hallway, Cameron lights into Chase for leaving her dangling in the meeting. The team is falling apart.

Vogler takes Foreman aside and asks if he likes working for House and values his job. Foreman responds in the affirmative.

Cameron is studying in the lab when House drops in on her to ask about the mistake with the heparin. Cameron insists that she didn't screw up but that she doesn't have another explanation. House then asks her who she would fire. She suggests that everyone take a pay cut so that they can all stay.

The next day, House announces to Vogler and Cuddy that he's made his decision. He wants to push for a 17% pay cut across the board so that everybody can stay. Vogler rejects this because it's not about the money. He wants to know that House will do whatever Vogler tells him to do, no matter how distasteful.

House catches up with his team, who reports that the necrosis is getting worse. Wilson thinks that if they don't stop it from spreading, it will kill Jessica in about three hours. They need to cut it out before it penetrates the abdominal wall. Wilson and Foreman break the news to Mrs. Simms that a radical mastectomy may be Jessica's only chance for survival because warfarin-induced necrosis attacks fatty tissue.

Cameron barges into House's office, accusing him of insisting that she made a mistake with the heparin so that he has an excuse to fire her. He counters that maybe she actually did make a mistake. Cameron wonders if House can't deal with his feelings for her. House says that she's the only one who has expressed feelings and maybe she's acting this way because she wants to be fired. Meanwhile, Vogler tells Chase that if he's the one fired, then he's going to need a new mole on House's team. Chase complains that he's been feeding Vogler information only to protect himself.

There is no change in Jessica's necrosis. House wonders if Cameron didn't actually screw up, but they don't know what else it could be besides warfarin. Chase posits that maybe Jessica's fatness is a symptom, not a cause. Could it be hypothyroidism? The parents are both big and tall, but Jessica's short. House starts putting it all together. Stunted growth, high blood pressure, blood clots and obesity are all symptoms of Cushing's disease. It can even explain the necrosis in rare cases.

Foreman points out that blood tests have not shown abnormal cortisol levels, but House says that is cyclical. They just haven't caught it at the right time. With only one hour left, they weigh the options between performing the mastectomy and treating her for Cushing's. If they're wrong on Cushing's, Jessica will die. House orders a quick MRI to look for what could cause hypercortisolism. Foreman and Chase study the brain scan. Chase spots a tumor on the brain, indicating Cushing's disease.

Foreman explains the situation to Mrs. Simms. The surgery is quite dangerous because the tumor is located between the cavernous sinuses, an area that controls eye movement, and the major arteries that feed the brain. The surgeon will make an incision under Jessica's lip and insert a fiber optic microscope. He will then go through that incision to chop the tumor into pieces for removal. After a few hours, the surgery ends in success.

A week later, a slimmer Jessica is back for her checkup. Chase, Foreman and Cameron are all happy to see her doing so well. House arrives for his meeting with Vogler and Cuddy. House nominates Chase to be the one who gets fired. Vogler rejects that and orders House to pick someone else. If he doesn't, the whole department is gone.

第16集（S1EP16:Heavy）
1.HOUSE: Why? Because he screwed up an angio a month ago?
15分06秒的時候，House問Foreman如果讓他選的話他會炒掉誰？Foreman回答說是Chase。大叔問到“為什麼？因為他一個月前弄砸了一條脈管？”
這裏指的是在14集"Control"中，Chase所引發的一次事故，當時大家都認為是他做脈管檢測而引發的問題。
同樣在33分07秒的時候，House堅持Cameron犯了錯，Cameron認為那是House對自己的偏見，“because you can’t deal with your feelings for me. ”（因為你無法處理好對我的感覺）。House回答到：“I believe that you are the only one to express feelings.”（我相信你是唯一一個喜歡表達自己感覺的人），這裏指的也是在14集中，Cameron問House是否喜歡她。並不是字幕裏翻譯的“我暫時相信你是唯一一個值得我感情流露的人”，就大叔的性格，大叔估計死都不會說這麼一句話的 -_-

2.SIMMS: Remember the story where the guy keeps saying that he hates green eggs and ham? And then at the end he realized that he really loved them?... You just gotta be like Sam-I-Am and don’t give up.
Simms: 記得那個故事中的那個人麼？他一直說他討厭綠蛋和火腿，結果最後他發現其實他很喜歡那些的...你只要像Sam-I-Am那樣，不要放棄。
本集開始的時候（大約1分10秒處），Jessica不想去學校，因為她的同學會嘲笑她。她的媽媽提到的這個故事。這裏說的綠蛋和火腿，指的是由Dr.Seuss寫的一本兒童讀物Green Eggs And Ham。什麼是綠蛋呢？綠蛋一般指的是和菠菜等蔬菜一起烹飪的普通雞蛋，配上火腿就是一頓早餐了。但是在該書中的綠蛋指的是那種天然的，有著綠色蛋黃的雞蛋。Sam-I-Am是這本書裏的主角名字，他在故事中嘗試說服另外一個人吃綠色的蛋和火腿，但是那人拒絕品嘗如此奇怪的食物。後來Sam-I-Am的不懈努力終於使那人嘗試了綠蛋和火腿，並發現自己很喜歡吃。

3.FOREMAN: It’s some kind of game, House’s own version of “Punk’d”.
Foreman: 這只是某種遊戲而已，House自創的“Punk’d”。
6分8秒的時候，House說要從手下中裁掉一個人，Foreman的第一反應就是表示懷疑“只是House在玩某種把戲而已”。Punk’d是MTV台的真（整）人秀，由Ashton Kutcher製作主持。由Kutcher和他的團隊幫助某名人整其他的名人，並用隱藏的攝像機拍下來。有點像《綜藝最愛憲》那種。

4.FOREMAN: The kids in my neighborhood used to call me Rerun.
9分04秒的時候，Foreman為了讓Jessica去稱體重，對她說自己小時候也很重。“鄰居的小孩都叫我“Rerun”呢。
Rerun是上世紀70年代流行的電視劇What’s Happening!!（《發生了什麼？》）中最重的角色，由[url=http://en.wikipedia.org/wiki/Fred_Berry]Fred Berry飾演的Freddy Stubbs的外號，講述的是3個黑人美國孩子成長的故事。Foreman作為一個黑人，如果真的很胖的話，那麼Rerun這個外號還是很適合他的。

5.HOUSE: On what? Sharon’s plan for Gaza?
House: 哪方面的？沙龍對加沙的計畫？
House必須要炒掉一個人，Wilson在餐廳問目前有什麼想法沒（10分22秒）。大叔問哪方面的想法。“沙龍對加沙的計畫”，就是以色列總理沙龍的加沙路線圖計畫了。看新聞的應該都知道。說句題外話，他們醫院的伙食真不錯。。。