House Season1 EP17

Role Model

Episode 117 : 2005-04-12

Senator Gary Wright speaks at a fundraiser, but stumbles through the end of his speech. Then he struggles to converse with a supporter. Wright vomits on the man's suit before collapsing and tumbling down a flight of stairs.

Vogler gives the Senator's case to House. He also notes that if House was a team player from the start, then he wouldn't have to fire Cameron or Foreman. Vogler wants House to give a speech at the National Cardiology Conference next week where he is to extol the virtues of Eastbrook Pharmaceuticals' new and more expensive ACE inhibitor. Eastbrook is owned by Vogler. House chafes at the request. Vogler says he is to make the speech and examine the Senator, or else he will have to fire one of his protégés.

House and Foreman examine Wright, but Foreman does all the work. The man has a big scar on his tongue, which Wright explains happened when he was six and fell off the swings. House doesn't buy that explanation, pointing out that tongues heal fast. Then House notices that Wright has no reflexes when Foreman taps him with a mallet. House orders an MRI and a lumbar puncture, telling the Senator to cancel his travel plans.

The LP results are negative for infection and the MRI is fairly clean. There is, however, a low intensity spot inside the Broca's area of the brain. House tells the team that the lesion could either be nothing, a brain tumor or an infection. He orders surgery. He also lets the team know that none of them will have to worry about their jobs. House doesn't go into further details.

Cuddy is angry at House for attempting a risky brain biopsy based on a spot on an MRI. It could cause permanent neurological damage. House argues that a tumor is just as bad, but Cuddy says that neither of them can make that call. They lay out the situation to Senator Wright, explaining that it could be something or it could be nothing. Wright asks what the voters will think. House becomes intrigued when he hears Wright stutter while asking the question.

Surgery begins. Afterwards, the biopsy shows that there is no tumor or bacterial infection. Yet Wilson becomes quite concerned as he examines the biopsy and finds toxoplasmosis. This means that Wright has full-blown AIDS. Foreman and House explain to Wright that toxoplasmosis is a fairly common fungus that people can get from eating undercooked meat or touching cat feces. It usually responds to treatment and it only causes lesions when a patient's immune system is not functioning. The doctors think he has AIDS. Wright angrily denies the possibility. House informs him that the toxo drugs will fight the fungi, but it's going to be nasty. Wright firmly orders House to give him the toxo drugs, test him for HIV under a false name, and then run a test for cancer. Wright again proclaims that he does not have AIDS.

Cameron comes across an email press release announcing House's upcoming speech and reads it to Chase. They're shocked that House would do this. House enters and explains his deal with Vogler. He tells them that Foreman is testing Wright for leukemia, but he needs Chase and Cameron to rush the Elisa test for HIV. Cameron thanks him for agreeing to give the speech, but House presses on.

Foreman administers the test by injecting Wright in the back, and he says that they can wait until the HIV test results return. Wright claims not to be lying because black politicians can't lie and nobody gives them the benefit of the doubt.

House gives Wright the results of the Elisa test. It's positive. His T cell count is so low, he is close to death. They will need to contact his sexual partners. Wright insists that he's only had two girlfriends since his wife died and that he used condoms. House tells him to come clean and admit to homosexual relations. Wright chides House for being so cynical and never believing in people. House draws some more blood from Wright.

The next day, Wright tries to get out of bed, but his foot is numb. Cuddy thinks the antiretrovirals aren't working, and she prods House for not seeing that Wright is just going to get worse. House is more concerned with why Cuddy is spying on his case. House tells Wright that the antiretrovirals are not working because he doesn't have AIDS. The test returned a false positive, which happens one time in five thousand. Wright's relief is erased when House says that he is still dying, only now they don't know why.

House convenes the team outside, away from Cuddy. Foreman notes that Wright is losing control of the muscles on his right side, his brain is getting foggier and his T cells are still in the single digits. What could be causing this? House orders a full body scan.

Wilson asks House if he ran a second AIDS test because he suspected a false positive. House claims that it is standard procedure, which Wilson knows he doesn't care about. House admits that he was moved by Wright's insistence that he didn't engage in risk behaviors. Wilson mocks House's first bout of actually believing in people. Wilson then wonders if being near the ultra-nice Cameron is rubbing off on House. He then realizes that House has an interest in Cameron.

A CT scan on Wright reveals five slightly enlarged lymph nodes and a cyst in both his liver and right kidney. Cuddy orders all this to be checked out. Vogler enters, handing House his notes for the speech. House criticizes Vogler for undermining him in front of his staff. Vogler retorts that they already know that House is undermined. House pulls Chase into his office for a speech. He asks Chase how they can work together with Chase constantly reporting on him. Chase responds that he had no choice.

Foreman performs the multiple biopsies on a sedated Wright. He finds that both cysts are benign and that all the lymph nodes are clean. House suspects hairy cell leukemia and wants to biopsy Wright's spleen. Everybody resists. Chase insists that the spleen will bleed too much and Cuddy believes that, because of the Senator's condition, this procedure could cause sepsis and death. Foreman says that Wright's brain is turning to mush. They have to do it.

House approaches Cameron in the lab and tries to inquire as to why she would like him, but it goes nowhere. They bicker about House's personal issues and he leaves.

Foreman approaches Wright to get a consent signature for the biopsy, but Wright now has a hacking cough. Foreman says they don't need consent because they can't perform the biopsy. He tells the team that Wright's breathing is severely impaired. His stain indicates pneumocystis carinii pneumonia, which is another killer fungus consistent with hairy cell leukemia. Yet with respiratory distress, they can't biopsy because Wright's blood won't clot. How else can they diagnose hairy cell? House wonders what other symptoms a patient with hairy cell would have. Chase and Cameron suggest virii like HTLV and interleukin-2. House orders tests for both.

Foreman shows House the test results. Wright is negative on all virii. It's not hairy cell. House notices that Wright is positive for Epstein Barr. He rushes into Wright's room and removes his oxygen mask. Wright begins gasping for air. House says that he knows the tongue scar is from an epileptic seizure. Wright says he hasn't had a seizure since he was six and has not been on medication since he was ten. House asks if the medication was phenytoin, which Wright confirms.

House bursts into his office and tells the team. Wright took phenytoin. This, along with the Epstein Barr virus, is associated with common variable immunodeficiency disease. The body can't fight off fungi. House posits that Wright contracted this as a kid. Yet recent stress, like giving big speeches, triggered its reemergence. Cameron doubts it, but House orders an IV immunoglobin. If Wright improves, House is right. If House is wrong, Wright is dead.

Foreman inserts the IV. The medicine begins to drip. After some time, Wright improves greatly. He'll need medication for the rest of his life, but he will be fine.

The time comes for House's big speech. He dispassionately reads a one paragraph statement about the drug. Vogler stops House and tells him that wasn't enough. House returns to the microphone and praises Vogler as a brilliant businessman. House then congratulates Eastbrook and Vogler for smartly tweaking their ACE inhibitor just slightly enough to win a new patent and make millions more.

That night, House is at home ignoring his phone when Cameron drops by. She tells House that he won't have to fire anyone because she's leaving. This is the only way she can deal with her feelings for him.

第17集（S1EP17:Role Model）
1.HOUSE: Fine, have it your way. Immaculate conception.
House: 好吧，照你說的。完美之身。
7分57秒處，House診斷本集的門診病人曾經懷孕流產，然而Susan說自己和丈夫分手後1年了就沒有過性生活。於是House稱這個為“完美之身”。Susan問自己應該怎麼辦，House回答到“很明顯啊，可以創立一個信仰”。
完美之身（Immaculate conception）是天主教關於聖母瑪麗亞的一個故事。如果你瞭解一點的話，你就應該聽說聖母瑪利亞生耶穌的時候是完美無罪之身，這裏的“罪”指的是人類的原罪，就是人類一切罪惡的根本。原本是指亞當夏娃偷吃禁果這件事，後來就可以指男女的婚姻（記得安潔麗娜朱莉的電影《原罪》麼，說的就是婚姻）和人類的誕生（born）了——正是亞當夏娃的原罪，使得兩人結合並哺育出人類。天主教認為上帝為誕生耶穌而派遣聖母瑪利亞來到人間，後來她受到聖靈感應而產子，即耶穌。因此耶穌也是無原罪的完美之身（沒有經歷過born過程）。後人就直接認為瑪麗亞是處女產子了。
Susan聲稱自己1年多都沒有過性生活，然而House卻診斷出她曾經懷孕過，因此大叔才認為說你簡直就是聖母瑪利亞（處女產子），並建議其創立一個信仰（因為聖母瑪麗亞的兒子就是耶穌，創立的基督教）。

2.HOUSE: This could leave you b-b-b-b-brain damaged, and you’re worried about NASCAR dads?
House要給參議員來個大腦切片，然而這可能帶來永久性腦損傷。參議員得知後擔心選民如果知道自己做大腦切片並可能造成腦損傷後的反應（說這話的時候還結巴了一下^^）。於是大叔的賤嘴也結巴的說道：“這可能造成你腦、腦、腦損傷，你居然還在擔心NASCAR dads？”（9分26秒處）
NASCAR dads並不是字幕裏翻譯的“看電視的白癡”，而是一種選票統計，統計的對象主要是工薪階層和中低收入的白人男性。在2004年小布希和克裏的總統競選中，這個階層的人比較搖擺不定，因此當時NASCAR dads也被認為是最為重要的一個統計結果（誰占優，誰就可能當總統）。那麼為什麼叫NASCAR dads（看NASCAR的父親們）呢，因為其統計物件被認為也是NASCAR——全美賽車比賽協會（National Association for Stock Car Auto Racing）的主要收視群體。與其對應的另一個統計叫Soccer moms（鼓勵孩子踢球的母親們），其物件自然就是家中有個剛上學的孩子的女性選民了，這個群體在選舉中的立場也常因為參選人對醫療，教育，稅收等與家庭有關的政策而搖擺不定，因此也是很需要拉攏的一個群體。

3.HOUSE: Which means the Great Black Hope has full-blown AIDS.
10分07秒的樣子，當Wilson從Wright的大腦切片看出弓漿蟲病的時候，House說“這意味著這個偉大的黑人夢想家得了愛滋”
這裏提到的“偉大的黑人夢想家”（The Great Black Hope）暗示的是1970年的電影《拳王奮鬥史》（“The Great White Hope”），該片曾獲得普利策獎，講述的是一個黑人重量級拳手如何反抗30年代美國的種族主義的故事。

4.HOUSE: But, when you’re 4th-down, 100 to go, in the snow, you don’t call a running play up the middle. Unless you’re the Jets.
House給Wright預訂了一個全身掃描，Cameron說記得House其實是討厭全身掃描的，House承認了，但又打了個美式橄欖球的比喻（21分51秒處）“如果你做第四次進攻時（也就是最後一次進攻），還有100碼到底，在雪裏你不會沖中路，除非你是Jets隊的”
這裏的Jets並不是指噴氣式飛機，而是紐約Jets隊（The New York Jets），其主場在新澤西。關於snow,running play up the middle這些我也不知道翻譯的對不對，希望熟悉美式足球規則的人來解釋下。
我也和CameronMM的觀點一樣：“我討厭用體育比賽做比喻”。
House一劇除了人物塑造等等外，還體現出美國的宗教，政治，傳媒，體育文化，這一集應該就可以看到一個縮影吧。