House Season3 EP13

Needle in a Haystack

Episode 313 : 2007-02-06

A sixteen year-old named Stevie is making out with his girlfriend Leah in a car when he has a hard time breathing. He turns blue.

House takes his car into work because of the weather, but when he pulls into the hospital lot he finds that the handicapped parking space closest to the building is already occupied. There is a sign over the space that reads "J. Whitner, MD." House has been assigned a more distant space than he had before, and Whitner has his old spot.

Foreman approaches House about Stevie's case, but House is more interested in the new parking situation and the identity of J. Whitner. Cameron explains that Dr. Whitner is a new female researcher confined to a wheelchair. Foreman tries to get him focused on the case, pointing out that Stevie suffered respiratory arrest with no history and that his ER work-up showed a bloody pleural effusion. That last part finally grabs House's attention. House suggests a blood leak and orders a veinogram.

House tracks down Dr. Whitner in the research lab. Since her wheelchair is motorized, he figures there must be some parking mix up because he has to walk while she only needs to push a joystick. Whitner points out that it's hard for cars to see her so the parking lot is dangerous. She won't be giving the spot back.

As Stevie struggles with breathing and chest pains, Foreman is unable to track down the boy's parents to sign consent forms. Leah offers to have her parents sign, but that's not legally viable. Stevie claims his parents are probably at a conference and had to shut off their cell phones. Suddenly, his oxygen stats plummet. Foreman has no choice but to perform the veinogram now. He will deal with the fallout later.

As Foreman begins the procedure, Stevie notices a diffusion pattern on the monitor and declares that it is Graham's law. He figures the leak has to be in his pulmonary veins in order to get into his lungs. Impressed, Foreman asks if he is studying this in high school. Stevie claims to read things on his own, and then he quickly changes the subject. When nothing shows up on the test, Stevie wonders how he can have a bloody effusion without any bleeding.

Cameron and Chase go to Stevie's home to look for drug use. The first thing they find is rotting food in the kitchen. Chase sees two people having sex in one of the bedrooms. The couple has no idea who Stevie is.

The doctors confront Stevie about the address he supplied. He tries to cover, but they know he's lying. Leah finally admits that Stevie is Romani, which is a gypsy. Stevie explains that the doctors cannot go to his home because their mere presence will spiritually pollute it and his parents treat that very seriously. He promises to tell them anything they need to know as long as they don't go where he lives. His family earns its living by buying and selling anything they can. Stevie was just in Chicago with his father last week on such a venture.

House confronts Cuddy about the parking issue and the debate quickly devolves into a bet. Cuddy predicts that House couldn't last one week in a wheelchair. He accepts the challenge. The team spots House rolling around the lobby and they update him on the case. Stevie's veinogram showed no leakage, and none in the lymphatics. House, adamant that blood outside the circulatory system could only come from a leak, advises his charges to stop trusting Stevie's claims and find some answers on their own. Either that, or they can thin out his blood for another veinogram.

Taking matters into their own hands, Cameron and Foreman perform an arteriogram first. Foreman suspects deep vein thrombosis from Stevie's recent long drive to and from Chicago. Cameron begins inserting a tube into a leg artery and Stevie cries out with stomach pain. The dye Cameron injected is entering Stevie's liver but not leaving it. The liver is completely blocked.

The team reconvenes with House, who sticks with his leak theory. Figuring a mass could be poking holes in Stevie's arteries, House asks for a CT, an MRI, a sputum and an ACE level. Then he wheels off. Stevie, who's beginning to turn yellow, enters the MRI. Foreman laments that Stevie's intelligence is being wasted by parents who are forcing him to sell scrap material. The doctors think they've spotted a granuloma on the MRI just as Stevie's parents barge into the room.

Foreman tracks down House in the parking lot and breaks the news about the granuloma. They now know it's Wegener's. House, encouraged by the development, tells Foreman that a liver biopsy will take too long. They need to start treatment with cyclophosphamide before things get worse. House then lifts himself from the wheelchair to his car, asking Foreman for help folding up the wheelchair. Foreman refuses and walks back into the hospital.

Foreman checks up on Stevie and notices that the parents Franklin and Constance have taken over the room, providing him with their clothing, their blankets and their food. Foreman chafes, noting that the hospital needs to control the environment in order to know if the tests are working. Stevie's parents argue that their son's life is simply out of balance and they're helping to restore it.

Later, Foreman returns for another checkup and finds Franklin and Constance shouting at Leah to get out of the room. They blame her for Stevie's troubles. Stevie begins to moan in agony. When Foreman pulls back the blankets, a large bloodstain covers Stevie's groin.

The team reports to House that the treatment for Wegenger's caused a massive hemorrhage in Stevie's bladder. House thinks that's good, which baffles his team. Everything else is ruled out. They have the correct diagnosis but the wrong treatment. They need to change the immune system, and House mentions an experimental drug named FT-28. Stevie's immune system is attacking his blood vessels. They can change his immune system so that the drug doesn't react to the blood vessels but works everywhere else. Cameron, ever mindful, points out that FT-28 isn't FDA approved. It has, however, worked for Crohn's disease. House suggests that they say Stevie has Crohn's so that they can administer the drug.

Franklin and Constance flatly refuse to allow the hospital to experiment on their son. Franklin mentions the medical experiments at Auschwitz and Foreman counters with the Tuskegee experiments. With no gains made in the argument, Foreman consults with House who advises him to become a better salesman. He must somehow earn the family's trust.

Stevie's extended family is now in the patient room and there's a festive, happy air. Foreman hooks up a new IV and then asks the family to give them some privacy so he can change the bandages around Stevie's groin. When the room is emptied, Foreman explains to Stevie that the doctors want to alter his treatment but that his parents won't let them. Stevie realizes that their resorting to experimental treatment means they must be out of answers. How can he trust Foreman? Foreman gives him the medicine and instructs him not tell his parents. If they find out, then Foreman will lose his license. That's how he knows he can be trusted. Stevie begins writhing in agony from intense pain.

A surgeon removes Stevie's ruptured spleen and gives it to Foreman to perform a biopsy for Wegener's. House watches from the observation deck in his wheelchair. He doesn't spot anything out of the ordinary or granulomas. House asks them to run Stevie's bowel, but the surgeon begins closing him up. House needs to get downstairs quickly, but he also needs to win his bet. The elevator is taking too long, so House bounces his wheelchair down the stairs and barges into the OR, insisting that a granuloma is indeed present. House stands up and sticks his gloved hands into Stevie's body to feel the small intestine for granuloma. The surgical team immediately stops working in fear of a lawsuit. House reaches the end of the small intestine and finds nothing. There is no granuloma. Stevie's parents were right.

House and his team head back to the drawing board. Still suspecting the bowel, House orders a colonoscopy. They will need to move fast because Stevie is in the ICU, which has limited visiting privileges. The doctors must get to Stevie before the family cuts off their access. The colonoscopy, like everything else, comes out normal. Suddenly, Foreman spots a toothpick. Stevie chews on them like his father does. He must have accidentally swallowed one. During his make-out session, an awkward movement could've pushed the toothpick through the colon wall and into the lung. From there, it traveled to the liver, then the kidney, then the spleen.

Franklin processes this news, then immediately blames Leah. If she wasn't kissing Stevie, this never would have happened. Leah blames Franklin for passing such a disgusting habit on to his son. Foreman visits with Stevie and says he will be fine in a few days. Foreman then mentions that the hospital lab has a paid internship which is usually given to a university student. He promises to arrange an interview for him. Stevie thanks him but passes on the offer. Foreman implores him to put his mind to use, but Stevie notes that Foreman, Cameron and Chase are all single and alone. Stevie wants a family.

House goes to reclaim his parking spot from Cuddy, but she knows that he stood up in the operating room. He lost the bet. House accuses Cuddy of never planning on giving him the space. That would explain why Dr. Whitner wasn't concerned about losing her parking when House confronted her earlier in the week. House asks Cuddy if she feels even a little bit guilty about her scheme.

That night, as he leaves the hospital, House sees a maintenance worker putting his name back on the spot closest to the building.

第13集（S3EP13:Needle in a Haystack）
這一集的病號是一個羅姆人（吉普賽人），所以瞭解一下羅姆人的背景和歷史上所受到的歧視將會有助於瞭解本集病人的想法和一些臺詞，比如25分56秒Foreman說的“這些窗戶上貼錫紙的人”（the crazy couple who put tinfoil over their windows）就是因為羅姆人以神秘形象著稱。再比如大叔在34分43秒替Foreman放風時為了吸引病人家長注意大喊的那句“Cuddy要騙我門都沒有！”（No way Cuddy is going to gyp me!）中的Gyp則是雙關語，因為長期以來對羅姆人的歧視，英語俚語中羅姆人，即吉普賽人的縮寫GYP就是欺騙，騙子的意思。以下引自維琪百科：

QUOTE:

羅姆人，為起源於印度北部，散居全世界的流浪民族。羅姆人與跟他們有密切關係的辛提人又合稱為吉卜賽人或吉普賽人。不過，大多數羅姆人都認為“吉卜賽人”這個名稱有歧視意義，所以不使用。歐洲亦有許多國家稱羅姆人為茨岡人。
羅姆人以其神秘的形象著稱，歷史上多從事占卜、歌舞等職業。但羅姆人在歷史上也遭受了歧視和迫害，納粹德國曾將羅姆人和猶太人一樣關進集中營進行屠殺，至今有許多人對羅姆人仍保有極其反面的印象，認為羅姆人是乞丐、小偷或者人販子。

1. WILSON: Ah yes, if it isn’t Doctor Ironside.
HOUSE: Ah, if it isn’t Doctor "I had no friends growing up, so all I did was watch TV by myself, which is why I can now make pop culture references that nobody understands but me."
WILSON: That’s my name... don’t wear it out!
WILSON: 啊，這不是"Ironside"醫生麼？
HOUSE: 啊，這不是“我從小就沒朋友，所以我只能獨自看電視，這讓我現在能夠說一些除我之外沒人能懂的關於流行文化的隱喻”醫生麼？
WILSON: 那是我的名字，別說破了。
21分35秒Wilson和House在洗手間的對話實在很搞笑。不過我看YDY的版本在這段的翻譯似乎有些小問題 :)。Wilson所說的"Ironside"是1967-1975年電視劇《輪椅神探》（"Ironside）。很顯然主角就是一個坐輪椅的偵探，李小龍曾經也參演過其中的部分劇集。在House反諷Wilson只能根據電視說些沒人能懂的冷笑話後，Wilson又“及時”說了句電影臺詞來氣大叔。“那是我的名字，別說破了”是約翰屈伏塔在1978年電影《火爆浪子》（"Grease"）中的一句臺詞。這部電影在2006年美國電影協會的最佳音樂電影排行中位元列第20，沒看過的話很難想像現在中年發福的屈伏塔年輕時的身手是多麼的矯健-__-。
P.S.我很懷疑House一劇的諸多編劇小時候也是只能獨自呆在家裡看電視的......

2. CUDDY: Last I checked, pigheadedness was not the eighth heavenly virtue.
CUDDY: 就我所知，頑固並不是第8條天授美德。
22分08秒，大叔和Cuddy關於車位問題爭論的時候Cuddy說的話。我們很多人都知道基督教有7宗原罪之說：驕傲（Pride）、嫉妒（Envy）、浪費（Gluttony）、性欲（Lust）、狂暴（Anger）、貪婪（Greed）、懶惰（Sloth）；但很少聽過7大美德（Seven heavenly virtue）。
7大美德其實是結合了4大宗教上的美德和3大精神上的美德而成，分別是：審慎（Prudence）、節欲（Temperance）、堅韌（Fortitude）、公正（Justice）和信念（Faith）、希望（Hope）、博愛（Love/Charity）。

3. HOUSE: That’s what they told Rosa Parks.
HOUSE: 他們對Rosa Parks也是這麼說的。
22分17秒，還是大叔和Cuddy爭論車位問題的時候，大叔說的話。現已逝世的黑人女性Rosa Parks（羅莎·帕克斯）是美國現代民權運動之母。1955年她因為在公共汽車上拒絕給一名白人乘客讓座而被捕，這件事激起廣大黑人民眾的義憤。在馬丁·路德·金等黑人領袖的組織下，黑人民眾展開了聲勢浩大的抵制公共汽車運動。2005年她去世的時候，美國各地都有多種紀念活動。

4. FOREMAN: Tuskegee went on for 28 years after World War II
FOREMAN: Tuskegee計畫在二戰後還持續了28年。
24分58秒，Foreman為了勸Stevie接受試驗療法時候2人的對話。Stevie之前說的奧斯維辛集中營大家可能都比較熟悉，二戰時納粹德國不但殘害了許多猶太人，同時也殺害了眾多的羅曼人/吉普賽人（就是Stevie的民族）。而Foreman說的Tuskegee計畫則可能比較陌生：1932年，美國公共衛生部（PHS）和當時梅毒的高發地Tuskegee進行了梅毒研究，受試者來自美國東南部偏遠小鎮的黑人，他們都是文盲，共有約600名，其中400多人患有梅毒。研究者許以他們免費治療、食物及安葬費。研究中用的是砷、鉍、汞等製劑，符合當時的梅毒常規治療方法。但是在1945年青黴素作為治療梅毒安全有效的藥物被廣泛應用後，研究者卻繼續原來的療法。PHS甚至指使徵兵局不招受試者入伍，以防止他們在軍隊裡得到有效治療。在試驗中，研究者還向受試者撒了謊，例如,他們說脊髓穿刺是“一種特別的新療法”,但實際上卻是為研究需要而掌握脊髓的蛋白質水準。這項嚴重違背了尊重、行善、公平等基本倫理原則的試驗，直到1971年被華盛頓郵報的一位元記者揭露後才停止下來。
Tuskegee梅毒事件和其他濫用醫學研究事件的揭露，使美國的人體受試者試驗遭到社會廣泛的批評，同時也促使美國國會成立了第一個國家有關生命倫理政策的機構——美國國家生命倫理委員會。

5. HOUSE: You may have a wheel. It doesn’t mean you get the grease. You gotta squeak.
HOUSE: 你也許已經有了輪子（暗指Whitner坐輪椅），但並不意味著你也有了油，你要學會咯吱響。
26分56秒，大叔在走廊裡遇上坐輪椅的Julie Whitner醫生，正所謂冤家路窄。大叔還在滔滔不絕的調侃Cuddy的胸部名不副實的時候，Whitner突然來了句“那胸部很辣，不是麼？”。大叔說Whitner要借此“把自己拉攏過來可不是這麼容易”。大叔說的輪子，油，咯吱響這些來自一句英語諺語：“The squeaky wheel gets the grease”，直譯就是“會咯吱作響的椅子才會給它上油”，意思就是“會叫的鳥兒有蟲吃”，告訴人們勇於表達自己的觀點才會受到重視，似乎比較符合西方的個人英雄主義，和我們的中庸之道不怎麼一樣。

6. HOUSE: Because we need to take the center square to block.
HOUSE: 因為我們要守住中間的這個方塊。
33分29秒，大叔要擴大範圍搜尋Stevie體內的肉芽腫時說的這句話。大叔當時用玩井字棋（Tic-Tac-Toe）的方式分析及排除病因所在位置。在井字棋遊戲中，中間的那個格子是至關重要的，因為此遊戲結構簡單，只有765個可能局面，26830個棋局。如果對稱也算不同的棋局的話，則有255168個棋局。而這其中雙方都不出錯的話，那麼第一位下子的玩家會贏131184次，第二位下子的玩家會贏77904次，雙方和局46080次。而只要第一位玩家第一步下在四個角中的任何一個位置，同時第二位玩家接下來沒有下在中間的格子，那麼如果雙方接下來都不出錯的情況下，第一位玩家將會獲得勝利。所以大叔這裡說“我們要守住中間這個方塊”。
另外1966年的美國電視節目"The Hollywood Squares"，參加的嘉賓分別坐在九個特製的方形框框裡回答主持人提出的問題，而參賽者則要判斷這些答案是否正確，如果正確則得到一個格子，就相當於在玩一個巨型“井字棋”。

7. HOUSE: I like that kid. He’s got spunk.
HOUSE: 我喜歡那小子，有膽量。
33分46秒，Foreman要給Stevie偷偷做結腸鏡檢查的時候，House說的這句話。出自70年代著名的美國劇集《瑪麗·泰勒·摩爾秀》（"The Mary Tyler Moore Show"）。這部1970-1977年的電視劇獲得了29座艾美獎。下面介紹來自網路：

QUOTE:

劇中主題抓住了大都會女性的社會地位等社會相關議題。它建議女性觀眾“友誼是女人可以期待的最好依歸，而男人只不過是蛋糕上面的糖衣”，但最重要的是要在光怪陸離的現代大都市中學會如何發現自己、愛自己。此劇敘事風格獨到，一方講述都市女性的生活，一方運用絢麗多姿的時尚、服飾、飲食、藝術等元素展現岀豐富熱鬧的社會人文景觀。

似乎和《欲望都市》差不多的主題。"He’s got spunk"出自這部戲的第一集，由Ed Asner飾演的Lou Grant（女主人公的老闆）的臺詞。另外在第一集中的音樂"Love is all around"也是經典之作，順帶一提的是據說現在女生穿的七分褲就是透過這部劇最初流行開的。

8. HOUSE: Veni, vidi, vici.
HOUSE: 到，見，勝
40分08秒，在大叔耍詭計獲得了車位後，大叔得以的引用了凱撒大帝（Julius Caesar）著名的“3V宣言”。西元前47年,凱撒大帝在小亞細亞吉拉城，只用五天時間一舉擊潰帕爾納凱斯，欣喜的凱撒向羅馬報捷時只用這三個拉丁文字母，翻譯成因為就是"I came, I saw, I conquered"（我來到，我看見，我征服）。