Damned If You Do
Encyclopedia
"Damned If You Do" is the fifth episode of the first season of House
, which premiered on the Fox
network on December 14, 2004. The title refers to a common saying, "damned if you do, damned if you don't", a saying that describes two equally repulsive choices, neither of which results in a positive outcome, in this case coming from Chase's reference to nuns. When House mentions saving the nun, Chase mutters "Damned if you do, damned if you don't!".
The episode's title is actually mentioned in the show by Chase, and the expression seems applicable to the main characters, who are all damned: "Chase for losing his belief, House for his possible error, Cameron for not holding true to her diagnosis even though she holds true to House."
) has hands red with rash. While her sister nun
s suggest stigmata
, House suspects contact dermatitis
brought on by an allergic reaction
to dish soap. He gives her an antihistamine
, suggests over-the-counter cortisone cream, advising that relief will take place quickly. Unfortunately, the antihistamine leaves Sister Augustine gasping for air. House believes it is an asthma attack caused by an allergic reaction to the pill. He administers epinephrine
, but soon afterwards, notices a rapid heartbeat and calls for a nurse.
Dr. Cuddy is certain that House made a mistake and maybe gave the nun a much higher dosage by mistake. Cuddy will have to notify hospital attorneys within 24 hours if House cannot find an underlying cause for the heart failure. He runs his team through possible explanations. Cameron hypothesizes that it is Churg-Strauss syndrome
, a systemic vasculitis
that even with treatment gives patients only five years survival. Foreman takes an easier route, merely suggesting that House messed up.
Sister Augustine goes into CT, but inside the tube she becomes frantic about a smell. The doctors cancel the test and Sister Augustine screams that Jesus is coming for her. Suddenly, she suffers convulsions. Foreman notices a rash appear on the Sister's leg as he holds her down. He finds out that the nun tested positive for herpetic encephalitis, the result of a weakened immune system
. The same symptom can be triggered by the medicine which House gave her earlier. The group tries to figure out other possible causes.
House then believes that the nun might have mixed connective tissue disease
. The treatment for that disease is prednisone
, which is what caused these problems in the first place. House recommends a hyperbaric oxygen chamber, but Foreman is concerned that that could make things even worse. Foreman goes to Cuddy and she becomes alarmed at the rash hyperbaric treatment. Cuddy pulls House off Sister Augustine's case.
Cuddy meets with Cameron, Foreman and Chase to discuss potential treatments. House, meanwhile, asks Chase if Sister Augustine is hiding something. Chase suggests talking to the Mother Superior
, and House pays a visit to the convent. Mother Superior discusses Augustine's troubled past as a foster child and the woman's self-aborted pregnancy. That does not interest House, but the tea which the convent serves does; it is figwort
tea, which House claims, when mixed with even the smallest level of epinephrine, causes instant cardiac arrest
: House was right all along. However, there is some allergy still lurking, which has gone untreated for so long that it has metamorphosed into a monster. House decides to introduce various allergens until one causes a reaction. Sister Augustine is placed into a cleanroom
, but still goes into convulsions. The doctors are baffled: what in this sterile environment could make someone react so violently?
Sister Augustine decides that God wants to take her, so she requests to go back to the convent. House chides her for repeatedly running away from her problems. Sister Augustine mentions that she has God inside her, which gives House a revelation. Examining X-rays, the doctors find a copper cross IUD
inside Sister Augustine's uterus; she is allergic to copper, which also explains the initial dermatitis (caused by some recently donated copper pots and pans she had been washing.) Surgical extraction of the IUD allows the nun's full recovery.
House (TV series)
House is an American television medical drama that debuted on the Fox network on November 16, 2004. The show's central character is Dr. Gregory House , an unconventional and misanthropic medical genius who heads a team of diagnosticians at the fictional Princeton-Plainsboro Teaching Hospital in...
, which premiered on the Fox
Fox Broadcasting Company
Fox Broadcasting Company, commonly referred to as Fox Network or simply Fox , is an American commercial broadcasting television network owned by Fox Entertainment Group, part of Rupert Murdoch's News Corporation. Launched on October 9, 1986, Fox was the highest-rated broadcast network in the...
network on December 14, 2004. The title refers to a common saying, "damned if you do, damned if you don't", a saying that describes two equally repulsive choices, neither of which results in a positive outcome, in this case coming from Chase's reference to nuns. When House mentions saving the nun, Chase mutters "Damned if you do, damned if you don't!".
The episode's title is actually mentioned in the show by Chase, and the expression seems applicable to the main characters, who are all damned: "Chase for losing his belief, House for his possible error, Cameron for not holding true to her diagnosis even though she holds true to House."
Plot
House's new patient, Sister Augustine (Elizabeth MitchellElizabeth Mitchell
Elizabeth Mitchell , is an American actress/modelwho is known for her roles as Dr. Juliet Burke on ABC's TV series Lost and as FBI agent Erica Evans on V. She has starred in such films as The Santa Clause 2, The Santa Clause 3: The Escape Clause, and Gia.-Early life:Mitchell was born Elizabeth...
) has hands red with rash. While her sister nun
Nun
A nun is a woman who has taken vows committing her to live a spiritual life. She may be an ascetic who voluntarily chooses to leave mainstream society and live her life in prayer and contemplation in a monastery or convent...
s suggest stigmata
Stigmata
Stigmata are bodily marks, sores, or sensations of pain in locations corresponding to the crucifixion wounds of Jesus, such as the hands and feet...
, House suspects contact dermatitis
Contact dermatitis
Contact dermatitis is a term for a skin reaction resulting from exposure to allergens or irritants . Phototoxic dermatitis occurs when the allergen or irritant is activated by sunlight....
brought on by an allergic reaction
Allergy
An Allergy is a hypersensitivity disorder of the immune system. Allergic reactions occur when a person's immune system reacts to normally harmless substances in the environment. A substance that causes a reaction is called an allergen. These reactions are acquired, predictable, and rapid...
to dish soap. He gives her an antihistamine
Antihistamine
An H1 antagonist is a histamine antagonist of the H1 receptor that serves to reduce or eliminate effects mediated by histamine, an endogenous chemical mediator released during allergic reactions...
, suggests over-the-counter cortisone cream, advising that relief will take place quickly. Unfortunately, the antihistamine leaves Sister Augustine gasping for air. House believes it is an asthma attack caused by an allergic reaction to the pill. He administers epinephrine
Epinephrine
Epinephrine is a hormone and a neurotransmitter. It increases heart rate, constricts blood vessels, dilates air passages and participates in the fight-or-flight response of the sympathetic nervous system. In chemical terms, adrenaline is one of a group of monoamines called the catecholamines...
, but soon afterwards, notices a rapid heartbeat and calls for a nurse.
Dr. Cuddy is certain that House made a mistake and maybe gave the nun a much higher dosage by mistake. Cuddy will have to notify hospital attorneys within 24 hours if House cannot find an underlying cause for the heart failure. He runs his team through possible explanations. Cameron hypothesizes that it is Churg-Strauss syndrome
Churg-Strauss syndrome
Churg–Strauss syndrome is a medium and small vessel autoimmune vasculitis, leading to necrosis. It involves mainly the blood vessels of the lungs , gastrointestinal system, and peripheral nerves, but also affects the heart, skin and kidneys. It is a rare disease that is non-inheritable and...
, a systemic vasculitis
Vasculitis
Vasculitis refers to a heterogeneous group of disorders that are characterized by inflammatory destruction of blood vessels. Both arteries and veins are affected. Lymphangitis is sometimes considered a type of vasculitis...
that even with treatment gives patients only five years survival. Foreman takes an easier route, merely suggesting that House messed up.
Sister Augustine goes into CT, but inside the tube she becomes frantic about a smell. The doctors cancel the test and Sister Augustine screams that Jesus is coming for her. Suddenly, she suffers convulsions. Foreman notices a rash appear on the Sister's leg as he holds her down. He finds out that the nun tested positive for herpetic encephalitis, the result of a weakened immune system
Immune system
An immune system is a system of biological structures and processes within an organism that protects against disease by identifying and killing pathogens and tumor cells. It detects a wide variety of agents, from viruses to parasitic worms, and needs to distinguish them from the organism's own...
. The same symptom can be triggered by the medicine which House gave her earlier. The group tries to figure out other possible causes.
House then believes that the nun might have mixed connective tissue disease
Mixed connective tissue disease
In medicine, mixed connective tissue disease , commonly abbreviated as MCTD, is an autoimmune disease, in which the body's defense system attacks itself. It was characterized in 1972....
. The treatment for that disease is prednisone
Prednisone
Prednisone is a synthetic corticosteroid drug that is particularly effective as an immunosuppressant drug. It is used to treat certain inflammatory diseases and some types of cancer, but has significant adverse effects...
, which is what caused these problems in the first place. House recommends a hyperbaric oxygen chamber, but Foreman is concerned that that could make things even worse. Foreman goes to Cuddy and she becomes alarmed at the rash hyperbaric treatment. Cuddy pulls House off Sister Augustine's case.
Cuddy meets with Cameron, Foreman and Chase to discuss potential treatments. House, meanwhile, asks Chase if Sister Augustine is hiding something. Chase suggests talking to the Mother Superior
Abbess
An abbess is the female superior, or mother superior, of a community of nuns, often an abbey....
, and House pays a visit to the convent. Mother Superior discusses Augustine's troubled past as a foster child and the woman's self-aborted pregnancy. That does not interest House, but the tea which the convent serves does; it is figwort
Scrophulariaceae
Scrophulariaceae, the figwort family, are a family of flowering plants. The plants are annual or perennial herbs with flowers with bilateral or rarely radial symmetry. Members of the Scrophulariaceae have a cosmopolitan distribution, with the majority found in temperate areas, including...
tea, which House claims, when mixed with even the smallest level of epinephrine, causes instant cardiac arrest
Cardiac arrest
Cardiac arrest, is the cessation of normal circulation of the blood due to failure of the heart to contract effectively...
: House was right all along. However, there is some allergy still lurking, which has gone untreated for so long that it has metamorphosed into a monster. House decides to introduce various allergens until one causes a reaction. Sister Augustine is placed into a cleanroom
Cleanroom
A cleanroom is an environment, typically used in manufacturing or scientific research, that has a low level of environmental pollutants such as dust, airborne microbes, aerosol particles and chemical vapors. More accurately, a cleanroom has a controlled level of contamination that is specified by...
, but still goes into convulsions. The doctors are baffled: what in this sterile environment could make someone react so violently?
Sister Augustine decides that God wants to take her, so she requests to go back to the convent. House chides her for repeatedly running away from her problems. Sister Augustine mentions that she has God inside her, which gives House a revelation. Examining X-rays, the doctors find a copper cross IUD
Intrauterine device
A copper IUD is a type of intrauterine device. Most IUDs have a plastic T- or U-shaped frame which is wrapped in copper wire, with the exception of Gynefix, which is a plastic string with several copper beads, affixed to the fundus of the uterus...
inside Sister Augustine's uterus; she is allergic to copper, which also explains the initial dermatitis (caused by some recently donated copper pots and pans she had been washing.) Surgical extraction of the IUD allows the nun's full recovery.
External links
- "Damned If You Do" at Fox.com