House M.D. Season 01 Episode 01 Guide

Pilot or You Can't Always Get What You Want

(Don't want to read everything here to find the name of the nasty disease presented in this episode? Scroll to the bottom for a quick episode summary)

Well this is the episode that started it all off. As befits a first episode, we are introduced to all the major characters, and given the show format. A prelude which shows the point that the mysterious disease manifests, kind of like Six Feet Under where the prelude to each episode shows someone kicking the bucket. So in episode 1 of House M.D. we get a kindergarten school teacher mysteriously keeling over and starting to babble.

We are introduced to Dr Gregory House with a shot of him walking next to another doctor. House is limping and using a cane, dressed causually. He is in conversation with another doctor (Dr Wilson) who is trying to convince him to take an interesting case by telling House she is his (Dr Wilson's) cousin. The first conversation reveals a lot about Dr House - we find out he is arrogant (he dismisses the case initially as a boring brain tumor, we also find out he is sarcastic as he quips "I'm just a lowly infectious disease guy"

We are then introduced to House's team as they look at an MRI of the patient's head. Immediately House puts forward one of his key philosophies when asked why they aren't speaking to the patient: "Everybody lies". And so we go through the first differential diagnosis with Cameron, Foreman and Chase....
Some diseases are thrown around - Creutzfeld-Jakob, Mad cow and Wernickie's encephalopathy, all ruled out by House, who then orders some more tests.

We are next introduced to Dr Lisa Cuddy, House's boss when she and House have a meeting with House trying to weasel out of clinic duty. Cuddy threatens House saying the only reason she doesn't fire him is because of his reputation. She also implies he has no personal life. We cut to House's team being stopped just before they get an MRI of Rebecca's head. House burtst into Cuddy office and they fight, Cuddy has told the hospital to stop any use of equipment and labs for House and his team until House starts doing his clinic time. House is pissed as he loses the argument with Cuddy.

As House's team start an MRI on Rebecca, she chokes and they have to cut a hole in her neck to allow her to breathe.

House start his clinic duty with a patient who is orange and complains of back spasm. We see House popping some pills (Vicodin for the pain in his leg). House diagnoses the orange patient speedily, showing both his brilliance as a Doctor and his total disregard for human emotions. He tells the clinic patient that his wife is having and affair because she hasn't noticed her husband is organge. He also tells the guy the root of his problem - carrots and mega-dose vitamins. The carrots turn him yellow and the niacin turns him red, House quips "get some finger paints and do the math". The guy is orange :)

House's second patient in the clinic is a young boy who has asthma whose mother worries about him taking steroids for it. House is sarcastic and tells the mother to trust doctors and walks out, deep in thought. Cut to House telling his team to give Rebecca steroids - high doses of prednisone. House is diagnosing inflamed blood vessels in the brain, Cameron says he needs a biopsy before he diagnoses, but House points out that starting treatment is essentially the same because if she gets better they know their diagnosis was correct. Cameron asks what happens if they are wrong and House says "We learn something new".

Foreman is sent to the nursery school to quiz the children and look for clues as to Rebecca's illness. He finds out there are animals in the kindergarten, including a parrot. Cut to a conversation with House dismissing the parrot as a possible cause of disease - Foreman postulating that it could be Psitticosis. House points out no kids in the class are sick so it isn't the parrot. House tells Foreman to break into her appartment and look for clues. We learn that Foreman has commited petty crime before.

Cuddy and House fight about House giving Rebecca steroids - House pointing out that despite him having no proof, 5 other doctors gave 5 different diagnosis based on the same evidence. House is again arrogant saying he finds it difficult to think of himself as wrong and asks Cuddy why she is affraid of making mistakes.

Wilson examines Rebecca and in the course of it she goes blind and has a seizure. When she comes round, Foreman examines her and finds she has intermittent altered mental status. Foreman still thinks it's a tumor. House says it isn't a tumor and that the steroids did something but he doesn't know what yet.

House is in the clinic with a patient who is tired all the time and thinks he has fibromyalgia - House gets him some candy, and puts it in a prescription bottle, giving the guy a placebo. Foreman and Cameron break into Rebecca's house, Foreman finds some ham.....and they return....they debrief House and it comes out that Wilson isn't the woman's cousing - he doesn't even know her name.

House tells Foreman he is an idiot for thinking they found nothing when in fact there was ham in Rebecca's house. Pork harbours tapeworm! The tapeworm explain the effects of steroids - the patient gets a little better then worse. In rare cases, tapeworm get into the brain. Tapeworms fool the body into thinking they aren't there, as long as they are healthy tapeworms, but once the tapeworm is no longer healthy, the immune system attacks it, which is bad if the problem is in the brain because the body starts to swell. Swelling in the brain explains the woman's symptoms perfectly and House proves his theory by treating Rebecca.

He talks to Rebecca who demands proof and also asks House what happened to his leg - we find out he had an infarction and was mis-diagnosed. Rebecca claims she wants to die with dignity and House says there's no such thing. She refuses treatment anyway. In conversation with Chase, they come up with the idea of X-raying Rebecca's leg to proove she has tapeworms. They do this and find the worms. Rebecca is convinced and she takes the medication Albendazole.

Cut to Cameron asking House why she was hired House says he hired her because she was pretty but not because she was the best in her class. Cameron is upset and House asks why - a gift of genetic beauty is like a gift of genetic intelligence. Cameron says she worked very hard to get where she is and House points out that she didn't have to - with her good looks she could have married rich or been a model - people would have given her money wherever she went just because she looked good, but she worked hard and that's why she was hired. House says "Gorgeous women do not go to medical school. Unless they’re as damaged as they are beautiful."

Cuddy is in conversation with the orange patient and she admits that House is the best doctor she has.

Rebecca is in the hospital and her whole class visits her and gives her a card saying "Miss Rebecca, we're glad you're not dead".

House is watching General Hospital on TV, smirking at a line on it that Cuddy used earlier on the show "when we make mistakes people die". House gets called away to refill a prescription - it's the tired guy that House gave candy to.
The episode ends with the Stones playing "you can't always get what you want".

Episode summary:
Writer: David Shore
Director: Bryan Singer
Patient: Rebecca, elementary school teacher who colapses and starts babbling.
Mis-diagnoses: Brain tumor then inflammation of blood vessels in the brain
Final diagnosis: Tapeworm in the brain / Neurocysticercosis.