House's Head
"House's Head" is the fifteenth episode of the fourth season of House and the eighty-fifth episode overall. It aired on May 12, 2008. This episode is the first part of the two-part fourth season finale, the second part being "Wilson's Heart".In this episode House is involved in a bus crash, but cannot remember why he was riding the bus or what he saw before the crash that makes him convinced he has a patient to save. Suffering from a concussion and post-traumatic retrograde amnesia[1], he tries throughout the episode to retrace his steps.
At first, House and his team focus on the bus driver; House thinks he may have had a seizure which precipitated the crash. Kutner suggests medical hypnosis, which Chase performs, to stimulate House's memory. Under hypnosis, House sees Amber but thinks she's there as a result of Wilson's presence in the room where the hypnosis is performed. Chase tells him to ignore Amber and Wilson. Then House recalls he had been drinking at a bar, and the bartender had taken his keys – explaining why he was riding the bus rather than his motorcycle. House then tries to recall details about the bus driver and other passengers.
The bus driver's condition is indeed enigmatic, and the team suggests and rules out several pathologies, such as Guillain-Barré syndrome, transverse myelitis, and Wilson's disease. House suspects Parkinson's disease, recollecting the way the driver shuffled his feet as he helped a woman onto the bus. Taub contends thyrotoxic periodic paralysis (TPP) fits all the symptoms, and House orders the "bagel test", which forces the patient to run on a treadmill while eating bagels. The driver collapses and is intubated, after which it is suspected he has a clot from a pulmonary embolism. But after noticing the driver's recent dental work, House abruptly realizes an air bubble accidentally injected into the patient's bloodstream through the gums would explain all the symptoms, and with Thirteen's help extracts the bubble, saving the patient.
Yet House's fragmented memory continues to trouble him, and he decides the bus driver was not the patient he had to save. He is haunted by images of a beautiful woman he does not know, but who tells him she is "the answer". To stimulate his memory, he has his team reenact the scene on the bus. For good measure, he overdoses on physostigmine, a medication intended for Alzheimer's patients. The technique works, and House's mind flashbacks to the scene before the accident, where again he sees the unknown woman. He tries to elicit her identity, but because she is only a product of his imagination, she cannot say. She can provide hints, and suggests looking at her necklace. He studies the pendant attached to the necklace and realizes its composition – amber. House realizes now that it's Amber who was symptomatic before the crash and he was ignoring her because of what Chase said in hypnosis; however, he is now in cardiac arrest because of the overdose.
His team manages to resuscitate him whereupon he immediately tells Wilson that Amber's life is in danger. Wilson argues Amber couldn't have been on the bus and was on call, but realizes he has not spoken to her since before the accident. Checking the patient roster, they realize that the description of one of the patients admitted to a different hospital matches Amber.
Disclamer
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