Wilson's Heart
"Wilson's Heart" is the sixteenth episode and season finale of the fourth season of House and the eighty-sixth episode overall. It aired on May 19, 2008. It is the second and final part of the two-part fourth season finale, the first part being "House's Head".A distraught Wilson and House find a comatose Amber at Princeton General Hospital and transfer her to Princeton-Plainsboro Teaching Hospital. In the ambulance, Amber goes into ventricular fibrillation. Instead of shocking her heart, Wilson suggests she be placed under protective hypothermia and put on bypass, giving House the time he needs to diagnose her.
During the differential diagnosis, House sends Taub to get a toxicity screen on Amber, and Kutner and Thirteen to check her home for environmental clues. They discover Amber is hiding amphetamines inside a multivitamin container, and the team tests Amber's heart to determine if a valve is calcified as a result. Before the heart can be tested, Chase and Taub notice jaundice in Amber's eyes, indicating that her liver is failing, which rules out the pills.
Later, House retraces his steps to a Sharrie's Bar; House and Wilson visit the bar and ask the bartender (guest star Fred Durst), who served House on the night of the accident, if he remembers any symptoms. After recollecting that Amber sneezed, House decides she is suffering from Hepatitis B, and requests she be put on IV interferon. Yet in another hallucination, Amber is shown to get up off her bed in the ICU and shows House she has a rash on her back, a symptom that does not fit with the Hepatitis B diagnosis. Taub suggests it is caused by influenza, while Wilson suspects she may have caught Rocky Mountain Spotted Fever from a tick several weeks ago when they were walking with their dogs. Wilson reiterates he does not want the team starting Amber's heart until they are 100% certain of the diagnosis, with which House concurs. Thirteen confronts House about his objectivity in the case. House says that his actions are more justified than her refusing to face her condition, and afterwards she draws blood from herself to test for Huntington's chorea.
Meanwhile, Foreman reviews Amber's records, and determines she will not be able to remain on bypass for much longer. Defying Wilson, he and Cuddy begin to warm Amber's body temperature. After analyzing Amber's EEG, an outraged Wilson finds the illness is spreading to her brain. House believes it to be caused by an autoimmune disease, and orders prednisone. Wilson, however, believes her illness to be caused by an infection, and says that steroids would destroy her immune system and kill her. As a last ditch effort to unlock his memories, Wilson asks House to undergo deep brain stimulation to try to unlock some final piece of information that might reveal the truth. House acquiesces and, during the procedure, he recalls going to Sharrie's Bar to get drunk. The bartender took his keys in exchange for a phone call to get a friend to drive him home. He calls Wilson, but since Wilson was on call that night, Amber answers and comes to get him instead. In the bar with him, she sneezes. House notes her sputum -- it seems like just a cold. He leaves to get on a bus rather than taking a ride from Amber, but Amber joins him on the bus to return his cane, which he left in the bar.
While on the bus, Amber sneezes again, mentions a flu, and House's attention is drawn to a bottle of prescription pills she pulls from her purse. The pills are amantadine, an antiviral drug designed to shorten the severity and duration of an influenza infection. However, Amber was taking a high dosage, and when the bus accident damaged her kidneys, her body could no longer filter the drug. Wilson suggests that Amber be put on dialysis, but House notes that amantadine binds with proteins, and that dialysis cannot filter it from her blood. Realizing that there is nothing that he can do to save Amber, House apologizes to Wilson, feeling partially responsible. At this point of the procedure, House suffers a complex partial seizure and slips into a coma. The team discuss the possibility of finding a donor heart for Amber, but Foreman states that her organs are too badly damaged, ruling her out as a candidate for transplant. Cuddy keeps Amber on bypass and weans her off of the anesthesia, allowing Wilson and the team to say their goodbyes. In her last moments, Wilson reminisces with Amber and reluctantly shuts off bypass. She dies in his arms.
In his comatose state, House dreams he and Amber are on the empty bus. He deduces that she has passed on and admits to her that he does not wish to leave the bus; he tells her that he doesn't feel any pain and misery on the bus, and above all, he does not want Wilson to hate him. Amber tells him, "you can't always get what you want", persuading House to exit the bus. He gets up from his seat and walks toward the front, with no cane or limp in his leg. He wakes to find Cuddy beside him. As the episode draws to a close, Thirteen discovers that she tested positive for the Huntington's. Meanwhile, Wilson returns to his home and collapses on the bed, where he finds a note Amber wrote on the night of the accident, reading, "Sorry I'm not here. Went to pick up House. Love, A." In the hospital, House silently contemplates, with a sleeping Cuddy holding his hand.
Disclamer
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