Wilson (episode)

Wilson is a 6th season episode of House that first aired on November 30, 2009. When an old friend and former patient of Wilson's exhibits paralysis in his left arm, Wilson puts himself on the case. House wagers Wilson that the patient's symptoms are attributed to new cancer cells. Wilson accepts even though he is reluctant to believe the cancer has returned. With the help of the team, Wilson works to diagnose the patient more optimistic results, but when things take a turn for the worse, Wilson must address his inability to separate patient from friend and he must put his own life at risk. Meanwhile, Cuddy seeks advice in her search for real estate.
==Recap==
Wilson wakes up wondering where a noise is coming from. House is strumming on his guitar and singing "Faith" by George Michael. House has retrieved his guitar, along with many of his other belongings, from his apartment. House wonders why Wilson isn't up by his usual time and he is obviously obsessed when he learns that Wilson is going hunting with his friend Tucker the "self-important jerk" instead of going to work, to which he says: "The guy calls you Jim. He doesn't even know your name." Wilson reminds him that Jim is a common short form of James and that the trait "self-important jerk" seems to attract him in friends and heads back for extra sleep.
Wilson and Tucker go hunting to celebrate Tucker's fifth year of survival after his cancer diagnosis by shooting at an empty chemotherapy bag pinned to a tree. Tucker once again thanks Wilson for saving his life. As they turn to go to "miss more wild turkeys", a shot rings out that narrowly misses Wilson. He walks over to Tucker who has collapsed on the ground, and Tucker apologizes because he cannot move his arm which is why he blindly fired the shot and almost took Wilson's head off. Tucker thinks he might be having a stroke but Wilson has no idea what is wrong with him.
Wilson gets Tucker to the hospital where he meets Tucker's new girlfriend (who he mistakes for his daughter). Wilson quickly rules out a stroke and the blood tests don't indicate that the cancer has returned. He is about to call House, but notices the girlfriend has a cold sore which could have caused transverse myelitis in Tucker. He starts him on acyclovir.
Wilson goes to brag to House about his diagnosis, saying he had a "House moment". House and his team are doing an ultrasound on another patient with stomach pains. House orders blood tests, then tells Wilson he follows his cases and that Tucker's low white blood cell count and right arm paralysis means his leukemia has returned. However, when Wilson says he's tested for it, House tells him he's not being objective because he's an oncologist with a recovered cancer patient. He bets $100.00 that he's right and Wilson accepts.
Wilson goes to another patient and tells him he's ready to go home. However, he gets a page but before he leaves, he starts to realize the patient isn't bragging about his grandchildren. He orders treatment for clinical depression and more tests just to be sure.
Wilson goes back to Tucker, who has a tingling feeling in his foot. It means the acyclovir isn't working and that he has to switch to ribavirin. Tucker is afraid the cancer has returned, but Wilson reassures him. He asks Wilson to call his daughter - he's estranged from her because of his new girlfriend. Wilson calls her, but she doesn't want to come. Cuddy comes to ask about Tucker. Wilson says that he's fine, but Cuddy is a little worried that he hasn't called House in on the case. She warns him about treating friends. She also asks him if his ex-wife Bonnie Wilson is still selling real estate, and Wilson says he thinks she is. She tells him she's moving in with Lucas Douglas. Wilson wonders why she didn't just contact Bonnie herself and he figures she's looking for his blessing.
Wilson reassures Tucker's girlfriend that the paralysis should end soon, but Tucker is coughing now. Suddenly, Tucker's daughter and ex-wife Melissa show up. All of a sudden, Wilson realizes something is very wrong and calls for a crash cart and administers oxygen - the problem is not just in Tucker's nerves.
Wilson finally goes to House and his team for help. They finished with the other patient who had been eating nothing but microwave popcorn, and the fumes from it damaged his lungs. House is not there because he's avoiding Cuddy, but Wilson decides to ask just the team for help. They think that, if it's not cancer, it might be aspergillus that spread to his spine.
Wilson goes to Tucker to explain that he needs surgery to deliver the anti-fungal medication. He tells them there is no time to test given the progression of the disease. He agrees as long as Wilson is there.
Wilson goes to get Chase for a surgery consult, but his assistant interrupts him about his other patient Saul Koplowicz and that House is looking for him. He goes to see Mr. Koplowicz and increases his pain medication so he can sleep. He hears the room's toilet flush and finds House in the bathroom. He lies to House that Cuddy was only interested in Tucker when she spoke to him. House knows about the fungus diagnosis and tells Wilson to just pay him the $100. Cuddy comes in to talk about the new loft she's looking at.
Wilson is with Tucker in the pre-op room and asks him why he left his wife. Tucker says he's not sure why he did it. Wilson goes to the observation room and House finds him there. House asks Chase why he's not working for him, and Chase reminds House he is avoiding new cases. House overheard about Cuddy's plan to move in with Lucas and wonders why Wilson was shielding him from the news after he had already said he was fine with it. Wilson says that dating is one thing, moving in together is quite another. House is trying to analyze Cuddy's choice of a loft and Wilson tells him not to overanalyze it. Chase reports that Tucker has global lung damage from pneumocystis pneumonia which rules out a fungal infection. House figures something must have fried Tucker's immune system, and that cancer is the most likely culprit.
Wilson is at his department conference telling them about the new growth he found on Mr. Tucker who was depressed even though he was in remission. House barges in and tells Wilson that Tucker has cancer too. He comes in with the test results to prove it and reminds him about the $100.
Wilson goes to tell Tucker he has acute lymphoblastic leukemia. It isn't related to his original leukemia but was probably caused by his previous chemotherapy treatment. However, because of the blood-brain barrier, it appears to be confined to his brain and it hasn't spread anywhere else. It seems treatable - a 90% chance of survival with chemotherapy alone. They have to insert a shunt to inject the drug directly into his brain. Wilson also asks Tucker to appoint a medical proxy, and Tucker appoints his ex-wife. However, House has bumped Tucker from the operating room. Wilson sees it as a deliberate delaying tactic.
The girlfriend confronts Tucker about his decision, but Tucker says it's just because the ex-wife had more experience with these decisions. The procedure is successful, but the paralysis isn't retreating. Wilson realizes the chemotherapy isn't working because Tucker's body is resistant to it from his previous treatment.
House tells Wilson that the patient he bumped Wilson for had a screw in his lung. They removed it, but he didn't improve. Wilson says House isn't listening, but House says he is listening and thinks Wilson's idea of doubling the chemotherapy dose is idiotic. He reminds Wilson that although it's just the sort of thing he tries himself, he's not emotionally invested in the patient - the chemotherapy could kill Tucker and he doesn't think Wilson could handle it.
Wilson goes to Tucker with his idea. He discusses it with his ex-wife and daughter because the girlfriend has taken off. They agree to try the treatment and his paralysis improves. However, Wilson sees that Tucker is jaundiced and says he has to run more tests.
The tests show that the cancer has disappeared, but half of Tucker's hepatocytes are dead even though he was only on the double dose for less than 24 hours. Tucker needs a new liver.
Wilson breaks the news to Tucker. He has 24 hours to live if he doesn't get a new liver. Neither his wife, daughter or girlfriend is a transplant match. House bursts in and tells him that there is a possible donor, but he didn't have a donor card and the next of kin won't consent. Wilson has to go and meet the next of kin to try to get consent. They go to the house but the next of kin isn't there. Wilson and House talk about Cuddy and House admits he's upset that Cuddy is moving in with Lucas. The next of kin soon appears and they go to talk to her, but she doesn't want them to do it for religious reasons. However, House talks to her and she agrees that donating a part of the liver would be acceptable. However, by that time, the donor liver is no longer viable.
Wilson breaks the news to Tucker. He's angry that Wilson talked him into the extra chemotherapy - he would have had 6 months instead of 24 hours. Tucker reminds Wilson that he would be a compatible donor. When Wilson says he can't because he's his doctor, Tucker fires him so he will only be his friend. However, Wilson says he can't do it.
Wilson goes home to House and doesn't want to talk. Wilson has been drinking - alone. Wilson tells House that Tucker wants a part of his liver. House realizes Wilson is feeling guilty even though he cured the cancer. He reminds Wilson he isn't responsible, but Wilson is angry at House for pushing him around and tells House to get his stuff and get out of his apartment.
Wilson arrives back at the hospital and his assistant tells him that Mr. Clinton has good results - the small spot on the lungs has disappeared. Mr. Clinton is amazed that Wilson figured it out just because he wasn't talking about his grandchildren.
Wilson goes to see Cuddy, who is having trouble getting a deal on the loft she wants. Wilson wants to donate a lobe of his liver to Tucker and she tells him he's insane. She reminds him he's a doctor with hundreds of patients, not a donor. He asks why he's the head of oncology and she says its because he's thoughtful and caring. She thinks he's only doing this because he feels guilty, but he says he's doing it out of friendship and he can save his life. Cuddy gives in.
Wilson breaks the news to House, expecting to be insulted. Instead, House asks why he's doing it. Wilson says it's because Tucker is his friend. House reminds Wilson he is his friend too and he asks what would be his reaction if House needed a liver transplant because of his Vicodin abuse. Wilson says he has come to ask House to be there for the operation, but House refuses - he says it's because if Wilson dies, he's alone.
They get ready for surgery and Tucker thanks Wilson. House comes to the operation anyway, and Wilson sees him just before he is put under anesthesia. Wilson wakes up in the recovery room and finds House by his side. House follows Wilson to his hospital room where they start talking and laughing. Tucker recovers too and Wilson goes to see him. Tucker has decided to stay with his girlfriend instead of returning to his ex-wife and is moving to be closer to her. The girlfriend comes in and says "Hi Jim", but Wilson says he prefers to be called "James".
Wilson goes back to his room and House asks Wilson if he's ready to admit that Tucker is a self-important jerk. Wilson says he still feels good about going ahead with the transplant. He says he's disappointed but not angry. House says disappointment is anger for wimps. Wilson grabs his cell phone and calls Bonnie.
Wilson has recovered and he and House go to look at the loft Cuddy wants. Bonnie has told Wilson what Cuddy has bid for it, and Wilson plans to outbid her. When House expresses shock, Wilson reminds him he needs a bigger refrigerator, and a chance to screw with Cuddy. He calls Bonnie to tell her he's taking the loft.
==Zebra Factor 1/10==
An easy and common diagnosis this time, as House kept telling Wilson. The symptoms kept pointing to some form of cancer and Tucker's form of leukemia was often caused by the very drugs that cured his first cancer.
It should be noted that Acute Lymphoblastic Leukemia (ALL) is rarely, if ever, secluded to the brain or CNS. There are many cases in which there is CNS involvement with ALL, such that intrathecal chemotherapy (administered directly to the CNS) is used to attack the cancerous cells that are "hiding" in the brain and are refractory to the regular chemotherapy because of the blood brain barrier (BBB). Nonetheless, the central cancer must be treated as well, and would almost always require systemic chemotherapy as well to deal with the immature lymphocytes rapidly accumulating within the bone marrow.
==Title==
The title of the episode comes from the episode's focus on the character of James Wilson.
==Major Events==
*Cuddy decides to move in with Lucas Douglas.
*Wilson donates half of his liver to save a friend's life.
*Wilson outbids Cuddy to get the loft that she wanted to punish her for hurting House. He plans to hide the deception from her.
==Trivia & Cultural References==
*More about the wild turkey.
*More about religion and organ donation. Contrary to House's dismissive attitude, most religions either encourage organ donation or leave it up to the individual donor.
*"The Pigeon Sisters" are characters in the play, movie and television series The Odd Couple. They were a pair of twin sisters who often dated the main characters Felix and Oscar.
*The response "That's Room 12A" to "I'm not here for an argument" is from Monty Python's Argument Sketch.
*The show that House is watching in Wilson's apartment before Wilson tells him about Tucker's proposal for a liver donation is "Stiletto: Warrior Queen of Space," the same sci-fi show the patient in the episode "Known Unknowns," was obsessed with.
*This is the only episode of the entire series which focuses solely on Wilson's life.
==Goofs and Continuity Errors==
*When Wilson is being prepped for surgery, the nurse starts an IV in his left arm. When he is shown is recovery, his left arm has only a blood pressure cuff on it, and an IV bag is hanging to his right. It's possible but unlikely that OR staff would have changed the location of his IV during the operation.
*House mentions paralysis in the right arm when it was Tucker's left. Also, it wasn't paralysis portrayed, but spasm.
*Similarly, when Wilson calls Bonnie from his hospital room, you can see that he has a hep lock or saline lock installed on his right hand, but when he visited Tucker earlier in the day, his hands were bare. Once again, it is possible but unlikely that nurses would have newly-installed a hep lock at that point in his recovery but not had it in place previously.
*When Wilson hangs the bag for Tucker to shoot, it says chemotherapy drug. After Tucker shoots it however, it can be very quickly seen that it is actually just a 0.9% saline bag.
*Wilson says that Blood Brain Barrier "separates the blood in the head from the blood in the body". The BBB in fact separates the blood flowing to the head from the brain. Only very selective substances pass across BBB into brain. Even a little amount of blood leaking into the brain matter can cause stroke.
*A living liver donor should abstain from consuming alcohol at least six weeks before the surgery. Making Wilson's impromptu donation improbable.
==Cast==
*Hugh Laurie as Gregory House
*Lisa Edelstein as Lisa Cuddy
*Omar Epps as Eric Foreman
*Robert Sean Leonard as James Wilson
*Jennifer Morrison as Allison Cameron (credit only)
*Jesse Spencer as Robert Chase
*Peter Jacobson as Chris Taub
*Olivia Wilde as Remy Hadley
*Joshua Malina as Tucker
*Katherine LaNasa as Melissa
*Marnette Patterson as Ashley
*Christina Vidal as Sandy
*Willie C. Carpenter as Del Wilson
*Jessica Whitaker as Emily
*Marisa Tayui as Aikoa Tanaka
*Robert Katims as Saul Koplowicz
*Anna Khaja as Dr. D'Razio
*Gil Espinoza as Juan
*Bobbin Bergstrom as Nurse
==Links==
*Review at National Post (Toronto)
*Review at Paste Magazine
*Episode summary on TV.com
*Review of the medicine at Polite Dissent
*Episode page at IMDB
*Episode review at Buzzsugar
Category:Episodes
Category:Season 6