Moving the Chains

Moving the Chains is a 6th season episode of House which first aired on February 1, 2010. House and the team rush to treat an ailing college football star in time for the patient to compete in NFL tryouts. But when the patient experiences an onslaught of varied and unusual symptoms, the team has trouble reaching a consensus on how to effectively treat him in time. Meanwhile, Foreman's brother Marcus (guest star Orlando Jones), finally out of prison, makes a surprise visit to the hospital, and House makes an employment decision sure to infuriate Foreman. In the clinic, House is mistaken for a disabled veteran by a soldier trying to avoid bring redeployed to the Middle East.
==Recap==
During a football practice, a large offensive lineman starts beating up one of the defensive players, then starts hitting himself in the head with his own helmet.
Meanwhile, Wilson wakes up and hears House singing. He confronts House because he's in Wilson's tub instead of House's shower. House complains his leg hurts and soaking helps it, but Wilson tells him the guy who holds the mortgage gets to choose the bedrooms, and to stay out of his.
The team is watching footage of the patient, who is 6'7", 22 years old, and 310 pounds, beating up a smaller player. He clearly has neurological issues, but the scans are clean, as was the psychiatric evaluation. House thinks it is roid rage, but the patient tested clean. House still thinks it is steroids, but Foreman wants to rule out brain injury that damaged the pituitary. House agrees to look for it, but he still thinks he's right.
House tells Foreman he knows his brother Marcus Foreman is being released from prison, and that Foreman is avoiding him. House tries to give Foreman the day off, but he declines.
The patient is in regular pain, but figures it's just from football. When Taub tells him it might be his pituitary, the patient's mother tells them they have to know how long it will take to treat it, because a major opportunity before the football scouts is approaching that Saturday and if he misses it, he won't be drafted into the NFL. Taub assures them if the pituitary is the problem, he will recover by then.
The results come back and the pituitary is fine, but his GNRH is elevated. House tells them to treat him for steroid abuse.
The patient denies taking steroids, but Taub tells him his level is too high in any case. His mother admonishes him - the drugs are bad for him and he's being tested. The patient maintains his denial. However, when they start the treatment, his heart rate skyrockets. Taub calls for a crash cart and tells them this rules out steroids.
Foreman rushes into the office and finds House with Marcus having an interview. House offers Marcus a job as his assistant. Foreman tells House it isn't steroids, then asks to talk to Marcus alone.
Marcus tries to be friendly. Foreman tells him he can't work at Princeton-Plainsboro Teaching Hospital. Marcus tells Foreman he understands why he doesn't want him around, but he wants to reconnect. Foreman tells Marcus that House did this to screw with him. Marcus tells him that he's not in a position to turn down a job. Foreman tells him to work it out because he can't work there.
Wilson goes into his bathroom and finds a surprise - an angry opossum.
The patient's heart checks out fine. Marcus brings in some coffee for House. Foreman thinks the patient has a PFO. House makes fun of an incident he learned from Marcus where Foreman wet the bed. Marcus then mentions a basketball player that died of heart attack on the court. Taub remembers the case - the player had a hypertrophic cardiomyopathy. House realizes the symptoms fit. Wilson bursts in and tells House he's paying for the animal damage, and he can expect payback, but House just seems confused. House orders a stress test. Thirteen points out this will cause a heart attack, but House points out at least they can treat him for it. Otherwise, they will just have to tell him to retire and hope he does.
Foreman goes to Cuddy about Marcus, and Cuddy wants to know why he's annoyed. Foreman tells her that his brother keeps getting into trouble when he's released from prison. However, Cuddy's not convinced there is a problem.
Wilson tells House that it will be at least $1,500 to repair the damage and wants to know why he's jerking Foreman around. House says it's fun to screw around with Foreman and tells him the opossum probably got in an open window. Wilson also thinks that House, who had no relationship with his family, doesn't want Foreman to make the same mistake.
The stress test only showed that the patient was in fantastic shape - his heart rate never rose above 150 no matter how hard they pushed him. House goes to see the patient, who has gotten dressed and wants to leave. He says he feels fine. House wants to give him an injection of a vasodilator to speed up his heart rate, but when he goes to do it, he notices the patient's hands are turning white.
Taub thinks that the pale pallor is a sign of rheumatoid arthritis. However, the test for it was negative. Thirteen thinks that it might be arterial plaque throwing clots, but House points out that it's unlikely he could have breezed through the stress test with clotting issues. Foreman wants to know why Marcus is getting his own desk. Chase thinks it might be Takayasu's arteritis, but Foreman thinks it might be lymphoma. Foreman recommends removing his spleen, but Chase wants to know why the rush. Foreman reminds him that if they wait to confirm, the patient will miss the combine. House orders an ethanol drip - the patient's reaction to it will help confirm whether it is Takayasu's or lymphoma.
Marcus has been assigned to shadow Foreman and wants to know why Foreman won't give him a chance. Foreman reminds him that his parents gave him 3 chances, and Foreman's not about to give him his 4th or 5th. Wilson thinks House is just trying to prove him wrong about trying to get Marcus and Foreman back together.
The patient wants to know when the test will be over, but Foreman tells him that he can't tell him about the test because he might respond to suggestion. The patient wants to know if it was Foreman's brother earlier, and Foreman asks how he knew. The patient says he has brothers himself and they always act like they want to kill each other. The patient starts itching and Foreman tells him he probably has lymphoma. They can remove his spleen immediately and he should be ready to leave in a few days. He can have radiation therapy afterwards.
House goes to have a bath in Wilson's tub, but when he goes to get out, he tries grabbing the assist bar he put in a few days before. It pulls out of the wall and House falls back into the tub and, without the bar, he has great difficulty getting out. He suffers a small face laceration. Once he dries off, he lies on the couch, wielding the bar like a club in deep thought. When he returns, Wilson is surprised to find House lying in wait on the couch. Wilson denies involvement. House says that this means war.
Chase gets the laparoscope and starts surgery. However, they find the patient's liver is inflamed. The itching wasn't caused by the spleen and problem wasn't lymphoma.
They do a liver biopsy, but it only shows general inflammation. His B cell and T cell counts are normal ruling out lymphoma. House tries to make fun of Foreman again, but Foreman just matter-of-factly denies what House is saying. Marcus admits he made one up, thinking Foreman had a sense of humor and would play along. Foreman thinks the patient has Polymyositis. However, House pointed out this causes muscle weakness. After shooting down Chase's idea because the inflammation isn't in the spleen, Taub suggests that he may have been infected by his lidocaine injections - viral hepatitis. House agrees to blood tests.
House goes to lunch with Marcus and asks why he made stuff up. Marcus tells him he's likely to be disappointed because Eric is a decent guy. House knows about Foreman's brush with the law, but Marcus admits he was with Foreman at the time and it may have been his idea to steal the car and not Eric's. Eric was only 14 at the time and Marcus was 16. Foreman comes in and tells House that when they drew blood for tests, it clotted in the container. He thinks it's cryoglobulinemia from working out in the cold. House orders warfarin. Marcus continues the story - they were caught 10 minutes later, taken to the police station and released into the custody of their mother. She said nothing until they arrived home where she said she would pray for them. After that, Eric never wanted to disappoint his mother again. Then Marcus mentions that he thought Eric would have told that story at his mother's eulogy. House didn't know Eric's mother was dead, and Marcus said that if Eric didn't tell him, he probably had a reason. Marcus then warns him he can be as hard as he wants on Foreman, but never to bring up their mother.
Foreman explains the diagnosis to the patient, and breaks the news he will need several weeks of treatment before he can be released. His mother asks if it can wait until after the combine, but Foreman tells him if he plays, he will probably die on the field. Foreman starts treatment.
House comes into see Wilson. He's realized Wilson didn't rig the assistance bar because he doesn't own a flathead screwdriver. House borrowed one from Nora and returned it. House figures someone is screwing with both of them. He also realizes the possum wasn't meant for Wilson, but for him. They go on a stakeout, and Wilson thinks this is House's revenge, but House says he's staying up too. Wilson still believes House planted the possum. Wilson tires of the game and heads off to bed, but when he does the fire alarm goes off and so do the sprinklers. Wilson rushes to save the flat screen TV, and suddenly realizes that House would never sacrifice the television. House can do nothing except admire their "nemesis".
House gets the "suspects" together in his office and begins to speak with a French accent. Cuddy leaves, unimpressed. He tells the rest of them to account for their whereabouts. Chase wants to know what his motive would be, and House says it was because he broke up his marriage. Chase says he and Thirteen were at the hospital all night monitoring the patient. Taub says he was with his wife. Foreman says he doesn't know where House lives. House goes to tell Foreman he's a liar, but Marcus tells him not to. House tells the team Foreman's mom died. Foreman confirms it. Marcus goes to confront House, but Foreman warns him not to. Marcus quits instead. Thirteen tells them to stop Marcus because he needs the job. Foreman instead goes to attend to the patient.
Foreman finds the patient getting ready to leave. Foreman says that the return of color to his hands means he's getting better, but he's not ready to leave yet. The patient says the team doctor cleared him to play. Even the patient's mother wants him to stay. The patient says he will be back on Sunday after the game. Foreman gets out of his way, but the mother asks him to follow him.
Foreman finds the patient suited up to play and to ask why he's risking his life against his mother's wishes. The patient explains his mother sacrificed everything for him, and he wants to take the risk for his family. However, as he walks toward the field, he has difficulty breathing and drops to one knee. He complains of blurry vision and realizes he can't see. He asks to be taken back to the hospital.
When Foreman reports the blindness, Taub thinks they were wrong about cryoglobulinemia, but Foreman reveals he spiked the patient's water bottle with nitrates to drop his blood pressure. His vision started to improve before he got back to the hospital. However, House realized that between his first and second admission, he only lost one pound of weight. A patient that size should have lost at least ten. Steroids would account for that, but they've already been ruled out. Paraneoplastic syndrome could account for a hormone imbalance. Lung, pancreatic, breast, and renal cancer could all affect human growth hormone. House orders tests.
Foreman goes to see Marcus. He offers to talk to House to see if he will offer him the job again. Marcus says House won't keep him if he knows Eric is okay with it. Marcus says he won't let him down, but Foreman says not to make promises. He wants to know if the probation officer will be okay with Marcus living with him instead of at the halfway house.
House and Wilson are in the cafeteria when House suddenly trips and loses his tray. Lucas Douglas appears and apologizes for sticking out his leg so far. He admits to the reign of terror, but needs new ideas. House grabs his cane, presumably intending to hit back but Lucas reminds him that he knows where he lives because he and Cuddy tried to buy the same condo. When House threatens revenge, Lucas says he's stopping and threatens to squeal to Cuddy that she lost the condo to them.
All the tests for cancer were negative, but House wasn't wrong about the weight loss: the patient now has blood in his urine indicating kidney failure. Thirteen says there has to be cancer somewhere, but Foreman points out they've checked everywhere inside him. House wonders if the cancer might not be inside him.
House goes to see the patient, who is watching the game he missed. House starts talking about melanin, the pigment that controls skin color. He starts examining the patient for melanoma, which wasn't seriously considered because it's rare in African-Americans. On Africans, it usually shows up on the lighter skin of the palms and soles, but since he has many football related bruises, it may have been missed. He finds a darkened patch on his right foot near the big toe. He just needs to have it removed. The patient is upset because he won't get a chance at pro football, but House tells him that if he studied, he will just have a normal life without the need to pay back student loans.
Lucas goes to see Cuddy, who asks if he knows anything about the pranks being pulled on House and Wilson. Lucas denies it, but Cuddy doesn't believe him. She already knows House and Wilson got the condo, but she's not terribly upset about it.
Wilson reports Foreman and Marcus are trying to work things out. He figures House set himself up as someone both of them could hate. House says he got Marcus to quit because he wasn't useful any more. However, House has no plans to get back at Lucas.
==Major Events==
*House and the team meet Foreman's estranged brother, Marcus, for the first time.
*It's revealed that Eric and Marcus Foreman's mother passed away.
==Clinic Patient==
The patient is complaining about problems with his eyes, but House can't find anything. The patient says he's wrong, but House figures by his close cut haircut that he's in the military and is being sent to the Middle East for duty. The patient says he's been deployed three times already and his wife is pregnant. He was supposed to be discharged, but he's being sent back. House goes to leave but the patient says he waited specifically for House because he thought he was a disabled war veteran from Vietnam. House is insulted (he's at least a decade too young), and tells the patient that back in the day a guy trying to avoid service would at least go to Canada or shoot himself in the foot.
However, the patient "accidentally" shoots himself in the foot, goes to the emergency room and asks for House. House asks him why he didn't choose Canada. He also tells him the damage will be easy to fix and he will be shipped out anyway. The patient refuses treatment and says he's afraid his child will grow up without a father if he's deployed. House only returns with indifference and leaves.
The patient develops an infection in his small toe, which means it has to be amputated. The patient is relieved, but House tells him the missing toe won't keep him out of action. If they let the infection spread, he will lose his foot, if not more. House advises to switch to a new antibiotic.
House sees the patient leaving the hospital - his entire right foot has been amputated. House is in shock as the patient smiles at him before being wheeled out.
==Zebra Factor 8/10==
While melanoma is a fairly common cancer, it is rarer for darker-skinned people due to increased melanin in their skin, which protects them from the sun's harmful rays.
==Title==
The title is a term from American football, referring to the 10-yard long link of chain between two poles used to measure when a team has gained the necessary yardage for a first down. When a first down is gained, the chains are moved forward. "Chains" is also a reference to prison and also refers to Marcus Foreman.
==Continuity==
Just before his bath, House is reading Stiletto, the same comic introduced in the episode Known Unknowns. House's copy appears to be autographed by the artist, Jeffrey Keener.
==Trivia & Cultural References==
*Division 1-AA, or now officially the NCAA Division I Football Championship is the second highest level of college football in the United States.
*The Vietnam War was an armed conflict that lasted from 1955 to 1975 involving various factions in Vietnam and their supporters in the United States and the USSR. House is right that he is far too young to have taken part - he would have been 16 when it ended.
*More about Prison rape.
*The opossum is the most common marsupial native to North America. It is about the size of a house cat. Its range has been moving steadily northward for several decades and it is now common in urban areas. They are not dangerous and the behavior it exhibited in this episode is merely a show that it wishes to be left alone.
*Hank Gathers was a college basketball player who died of a congenital heart conditions during a basketball game when he was 23. One of the factors that contributed to his death was his refusal to take beta blockers when he developed tachycardia.
*The Sudetenland was a German-speaking region of Czechoslovakia prior to World War II. The region was handed over to Nazi Germany in 1938.
*Amusingly, House chooses a rather British weapon to defend himself during the stakeout: a cricket bat. While the character of Gregory House is American, the actor Hugh Laurie is British.
*When House gets the suspects together, he puts on an accent to approximate Hercule Poirot, a fictional Belgian detective that appears several times in the works of author Agatha Christie.
*The references to Professor Chase and Colonel Taub are from the board game Cluedo (more commonly called "Clue" in North America) and the characters Professor Plum and Colonel Mustard.
*Bob Marley died from a melanoma tumor on his toe that metastasized into the rest of his body. The diagnosis confirmation could be a veiled reference.
* The patient is upset because treatment means that he will miss the big showcase game and go undrafted, but many NFL players go undrafted for one reason or another and still manage to go on and have solid careers. Several have even been considered all-time and are in the NFL Hall of Fame. Daryl having surgery and going undrafted is not a deathblow to his NFL dreams.
==Goofs==
*The mother of the patient is sitting on the right side of the talent scout and on the same row, but later she is sitting behind him on his left.
*During the scene when the patient is walking through the tunnel with Foreman, his shoes change from tennis shoes to cleats.
==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
*Jesse Spencer as Robert Chase
*Peter Jacobson as Chris Taub
*Olivia Wilde as Remy Hadley
*Michael Weston as Lucas Douglas
*Da'Vone McDonald as Daryl
*Denise Dowse as Glenda
*Trever O'Brien as Jim Dunnagan
*Orlando Jones as Marcus Foreman
*Shon Little as Scout
*Harry Zinn as Coach Denning
*Christopher Robbins as Quarterback
*Bobbin Bergstrom as Nurse
*Rick L. Dean as Parent
*Mark Anthony Lopez as Football Player
==Links==
*Episode page at IMDB
*Episode transcript at Clinic Duty
*Episode review at Blogcritics
*Episode page at House MD Guide
*Episode guide at Ace Showbiz
*Episode article at The TV IV
*A review of the medicine at Polite Dissent
*Episode page at TV.com
Category:Episodes
Category:Season 6