| "DNR" | |
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| House episode | |
| Episode no. | Season 1 Episode 9 |
| Directed by | Frederick King Keller |
| Written by | David Foster |
| Original air date | February 1, 2005 |
| Guest stars | |
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| Season 1 episodes | |
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| List of House episodes | |
"DNR" (short for do not resuscitate) is the 9th episode in the first season of House, which premiered on the Fox network on February 1, 2005.
When legendary jazz musician John Henry Giles collapses mid-session, House and his team run into technical difficulties treating the man, who was diagnosed with ALS by his doctor in California, Marty Hamilton. Foreman, who did a residency with Hamilton, is requested to lead the case. Although Foreman and House clash at every turn, Foreman listens to House's advice and treatment options. After House's suggestion causes the patient to crash suddenly, House disobeys a DNR order and must go to court.
At the trial, House makes up a diagnosis for the judge causing a ruling in House's favor. Meanwhile, Foreman has called Marty Hamilton, Giles's old doctor, to help on the case.
A famous wheelchair-using trumpet player named John Henry Giles plays with a band. By mid-session he loses his breath and collapses from a lack of oxygen. At the hospital, House is intrigued that John Henry has been paralyzed for two years without sufficient explanation. Cuddy tells House that they are only treating John Henry for pneumonia, since his paralysis is treated by his doctor in California, Marty Hamilton. Foreman, who did a residency with Hamilton, is requested to lead the case.
Hamilton had already diagnosed the paralysis as an effect of ALS, which would explain the pneumonia. House does not agree with this suggestion and seeks other explanations for the paralysis. As Foreman does the blood work, John Henry requests a "Do Not Resuscitate" order. Foreman has John Henry administer an IVIG, which ends up limiting the blood in his lungs, causing him to crash. Chase wants to intubate, but Foreman mentions the DNR. House intubates anyway.
House reasons that it was the IVIG that caused the reaction, not the disease. Foreman angrily points out that this was House's fault for suggesting the treatment. House is hit with a restraining order to stay away from John Henry. Criminal charges for battery will be filed. House presses on, ordering Cameron and Chase to consider other possibilities. Yet Foreman has called Dr. Hamilton, who is now flying in from Los Angeles.
In court, the hospital lawyer argues that House has the right to face his accuser. Since John Henry is on life support, the trial will have to wait. Back at the hospital, Chase sees on the lung biopsy that there is only inflammation. Since House cannot order more testing, he begins blind treatment. He suggests starting John Henry on cytoxan, which treats Wegener's disease. If House is right, John Henry will start walking again. If House is wrong, Cameron and Chase could lose their medical licenses.
House is about to administer the cytoxan when Dr. Hamilton arrives. Hamilton, who only calls House by his first name, says that he had initially checked for Wegener's. House reminds Hamilton of the error rate that occurs in those blood tests and biopsies. Hamilton wants to discontinue life support. House tells Wilson that if it is indeed Wegener's, John Henry's lungs will not be able to handle the stress and he will die. When he is removed from life support, John Henry starts to breathe on his own, so Wegener's was the wrong diagnosis.
With John Henry's arm now paralyzed, everybody but House is convinced he is stricken with ALS. The battery charges have been dropped, so House can treat John Henry once again. House visits the patient, who admits that since he cannot play the trumpet any more, he does not mind dying. House asks John Henry to just let him find out what is afflicting him. If he still wants to die, House will help make it quick and painless. The patient declines. House puts John Henry into an MRI.
Hamilton offers Foreman a job in Los Angeles that pays three times what he now makes and includes many other perks. When Foreman mentions the offer to Cameron and Chase, the latter claims that he does not work at his job for the money while Cameron says she does not hate House like Foreman does. Looking over John Henry's MRI, Cameron notices signs of a stroke, which would explain the paralyzed arm. Foreman explains the options to John Henry. They can give him heparin to thin his blood and remove the clot, but it could hurt his lungs. Another option is brain surgery to remove the clot. The surgery will either result in his death, or a clearing of the blood clot. Not wanting to risk his lungs, John Henry opts for the surgery, because it offers him the chance at death without prolonged pain.
The surgery is a success. John Henry can move his arm following the embolectomy and is able to feel House touching his leg. The doctors are baffled. Hamilton thinks his ALS treatments are the answer. House thinks they need to take John Henry off the dozen drugs they are giving him in order to restart the dosage one by one to see which is having the effect. If not, the toxicity of the useless drugs could kill him.
Hamilton asks House which medications are used to treat John Henry. House resists, but then realizes that Hamilton needs to know because the patient is worsening. He cannot feel his leg anymore. House prescribes steroids and a second MRI. Meanwhile, House and Foreman discuss their working relationship. House tells Foreman to take the new job if he thinks Hamilton is a better doctor.
The MRI results show that John Henry suffers from arteriovenous malformation. It was compressing his spine, which caused the paralysis. Foreman wonders how Hamilton could have missed something so simple. House points out that they all missed it too, so something must have been hiding it. It was the inflammation that they first saw on the lung biopsy. The steroids treated the inflammation and allowed the AVM to show on the MRI. After surgery to remove the AVM, John Henry walks out of the hospital with a simple cane, not a wheelchair (with House commenting that eventually John Henry won't even need the cane). John Henry then gives House his own trumpet, on the condition that House never plays it. As the two leave the Hospital, House tells Foreman that he will see him tomorrow, calling him by his first name "Eric", in mockery of Dr Hamilton's familiar style.
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