Airborne (House)

Airborne is the eighteenth episode of the third season of House and the sixty-fourth episode overall.

Synopsis

Template:Spoiler House is returning from a pandemics symposium in Singapore with Dr. Lisa Cuddy. During the flight, the man sitting next to House (Peng) begins vomiting. He also presents with fever, headache, abdominal pain and petechial rashes on his lower back. Cuddy notes that these are classic symptoms of Meningococcus and that an outbreak of the disease might be imminent. Because of their flight path, they must turn back immediately or they will be unable to get medical attention. House is not convinced there is a problem, and convinces the flight crew not to turn the plane around.

Soon another passenger becomes ill with the same symptoms. House assembles a makeshift diagnostic team with three passengers: a blond boy whom he instructs to agree with everything House says as Chase, a man who does not understand English but is "close enough" as Foreman, and a brunette woman who House instructs to get morally outraged at everything he says as Cameron. After a discussion with his "team", House is convinced that both passengers are sick with Ciguatera poisoning because they both ate seafood. He announces that the rest of the passengers who ate seafood should go to the restroom and vomit.

This theory is contradicted by Cuddy, who is showing similar symptoms despite having not eaten the sea bass. House tells the stewardess to tell the plane not to worry, but three more people apparently succumb to the same illness. Without any medicine, House goes collect what antibiotics he can from the passengers. Cuddy then persuades House to do a lumbar puncture to find out whether the illness is meningitis. House does the test, which comes back negative, and he realizes that the whole plane is suffering from hysteria. He tests this theory by telling the passengers one symptom is uncontrollable trembling of the left hand, which they all immediately start to exhibit.

Peng, however, is still dying, and House does not know why. He believes it is because the man has cocaine in his system, and prepares to operate. As his "team" holds Peng down, House realizes that the man is having joint pains. Searching through his wallet, he finds a scuba lisense and a receipt for scuba gear rental, dated the previous day. Peng is diagnosed with decompression sickness, caused by surfacing too quickly when diving, which was further worsened by boarding an airplane, which is pressurized to 8000 feet above sea level. Cuddy tells the flight crew to drop the plane below 5000 feet and get Peng oxygen, and he will be fine.

At the hospital, a 58 year old woman has been admitted with unexplained seizures and vision loss. With her is an outcall prostitute who had just met Fran, but she stays at the behest of Dr. Wilson, who is leading House's team. Chase and Cameron visit Fran's house to search for clues, but are distracted by the allure of an empty bed. They return without a diagnosis, leaving Forman with the belief that he has no option but to perform a potentially dangerous brain surgery. Chase, however, realizes something and goes back to the house to find evidence: Fran's house was once on the same electrical system as her neighbors, and when the neighbors had their home fumigated, some of the poison entered Fran's house. Fran is diagnosed with methyl bromide toxicity before the operation can be completed, although Foreman did make a cut into her skull and was ready to begin operating before Chase stopped him.

At the end of the episode, Chase suggests that he and Cameron take their relationship to the next level. Cameron responds that all she was looking for was sex, and says "It was fun. And now it's over."

Diagnosis

Fran - Methyl Bromide toxicity caused by the fumigation of the house next door.
Peng - Decompression sickness (The Bends) caused by scuba diving, worsened by subsequently flying
Other passengers on the plane (including Lisa Cuddy) - Mass hysteria/Conversion disorder
Unnamed female passenger- Pregnancy (Not definitive)

Medical Terms

Clinic Patients

None

Arc advancement

Characters

Cameron and Chase - Cameron and Chase's relationship comes to a close at the end of this episode, when Chase suggests that they should progress with their relationship which Cameron declines.
Chase - Chase solves the hospital case when he realizes that Fran's cat was showing similar syptoms (lack of hunger), making it the second case he's solved directly (the other being in Finding Judas).

Behind the Scenes

The layout of the plane depicted in the episode resembled a Boeing 767 interior, which is unable to fly non-stop from Singapore to the United States. At the time the episode is aired, Airbus A340-500 and Boeing 777-200LR are the only type capable of flying Singapore - U.S. non-stop and Singapore Airlines is the only airline flying from Singapore to U.S. non-stop with daily non-stop flights from Singapore to both Los Angeles and New York using Airbus A340-500 aircraft.
Though they were on a fictional Malaysian Pacific Air flight, the flight attendant spoke in Tagalog when she addressed Peng.

Quotes

House: [to crying baby's mother] "Give her 20 milligrams of antihistamine, it may save her life; 'cause if she doesn't shut up, I'll kill her."

House on airplane intercom: "Ladies and gentlemen, we have a passenger with a confirmed case of bacterial meningitis..." People start to worry "...If we land as soon as possible the passenger will not survive. It's very likely that you have been infected as well." People start to look sick "As soon as you start feeling symptoms we need to isolate you into First Class cabin..." People start to cough "...fever, rash..." People start to scratch and look for a rash "...nausea. And in the late stages...tremor in the left hand." People start to shake their left hands franticly including the female patient already with full blown symptoms and panic begins to erupt
Flight Attendant: "What do we do?"
House: "Break out the bubbly. To passengers: YO, LISTEN UP! Bad news is you have an illness. The good news is it's not meningitis. It's not fatal, it's just embarrassing. It's conversion disorder, more commonly known as mass hysteria. It happens often in high anxiety situations, especially to women. I know it sounds sexist, but science says you're weak and soft, what can I do?"
Cuddy: "House, you're wrong."
Patient: "Look at my hand!" Shaking her left hand frantically.
House: "Yeah, look at her hand. Shaking left hand. What is that a symptom of? Not meningitis. It's basically a symptom of nothing. Put the idea into their heads and watched what happened. Same thing that Peng did with puking and the rash." Peng still shaking.
Patient: "The rash is in my head?"
House: "Your mind controls your body. It thinks you're sick, it makes you sick.... (on intercom) If you all just calm down, your symptoms will soon go away. And to facilitate this process your flight crew will move through the cabin with complimentary bar service. Thank you, and as always have a pleasant flight."

House: "You're mean."
Cuddy: "It's how I compensate for being weak, and soft."

Flight Attendant: "I'm in New York every Monday."
House: "Are you handicap accessible?"

House: "Look that way (points to the left)
Patient: (looks to the left) Why?
House: Because you're gonna throw up, and I don't want it on me.
Patient throws up.

References

External links