|Episode no.||Season 4
|Directed by||Katie Jacobs|
|Written by||Peter Blake
|Original air date||May 19, 2008|
"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".
In the second part of the two-part season finale, House remains affected by injuries sustained from a bus accident that has also left Amber Volakis rapidly deteriorating from a mysterious condition. Clues inside House's head hold the key to Amber's condition, and House's friendship with Wilson is tested beyond limits as murky memories from the bus accident the night before threaten to change their lives forever.
The episode begins with House and Wilson at Princeton General Hospital, where the 8 overflow victims of the bus crash that weren't taken to Princeton-Plainsboro Teaching Hospital (PPTH) ended up being taken, including Amber, who up until now was only known as Jane Doe #2 due to a lack of ID on her. The attending physician at Princeton General cannot explain Amber's sudden onset tachycardia, but explains that whatever is causing this condition isn't from the bus crash. House demands that the patient be moved via ambulance to PPTH, which the attending initially refuses, until House says Wilson "her husband" can demand she be moved, and Wilson demands she be moved.
While being moved via the ambulance, Amber's tachycardia degenerates into v-fib. House goes to shock Amber to stabilize her heart, and Wilson demands he stop and put her into protective hypothermia. He tells House that if he restarts her heart now, it will keep racing, shoot off free radicals, and kill her brain. So in an attempt to buy more time for a proper diagnosis, Wilson figures protective hypothermia along with dialysis is her best option. House agrees, however during the further testing that follows, Amber develops multisystem organ failure, including liver and neurological damage.
In an attempt to remember exactly what he saw that caused his initial concern and help definitively diagnosis her, House decides to undergo deep brain stimulation with Wilson's urging. During the stimulation he recalls the symptom which presented in Amber before the bus crash. House also remembers the events that led up to him and Amber being on the bus to begin with: he got drunk at Sharrie's bar, and the bartender (Fred Durst) took his keys away, so House called Wilson for a ride, but he was on call so Amber came instead. House angrily storms off after Amber won't drink with him, and boards a bus. Amber followed him to give him his cane, as he forgot it as he left her to pay his tab at the bar.
House recalls that during the bus ride, Amber sneezes, reaches for a Kleenex, and complains that she has the flu. He then recalls what caused his concern, he recalls that after she wipes her nose, she reached into her purse and pulls out prescription pills to take, which turn out to be amantadine. She takes a heavy dose of 2-3 amatadine pills, right as the garbage truck plows into the bus. The crash caused such extensive anatomical and physiological trauma (especially the blood loss and shock from her leg injury) to Amber that she ended up suffering acute renal failure. This damage to her kidneys made them unable to adequately filter out the amantadine, causing her to overdose, and thus causing all her unexplained symptoms. Wilson suggests kidney dialysis as a treatment, however House tells him during the memory of the moments leading up to the bus crash that when unfiltered, amantadine binds to proteins in the kidneys, and therefore dialysis is unable to clear it from the blood, and ultimately there is no treatment for Amber. House and Wilson begin to cry, and House goes into a seizure while still connected to the Deep Brain Stimulation equipment. The seizure causes the equipment to shift, thus causing House's brain to bleed, leading to him falling into a coma.
The team confirms House's diagnosis of Amber. With all of her organs damaged, she is unable to qualify for a heart transplant, and so there is nothing they can do to treat her. Wilson weans Amber off anesthesia in order to spend her last moments alive with her. The team comes in one by one to say goodbye to Amber, and after Wilson himself says goodbye, he shuts off Amber's bypass, and she passes away. An unconscious House has a vision of Amber who persuades him not to give up on life and die, telling him that he "can't always get what he wants".
Back at the hospital, Thirteen discovers she has inherited Huntington's disease, and House awakes with Cuddy at his side. Taub crawls into bed with his wife, Kutner watches TV alone, and Chase and Cameron meet Foreman in a restaurant. Wilson visits House, but the two just silently stare at each other as House awakens. Wilson returns home and finds the note Amber left him in their bedroom saying she went to pick up House and would return home soon, causing him to breakdown in tears. House lies awake in his hospital bed staring blankly into space with Cuddy holding his hand.
The episode increased ratings from the previous week, with 16.358 million viewers tuning in.
The song "Re:Stacks" by Bon Iver is used during Amber and Wilson's final moments together.
The song that plays near the end of the episode when House and Amber are on the bus is "Light for the Deadvine" by People in Planes.
The song that plays as House exits the bus until the end of the episode is "Passing Afternoon" by Iron and Wine.
- Gorman, Bill (May 28, 2008). "Top Fox Primetime Shows, May 19-25". TVbythenumbers.com. Retrieved June 10, 2011.