The Social Contract (House)

"The Social Contract (House)"

"The Social Contract" is the seventeenth episode of the fifth season of House. It aired on March 9, 2009.

Plot

The episode starts with an author, Timothy Moore, making a toast to his soon to be best-seller. After the toast, Nick Greenwald, the editor, insults the book by saying how short stories will not make money. After making the rude remark, he apologizes, only to insult the publisher. When his wife tells him to stop, he notices he has a nosebleed, but it appears nothing is wrong with him and he continues to insult the book. Then he collapses.

House and his team take on the case. Kutner likens their patient to Phineas Gage who similarly suffered from personality changes after having a railroad spike speared through his brain. They immediately note Nick has frontal lobe disinhibition, which causes him to speak his mind and have no control over what he says. Thirteen says what is causing the problem could be a tumor in the nasal cavity and they could check with a nasal scope. When Kutner and Taub are inserting the scope up Nick's nose, Nick once again speaks his mind, offending his wife and Taub.

The scene switches to House inviting Wilson over to a monster truck show, and is suspicious as to why Wilson declines. Wilson insists he is playing raquetball with Taub. After some careful probing House realizes Wilson was lying and Taub was covering for him. House talks Taub into helping him find out what Wilson is really doing. Taub prints off some deleted emails from Wilson's computer and soon House finds out Wilson has an appointment with a Dr. Gonzales in New York Mercy Psychiatric Hospital. Wilson is going to New York to visit his estranged, homeless brother Daniel Wilson. Wilson didn't want to tell House because he thought House would mock him. House, to Wilson's surprise, offers to go with Wilson to New York to be with him in case things don't turn out as Wilson hoped. The pair go to New York. In the waiting room of New York Mercy, Wilson reveals he last saw his brother 13 years ago in Princeton. House deduces that's why Wilson accepted the job at Princeton in the first place, because his brother was in Princeton as well. Wilson also reveals he feels responsible for his brother's homelessness. Thirteen years ago when Wilson was in med school Daniel was on meds for his schizophrenia. Daniel used to call Wilson, paranoid and scared, every night and speak to him for a couple of hours. One night Wilson couldn't take anymore, and he hung up the phone. That night his brother ran away from home. Wilson had felt responsible since then and hence tried to overcompensate with his niceness.

Kutner says what's causing Nick's frontal lobe disinhibition isn't nasal cancer. He also remarks that Nick will lose his wife. Later on, House realizes the patient's words unintentionally push away the people closest to him. House, seeing himself in Nick, asks Chase to help him because Nick's marriage will be ruined as soon as he leaves the hospital. Chase agrees to do the surgery on Nick to help him save his career and marriage. However, after the surgery Nick continues to relentlessly speak the truth, further insulting his wife by calling her stupid and saying he regrets marrying her. The team realizes the brain wasn't the problem after all.

In New York, House suddenly realizes that Nick's high glucose levels paired with the "wanna-be" cyst the team found in the full body scan, indicates Doege-Potter syndrome. Nick's fibromas have been creating Human Growth Hormone which acted like insulin by lowering his glucose levels. The one small fibroma which has been causing the problem has fooled Nick's body to suspect a much more perilous invader. His body has been creating antibodies to fight the benign fibroma and consequently attacked his other systems causing multiple organ failure. House concludes that by taking out the fibroma Nick will return to being a "happy hypocrite" in no time.

In the end, Nick and his wife awkwardly make up. Wilson wonders whether House minds that there is no "social contract" of forced politeness between them. House replies no. Wilson asks House whether he thinks things will work out with Daniel. House truthfully replies no. Wilson concludes seeing his brother wasn't as magnanimous as he thought it would be, after thirteen years the two are strangers to one another. House asks Wilson whether he truly likes monster trucks. Wilson replies with "absolutely," suggesting an existence of a social contract after all.

Music

• The song that plays at the end of the episode while House and Wilson leave the hospital is "The Shining" by Badly Drawn Boy