House sleeping dogs lie

Thursday May 18th 9pmHouse takes the case of a woman whose life is threatened by chronic insomnia. Hannah Ward hasn't slept in ten days, which should have killed her as the brain shuts down without REM sleep – the longest anybody has ever survived without sleep is 11 days. Hannah has even downed an entire bottle of sleeping pills with no effect. An intrigued House calls his team together, interrupting Cameron and Foreman’s argument about one of Cameron's cases that they are both writing up for a medical journal. House calls them to order and dispatches them to perform a battery of tests on their new patient. Hannah falls asleep during the tests, but wakes up seconds later. The team's challenge is to determine why she cannot remain asleep.House figures that Hannah is not sick enough to present symptoms, and orders the team to keep her awake. Depriving her of the few minutes she does sleep will stress her body and help them find what's afflicting her. Cameron and Foreman take the first shift, waking up Hannah when she drifts off. Each time, she denies falling asleep. Then they notice a pool of blood on the bed sheets. House thinks the rectal bleeding is could be the result of a colon tumour, so Chase heads off to perform a colonoscopy. House makes it clear that Hannah needs to be kept awake through the procedure. She will not be given sedatives unless a tumour is found. Hannah screams as Chase performs the colonoscopy. Blood begins to drain from her nostrils as she struggles to breathe. Cameron reports that the rectal exam showed traces of nasal matters. Was a massive sinus haemorrhage draining down her throat and out the back? While Cameron and Foreman squabble over possible diagnoses, House considers the poison ivy rash that Hannah's developed around the same time as the insomnia.

Chase suggests they should consider allergies, based on the fact that Hannah’s long-term girlfriend Max recently bought them a dog, but had to send it back because Hannah said she was allergic. House seriously doubts this theory because the poison ivy treatment should have suppressed any allergic reaction.

He thinks Hannah was lying about being allergic – keeping a dog is a commitment and he believes she intended to break up with Max. Cameron is not convinced: “Well, we can either base our diagnosis on your admittedly keen understanding of lesbian relationships, or we could do a scratch test.” During the test she asks Hannah about her relationship with Max, and Hannah admits that she has decided to dump her.

Suddenly, she complains of a sharp pain. Cameron rolls her over and is shocked to discover her abdomen covered with dark bruises, showing that she is bleeding massively inside. Foreman reports that Hannah’s liver is dead. She needs a transplant and they only have six hours to determine what’s affecting her.

House points out that Max donated blood to Hannah, so they must be a match. “You can’t ask the person she’s going to dump to donate her liver!" says Cameron, aghast. "It does seem tacky, doesn't it," agrees House – before setting off to manipulate Max into making the offer.

With Max preparing for surgery, the doctors now have another 36 hours to diagnose Hannah. But while they search for the right diagnosis, Cameron is worried they are ignoring an ethical dilemma. House quickly tires of her questions and shouts that if they tell Max and she changes her mind, then Hannah will die. He threatens to fire anyone who tells Max about Hannah's intentions, but Cameron begins to lay the guilt on Hannah.

Max is undergoing painful procedures and will risk her life with the transplant. Cameron thinks that if Hannah truly loved Max, she would tell her the truth. But Hannah knows that if she tells Max, she dies. Will she decide to take advantage of Max and let the operation go ahead?

And will the team be able to save both their lives?