"Needle in a Haystack" is the thirteenth episode of the third season of House and the fifty-ninth episode overall.
Plot
House arrives at the hospital to discover a wheelchair-accessible van in his usual parking space. He seeks out the van's owner, who turns out to be the hospital's new researcher, Julie Whitner, who is paralyzed from the waist down. She and House exchange some sardonic banter, following which House begins using a wheelchair himself in a bet with Cuddy to get his parking space back. The patient, teenage Stevie Lipa, has a respiratory attack while kissing his girlfriend. The ER workup reveals a bloody pleural effusion. Chase suspects drugs, but House does not think so. House orders them to do a venogram to find the "low pressure leak", and orders Chase and Cameron to break into his house. Foreman tries to contact the boy's parents to get consent in order to carry out the venogram. When neither parent can be reached, Foreman does the venogram anyway. Meanwhile, Cameron and Chase, while breaking into his house, find that the patient has been lying about everything and that he is a Romani, and does not want to share his personal information or medical history with outsiders. After a consultation with House, Foreman tries to find a deep-vein thrombosis by carrying out an arteriogram, although House suggests thinning his blood and redoing the venogram. Foreman discovers his liver is failing, after which House suggests doing a CT scan, MRI, and other tests. After the MRI, they find a granuloma, and believe he has granulomatosis with polyangiitis ; House suggests immediate treatment since a liver biopsy to confirm GPA would take too long to obtain results. The treatment improved his liver, but causes a hemorrhage in his bladder, so they switch to an experimental treatment, FT28. While Foreman tries to convince his patient to take the medicine, his spleen bursts. The exchange between the patient's father and Foreman reveals that the father is comparing the experimental treatment to the Porajmos. Foreman replies citing his people's slavery. During surgery, House looks and finds there are no granulomas, so the diagnosis can not be GPA. House then orders a colonoscopy, at which point his team finds a toothpick stuck in his colon. They conclude that he must have accidentally swallowed the toothpick and folded awkwardly while making out with his girlfriend, causing the toothpick to pierce his intestines and infect the rest of his organ system. Throughout Stevie's stay at the hospital, he displays a deep curiosity and interest in science and medical knowledge. After the toothpick is removed, Foreman offers Stevie a chance to become a paid intern at the lab. However, Stevie refuses because of his attachment to his life and family as it is, and because he does not want to become "alone", as he admits to seeing Foreman and the other doctors. Near the end of the episode, House approaches Cuddy and asks about the bet concerning the wheelchair; she reveals she was not going to give House the parking space. Hoping to make her feel guilty about lying to him, he says to her, "Don't make commitments you can't keep." Cuddy feels guilty about misleading House, but in truth, House planned on making Cuddy feel guilty to get his parking space back. The end of the episode shows first Stevie being discharged from the hospital with his family, giving a nod to Foreman. It then shows a man writing House's name on the parking space and House smiling.
Music
The song in the end of the episode is "In the Waiting Line" by Zero 7.
