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Instant Karma (House)

"Instant Karma"
House episode
Episode no. Season 6
Episode 5
Directed by Greg Yaitanes
Written by Thomas L. Moran
Original air date October 12, 2009
Guest appearance(s)
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"Instant Karma" is the fifth episode of the sixth season of House. It aired on October 12, 2009.

Wealthy and successful Roy Randall ends his business meeting partway through and heads upstairs to his ill son Jack's room. Jack's doctor says the diagnosis is not what he thought, and recommends his father get him to the hospital. Roy wants House to work on the case, and despite explaining that House is currently unavailable, Cuddy eventually agrees to get House on the case. The patient will officially belong to Foreman but House will lead the team. House decides to start off by completely re-analyzing Jack's history and symptoms. Cameron does a physical on Jack; she notices that Jack feels no pain when she presses his belly. Cameron shows the team Jack's x-rays. She says he's constipated. Foreman diagnoses Hirschsprung's disease. They do a barium enema and a biopsy to confirm.

Cameron reviews the x-rays they've done on Jack over the course of over a week which show his colon is clear. Cameron checks Jack's belly and says while it feels better, it appears larger. Just then, Jack's right eye fixes (lateral rectus palsy) and he seizes. They give him diazepam for the seizure. Foreman sees Jack's optic disc is swollen, indicating intracranial hypertension. They give him furosemide and phenytoin to relieve the pressure but it does nothing so they rush him to the O.R to relieve the pressure before Jack's brain herniates and he has irreversible brain damage. They paralyze him for the procedure with pancuronium. They manage to relieve the pressure and Jack does not have any more seizures, but he continues to build up fluid in his abdominal and dural cavities. Foreman notices the shape of the fluid collection is odd, House recommends they do a dural biopsy to confirm brain cancer.

Meanwhile, Cuddy also says that he and Chase must present the Dibala case, which unsettles Chase. Foreman and Chase go over the Dibala presentation, making sure they're covering all the evidence. Foreman is extremely apprehensive about the situation. It will get a lot of attention since it was House's case. House overhears Foreman saying, 'I just need to know you've got everything covered,' and asks them what they're talking about. Later, Foreman tells Chase that when Cameron ran Dibala's blood, the printout he got was only what tests Cameron ordered, but the lab did a full work up and Chase did not check the man's cholesterol. Foreman informs a speechless Chase he was off by 20%. Cameron asks Chase what's wrong. Chase denies anything is wrong, but finally tells her there is a problem with the figures on Dibala's blood panels.


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