The Tyrant (House)

"The Tyrant" is the fourth episode of the sixth season of House. It first aired October 5, 2009.

The team treats a brutal African dictator named Dibala (James Earl Jones) who has fallen ill. The dictator had made threats of ethnic cleansing against an ethnic minority, the Sitibi, and the team deals with ethical issues of treating a potential mass murderer.

The episode features an African man seen to be persuading Chase to not save Dibala. Later he dresses as a nurse and tries to enter Dibala's room. He's attacked by Dibala's guards. Chase finds out that Dibala forced this man to rape and murder a woman, and the man tells Chase that Dibala will do this to all the Sitibi. Chase is more curious than others and confronts Dibala, who eventually reveals his plans to kill off the ethnic minority. Dibala also mentions his youngest son is studying in Princeton and hasn't spoken to him in years because of what he reads in the papers about Dibala.

Since Taub has resigned and Thirteen was fired, Cuddy gets Chase and Cameron to help Foreman. They first consider dioxin poisoning from an assassination attempt and start Dibala on olestra. Afterwards, Dibala has a heart attack and runs a fever. House suggests Lassa fever, and Dibala is started on ribavirin. Dibala brings in a lady called Ama, claiming his Health Minister advised that blood plasma from one with antibodies for Lassa fever is more effective than ribavirin, and wants the team to use her blood. She insists they let her do this. Cameron suspects she is being threatened, and Cuddy says that if she is, she'd rather have a prick on her conscience than the death of Ama's family members, so Cuddy tells the team to use Ama's blood.

Dibala's right eye becomes bloody, a result of an enlarged lymph node which blocked the retinal vein. Foreman suggests lymphoma. They do a lymph node biopsy which comes back negative. Dibala also develops lack of short-term memory, spikes a fever and has nodules in his fingers. House thinks it's scleroderma. Cameron doesn't care enough to give an opinion, and Chase and Foreman think it's blastomycosis, so they start him on amphotericin B. Dibala's colonel, Ntiba, asks Cameron if Dibala is capable of thinking clearly. She replies that he definitely is not right now. She adds that neurons don't grow back and Dibala is already in his decline. She questions the colonel as to whether he can ever be sure if the commands Dibala from now on aren't just delusions of a sick, mad, dying old man.