Lines in the Sand (House)

Lines in the Sand (House)

:"This page refers to the TV episode, for other uses of this phrase, see the Lines in the Sand disambiguation page"

House (TV series) episode
episode_name = Lines in the Sand
episode_no = HOU-304
airdate = September 26 2006
writer = David Hoselton
director = Newton Thomas Sigel
guest_star = Heather Kafka as Sarah
Geoffrey Blake as Dominic
Braeden Lemasters as Adam
Leighton Meester as Ali
Stephanie Venditto as Nurse Brenda

season = 3
diagnosis = Baylisascaris

"Lines in the Sand" is the fourth episode of the third season of "House" and the fiftieth episode overall.



Adam, who is severely autistic, is learning shapes and words in his backyard. His father, Don, is trying very hard to show Adam words, but Adam seems more interested in drawing lines on his chalkboard. While eating his lunch, Adam gags as if choking, grabs at his chest, and screams loudly.

While House is doing the differential diagnosis for Adam, he notices that his blood-stained carpet has been taken out. He goes to complain to Cuddy, who has no intentions of indulging House's request. As a result, House refuses to work in his office. He begins to work in other people's offices during the course of the episode. While House is complaining to Cuddy, the rest of House's team tries to strap Adam down and get him into an MRI machine. After the MRI, Chase and Cameron go to Adam's house to run tests. Foreman tells House that all the tests are negative. Then, House holds a meeting in the clinic, and orders his team to get a stool sample. During the sample, Adam has another fit and coughs up fluid from his lungs. House moves into Wilson's office after he is evicted by Cuddy, and Wilson is not happy. The team finds a heart problem. House brushes this off and continues with his diagnosis. House's team takes a biopsy of the lymph node under Adam's arm per the suggestion of Foreman, and find that there are liver cells under his arm. Another differential in Wilson's office shows that Adam's liver may be damaged and is flowing into the lymphatic system, and was deposited in the underarm lymph node. House then moves to Cuddy's office for the differential and discusses the calcium carbonate in Adam's stool when House is evicted by Cuddy again, because she tells House that Adam is in a cardiac intensive care unit. Adam is stabilized and House discusses the possibility of pica, and suspects that Adam put something unnatural in his mouth. He orders his staff to get samples from the house. While searching the house, Foreman finds jimson weed, and suspects that might be the source of the problem. However, House is skeptical.

House finally makes a connection and stops the surgery to examine Adam's eye and shows that he has worms floating in his eye, and in other parts of his body. This is due to Adam eating sand from his sandbox with raccoon feces inside.

As Adam and his parents are leaving, they thank House, who is sitting nearby. Adam holds eye contact with House and gives him his PSP, a most unusual gesture for a child with autism. Wilson comments: "That was a ten". The new carpet covering the old, blood-stained carpet is rolled up, and Cameron asks House: "so all change is bad? It's not true, you know".


While House is treating Adam a daughter of a clinic patient in the last episode has developed crush on him. She tracks House down by visiting the clinic, flirting heavily with him and even flashing him at one point (the exchange cut short by Foreman). Cuddy tells House that Ali is stalking him and that she will call security. As House is leaving for the night, he finds Ali sitting on his motorcycle. She continues flirting, mentioning that the age of consent is fourteen in Iceland and that it's just an arbitrary number. However, Cuddy interrupts their exchange again and sends Ali on her way. Cuddy lies to House, trying to get him away from Ali, but then cracks under House's pressure and reveals that Ali is locked in her office and House should talk her out of what she is doing. House tells her that she suffers from Coccidioidomycosis, caused by the fungal spores of Coccidioides immitis in her brain, which she inhaled during an earthquake in Fresno. House says as most of her symptoms developed in her head, it may be that the spores mostly concentrated in her sinuses and the Frontal lobe of her cerebral cortex, most likely due to sniffing a flower coated in a loose dust-like film of the spores, resulting in headaches, cough, and her flawed judgement. However, impaired judgement is not a symptom of coccidioidomycosis, and was likely invented by House (given his apparent disappointment) as a means to get rid of her which he does by quoting the movie "Casablanca".

Cultural references

When House meets with Ali in Cuddy's office to say goodbye, most of the exchange is borrowed or adapted from the famous airport scene in the film "Casablanca" in which Rick Blaine (Humphrey Bogart) implores Ilsa Lund (Ingrid Bergman) to get on a plane with her husband rather than staying with him. House even tells Ali she belongs with Victor (Lund's husband in the film), adding "is there a Victor in your class?". As the scene progresses, a soft piano piece reminiscent of the score in the film is added.

House also makes a reference to the childrens novel "Hansel and Gretel" by saying to Foreman: "Hansel, get samples from the gingerbread house," meaning go around the Adam's home and take samples of everything that he could possibly consume.

As House prepares to get onto his motorbike in the hospital car park, he mimics the actions of Wesley Snipes in "Blade" by spinning his cane and sliding it down the back of his jacket.

External links

* ["House" official site]
* [ "House M.D." Guide]
* [ TVGuide's Page: Full list of "House" Episodes]
* [ Television Without Pity-"House" recaps]
* [ Medical Reviews of "House": "Lines the Sand"]

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