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


Plot

The team treats a brutal African dictator named Dibala (
James Earl Jones James Earl Jones (born January 17, 1931) is an American actor. He has been described as "one of America's most distinguished and versatile" actors for his performances in film, television, and theater, and "one of the greatest actors in America ...
) 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 a refugee who attempts to persuade Chase to let Dibala die from his illness. Later he dresses as a nurse and tries to enter Dibala's room with a pistol. This assassination attempt is violently thwarted by Dibala's guards. Chase finds out that this man was one of Dibala's child soldiers, ordered to torture and murder an innocent 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 as Sitibi rebels massacred tens of thousands in the south of his country twenty years prior and he fears a genocide from them. 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 his father, though he admits he made a mistake that lead to his youth labor league experiencing abuses and promises to prevent such an event in the future. Since Taub has resigned and Thirteen was fired, Cuddy gets Chase and Cameron to help Foreman in his diagnosis. They first consider dioxin poisoning from an assassination attempt and start Dibala on
olestra Olestra (also known by its brand name Olean) is a fat substitute that adds no calories to products. It has been used in the preparation of otherwise high-fat foods thereby lowering or eliminating their fat content. The Food and Drug Administrati ...
. Afterwards, Dibala has a heart attack and runs a fever. House suggests
Lassa fever Lassa fever, also known as Lassa hemorrhagic fever (LHF), is a type of viral hemorrhagic fever caused by the Lassa virus. Many of those infected by the virus do not develop symptoms. When symptoms occur they typically include fever, weakness, ...
, and Dibala is started on
ribavirin Ribavirin, also known as tribavirin, is an antiviral medication used to treat RSV infection, hepatitis C and some viral hemorrhagic fevers. For hepatitis C, it is used in combination with other medications such as simeprevir, sofosbuvir, pe ...
. Dibala brings in a lady called Ama, claiming his Health Minister advised that
blood plasma Blood plasma is a light amber-colored liquid component of blood in which blood cells are absent, but contains proteins and other constituents of whole blood in suspension. It makes up about 55% of the body's total blood volume. It is the intr ...
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 Lymphoma is a group of blood and lymph tumors that develop from lymphocytes (a type of white blood cell). In current usage the name usually refers to just the cancerous versions rather than all such tumours. Signs and symptoms may include enla ...
. 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 Scleroderma is a group of autoimmune diseases that may result in changes to the skin, blood vessels, muscles, and internal organs. The disease can be either localized to the skin or involve other organs, as well. Symptoms may include areas ...
, Cameron doesn't give an opinion, and Chase and Foreman think it's
blastomycosis Blastomycosis or blasto is a fungal infection caused by inhaling spores of a ''Blastomyces'' fungus. Only about half of people with the disease have symptoms, which can include fever, cough, night sweats, muscle pains, weight loss, chest pain, a ...
, so they start him on
amphotericin B Amphotericin B is an antifungal medication used for serious mycosis, fungal infections and leishmaniasis. The fungal infections it is used to treat include mucormycosis, aspergillosis, blastomycosis, candida infections, candidiasis, coccidioidomy ...
. Dibala's colonel, Ntiba, asks Cameron if Dibala is capable of thinking clearly. She replies that he definitely is not in his right mind at the moment. She adds that neurons don't regenerate and Dibala is already in his decline. She questions the colonel as to whether he can ever be sure if the commands Dibala gives from now on aren't just delusions of a sick, mad, dying old man. While giving Dibala a dose of amphotericin B, a minuscule but visible-enough air bubble appears, whereupon Dibala violently grabs her wrist and suspects her of attempting to kill him with another heart attack by injecting the bubble into his bloodstream. He confronts her about what she told Colonel Ntiba, and says she was putting a gun in Ntiba's hand. Now, he states, the gun is in her hand by only a practical difference, and he tells her she should kill him if she wants him dead, but notes that it's not so easy to kill on one's own. After a moment, Cameron puts the dose back in the bottle. Chase swears to kick Dibala out onto the street if he touches Cameron like that again. Dibala claims he showed Cameron her true character, saying she's too weak to act on her beliefs. Chase confronts him about what his planned genocide of the Sitibi truly is to him. Dibala answers with: 'Whatever it takes to protect my country!' After this, Cameron decides to take a side, and asks Chase for a blood test to confirm scleroderma. The blood test hints towards scleroderma, so Foreman switches Dibala to steroids. Dibala eventually dies from severe bleeding into his lungs. Foreman finds a piece of paper that shows Chase had signed into the morgue right before he performed the blood test on Dibala. He realizes Chase faked the results of the test using another patient's blood, to cause the team to treat incorrectly and kill the dictator and confronts him about this. Chase says there is now a chance for peace and tells Foreman that if the police are to come for him, to warn him so he can first explain to Cameron. The subplot involves Wilson and House trying to make amends with a difficult neighbor, whose complaints range from noise pollution to the smell of Wilson's cooking. House is staying with Wilson and his curiosity and meddling leads him to confront the neighbor and look into his apartment. He finds that the neighbor is a wounded veteran who lost an arm in Vietnam. However, House's further investigations lead him to discover the neighbor is Canadian, and suspects him of being a
military impostor A military impostor is a person who makes false claims about their military service in civilian life. This includes claims by people that have never been in the military as well as lies or embellishments by genuine veterans. Some individuals who d ...
. Their neighbor's anger is derived from his pain, and his pain is due to a psychosomatic attachment to a
phantom limb A phantom limb is the sensation that an amputated or missing limb is still attached. Approximately 80 to 100% of individuals with an amputation experience sensations in their amputated limb. However, only a small percentage will experience pain ...
. House confronts him about his veteran status, claiming that Canada was not a belligerent in the Vietnam War. Wilson's neighbor retorts that historically Canada ''did'' send troops to Vietnam in 1973 to enforce the peace process where he struck a land mine saving a child. House solves the dispute with Wilson's neighbor by kidnapping him and forcing him to undergo
V.S. Ramachandran Vilayanur Subramanian Ramachandran (born 10 August 1951) is an Indian-American neuroscientist. He is known for his wide-ranging experiments and theories in behavioral neurology, including the invention of the mirror box. Ramachandran is a disti ...
's
Mirror box Mirror therapy (MT) or mirror visual feedback (MVF) is a therapy for pain or disability that affects one side of the patient more than the other side. It was invented by Vilayanur S. Ramachandran to treat post-amputation patients who had phantom ...
therapy, curing his phantom pains in his amputated hand. The neighbor is extremely happy and thanks House. Wilson finds the neighbor has withdrawn all accusations and is no longer interfering in his matters. Wilson wonders what House did, and House says he was nice. Wilson doesn't really believe him, but House merely asks, 'Do you really want to know?' Wilson says he'll give House the benefit of the doubt. Meanwhile, Thirteen breaks up with Foreman, saying he wanted to do it to her but didn't have the guts and therefore fired her instead. He insists this isn't true and asks her to dinner. She initially refuses, but later accepts when she finds that Foreman got her a job at Princeton-General. She asks him why he didn't simply step down instead of firing her, and asks him if he would do that instead if he could turn back time. Foreman insists he made the right choice, so Thirteen leaves. The episode ends with House and Wilson watching TV in peace. Dibala's son arrives from Princeton and is shown crying over the dictator's dead body. Chase goes home and lies down in bed next to Cameron, very clearly feeling guilt about his actions. Foreman is seen in his office, burning the records that showed that Chase had accessed the morgue without a valid reason and faked the blood test.


References


External links


"The Tyrant"
at
Fox.com The Fox Broadcasting Company, commonly known simply as Fox and stylized in all caps as FOX, is an American commercial broadcast television network owned by Fox Corporation and headquartered in New York City, with master control operations and ...
* {{DEFAULTSORT:Tyrant, The House (season 6) episodes 2009 American television episodes Television episodes directed by David Straiton fr:Le Serment d'Hippocrate it:Episodi di Dr. House - Medical Division (sesta stagione)#Il tiranno