1 00:00:03,671 --> 00:00:06,424 Hey. Thanks. 2 00:00:06,799 --> 00:00:08,384 No, no, no... here. 3 00:00:09,927 --> 00:00:11,345 You got this whole thing wrong, em. 4 00:00:11,679 --> 00:00:13,514 It's the rock star that's supposed to be late, 5 00:00:13,639 --> 00:00:14,891 not the rock-star photographer. 6 00:00:15,224 --> 00:00:18,186 Sorry. Morning sickness. Touch the belly. 7 00:00:18,477 --> 00:00:20,605 It's the first time I've been asked to do that. 8 00:00:20,730 --> 00:00:22,064 Come on. It's good luck. 9 00:00:22,190 --> 00:00:23,774 Okay. 10 00:00:24,650 --> 00:00:26,569 Hit the kinos behind the drop. 11 00:00:31,866 --> 00:00:33,659 So what do you think? 12 00:00:34,744 --> 00:00:36,454 I think people aren't gonna get it. 13 00:00:36,579 --> 00:00:38,831 Come on. "All-American rejects." 14 00:00:38,956 --> 00:00:43,544 Juxtaposing a classic image of americana with modern pop culture youth. 15 00:00:44,045 --> 00:00:45,922 Oh, yeah. 16 00:00:46,047 --> 00:00:48,257 Everyone loves a good juxtaposition. 17 00:00:48,382 --> 00:00:49,967 My fans were born in the '90s. 18 00:00:50,092 --> 00:00:53,763 You know what? You do this picture, you'll gain 40 years of fans. 19 00:00:54,138 --> 00:00:55,389 - Yeah? - Yeah. 20 00:00:55,514 --> 00:00:57,892 - I love the Rockwell thing. - I thought so. 21 00:00:58,476 --> 00:01:00,853 Okay. Kill the house lights. Let's go! 22 00:01:07,652 --> 00:01:09,862 Hang on. Hey, who's in charge of the backdrop? 23 00:01:09,987 --> 00:01:11,697 - Naomi? - Yeah? 24 00:01:12,156 --> 00:01:13,783 What's wrong with it? 25 00:01:13,908 --> 00:01:16,369 Well, the words are completely jumbled. 26 00:01:17,328 --> 00:01:19,664 What, you can read that? 27 00:01:20,122 --> 00:01:21,749 Of course. 28 00:01:21,958 --> 00:01:24,377 - You okay? - No. Oh, god. 29 00:01:24,502 --> 00:01:26,462 I could be having a... 30 00:01:27,004 --> 00:01:29,006 What's the mnemonic? 31 00:01:29,924 --> 00:01:32,843 "F" is for face. Is my smile crooked? 32 00:01:34,011 --> 00:01:35,263 What are you doing? 33 00:01:35,388 --> 00:01:37,890 "A" is for arms. 34 00:01:38,015 --> 00:01:38,849 Arms. 35 00:01:38,975 --> 00:01:40,351 You should really sit down. 36 00:01:40,476 --> 00:01:41,811 Can someone get her some water? 37 00:01:41,936 --> 00:01:43,521 "S" is speech. 38 00:01:43,646 --> 00:01:45,398 I'm slurring? I'm slurring? 39 00:01:49,193 --> 00:01:51,195 "F-a-s-t." 40 00:01:51,862 --> 00:01:53,447 "T" is for time. 41 00:01:53,572 --> 00:01:58,160 Hurry. Somebody, call 911. Tell them I'm having a stroke. 42 00:02:40,328 --> 00:02:42,038 Hi. I'm Dr. House. 43 00:02:42,163 --> 00:02:44,040 My boss says you're important. 44 00:02:44,582 --> 00:02:46,059 Personally I don't get what's so hard about 45 00:02:46,083 --> 00:02:48,002 making Scarlett Johansson look pretty. 46 00:02:48,127 --> 00:02:49,712 Arms out in front of you. 47 00:02:49,837 --> 00:02:51,881 Palms up like you're holding a pizza. 48 00:02:52,590 --> 00:02:53,799 Close your eyes. 49 00:02:55,009 --> 00:02:58,346 It's so easy you should consider a career change. 50 00:02:58,471 --> 00:02:59,847 Probably make a lot more money. 51 00:03:00,598 --> 00:03:02,808 Dr. Mackman tell you the clot was clear? 52 00:03:02,933 --> 00:03:03,933 Yes. 53 00:03:04,018 --> 00:03:06,145 And he said that you and the fetus are fine? 54 00:03:06,270 --> 00:03:07,396 Yeah. 55 00:03:07,688 --> 00:03:10,107 He didn't mention your pronator drift? 56 00:03:10,733 --> 00:03:14,195 - What's that mean? - Means mackman is an idiot. 57 00:03:14,737 --> 00:03:16,197 - May I? - Yeah. 58 00:03:19,033 --> 00:03:21,410 You take thousands of photos of someone, 59 00:03:21,535 --> 00:03:23,871 but only one has to look good. 60 00:03:23,996 --> 00:03:25,182 Kind of the opposite of my business. 61 00:03:25,206 --> 00:03:26,665 It's not about looking good. 62 00:03:26,791 --> 00:03:27,976 People are always hiding things. 63 00:03:28,000 --> 00:03:31,295 I just keep shooting until I can see what's really inside them. 64 00:03:32,213 --> 00:03:34,673 - My eyes okay? - Eyes are gorgeous. 65 00:03:34,799 --> 00:03:36,675 The vessels don't look so hot. 66 00:03:36,884 --> 00:03:39,637 Microaneurysms predict further strokes. 67 00:03:39,762 --> 00:03:40,781 This is gonna happen again? 68 00:03:40,805 --> 00:03:43,432 Unless I can figure out the underlying cause. 69 00:03:43,557 --> 00:03:45,226 Puff up your cheeks. 70 00:03:47,061 --> 00:03:50,398 You should be able to keep the air in. Means there's weakness around the mouth. 71 00:03:50,523 --> 00:03:52,376 So where'd you learn to self-diag nose a stroke? 72 00:03:52,400 --> 00:03:56,779 Oh, my baby's biological father is a neurologist. 73 00:03:57,071 --> 00:04:00,533 He once told me the fast mnemonic could save my life one day. So... 74 00:04:00,825 --> 00:04:02,493 Interesting pet name. 75 00:04:02,827 --> 00:04:05,413 Most people go with "husband" or "pookie." 76 00:04:05,830 --> 00:04:07,540 He's gay. 77 00:04:07,665 --> 00:04:09,375 Just a sperm donor. So when you... 78 00:04:09,500 --> 00:04:11,127 You turned him for a night? 79 00:04:11,252 --> 00:04:12,920 Just straight for one date? 80 00:04:13,671 --> 00:04:14,839 Okay. 81 00:04:15,214 --> 00:04:18,843 He took a magazine and a cup into my bathroom. 82 00:04:18,968 --> 00:04:20,761 A man after my own heart. 83 00:04:20,886 --> 00:04:22,721 Different magazine obviously. 84 00:04:22,930 --> 00:04:25,891 I'm rescinding mackman's discharge order. 85 00:04:26,016 --> 00:04:27,893 My lackeys will be in to do some tests, 86 00:04:28,018 --> 00:04:30,896 take some more blood and empty your catheter bag. 87 00:04:36,402 --> 00:04:39,655 Not a moment you'll want to Cherish. 88 00:04:41,824 --> 00:04:44,785 This is definitely different. 89 00:04:44,910 --> 00:04:47,079 It looks almost like... 90 00:04:47,288 --> 00:04:48,956 He's caring. 91 00:04:54,920 --> 00:04:58,382 Find anything else in the patient's folder? Like a diagnosis? 92 00:04:58,507 --> 00:05:01,969 Urinalysis revealed excessive protein and red blood cells. 93 00:05:02,094 --> 00:05:04,722 Chem panel showed a creatinine level over 2.5. 94 00:05:04,847 --> 00:05:08,267 So first she strokes, now her kidneys are shutting down. Why? 95 00:05:08,392 --> 00:05:10,144 Ultrasound showed no tumors or stones. 96 00:05:10,269 --> 00:05:12,897 No signs of fetal distress. No urinary tract obstructions. 97 00:05:13,022 --> 00:05:14,857 BP is fine. No pre-eclampsia. 98 00:05:14,982 --> 00:05:17,151 Any of you guys ever been to the galapagos? 99 00:05:17,276 --> 00:05:18,611 Was our patient there? 100 00:05:18,736 --> 00:05:20,738 Dengue fever, avian pox, even west nile. 101 00:05:22,072 --> 00:05:23,616 I'm looking for a vacation spot. 102 00:05:23,741 --> 00:05:24,950 That mean we get vacation? 103 00:05:25,075 --> 00:05:27,536 How would that differ from your current status? 104 00:05:27,661 --> 00:05:28,996 You're gonna do what? Relax? 105 00:05:29,121 --> 00:05:30,122 Visiting family. 106 00:05:30,247 --> 00:05:31,665 My uncle's a giant turtle. 107 00:05:31,790 --> 00:05:33,542 What if the kidney failure came first? 108 00:05:33,667 --> 00:05:36,067 Kidneys could've caused the stroke, not the other way around. 109 00:05:36,170 --> 00:05:38,172 Kidneys don't often get stuck in the brain. 110 00:05:38,297 --> 00:05:39,673 I'm saying it threw a clot. 111 00:05:39,798 --> 00:05:42,559 Early symptoms of kidney failure are nausea, vomiting, ankle swelling. 112 00:05:42,676 --> 00:05:44,476 She would've mistaken it for morning sickness. 113 00:05:44,512 --> 00:05:46,639 Heart's way more likely to throw a clot than a kidney. 114 00:05:46,764 --> 00:05:49,892 Echo was normal. The history indicates no sign of cardiac problems. 115 00:05:50,017 --> 00:05:52,186 No, but if one were to read the history closely, 116 00:05:52,311 --> 00:05:54,605 one would notice that she had six cases of strep. 117 00:05:54,730 --> 00:05:57,525 In her throat. That's the one about 10 inches above her heart. 118 00:05:57,650 --> 00:06:00,402 Let me rephrase, six cases of untreated strep. 119 00:06:00,528 --> 00:06:01,820 She was prescribed antibiotics. 120 00:06:01,946 --> 00:06:02,988 No one takes them all. 121 00:06:03,280 --> 00:06:06,450 They stop when they start feeling better. All strep is untreated strep. 122 00:06:06,575 --> 00:06:08,095 What happens when strep goes untreated? 123 00:06:08,202 --> 00:06:09,328 Leads to rheumatic fever. 124 00:06:09,578 --> 00:06:10,621 Which leads to... Cameron? 125 00:06:10,829 --> 00:06:11,997 Mitral valve stenosis. 126 00:06:12,122 --> 00:06:15,084 Which is a thickening in the valve of the... kidney? 127 00:06:16,418 --> 00:06:17,938 The kidney doesn't have a mitral valve. 128 00:06:18,003 --> 00:06:20,089 We'll go look at her heart. 129 00:06:21,757 --> 00:06:23,092 Be easy to find. 130 00:06:23,425 --> 00:06:27,096 It's the big red pumping thing about 10 inches below her throat. 131 00:06:27,680 --> 00:06:29,139 That was weird. 132 00:06:29,765 --> 00:06:32,810 - He was the way he always is. - Which is weird. 133 00:06:34,103 --> 00:06:36,063 - Very still, Emma. - Sorry. 134 00:06:36,188 --> 00:06:37,231 No problem. 135 00:06:37,565 --> 00:06:40,568 He caught us with your hand up my shirt. He's gotta have a reaction to that. 136 00:06:40,693 --> 00:06:42,087 You think that's what the vacation is? 137 00:06:42,111 --> 00:06:43,112 Yes. 138 00:06:43,237 --> 00:06:46,782 The pain of losing you is obviously forcing him away. 139 00:06:46,907 --> 00:06:48,117 Coronal slice appears normal. 140 00:06:48,242 --> 00:06:50,411 There's no way house just lets this slide. 141 00:06:50,536 --> 00:06:51,816 He's gotta be planning something. 142 00:06:51,912 --> 00:06:53,998 Maybe he just doesn't give a crap. 143 00:06:54,123 --> 00:06:55,416 Sagittal slice is clean. 144 00:06:55,541 --> 00:06:57,102 You think he just stumbled into that closet? 145 00:06:57,126 --> 00:06:59,479 He knew we were there and he wanted us to know that he knew. 146 00:06:59,503 --> 00:07:01,130 Or you wanted him to know. 147 00:07:01,255 --> 00:07:04,383 Now he does and you're annoyed because he doesn't care. 148 00:07:04,675 --> 00:07:05,675 Right there. 149 00:07:05,884 --> 00:07:08,429 Trans-axial slice. Calcified mitral valve. 150 00:07:08,554 --> 00:07:10,723 Barely. That's not big enough to throw a clot. 151 00:07:10,848 --> 00:07:13,183 Obviously it is, because it did. 152 00:07:13,309 --> 00:07:14,727 House was right. 153 00:07:15,519 --> 00:07:17,855 A valve in your heart is narrowed. 154 00:07:17,980 --> 00:07:20,649 It caused the clot which lead to your stroke, 155 00:07:20,774 --> 00:07:24,445 and the reduced circulation caused the problem with your kidneys. 156 00:07:24,862 --> 00:07:26,071 And this will fix it? 157 00:07:26,196 --> 00:07:29,575 The balloon will force the valve back open and you'll be fine. 158 00:07:29,700 --> 00:07:31,260 Emma: Can we do this without a sedative? 159 00:07:31,285 --> 00:07:34,204 It's very mild. There really is no risk to the fetus. 160 00:07:34,330 --> 00:07:36,540 We'll monitor your baby's heart rate separately. 161 00:07:36,957 --> 00:07:40,377 We won't allow it to decrease anywhere near dangerous levels. 162 00:07:43,631 --> 00:07:44,631 Thank you. 163 00:07:44,673 --> 00:07:45,758 You're both gonna be fine. 164 00:07:48,677 --> 00:07:50,054 Go ahead, Dr. Cameron. 165 00:07:51,930 --> 00:07:55,100 Listen to that heartbeat. It sounds so... 166 00:07:56,560 --> 00:07:58,687 Start threading the catheter. 167 00:08:05,694 --> 00:08:10,658 No, I don't want a layover in Frankfurt, Taipei, Singapore or London, Ontario. 168 00:08:10,783 --> 00:08:12,863 That's why I asked for a direct flight to Phnom Penh. 169 00:08:13,327 --> 00:08:16,497 How hard is it to not land? Does it matter what I answer? 170 00:08:16,872 --> 00:08:19,124 Well, then fine. I'd be delighted to hold. 171 00:08:19,249 --> 00:08:21,293 - What's new? - Can cuddy stop interfering? 172 00:08:21,418 --> 00:08:22,670 It's herjob. What's new? 173 00:08:22,795 --> 00:08:24,147 Good news is Emma's heart is fixed. 174 00:08:24,171 --> 00:08:27,549 Bad news is it's not her underlying problem. Her kidneys are still failing. 175 00:08:27,675 --> 00:08:29,593 You're vacationing in Cambodia? 176 00:08:29,718 --> 00:08:30,945 You gonna unwind in the killing fields? 177 00:08:30,969 --> 00:08:31,804 Nope. 178 00:08:31,929 --> 00:08:33,597 Gonna catch me a fish this big. 179 00:08:33,722 --> 00:08:36,100 Mekong giant catfish. Weighs over 600 pounds. 180 00:08:36,225 --> 00:08:37,702 Aren't those catfish critically endangered? 181 00:08:37,726 --> 00:08:39,561 That's why it's my last chance to catch one. 182 00:08:39,687 --> 00:08:41,127 All of our operators are currently... 183 00:08:41,230 --> 00:08:42,791 If the mitral valve had been properly fixed 184 00:08:42,815 --> 00:08:44,084 the kidney should be getting better, 185 00:08:44,108 --> 00:08:46,670 which leads us to the conclusion that you screwed up the procedure. 186 00:08:46,694 --> 00:08:48,112 Or you screwed up the diagnosis. 187 00:08:48,237 --> 00:08:49,923 The mitral valve thickening was so insignificant 188 00:08:49,947 --> 00:08:52,175 it probably wasn't the cause of the kidneys or the stroke. 189 00:08:52,199 --> 00:08:53,551 Probably never would've been a problem. 190 00:08:53,575 --> 00:08:55,828 She needs dialysis and we need a new theory. 191 00:08:56,203 --> 00:08:57,955 Chase: There are only a few possibilities. 192 00:08:58,080 --> 00:09:00,249 Patient's pregnant, could be pre-eclampsia. 193 00:09:00,374 --> 00:09:01,750 We eliminated it before because... 194 00:09:01,875 --> 00:09:04,086 Re-check for proteinuria and low platelets. What else? 195 00:09:04,211 --> 00:09:05,295 Hypoperfusion. 196 00:09:05,421 --> 00:09:08,632 The fetus is basically a parasite stealing nutrients, minerals, blood. 197 00:09:08,757 --> 00:09:09,842 Put her on telemetry. 198 00:09:09,967 --> 00:09:11,301 Or the pregnancy is irrelevant. 199 00:09:11,427 --> 00:09:14,054 Could be infection, sepsis, husittp. 200 00:09:14,179 --> 00:09:16,140 Chase: A cholesterol embolism is just as likely. 201 00:09:16,265 --> 00:09:19,727 Tiny particles of cholesterol rain down, clog up small vessels of the kidneys. 202 00:09:19,852 --> 00:09:21,812 Get a smear and ultrasound her vessels for plaque. 203 00:09:21,937 --> 00:09:23,731 That's it. Has to be one of those five. 204 00:09:23,856 --> 00:09:27,860 You know what would be even better? If we'd narrow it all the way down to one. 205 00:09:28,819 --> 00:09:30,821 Thank you for holding. 206 00:09:30,946 --> 00:09:33,407 We are experiencing extremely high call volume. 207 00:09:33,532 --> 00:09:35,659 Thank you for your Patience. 208 00:09:41,039 --> 00:09:42,624 She's 0 for five. 209 00:09:44,835 --> 00:09:48,130 Either the differential was wrong or she's faking it. 210 00:09:48,255 --> 00:09:50,466 Kidney failure has to be precipitated by... 211 00:09:50,591 --> 00:09:51,985 One of the five we've already ruled out. 212 00:09:52,009 --> 00:09:54,636 The body only has so many ways of screwing with the kidneys. 213 00:09:54,762 --> 00:09:56,322 - The labs must be wrong. - We did the labs. 214 00:09:56,346 --> 00:09:57,848 No one else had access. 215 00:09:57,973 --> 00:09:59,600 That's not quite true. 216 00:10:06,273 --> 00:10:10,486 You put all your patients through this many tests or just the important ones? 217 00:10:11,779 --> 00:10:14,990 We wanted to explore all possibilities. 218 00:10:17,659 --> 00:10:18,660 And? 219 00:10:19,286 --> 00:10:21,705 We've eliminated all the possibilities. 220 00:10:21,830 --> 00:10:23,790 You telling me I'm dying and you have no idea why? 221 00:10:23,916 --> 00:10:25,918 Your body is functioning properly. 222 00:10:26,043 --> 00:10:27,503 So why are my kidneys failing? 223 00:10:29,671 --> 00:10:31,381 The other body isn't. 224 00:10:32,674 --> 00:10:35,302 There's something wrong with the fetus. 225 00:10:44,645 --> 00:10:48,398 Welcome to the world of maternal mirror syndrome. 226 00:10:49,817 --> 00:10:51,443 Mom's body is like 227 00:10:52,402 --> 00:10:54,738 an intricate German Metro system. 228 00:10:54,863 --> 00:10:56,365 All the trains run on time. 229 00:10:56,740 --> 00:11:00,869 When she gets pregnant, it's like a new station opening in dusseldorf. 230 00:11:00,994 --> 00:11:03,831 Bunch or rookies running things. Bound to be mistakes. 231 00:11:03,956 --> 00:11:05,999 Kids play on the tracks, get electrocuted. 232 00:11:06,124 --> 00:11:08,724 Before you know it, the trains are backed up all the way to Berlin 233 00:11:08,752 --> 00:11:10,939 and you've got a bunch of angry Germans with nowhere to go. 234 00:11:10,963 --> 00:11:12,756 And we all know that ain't good for the Jews. 235 00:11:12,881 --> 00:11:14,025 Who are the Jews in this metaphor? 236 00:11:14,049 --> 00:11:15,968 A few things can happen to a fetus in distress. 237 00:11:16,093 --> 00:11:18,387 It can become a miscarriage, stillbirth, 238 00:11:18,512 --> 00:11:21,807 a very sick baby or on rare occasion a time bomb 239 00:11:22,057 --> 00:11:23,892 that kills mom while it's dying. 240 00:11:24,017 --> 00:11:27,062 Good news is, we fix the fetus, mom gets better. 241 00:11:27,187 --> 00:11:29,273 It's the diagnostic equivalent of a two-for-one sale. 242 00:11:29,398 --> 00:11:32,484 I have read the outcome of mirror syndrome is almost always unfavorable. 243 00:11:32,818 --> 00:11:35,612 "Unfavorable." is that doctor speak for "dead baby"? 244 00:11:35,988 --> 00:11:38,407 You think she'll be less upset if you phrase it nicely? 245 00:11:38,532 --> 00:11:40,617 We can tell her the truth, that she'll be fine 246 00:11:40,868 --> 00:11:44,288 as soon as we diagnose a person who weighs about one pound. 247 00:11:44,663 --> 00:11:47,916 Can't touch it, can't ask where it hurts, can't see it. 248 00:11:48,166 --> 00:11:52,045 If only there existed giant machines that could look through human skin. 249 00:11:52,170 --> 00:11:54,548 Mirror syndrome has a limited number of known causes. 250 00:11:54,965 --> 00:11:57,759 Tachyarrhythmia, fetal anemia, placental chorioangioma. 251 00:11:57,885 --> 00:11:59,845 All of which are fixable. 252 00:11:59,970 --> 00:12:01,889 Which would be UN-unfavorable, right? 253 00:12:02,014 --> 00:12:03,765 Could also be trisomy 13. 254 00:12:03,891 --> 00:12:06,602 Ebstein's anomaly, an aneurysm of galen's vein. 255 00:12:06,727 --> 00:12:10,230 And Dr. Storm cloud rained all over the differential 256 00:12:10,355 --> 00:12:12,107 and killed the beautiful little baby. 257 00:12:12,232 --> 00:12:15,444 Heart's easiest to see, easiest to fix. So let's start there. 258 00:12:15,569 --> 00:12:18,047 When you did mom's mri, did you get a look at the fetus's heart? 259 00:12:18,071 --> 00:12:21,533 It was in the range but blurry. The fetus was moving all over the place. 260 00:12:21,658 --> 00:12:23,368 - So we need another scan. - Yeah. 261 00:12:23,493 --> 00:12:26,038 We'll just ask the fetus to lie very, very still. 262 00:12:26,163 --> 00:12:29,082 No need. I'm going to paralyze it. 263 00:12:31,126 --> 00:12:34,004 You wanna paralyze Emma Sloan's baby? 264 00:12:34,546 --> 00:12:36,089 Let me guess. Cameron? 265 00:12:36,214 --> 00:12:38,258 Cameron and chase both had their concerns. 266 00:12:38,383 --> 00:12:39,927 No, Cameron had concerns. 267 00:12:40,052 --> 00:12:41,094 Chase just agreed with her 268 00:12:41,219 --> 00:12:44,181 because he didn't want to lose his all-access pass to her love rug. 269 00:12:44,306 --> 00:12:45,599 They're sleeping together? 270 00:12:45,724 --> 00:12:49,019 If by "sleeping together" you mean having sex in the janitor's closet. 271 00:12:49,144 --> 00:12:50,144 Here? 272 00:12:50,270 --> 00:12:52,814 No, the janitor's closet at the local high school. 273 00:12:52,940 --> 00:12:54,650 Go, tiger cats! 274 00:12:55,067 --> 00:12:57,795 Do you have one of those camera phones? 'Cause I got a MySpace account. 275 00:12:57,819 --> 00:12:59,905 I will deal with them after I deal with you. 276 00:13:00,030 --> 00:13:01,531 Oh, come on. Let's gossip some more. 277 00:13:01,657 --> 00:13:03,283 I'm sure she's into bondage. 278 00:13:03,408 --> 00:13:05,827 Paralyzing a one-pound baby risks damaging... 279 00:13:05,953 --> 00:13:09,206 Not paralyzing the thing risks not getting a clean mri of its heart, 280 00:13:09,331 --> 00:13:13,251 which we need to save its life, which we need to do to save Emma's life. 281 00:13:14,169 --> 00:13:15,521 You're gonna need to get her consent. 282 00:13:15,545 --> 00:13:17,130 Well, that shouldn't be too hard. 283 00:13:17,255 --> 00:13:19,257 "Sign here or you and your baby both die." 284 00:13:21,009 --> 00:13:22,636 I'm going with you. 285 00:13:24,179 --> 00:13:26,014 Oh, good. 286 00:13:26,640 --> 00:13:29,643 You said sedation was risky. This sounds insane. 287 00:13:29,768 --> 00:13:32,688 The injection goes into the umbilical cord. 288 00:13:32,813 --> 00:13:33,981 The baby won't feel a thing. 289 00:13:34,731 --> 00:13:35,857 Fetus. 290 00:13:36,733 --> 00:13:40,654 I'm lowering expectations. It works here and on dates. 291 00:13:40,779 --> 00:13:42,280 The benefits outweigh the risks 292 00:13:42,406 --> 00:13:45,117 and the paralytic will wear off in an hour, okay? 293 00:13:45,909 --> 00:13:49,413 Must be easier to hear you might die than your baby might die. 294 00:13:49,830 --> 00:13:52,833 But if there's anyone I would trust to save my baby, 295 00:13:53,792 --> 00:13:55,544 it would be Dr. House. 296 00:13:59,715 --> 00:14:01,216 Fetus. 297 00:14:03,093 --> 00:14:04,219 Hold this. 298 00:14:32,456 --> 00:14:34,499 Dr. Cameron. The mri results back? 299 00:14:34,624 --> 00:14:36,102 The fetus's heart is structurally sound. 300 00:14:36,126 --> 00:14:38,396 The problem's with the bladder. It's four times normal size. 301 00:14:38,420 --> 00:14:39,420 Let me see. 302 00:14:39,504 --> 00:14:41,524 The bladder's so engorged it's taking up the whole torso, 303 00:14:41,548 --> 00:14:42,841 squeezing all the other organs. 304 00:14:42,966 --> 00:14:44,527 There's no room for the lungs to develop. 305 00:14:44,551 --> 00:14:46,391 The baby has a lower urinary tract obstruction. 306 00:14:46,470 --> 00:14:47,910 We can fix that by inserting a shunt. 307 00:14:48,138 --> 00:14:49,306 I'll give Emma the news. 308 00:14:49,431 --> 00:14:51,183 Are you taking over the case? 309 00:14:51,308 --> 00:14:53,310 House won't care. He has his diagnosis. 310 00:14:55,395 --> 00:14:57,022 Doctor Cameron. 311 00:14:58,565 --> 00:15:01,860 Dating chase can only end in one of two ways. 312 00:15:01,985 --> 00:15:02,986 House told you? 313 00:15:03,111 --> 00:15:05,489 You get married and live happily ever after, 314 00:15:05,614 --> 00:15:08,325 or somebody gets hurt and you two can't work together, 315 00:15:08,450 --> 00:15:09,826 and I have to fire somebody. 316 00:15:09,951 --> 00:15:12,013 I would hate to see my personal life become such a burden to you. 317 00:15:12,037 --> 00:15:13,181 I'm telling you this for your own good. 318 00:15:13,205 --> 00:15:15,224 I assume you're gonna have this same conversation with chase 319 00:15:15,248 --> 00:15:16,083 for his own good. 320 00:15:16,208 --> 00:15:18,710 Chase isn't the one that's gonna get hurt here. 321 00:15:34,643 --> 00:15:37,646 There's only room for one but I could scooch over. 322 00:15:37,771 --> 00:15:39,272 My social life is my social life. 323 00:15:39,689 --> 00:15:41,024 Couldn't agree more. 324 00:15:41,149 --> 00:15:43,527 What goes on in the privacy of a janitor's closet 325 00:15:43,652 --> 00:15:44,528 is nobody's business except... 326 00:15:44,653 --> 00:15:46,413 She told me to end it. Is that what you want? 327 00:15:46,696 --> 00:15:48,416 I was actually hoping she'd fire one of you. 328 00:15:48,532 --> 00:15:51,118 - What are you doing? - Trying to avoid altitude sickness. 329 00:15:51,243 --> 00:15:52,923 Couldn't score a direct flight to Cambodia, 330 00:15:52,953 --> 00:15:56,498 so I've decided to scale Argentina's infamous mount aconcagua. 331 00:15:56,623 --> 00:15:58,543 Perfect, except for the fact that you can't walk. 332 00:15:58,583 --> 00:16:01,795 There's a tribe of mocovi Indians who actually carry the elders up... 333 00:16:01,920 --> 00:16:02,920 You're insane. 334 00:16:03,255 --> 00:16:04,756 I'm an insane genius. 335 00:16:04,881 --> 00:16:07,259 I set the chamber to low pressure instead of high. 336 00:16:07,384 --> 00:16:09,803 Thinner air builds up the extra red blood cells, 337 00:16:09,928 --> 00:16:11,012 creates new capillaries. 338 00:16:11,138 --> 00:16:14,182 Few more days in here, I can save myself six weeks at base camp. 339 00:16:14,599 --> 00:16:15,934 Where's my mri? 340 00:16:18,728 --> 00:16:20,897 There's a blockage in the urinary tract. 341 00:16:21,022 --> 00:16:22,983 Simple terms, your baby can't pee. 342 00:16:23,108 --> 00:16:25,819 His bladder is swollen and it's crushing his lungs. 343 00:16:25,944 --> 00:16:27,070 Can you fix it? 344 00:16:27,195 --> 00:16:29,698 We can insert a small tube in the baby's bladder 345 00:16:29,823 --> 00:16:31,759 that makes the urine come out straight through his belly 346 00:16:31,783 --> 00:16:33,660 for the duration of the pregnancy. 347 00:16:33,785 --> 00:16:36,746 The bladder decompresses and the lungs will be able to develop normally. 348 00:16:37,122 --> 00:16:40,000 When the baby gets better, you should get better. 349 00:16:40,125 --> 00:16:42,002 First we just have to do a test 350 00:16:42,127 --> 00:16:44,880 to determine whether the baby's kidneys are functioning properly. 351 00:16:45,005 --> 00:16:46,798 And what if they're not? 352 00:16:46,923 --> 00:16:50,635 If they're already too damaged, then there's really nothing we can do. 353 00:16:50,760 --> 00:16:53,930 If this doesn't work out, you can always try again. 354 00:16:57,392 --> 00:17:00,020 I miscarried twice when I was married. 355 00:17:00,812 --> 00:17:04,274 After the divorce, I tried in vitro like four times before this. 356 00:17:05,108 --> 00:17:08,653 I'm 42. Maybe it's just not meant to be. 357 00:17:16,703 --> 00:17:18,038 What are you doing? 358 00:17:18,663 --> 00:17:20,808 You're trying to be me, so I thought I'd try to be you. 359 00:17:20,832 --> 00:17:22,192 You don't have the cleavage for it. 360 00:17:22,292 --> 00:17:23,877 But I have a much tighter ass. 361 00:17:24,002 --> 00:17:27,339 Think every day should be naked Thursday or is that an oxymoron? 362 00:17:29,466 --> 00:17:31,027 Let me see the results from the bladder tap. 363 00:17:31,051 --> 00:17:32,719 They aren't back yet. 364 00:17:32,844 --> 00:17:34,262 They're gonna be inconclusive. 365 00:17:34,387 --> 00:17:35,931 You think my diagnosis is wrong? 366 00:17:36,056 --> 00:17:38,683 Fetus doesn't pee, amniotic fluid should be low. 367 00:17:38,808 --> 00:17:39,808 Mom's level is fine. 368 00:17:39,851 --> 00:17:40,977 Doesn't mean I'm wrong. 369 00:17:41,102 --> 00:17:42,955 Could just mean we caught the obstruction early. 370 00:17:42,979 --> 00:17:44,648 Either way your test will be inconclusive. 371 00:17:44,773 --> 00:17:45,857 The urine you've collected 372 00:17:45,982 --> 00:17:47,919 has been sitting in that fetus's bladder for weeks. 373 00:17:47,943 --> 00:17:51,321 As my pappy always said, "stale pee is useless pee." 374 00:17:51,696 --> 00:17:53,114 Fine. I'll do another tap. 375 00:17:53,240 --> 00:17:54,324 Just as useless. 376 00:17:54,991 --> 00:17:57,744 Old urine drops down from the kidney right after the first tap 377 00:17:57,869 --> 00:17:58,912 'cause it's so backed up. 378 00:17:59,037 --> 00:18:01,665 Bladder tap number three will give you the freshest pee. 379 00:18:01,790 --> 00:18:04,510 That's when you'll find out if this fetus has even a fighting chance. 380 00:18:04,584 --> 00:18:05,627 Thank you. 381 00:18:06,586 --> 00:18:07,754 I'll run two more taps. 382 00:18:07,879 --> 00:18:10,757 Since when does the Dean of medicine run bladder taps? 383 00:18:10,882 --> 00:18:11,967 She's an important patient. 384 00:18:12,425 --> 00:18:15,595 Because she takes pictures or because she's you? 385 00:18:17,555 --> 00:18:19,724 Woman in her 40s, single, 386 00:18:20,809 --> 00:18:24,187 using a Turkey baster as a last gasp at motherhood. 387 00:18:25,105 --> 00:18:29,067 Maybe you want to make sure she succeeds so you'll still have hope. 388 00:18:29,985 --> 00:18:32,821 You can't be a good doctor if you're not objective. 389 00:18:33,321 --> 00:18:35,115 - It's your file. - I don't want it. 390 00:18:35,365 --> 00:18:37,450 Then why did you just say all that stuff? 391 00:18:37,575 --> 00:18:38,785 To humiliate you. 392 00:18:38,910 --> 00:18:41,246 - You're taking the case back. - I don't want it. 393 00:18:41,371 --> 00:18:43,331 Your diagnosis is right. I want to go on vacation. 394 00:18:43,456 --> 00:18:45,959 You can go on vacation after you've cured her. 395 00:18:51,339 --> 00:18:52,382 Chase: Good news. 396 00:18:52,716 --> 00:18:55,802 The fetus's urine had appropriate levels of protein and electrolytes, 397 00:18:55,927 --> 00:18:57,804 so its kidneys aren't damaged. 398 00:18:59,472 --> 00:19:00,682 Oh, wow. 399 00:19:01,308 --> 00:19:02,767 We're gonna put the shunt in. 400 00:19:02,892 --> 00:19:04,732 Your baby's lungs should have more room to grow 401 00:19:04,769 --> 00:19:07,230 and your symptoms should go away. 402 00:19:08,064 --> 00:19:10,191 But he'll still need surgery, after he's born? 403 00:19:10,317 --> 00:19:12,694 That's when we'll remove the blockage in the ureter. 404 00:19:12,819 --> 00:19:14,404 You'll be the only mother on the planet 405 00:19:14,529 --> 00:19:16,489 who appreciates the value of a wet diaper. 406 00:19:16,614 --> 00:19:18,158 Hey, could you hand me that? 407 00:19:18,283 --> 00:19:19,563 I'm keeping a visual memory book 408 00:19:19,659 --> 00:19:23,038 of this entire surreal process and this is the best part of the story so far. 409 00:19:23,330 --> 00:19:25,040 - Yeah. Sure. - Thanks. 410 00:19:26,708 --> 00:19:28,376 When'd you take this? 411 00:19:28,752 --> 00:19:30,170 She did the second bladder tap. 412 00:19:31,421 --> 00:19:32,421 You should keep it. 413 00:19:32,589 --> 00:19:35,216 Oh, I see her all day at work. I don't need it. 414 00:19:36,509 --> 00:19:38,595 Maybe you want to see her after work. 415 00:19:39,721 --> 00:19:41,222 I'm right, right? 416 00:19:42,974 --> 00:19:44,976 I saw the way you look at her. 417 00:19:54,152 --> 00:19:55,153 Thanks. 418 00:20:05,789 --> 00:20:07,957 The shunt is in the right position. 419 00:20:08,083 --> 00:20:09,876 Bladder is starting to decompress. 420 00:20:10,335 --> 00:20:11,503 No infection. 421 00:20:13,838 --> 00:20:16,216 Did house say anything else? About us? 422 00:20:16,341 --> 00:20:19,886 I thought you didn't care about his reaction. Trying to make him jealous? 423 00:20:20,303 --> 00:20:21,596 I like my job. 424 00:20:21,721 --> 00:20:23,681 He can't fire you just because we're together. 425 00:20:23,807 --> 00:20:26,684 We're not "together," and house can do whatever he wants. 426 00:20:30,605 --> 00:20:32,732 - How's my baby? - Doing just fine, Emma. 427 00:20:32,857 --> 00:20:34,734 - So are you. - My stomach's killing me. 428 00:20:35,860 --> 00:20:37,737 That's not her stomach. 429 00:20:38,154 --> 00:20:41,366 Can you open your eyes, Emma? I just need to take a look. 430 00:20:44,953 --> 00:20:46,454 What is it? 431 00:20:48,540 --> 00:20:50,667 Emma's jaundiced. Her liver's shutting down. 432 00:20:52,961 --> 00:20:55,755 Figures. Just booked my trip to johnston strait. 433 00:20:55,880 --> 00:20:58,883 I thought you were climbing mount whatever in Argentina. 434 00:20:59,008 --> 00:21:01,845 Apparently I'd have to live with the mocovi Indians for 20 years 435 00:21:01,970 --> 00:21:03,763 before they'd consider me an elder. 436 00:21:03,888 --> 00:21:07,183 Decided to go kayaking with orca instead. No legs required. 437 00:21:07,308 --> 00:21:10,562 Can't leave yet. Liver failure puts her case back into the unsolved pile. 438 00:21:10,687 --> 00:21:13,898 Increased ast, alt and her bilirubin's off the charts. 439 00:21:15,233 --> 00:21:16,860 Even fetuses lie. 440 00:21:19,404 --> 00:21:23,658 We diagnosed a lower urinary tract obstruction because we saw one. 441 00:21:24,784 --> 00:21:26,995 What if that's not the whole story? 442 00:21:27,871 --> 00:21:30,915 What if the little bugger is hiding something? 443 00:21:31,416 --> 00:21:33,918 The real reason for the mirror syndrome. 444 00:21:34,878 --> 00:21:36,337 Have we looked under its bed? 445 00:21:36,463 --> 00:21:37,630 We checked its diary? 446 00:21:37,755 --> 00:21:39,299 If it's not go, could be the heart. 447 00:21:39,424 --> 00:21:40,693 Hypoplastic left heart syndrome. 448 00:21:40,717 --> 00:21:42,361 - There were no structural problems. - The lungs. 449 00:21:42,385 --> 00:21:44,238 We won't be able to get a good look until they develop. 450 00:21:44,262 --> 00:21:46,222 - It'll be weeks... - She's not gonna last weeks. 451 00:21:46,347 --> 00:21:47,640 What do you want to do? 452 00:21:47,765 --> 00:21:50,810 Maternal mirror syndrome has one sure fire cure. 453 00:21:51,603 --> 00:21:52,729 Deliver the fetus. 454 00:21:52,854 --> 00:21:55,023 That's not viable at 21 weeks. You'll kill the baby. 455 00:21:55,148 --> 00:21:57,400 - Fetus. - Semantics make you feel better? 456 00:21:57,525 --> 00:21:58,565 Pretend it's not a person? 457 00:21:58,651 --> 00:22:00,695 Can it play catch? Can it eat? 458 00:22:00,820 --> 00:22:02,822 Can it take pretty pictures? 459 00:22:04,073 --> 00:22:05,909 Who wants to tell her? 460 00:22:13,416 --> 00:22:15,835 The swollen bladder was not the only problem. 461 00:22:17,921 --> 00:22:20,757 We can't leave it inside you. We have to terminate. 462 00:22:21,466 --> 00:22:22,717 Well, can't you deliver him? 463 00:22:22,842 --> 00:22:26,012 Put him on a respiratory machine till you figure out what's wrong? 464 00:22:26,137 --> 00:22:28,389 We can. And it won't matter. 465 00:22:29,933 --> 00:22:33,394 The fetus is still at least two weeks away from being viable. 466 00:22:33,686 --> 00:22:37,357 Well, I'll suffer through this for two more weeks then. 467 00:22:39,901 --> 00:22:43,071 You're on dialysis for your kidneys. Your kidneys can wait. 468 00:22:44,072 --> 00:22:46,574 They don't make dialysis for your liver. 469 00:22:48,326 --> 00:22:50,787 You're not gonna make it two more days. 470 00:22:57,752 --> 00:22:59,963 I'm not gonna let you kill my baby. 471 00:23:00,630 --> 00:23:02,257 It's killing you. 472 00:23:03,716 --> 00:23:05,843 I'm not having an abortion. 473 00:23:06,511 --> 00:23:09,389 It's not a baby. It's a tumor. 474 00:23:14,644 --> 00:23:16,521 I understand dying for a cause. 475 00:23:16,646 --> 00:23:18,898 Sacrificing your life so your child might live. 476 00:23:19,023 --> 00:23:20,692 But that's not the choice here. 477 00:23:23,945 --> 00:23:26,864 Either it dies or you both die. 478 00:23:27,448 --> 00:23:29,659 Or you fix him and we both live. 479 00:23:29,784 --> 00:23:31,035 I can't fix it. 480 00:23:35,832 --> 00:23:37,834 I'm scheduling a dandc. 481 00:23:37,959 --> 00:23:38,959 I won't consent. 482 00:23:41,879 --> 00:23:44,882 So I guess you have two days to figure it out. 483 00:23:55,018 --> 00:23:56,728 Her kidneys are almost irreparable. 484 00:23:56,853 --> 00:23:59,856 She's developed severe dic. You have to force her to terminate. 485 00:23:59,981 --> 00:24:02,900 Did you give corticosteroids to speed up the baby's lung development? 486 00:24:03,026 --> 00:24:06,613 No. I dropped an anvil on its chest to prevent lung development. 487 00:24:07,155 --> 00:24:09,907 I'm trying to extinguish the human race one fetus at a time. 488 00:24:10,033 --> 00:24:13,036 Give the lungs more time to expand so you can see inside them. 489 00:24:13,161 --> 00:24:14,221 See if they're the problem. 490 00:24:14,245 --> 00:24:16,080 My real patient is dying. 491 00:24:16,205 --> 00:24:19,834 Very quickly. Like I wouldn't advise her to buy any green bananas. 492 00:24:19,959 --> 00:24:21,979 The fetus is nothing more than a parasite at this point. 493 00:24:22,003 --> 00:24:23,546 Removing it is an instant cure. 494 00:24:23,671 --> 00:24:25,190 You're not gonna get Emma to see it that way. 495 00:24:25,214 --> 00:24:26,442 She's probably already named the baby, 496 00:24:26,466 --> 00:24:28,509 read him books, had conversations with him. 497 00:24:28,635 --> 00:24:31,179 - See, you get it. She'll listen to you. - No. 498 00:24:31,638 --> 00:24:33,556 If you let this woman refuse to terminate, 499 00:24:33,681 --> 00:24:35,391 you're helping her commit suicide. 500 00:24:35,892 --> 00:24:38,186 As her doctor my recommendation is against suicide. 501 00:24:38,311 --> 00:24:39,812 If the baby had a doctor, 502 00:24:39,937 --> 00:24:42,357 I think she would recommend exhausting all possibilities 503 00:24:42,482 --> 00:24:44,817 - before taking its life. - Then she'd be an idiot. 504 00:24:44,942 --> 00:24:46,778 Too bad she's your boss! 505 00:24:48,655 --> 00:24:50,448 What if our original assumption is wrong? 506 00:24:50,573 --> 00:24:51,866 It isn't. 507 00:24:51,991 --> 00:24:53,719 If we assume she doesn't have mirror syndrome, 508 00:24:53,743 --> 00:24:56,138 then terminating her pregnancy isn't gonna help her liver at all. 509 00:24:56,162 --> 00:24:58,247 We eliminated all other possibilities. 510 00:24:58,373 --> 00:25:00,375 The fetus is hydropic and in distress. 511 00:25:00,875 --> 00:25:03,711 Emma's kidneys and liver are failing. The diagnosis is solid. 512 00:25:03,961 --> 00:25:06,798 Wow! The ass-kisser won't agree with you. 513 00:25:06,923 --> 00:25:08,483 You must be even wronger than I thought. 514 00:25:09,258 --> 00:25:10,258 Fine. 515 00:25:10,927 --> 00:25:12,762 Let's assume she had mirror syndrome 516 00:25:12,887 --> 00:25:15,848 but we fixed it when we fixed the baby's bladder. 517 00:25:15,973 --> 00:25:19,727 That means that her failing liver would be completely unrelated. 518 00:25:19,977 --> 00:25:23,314 If it is, we can fix it and we don't have to terminate. 519 00:25:23,439 --> 00:25:26,401 So her theory is that our patient's liver problems 520 00:25:26,526 --> 00:25:28,319 were just a giant coincidence. 521 00:25:28,820 --> 00:25:30,047 It's not a surprising coincidence. 522 00:25:30,071 --> 00:25:32,240 Pregnant women can develop liver problems. 523 00:25:32,365 --> 00:25:36,119 If this is the case, we can actually do something here. 524 00:25:36,786 --> 00:25:38,996 Don't you guys think that's worth exploring? 525 00:25:39,122 --> 00:25:41,999 Acute fatty liver of pregnancy would have the same symptoms. 526 00:25:42,125 --> 00:25:44,627 - Thank you. - Brownnoser. 527 00:25:45,670 --> 00:25:48,798 - Viral hepatitis, hellp syndrome. - Oh, look. 528 00:25:49,340 --> 00:25:52,844 Sticking up for your girlfriend. Who says chivalry's dead? 529 00:25:54,053 --> 00:25:55,847 He's not joking? 530 00:25:57,014 --> 00:25:58,933 Be patient. She's going through all of us. 531 00:25:59,058 --> 00:26:01,769 She'll get that jungle fever eventually. 532 00:26:01,894 --> 00:26:05,022 - I'm not going through anyone. - You love him? 533 00:26:05,148 --> 00:26:07,900 This can probably wait until after you biopsy Emma's liver, right? 534 00:26:08,025 --> 00:26:09,902 We can't. Her platelets are too low. 535 00:26:10,027 --> 00:26:13,781 Once we Pierce her liver, it'll be next to impossible to stop the bleeding. 536 00:26:13,906 --> 00:26:15,158 Come in from above. 537 00:26:16,617 --> 00:26:18,387 Instead of going straight in through her abdomen, 538 00:26:18,411 --> 00:26:19,871 go in through the veins in her neck. 539 00:26:19,996 --> 00:26:22,832 Transjugular hepatic biopsy. 540 00:26:22,957 --> 00:26:26,753 If the liver starts to bleed, it'll bleed right back into her own veins. 541 00:26:36,971 --> 00:26:39,348 Why don't you start your vacation now? 542 00:26:46,230 --> 00:26:48,858 Threading the guide wire through the right internal jugular vein. 543 00:26:48,983 --> 00:26:51,694 So, the sleep lab... 544 00:26:52,320 --> 00:26:54,322 You and Cameron not sleeping. 545 00:26:54,989 --> 00:26:57,074 How serious is it? 546 00:26:57,200 --> 00:26:58,200 It's nothing. 547 00:26:58,618 --> 00:27:00,369 She's only doing it to make house jealous. 548 00:27:00,703 --> 00:27:02,830 - Then why are you doing it? - You kidding? 549 00:27:02,955 --> 00:27:05,875 You're approaching the inferior vena cava. Slow down. 550 00:27:07,543 --> 00:27:08,920 You better not hurt her. 551 00:27:09,796 --> 00:27:12,256 - She already has a big brother. - She does? 552 00:27:12,381 --> 00:27:14,300 You obviously care very deeply about her. 553 00:27:14,425 --> 00:27:17,011 I'm not protecting her. I'm protecting myself. 554 00:27:17,470 --> 00:27:19,680 A heartbroken, lovesick Cameron 555 00:27:19,806 --> 00:27:22,767 would be even more unbearable than she is now. 556 00:27:23,226 --> 00:27:24,727 You're through the hepatic vein. 557 00:27:24,852 --> 00:27:26,437 I'm firing the needle. 558 00:27:27,522 --> 00:27:30,149 Heart rate and BP spiking. Get that out of her. 559 00:27:30,358 --> 00:27:32,860 Fetus's heart rate just dropped to 50. 560 00:27:34,529 --> 00:27:36,781 - We've got contractions. - Pre-terrn labor. 561 00:27:36,906 --> 00:27:38,950 Start a terbutaline drip! 562 00:27:47,792 --> 00:27:50,711 We were able to control the pre-terrn labor with tocolytics. 563 00:27:50,837 --> 00:27:52,713 The contractions have subsided for now. 564 00:27:52,839 --> 00:27:55,758 And the liver biopsy was negative. This is definitely mirror syndrome. 565 00:27:55,883 --> 00:27:56,944 Her baby's doing this to her. 566 00:27:56,968 --> 00:27:57,968 We're out of options. 567 00:27:58,094 --> 00:28:00,781 Did the biopsy cause the pre-terrn labor or did it happen on its own? 568 00:28:00,805 --> 00:28:01,639 It doesn't make a difference. 569 00:28:01,764 --> 00:28:03,266 Pre-tenn labor can be a new symptom. 570 00:28:03,391 --> 00:28:05,935 New information gives us new theories. Isn't that how it works? 571 00:28:06,060 --> 00:28:07,061 Not in this case. 572 00:28:07,186 --> 00:28:10,606 Her body's trying to do what you refuse to, get the baby out and save itself. 573 00:28:10,940 --> 00:28:13,234 Patient's transaminases are 10 times normal. 574 00:28:13,359 --> 00:28:15,254 Her liver is on the verge of shutting down completely. 575 00:28:15,278 --> 00:28:16,404 A torch test could... 576 00:28:16,529 --> 00:28:18,281 We don't have time for more tests. 577 00:28:18,406 --> 00:28:20,575 We have to terminate or she'll die. 578 00:28:21,951 --> 00:28:23,744 Then let's work faster. 579 00:28:23,953 --> 00:28:26,831 Medicine doesn't work faster just because you hope real hard. 580 00:28:26,956 --> 00:28:29,036 But it could help to see what the baby's been hiding. 581 00:28:29,125 --> 00:28:32,086 The only organ we haven't been able to look inside is its lungs. 582 00:28:32,211 --> 00:28:33,371 The problem must be in there. 583 00:28:33,421 --> 00:28:36,090 We haven't been able to see inside because they're underdeveloped. 584 00:28:36,340 --> 00:28:38,134 We've already got her on corticosteroids, 585 00:28:38,259 --> 00:28:39,444 but it'll take weeks for them... 586 00:28:39,468 --> 00:28:42,430 Then let's drown them in corticosteroids, multiple courses. 587 00:28:42,555 --> 00:28:43,431 Speed up their development. 588 00:28:43,556 --> 00:28:46,476 Giving the baby more than one course will suppress adrenal gland function. 589 00:28:46,559 --> 00:28:49,604 Have long-terrn adverse effects on fetal organ development. 590 00:28:49,729 --> 00:28:51,707 - Worse than death? - Emma's already on tocolytics. 591 00:28:51,731 --> 00:28:53,816 The combination could put her into pulmonary edema. 592 00:28:53,941 --> 00:28:55,067 You'll just kill her faster. 593 00:28:55,192 --> 00:28:57,695 It's the only chance we have to see inside those lungs. 594 00:28:57,820 --> 00:29:01,574 We're just gonna have to make the baby better faster than we make Emma worse. 595 00:29:02,366 --> 00:29:04,577 Come on! This is the kind of thing house does every day. 596 00:29:04,785 --> 00:29:07,413 House thought we should terminate six hours ago. 597 00:29:10,791 --> 00:29:12,043 I'll do it myself. 598 00:29:18,341 --> 00:29:19,341 Anybody gonna stop her? 599 00:29:19,592 --> 00:29:21,010 Stopping the madness is herjob. 600 00:29:21,135 --> 00:29:23,679 Somebody's got to be cuddy's cuddy. 601 00:29:32,688 --> 00:29:33,688 Nurse! 602 00:29:39,612 --> 00:29:42,406 - Pulmonary edema? - Who tattled? It doesn't matter. 603 00:29:42,657 --> 00:29:45,534 There's a reason we don't give multiple courses of corticosteroids. 604 00:29:45,660 --> 00:29:46,994 Gee, thanks. 605 00:29:47,119 --> 00:29:48,412 It's time to terminate. 606 00:29:48,871 --> 00:29:49,890 That's not what she wants. 607 00:29:49,914 --> 00:29:50,915 Look at her. 608 00:29:51,290 --> 00:29:55,670 She didn't want to be an Incubator for a dead baby, but that's what you've done. 609 00:29:55,795 --> 00:29:58,464 Either get me a iaryngoscope or get out! 610 00:30:42,466 --> 00:30:43,968 You were right. 611 00:30:44,093 --> 00:30:45,761 You were all right. 612 00:30:45,886 --> 00:30:48,222 Now the mom's lungs are shutting down. 613 00:30:49,098 --> 00:30:52,268 She's dying faster than the baby's lungs are developing. 614 00:30:52,560 --> 00:30:54,395 I had to stop the corticosteroids. 615 00:30:54,603 --> 00:30:56,230 Have you spoken to the family? 616 00:30:56,355 --> 00:30:58,774 The only family she's got is that baby. 617 00:30:58,899 --> 00:31:00,276 Well, he's biased. 618 00:31:01,485 --> 00:31:03,487 What do you think house would do? 619 00:31:03,612 --> 00:31:05,031 House wants to terminate. 620 00:31:05,781 --> 00:31:07,158 I mean if he didn't. 621 00:31:07,283 --> 00:31:09,744 If he shared my position, what do you think he would do? 622 00:31:10,119 --> 00:31:11,787 He wouldn't share your pain. 623 00:31:12,496 --> 00:31:14,373 He'd be objective. 624 00:31:14,999 --> 00:31:16,125 Right. 625 00:31:17,710 --> 00:31:20,463 - He would prioritize his problems. - He'd terminate. 626 00:31:20,713 --> 00:31:23,650 He wouldn't be afraid of screwing with her lungs if there was a bigger issue. 627 00:31:23,674 --> 00:31:24,675 There is no bigger issue. 628 00:31:24,800 --> 00:31:26,719 - She needs her lungs. - Not right now. 629 00:31:26,844 --> 00:31:28,679 She's already on a respirator. 630 00:31:28,804 --> 00:31:30,084 The machine is breathing for her. 631 00:31:30,139 --> 00:31:31,849 I can do whatever I want to her lungs. 632 00:31:31,974 --> 00:31:34,974 If you're playing catch in the living room and you break your mother's vase, 633 00:31:35,019 --> 00:31:37,414 you may as well keep playing catch. The vase is already broken. 634 00:31:37,438 --> 00:31:41,150 Yeah, except that room can't breathe without that vase. 635 00:31:41,358 --> 00:31:44,028 I'm putting her back on corticosteroids. 636 00:31:50,034 --> 00:31:52,328 - It worked. - What worked? 637 00:31:52,453 --> 00:31:54,121 I got the baby's lungs to expand. 638 00:31:54,246 --> 00:31:56,099 - We should be able to figure... - Cab's on its way. 639 00:31:56,123 --> 00:31:58,084 I have to finish packing. 640 00:31:59,710 --> 00:32:02,046 I have a whole new appreciation for what you do. 641 00:32:02,171 --> 00:32:04,465 How hard it is to believe when everyone around you 642 00:32:04,590 --> 00:32:05,650 is telling you that you're wrong. 643 00:32:05,674 --> 00:32:07,510 Helps to know they're idiots. 644 00:32:07,802 --> 00:32:10,054 Do you think I'm an idiot? 645 00:32:10,179 --> 00:32:12,014 You're not objective. 646 00:32:13,808 --> 00:32:15,684 But you're not an idiot. 647 00:32:18,521 --> 00:32:20,856 These lungs are still two weeks away from being viable. 648 00:32:20,981 --> 00:32:22,441 But big enough for a diagnosis. 649 00:32:22,775 --> 00:32:24,235 These tissue buds are new. 650 00:32:24,360 --> 00:32:26,904 Could indicate bronchopulmonary sequestration 651 00:32:27,029 --> 00:32:28,823 or diaphragmatic eventration. 652 00:32:28,948 --> 00:32:31,784 I was thinking bronchogenic cyst or bronchial atresia. 653 00:32:31,909 --> 00:32:33,619 Could be lung lesions, ccam. 654 00:32:33,953 --> 00:32:35,037 What about... 655 00:32:42,795 --> 00:32:43,921 Move. 656 00:32:46,715 --> 00:32:48,217 Thoughtyou started your vacation. 657 00:32:48,342 --> 00:32:51,345 Somebody had to save our boss's rotundus ass. 658 00:32:51,470 --> 00:32:53,764 Latest mri of the Sloan fetus. 659 00:32:53,889 --> 00:32:55,450 Small buds in the lungs could indicate... 660 00:32:55,474 --> 00:32:57,476 Thanks. Got the multiple choice all worked out. 661 00:32:57,685 --> 00:33:00,938 Question is, how do we pick between a, b, c, d, and none of the above? 662 00:33:01,063 --> 00:33:03,344 Portable mri is in her room. We could get a current image. 663 00:33:03,399 --> 00:33:06,402 The fetal lungs are so tiny the mri won't give us the details we need. 664 00:33:06,527 --> 00:33:10,656 What would we do if this patient were not just a tadpole? 665 00:33:10,781 --> 00:33:11,907 Say it was an actual person. 666 00:33:12,199 --> 00:33:13,576 He is a person. 667 00:33:13,701 --> 00:33:14,952 Thanks for playing along. 668 00:33:15,369 --> 00:33:17,037 Pretend it's a one-pound adult. 669 00:33:17,163 --> 00:33:19,790 Forget the mom, forget the womb, the placenta. 670 00:33:20,207 --> 00:33:22,626 How would we get a better look at what's in the lungs? 671 00:33:22,751 --> 00:33:23,752 Transesophageal echo. 672 00:33:23,878 --> 00:33:25,212 Can't access his esophagus. 673 00:33:25,337 --> 00:33:26,982 High resolution ct could give us a clearer... 674 00:33:27,006 --> 00:33:29,675 Too much radiation for a one-pound person. 675 00:33:29,925 --> 00:33:33,053 You can't just shoot everything down, chase. 676 00:33:33,262 --> 00:33:35,472 You're not me. Collaborate. 677 00:33:36,390 --> 00:33:38,726 A ventilation perfusion scan would be next. 678 00:33:39,143 --> 00:33:42,438 How do we get a fetus to breathe in a radioactive isotope, idiot? 679 00:33:43,189 --> 00:33:45,309 If it were really a person and we had no other options 680 00:33:45,357 --> 00:33:46,901 we'd do an exploratory surgery. 681 00:33:47,026 --> 00:33:49,278 Cut into its chest and have a look around. 682 00:33:49,403 --> 00:33:50,738 Let's do that. 683 00:33:51,780 --> 00:33:54,617 You're the one who insists we treat it like a person. 684 00:33:54,742 --> 00:33:56,577 I'll put it back when I'm done. 685 00:33:59,705 --> 00:34:01,040 Me again. 686 00:34:01,165 --> 00:34:03,834 It's your friendly neighborhood belly squirter. 687 00:34:03,959 --> 00:34:05,961 We're gonna do open fetal surgery. 688 00:34:06,086 --> 00:34:09,006 Open the uterus, cut out the fetus so we can look around. 689 00:34:09,548 --> 00:34:13,344 I know you can't talk so I need you to look petrified if you consent. 690 00:34:13,636 --> 00:34:15,429 The umbilical cord won't be cut. 691 00:34:15,846 --> 00:34:19,225 During surgery, your body will basically serve as the baby's heart/lung machine. 692 00:34:19,725 --> 00:34:21,977 We find what's wrong and we fix it. 693 00:34:22,436 --> 00:34:23,270 If we can. 694 00:34:23,395 --> 00:34:26,565 Don't lower expectations if you want them to do something. 695 00:34:26,941 --> 00:34:29,068 She should know what she's facing. 696 00:34:32,154 --> 00:34:34,281 This is incredibly dangerous. 697 00:34:34,406 --> 00:34:36,325 It risks both your lives. 698 00:34:36,867 --> 00:34:38,427 The only reason why we're suggesting it, 699 00:34:38,452 --> 00:34:41,080 is because there's nothing else we can do. 700 00:35:04,436 --> 00:35:06,647 You all here for the fetal surgery? 701 00:35:06,897 --> 00:35:08,899 'Cause we're way over capacity. 702 00:35:09,024 --> 00:35:10,651 Mind each other's personal space. 703 00:35:11,110 --> 00:35:13,195 There are sharp implements in the room. 704 00:35:13,320 --> 00:35:14,697 Like this one. 705 00:35:22,079 --> 00:35:24,498 Uterus is fully exposed. 706 00:35:33,382 --> 00:35:34,633 And we're in. 707 00:35:34,842 --> 00:35:36,969 Start draining the amniotic fluid. 708 00:35:39,722 --> 00:35:42,141 Have you never sucked beer out of the bottom of a keg? 709 00:35:42,474 --> 00:35:44,393 Where'd you go to college? Give me that. 710 00:36:11,337 --> 00:36:13,297 Affix the pulse ox to the palm. 711 00:36:18,761 --> 00:36:19,762 House? 712 00:36:22,139 --> 00:36:23,140 Sorry. 713 00:36:23,766 --> 00:36:26,018 Just realized I forgot to TiVo alien. 714 00:36:33,275 --> 00:36:36,195 Fetal heart rate good. Stats are stable. 715 00:36:36,945 --> 00:36:39,281 Position him for the incision. 716 00:36:44,745 --> 00:36:47,081 I see three well-defined lesions. 717 00:36:47,206 --> 00:36:50,125 It's definitely ccam. I should be able to resect them. 718 00:36:53,128 --> 00:36:55,547 It's the mom. She's in v-fib. 719 00:36:57,049 --> 00:36:58,592 Charging. 720 00:37:00,302 --> 00:37:02,429 - Clear! - I'm clear. 721 00:37:04,556 --> 00:37:06,785 Looks like asystole. Paddling isn't going to do anything. 722 00:37:06,809 --> 00:37:08,811 It's fine v-fib. I'm going again. Clear! 723 00:37:11,772 --> 00:37:13,816 We're gonna lose them both. Clamp! 724 00:37:15,150 --> 00:37:17,277 The surgery's not doing this to her. The fetus is. 725 00:37:17,403 --> 00:37:18,821 Step away, house. I'm going again. 726 00:37:18,946 --> 00:37:22,491 The only way to save her is to cut away the anchor holding her down. 727 00:37:22,616 --> 00:37:25,119 You keep going, you're gonna get electrocuted. 728 00:37:25,828 --> 00:37:27,830 Clear! 729 00:37:28,664 --> 00:37:31,333 Going again. Clear! 730 00:37:33,794 --> 00:37:36,463 Heart rate's returning to normal. 731 00:37:39,216 --> 00:37:41,385 Continue with the lobectomy. 732 00:37:50,727 --> 00:37:53,981 So my kidneys, liver and lungs are all fine just like that? 733 00:37:55,232 --> 00:37:57,609 - Just like that. - That's amazing. 734 00:37:58,902 --> 00:38:02,406 What's amazing is how blonde your baby's hair is. 735 00:38:05,033 --> 00:38:06,410 My baby? 736 00:38:06,535 --> 00:38:08,495 The thing in your belly that tried to kill you. 737 00:38:08,871 --> 00:38:10,956 You've never called him a baby before. 738 00:38:17,713 --> 00:38:18,714 Any pain? 739 00:38:19,006 --> 00:38:20,507 Nothing I can't deal with. 740 00:38:20,632 --> 00:38:23,051 You can only get out of bed to pee, pooh or shower. 741 00:38:23,177 --> 00:38:26,555 And absolutely no sex. So stop flirting with me. 742 00:38:28,182 --> 00:38:29,308 Sorry. 743 00:38:31,977 --> 00:38:35,272 So this really worked? He'll be normal? 744 00:38:36,690 --> 00:38:39,985 Well, if you call being born twice normal. 745 00:38:45,324 --> 00:38:46,700 Hey, thank you. 746 00:38:49,953 --> 00:38:53,457 Don't thank me. I would've killed the kid. 747 00:39:02,299 --> 00:39:04,843 - Wanna grab a bite? - In a minute. 748 00:39:04,968 --> 00:39:07,054 Emma asked me to bring up her camera. 749 00:39:07,429 --> 00:39:08,972 I'll walk with you. 750 00:39:11,308 --> 00:39:13,560 When'd she take this picture of you? 751 00:39:14,770 --> 00:39:16,688 You look so... 752 00:39:17,064 --> 00:39:18,148 I'm smiling. 753 00:39:19,483 --> 00:39:20,984 I have a nice smile. 754 00:39:21,109 --> 00:39:23,445 No, I've never seen you like this. 755 00:39:23,779 --> 00:39:25,906 She got you to glow. 756 00:39:26,907 --> 00:39:28,742 What were you doing? 757 00:39:29,535 --> 00:39:31,495 What did she say to you? 758 00:39:32,788 --> 00:39:34,373 I always glow. 759 00:39:46,635 --> 00:39:47,761 House. 760 00:39:48,637 --> 00:39:50,305 Need you to take a look at something. 761 00:39:50,430 --> 00:39:52,849 - I'm off the clock. - Just open it. 762 00:39:58,897 --> 00:40:01,149 A first-class ticket to Vancouver island. 763 00:40:01,275 --> 00:40:04,361 Shoot! The wrong envelope. 764 00:40:08,240 --> 00:40:10,659 - I think it's great. - Yeah. 765 00:40:11,410 --> 00:40:13,954 - Who doesn't like Canadians? - It's big. 766 00:40:14,079 --> 00:40:17,291 You're trying to have a life. You're trying to enjoy yourself. 767 00:40:17,416 --> 00:40:19,042 You didn't need to apologize. 768 00:40:19,334 --> 00:40:20,711 I'm not. I told you why I... 769 00:40:20,836 --> 00:40:22,004 Screwed up. 770 00:40:22,129 --> 00:40:23,589 I saved a life. I saved two lives. 771 00:40:24,089 --> 00:40:25,215 You 772 00:40:25,882 --> 00:40:30,053 let your maternal instinct get the best of you and nearly kill two people. 773 00:40:30,178 --> 00:40:32,723 Case like this, you terminate, mom lives 10 times out of 10. 774 00:40:32,848 --> 00:40:33,890 You do what you did 775 00:40:34,016 --> 00:40:36,643 mom and baby both die 9.9 times out of 10. 776 00:40:37,102 --> 00:40:39,771 Sometimes point one is bigger than 9.9. 777 00:40:39,896 --> 00:40:41,815 No, it's smaller. 778 00:40:42,274 --> 00:40:45,193 Exactly 9.8 smaller. Always is. Always will be. 779 00:40:45,902 --> 00:40:48,739 Well, not for Emma. And not for her son. 780 00:40:50,282 --> 00:40:53,243 Now go away and be happy.