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1
00:00:00,444 --> 00:00:02,179
He is not sick.
2
00:00:02,213 --> 00:00:04,781
Dr. Riley is throwing up.
He obviously can't lecture.
3
00:00:04,815 --> 00:00:05,849
You witness the spew
4
00:00:05,882 --> 00:00:07,851
or do you just have
his word for it?
5
00:00:07,884 --> 00:00:10,254
I think I'm coming down
with a little bit of the clap.
6
00:00:10,287 --> 00:00:11,855
May have to go home
for a few days.
7
00:00:11,888 --> 00:00:14,225
Dr. Riley doesn't have
a history of lying to me.
8
00:00:14,258 --> 00:00:15,626
You said this is
the fifth time
9
00:00:15,659 --> 00:00:16,860
he's missed a class
this year.
10
00:00:16,893 --> 00:00:17,728
Either he's dying
or he's lying.
11
00:00:17,761 --> 00:00:20,231
I'll give you two hours
off clinic duty.
12
00:00:20,264 --> 00:00:21,532
Fine. I'll have Cameron
do it.
13
00:00:21,565 --> 00:00:22,866
She loves inspiring
the inspired.
14
00:00:22,899 --> 00:00:24,535
You'll do it.
15
00:00:24,568 --> 00:00:26,403
Why is it always me?
16
00:00:26,437 --> 00:00:27,271
Because the world
hates you.
17
00:00:27,304 --> 00:00:29,173
Or because it's a class
on diagnostics.
18
00:00:29,206 --> 00:00:32,143
Pick whichever reason
feeds your narcissism better.
19
00:00:32,176 --> 00:00:34,111
I'm not doing it.
20
00:00:46,890 --> 00:00:49,160
You're supposed to stop me.
Renegotiate.
21
00:00:49,193 --> 00:00:51,195
And you were supposed
to keep on walking.
22
00:00:51,228 --> 00:00:52,396
Sorry. I guess
we both screwed up.
23
00:00:52,429 --> 00:00:53,864
Go on. Do it again.
24
00:00:53,897 --> 00:00:57,868
I'll do the lecture
for four hours off clinic.
25
00:00:57,901 --> 00:00:58,869
Two.
26
00:00:58,902 --> 00:01:01,438
I know you'd rather spend
a couple of hours
27
00:01:01,472 --> 00:01:04,208
listening to yourself
than listening to patients.
28
00:01:05,776 --> 00:01:07,144
Class starts in 20 minutes.
29
00:01:10,181 --> 00:01:12,183
Dr. House,
there's a patient.
30
00:01:12,216 --> 00:01:13,884
I'm out of here.
Take it up with Cuddy.
31
00:01:13,917 --> 00:01:15,686
(woman)
Greg.
32
00:01:20,957 --> 00:01:22,326
Hi, Stacy.
33
00:01:24,195 --> 00:01:26,497
How you doin'?
34
00:01:26,530 --> 00:01:28,499
How am I doing?
35
00:01:28,532 --> 00:01:32,836
The last five years
have been like...
36
00:01:32,869 --> 00:01:35,306
You ever see
those Girls Gone Wild videos?
37
00:01:35,339 --> 00:01:36,507
Your life's been like that
38
00:01:36,540 --> 00:01:39,176
or your life's been spent
watching them?
39
00:01:43,880 --> 00:01:45,816
I have missed you.
40
00:01:45,849 --> 00:01:49,320
Is that why you're here?
41
00:01:53,890 --> 00:01:55,492
I need your help.
42
00:02:05,969 --> 00:02:07,604
Who am I looking at?
43
00:02:07,638 --> 00:02:09,906
My husband.
44
00:02:12,443 --> 00:02:14,745
Who is suffering
abdominal pain
45
00:02:14,778 --> 00:02:16,880
and fainting spells.
46
00:02:16,913 --> 00:02:20,884
No sign of tumors.
No vasculitis.
47
00:02:20,917 --> 00:02:22,719
Could be indigestion.
48
00:02:23,754 --> 00:02:25,856
Or maybe a kidney stone.
49
00:02:25,889 --> 00:02:28,859
Little one
can pack a lot of wallop.
50
00:02:28,892 --> 00:02:30,827
Did you think I wasn't going
to get married?
51
00:02:30,861 --> 00:02:33,830
[exhales]
Not to someone
so poorly endowed.
52
00:02:33,864 --> 00:02:36,867
This guy's pancreas
is pathetic.
53
00:02:41,605 --> 00:02:42,739
There is no kidney stone.
54
00:02:42,773 --> 00:02:43,907
No indigestion.
55
00:02:43,940 --> 00:02:45,509
Three hospitals.
Five doctors.
56
00:02:45,542 --> 00:02:46,910
Not one of them
found anything.
57
00:02:46,943 --> 00:02:48,512
Maybe there's nothing
to be found.
58
00:02:48,545 --> 00:02:49,980
Right. You suddenly
trust doctors,
59
00:02:50,013 --> 00:02:52,015
love puppies,
and long walks in the rain.
60
00:02:52,048 --> 00:02:52,983
Walks are out.
61
00:02:55,286 --> 00:02:56,653
I was around you
long enough
62
00:02:56,687 --> 00:02:57,888
to know when something's
not right.
63
00:02:57,921 --> 00:02:59,256
Mark's had
personality changes,
64
00:02:59,290 --> 00:03:00,991
he's acting strange,
65
00:03:01,024 --> 00:03:02,459
disconnected.
66
00:03:02,493 --> 00:03:03,960
Interesting.
67
00:03:03,994 --> 00:03:05,962
Means there's either
a neurological component
68
00:03:05,996 --> 00:03:08,399
or he's having an affair.
69
00:03:08,432 --> 00:03:10,867
No affair. No nothing.
He's sick.
70
00:03:10,901 --> 00:03:12,636
I know you're not
too busy.
71
00:03:12,669 --> 00:03:15,472
You avoid work
like the plague.
72
00:03:15,506 --> 00:03:16,940
Unless it actually is
the plague.
73
00:03:16,973 --> 00:03:20,377
I'm asking you a favor.
74
00:03:20,411 --> 00:03:21,912
I'm not too busy.
75
00:03:23,947 --> 00:03:27,017
But I'm not sure
I want him to live.
76
00:03:28,952 --> 00:03:31,288
It's good seeing you again.
77
00:03:37,328 --> 00:03:40,297
[Massive Attack's Teardrop]
78
00:03:40,331 --> 00:03:49,005
*
79
00:04:23,106 --> 00:04:27,043
Three guys walk
into a clinic.
80
00:04:27,077 --> 00:04:29,680
Their legs hurt.
81
00:04:29,713 --> 00:04:30,681
What's wrong with them?
82
00:04:33,016 --> 00:04:35,051
I'm not going to like you,
am I?
83
00:04:35,085 --> 00:04:37,888
Most likely cause of leg pain
is muscle strain.
84
00:04:37,921 --> 00:04:39,856
Apply heat and rest
affected areas.
85
00:04:39,890 --> 00:04:42,659
Statistically, you're right.
Very good.
86
00:04:42,693 --> 00:04:44,661
My experience,
over half of leg pain
87
00:04:44,695 --> 00:04:46,530
is musculoskeletal,
88
00:04:46,563 --> 00:04:48,765
generally
from excessive exercise.
89
00:04:48,799 --> 00:04:52,469
12% is varicose veins
brought on by pregnancy.
90
00:04:52,503 --> 00:04:53,670
And most of the rest
91
00:04:53,704 --> 00:04:56,039
is a result
of vehicular accidents.
92
00:04:56,072 --> 00:04:58,442
I said three people.
That's six legs.
93
00:04:58,475 --> 00:05:00,611
So you've got three
hurt jogging,
94
00:05:00,644 --> 00:05:02,045
two in collisions,
95
00:05:02,078 --> 00:05:03,780
and one of the legs
is pregnant.
96
00:05:05,549 --> 00:05:07,518
What were they doing
when pain presented?
97
00:05:07,551 --> 00:05:08,452
I have no idea.
98
00:05:08,485 --> 00:05:10,521
You didn't ask?
You didn't take a history?
99
00:05:10,554 --> 00:05:11,588
Of course.
100
00:05:11,622 --> 00:05:14,725
But all that told us
was what they said happened.
101
00:05:14,758 --> 00:05:18,695
Person A, farmer,
says he was fixing a fence.
102
00:05:21,632 --> 00:05:24,568
Tightness in the ankle.
Loss of muscle control.
103
00:05:25,969 --> 00:05:29,506
Person B,
volleyball practice.
104
00:05:33,744 --> 00:05:36,813
Coach figured
it was a pulled muscle.
105
00:05:36,847 --> 00:05:38,815
And C,
106
00:05:38,849 --> 00:05:41,618
we got Carmen Electra
golfing.
107
00:05:41,652 --> 00:05:43,720
Yes!
108
00:05:43,754 --> 00:05:45,589
Whoa. You treated
the Baywatch chick?
109
00:05:45,622 --> 00:05:47,558
The Baywatch thespian.
110
00:05:47,591 --> 00:05:48,959
And, no.
111
00:05:48,992 --> 00:05:52,496
Gotta disguise the identity
of each of the patients
112
00:05:52,529 --> 00:05:54,665
and I got tired
of using the middle-aged man.
113
00:05:54,698 --> 00:05:57,501
Carmen seemed like
a pleasant alternative.
114
00:05:57,534 --> 00:05:59,936
Also, she's apparently
quite the golfer.
115
00:05:59,970 --> 00:06:01,872
In less than two hours,
116
00:06:01,905 --> 00:06:05,108
one of these three will be
tossed out of the hospital
117
00:06:05,141 --> 00:06:07,110
because they were faking it
to score narcotics
118
00:06:07,143 --> 00:06:09,212
and one will be very close
119
00:06:09,245 --> 00:06:11,682
to death.
120
00:06:11,715 --> 00:06:13,917
Any guesses
on which is which?
121
00:06:16,687 --> 00:06:19,456
Okay. I say we start
with the farmer.
122
00:06:20,657 --> 00:06:21,692
Did you hike to the fence
123
00:06:21,725 --> 00:06:23,760
and how far?
124
00:06:23,794 --> 00:06:27,898
Yes. It's about a half a mile
from my farm house.
125
00:06:27,931 --> 00:06:29,866
And where is the pain
localized?
126
00:06:29,900 --> 00:06:31,568
It started just above
my ankle
127
00:06:31,602 --> 00:06:33,003
and it's radiating up.
128
00:06:33,036 --> 00:06:35,672
So what should we do first?
129
00:06:35,706 --> 00:06:36,707
Family history?
130
00:06:36,740 --> 00:06:39,610
Indicative of leg pain?
That's a very short list.
131
00:06:39,643 --> 00:06:42,479
Any history of bone cancer,
osteogenesis imperfecta,
132
00:06:42,513 --> 00:06:43,680
or multiple myeloma?
133
00:06:45,015 --> 00:06:46,650
Could be a blood issue.
134
00:06:46,683 --> 00:06:48,552
We should run a CBC
and a D-Dimer.
135
00:06:48,585 --> 00:06:50,020
And get an MRI.
136
00:06:50,053 --> 00:06:51,121
MRI or a PET scan?
137
00:06:51,154 --> 00:06:52,923
If the problem's
vascular, he's--
138
00:06:52,956 --> 00:06:53,924
[buzzer sound]
139
00:06:53,957 --> 00:06:55,125
Sorry. Thanks for playing.
140
00:06:55,158 --> 00:06:57,794
The patient's dead.
You killed him.
141
00:06:58,995 --> 00:07:00,964
We had no time
to run any tests.
142
00:07:00,997 --> 00:07:02,198
There was nothing
we could do.
143
00:07:02,232 --> 00:07:03,834
You had time
to look at the leg.
144
00:07:10,240 --> 00:07:12,576
I thought we were starting
with the farmer's case first.
145
00:07:12,609 --> 00:07:13,744
We are.
146
00:07:13,777 --> 00:07:16,079
But if we're going to look
at a leg...
147
00:07:16,112 --> 00:07:18,048
I need you to take off
your pants.
148
00:07:46,309 --> 00:07:47,911
Puncture.
149
00:07:47,944 --> 00:07:48,912
(female student)
Snake bite.
150
00:07:48,945 --> 00:07:50,313
That would be my guess.
151
00:07:50,346 --> 00:07:52,583
Farmer didn't know he'd been
bitten by a snake?
152
00:07:52,616 --> 00:07:53,950
(House)
That's what he said.
Sudden, shooting pain.
153
00:07:53,984 --> 00:07:55,552
Tall grass.
Never saw a thing.
154
00:07:55,586 --> 00:07:56,987
(male student)
What kind of snake?
155
00:07:57,020 --> 00:07:58,622
(House)
You want me to tell you
156
00:07:58,655 --> 00:07:59,823
what kind of snake it was
157
00:07:59,856 --> 00:08:01,191
from the shape of the hole
in the leg?
158
00:08:01,224 --> 00:08:02,593
How are we supposed to know
159
00:08:02,626 --> 00:08:03,526
what kind of anti-venom
to use
160
00:08:03,560 --> 00:08:05,596
if we don't know
what kind of snake it is?
161
00:08:05,629 --> 00:08:07,598
Oh, there are people
to find those things out.
162
00:08:07,631 --> 00:08:10,000
Shouldn't we wait for the
Humane Society or something?
163
00:08:10,033 --> 00:08:12,569
Guy might only have
a couple of hours.
164
00:08:12,603 --> 00:08:15,305
[dog barks]
165
00:08:19,676 --> 00:08:22,646
And while we wait for
the Humane Society to show up,
166
00:08:22,679 --> 00:08:25,782
what say we check in
on the volleyball player?
167
00:08:25,816 --> 00:08:26,983
[grunts]
168
00:08:27,017 --> 00:08:28,652
You have tendonitis.
169
00:08:28,685 --> 00:08:31,722
(female student)
How old is this person?
170
00:08:31,755 --> 00:08:34,024
I mean, it's not really
a 40-year-old man
171
00:08:34,057 --> 00:08:35,659
on a girl's
volleyball team, right?
172
00:08:35,692 --> 00:08:37,794
It's a leg.
A leg's a leg's a leg.
173
00:08:37,828 --> 00:08:39,362
Well, I was just
worried that--
174
00:08:39,395 --> 00:08:42,365
Would you worry about her more
if she was younger?
175
00:08:42,398 --> 00:08:43,967
(male student)
Obviously, we should care
176
00:08:44,000 --> 00:08:46,202
about all our patients,
no matter what age--
177
00:08:46,236 --> 00:08:47,170
[scoffs]
Yeah, right.
178
00:08:47,203 --> 00:08:49,706
I saw the way
you were looking at Carmen.
179
00:08:49,740 --> 00:08:50,807
She's mine.
180
00:08:50,841 --> 00:08:52,208
Stay away.
181
00:08:52,242 --> 00:08:54,344
Would you operate
on your mother?
182
00:08:54,377 --> 00:08:56,346
Of course not.
183
00:08:56,379 --> 00:08:59,382
I'd be too nervous.
Couldn't be objective.
184
00:08:59,415 --> 00:09:01,618
Then why are you so anxious
to treat every patient
185
00:09:01,652 --> 00:09:03,086
like they're family?
186
00:09:03,119 --> 00:09:06,389
Patient is 16.
187
00:09:06,422 --> 00:09:08,725
Here's what happens
when doctors care too much.
188
00:09:08,759 --> 00:09:12,095
I need to know
everything about you.
189
00:09:14,765 --> 00:09:15,899
I went back
three generations.
190
00:09:15,932 --> 00:09:17,333
No history of cancer,
Parkinson's,
191
00:09:17,367 --> 00:09:19,102
or any other
degenerative condition.
192
00:09:19,135 --> 00:09:20,303
But there's this boy
at school
193
00:09:20,336 --> 00:09:21,705
and he's on the boy's
volleyball team.
194
00:09:21,738 --> 00:09:23,106
And they made out
at a party
195
00:09:23,139 --> 00:09:24,708
and now he won't
call her back.
196
00:09:24,741 --> 00:09:25,909
And this friend of hers
at school
197
00:09:25,942 --> 00:09:27,911
said this boy didn't
like her and never did.
198
00:09:27,944 --> 00:09:30,080
You got all this
from an examination of the knee?
199
00:09:30,113 --> 00:09:31,214
I think she's depressed.
200
00:09:31,247 --> 00:09:32,382
She doesn't have
tendonitis.
201
00:09:32,415 --> 00:09:33,249
She has tendonitis.
202
00:09:33,283 --> 00:09:34,117
She's depressed
about having tendonitis.
203
00:09:34,150 --> 00:09:35,786
She's depressed
for the same reason
204
00:09:35,819 --> 00:09:37,353
that she has tendonitis.
Not the boy?
205
00:09:37,387 --> 00:09:38,254
No, the boy's a jerk.
206
00:09:38,288 --> 00:09:40,023
She knows that.
And yet she's depressed.
207
00:09:40,056 --> 00:09:41,357
I found a nodule.
208
00:09:41,391 --> 00:09:45,028
Huh. Problems
with the thyroid gland
209
00:09:45,061 --> 00:09:46,730
causes depressed
mental state.
210
00:09:46,763 --> 00:09:48,932
Can cause inflammation
of the tendons.
211
00:09:48,965 --> 00:09:50,667
I'll run the tests.
212
00:09:50,701 --> 00:09:51,968
(female student)
So because she took
213
00:09:52,002 --> 00:09:54,270
such an extreme interest,
214
00:09:54,304 --> 00:09:56,873
she found out that the person
had a thyroid condition.
215
00:09:56,907 --> 00:09:59,042
No. Because she took
such an interest,
216
00:09:59,075 --> 00:10:00,844
she discovered
a tiny nodule,
217
00:10:00,877 --> 00:10:03,914
which in reality
signified nothing,
218
00:10:03,947 --> 00:10:05,415
but gave us no choice
219
00:10:05,448 --> 00:10:07,751
but to put a person with
tendonitis through an expensive
220
00:10:07,784 --> 00:10:09,652
and painful test.
221
00:10:16,226 --> 00:10:19,662
Here's how a well-adjusted
doctor handles the case.
222
00:10:23,867 --> 00:10:25,769
[sighs]
223
00:10:25,802 --> 00:10:27,337
Can I put my pants
back on now?
224
00:10:27,370 --> 00:10:29,706
I'd rather you didn't.
225
00:10:29,740 --> 00:10:32,108
(female student)
Which Carmen Electra is this?
226
00:10:32,142 --> 00:10:34,711
The first one.
The golfer.
227
00:10:34,745 --> 00:10:36,379
Then why isn't
she wearing pants?
228
00:10:38,414 --> 00:10:41,752
You have decreased reflexes
in your patellar tendon.
229
00:10:41,785 --> 00:10:42,753
Anyone?
230
00:10:42,786 --> 00:10:44,921
Slipped disk?
Could be.
231
00:10:44,955 --> 00:10:46,790
How bad does it hurt?
232
00:10:46,823 --> 00:10:48,759
It hurts really,
really bad.
233
00:10:48,792 --> 00:10:50,393
Yeah.
234
00:10:50,426 --> 00:10:52,729
It doesn't seem real.
Is she the one faking?
235
00:10:52,763 --> 00:10:54,798
Oh, for God's sake,
236
00:10:54,831 --> 00:10:56,199
she's here to play
into my fantasy,
237
00:10:56,232 --> 00:10:57,367
not 'cause
she's Meryl Streep.
238
00:11:00,403 --> 00:11:02,138
Fine.
239
00:11:02,172 --> 00:11:03,840
What the hell
is wrong with me?!
240
00:11:05,241 --> 00:11:06,877
Do something!
241
00:11:06,910 --> 00:11:09,479
[groans]
242
00:11:09,512 --> 00:11:11,147
Too much pain to be
a slipped disk.
243
00:11:11,181 --> 00:11:13,016
Could be herniating
and impinging the nerve root.
244
00:11:13,049 --> 00:11:15,852
Or it could be referred pain
from his groin.
245
00:11:15,886 --> 00:11:17,487
Sir, are you getting pain
anywhere else?
[screaming]
246
00:11:17,520 --> 00:11:19,322
He's curling.
It's not the back.
247
00:11:19,355 --> 00:11:21,191
Sir, where are you--
248
00:11:21,224 --> 00:11:22,425
Help me!
249
00:11:22,458 --> 00:11:24,094
(male student)
He's not going to tell us
250
00:11:24,127 --> 00:11:25,896
anything if we don't get him
out of pain.
251
00:11:25,929 --> 00:11:27,163
Give him 50 milligrams
of Demerol.
252
00:11:27,197 --> 00:11:28,965
We have no history.
He could be allergic.
253
00:11:28,999 --> 00:11:30,166
What do I do?
254
00:11:30,200 --> 00:11:31,835
We can't diagnose him
while he screams.
255
00:11:31,868 --> 00:11:33,403
Better than killing him
with pain killers.
256
00:11:39,976 --> 00:11:42,378
[sighs]
257
00:11:42,412 --> 00:11:44,948
Apparently,
he's not allergic.
258
00:11:47,317 --> 00:11:49,052
Thank you.
259
00:11:49,085 --> 00:11:52,222
I feel a lot better now.
260
00:11:54,290 --> 00:11:56,092
We screwed up.
261
00:11:56,126 --> 00:11:58,261
No. You did exactly
what his attending did.
262
00:11:58,294 --> 00:12:00,463
(male student)
And that was the proper way
to handle the case?
263
00:12:00,496 --> 00:12:01,564
Yeah.
264
00:12:01,597 --> 00:12:03,800
The guy used him
as a dealer.
265
00:12:03,834 --> 00:12:05,401
You're gonna see a lot
of drug-seeking behavior
266
00:12:05,435 --> 00:12:06,402
in your practice.
267
00:12:06,436 --> 00:12:08,504
There's a reason:
It works.
268
00:12:08,538 --> 00:12:12,542
Meanwhile,
back on the farm...
269
00:12:12,575 --> 00:12:14,177
[rattling and hissing]
270
00:12:17,280 --> 00:12:19,349
Yeah. Timber Rattlesnake.
271
00:12:21,317 --> 00:12:23,586
Four vials
of the CroFab antivenom.
272
00:12:23,619 --> 00:12:24,921
Hey, how you doin'?
273
00:12:24,955 --> 00:12:25,989
All right.
274
00:12:26,022 --> 00:12:28,825
Thank you.
275
00:12:28,859 --> 00:12:34,464
This will start making you
feel better really fast.
276
00:12:34,497 --> 00:12:38,268
[sucking in air]
277
00:12:38,301 --> 00:12:39,903
He's having an allergic
reaction.
278
00:12:39,936 --> 00:12:41,471
Bag.
279
00:12:43,573 --> 00:12:45,408
Paddles and epi.
His heart's fine.
280
00:12:45,441 --> 00:12:46,877
It's not going
to stay that way.
281
00:12:46,910 --> 00:12:48,511
[beeping]
282
00:12:48,544 --> 00:12:50,013
Paddles!
283
00:12:57,553 --> 00:12:59,222
What say we take five?
284
00:12:59,255 --> 00:13:02,425
Get some coffee. Go pee.
285
00:13:10,433 --> 00:13:13,636
You didn't think
she was going to get married?
286
00:13:13,669 --> 00:13:16,139
She asked me
the same question.
287
00:13:19,142 --> 00:13:21,011
And what?
288
00:13:21,044 --> 00:13:22,412
You're not going
to treat him?
289
00:13:24,514 --> 00:13:26,516
There's probably
nothing wrong with him.
290
00:13:26,549 --> 00:13:27,450
Oh, sure.
That makes sense.
291
00:13:27,483 --> 00:13:30,053
She's just using
the old sick husband routine
292
00:13:30,086 --> 00:13:32,588
as an excuse to get back
in touch with you.
293
00:13:32,622 --> 00:13:36,126
You think this is easy
for her?
294
00:13:36,159 --> 00:13:37,928
The only reason
she'd be anywhere near you
295
00:13:37,961 --> 00:13:39,129
is if she was desperate.
296
00:13:39,162 --> 00:13:41,664
So I should help her
because she hates me.
297
00:13:41,697 --> 00:13:42,999
She doesn't hate you.
298
00:13:43,033 --> 00:13:44,467
She loves you.
299
00:13:44,500 --> 00:13:46,970
She just...
300
00:13:47,003 --> 00:13:50,907
can't stand
to be around you.
301
00:13:53,476 --> 00:13:55,378
Uh, Dr. House?
302
00:13:55,411 --> 00:13:58,048
It's been
almost six minutes.
303
00:14:06,022 --> 00:14:07,023
Found him.
304
00:14:09,692 --> 00:14:11,427
(House)
The volleyball player
305
00:14:11,461 --> 00:14:15,231
was responding
to the anti-inflamatories
306
00:14:15,265 --> 00:14:17,067
as you'd expect
in a case of tendonitis.
307
00:14:17,100 --> 00:14:18,401
(male student)
Whoa, whoa, whoa.
308
00:14:18,434 --> 00:14:20,971
What about
the snake bite guy?
309
00:14:21,004 --> 00:14:22,605
I don't really care
about the volleyball player.
310
00:14:22,638 --> 00:14:24,474
What if I told you
the volleyball player
311
00:14:24,507 --> 00:14:26,676
had a sudden,
massive stroke?
312
00:14:26,709 --> 00:14:27,677
Really?
313
00:14:27,710 --> 00:14:29,579
No.
314
00:14:29,612 --> 00:14:31,481
But that would make
you interested, right?
315
00:14:31,514 --> 00:14:33,483
What if her T4
came back low?
316
00:14:33,516 --> 00:14:35,385
It's not quite
as interesting,
317
00:14:35,418 --> 00:14:37,220
but it has the benefit
of being true.
318
00:14:37,253 --> 00:14:39,289
You said the thyroid biopsy
was a wasted test.
319
00:14:39,322 --> 00:14:40,957
No, I didn't.
320
00:14:40,991 --> 00:14:42,625
I said she put a person
with tendonitis
321
00:14:42,658 --> 00:14:44,560
through an expensive
and painful test.
322
00:14:44,594 --> 00:14:46,362
Apparently, the patient
had tendonitis
323
00:14:46,396 --> 00:14:48,331
and a thyroid condition.
324
00:14:48,364 --> 00:14:49,632
We're going to start you
on thyroxine.
325
00:14:49,665 --> 00:14:52,535
It'll make you feel better
and level your moods.
326
00:14:54,470 --> 00:14:55,471
Thank you.
327
00:15:07,417 --> 00:15:08,518
So that's it?
328
00:15:08,551 --> 00:15:10,220
You were right
the first time.
329
00:15:10,253 --> 00:15:12,688
Snake bite guy's
way more interesting.
330
00:15:12,722 --> 00:15:14,657
Gross actually.
331
00:15:17,227 --> 00:15:18,661
(Foreman)
The patient responded
to epinephrine
332
00:15:18,694 --> 00:15:21,364
and the allergic reaction
was arrested.
333
00:15:21,397 --> 00:15:22,999
Unfortunately,
334
00:15:23,033 --> 00:15:24,167
the patient continues
to deteriorate.
335
00:15:24,200 --> 00:15:25,501
(Chase)
Maybe the snake wrangler
336
00:15:25,535 --> 00:15:27,137
was wrong about the type
we caught.
337
00:15:27,170 --> 00:15:28,404
He faxed us
the venom tests.
338
00:15:28,438 --> 00:15:29,572
Confirmed.
It's a Timber Rattlesnake.
339
00:15:32,075 --> 00:15:33,043
No, it's not.
340
00:15:33,076 --> 00:15:34,510
Notice the volume?
341
00:15:34,544 --> 00:15:37,447
I skimmed over that
and the gender and the coloring,
342
00:15:37,480 --> 00:15:39,315
jumped right to the name
of the snake.
343
00:15:39,349 --> 00:15:41,017
200 milligrams.
344
00:15:41,051 --> 00:15:42,718
Our guy got bit
345
00:15:42,752 --> 00:15:43,786
less than four hours ago.
346
00:15:43,819 --> 00:15:44,754
There's no way a snake
347
00:15:44,787 --> 00:15:47,657
regenerates that much venom
that quickly.
348
00:15:47,690 --> 00:15:50,393
We're supposed to know how fast
snakes make their venom?
349
00:15:50,426 --> 00:15:52,395
No, unless you got
a patient bit by one.
350
00:15:52,428 --> 00:15:53,529
Then it might be helpful.
351
00:15:53,563 --> 00:15:56,132
So what do we do now?
352
00:15:56,166 --> 00:15:58,101
He must've been bitten
by a different snake.
353
00:15:58,134 --> 00:15:59,369
We go back and find it.
354
00:15:59,402 --> 00:16:00,436
(House)
Or you go online
355
00:16:00,470 --> 00:16:02,438
and you find there's only
three poisonous snakes
356
00:16:02,472 --> 00:16:03,439
common in New Jersey:
357
00:16:03,473 --> 00:16:06,109
the Copperhead,
Timber Rattler, and the Coral.
358
00:16:06,142 --> 00:16:07,443
Copperhead
and Timber Rattler
359
00:16:07,477 --> 00:16:10,213
both respond to the antivenoms
we gave the guy.
360
00:16:10,246 --> 00:16:12,415
So we give him the antivenom
for the other one?
361
00:16:12,448 --> 00:16:14,517
Is that a question?
362
00:16:14,550 --> 00:16:15,751
We can't blindly
give him another antivenom.
363
00:16:15,785 --> 00:16:18,454
Especially after the first one
almost killed him.
364
00:16:18,488 --> 00:16:20,123
You said only three types
of poisonous snakes
365
00:16:20,156 --> 00:16:21,291
commonly found
in New Jersey.
366
00:16:21,324 --> 00:16:23,093
But what if this
is an uncommon one?
367
00:16:23,126 --> 00:16:25,395
Very good.
368
00:16:25,428 --> 00:16:26,829
We gotta find
the right snake.
369
00:16:26,862 --> 00:16:28,831
No need. Odds are,
by the time you get back,
370
00:16:28,864 --> 00:16:31,601
the autopsy results will tell
you what kind of snake it was.
371
00:16:31,634 --> 00:16:32,768
But you said--
372
00:16:32,802 --> 00:16:34,470
So we do give him
the antivenom
373
00:16:34,504 --> 00:16:35,605
for the other one.
374
00:16:35,638 --> 00:16:37,640
Again, was that
a question?
375
00:16:37,673 --> 00:16:39,575
I asked what you would do.
376
00:16:39,609 --> 00:16:42,445
Seems unfair for you to ask me
what you would do.
377
00:16:42,478 --> 00:16:45,415
Who gives the guy
the other antivenom?
378
00:16:46,749 --> 00:16:49,119
And who goes looking
for the snake?
379
00:16:51,321 --> 00:16:52,488
I assume that one choice
kills him,
380
00:16:52,522 --> 00:16:53,756
the other one saves him.
381
00:16:53,789 --> 00:16:55,625
That's usually the way
it works
382
00:16:55,658 --> 00:16:57,193
at the leg
turning black stage.
383
00:16:57,227 --> 00:16:58,661
(female student)
So half of us killed him
384
00:16:58,694 --> 00:17:01,164
and half of us
saved his life.
385
00:17:01,197 --> 00:17:03,566
Yeah.
386
00:17:03,599 --> 00:17:04,867
We can't be blamed--
387
00:17:04,900 --> 00:17:06,336
I'm sure this goes against
388
00:17:06,369 --> 00:17:07,337
everything
you've been taught,
389
00:17:07,370 --> 00:17:10,106
but right and wrong
do exist.
390
00:17:10,140 --> 00:17:12,242
Just 'cause you don't know
what the right answer is--
391
00:17:12,275 --> 00:17:13,709
maybe there's even no way
you could know
392
00:17:13,743 --> 00:17:15,178
what the right answer is--
393
00:17:15,211 --> 00:17:16,779
doesn't make your answer
right or even okay.
394
00:17:16,812 --> 00:17:19,182
It's much simpler
than that.
395
00:17:19,215 --> 00:17:21,817
It's just plain wrong.
396
00:17:24,487 --> 00:17:25,788
We gave the guy
the antivenom.
397
00:17:25,821 --> 00:17:28,124
What if I'm allergic again?
398
00:17:28,158 --> 00:17:30,260
That's why these people
are here.
399
00:17:30,293 --> 00:17:31,894
If you have a reaction,
400
00:17:31,927 --> 00:17:33,596
we're ready to do
whatever's necessary
401
00:17:33,629 --> 00:17:35,131
to ensure your airways
stay open
402
00:17:35,165 --> 00:17:36,399
and your heart
keeps beating.
403
00:17:36,432 --> 00:17:38,668
My wife's on her way in.
Can't this wait?
404
00:17:38,701 --> 00:17:41,637
I'm sorry. It can't.
405
00:18:11,867 --> 00:18:14,504
It hurts again.
406
00:18:14,537 --> 00:18:16,306
(female student)
He came back?
407
00:18:16,339 --> 00:18:19,442
On average, drug addicts
are stupid.
408
00:18:21,377 --> 00:18:22,812
I'd call the cops.
409
00:18:22,845 --> 00:18:24,514
Good for you.
410
00:18:24,547 --> 00:18:26,682
A lot of doctors wouldn't
risk their careers on a hunch.
411
00:18:26,716 --> 00:18:29,385
It's not a hunch.
I mean, I know he wants drugs.
412
00:18:29,419 --> 00:18:31,221
Even drug addicts
get sick.
413
00:18:31,254 --> 00:18:34,590
Actually, for some reason,
they tend to get sick more often
414
00:18:34,624 --> 00:18:37,627
than non-drug addicts.
415
00:18:37,660 --> 00:18:38,961
Luckily,
416
00:18:38,994 --> 00:18:41,531
you don't have to play
your hunch.
417
00:18:41,564 --> 00:18:43,199
There's a faster way.
418
00:18:43,233 --> 00:18:44,367
Actually,
there are several.
419
00:18:44,400 --> 00:18:46,636
My preference
is urine testing.
420
00:18:46,669 --> 00:18:48,671
But you already know
he has drugs in his system.
421
00:18:48,704 --> 00:18:50,540
That's not what
I'm testing for.
422
00:18:50,573 --> 00:18:52,508
We're going to put
this hard rubber tube
423
00:18:52,542 --> 00:18:54,210
up your urethra
and into your bladder.
424
00:18:54,244 --> 00:18:55,978
It may be a little
uncomfortable.
425
00:18:56,011 --> 00:18:57,513
Shouldn't I be getting
426
00:18:57,547 --> 00:18:59,515
some sort of anesthetic?
427
00:18:59,549 --> 00:19:01,851
Ah!
We're concerned about
allergic reactions today.
428
00:19:01,884 --> 00:19:05,221
Ah-ah!
429
00:19:09,825 --> 00:19:12,962
If the guy can handle a rod
in his penis for half an hour,
430
00:19:12,995 --> 00:19:14,630
he's really sick.
431
00:19:14,664 --> 00:19:17,333
Or he's really jonesing.
432
00:19:17,367 --> 00:19:19,235
Well, there's easier ways
to get ahold of drugs.
433
00:19:19,269 --> 00:19:21,604
Other hospitals
for example.
434
00:19:22,838 --> 00:19:24,540
The volleyball player
435
00:19:24,574 --> 00:19:28,411
is not responding
to treatment.
436
00:19:28,444 --> 00:19:31,714
At least we think
it's not working
437
00:19:31,747 --> 00:19:33,649
on account of the fact
that she's getting worse!
438
00:19:33,683 --> 00:19:35,485
Can you still hear me?
439
00:19:35,518 --> 00:19:37,487
No.
A little.
440
00:19:37,520 --> 00:19:38,954
Not really.
441
00:19:40,656 --> 00:19:43,726
Well, if you can't hear me,
how do you know what I asked?
442
00:19:43,759 --> 00:19:45,495
Ow!
443
00:19:45,528 --> 00:19:46,562
I'm sorry.
What did I do?
444
00:19:46,596 --> 00:19:47,930
I don't know.
It really hurts.
445
00:19:47,963 --> 00:19:50,333
I promise to be
very careful.
446
00:19:50,366 --> 00:19:51,467
Ow!
Susan--
447
00:19:51,501 --> 00:19:53,436
Not her real name!
448
00:19:53,469 --> 00:19:55,938
Susan,
I barely touched you.
449
00:19:55,971 --> 00:19:57,873
Ow! It hurts so much!
450
00:19:57,907 --> 00:19:59,675
I'm sorry.
I have to get this blood.
451
00:19:59,709 --> 00:20:01,377
Just hold on.
452
00:20:01,411 --> 00:20:03,012
Hypersensitivity
to touch.
453
00:20:03,045 --> 00:20:04,714
(Chase)
Her calcium up?
454
00:20:04,747 --> 00:20:05,848
Lab over 16.
455
00:20:05,881 --> 00:20:07,417
(House)
Question is why.
456
00:20:07,450 --> 00:20:08,651
Likely suspects.
457
00:20:08,684 --> 00:20:09,652
Parathyroid adenoma.
458
00:20:09,685 --> 00:20:10,653
Kidney problems.
459
00:20:10,686 --> 00:20:11,487
Vit D intoxication.
460
00:20:11,521 --> 00:20:13,356
Hyperthyroid?
Caused by our treatment.
461
00:20:13,389 --> 00:20:14,957
Whoa, whoa, whoa.
Can you please slow down?
462
00:20:19,895 --> 00:20:22,632
The adenoma is most likely.
463
00:20:22,665 --> 00:20:26,302
Check her PTH,
phosphorous,
464
00:20:26,336 --> 00:20:28,804
[very slowly]
and ionized calcium.
465
00:20:28,838 --> 00:20:31,307
And do a technetium
sestamibi.
466
00:20:31,341 --> 00:20:34,577
Okay, that's enough
about the volleyball player.
467
00:20:34,610 --> 00:20:35,978
What's up with the farmer?
468
00:20:37,112 --> 00:20:38,381
What farmer?
469
00:20:38,414 --> 00:20:40,350
Snake bite guy.
470
00:20:40,383 --> 00:20:41,684
Oh, right.
471
00:20:41,717 --> 00:20:43,553
You guys don't know
about it.
472
00:20:43,586 --> 00:20:44,754
He doesn't get bitten
until three months
473
00:20:44,787 --> 00:20:46,889
after we treat
the volleyball player.
474
00:20:46,922 --> 00:20:48,391
Luckily, it's been
well established
475
00:20:48,424 --> 00:20:50,460
that time is not
a fixed construct.
476
00:20:50,493 --> 00:20:52,027
His condition's
not improving.
477
00:20:52,061 --> 00:20:53,696
Double the dosage.
478
00:20:53,729 --> 00:20:55,097
Already did.
479
00:20:55,130 --> 00:20:56,098
There's another antivenom.
480
00:20:56,131 --> 00:20:57,367
It's not as effective, but--
481
00:20:57,400 --> 00:20:58,300
Already tried it.
482
00:20:58,334 --> 00:20:59,935
The first stuff.
Stuff he was allergic to.
483
00:20:59,969 --> 00:21:01,537
Gave it to him
with high-dose steroids.
484
00:21:01,571 --> 00:21:03,072
Nothing's working.
485
00:21:03,105 --> 00:21:04,640
What does it all mean?
486
00:21:04,674 --> 00:21:05,541
Wrong snake?
487
00:21:05,575 --> 00:21:08,478
We tried every other
antivenom we had.
488
00:21:08,511 --> 00:21:10,012
We're too late?
Yup.
489
00:21:10,045 --> 00:21:12,748
He's dying.
His wife's here.
490
00:21:12,782 --> 00:21:15,084
Finally found
a baby-sitter.
491
00:21:15,117 --> 00:21:16,519
Who wants to let him know?
492
00:21:16,552 --> 00:21:19,689
Actually, I'm kidding.
493
00:21:19,722 --> 00:21:20,690
He's not dying?
494
00:21:20,723 --> 00:21:22,492
Oh, yeah, he's dying.
495
00:21:22,525 --> 00:21:25,395
But there's no wife and kid,
which is great.
496
00:21:25,428 --> 00:21:28,498
Makes the breaking
the news thing way easier.
497
00:21:30,165 --> 00:21:32,602
Oh, yeah.
One more piece of news.
498
00:21:37,707 --> 00:21:39,675
The drug addict
499
00:21:39,709 --> 00:21:41,611
is peeing blood.
500
00:21:46,616 --> 00:21:48,451
How do they teach you
how to tell someone
501
00:21:48,484 --> 00:21:51,654
that they're dying?
502
00:21:51,687 --> 00:21:53,723
It's kind of like
503
00:21:53,756 --> 00:21:55,558
teaching architects
how to explain
504
00:21:55,591 --> 00:21:58,561
why their building
fell down.
505
00:21:58,594 --> 00:22:00,730
Do you role play and stuff?
506
00:22:00,763 --> 00:22:02,732
Yeah. One of us
gives the bad news
507
00:22:02,765 --> 00:22:05,468
and one of us
gets the bad news.
508
00:22:05,501 --> 00:22:08,671
What do you have to do to get
an "A" in You're Dying 101?
509
00:22:08,704 --> 00:22:12,608
They grade you on gentleness
and supportiveness?
510
00:22:12,642 --> 00:22:17,413
Is there a scale
for measuring compassion?
511
00:22:17,447 --> 00:22:20,483
This buddy of mine...
512
00:22:20,516 --> 00:22:22,618
I gotta give him ten bucks
513
00:22:22,652 --> 00:22:23,953
every time
someone says thank you.
514
00:22:23,986 --> 00:22:26,121
Imagine that.
515
00:22:26,155 --> 00:22:27,857
This guy's so good,
516
00:22:27,890 --> 00:22:31,527
people thank him for telling
them that they're dying.
517
00:22:36,031 --> 00:22:37,433
Needs brown.
518
00:22:37,467 --> 00:22:38,568
[tosses crayon]
519
00:22:38,601 --> 00:22:41,036
I don't get thanked
that often.
520
00:22:41,070 --> 00:22:43,005
You're dying.
521
00:22:44,907 --> 00:22:47,109
In a few hours.
522
00:22:49,044 --> 00:22:52,448
There's nothing we can do
except deal with the pain.
523
00:22:52,482 --> 00:22:54,650
Well, I need to go home.
524
00:22:54,684 --> 00:22:56,686
You're not going home.
525
00:22:58,954 --> 00:23:01,090
My dog.
526
00:23:01,123 --> 00:23:03,526
What will happen to my dog?
527
00:23:08,864 --> 00:23:11,667
Her neck looks clean.
No adenoma.
528
00:23:11,701 --> 00:23:13,135
(male student)
Wait, wait, wait.
529
00:23:13,168 --> 00:23:16,672
The guy's dying, and all
he cares about is his dog?
530
00:23:17,940 --> 00:23:21,777
Any of you guys go the dog route
in your improv sessions?
531
00:23:23,613 --> 00:23:25,581
It's a basic truth
of the human condition
532
00:23:25,615 --> 00:23:29,184
that everybody lies.
533
00:23:29,218 --> 00:23:31,554
The only variable
is about what.
534
00:23:31,587 --> 00:23:34,089
The great thing about
telling someone they're dying
535
00:23:34,123 --> 00:23:38,494
is that it tends to focus
their priorities--
536
00:23:38,528 --> 00:23:41,664
find out what matters
to them,
537
00:23:41,697 --> 00:23:44,166
what they're willing
to die for.
538
00:23:46,569 --> 00:23:48,604
What they're willing
to lie for.
539
00:23:48,638 --> 00:23:49,939
You must have
a neighbor who can--
540
00:23:49,972 --> 00:23:52,241
The neighbors
don't like him.
541
00:23:52,274 --> 00:23:54,677
So the Humane Society
will take him in,
542
00:23:54,710 --> 00:23:57,613
find him a home.
No, they won't.
543
00:24:00,916 --> 00:24:03,052
Maybe--maybe my aunt--
544
00:24:03,085 --> 00:24:05,521
It wasn't a snake bite,
was it?
545
00:24:07,757 --> 00:24:09,692
I said I don't remember
being bit.
546
00:24:09,725 --> 00:24:12,562
Sure, you do.
Just not by a snake.
547
00:24:12,595 --> 00:24:14,263
I assume that Cujo
548
00:24:14,296 --> 00:24:16,866
bit one of your neighbors
awhile back.
549
00:24:16,899 --> 00:24:20,169
You tell me that he bit you,
and I got to report it.
550
00:24:20,202 --> 00:24:22,271
Cujo's got a record,
he gets the chair.
551
00:24:26,609 --> 00:24:29,579
Good news is,
you might just live.
552
00:24:29,612 --> 00:24:31,681
Bad news is,
your dog's going to die.
553
00:24:31,714 --> 00:24:33,248
[dog barking]
554
00:24:33,282 --> 00:24:35,150
Guy risked his life
to save this thing?
555
00:24:37,720 --> 00:24:40,756
I'll hold him.
You swab the mouth.
556
00:24:40,790 --> 00:24:42,658
I think I've got
a better grip here.
557
00:24:42,692 --> 00:24:43,626
You go for the mouth.
558
00:24:43,659 --> 00:24:45,160
[dog barking]
559
00:24:45,194 --> 00:24:46,629
All right, I'm odds.
560
00:24:46,662 --> 00:24:48,063
You serious?
Come on.
561
00:24:48,097 --> 00:24:49,565
One, two, three.
562
00:24:49,599 --> 00:24:51,634
Damn.
563
00:24:51,667 --> 00:24:53,769
I don't care if he's scratching
your nads off,
564
00:24:53,803 --> 00:24:55,537
you don't let go.
Just do it.
565
00:24:59,775 --> 00:25:01,276
I say we let the guy die.
566
00:25:01,310 --> 00:25:03,145
I got his head.
Just do it.
567
00:25:03,178 --> 00:25:04,614
Got it.
568
00:25:09,151 --> 00:25:11,721
What would you call that?
569
00:25:11,754 --> 00:25:15,224
It's tea colored, right?
570
00:25:15,257 --> 00:25:18,594
The guy we thought
was just after the drugs,
571
00:25:18,628 --> 00:25:21,263
what's the differential
diagnosis for urine
572
00:25:21,296 --> 00:25:23,599
that's tea colored?
573
00:25:23,633 --> 00:25:25,367
(female student)
Kidney stone.
574
00:25:25,400 --> 00:25:28,738
Kidney stones
would cause what?
575
00:25:28,771 --> 00:25:30,706
Blood in urine.
576
00:25:30,740 --> 00:25:31,641
What color is your pee?
577
00:25:31,674 --> 00:25:32,642
Yellow.
578
00:25:32,675 --> 00:25:33,709
What color is your blood?
579
00:25:33,743 --> 00:25:34,710
Red.
580
00:25:34,744 --> 00:25:35,845
What colors did I use?
581
00:25:35,878 --> 00:25:38,914
Red, yellow, and brown.
582
00:25:38,948 --> 00:25:40,149
And brown.
What causes brown?
583
00:25:40,182 --> 00:25:41,951
Waste.
584
00:25:41,984 --> 00:25:43,352
Which means the kidney's
are shutting down. Why?
585
00:25:43,385 --> 00:25:44,954
Trauma.
586
00:25:44,987 --> 00:25:46,255
None that his history
would indicate.
587
00:25:46,288 --> 00:25:47,657
Could be damage done
by the self-injection
588
00:25:47,690 --> 00:25:49,024
of the Demerol.
Treatment?
589
00:25:49,058 --> 00:25:50,392
Heat and rest.
590
00:25:50,425 --> 00:25:51,326
Other possible causes.
591
00:25:51,360 --> 00:25:52,828
Infection.
592
00:25:52,862 --> 00:25:55,097
Start him on antibiotics.
What else?
593
00:25:55,130 --> 00:25:56,832
Come on! Come on!
594
00:25:56,866 --> 00:25:58,400
I-I don't know.
595
00:25:58,433 --> 00:26:02,071
You're useless.
But at least you know it.
596
00:26:02,104 --> 00:26:03,238
Blood tests show
597
00:26:03,272 --> 00:26:04,640
elevated creatine kinase.
598
00:26:04,674 --> 00:26:05,708
What does that tell you?
599
00:26:05,741 --> 00:26:07,042
The trauma diagnosis
is right.
600
00:26:07,076 --> 00:26:09,679
He takes it easy for a few days,
he'll be fine.
601
00:26:09,712 --> 00:26:11,146
You sure?
The elevated CK
rules out infection--
602
00:26:11,180 --> 00:26:12,682
You know what's worse
than useless?
603
00:26:12,715 --> 00:26:14,684
Useless and oblivious.
604
00:26:16,185 --> 00:26:17,887
What are they missing?
605
00:26:17,920 --> 00:26:19,889
You know,
it's kind of hard to think
606
00:26:19,922 --> 00:26:21,323
when you're
in our face like--
607
00:26:21,356 --> 00:26:22,992
Yeah? You think it's going
to be easier
608
00:26:23,025 --> 00:26:25,661
when you got a real patient
really dying?
609
00:26:25,695 --> 00:26:27,129
What are you missing?
610
00:26:27,162 --> 00:26:29,031
(Cameron)
Muscle death.
611
00:26:32,735 --> 00:26:34,670
Not your case.
612
00:26:34,704 --> 00:26:37,907
Nothing wrong with a consult.
613
00:26:37,940 --> 00:26:40,375
Dying muscle leaks
myoglobin.
614
00:26:40,409 --> 00:26:42,745
It's toxic to the kidneys.
615
00:26:42,778 --> 00:26:45,380
Brilliant.
616
00:26:45,414 --> 00:26:48,951
MRI the leg.
See what's killing it.
617
00:26:56,091 --> 00:26:57,693
Why is the girl
getting the MRI?
618
00:26:57,727 --> 00:26:58,493
Because the neck scan
revealed nothing
619
00:26:58,527 --> 00:27:00,029
and her doctor's
way more obsessive
620
00:27:00,062 --> 00:27:01,430
than she thinks she is.
621
00:27:01,463 --> 00:27:03,899
(male student)
But you said the guy
needed the MRI.
622
00:27:03,933 --> 00:27:06,035
Because Dr. Cameron back there
said muscle death.
623
00:27:06,068 --> 00:27:07,436
Not one of you said it.
624
00:27:07,469 --> 00:27:09,972
Not one of this guy's
doctors said it.
625
00:27:10,005 --> 00:27:11,741
They gave him bed rest
and antibiotics
626
00:27:11,774 --> 00:27:14,343
just like you guys
would have.
627
00:27:14,376 --> 00:27:15,845
Did he get better?
628
00:27:15,878 --> 00:27:17,279
No.
629
00:27:17,312 --> 00:27:18,347
How long?
630
00:27:18,380 --> 00:27:19,915
Three days.
631
00:27:19,949 --> 00:27:21,751
It is in the nature
of medicine
632
00:27:21,784 --> 00:27:24,419
that you are going
to screw up.
633
00:27:24,453 --> 00:27:26,388
You are going
to kill someone.
634
00:27:26,421 --> 00:27:29,291
If you can't handle
that reality,
635
00:27:29,324 --> 00:27:30,793
pick another profession
636
00:27:30,826 --> 00:27:34,463
or finish medical school
and teach.
637
00:27:34,496 --> 00:27:35,264
Three days
before they thought
638
00:27:35,297 --> 00:27:37,499
it might have been
muscle death.
639
00:27:37,532 --> 00:27:39,501
No, three days
before the patient suggested
640
00:27:39,534 --> 00:27:42,071
it might have been
muscle death.
641
00:27:44,940 --> 00:27:48,443
The MRI revealed
an osteosarcoma.
642
00:27:48,477 --> 00:27:51,480
A cancerous tumor
in your femur.
643
00:27:51,513 --> 00:27:53,949
It needs to be removed
surgically.
644
00:27:53,983 --> 00:27:55,184
With chemo,
645
00:27:55,217 --> 00:27:58,020
she has an excellent chance
of survival.
646
00:27:58,053 --> 00:27:59,488
But I have to warn you,
647
00:27:59,521 --> 00:28:01,256
depending on how large
the tumor is
648
00:28:01,290 --> 00:28:05,327
and how ingrained it is...
649
00:28:05,360 --> 00:28:09,364
the surgeon may need
to amputate your leg.
650
00:28:09,398 --> 00:28:10,766
I'm sorry.
651
00:28:13,068 --> 00:28:14,036
It's okay.
652
00:28:14,069 --> 00:28:20,542
[crying]
653
00:28:20,575 --> 00:28:22,544
Dogs' mouths
are pretty filthy.
654
00:28:22,577 --> 00:28:24,179
But they have natural
antibodies to fight off
655
00:28:24,213 --> 00:28:25,180
most of the stuff.
656
00:28:25,214 --> 00:28:26,215
We don't.
657
00:28:26,248 --> 00:28:28,550
That's why dog bites
can be so nasty.
658
00:28:28,583 --> 00:28:30,385
The lab tests
of your dog's saliva
659
00:28:30,419 --> 00:28:32,187
revealed a type
of strep bacteria.
660
00:28:32,221 --> 00:28:34,857
It's commonly known
as the flesh-eating disease.
661
00:28:34,890 --> 00:28:37,192
We need to operate
immediately
662
00:28:37,226 --> 00:28:39,494
to remove
the damaged tissue.
663
00:28:39,528 --> 00:28:42,397
We may need
to remove the leg.
664
00:28:50,439 --> 00:28:53,042
The MRI revealed
a problem.
No kidding.
665
00:28:53,075 --> 00:28:54,443
I'm sorry none
of your doctors
666
00:28:54,476 --> 00:28:55,444
found it earlier.
667
00:28:55,477 --> 00:28:57,512
I am personally going
to oversee your treatment
668
00:28:57,546 --> 00:28:59,381
from now on.
You're going
to cut me open,
669
00:28:59,414 --> 00:29:00,950
aren't you?
670
00:29:03,418 --> 00:29:05,821
We may need to remove
the leg.
671
00:29:15,630 --> 00:29:18,600
The MRI showed that the leg pain
wasn't caused
672
00:29:18,633 --> 00:29:21,904
by the self-injection.
673
00:29:21,937 --> 00:29:25,875
It wasn't caused
by an infection.
674
00:29:25,908 --> 00:29:29,544
It was an aneurysm
that clotted
675
00:29:29,578 --> 00:29:32,381
leading to an infarction.
676
00:29:32,414 --> 00:29:35,417
Oh, God, you were right.
It's House.
677
00:29:35,450 --> 00:29:39,454
(Cuddy)
We have to do the surgery.
678
00:29:39,488 --> 00:29:42,157
The necrotic tissue
has to be removed.
679
00:29:42,191 --> 00:29:43,492
If there's too much--
680
00:29:43,525 --> 00:29:45,194
I don't care
what you find.
681
00:29:45,227 --> 00:29:47,329
It may become necessary
in order to save your life.
682
00:29:47,362 --> 00:29:49,631
I like my leg.
683
00:29:49,664 --> 00:29:53,002
I've had it for as long
as I can remember.
684
00:29:53,035 --> 00:29:55,204
I love your leg
as much as you do.
685
00:29:55,237 --> 00:29:57,439
They're not cutting it off.
686
00:30:00,976 --> 00:30:03,578
Patient made
the right choice.
687
00:30:03,612 --> 00:30:06,415
Tell a surgeon it's okay
to cut a leg off,
688
00:30:06,448 --> 00:30:09,618
he's going to spend the night
polishing his good hacksaw.
689
00:30:09,651 --> 00:30:10,585
Right.
690
00:30:10,619 --> 00:30:12,988
Surgeons could care less
about saving limbs.
691
00:30:13,022 --> 00:30:14,456
Of course they care
about their patients.
692
00:30:14,489 --> 00:30:17,326
They just care
about themselves more,
693
00:30:17,359 --> 00:30:19,494
which is not
an unreasonable position.
694
00:30:19,528 --> 00:30:22,164
Trying to maximize
the tissue you save
695
00:30:22,197 --> 00:30:25,534
also maximizes the chances
of something going wrong,
696
00:30:25,567 --> 00:30:27,402
which means you gotta be
extra careful,
697
00:30:27,436 --> 00:30:29,338
which is such
a pain in the ass.
698
00:30:31,340 --> 00:30:33,575
Amazing advances
have been made.
699
00:30:33,608 --> 00:30:35,077
Kids with prosthetic legs
700
00:30:35,110 --> 00:30:37,312
are running the 100 meter dash
in 12 seconds.
701
00:30:37,346 --> 00:30:39,881
Yeah.
They're just not as pretty.
702
00:30:41,083 --> 00:30:43,953
Do a bypass.
Restore the circulation.
703
00:30:43,986 --> 00:30:45,420
Amputation is safer.
704
00:30:45,454 --> 00:30:46,421
For you or me?
705
00:30:46,455 --> 00:30:47,923
The blockage of blood flow--
706
00:30:47,957 --> 00:30:50,292
Four day blockage.
707
00:30:50,325 --> 00:30:52,427
Yes. It caused
muscle cell death.
708
00:30:52,461 --> 00:30:53,595
When those cells die,
709
00:30:53,628 --> 00:30:55,097
they release cytokines
and potassium--
710
00:30:55,130 --> 00:30:56,565
And if you restore
the blood flow,
711
00:30:56,598 --> 00:30:58,267
instead of just lopping
it all off,
712
00:30:58,300 --> 00:31:00,602
then all that crap gets washed
back into my system.
713
00:31:00,635 --> 00:31:02,604
The cytokines
can cause organ failure.
714
00:31:02,637 --> 00:31:04,473
And the potassium
can cause cardiac arrest.
715
00:31:04,506 --> 00:31:07,409
On the other hand, I may just
get the use of my leg back.
716
00:31:07,442 --> 00:31:10,079
The post-operative
pain alone--
717
00:31:10,112 --> 00:31:11,413
I'll get through it.
718
00:31:11,446 --> 00:31:13,682
I understand the risks.
You're in the clear.
719
00:31:13,715 --> 00:31:15,284
Go schedule an O.R.
720
00:31:22,391 --> 00:31:23,458
God, you're an idiot.
721
00:31:23,492 --> 00:31:26,996
I think I'm more
of a jerk.
722
00:31:27,029 --> 00:31:29,331
I'm not being glib
and I'm not being cute.
723
00:31:29,364 --> 00:31:32,534
I don't want you
to kill yourself.
724
00:31:32,567 --> 00:31:34,503
I'm not going to die.
725
00:31:34,536 --> 00:31:38,407
Oh. I feel completely
reassured.
726
00:32:06,635 --> 00:32:11,573
[machine beeping]
727
00:32:11,606 --> 00:32:16,178
[hose sucking]
728
00:32:19,814 --> 00:32:23,518
[drill whirring]
729
00:33:13,102 --> 00:33:14,436
[House screams]
730
00:33:14,469 --> 00:33:18,507
[agonized pants]
731
00:33:18,540 --> 00:33:22,677
They--they got to up
the morphine.
732
00:33:22,711 --> 00:33:24,446
Doctors say they can't.
733
00:33:24,479 --> 00:33:26,715
Doctors recommended
bed rest and antibiotics.
734
00:33:26,748 --> 00:33:28,250
They screwed up.
735
00:33:28,283 --> 00:33:29,651
It doesn't mean
they're wrong this time.
736
00:33:29,684 --> 00:33:30,519
Sure doesn't mean
they're right.
737
00:33:30,552 --> 00:33:31,686
Morphine
will kill you.
738
00:33:31,720 --> 00:33:33,822
I can handle it.
You're in pain.
739
00:33:33,855 --> 00:33:35,190
You're not
thinking right.
740
00:33:35,224 --> 00:33:37,726
That's why I need
the damn morphine!
741
00:33:37,759 --> 00:33:39,461
I'll talk to them.
742
00:33:44,333 --> 00:33:46,535
My God, how much longer
is the pain going to last?
743
00:33:46,568 --> 00:33:48,537
It depends on how much
muscle cell death there was.
744
00:33:48,570 --> 00:33:51,106
He could be right. He could
come out of this with almost
745
00:33:51,140 --> 00:33:52,307
full use of his leg.
746
00:33:52,341 --> 00:33:53,608
Or?
747
00:33:53,642 --> 00:33:56,645
He could be in pain
for the rest of his life.
748
00:33:59,614 --> 00:34:01,450
There's a third option,
749
00:34:01,483 --> 00:34:03,152
surgically.
750
00:34:03,185 --> 00:34:04,586
A middle ground
between what we did
751
00:34:04,619 --> 00:34:06,221
and amputation.
752
00:34:09,524 --> 00:34:13,295
He's not big
on middle grounds.
753
00:34:13,328 --> 00:34:15,197
Yeah.
754
00:34:38,587 --> 00:34:39,721
Nurse.
755
00:34:41,556 --> 00:34:44,259
Nurse. I need more
calcium gluconate.
756
00:34:45,360 --> 00:34:46,628
You just had 5 ML.
757
00:34:46,661 --> 00:34:49,198
QRS is getting wider.
My potassium is rising.
758
00:34:49,231 --> 00:34:50,265
I'll talk to a doctor.
759
00:34:50,299 --> 00:34:51,600
Well, you better
make it fast
760
00:34:51,633 --> 00:34:53,568
'cause I'm about to go
into cardiac arrest.
761
00:34:53,602 --> 00:34:54,703
You give me the dose
762
00:34:54,736 --> 00:34:57,872
or I go into wide complex
tachycardia.
763
00:34:57,906 --> 00:34:59,774
I could get in trouble--
It's not a narcotic!
764
00:34:59,808 --> 00:35:01,510
I'm not looking
for a buzz.
765
00:35:01,543 --> 00:35:04,346
You got about 20 seconds.
766
00:35:04,379 --> 00:35:06,181
[hyperventilating]
767
00:35:06,215 --> 00:35:09,551
[rapid beeping]
768
00:35:09,584 --> 00:35:11,653
I was wrong.
769
00:35:19,694 --> 00:35:20,629
Wide complex
tachycardia.
770
00:35:20,662 --> 00:35:22,331
You diagn--
He did.
771
00:35:22,364 --> 00:35:23,898
Paddles.
772
00:35:25,234 --> 00:35:26,535
Clear.
773
00:35:28,437 --> 00:35:31,840
[machine flatlines]
774
00:35:31,873 --> 00:35:33,442
The patient
was technically dead
775
00:35:33,475 --> 00:35:35,677
for over a minute.
776
00:35:53,562 --> 00:35:57,332
[cheers and applause]
777
00:36:06,541 --> 00:36:09,511
[machine beeping]
778
00:36:09,544 --> 00:36:12,547
He's back.
779
00:36:17,552 --> 00:36:19,654
(Wilson)
Do you think he was dead?
780
00:36:19,688 --> 00:36:22,524
Do you think
those experiences were real?
781
00:36:22,557 --> 00:36:25,660
Define real.
782
00:36:27,729 --> 00:36:28,863
They were real experiences.
783
00:36:28,897 --> 00:36:31,866
What they meant--
784
00:36:31,900 --> 00:36:33,402
personally,
I choose to believe
785
00:36:33,435 --> 00:36:35,537
that the white light people
sometimes see
786
00:36:35,570 --> 00:36:38,607
visions this patient saw.
787
00:36:38,640 --> 00:36:40,475
They're all just
chemical reactions
788
00:36:40,509 --> 00:36:42,711
that take place
while the brain shuts down.
789
00:36:44,446 --> 00:36:45,747
You choose to believe that?
790
00:36:45,780 --> 00:36:47,916
(House)
There's no conclusive science.
791
00:36:47,949 --> 00:36:51,986
My choice has no practical
relevance to my life.
792
00:36:52,020 --> 00:36:54,689
I choose the outcome
I find more comforting.
793
00:36:54,723 --> 00:36:57,659
You find it more comforting
to believe that this is it?
794
00:36:57,692 --> 00:37:00,529
I find it more comforting
to believe that this
795
00:37:00,562 --> 00:37:05,266
isn't simply a test.
796
00:37:10,872 --> 00:37:13,642
How bad is the pain
right now?
797
00:37:13,675 --> 00:37:15,410
It's bad.
798
00:37:15,444 --> 00:37:16,611
It's not getting
any better.
799
00:37:16,645 --> 00:37:18,947
If you were right,
the pain would be subsiding.
800
00:37:18,980 --> 00:37:20,315
You'd be getting
better.
801
00:37:20,349 --> 00:37:21,650
It's just taking longer.
802
00:37:21,683 --> 00:37:23,785
No, it's not.
803
00:37:23,818 --> 00:37:26,855
You've got to let them
cut the leg off.
804
00:37:29,558 --> 00:37:34,028
It's my leg.
It's my life.
805
00:37:34,062 --> 00:37:36,731
Would you give up your leg
to save my life?
806
00:37:36,765 --> 00:37:38,967
Of course I would.
807
00:37:39,000 --> 00:37:41,470
Why do you think your life
is worth less than mine?
808
00:37:43,438 --> 00:37:44,839
If this were
any other patient,
809
00:37:44,873 --> 00:37:46,708
what would you
tell them to do?
810
00:37:51,079 --> 00:37:52,981
I would say
it's their choice.
811
00:37:53,014 --> 00:37:54,816
Not a chance.
812
00:37:54,849 --> 00:37:56,351
You'd browbeat them
813
00:37:56,385 --> 00:37:59,554
until they made the choice
you knew was right.
814
00:37:59,588 --> 00:38:00,722
You'd shove in their face
815
00:38:00,755 --> 00:38:04,058
that it's just
a damn leg.
816
00:38:04,092 --> 00:38:06,861
You don't think
you deserve to live?
817
00:38:06,895 --> 00:38:11,533
You don't think you deserve
to be happy?
818
00:38:11,566 --> 00:38:14,035
Now let them cut off
your leg.
819
00:38:16,705 --> 00:38:21,543
I can't. I can't.
820
00:38:21,576 --> 00:38:22,944
I'm sorry.
821
00:38:31,085 --> 00:38:33,788
The pain alone
is going to kill you.
822
00:38:33,822 --> 00:38:35,657
I know. I know.
823
00:38:40,729 --> 00:38:43,598
I need you to talk
to the doctor.
824
00:38:52,073 --> 00:38:54,142
He change his mind?
825
00:38:54,175 --> 00:38:56,978
No.
826
00:38:57,011 --> 00:38:59,948
He's asked to be put
in a chemically induced coma
827
00:38:59,981 --> 00:39:01,950
so that he can sleep
through the worst part
828
00:39:01,983 --> 00:39:03,585
of the pain.
829
00:39:03,618 --> 00:39:06,588
We can do that.
830
00:39:08,990 --> 00:39:12,494
What happens
after he's in the coma?
831
00:39:12,527 --> 00:39:14,596
We'll obviously monitor
his condition closely.
832
00:39:14,629 --> 00:39:17,131
And if he can get through
the next 48 hours
833
00:39:17,165 --> 00:39:18,500
without another cardiac
incident--
834
00:39:18,533 --> 00:39:19,968
I meant,
I'm his health care proxy.
835
00:39:20,001 --> 00:39:21,903
I get to make
medical decisions for him
836
00:39:21,936 --> 00:39:23,805
if he's not able to.
837
00:39:23,838 --> 00:39:28,610
You should talk to him
about what he wants to do.
838
00:39:28,643 --> 00:39:29,878
I know what he wants.
839
00:39:29,911 --> 00:39:32,814
But if he's out,
it's my call, right?
840
00:39:49,664 --> 00:39:52,166
You'll be out
in less than a minute.
841
00:39:56,705 --> 00:39:58,573
Thank you.
842
00:40:03,011 --> 00:40:03,978
Hey.
843
00:40:04,012 --> 00:40:06,515
Hey.
844
00:40:06,548 --> 00:40:08,517
I'll see you
when I wake up.
845
00:40:09,984 --> 00:40:12,220
We'll go golfing.
846
00:40:15,757 --> 00:40:17,225
I love you.
847
00:40:20,595 --> 00:40:22,063
I love you too.
848
00:40:24,032 --> 00:40:27,401
I'm sorry.
849
00:40:31,272 --> 00:40:33,642
You got nothing
to be sorry--
850
00:40:51,893 --> 00:40:55,029
The middle ground
you were talking about.
851
00:40:55,063 --> 00:40:57,031
We go in,
take out the dead muscle.
852
00:40:57,065 --> 00:41:00,134
There's still some risk
of reperfusion injury, but--
853
00:41:00,168 --> 00:41:02,571
Get me the forms
you need signed.
854
00:41:06,340 --> 00:41:07,709
You're saving his life.
855
00:41:07,742 --> 00:41:11,680
He won't see it that way.
856
00:41:29,831 --> 00:41:34,268
Because of the extent
of the muscle removed,
857
00:41:34,302 --> 00:41:36,605
the utility
of the patient's leg
858
00:41:36,638 --> 00:41:38,607
was severely compromised.
859
00:41:38,640 --> 00:41:42,744
Because of the time delay
in making the diagnosis,
860
00:41:42,777 --> 00:41:46,147
the patient continues
to experience chronic pain.
861
00:41:52,320 --> 00:41:54,589
(female student)
She had no right
to do that.
862
00:41:54,623 --> 00:41:55,657
She had the proxy.
863
00:41:55,690 --> 00:41:57,058
She knew he didn't want
the surgery.
864
00:41:57,091 --> 00:41:58,092
She saved his life.
865
00:41:58,126 --> 00:41:59,093
We don't know that.
866
00:41:59,127 --> 00:42:00,695
Maybe he would've been fine.
867
00:42:00,729 --> 00:42:02,163
It doesn't matter.
It's the patient's call.
868
00:42:02,196 --> 00:42:04,599
The patient's an idiot.
869
00:42:04,633 --> 00:42:06,901
They usually are.
870
00:42:06,935 --> 00:42:09,070
Do you have a buzzer
or something?
871
00:42:09,103 --> 00:42:11,706
What time
does this class end?
872
00:42:11,740 --> 00:42:13,775
20 minutes ago.
873
00:42:18,780 --> 00:42:21,282
I'm not doing this again.
874
00:42:21,315 --> 00:42:23,985
And this guy is not
the world's greatest dad.
875
00:42:24,018 --> 00:42:25,754
Not even ranked.
876
00:42:25,787 --> 00:42:27,622
Who the hell
let's their kids play
877
00:42:27,656 --> 00:42:28,690
with lead-based paint?
878
00:42:28,723 --> 00:42:30,358
That's why
he's always sick.
879
00:42:30,391 --> 00:42:33,361
Find him some plastic cups
and the class is all his again.
880
00:43:01,823 --> 00:43:02,991
Stacy, it's Greg.
881
00:43:03,024 --> 00:43:05,326
I've got an opening
in my calendar
882
00:43:05,359 --> 00:43:07,729
for 10:00 tomorrow morning.
883
00:43:07,762 --> 00:43:10,765
Make sure your husband
isn't late.
884
00:43:18,807 --> 00:43:18,873
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