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Would you like to inspect the original subtitles? These are the user uploaded subtitles that are being translated: 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 Captioning by CaptionMax www.captionmax.com 61871

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