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1
00:00:04,046 --> 00:00:07,049
Man 1: On your right.
On your right. On your right.
2
00:00:07,175 --> 00:00:08,318
Back, back, back, back, back.
3
00:00:08,342 --> 00:00:09,969
Come on, buddy.
4
00:00:12,847 --> 00:00:15,183
Yeah, Dan! Yeah!
5
00:00:15,308 --> 00:00:16,976
Yeah! Yeah!
6
00:00:17,143 --> 00:00:18,769
Man 1: Back, back,
back, back, back.
7
00:00:18,895 --> 00:00:21,063
Man 2: Come on!
Watch the winger!
8
00:00:32,200 --> 00:00:33,201
Man 3: Yeah!
9
00:00:58,017 --> 00:00:59,017
You okay?
10
00:00:59,810 --> 00:01:04,065
Dan? Dan, talk to me. Dan. Dan.
11
00:01:05,900 --> 00:01:07,735
Get a doctor!
12
00:01:48,818 --> 00:01:50,736
- Hey.
- Close the door.
13
00:01:50,861 --> 00:01:52,196
Close the door.
14
00:01:55,616 --> 00:01:58,160
Is cuddy down the hall
counting to 50?
15
00:01:58,828 --> 00:02:01,580
She knows I'm in here,
in the clinic, as she commanded.
16
00:02:01,706 --> 00:02:03,124
She just doesn't know I'm alone.
17
00:02:03,457 --> 00:02:05,167
Well, you've got
a full waiting room.
18
00:02:05,293 --> 00:02:06,853
How long do you think
you can ignore them?
19
00:02:06,877 --> 00:02:08,379
I'm off at 4:00.
20
00:02:09,547 --> 00:02:12,550
You're doing this
to avoid five minutes of work?
21
00:02:12,675 --> 00:02:14,945
If I go out there, I get assigned
a kid with a runny nose.
22
00:02:14,969 --> 00:02:16,238
That's 30 seconds
looking at the nose,
23
00:02:16,262 --> 00:02:18,180
25 minutes
talking to a worried mom
24
00:02:18,306 --> 00:02:20,742
who won't leave until she's sure
it's not meningitis or a tumor.
25
00:02:20,766 --> 00:02:23,060
Yes. Concerned parents
can be so annoying.
26
00:02:23,352 --> 00:02:25,664
Just tell cuddy you've got
an urgent case. You had to leave early.
27
00:02:25,688 --> 00:02:27,982
- That would be lying.
- And that would be wrong.
28
00:02:28,107 --> 00:02:31,569
But luckily the definition
of "urgent" is fungible.
29
00:02:31,986 --> 00:02:34,697
Not the definition
of "case", though.
30
00:02:37,700 --> 00:02:39,327
You have no cases?
31
00:02:41,037 --> 00:02:43,122
You have no cases?
32
00:02:43,956 --> 00:02:46,625
You've got handpicked doctors,
specialists
33
00:02:46,751 --> 00:02:49,879
working for you,
and they're sitting on their hands?
34
00:02:50,004 --> 00:02:53,632
- Cameron's answering my mail.
- Oh, time well spent, I'm sure.
35
00:02:53,758 --> 00:02:55,343
Foreman and chase?
36
00:02:56,344 --> 00:02:57,386
Research?
37
00:03:04,393 --> 00:03:07,146
Nine letters.
Iodine deficiency in children.
38
00:03:07,271 --> 00:03:08,689
Cretinism.
39
00:03:18,449 --> 00:03:21,827
So, 4:03 P.M.,
Dr. House checks out.
40
00:03:21,952 --> 00:03:24,497
- Please write that down.
- Dr. House.
41
00:03:24,622 --> 00:03:27,375
Sorry. Done for the day.
Plenty of docs here to take care of you.
42
00:03:27,500 --> 00:03:29,085
But we had an appointment.
43
00:03:29,210 --> 00:03:31,003
Nice try,
but this is a walk-in clinic,
44
00:03:31,128 --> 00:03:32,230
which means there
are no appointments.
45
00:03:32,254 --> 00:03:34,191
You walk in, sign the chart
and a doctor will see you.
46
00:03:34,215 --> 00:03:35,216
Just not me.
47
00:03:35,341 --> 00:03:38,135
Your letter says
that we'd see you.
48
00:03:39,053 --> 00:03:41,972
- Not a big letter writer.
- Here.
49
00:03:44,892 --> 00:03:47,353
When did my signature
get so girlie?
50
00:03:48,270 --> 00:03:49,271
I can explain.
51
00:03:49,397 --> 00:03:50,689
See that "g"?
52
00:03:50,815 --> 00:03:52,358
See how it makes
a big loop on top?
53
00:03:52,483 --> 00:03:54,735
Doesn't even look
like my handwriting.
54
00:03:54,860 --> 00:03:57,321
Think I have something?
What's the differential diagnosis
55
00:03:57,446 --> 00:03:59,323
for writing g's like
ajunior high school girl?
56
00:03:59,448 --> 00:04:01,385
It's impossible to get to you
through normal channels.
57
00:04:01,409 --> 00:04:02,535
They have called, e-mailed.
58
00:04:02,660 --> 00:04:04,137
Perseverance does
not equal worthiness.
59
00:04:04,161 --> 00:04:06,789
Next time you want to get my attention,
wear something fun.
60
00:04:06,914 --> 00:04:10,334
- Low-riderjeans are hot.
- Sixteen-year-old male.
61
00:04:10,459 --> 00:04:12,753
Sudden onset of double vision
and night terrors,
62
00:04:12,878 --> 00:04:14,046
with no apparent cause.
63
00:04:14,171 --> 00:04:16,799
- The kid's been to two neurologists...
- Night terrors?
64
00:04:16,924 --> 00:04:20,094
- As in big scary monsters?
- Yes.
65
00:04:23,264 --> 00:04:25,933
- Where are you going?
- To see the family.
66
00:04:26,058 --> 00:04:27,160
You're going to
examine a patient?
67
00:04:27,184 --> 00:04:29,812
Nine times out of 10,
there's no reason to talk to a patient.
68
00:04:29,937 --> 00:04:31,730
But night terrors
in a 16-year-old
69
00:04:31,856 --> 00:04:35,901
is a very good reason to talk
to this family. Good work.
70
00:04:38,821 --> 00:04:40,739
Margins are fine.
71
00:04:41,365 --> 00:04:42,825
No lesions.
72
00:04:44,118 --> 00:04:45,870
Color is good.
73
00:04:46,537 --> 00:04:48,747
How long have you been
having night terrors?
74
00:04:48,873 --> 00:04:50,958
- Three weeks.
- He's afraid to go to bed.
75
00:04:51,083 --> 00:04:53,752
He's exhausted,
can barely function.
76
00:04:55,087 --> 00:04:56,088
What does that tell you?
77
00:04:56,213 --> 00:04:58,632
Nothing. It's just fun
watching him blink.
78
00:04:59,133 --> 00:05:00,634
Name as many animals as you can
79
00:05:00,759 --> 00:05:03,304
that begin with
the letter "b". Go.
80
00:05:10,436 --> 00:05:11,437
Baby elephant?
81
00:05:11,562 --> 00:05:13,439
Baby elephant is
actually a good answer.
82
00:05:13,564 --> 00:05:15,500
- "B" is a bear of a letter.
- What does that tell you?
83
00:05:15,524 --> 00:05:17,610
House: Proves two things,
no neurological damage,
84
00:05:17,735 --> 00:05:19,737
and your son is never gonna
be chief fry cook.
85
00:05:20,571 --> 00:05:24,033
In teens, there are
two likely causes of night terrors.
86
00:05:24,158 --> 00:05:25,158
Post-traumatic stress.
87
00:05:25,242 --> 00:05:26,994
Any recent shoot-outs
at your high school?
88
00:05:27,119 --> 00:05:28,329
- No.
- Well, then, Dave...
89
00:05:28,454 --> 00:05:29,997
- Dan.
- If there's no trauma,
90
00:05:30,122 --> 00:05:33,042
the other cause is sexual abuse.
91
00:05:36,128 --> 00:05:37,671
So who's molesting you?
92
00:05:37,796 --> 00:05:39,840
Teacher?
Extra-friendly neighbor?
93
00:05:40,424 --> 00:05:42,527
I'd ask if either of you were involved,
but you'd deny it.
94
00:05:42,551 --> 00:05:44,231
No. We would never do
anything to hurt Dan.
95
00:05:44,261 --> 00:05:46,222
I say it here,
it comes out there.
96
00:05:46,764 --> 00:05:49,183
This lack of response is
consistent with abuse.
97
00:05:49,308 --> 00:05:51,310
There's no one, okay? I swear.
98
00:05:52,144 --> 00:05:53,229
There was trauma.
99
00:05:53,354 --> 00:05:55,981
I got hit in the head
during a lacrosse game.
100
00:05:56,857 --> 00:05:59,610
Did you know that
he got hit in the head?
101
00:06:00,110 --> 00:06:02,071
They didn't mention it. No.
102
00:06:02,196 --> 00:06:03,656
Yeah. Why bother?
103
00:06:06,659 --> 00:06:09,662
No, no. We took him to
the er after the game.
104
00:06:09,787 --> 00:06:12,164
He was scanned. They tested him.
They said he was fine.
105
00:06:12,289 --> 00:06:13,433
No concussion. It's gotta be...
106
00:06:13,457 --> 00:06:17,211
You hound me for my opinion,
and then you question my diagnosis.
107
00:06:17,336 --> 00:06:18,420
Cool.
108
00:06:18,546 --> 00:06:20,798
Er obviously screwed up.
Kid's got a concussion.
109
00:06:20,923 --> 00:06:22,383
I had double vision
before I was hit.
110
00:06:22,508 --> 00:06:24,343
Well, that changes everything.
111
00:06:24,468 --> 00:06:27,137
You need glasses.
That's why you had double vision,
112
00:06:27,263 --> 00:06:29,241
which is why you got hit,
which is why you have a concussion,
113
00:06:29,265 --> 00:06:31,559
which is why you
have night terrors.
114
00:06:31,684 --> 00:06:34,687
You need to see an ophthalmologist,
which I am not.
115
00:06:35,187 --> 00:06:36,605
You enjoyed that.
116
00:06:36,730 --> 00:06:38,250
I brought a reasonable case
to your attention,
117
00:06:38,274 --> 00:06:40,234
and you shoved it in my face
just to humiliate me.
118
00:06:40,276 --> 00:06:43,153
- You're an only child, aren't you?
- Why would you say that?
119
00:06:43,279 --> 00:06:44,863
Because everything is about you.
120
00:06:46,115 --> 00:06:47,950
This may seem
incredibly controversial,
121
00:06:48,075 --> 00:06:50,286
but I think sexual abuse is bad.
122
00:06:50,411 --> 00:06:53,789
I just wanted to make sure he wasn't
being diddled by daddy or mommy.
123
00:06:53,914 --> 00:06:55,958
Anything else is just a bonus.
124
00:07:06,468 --> 00:07:09,138
- I'm not an only child.
- Interesting.
125
00:07:10,347 --> 00:07:12,516
- What?
- Don't move.
126
00:07:13,350 --> 00:07:17,062
- Did I bore you in there?
- What? No. Not really.
127
00:07:17,187 --> 00:07:18,187
Are you tired?
128
00:07:19,523 --> 00:07:21,609
- Sometimes.
- He never sleeps. Of course he's tired.
129
00:07:21,734 --> 00:07:23,652
- Right now. Are you tired?
- No. No.
130
00:07:23,777 --> 00:07:27,031
That twitch in your leg.
Did you feel that?
131
00:07:28,198 --> 00:07:30,492
- Didn't hurt.
- His leg twitched. I don't see what...
132
00:07:30,618 --> 00:07:32,328
It's called a myoclonic jerk.
133
00:07:32,453 --> 00:07:34,173
It's very common
when you're falling asleep.
134
00:07:34,204 --> 00:07:35,414
Respiration rate falls,
135
00:07:35,539 --> 00:07:38,083
and the brain sometimes
interprets this as the body dying,
136
00:07:38,208 --> 00:07:39,269
so it sends
a pulse to wake it up.
137
00:07:39,293 --> 00:07:42,880
- So?
- So, he's not asleep. He's awake.
138
00:07:44,798 --> 00:07:46,258
Admit him.
139
00:07:49,553 --> 00:07:52,348
House: I recognize
that loopy "g".
140
00:07:53,223 --> 00:07:55,059
So, what does the jerk tell us?
141
00:07:55,184 --> 00:07:57,811
Nothing good.
The brain's losing control of the body.
142
00:07:57,936 --> 00:07:59,146
Can't order the eyes to focus,
143
00:07:59,271 --> 00:08:00,832
regulate sleep patterns
or control muscles.
144
00:08:00,856 --> 00:08:03,108
A movement disorder
or a degenerative brain disease.
145
00:08:03,233 --> 00:08:05,211
Either way, this kid's gonna be
picking up his diploma
146
00:08:05,235 --> 00:08:06,355
in diapers and a wheelchair.
147
00:08:06,403 --> 00:08:08,530
Maybe not that bad.
Could be an infection.
148
00:08:08,656 --> 00:08:10,949
You wish.
No fever, no white count.
149
00:08:11,075 --> 00:08:13,869
Anyone think this differential
diagnosis might be compromised
150
00:08:13,994 --> 00:08:16,246
because we don't have
an accurate family history?
151
00:08:16,372 --> 00:08:17,873
I took
an accurate family history.
152
00:08:17,998 --> 00:08:20,501
You didn't even take
an accurate family.
153
00:08:20,626 --> 00:08:22,646
- His father's not his father.
- Why would you say that?
154
00:08:22,670 --> 00:08:24,022
Thirty percent of all
dads out there
155
00:08:24,046 --> 00:08:25,940
don't realize they're
raising someone else's kid.
156
00:08:25,964 --> 00:08:27,776
From what I've read,
false paternity's more like 10%.
157
00:08:27,800 --> 00:08:29,402
That's what our moms
would like us to believe.
158
00:08:29,426 --> 00:08:32,030
Who cares? If he got it from his
parents, they'd both be dead by now.
159
00:08:32,054 --> 00:08:33,657
Can we get on with
the differential diagnosis?
160
00:08:33,681 --> 00:08:34,848
Fifty bucks says I'm right.
161
00:08:34,973 --> 00:08:36,850
- I'll take your money.
- Hit a nerve?
162
00:08:36,975 --> 00:08:37,975
Don't worry, foreman.
163
00:08:38,060 --> 00:08:39,954
I'm sure the guy who tucked you in
at night was your daddy.
164
00:08:39,978 --> 00:08:41,522
Make it $100.
165
00:08:41,647 --> 00:08:44,817
What about ieukoencephalopathy
in a 16-year-old?
166
00:08:44,942 --> 00:08:47,027
It doesn't necessarily
have to be that bad.
167
00:08:47,152 --> 00:08:47,945
If we exclude the night terrors,
168
00:08:48,070 --> 00:08:49,130
it could be something systemic.
169
00:08:49,154 --> 00:08:51,740
His liver, kidneys.
Something outside the brain.
170
00:08:51,865 --> 00:08:55,202
Yes. Feel free to exclude any symptom
if it makes your job easier.
171
00:08:55,327 --> 00:08:57,681
The night terrors were anecdotal.
He could've had a bad dream.
172
00:08:57,705 --> 00:08:59,599
No. Parents said he was
conscious during the event
173
00:08:59,623 --> 00:09:01,750
and didn't remember
anything aftewvards.
174
00:09:01,875 --> 00:09:03,435
- That's a night terror.
- Parents said?
175
00:09:04,169 --> 00:09:05,230
House: That's a good point.
176
00:09:05,254 --> 00:09:08,757
Before we condemn this kid, maybe we
should entertain Dr. Chase's skepticism.
177
00:09:08,882 --> 00:09:10,384
I want a detailed
polysomnograph.
178
00:09:10,509 --> 00:09:13,721
If he's having night terrors,
I want to see them.
179
00:09:36,869 --> 00:09:38,996
I usually don't move
during night terrors.
180
00:09:39,121 --> 00:09:40,622
I'm not
restraining you for them.
181
00:09:43,584 --> 00:09:47,129
Eeg revealed
abnormalities in your brain,
182
00:09:47,254 --> 00:09:49,506
caused nerve damage
in your toes.
183
00:09:55,929 --> 00:10:00,017
- What are you doing?
- Fixing it.
184
00:10:00,601 --> 00:10:02,102
Can I talk to my parents?
185
00:10:02,644 --> 00:10:06,982
- Oh, they know all about this.
- I'd really like to see them.
186
00:10:15,866 --> 00:10:19,077
Please.
I'd really like them here.
187
00:10:21,205 --> 00:10:23,123
This is gonna hurt, Dan.
188
00:10:23,248 --> 00:10:24,958
Oh. Oh, god.
189
00:10:41,642 --> 00:10:43,477
That's a night terror.
190
00:10:55,113 --> 00:10:59,034
Foreman: We did a ct, mri,
cbc, chem-7 and chest X-ray.
191
00:10:59,159 --> 00:11:00,261
All the tests came back normal.
192
00:11:00,285 --> 00:11:01,596
There's nothing to
explain his symptoms.
193
00:11:01,620 --> 00:11:04,260
House: Okay, but let's pretend
there's something and go from there.
194
00:11:04,456 --> 00:11:06,041
Who sees something on this mri?
195
00:11:08,293 --> 00:11:11,421
- No lesions in the white matter.
- No structural abnormalities.
196
00:11:11,547 --> 00:11:13,006
No space-occupying tumors.
197
00:11:13,131 --> 00:11:16,718
He's 16, so he should have
an absolutely pristine brain.
198
00:11:16,844 --> 00:11:19,179
The smallest thing is abnormal.
199
00:11:19,555 --> 00:11:21,390
Meningeal enhancement.
200
00:11:22,140 --> 00:11:24,810
- My bet is viral meningitis.
- Excellent.
201
00:11:25,185 --> 00:11:26,770
Do you see what he did there?
202
00:11:26,895 --> 00:11:29,064
Took a small clue
that there's a neurological problem
203
00:11:29,189 --> 00:11:30,416
and wasn't afraid
to run with it.
204
00:11:30,440 --> 00:11:32,901
There's no evidence of meningitis
on that mri.
205
00:11:33,026 --> 00:11:35,279
No, there's not.
He's completely wrong.
206
00:11:35,404 --> 00:11:36,947
Then what clue are
you talking about?
207
00:11:37,072 --> 00:11:38,883
House: He knew that
I saw something on the mri,
208
00:11:38,907 --> 00:11:41,743
so he figured there must be
something there and took a guess.
209
00:11:41,869 --> 00:11:45,247
- Clever, but also pathetic.
- So what did you find?
210
00:11:45,956 --> 00:11:48,709
Take a close look
at the corpus callosum.
211
00:11:51,086 --> 00:11:53,046
Looks okay.
212
00:11:53,213 --> 00:11:54,923
Are we all looking
at the same thing?
213
00:11:55,048 --> 00:11:57,259
Two hundred million
interhemispheric nerve fibers.
214
00:11:57,384 --> 00:12:01,722
The George Washington bridge between
the left and right side of the brain.
215
00:12:01,972 --> 00:12:02,972
It's subtle.
216
00:12:06,685 --> 00:12:10,314
There's some bowing. There.
An upward arch.
217
00:12:10,439 --> 00:12:13,525
- Are you guessing?
- Yes.
218
00:12:13,692 --> 00:12:16,612
- Too bad. You're right.
- He probably just moved.
219
00:12:16,737 --> 00:12:19,406
Nobody stays perfectly still
for the entire mri.
220
00:12:19,531 --> 00:12:21,408
Yeah. Probably got restless
221
00:12:21,533 --> 00:12:23,327
and shifted
one hemisphere of his brain
222
00:12:23,452 --> 00:12:26,538
to a more comfortable position.
Something is pushing on it.
223
00:12:26,663 --> 00:12:28,143
If there was bowing,
could be a tumor.
224
00:12:28,248 --> 00:12:30,042
Do you see a tumor on this mri?
225
00:12:30,167 --> 00:12:31,919
No, but I don't see
any bowing either.
226
00:12:32,044 --> 00:12:35,172
There's no tumor. Just a blockage
causing pressure causing symptoms.
227
00:12:35,297 --> 00:12:39,092
Today, night terrors.
Tomorrow, he's bleeding out of his eyes.
228
00:12:39,760 --> 00:12:41,553
Get him a radionucleotide
cisternogram.
229
00:12:41,678 --> 00:12:43,513
I guarantee
you'll see a blockage.
230
00:12:50,062 --> 00:12:51,229
Okay.
231
00:12:54,816 --> 00:12:55,817
Easy.
232
00:12:55,943 --> 00:12:57,778
Okay. Squeeze my hand.
233
00:13:02,240 --> 00:13:04,201
All right. Squeeze hard.
234
00:13:06,954 --> 00:13:08,413
All right.
235
00:13:15,170 --> 00:13:18,465
Now I'm injecting a material
that's tagged with a radioisotope.
236
00:13:19,424 --> 00:13:23,095
It's gonna enter your spine
and travel up to your brain.
237
00:13:23,637 --> 00:13:26,515
It'll make you able
to think deep thoughts,
238
00:13:26,765 --> 00:13:28,350
run 100 miles an hour.
239
00:13:30,060 --> 00:13:31,103
Dan's father: Easy.
240
00:13:45,283 --> 00:13:48,412
Their eyes aren't the same color,
but that fleck in the eyes,
241
00:13:48,537 --> 00:13:51,081
that's maybe a 1-in-10 chance
if they're not related?
242
00:13:51,206 --> 00:13:53,500
No. House isn't gonna
pay you based on that.
243
00:13:54,876 --> 00:13:57,337
Any excuse we can give the folks
to justify a DNA test?
244
00:13:57,462 --> 00:13:59,214
We could tell them
he's got huntington's,
245
00:13:59,339 --> 00:14:02,509
whole family should be tested
or they'll all die.
246
00:14:05,137 --> 00:14:06,346
Hey.
247
00:14:07,055 --> 00:14:08,849
There's a lot of blockage.
248
00:14:08,974 --> 00:14:10,809
I've scheduled him for surgery.
249
00:14:10,934 --> 00:14:12,745
We're gonna put a shunt
into one of the ventricles
250
00:14:12,769 --> 00:14:14,855
to give the cerebrospinal fluid
an out.
251
00:14:14,980 --> 00:14:17,774
No more pressure,
everything goes back to normal.
252
00:14:17,899 --> 00:14:20,402
He's lucky to have
you as his doctors.
253
00:14:28,827 --> 00:14:32,456
No formula. Just mommy's healthy,
natural breast milk.
254
00:14:33,749 --> 00:14:35,042
Yummy.
255
00:14:35,167 --> 00:14:38,253
Her whole face just got
swollen like this overnight.
256
00:14:40,422 --> 00:14:41,798
No fever.
257
00:14:42,966 --> 00:14:46,261
Glands normal.
Missing her vaccination dates.
258
00:14:46,386 --> 00:14:47,971
We're not vaccinating.
259
00:14:54,436 --> 00:14:55,479
Think they don't work?
260
00:14:55,604 --> 00:14:57,898
I think some multinational
pharmaceutical company
261
00:14:58,023 --> 00:15:01,109
wants me to think they work,
pad their bottom line.
262
00:15:02,819 --> 00:15:04,154
- May I?
- Sure.
263
00:15:10,494 --> 00:15:13,497
Yeah. All-natural, no dyes
is a good business.
264
00:15:13,622 --> 00:15:15,457
All-natural children's toys.
265
00:15:15,582 --> 00:15:18,543
Toy companies, they don't arbitrarily
Mark up their frogs.
266
00:15:18,668 --> 00:15:22,047
They don't lie about how much they
spend on research and development.
267
00:15:22,172 --> 00:15:24,424
The worst that a toy company
could be accused of
268
00:15:24,549 --> 00:15:27,177
is making a really boring frog.
269
00:15:29,930 --> 00:15:32,474
You know another
really good business?
270
00:15:32,724 --> 00:15:35,185
Teeny, tiny baby coffins.
271
00:15:36,937 --> 00:15:40,649
You can get them in frog green,
fire-engine red. Really.
272
00:15:41,608 --> 00:15:45,529
The antibodies in yummy mummy
only protect the kid for six months,
273
00:15:45,654 --> 00:15:48,115
which is why these companies
think they can gouge you.
274
00:15:48,240 --> 00:15:51,868
They think that you'll spend whatever
they ask to keep your kid alive.
275
00:15:51,993 --> 00:15:53,995
Want to change things?
Prove them wrong.
276
00:15:54,121 --> 00:15:56,557
Few hundred parents like you
decide they'd rather let their kid die
277
00:15:56,581 --> 00:15:58,500
than cough up 40 bucks
for a vaccination,
278
00:15:58,625 --> 00:16:01,336
believe me,
prices will drop really fast.
279
00:16:06,550 --> 00:16:08,051
Tell me what she has.
280
00:16:10,971 --> 00:16:11,972
A cold.
281
00:16:13,807 --> 00:16:15,392
Cameron: There's a problem.
282
00:16:15,517 --> 00:16:16,852
Complications in surgery?
283
00:16:16,977 --> 00:16:18,371
Surgery went fine.
He's in recovery.
284
00:16:18,395 --> 00:16:20,272
But we took a vial
of csf and tested it.
285
00:16:20,397 --> 00:16:21,397
Really?
286
00:16:21,481 --> 00:16:23,042
Turns out the bowing
wasn't the cause of his problems.
287
00:16:23,066 --> 00:16:24,067
It was a symptom.
288
00:16:24,192 --> 00:16:26,945
Oligoclonal bands
and increased intrathecal igg.
289
00:16:27,070 --> 00:16:28,822
Which means multiple sclerosis.
290
00:16:28,947 --> 00:16:30,967
And the reason it takes
three of you to tell me this?
291
00:16:30,991 --> 00:16:33,261
Because we're having a disagreement
about whether or not it is Ms.
292
00:16:33,285 --> 00:16:34,619
No lesions on the mri.
293
00:16:34,744 --> 00:16:36,472
It's early. He's had the disease
for maybe two weeks.
294
00:16:36,496 --> 00:16:39,291
McDonald criteria requires six months
to make a definitive diagnosis.
295
00:16:39,416 --> 00:16:41,042
Who cares about macphearson?
296
00:16:41,168 --> 00:16:43,003
- I hear he tortured kittens.
- McDonald.
297
00:16:43,128 --> 00:16:45,172
Oh, McDonald.
Wonderful doctor, loved kittens.
298
00:16:45,297 --> 00:16:47,883
The vep indicates
slowing of the brain.
299
00:16:48,008 --> 00:16:49,193
Cameron: Without the lesions,
we can't be sure.
300
00:16:49,217 --> 00:16:51,595
Well, if it is, it's gone
from 0 to 60 in three weeks,
301
00:16:51,720 --> 00:16:54,139
which would indicate
rapidly progressive Ms.
302
00:16:54,264 --> 00:16:55,891
Not the fun ms with the balloons
303
00:16:56,016 --> 00:16:57,743
and the bike rides
for cripples in wheelchairs.
304
00:16:57,767 --> 00:17:00,604
- We should wait until...
- Start treating him now,
305
00:17:00,729 --> 00:17:02,529
maybe he can walk
for another couple of years,
306
00:17:02,647 --> 00:17:05,025
maybe live for another five.
307
00:17:05,150 --> 00:17:07,319
Break it to the family.
I'm going home.
308
00:17:07,444 --> 00:17:10,197
Chase: It'll take months
for a definitive diagnosis.
309
00:17:10,322 --> 00:17:11,656
What'll happen to me?
310
00:17:13,200 --> 00:17:15,952
Ms is an incredibly
variable disease.
311
00:17:16,077 --> 00:17:19,206
If it is ms,
and we're not 100% sure.
312
00:17:19,331 --> 00:17:21,791
What do you think
is gonna happen?
313
00:17:24,961 --> 00:17:27,005
There are some medications
to manage the symptoms,
314
00:17:27,130 --> 00:17:31,176
but as the disease progresses,
the problems will become more severe.
315
00:17:31,301 --> 00:17:33,220
Bowel and bladder dysfunction,
316
00:17:33,345 --> 00:17:35,472
loss of cognitive function,
pain...
317
00:17:35,597 --> 00:17:37,015
So it's gonna hurt?
318
00:17:39,184 --> 00:17:41,728
The brain's like
a big jumble of wires.
319
00:17:41,853 --> 00:17:44,898
Ms strips them of the insulation,
and the nerves die.
320
00:17:45,023 --> 00:17:47,067
Brain interprets it as pain.
321
00:17:47,192 --> 00:17:51,196
But by starting treatment, we're gonna
prevent that for as long as possible.
322
00:17:51,321 --> 00:17:53,001
We're looking into
a couple of specialists,
323
00:17:53,073 --> 00:17:56,826
and until we get you squared away,
you'll stay here, okay?
324
00:18:17,555 --> 00:18:20,141
Security checked the videotapes
from all perimeter cameras.
325
00:18:20,267 --> 00:18:21,369
He's still gotta be
in the hospital.
326
00:18:21,393 --> 00:18:22,393
Where's chase?
327
00:18:22,477 --> 00:18:23,645
- Main floor.
- Okay.
328
00:18:23,770 --> 00:18:25,248
You take the cafeteria
and administration.
329
00:18:25,272 --> 00:18:27,607
I'll hit the research annex
and work my way back to you.
330
00:19:05,437 --> 00:19:06,604
Dan?
331
00:19:12,819 --> 00:19:14,904
House on ma chine:
I'm not here. Leave a message.
332
00:19:20,577 --> 00:19:23,330
Dr. Cuddy. Great outfit.
333
00:19:23,455 --> 00:19:25,540
What are you doing back here?
Patient?
334
00:19:25,665 --> 00:19:27,000
No. Hooker.
335
00:19:27,125 --> 00:19:28,918
Went to my office
instead of my home.
336
00:19:39,804 --> 00:19:41,014
Foreman: Dr. House.
337
00:19:41,931 --> 00:19:43,141
Dan's missing.
338
00:19:43,266 --> 00:19:44,976
Yeah. I got that part
from the message.
339
00:19:45,101 --> 00:19:46,162
You said I was
needed immediately.
340
00:19:46,186 --> 00:19:48,063
He shouldn't move
after a lumbar puncture.
341
00:19:48,188 --> 00:19:50,940
I agree. He's gonna have
a very nasty headache.
342
00:19:51,066 --> 00:19:53,902
That would also be my opinion
if consulted tomorrow morning.
343
00:19:54,027 --> 00:19:55,403
We wanted to keep you informed.
344
00:19:55,528 --> 00:19:57,947
He heard some pretty heavy news.
345
00:19:59,074 --> 00:20:01,701
This is not a toddler
wandering around a department store.
346
00:20:01,826 --> 00:20:03,953
He's 16. You'll find him.
347
00:20:05,080 --> 00:20:06,706
I'm going home.
348
00:20:07,624 --> 00:20:10,019
When you say, "call me if you need
anything", you mean, "don't call"?
349
00:20:10,043 --> 00:20:12,295
No, I mean call me
if I could do something.
350
00:20:12,420 --> 00:20:13,505
I'm bad at search parties,
351
00:20:13,630 --> 00:20:16,716
and I'm bad at sitting around
looking nervous, doing nothing.
352
00:20:16,841 --> 00:20:18,635
What about his parents?
Should we call them?
353
00:20:18,760 --> 00:20:21,137
Why? Do you think
they're hiding him?
354
00:20:21,971 --> 00:20:23,973
Make sure someone
checks the roof.
355
00:20:24,099 --> 00:20:28,269
Some of the orderlies keep the door
propped open so they can grab a smoke.
356
00:21:03,054 --> 00:21:04,889
Chase: Dan. You okay?
357
00:21:12,313 --> 00:21:14,566
There are
experimental treatments.
358
00:21:14,691 --> 00:21:15,900
Ongoing research.
359
00:21:16,568 --> 00:21:18,945
Who knows what they'll discover
in a year or two.
360
00:21:19,070 --> 00:21:20,864
This is where
I dropped the ball.
361
00:21:20,989 --> 00:21:24,075
Dan, we're standing
on the roof of the hospital.
362
00:21:25,994 --> 00:21:27,078
Dan.
363
00:21:28,079 --> 00:21:29,998
Dan, you're not on the field.
364
00:21:30,874 --> 00:21:32,667
- He doesn't know where he is.
- Dan!
365
00:21:32,792 --> 00:21:33,877
Foreman.
366
00:21:35,378 --> 00:21:36,546
Dan.
367
00:21:38,173 --> 00:21:39,757
- Dan?
- Dan, no!
368
00:21:51,227 --> 00:21:52,687
Dr. Foreman.
369
00:21:54,606 --> 00:21:56,316
I assume you found the kid.
370
00:21:56,441 --> 00:21:58,943
- He almost walked off the roof.
- Suicidal?
371
00:21:59,068 --> 00:22:01,237
No, he thought he was
on his lacrosse field.
372
00:22:01,362 --> 00:22:03,323
Look, I was just gonna run home,
shower, change...
373
00:22:03,448 --> 00:22:05,325
- Conscious?
- Yeah.
374
00:22:06,701 --> 00:22:07,744
How'd you talk him down?
375
00:22:07,869 --> 00:22:10,997
- Actually, chase tackled him.
- How come you didn't do it?
376
00:22:11,122 --> 00:22:13,500
Right. Well, I am black,
but he was closer.
377
00:22:16,669 --> 00:22:18,922
Come on.
You can ride up with me.
378
00:22:24,761 --> 00:22:27,281
Anybody tell the family that their boy
almost stepped off a roof?
379
00:22:27,305 --> 00:22:28,348
They must be thrilled.
380
00:22:28,473 --> 00:22:31,059
They're not suing,
but I think only because chase asked...
381
00:22:31,184 --> 00:22:33,224
Why does everybody
always think I'm being sarcastic?
382
00:22:33,311 --> 00:22:36,397
This is great news.
He doesn't have Ms.
383
00:22:36,523 --> 00:22:38,650
Parents should be thrilled.
Well, the mom anyway.
384
00:22:38,775 --> 00:22:40,002
Of course, the dad
probably doesn't know...
385
00:22:40,026 --> 00:22:41,569
Why doesn't he have ms?
386
00:22:41,694 --> 00:22:43,839
He was on the roof,
thinking he was on a lacrosse field.
387
00:22:43,863 --> 00:22:45,257
Conscious, and
therefore not a night terror.
388
00:22:45,281 --> 00:22:47,659
- You want some of this?
- Yeah, sure.
389
00:22:48,076 --> 00:22:50,203
He was in an acute
confusional state,
390
00:22:50,328 --> 00:22:52,664
which doesn't fit with
a demyelinating disease like Ms.
391
00:22:52,789 --> 00:22:53,790
Oligoclonal bands...
392
00:22:53,915 --> 00:22:55,041
Were real.
393
00:22:55,166 --> 00:22:56,960
They just mean
something other than Ms.
394
00:22:57,085 --> 00:22:58,753
So, what are they telling us?
395
00:22:58,878 --> 00:23:00,105
That the immune system
is working?
396
00:23:00,129 --> 00:23:01,172
Right.
397
00:23:01,297 --> 00:23:02,966
He has
an infection in his brain.
398
00:23:03,091 --> 00:23:06,719
- What about sex?
- Well, it might get complicated.
399
00:23:06,844 --> 00:23:07,887
I mean, we work together.
400
00:23:08,012 --> 00:23:09,532
I'm older, certainly,
but maybe you like that.
401
00:23:09,556 --> 00:23:11,266
I meant maybe he
has neurosyphilis.
402
00:23:12,141 --> 00:23:13,142
Nice cover.
403
00:23:13,268 --> 00:23:14,519
Sorry. Rpr was negative.
404
00:23:14,644 --> 00:23:16,455
House: We don't need
a definitive test to confirm this.
405
00:23:16,479 --> 00:23:18,273
Sure. Didn't need
one to confirm Ms.
406
00:23:18,398 --> 00:23:20,984
Okay. Let's wait for you to
run titers on 1,400 viruses
407
00:23:21,109 --> 00:23:23,027
while this kid's
brain turns to mush.
408
00:23:23,152 --> 00:23:24,946
So the fact that
he doesn't have ms,
409
00:23:25,071 --> 00:23:27,031
it's really not
good news after all.
410
00:23:27,156 --> 00:23:28,992
Well, it is if
it's neurosyphilis.
411
00:23:29,117 --> 00:23:32,120
The likelihood of
a false negative on an rpr test, 30%.
412
00:23:32,245 --> 00:23:35,873
Likelihood of a 16-year-old having sex,
roughly 120%.
413
00:23:35,999 --> 00:23:37,142
I'll start him on iv penicillin.
414
00:23:37,166 --> 00:23:38,269
House: No. We're not
gonna wait for that.
415
00:23:38,293 --> 00:23:39,933
The most effective way
to deliver the drug
416
00:23:40,003 --> 00:23:41,397
is right into his
brain via the spine.
417
00:23:41,421 --> 00:23:43,381
We can't. In a cramped
space like the brain,
418
00:23:43,506 --> 00:23:46,306
increased intracranial pressure
from a high-volume drug like penicillin
419
00:23:46,384 --> 00:23:48,678
could herniate his brain stem.
It'd kill him.
420
00:23:48,803 --> 00:23:50,906
No neurologist in his right mind
would recommend that.
421
00:23:50,930 --> 00:23:53,683
Show of hands.
Who thinks I'm not in my right mind?
422
00:23:54,392 --> 00:23:57,645
And who thinks I forget
this fairly basic neurological fact?
423
00:23:58,271 --> 00:24:00,773
Who thinks
there's a third option?
424
00:24:02,191 --> 00:24:04,110
Very good.
What's the third choice?
425
00:24:04,235 --> 00:24:07,280
No idea. You just asked
if I thought there was one.
426
00:24:09,741 --> 00:24:11,492
The patient has
a shunt in his brain.
427
00:24:11,618 --> 00:24:12,886
There'll be no
increased pressure.
428
00:24:12,910 --> 00:24:15,204
We can put as much penicillin
into his body as we want.
429
00:24:15,330 --> 00:24:18,166
Excellent.
Inject him through a lumbar puncture.
430
00:24:21,169 --> 00:24:25,465
One of us is gonna do this to you
twice a day for the next two weeks.
431
00:24:27,634 --> 00:24:28,635
I'm ready. Go.
432
00:24:28,760 --> 00:24:32,388
He could get syphilis
even if he's not sexually active?
433
00:24:33,389 --> 00:24:36,851
Well, it's unusual,
but it's possible.
434
00:24:37,810 --> 00:24:39,729
Okay. Relax.
435
00:24:52,784 --> 00:24:56,079
It's infected,
with a really big hole,
436
00:24:56,204 --> 00:24:58,539
like you stuck a nail in it
to relieve the pressure.
437
00:24:58,665 --> 00:24:59,665
I wouldn't do that.
438
00:24:59,749 --> 00:25:00,893
House: Although
the wound is irregular.
439
00:25:00,917 --> 00:25:02,919
It's not cylindrical.
It's shaped like a triangle.
440
00:25:03,044 --> 00:25:05,213
So, not a nail.
441
00:25:05,338 --> 00:25:07,256
- Steak knife?
- Wife's nail file.
442
00:25:07,382 --> 00:25:08,966
Nail file.
443
00:25:09,801 --> 00:25:12,595
Yeah. Pain will make
you do stupid things.
444
00:25:13,012 --> 00:25:14,889
Something to take the edge off?
445
00:25:15,014 --> 00:25:16,014
Yeah.
446
00:25:18,434 --> 00:25:19,811
Cheers.
447
00:25:24,148 --> 00:25:26,943
So, you have family
here in Princeton?
448
00:25:29,028 --> 00:25:30,029
Here on work?
449
00:25:30,154 --> 00:25:31,874
- No. Why are you...
- Does your penis hurt?
450
00:25:31,989 --> 00:25:34,242
No. What? Should it?
451
00:25:34,367 --> 00:25:38,079
No. Just thought I'd toss you
a really inappropriate question.
452
00:25:38,204 --> 00:25:39,414
Your lawyer's gonna love it.
453
00:25:39,539 --> 00:25:40,707
Why would I want to sue you?
454
00:25:40,832 --> 00:25:41,832
I want you to treat me.
455
00:25:41,916 --> 00:25:43,060
You're from Maplewood,
New Jersey, right?
456
00:25:43,084 --> 00:25:44,085
Yeah.
457
00:25:44,210 --> 00:25:46,921
Now, why would you
drive 70 miles
458
00:25:47,046 --> 00:25:47,922
to get treatment for a condition
459
00:25:48,047 --> 00:25:50,717
that a nine-year-old
could diagnose?
460
00:25:51,884 --> 00:25:54,303
It's the free-flowing pus
that's the tip-off.
461
00:25:54,429 --> 00:25:55,429
I was in town.
462
00:25:55,513 --> 00:25:57,348
Not for family. Not for work.
463
00:25:57,473 --> 00:25:59,434
You drove 70 miles
to a walk-in clinic.
464
00:25:59,559 --> 00:26:00,953
You passed two hospitals
on the road.
465
00:26:00,977 --> 00:26:03,187
Now, either you've got a problem
with those hospitals,
466
00:26:03,312 --> 00:26:04,540
or they have a problem with you.
467
00:26:04,564 --> 00:26:07,233
My guess is you've sued
half the doctors in Maplewood,
468
00:26:07,358 --> 00:26:09,068
and the rest are now
refusing to help you.
469
00:26:09,193 --> 00:26:10,445
It's ironic, isn't it?
470
00:26:10,570 --> 00:26:13,114
Sort of like
the boy who sued wolf.
471
00:26:13,698 --> 00:26:16,117
You know, I bet we have
a doctor here named wolf.
472
00:26:16,242 --> 00:26:18,202
How perfect would that be?
473
00:26:18,745 --> 00:26:19,746
I'm gonna page him.
474
00:26:19,871 --> 00:26:21,111
Okay. You know what? Thank you.
475
00:26:21,164 --> 00:26:23,541
I'm gonna find a doctor
to take care of this.
476
00:26:23,666 --> 00:26:25,668
I didn't say
I wouldn't treat you.
477
00:26:25,793 --> 00:26:28,021
We'll drain your knee,
run some lab work. Fix you right up.
478
00:26:28,045 --> 00:26:30,757
- Why would you do that?
- I'm a people person.
479
00:26:32,091 --> 00:26:33,509
You actually treated him?
480
00:26:33,634 --> 00:26:35,011
All I know is
he sued some doctors.
481
00:26:35,136 --> 00:26:37,680
Who am I to assume
they didn't have it coming to them?
482
00:26:37,805 --> 00:26:39,557
The cutest little tennis outfit.
483
00:26:39,682 --> 00:26:41,642
My god, I thought
I was gonna have a heart attack.
484
00:26:41,768 --> 00:26:43,746
Oh, my. I didn't see you there.
That is so embarrassing.
485
00:26:43,770 --> 00:26:45,104
How's your hooker doing?
486
00:26:45,229 --> 00:26:46,981
Sweet of you to ask.
Funny story.
487
00:26:47,106 --> 00:26:48,666
She was gonna be
hospital administrator,
488
00:26:48,691 --> 00:26:50,860
but just hated having to
screw people like that.
489
00:26:50,985 --> 00:26:52,087
I heard you found
her on the roof.
490
00:26:52,111 --> 00:26:55,156
- You have very acute hearing.
- You notify the parents?
491
00:26:55,281 --> 00:26:56,407
In due course, of course.
492
00:26:56,532 --> 00:27:00,703
And is there a paternity bet
on the father of the patient?
493
00:27:00,828 --> 00:27:01,829
Doesn't sound like me.
494
00:27:01,954 --> 00:27:04,154
Well, it does, actually,
but doesn't mean you're guilty.
495
00:27:04,248 --> 00:27:06,459
- You think?
- I saw the parents in the lobby.
496
00:27:06,584 --> 00:27:09,128
Smart money's
obviously on the father.
497
00:27:09,253 --> 00:27:11,422
My guy knows a guy
who can get you in for 50 bucks.
498
00:27:11,547 --> 00:27:13,257
Fine. Tell your guy, if I win,
499
00:27:13,382 --> 00:27:15,360
you attend the faculty symposium,
and you wear a tie.
500
00:27:15,384 --> 00:27:18,721
And if I win,
no clinic hours for a week.
501
00:27:18,846 --> 00:27:20,848
My guy will call your guy.
502
00:27:22,725 --> 00:27:24,852
She's very good at herjob.
503
00:27:29,357 --> 00:27:31,567
The treatments
should start helping soon.
504
00:27:31,692 --> 00:27:35,655
Let us know if it gets easier
to focus on things, remember stuff.
505
00:27:36,906 --> 00:27:38,032
Hey, Dan.
506
00:27:38,157 --> 00:27:40,785
Isn't Dr. Cameron's necklace
a beauty?
507
00:27:40,910 --> 00:27:43,037
Something south American,
I think.
508
00:27:43,162 --> 00:27:44,914
Yeah. Guatemalan.
509
00:27:45,957 --> 00:27:47,959
It's a cool necklace.
510
00:27:49,585 --> 00:27:52,171
- Thank you so much.
- The kid's in pain.
511
00:27:54,131 --> 00:27:55,691
Man: Don't fight it.
Just let it happen.
512
00:27:56,884 --> 00:27:58,153
Woman: You'll be dead in two days.
Chase: "No" what?
513
00:27:58,177 --> 00:27:59,177
Woman: I give it a day.
514
00:27:59,262 --> 00:28:00,972
Dan? You okay?
515
00:28:01,097 --> 00:28:02,390
Dan? Man: Night terrors.
516
00:28:02,515 --> 00:28:04,851
Woman: Body decomposition
once he's in the grave.
517
00:28:04,976 --> 00:28:06,370
Man: Say goodbye to
your mother and father.
518
00:28:06,394 --> 00:28:07,395
He's hearing voices.
519
00:28:07,520 --> 00:28:09,981
Woman: You're dying.
It's all over, Dan.
520
00:28:11,983 --> 00:28:13,126
Woman: You're dying.
Dying. Dead!
521
00:28:13,150 --> 00:28:15,069
Man: You're a dead man!
522
00:28:15,945 --> 00:28:17,989
Push 2 milligrams
iv ativan, stat.
523
00:28:18,114 --> 00:28:19,949
Woman: It's all over.
524
00:28:20,283 --> 00:28:21,450
Come on, Dan.
525
00:28:21,576 --> 00:28:23,119
Get out of my head!
526
00:28:25,997 --> 00:28:28,583
Auditory hallucination shows
further brain degeneration.
527
00:28:28,708 --> 00:28:29,988
Chase: Penicillin's not working.
528
00:28:30,042 --> 00:28:32,837
So either it's a
bad batch of penicillin,
529
00:28:32,962 --> 00:28:34,797
or our diagnosis is wrong.
530
00:28:36,424 --> 00:28:39,427
Square one. Midnit.
531
00:28:39,552 --> 00:28:42,555
Foreman: Lfts, bun and
creatinine are all normal.
532
00:28:42,680 --> 00:28:43,806
Diabetes is out, and no gap.
533
00:28:43,931 --> 00:28:46,475
- There goes metabolic.
- Mra rules out vasculitis.
534
00:28:46,601 --> 00:28:47,852
"I" for inflammation.
535
00:28:47,977 --> 00:28:49,371
Too young for
anything degenerative.
536
00:28:49,395 --> 00:28:50,855
House: "D", see ya.
537
00:28:50,980 --> 00:28:53,399
- "N" for neoplastic.
- Mri was clean.
538
00:28:54,692 --> 00:28:56,611
- "I" for inflammation.
- We already did that.
539
00:28:56,736 --> 00:28:59,131
Stupid to have two I's in one mnemonic.
What's the other one?
540
00:28:59,155 --> 00:28:59,989
Infection.
541
00:29:00,114 --> 00:29:01,592
Oligoclonal bands
still have to mean something.
542
00:29:01,616 --> 00:29:02,658
But no fevers.
543
00:29:02,783 --> 00:29:04,177
White count's elevated,
but within range.
544
00:29:04,201 --> 00:29:06,996
We've tested for anything remotely
possible. Everything's negative.
545
00:29:07,121 --> 00:29:08,664
Ct scan rules out subdural.
546
00:29:08,831 --> 00:29:10,416
Trauma. Later much.
547
00:29:16,047 --> 00:29:17,256
You know the problem?
548
00:29:17,381 --> 00:29:20,801
"Midnight" is actually spelled
with a "g" and an "h".
549
00:29:21,135 --> 00:29:24,722
If we could just figure out
what those letters stand for.
550
00:29:27,975 --> 00:29:31,062
It's a sick brain, having fun,
551
00:29:33,105 --> 00:29:35,775
torturing him, talking to him.
552
00:29:40,947 --> 00:29:42,865
Scaring the hell out of him.
553
00:29:45,117 --> 00:29:49,372
Get him an eeg, left and right eog,
esophageal microphones.
554
00:29:50,122 --> 00:29:53,876
If this thing wants
to talk, let's listen.
555
00:29:56,003 --> 00:29:59,966
We're missing something.
This is screwed up.
556
00:30:00,091 --> 00:30:03,886
That's why you came up with the brain
talking to the virus thing?
557
00:30:04,011 --> 00:30:06,097
I panicked, okay?
558
00:30:06,222 --> 00:30:08,683
Sounded cool, though.
They bought it.
559
00:30:12,353 --> 00:30:13,479
Crap.
560
00:30:14,021 --> 00:30:16,023
Another reason I don't
like meeting patients.
561
00:30:16,148 --> 00:30:19,026
If they don't know what you look like,
they can't yell at you.
562
00:30:19,151 --> 00:30:20,569
Here we go.
563
00:30:25,324 --> 00:30:27,451
How can you just sit there?
564
00:30:28,577 --> 00:30:29,996
If I eat standing up, I spill.
565
00:30:30,121 --> 00:30:33,332
Our son is dying,
and you could care less?
566
00:30:34,125 --> 00:30:37,169
We're going through hell.
You're doing nothing?
567
00:30:38,504 --> 00:30:40,631
I'm sorry.
You need to vent. I understand.
568
00:30:40,756 --> 00:30:42,591
Don't be condescending.
569
00:30:43,092 --> 00:30:45,720
You haven't
checked in on him once.
570
00:30:45,928 --> 00:30:47,972
Blood pressure is 110 over 70.
571
00:30:48,764 --> 00:30:51,284
His shunt is patent, well-placed
in the right lateral ventricle.
572
00:30:51,308 --> 00:30:53,060
The EKG shows a normal qrs
573
00:30:53,185 --> 00:30:55,938
with deep-wave inversions throughout
both limb and precordial leads.
574
00:30:56,063 --> 00:30:58,983
Lfts are elevated,
but only twice the normal range.
575
00:30:59,108 --> 00:31:01,402
Oh, yeah.
And he's hearing voices.
576
00:31:06,532 --> 00:31:08,117
Go hold his hand.
577
00:31:10,161 --> 00:31:12,246
Go on. I'll bus your tray.
578
00:31:25,843 --> 00:31:27,678
Got any sample bags on you?
579
00:31:27,803 --> 00:31:30,848
I don't believe you.
You're gonna run DNA tests?
580
00:31:30,973 --> 00:31:34,310
Their son is deathly ill.
I know. It's terrible.
581
00:31:34,435 --> 00:31:35,871
But the fact is,
if I don't keep busy
582
00:31:35,895 --> 00:31:38,331
with trivial things like this,
I'm afraid I might start to cry.
583
00:31:38,355 --> 00:31:39,482
You're an ass.
584
00:31:39,607 --> 00:31:41,817
Yeah?
You want to double the bet?
585
00:31:52,912 --> 00:31:55,706
General hospital
is on channel 6.
586
00:31:55,831 --> 00:31:58,834
Dan's brain's not showing
channel 6 right now. Only mush.
587
00:31:58,959 --> 00:32:00,961
No epileptiforrn activity.
588
00:32:02,880 --> 00:32:03,923
What are you doing?
589
00:32:04,048 --> 00:32:07,760
- Waiting for cbc and chem-7.
- Good. Run DNA on these.
590
00:32:10,805 --> 00:32:13,224
- What's this?
- Parents' coffee cups.
591
00:32:14,642 --> 00:32:15,643
I can't believe you.
592
00:32:15,768 --> 00:32:17,037
I've had this
conversation once already.
593
00:32:17,061 --> 00:32:20,022
If you've got something else to do,
do it. Otherwise, do this.
594
00:32:28,155 --> 00:32:29,782
Dr. House?
595
00:32:29,907 --> 00:32:31,158
Hey. Mr. Funsten.
596
00:32:31,325 --> 00:32:32,868
I was wondering
when you'd be back.
597
00:32:32,993 --> 00:32:34,578
You got some papers for me?
598
00:32:34,703 --> 00:32:36,705
You've caused me
considerable mental distress.
599
00:32:36,831 --> 00:32:38,499
I certainly hope so.
600
00:32:39,041 --> 00:32:41,502
What? Too cheap to get your lawyer
to serve it for you,
601
00:32:41,627 --> 00:32:42,907
or is it just more fun this way?
602
00:32:43,003 --> 00:32:45,089
I'm obviously prepared
to consider a settlement.
603
00:32:45,214 --> 00:32:46,882
You have gonorrhea.
604
00:32:49,426 --> 00:32:50,553
No, I don't.
605
00:32:50,678 --> 00:32:53,305
Well, maybe you're right,
but I have a lab result says you do.
606
00:32:53,430 --> 00:32:55,891
Could be a false positive,
and normally I'd run a second test,
607
00:32:56,016 --> 00:32:57,661
but since you're here,
I'll just go with the first.
608
00:32:57,685 --> 00:32:58,925
You're just trying to scare me.
609
00:32:58,978 --> 00:33:01,021
It's reportable, you know.
Public health issue.
610
00:33:01,147 --> 00:33:02,898
I'll be sure to
let my wife know.
611
00:33:03,023 --> 00:33:05,023
Don't bother yourself.
The state will call for you.
612
00:33:05,109 --> 00:33:08,070
Look, if you're clean, I'm
sure it'll all blow over. No big deal.
613
00:33:08,195 --> 00:33:09,464
There's an easy way to find out.
614
00:33:09,488 --> 00:33:11,448
Get one of your
doctors to run a test.
615
00:33:13,450 --> 00:33:14,451
Uh-uh.
616
00:33:15,202 --> 00:33:17,997
These are mine now.
I'll see you in court.
617
00:33:22,209 --> 00:33:25,296
Foreman: West nile, negative. Not
surprising since not too many mosquitoes
618
00:33:25,421 --> 00:33:26,781
passing through
Jersey in December.
619
00:33:26,881 --> 00:33:28,024
Chase: No eastern
equine encephalitis.
620
00:33:28,048 --> 00:33:29,401
You guys aren't
gonna believe this.
621
00:33:29,425 --> 00:33:30,467
What's that?
622
00:33:30,593 --> 00:33:33,012
House is right.
The father's not the father.
623
00:33:34,471 --> 00:33:36,265
Dude doubled up on me.
624
00:33:36,932 --> 00:33:39,059
You're not gonna believe this.
625
00:33:39,185 --> 00:33:41,020
The mother's not
the mother either.
626
00:33:43,522 --> 00:33:46,275
It's not a good idea
to move your son in his condition.
627
00:33:46,400 --> 00:33:48,694
- We just want a second opinion.
- We need an answer.
628
00:33:50,196 --> 00:33:53,157
You idiots. You lied to me.
629
00:33:53,282 --> 00:33:55,075
We didn't lie about anything.
630
00:33:55,201 --> 00:33:58,037
You, on the other hand,
accused us of molesting our son.
631
00:33:58,162 --> 00:34:00,080
- Perfect.
- Can we get off my screw-ups
632
00:34:00,206 --> 00:34:02,166
and focus on theirs?
Theirs is bigger.
633
00:34:02,291 --> 00:34:04,919
- You're not Dan's parents.
- We're his parents.
634
00:34:05,044 --> 00:34:06,604
He was adopted.
He doesn't need to know.
635
00:34:06,670 --> 00:34:07,670
I do.
636
00:34:07,755 --> 00:34:09,173
Adoption makes
us just as much...
637
00:34:09,298 --> 00:34:13,177
Listen. When we were taking
his medical history, were you confused?
638
00:34:13,344 --> 00:34:15,780
Did you think we were looking
for a genetic clue to his condition,
639
00:34:15,804 --> 00:34:17,199
or did you think we were
trying to ascertain
640
00:34:17,223 --> 00:34:19,850
who loves him the most
in the whole wide world?
641
00:34:19,975 --> 00:34:22,102
How did you find out about this?
642
00:34:22,853 --> 00:34:25,898
- I sampled their DNA.
- We didn't give you any DNA.
643
00:34:26,023 --> 00:34:27,983
Your coffee cups
from the cafeteria.
644
00:34:28,108 --> 00:34:29,401
You can't do that.
645
00:34:29,526 --> 00:34:31,987
Again, why are we getting hung up
on what I did?
646
00:34:32,112 --> 00:34:33,530
Your medical history is useless.
647
00:34:33,656 --> 00:34:37,868
No. We gave you a detailed history
of his biological mother.
648
00:34:38,118 --> 00:34:41,163
Her history.
Non-smoker, good health,
649
00:34:41,288 --> 00:34:44,083
low cholesterol,
no blood pressure problems.
650
00:34:44,208 --> 00:34:46,126
Dan was adopted two weeks
after he was born.
651
00:34:46,252 --> 00:34:47,896
You have his history.
There's nothing you need to know
652
00:34:47,920 --> 00:34:50,089
- that we didn't tell you.
- Sounds reasonable.
653
00:34:50,714 --> 00:34:54,051
Well, if you want to transfer your boy,
that is your choice.
654
00:34:54,176 --> 00:34:55,403
I still think it's the wrong...
655
00:34:55,427 --> 00:34:57,137
Was she vaccinated?
656
00:34:58,347 --> 00:34:59,765
The biological mother.
657
00:34:59,890 --> 00:35:01,576
When she was a baby,
did she get her vaccinations?
658
00:35:01,600 --> 00:35:04,186
Dan was vaccinated
at six months.
659
00:35:05,604 --> 00:35:08,857
Do you know why kids get
vaccinated at six months?
660
00:35:08,983 --> 00:35:10,463
Because before that
they are protected
661
00:35:10,567 --> 00:35:13,904
by their biological
mother's immune system.
662
00:35:14,029 --> 00:35:16,240
So, was she vaccinated?
663
00:35:19,785 --> 00:35:22,913
House: An infant picks up
a regular old measles virus.
664
00:35:23,289 --> 00:35:26,041
Gets a rash.
He's extremely uncomfortable,
665
00:35:26,166 --> 00:35:28,294
has a wicked fever,
but he lives.
666
00:35:28,419 --> 00:35:29,837
Here's the kicker.
667
00:35:29,962 --> 00:35:33,632
Once every million or so times,
the virus mutates.
668
00:35:34,633 --> 00:35:37,219
Instead of Dan having
a fever and a rash,
669
00:35:37,344 --> 00:35:41,307
the virus travels to his brain
and hides, like a time bomb.
670
00:35:41,932 --> 00:35:44,810
In this case, for 16 years.
671
00:35:44,935 --> 00:35:47,604
Subacute
sclerosing panencephalitis.
672
00:35:48,314 --> 00:35:50,149
I know.
There's only been 20 cases
673
00:35:50,274 --> 00:35:51,914
in the United States
in the last 30 years.
674
00:35:51,942 --> 00:35:55,237
I suppose you could make an argument
the kid's still in stage 1.
675
00:35:55,362 --> 00:35:57,448
Once sspe moves
to stage 2, it's...
676
00:35:57,573 --> 00:36:00,868
Boom.
Stage 2 is universally fatal.
677
00:36:00,993 --> 00:36:02,053
I assume it's impossible to know
678
00:36:02,077 --> 00:36:03,495
when he might move into stage 2.
679
00:36:03,620 --> 00:36:05,664
He's already
started showing symptoms.
680
00:36:05,789 --> 00:36:08,000
Could be a month.
Could be tonight.
681
00:36:08,375 --> 00:36:10,252
Can we treat it?
House: Ask the neurologist.
682
00:36:10,377 --> 00:36:12,588
Intraventricular interferon.
683
00:36:12,713 --> 00:36:14,107
Not gonna shove
a spike into his brain
684
00:36:14,131 --> 00:36:16,759
and drip interferon
without confirming this diagnosis.
685
00:36:16,884 --> 00:36:18,927
- Tap him.
- We won't get a reliable result
686
00:36:19,053 --> 00:36:20,596
for measles antibodies
in his csf.
687
00:36:20,721 --> 00:36:21,865
Not after everything
we've given him.
688
00:36:21,889 --> 00:36:24,975
So the wrong treatment kills any hope
of the right diagnosis.
689
00:36:25,100 --> 00:36:27,019
Why do people lie to me?
690
00:36:29,146 --> 00:36:31,982
Could also kill him.
Your ball, foreman.
691
00:36:32,107 --> 00:36:34,068
Tell me I don't have
to biopsy his brain.
692
00:36:35,986 --> 00:36:38,113
Well, there is one other way.
693
00:36:39,782 --> 00:36:41,825
You sure this isn't gonna hurt?
694
00:36:41,950 --> 00:36:43,994
Yeah. It's just scary as hell.
695
00:36:44,411 --> 00:36:45,996
Foreman: See,
we go through the pupil.
696
00:36:46,121 --> 00:36:48,624
But you won't feel it.
The eye's been paralyzed.
697
00:36:48,749 --> 00:36:50,417
The needle travels to
the back of the eye,
698
00:36:50,542 --> 00:36:53,796
which is where we'll perform
the biopsy on your retina.
699
00:36:59,009 --> 00:37:02,179
So we've confirmed that the problem
is this mutated virus.
700
00:37:02,429 --> 00:37:05,849
The treatment for sspe is
intraventricular interferon.
701
00:37:05,974 --> 00:37:08,977
We implant an ommaya reservoir
under the scalp,
702
00:37:09,103 --> 00:37:10,854
which is connected to
a ventricular catheter
703
00:37:10,979 --> 00:37:13,941
that delivers the antiviral
directly to the left hemisphere.
704
00:37:14,066 --> 00:37:15,401
You want us to consent to this?
705
00:37:15,526 --> 00:37:17,337
I don't even understand
what you're talking about.
706
00:37:17,361 --> 00:37:19,196
Well, the antiviral...
707
00:37:22,825 --> 00:37:24,326
Look. I'm sorry.
708
00:37:24,451 --> 00:37:26,495
I can explain this
as best I can,
709
00:37:26,620 --> 00:37:29,540
but the notion that you're gonna
fully understand your son's treatment
710
00:37:29,665 --> 00:37:33,001
and make an informed decision
is kind of insane.
711
00:37:35,045 --> 00:37:37,297
Here's what you need to know.
712
00:37:38,090 --> 00:37:41,802
It's dangerous.
It could kill him.
713
00:37:42,845 --> 00:37:44,388
You should do it.
714
00:37:55,649 --> 00:37:57,818
Woman: Did you
need something else?
715
00:38:16,753 --> 00:38:19,965
You can't order a $3,200 DNA test
to win a bet.
716
00:38:20,090 --> 00:38:22,050
It's not an actual cost.
717
00:38:22,468 --> 00:38:23,611
I don't know if you know this,
718
00:38:23,635 --> 00:38:26,013
but the hospital actually owns
the sequencing machine.
719
00:38:26,138 --> 00:38:27,365
- I'm serious.
- Tell the parents
720
00:38:27,389 --> 00:38:28,724
to submit the bill to insurance.
721
00:38:28,849 --> 00:38:30,934
Insurance is not
gonna pay for a bet.
722
00:38:31,059 --> 00:38:32,059
It should.
723
00:38:32,144 --> 00:38:34,062
We don't make that bet,
the kid dies.
724
00:38:34,980 --> 00:38:37,500
If not for the paternity bet,
I never would have taken their DNA.
725
00:38:37,524 --> 00:38:39,127
Without their DNA,
we never would have discovered
726
00:38:39,151 --> 00:38:42,362
that Dan was adopted,
which was the key to this case.
727
00:38:42,905 --> 00:38:45,365
You just don't
want to pay your end.
728
00:38:45,782 --> 00:38:48,035
Big mistake. My guy knows a guy.
729
00:38:48,160 --> 00:38:51,205
Fine. I will let you
out of clinic duty for one week,
730
00:38:51,330 --> 00:38:54,291
after you pay
the $3,200 for the pcr test.
731
00:39:03,926 --> 00:39:06,762
Well, now,
there's the $100 you owe me.
732
00:39:08,138 --> 00:39:10,265
Here's the $100
I won from Cameron.
733
00:39:10,390 --> 00:39:12,809
$200 I took off of foreman.
734
00:39:14,144 --> 00:39:17,773
And $600 I got from Wilson.
735
00:39:20,859 --> 00:39:21,902
Very bitter.
736
00:39:25,948 --> 00:39:27,574
Cameron: Hey. Good morning.
737
00:39:27,991 --> 00:39:29,576
Foreman: Good news on your eeg.
738
00:39:29,701 --> 00:39:30,953
Treatment is working.
739
00:39:31,078 --> 00:39:33,038
And your immune system
is responding.
740
00:39:33,747 --> 00:39:37,000
I know it's early,
but I just want to take a look.
741
00:39:38,085 --> 00:39:39,419
All right.
742
00:39:39,545 --> 00:39:41,922
Let's see what that
brain of yours can do.
743
00:39:42,047 --> 00:39:43,382
Name as many animals as you can
744
00:39:43,507 --> 00:39:45,300
that start with the letter "0".
745
00:39:46,093 --> 00:39:47,386
Ostrich.
746
00:39:48,387 --> 00:39:51,098
Ox. Old elephant.
747
00:39:51,807 --> 00:39:54,476
Well, that's two
better than last time.
748
00:39:54,851 --> 00:39:57,354
How you doing
with the whole adoption thing?
749
00:39:57,479 --> 00:39:58,855
I knew since fifth grade.
750
00:39:59,731 --> 00:40:00,899
How's that?
751
00:40:01,024 --> 00:40:02,276
Cleft chin.
752
00:40:03,694 --> 00:40:06,196
I have one. My dad doesn't.
753
00:40:06,905 --> 00:40:07,924
Looked it up on the Internet.
754
00:40:07,948 --> 00:40:10,534
It's one of those trait things.
755
00:40:10,659 --> 00:40:13,203
That's right.
It's autosomal dominant.
756
00:40:13,829 --> 00:40:15,956
Since neither of your parents
have cleft chins,
757
00:40:16,081 --> 00:40:19,042
it's highly unlikely
you're biologically related.
758
00:40:21,003 --> 00:40:22,462
Are you sure you're okay?
759
00:40:22,588 --> 00:40:25,007
I've got no problems
with being adopted.
760
00:40:26,383 --> 00:40:27,968
I love my parents.
761
00:40:31,096 --> 00:40:32,097
How's he doing?
762
00:40:32,222 --> 00:40:35,142
He's doing pretty well.
He's a smart kid.
763
00:40:35,851 --> 00:40:37,185
I think he's gonna be fine.
764
00:40:41,189 --> 00:40:43,066
- Hey.
- Thanks.
765
00:41:19,102 --> 00:41:21,188
Wheels, 18. Wheels.
56722
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