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Would you like to inspect the original subtitles? These are the user uploaded subtitles that are being translated: 1 00:00:04,046 --> 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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