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Narrator:
The human heart is a giant muscle
2
00:00:02,420 --> 00:00:05,715
squeezing or contracting
over 60 times each minute.
3
00:00:05,840 --> 00:00:07,425
That's 3,600...
4
00:00:07,550 --> 00:00:10,678
Walsh: At this point,
your blood is a deep purple
5
00:00:10,803 --> 00:00:13,681
because it's just finished
dropping off oxygen
6
00:00:13,806 --> 00:00:15,308
for all the parts of your body.
7
00:00:17,685 --> 00:00:19,395
Come on, follow me.
8
00:00:22,023 --> 00:00:23,191
Come on.
9
00:00:28,029 --> 00:00:30,281
I have a question
and I need to go to the bathroom.
10
00:00:30,406 --> 00:00:31,991
Which would you like to do first?
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00:00:32,825 --> 00:00:33,659
The question.
12
00:00:33,784 --> 00:00:36,078
- Okay.
- Where's the bathroom?
13
00:00:37,246 --> 00:00:38,831
Who knows where the bathroom is?
14
00:00:38,956 --> 00:00:39,957
I do.
15
00:00:40,082 --> 00:00:41,626
Go with Ian to the bathroom.
16
00:00:41,751 --> 00:00:42,752
I don't have to go.
17
00:00:42,877 --> 00:00:45,379
We're not at school,
nobody goes anywhere by themselves.
18
00:00:45,504 --> 00:00:47,298
- Why?
- In case you get lost.
19
00:00:47,423 --> 00:00:49,008
Orin case somebody kidnaps us.
20
00:00:49,133 --> 00:00:51,510
If somebody kidnaps Ian,
they'll kidnap me, too.
21
00:00:51,636 --> 00:00:52,836
I want to stay with the class.
22
00:00:52,929 --> 00:00:54,263
Michael, go with Ian...
23
00:00:55,514 --> 00:00:56,557
Do you need help?
24
00:00:56,682 --> 00:00:57,882
I need you to find a grown-up.
25
00:00:57,975 --> 00:00:58,975
Is the baby coming?
26
00:01:00,144 --> 00:01:02,230
- Who should I take with me?
- You're fine.
27
00:01:02,355 --> 00:01:05,066
Go to the front desk
or find a security guard.
28
00:01:05,191 --> 00:01:06,943
I really have to pee.
29
00:01:08,945 --> 00:01:10,321
Walsh: Oh, god.
30
00:01:10,696 --> 00:01:13,824
Is the baby coming?
I don't know how to do this.
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00:01:14,116 --> 00:01:15,785
Are you okay, Ian?
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00:01:15,910 --> 00:01:17,161
Yeah. Sure.
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00:01:19,997 --> 00:01:21,791
I don't think you are.
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00:01:24,835 --> 00:01:26,337
You're bleeding.
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00:01:29,340 --> 00:01:30,549
Walsh: Help!
36
00:01:31,050 --> 00:01:32,218
Help!
37
00:02:29,275 --> 00:02:30,943
- $20.
- Call.
38
00:02:31,819 --> 00:02:33,279
You'll call anything.
39
00:02:33,404 --> 00:02:35,573
My stack is bigger than your stack.
40
00:02:36,824 --> 00:02:37,825
You in or out?
41
00:02:37,950 --> 00:02:39,785
You know that relative to their size,
42
00:02:39,910 --> 00:02:42,830
gorillas have smaller testicles
than humans.
43
00:02:43,539 --> 00:02:46,917
Well, then you'd probably have an edge
over a gorilla, but not over me.
44
00:02:47,043 --> 00:02:49,795
Reason is, primate testes' size
45
00:02:49,920 --> 00:02:53,007
inversely corresponds to the fidelity
of our females.
46
00:02:54,550 --> 00:02:57,303
You think there might be a better time
to annoy me about my wife?
47
00:02:57,428 --> 00:02:58,788
- I'm talking about poker.
- Right.
48
00:02:58,888 --> 00:03:00,973
Women are evil,
you're right to drive them away.
49
00:03:01,098 --> 00:03:03,309
Call, fold or raise.
Story time can wait.
50
00:03:03,434 --> 00:03:05,978
We're smaller and better than chimps,
51
00:03:06,687 --> 00:03:08,564
bigger and worse than gorillas.
52
00:03:08,689 --> 00:03:10,024
For all our rationality,
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00:03:10,149 --> 00:03:13,402
our supposed trust and fealty
to a higher power,
54
00:03:13,527 --> 00:03:17,281
our ability to create a system of rules
and laws,
55
00:03:17,573 --> 00:03:20,743
our baser drives are more powerful
than any of that.
56
00:03:20,868 --> 00:03:23,871
We want to control our emotions,
but we can't.
57
00:03:24,580 --> 00:03:27,124
If we're happy, things don't annoy us.
58
00:03:27,708 --> 00:03:30,920
If, on the other hand,
we're sitting on crappy hole cards,
59
00:03:31,045 --> 00:03:34,048
little tiny things annoy us
a whole lot more.
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00:03:38,886 --> 00:03:39,762
I raise.
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00:03:39,887 --> 00:03:42,367
So, are you gonna tell me
an annoying story every time I raise?
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00:03:42,431 --> 00:03:44,600
God, that would be annoying.
63
00:03:45,226 --> 00:03:46,477
I call.
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00:03:46,894 --> 00:03:49,146
Dr. Cuddy, I got one of your patients
in the er.
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00:03:49,271 --> 00:03:50,940
Ian alston, six-years-old.
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00:03:51,399 --> 00:03:53,818
Oh, I know him. What's the problem?
I'm all in.
67
00:03:53,943 --> 00:03:55,736
Bloody diarrhea. Hemodynamically
stable,
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00:03:55,861 --> 00:03:57,947
but he's been developing some
coordination problems.
69
00:03:58,072 --> 00:04:00,032
It sounds like gastroenteritis
and dehydration.
70
00:04:00,157 --> 00:04:02,284
Order fluids and I'll take it
on my service.
71
00:04:02,410 --> 00:04:03,536
Bet's to you, house.
72
00:04:03,661 --> 00:04:05,621
- They scan his head?
- No, why would they scan...
73
00:04:05,663 --> 00:04:07,456
Don't play games. You gonna call?
74
00:04:07,581 --> 00:04:09,625
- How's the heart rate?
- Stable.
75
00:04:09,750 --> 00:04:14,171
I'm sorry. House, it's gastroenteritis.
I'm not going anywhere.
76
00:04:14,296 --> 00:04:15,381
Put the order in,
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00:04:15,506 --> 00:04:19,009
and have someone tell Alan and Sarah
that I'll be up when I'm done.
78
00:04:19,885 --> 00:04:21,262
You in or out?
79
00:04:25,266 --> 00:04:26,559
I'm out.
80
00:04:30,980 --> 00:04:32,356
Stone cold bluff.
81
00:04:32,481 --> 00:04:36,235
You might want to spend a little more
time paying attention to your cards
82
00:04:36,360 --> 00:04:39,113
and a little less time staring
at my breasts.
83
00:04:39,238 --> 00:04:40,865
They don't match either.
84
00:04:40,990 --> 00:04:42,950
I'm gonna take some air.
85
00:05:02,928 --> 00:05:04,930
Follow my finger with your eyes.
86
00:05:11,395 --> 00:05:13,397
How much longer will Dr. Cuddy be?
87
00:05:13,522 --> 00:05:16,442
Well, given the number of mojitos
she's knocking back at the party,
88
00:05:16,567 --> 00:05:20,571
I'd say it's gonna be at least
three hours before she's even conscious.
89
00:05:20,696 --> 00:05:22,364
Sarah: Weren't you at the same party?
90
00:05:22,490 --> 00:05:23,824
I don't drink.
91
00:05:26,160 --> 00:05:29,121
I want you to reach out
and grab my cane.
92
00:05:34,627 --> 00:05:35,711
What's wrong?
93
00:05:35,836 --> 00:05:39,048
Your son's brain is losing control
of his muscles.
94
00:05:39,173 --> 00:05:42,551
Dr. Cuddy's message said it was just
dehydration from diarrhea.
95
00:05:42,676 --> 00:05:44,178
She's wrong.
96
00:05:45,804 --> 00:05:47,681
Is he gonna be all right?
97
00:05:50,768 --> 00:05:52,102
I don't know.
98
00:06:21,048 --> 00:06:23,425
So, were you in one of those cages?
99
00:06:24,009 --> 00:06:28,222
No. No, no, no, no.
No, those are for tourists.
100
00:06:28,889 --> 00:06:30,849
You were in the water
with the great white?
101
00:06:30,975 --> 00:06:34,937
Sure, it's no big deal. You just have to
keep an eye on them.
102
00:06:35,062 --> 00:06:38,065
If they get too close,
punch them in the nose.
103
00:06:38,315 --> 00:06:40,192
Send them on their way.
104
00:06:41,819 --> 00:06:43,028
I had you going.
105
00:06:43,153 --> 00:06:44,196
You are mean.
106
00:06:44,905 --> 00:06:47,157
Hey. How's that anal fissure?
107
00:06:47,992 --> 00:06:50,119
Did it heal yet?
Or is it still draining?
108
00:06:50,244 --> 00:06:51,579
Oh, I'm sorry.
109
00:06:51,704 --> 00:06:53,464
I didn't realize you'd come back
for seconds.
110
00:06:53,497 --> 00:06:56,497
I figured that after that girl in the
staiwvell you'd be done for the night.
111
00:06:56,542 --> 00:06:57,543
He's joking.
112
00:06:57,668 --> 00:06:59,461
No Adam's apple, small hands.
113
00:06:59,587 --> 00:07:01,463
It's no surprises this time.
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00:07:02,464 --> 00:07:04,174
I'll see you later.
115
00:07:07,052 --> 00:07:08,052
Got a case.
116
00:07:08,137 --> 00:07:09,497
Well, you could've just said that.
117
00:07:09,597 --> 00:07:10,917
You didn't have to screw with me.
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00:07:10,973 --> 00:07:12,053
If I didn't screw with you,
119
00:07:12,099 --> 00:07:14,299
you'd spent the whole night thinking
you might get laid,
120
00:07:14,351 --> 00:07:16,895
which means you'd be useless.
Better to extinguish all hope.
121
00:07:17,021 --> 00:07:20,149
Get foreman and Cameron and meet me
upstairs. Stat.
122
00:07:25,321 --> 00:07:26,655
What's so urgent?
123
00:07:26,780 --> 00:07:29,908
Two cases, same symptoms.
124
00:07:30,242 --> 00:07:33,287
What do six-year-olds and 70-year-olds
have in common?
125
00:07:33,412 --> 00:07:34,997
Their immune systems don't work as
well.
126
00:07:35,122 --> 00:07:37,124
- Could be listeria.
- I already checked for that.
127
00:07:37,249 --> 00:07:39,960
Leukemia has a higher prevalence
in both young and old.
128
00:07:40,085 --> 00:07:42,463
- So does asthma.
- House: No, no, no.
129
00:07:42,588 --> 00:07:44,028
Cameron: They can both get diabetes.
130
00:07:48,010 --> 00:07:49,928
The nearly dead and the newly bred
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00:07:50,054 --> 00:07:53,223
have more in common with each other
than with people in the middle.
132
00:07:53,349 --> 00:07:56,602
It's weird.
It's kind of a circle of life thing.
133
00:07:56,727 --> 00:07:59,271
- This kid doesn't have kidney failure.
- He will.
134
00:07:59,396 --> 00:08:02,149
Based on this file,
the kid just ate some bad food.
135
00:08:02,274 --> 00:08:03,317
Was the old man...
136
00:08:03,442 --> 00:08:07,404
They were nowhere near each other
in any of the four dimensions.
137
00:08:07,780 --> 00:08:09,573
- This case is 12 years old.
- Yep.
138
00:08:09,698 --> 00:08:11,659
And this case is cuddy's.
139
00:08:11,784 --> 00:08:13,035
She assigned it to me.
140
00:08:13,160 --> 00:08:16,872
She agrees with you that this is
something more than gastroenteritis?
141
00:08:16,997 --> 00:08:19,708
She wouldn't have assigned it to me
if she didn't, would she?
142
00:08:27,508 --> 00:08:29,259
What were we talking about?
143
00:08:29,385 --> 00:08:31,637
Two patients with two symptoms
in common.
144
00:08:31,762 --> 00:08:34,098
And five symptoms not in common.
145
00:08:34,223 --> 00:08:37,017
While you were all wearing your
"Frankie says relax" t-shirts,
146
00:08:37,142 --> 00:08:39,186
I was treating a 73-year-old woman
147
00:08:39,311 --> 00:08:41,397
who went through this progression
of symptoms.
148
00:08:41,522 --> 00:08:43,524
The last of which was...
149
00:08:46,819 --> 00:08:49,113
And in case any of you missed that class
in med school,
150
00:08:49,238 --> 00:08:50,948
that one's untreatable.
151
00:08:51,073 --> 00:08:52,491
Kid's got the first two.
152
00:08:52,616 --> 00:08:56,203
It took ester an hour and 20 minutes to
go from two to three.
153
00:08:56,328 --> 00:08:58,598
And less than a day to make it
all the way to the rear exit.
154
00:08:58,622 --> 00:09:02,334
This is all because a child
has some blood in his diarrhea?
155
00:09:02,543 --> 00:09:03,543
He's got a tummy ache.
156
00:09:03,585 --> 00:09:05,745
If there was any reason to think it was
anything worse,
157
00:09:05,796 --> 00:09:07,047
cuddy would be all over it.
158
00:09:07,172 --> 00:09:08,549
Great. Do a colonoscopy.
159
00:09:08,674 --> 00:09:11,754
On a six-year-old kid who probably has
nothing worse than some food poisoning?
160
00:09:11,844 --> 00:09:13,971
And if you happen to find any purple
papules,
161
00:09:14,096 --> 00:09:15,639
do me a favor and grab a slice.
162
00:09:15,764 --> 00:09:17,766
I wanna check for erdheim-Chester.
163
00:09:17,891 --> 00:09:22,312
A disease that there have been, what,
maybe 200 reported cases of ever?
164
00:09:22,438 --> 00:09:26,817
If ester's family had let me do
an autopsy, there'd be 201.
165
00:09:39,747 --> 00:09:41,248
Foreman: See anything?
166
00:09:41,373 --> 00:09:43,417
Chase: No, and I don't expect to.
167
00:09:44,752 --> 00:09:46,587
House usually avoids cases.
168
00:09:46,712 --> 00:09:50,007
If he's actually stealing a case
from cuddy, there's gotta be a reason.
169
00:09:50,132 --> 00:09:53,051
It's not the first time I've seen
this file.
170
00:09:53,510 --> 00:09:55,429
About a month before Cameron was
hired,
171
00:09:55,554 --> 00:09:57,556
some trucker came in here
with these symptoms.
172
00:09:57,681 --> 00:09:59,433
House decided he was dying.
173
00:09:59,558 --> 00:10:01,268
Two days and a spinal tap,
174
00:10:01,393 --> 00:10:03,604
bone marrow extraction,
and three colonoscopies later,
175
00:10:03,729 --> 00:10:05,939
we send the guy home
with a bunch of painkillers
176
00:10:06,064 --> 00:10:08,817
and a diagnosis
of a bad cheese sandwich.
177
00:10:09,610 --> 00:10:11,210
One of the guys who worked here
before me
178
00:10:11,236 --> 00:10:14,865
said house tried to cure ester
at least three other times.
179
00:10:15,616 --> 00:10:19,411
You know how people see
the virgin Mary in danishes and stuff?
180
00:10:20,287 --> 00:10:23,332
Someone died 12 years ago
and house doesn't know why.
181
00:10:23,457 --> 00:10:26,710
House sees that case now
in paint peeling,
182
00:10:27,795 --> 00:10:30,214
in clouds, and now in this poor kid.
183
00:10:30,506 --> 00:10:33,842
Erdheim-Chester is an abnormal growth of
some of the cells that fight infection.
184
00:10:33,967 --> 00:10:36,261
Is that cancer?
Cos he seems okay now.
185
00:10:36,386 --> 00:10:38,680
The other doctor kind of scared us
about that.
186
00:10:38,806 --> 00:10:41,558
He shouldn't have. We're just testing.
It'll probably be negative.
187
00:10:41,683 --> 00:10:42,559
I don't understand.
188
00:10:42,684 --> 00:10:45,764
You don't think that's what it is but
you want to do this thing to him anyway?
189
00:10:45,813 --> 00:10:48,148
- We need to be sure.
- Isn't there any other way?
190
00:10:48,273 --> 00:10:50,150
It shouldn't take long.
191
00:10:50,818 --> 00:10:52,027
All right.
192
00:10:52,152 --> 00:10:55,113
Those ridges look a lot like purple
papules.
193
00:10:55,239 --> 00:10:58,659
They're not purple. They're red.
Probably just blood blisters.
194
00:11:00,786 --> 00:11:02,663
Give me the biopsy needle.
195
00:11:13,048 --> 00:11:15,217
- How long is this gonna take?
- Forget it, chase.
196
00:11:15,342 --> 00:11:19,429
Your punching out the shark story's
good, but she's not waiting for you.
197
00:11:20,722 --> 00:11:22,562
We couldn't confirm the source of
the bleeding,
198
00:11:22,683 --> 00:11:23,892
but we did biopsy some...
199
00:11:24,017 --> 00:11:26,645
- Blood blisters.
- You mean papules.
200
00:11:26,770 --> 00:11:28,647
Come on, Cameron. Who's right?
201
00:11:30,566 --> 00:11:33,193
Chase is. Negative for erdheim-Chester.
202
00:11:33,318 --> 00:11:34,778
Let me see.
203
00:11:42,494 --> 00:11:44,121
If it's not erdheim-Chester...
204
00:11:44,246 --> 00:11:47,875
It's exactly what we said before,
a garden-variety viral gastroenteritis.
205
00:11:48,000 --> 00:11:49,209
Can we go back to the party?
206
00:11:49,334 --> 00:11:51,253
Do a kidney biopsy.
207
00:11:52,087 --> 00:11:53,964
Ester's shut down in exactly...
208
00:11:54,089 --> 00:11:55,382
Chase: This kid is not ester.
209
00:11:55,507 --> 00:11:57,217
You screwed up. She died. I'm sorry.
210
00:11:57,342 --> 00:11:59,469
But that does not mean this kid is dying
as well.
211
00:11:59,595 --> 00:12:03,765
Jeez, you're testy when you don't get
any fuzz. Come on.
212
00:12:18,488 --> 00:12:19,531
What'd the test say?
213
00:12:19,656 --> 00:12:21,033
Colonoscopy was clean.
214
00:12:21,158 --> 00:12:23,702
And the biopsy was negative for
erdheim-Chester.
215
00:12:23,827 --> 00:12:27,205
So Ian's going to be all right?
It was just some sort of virus.
216
00:12:27,581 --> 00:12:28,790
What's that?
217
00:12:29,499 --> 00:12:30,626
Urine.
218
00:12:30,751 --> 00:12:32,461
Yeah, but it's brown.
219
00:12:33,670 --> 00:12:35,505
Ian's kidneys are shutting down.
220
00:12:35,631 --> 00:12:38,050
Still think it's not the same case?
221
00:12:54,191 --> 00:12:56,985
House: So, what can cause
bloody diarrhea,
222
00:12:57,110 --> 00:12:59,863
ataxia and kidney failure?
223
00:12:59,988 --> 00:13:02,115
- I'll go do a biopsy.
- Forget it!
224
00:13:02,240 --> 00:13:03,700
That battle's over.
225
00:13:03,825 --> 00:13:06,078
His rising creatinine is his kidneys'
way of saying,
226
00:13:06,203 --> 00:13:07,913
"go on without me."
227
00:13:08,705 --> 00:13:10,916
What explains everything?
228
00:13:12,626 --> 00:13:15,921
E. Coli ho-157 causes bloody diarrhea
229
00:13:16,046 --> 00:13:17,965
and leads to hemolytic-uremic
syndrome.
230
00:13:18,090 --> 00:13:20,759
Toxins from the bacteria
cause his kidneys to shut down.
231
00:13:20,884 --> 00:13:22,427
We should start him on plasmapheresis.
232
00:13:22,552 --> 00:13:25,806
Clear, concise
and completely plausible.
233
00:13:25,931 --> 00:13:29,101
And exactly what I did last time.
Didn't work.
234
00:13:29,351 --> 00:13:31,478
- What else?
- Goodpasture's syndrome.
235
00:13:31,603 --> 00:13:33,897
Circulating antibodies cause kidney
failure and bleeding.
236
00:13:34,022 --> 00:13:35,857
But not the purple papules.
237
00:13:35,983 --> 00:13:37,693
If you throw in ester's next symptom,
238
00:13:37,818 --> 00:13:39,611
brain, makes me think
heavy metal toxicity.
239
00:13:39,736 --> 00:13:42,155
His hematocrit would have to be low.
It's at 44,
240
00:13:42,280 --> 00:13:43,699
and ester's never dropped below...
241
00:13:43,824 --> 00:13:45,742
- 42.
- You have the file memorized?
242
00:13:45,867 --> 00:13:47,536
It's my lucky number.
243
00:13:47,661 --> 00:13:48,745
What about lymphoma?
244
00:13:48,870 --> 00:13:53,500
Causes kidney failure, gi bleed, and can
infiltrate the base of the brain.
245
00:13:54,876 --> 00:13:56,003
You check ester for that?
246
00:13:56,128 --> 00:13:58,547
She never showed any signs of...
247
00:13:59,965 --> 00:14:01,800
If he has lymphoma this far advanced,
248
00:14:01,925 --> 00:14:04,052
we should be able to see it in his blood
and brain.
249
00:14:04,177 --> 00:14:06,805
Chase, run a blood smear
and immunochemistries.
250
00:14:06,930 --> 00:14:08,890
Foreman, get an mri.
251
00:14:09,307 --> 00:14:11,685
- I'll page cuddy.
- No, you won't.
252
00:14:11,810 --> 00:14:13,290
She thinks the kid has a stomachache.
253
00:14:13,353 --> 00:14:15,498
Then she'll come right up here and do
one of two things.
254
00:14:15,522 --> 00:14:18,418
If she agrees with me, I don't need her.
If she disagrees, I don't want her.
255
00:14:18,442 --> 00:14:20,110
Can't handle people
disagreeing with you?
256
00:14:20,235 --> 00:14:21,835
She might have a different take on this.
257
00:14:21,862 --> 00:14:25,198
Subordinates can disagree with me
all they want. It's healthy.
258
00:14:25,323 --> 00:14:27,951
People who can shut me down
on the other hand...
259
00:14:28,076 --> 00:14:30,746
Forget cuddy.
I'll have Wilson keep her busy.
260
00:14:38,587 --> 00:14:41,882
Keep your answers short and discreet.
Is cuddy still playing?
261
00:14:42,966 --> 00:14:45,886
The chicken is still
in piccadilly square.
262
00:14:46,011 --> 00:14:48,889
Brilliant. She'll never suspect that
normandy is our target.
263
00:14:49,014 --> 00:14:50,390
Is that house?
264
00:14:50,557 --> 00:14:53,810
Tell him that the blinds just went to
20-40 and he's running out of chips.
265
00:14:53,935 --> 00:14:56,188
- How's she doing?
- What's going on?
266
00:14:56,313 --> 00:14:58,113
The way you took off,
something's obviously...
267
00:14:58,231 --> 00:15:01,193
Love to chat but got a game to play.
How's she doing?
268
00:15:01,610 --> 00:15:04,005
The patient is on life support.
We're about to pull the plug.
269
00:15:04,029 --> 00:15:05,030
Are you talking about me?
270
00:15:05,155 --> 00:15:06,615
What've you got?
271
00:15:06,907 --> 00:15:09,701
Those sounds like high-dose cardio
meds.
272
00:15:09,826 --> 00:15:11,578
Two hearts.
273
00:15:11,703 --> 00:15:12,703
You got the flush?
274
00:15:12,788 --> 00:15:14,164
Still waiting on the final labs.
275
00:15:14,289 --> 00:15:16,083
Is she drinking her seltzer?
276
00:15:16,583 --> 00:15:19,127
No, hydration is not a problem.
277
00:15:19,252 --> 00:15:21,713
She's bluffing. Push her all in.
278
00:15:24,299 --> 00:15:25,467
Call.
279
00:15:25,926 --> 00:15:28,887
Two pair. Show me your hearts.
280
00:15:33,934 --> 00:15:35,310
Seven of clubs.
281
00:15:36,019 --> 00:15:38,188
Oh, dear. Sounds like I messed up.
282
00:15:38,313 --> 00:15:40,816
You're gonna be stuck with her
for a while.
283
00:15:40,941 --> 00:15:42,150
Talk to you soon.
284
00:15:43,443 --> 00:15:45,362
Cuddy: Oh, yes!
285
00:16:00,085 --> 00:16:02,045
Why are you taking a picture
of his head?
286
00:16:02,170 --> 00:16:04,047
We're looking for lymphoma, but...
287
00:16:04,172 --> 00:16:07,801
So, it's not erdheim-something
and it's not his kidneys,
288
00:16:07,926 --> 00:16:09,553
but his kidneys are failing.
289
00:16:09,678 --> 00:16:10,846
Where's Dr. Cuddy?
290
00:16:10,971 --> 00:16:12,305
Dr. House mentioned another case.
291
00:16:12,430 --> 00:16:14,975
Is there another patient
with the same thing that Ian has?
292
00:16:15,100 --> 00:16:17,310
- Not exactly.
- What does that mean?
293
00:16:17,435 --> 00:16:19,563
Dr. House had a patient a while back
294
00:16:19,688 --> 00:16:21,857
who exhibited the same symptoms
as your son.
295
00:16:21,982 --> 00:16:25,068
- Then you know what's wrong?
- No.
296
00:16:25,193 --> 00:16:26,611
So what do you know?
297
00:16:26,736 --> 00:16:29,447
We know the likely course
the disease will take.
298
00:16:29,573 --> 00:16:30,574
Which is?
299
00:16:30,699 --> 00:16:32,576
She had multiple system failures
affecting...
300
00:16:32,701 --> 00:16:34,161
What happened to her?
301
00:16:38,081 --> 00:16:41,084
She died 24 hours after her admission.
302
00:16:48,216 --> 00:16:51,344
Mr. or Mrs. Alston,
would you mind giving me a hand?
303
00:16:53,471 --> 00:16:55,724
Foreman: He's having trouble
sitting still.
304
00:16:55,849 --> 00:16:57,934
It's impossible to get the detail
we need.
305
00:16:58,059 --> 00:17:02,147
So I figured he might feel
more comfortable hearing your voices.
306
00:17:07,110 --> 00:17:08,320
Ian, honey.
307
00:17:09,988 --> 00:17:14,201
Just sit still. They'll be done
in a moment. We're here with you.
308
00:17:14,326 --> 00:17:15,785
I'm scared.
309
00:17:17,287 --> 00:17:19,039
It's okay, honey. It's...
310
00:17:19,164 --> 00:17:23,084
It's only a big camera. It's gonna take
a picture of your head.
311
00:17:24,169 --> 00:17:26,838
You love it when I take your picture
at home, don't you?
312
00:17:26,963 --> 00:17:28,089
Yeah.
313
00:17:29,090 --> 00:17:32,177
And you have to hold still for that,
too, right?
314
00:17:32,469 --> 00:17:34,471
But this isn't like that.
315
00:17:36,723 --> 00:17:40,185
I know it's scary, Ian,
but you can do it.
316
00:17:41,561 --> 00:17:43,980
You're getting to be so grown-up.
317
00:17:46,274 --> 00:17:51,196
So just hold perfectly still,
just for a little bit.
318
00:17:51,863 --> 00:17:54,199
Mommy, are you crying?
319
00:17:55,200 --> 00:17:58,995
No. No, honey, I'm just tired.
320
00:18:00,497 --> 00:18:02,666
Okay. |'|| try.
321
00:18:31,903 --> 00:18:34,990
The base of his brain's been infiltrated
by a small mass. We think...
322
00:18:35,115 --> 00:18:36,908
- Pituitary?
- Looks that way.
323
00:18:37,033 --> 00:18:39,202
Explains the low blood pressure.
324
00:18:41,121 --> 00:18:43,665
And pretty much confirms the lymphoma.
325
00:18:48,420 --> 00:18:50,630
If we'd started ester on prednisone...
326
00:18:50,755 --> 00:18:53,174
Did anyone see the lymphoma?
327
00:18:53,300 --> 00:18:55,969
No, we saw a mass.
The location is consistent with...
328
00:18:56,094 --> 00:18:58,013
Didn't see any in the blood either.
329
00:18:58,138 --> 00:19:01,224
White blood cells show no spindling
or abnormal nuclei.
330
00:19:01,349 --> 00:19:04,769
Nothing on immunochemistries either.
It's not lymphoma.
331
00:19:37,177 --> 00:19:38,553
Foreman: House!
332
00:19:40,305 --> 00:19:41,639
It's a train.
333
00:19:42,640 --> 00:19:44,976
- We don't know what kind of train...
- Whoa. Whoa. Whoa.
334
00:19:45,101 --> 00:19:47,145
- I'm thirsty.
- It's closed.
335
00:19:51,274 --> 00:19:52,650
It's not now.
336
00:19:59,324 --> 00:20:02,327
We got one advantage.
We know where the tracks are going.
337
00:20:02,452 --> 00:20:06,164
The fact that the end of the line
is death is an advantage?
338
00:20:06,289 --> 00:20:08,625
The fact that we know is an advantage.
339
00:20:08,750 --> 00:20:11,086
It means maybe we can get ahead of it.
340
00:20:11,711 --> 00:20:13,129
Next station is the liver.
341
00:20:13,254 --> 00:20:15,757
We got about 90 minutes
before it gets there.
342
00:20:15,882 --> 00:20:19,177
Maybe we can cut down a tree
across the line just outside of town.
343
00:20:19,302 --> 00:20:20,303
I'll do an ultrasound.
344
00:20:20,428 --> 00:20:22,222
No, treatment will tell us more, faster.
345
00:20:22,347 --> 00:20:25,183
How can we start treatment if we have
no idea what we're treating for?
346
00:20:25,308 --> 00:20:27,185
Treat him for everything.
347
00:20:27,310 --> 00:20:30,188
Give him acetylcysteine, and interferon,
and silymarin,
348
00:20:30,313 --> 00:20:33,566
and whatever else you can think of
to protect the liver.
349
00:20:47,455 --> 00:20:48,289
What's going on?
350
00:20:48,415 --> 00:20:51,918
Oh, just catching up on some TV.
How're you doing?
351
00:20:52,043 --> 00:20:55,255
Well, thanks to your last consult,
the patient has improved dramatically.
352
00:20:55,380 --> 00:20:57,924
Tell house the patient is about
to kill the doctor.
353
00:20:58,049 --> 00:20:59,551
- She says the patient...
- I heard.
354
00:20:59,676 --> 00:21:02,470
- What've you got?
- Well, cuddy just raised and...
355
00:21:02,595 --> 00:21:03,721
- You're paired.
- What?
356
00:21:03,847 --> 00:21:05,056
Nines.
357
00:21:07,434 --> 00:21:08,518
How do you know?
358
00:21:08,643 --> 00:21:11,187
Anything lower,
you wouldn't sound so excited.
359
00:21:11,312 --> 00:21:12,814
Jacks or higher,
360
00:21:12,939 --> 00:21:16,192
your voice sounds like Debbie from
accounting is sitting in your lap.
361
00:21:16,317 --> 00:21:18,445
Ask cuddy if she can beat
a pair of threes.
362
00:21:18,570 --> 00:21:20,370
What's going on?
If you're gonna mess with me,
363
00:21:20,447 --> 00:21:22,091
wouldn't it be more fun to do it
in person?
364
00:21:22,115 --> 00:21:23,700
Yes, it would.
365
00:21:25,869 --> 00:21:27,579
Can you beat a pair of threes?
366
00:21:27,704 --> 00:21:28,746
What'd she do?
367
00:21:28,872 --> 00:21:30,999
I left orders for p0 fluids, doctor.
368
00:21:31,124 --> 00:21:33,376
Enough with the codes.
She obviously knows it's me.
369
00:21:33,501 --> 00:21:35,628
She's drinking her seltzer.
370
00:21:36,171 --> 00:21:37,464
Did she stop?
371
00:21:37,672 --> 00:21:39,174
- Yes.
- Go all in.
372
00:21:40,258 --> 00:21:41,968
- But...
- Just do it.
373
00:21:42,385 --> 00:21:44,304
You couldn't care less about
this charity event.
374
00:21:44,429 --> 00:21:46,389
You claim not to be messing with me.
375
00:21:46,514 --> 00:21:47,874
You're either trying to keep me...
376
00:21:47,974 --> 00:21:49,225
Shut up.
377
00:21:49,350 --> 00:21:52,812
Look, last time I wanted the game
to go on. I still do.
378
00:21:52,937 --> 00:21:55,148
It means that this time you get to win.
379
00:21:55,273 --> 00:21:56,316
Hold on.
380
00:22:03,156 --> 00:22:04,407
I fold.
381
00:22:12,957 --> 00:22:15,376
House, are you sure you're okay?
382
00:22:46,950 --> 00:22:50,161
Meds seem to be working.
Liver's holding its own.
383
00:22:50,828 --> 00:22:51,829
Good.
384
00:22:51,955 --> 00:22:54,374
- But the platelets are dropping.
- Even better.
385
00:22:54,499 --> 00:22:55,959
Why? It means he's getting sicker.
386
00:22:56,084 --> 00:22:58,419
It's new. New is good.
387
00:22:59,546 --> 00:23:01,506
Because old ended in death.
388
00:23:04,676 --> 00:23:06,219
I can't breathe.
389
00:23:07,595 --> 00:23:08,595
Chase!
390
00:23:11,057 --> 00:23:12,684
Sarah: What's happening?
391
00:23:17,313 --> 00:23:18,690
Sarah: Ian, come on.
392
00:23:19,315 --> 00:23:21,234
Honey, just relax.
393
00:23:21,693 --> 00:23:24,529
Ian, breathe. Come on, honey. Please.
394
00:23:25,113 --> 00:23:26,447
Please, honey.
395
00:24:19,626 --> 00:24:21,336
Foreman: We had to put him
on a ventilator.
396
00:24:21,461 --> 00:24:23,504
He's back on ester's path
397
00:24:24,213 --> 00:24:26,758
and we managed to make the train skip
a few stations.
398
00:24:26,883 --> 00:24:30,845
Which means that instead of 12 hours,
he's probably got less than two.
399
00:24:30,970 --> 00:24:33,681
Which begs the question, why?
What did we do?
400
00:24:33,806 --> 00:24:35,475
Acetylcysteine could mess
with the lungs.
401
00:24:35,600 --> 00:24:38,311
Mess with them, not shut them down
in 20 minutes.
402
00:24:38,436 --> 00:24:40,480
Interferon modulates the immune
system.
403
00:24:40,605 --> 00:24:43,524
It could affect a cancer of the blood,
like one of the ieukemias.
404
00:24:43,650 --> 00:24:45,526
It doesn't speed them up.
It slows them down.
405
00:24:45,652 --> 00:24:47,278
It slows down all 500 of them?
406
00:24:47,403 --> 00:24:50,948
Anybody know where we can find
an oncologist at this hour?
407
00:24:55,495 --> 00:24:58,831
What effects would interferon have
on leukemia?
408
00:24:59,123 --> 00:25:01,793
Depends on what type. Could make
it better. Could make it worse.
409
00:25:01,918 --> 00:25:03,795
A four-year fellowship to learn that.
410
00:25:03,920 --> 00:25:05,640
Cuddy: Tell house if he wants
to play cards,
411
00:25:05,672 --> 00:25:07,548
he can get his ass back down here
and play.
412
00:25:07,674 --> 00:25:10,593
You hear that.
She wants me off the phone.
413
00:25:10,718 --> 00:25:12,261
Means she's vulnerable.
Go all in.
414
00:25:12,387 --> 00:25:16,140
But the party's over
in less than three hours.
415
00:25:16,599 --> 00:25:18,601
Cuddy: It's over in less than two hours,
416
00:25:18,726 --> 00:25:20,895
which means you either have
417
00:25:21,646 --> 00:25:24,023
three of a kind or just threes.
418
00:25:24,732 --> 00:25:26,693
I'm guessing threes.
419
00:25:27,610 --> 00:25:29,862
I bet $500.
420
00:25:31,614 --> 00:25:34,117
- Go all in.
- You obviously want to bust me.
421
00:25:34,242 --> 00:25:35,243
Why would you...
422
00:25:35,368 --> 00:25:36,411
Either you go all in,
423
00:25:36,536 --> 00:25:39,956
or I tell everybody in the building
that you wear toenail Polish.
424
00:25:41,124 --> 00:25:42,583
I'm all in.
425
00:25:44,210 --> 00:25:45,837
I'll call.
426
00:25:46,462 --> 00:25:49,006
I'm betting you have a pair of threes,
427
00:25:49,132 --> 00:25:51,801
but even if you have three,
428
00:25:52,969 --> 00:25:55,722
it's not gonna beat trip nines.
429
00:25:57,807 --> 00:25:59,559
Oh! Oh! Oh, no!
430
00:26:00,309 --> 00:26:03,688
Oh, no! Oh! Oh, that's gotta hurt.
431
00:26:03,813 --> 00:26:04,813
What happened?
432
00:26:04,897 --> 00:26:06,537
I just killed two birds
with one straight.
433
00:26:06,649 --> 00:26:07,734
Good bye.
434
00:26:08,609 --> 00:26:11,237
Fine, keep playing. But I need you
to recommend a good oncologist
435
00:26:11,362 --> 00:26:13,590
because if I don't get one up here
in the next few minutes,
436
00:26:13,614 --> 00:26:15,658
I got a dead six-year-old.
437
00:26:18,411 --> 00:26:21,664
If you need help, ask.
These games are insane.
438
00:26:22,248 --> 00:26:24,208
The games have a higher success rate.
439
00:26:24,333 --> 00:26:26,627
Well, I don't see anything that looks
like leukemia.
440
00:26:26,753 --> 00:26:29,046
- You do a bone marrow biopsy?
- No time.
441
00:26:29,172 --> 00:26:31,340
Even if there is an occult blood cancer,
442
00:26:31,466 --> 00:26:33,509
you wouldn't expect interferon
to make it worse.
443
00:26:33,634 --> 00:26:35,136
Certainly not this fast.
444
00:26:35,261 --> 00:26:37,901
- House: What would move this fast?
- Cameron: Autoimmune diseases.
445
00:26:37,972 --> 00:26:39,732
If his body's own defenses
are attacking him,
446
00:26:39,849 --> 00:26:41,827
beefing them up is just gonna put
fuel on the fire.
447
00:26:41,851 --> 00:26:43,978
Sarcoidosis could be in his brain and
lungs.
448
00:26:44,103 --> 00:26:46,647
No. No enlarged hilar lymph nodes on his
chest X-ray.
449
00:26:46,773 --> 00:26:49,776
The systemic nature suggests juvenile
rheumatoid arthritis.
450
00:26:49,901 --> 00:26:51,152
Or kawasaki's disease.
451
00:26:51,277 --> 00:26:52,612
Can't be kawasaki's.
452
00:26:52,737 --> 00:26:54,655
That doesn't affect the elderly.
453
00:26:55,990 --> 00:26:57,575
This is a kid's X-ray?
454
00:26:57,700 --> 00:26:59,744
House had another patient.
455
00:27:01,788 --> 00:27:03,581
Who may or may not have had
kawasaki's.
456
00:27:03,706 --> 00:27:04,874
This kid on the other hand,
457
00:27:04,999 --> 00:27:08,544
he makes antibodies that are eating
the inside of his arteries,
458
00:27:08,669 --> 00:27:11,631
choking off blood to his major organs,
one by one.
459
00:27:11,756 --> 00:27:15,635
First the gi tract, then the kidneys,
then the brain, now the lungs.
460
00:27:16,969 --> 00:27:21,265
Can anyone think of a reason why
kawasaki's can't affect the elderly,
461
00:27:21,641 --> 00:27:26,437
other than that it doesn't? Nice.
462
00:27:26,562 --> 00:27:28,523
Foreman: We can confirm with blood
work.
463
00:27:28,648 --> 00:27:30,483
We need an Ana, sed rate...
464
00:27:30,608 --> 00:27:32,235
Labs will take two hours.
465
00:27:32,860 --> 00:27:34,278
What was the old lady's sed rate?
466
00:27:34,403 --> 00:27:35,780
House: Elevated, 98.
467
00:27:35,905 --> 00:27:39,700
You can't use another patient's labs
to diagnosis kawasaki's disease.
468
00:27:39,826 --> 00:27:41,146
Is that like a dare or something?
469
00:27:41,202 --> 00:27:42,662
You don't have time to be wrong.
470
00:27:42,787 --> 00:27:45,790
Fine. We'll look for kawasaki where he
lives,
471
00:27:45,915 --> 00:27:47,875
Ian's coronary arteries.
472
00:27:53,965 --> 00:27:55,883
This other patient,
473
00:27:58,135 --> 00:28:00,805
the old lady, ester?
474
00:28:04,475 --> 00:28:06,018
Have you read Moby dick?
475
00:28:06,143 --> 00:28:07,436
It was a book?
476
00:28:07,687 --> 00:28:10,106
- It was ten years ago.
- Twelve.
477
00:28:10,439 --> 00:28:11,983
Obsession is dangerous.
478
00:28:12,108 --> 00:28:14,777
Only if you're on a wooden ship,
and your obsession is a whale.
479
00:28:14,902 --> 00:28:16,195
I think I'm in the clear.
480
00:28:16,320 --> 00:28:17,572
You do realize it's a metaphor.
481
00:28:17,697 --> 00:28:20,867
You realize the point of metaphors
is to scare people from doing things
482
00:28:20,992 --> 00:28:23,369
by telling them that something much
scarier is gonna happen
483
00:28:23,494 --> 00:28:25,788
than what will really happen.
484
00:28:25,997 --> 00:28:29,166
God, I wish I had a metaphor
to explain that better.
485
00:28:29,292 --> 00:28:33,129
Go back to the game. Don't worry,
I'm not gonna get eaten by witches.
486
00:28:37,925 --> 00:28:40,803
Chase: Coronary arteries clear.
No aneurysms.
487
00:28:40,970 --> 00:28:43,514
Flip the mode. Let's see the flow.
488
00:28:46,934 --> 00:28:49,186
Sarah: How did that other woman die?
489
00:28:49,729 --> 00:28:52,773
She went into respiratory distress.
490
00:28:53,232 --> 00:28:55,943
- Her heart and liver were already...
- No.
491
00:28:57,153 --> 00:28:58,571
Did she suffer?
492
00:29:00,072 --> 00:29:01,657
Was she in pain?
493
00:29:01,782 --> 00:29:03,200
I don't know.
494
00:29:06,579 --> 00:29:10,374
Laminar flow. No blood clots,
no ragged edges.
495
00:29:10,791 --> 00:29:13,669
Damn. Shut it down.
We're just wasting time.
496
00:29:19,967 --> 00:29:21,385
Look at the right atrium.
497
00:29:21,510 --> 00:29:23,638
- That's not kawasaki's.
- No.
498
00:29:24,555 --> 00:29:26,265
Chase: It's small, but it's there.
499
00:29:26,390 --> 00:29:28,809
Ester didn't have a mass in her heart.
500
00:29:28,935 --> 00:29:31,270
Ian's younger.
He can take more of a pounding.
501
00:29:31,395 --> 00:29:33,439
Ester died before the disease
reached her heart.
502
00:29:33,564 --> 00:29:35,566
The disease made a mass
and made it fast.
503
00:29:35,691 --> 00:29:37,276
- Could be bacteria.
- Muscle.
504
00:29:37,401 --> 00:29:38,401
Connective tissue.
505
00:29:38,444 --> 00:29:40,404
House: The kid can't take
any more theories.
506
00:29:40,529 --> 00:29:42,449
Only thing we know is that
whatever that mass is,
507
00:29:42,531 --> 00:29:43,950
that's what he's got.
508
00:29:44,075 --> 00:29:47,411
We need a piece of it.
I'm doing a biopsy.
509
00:30:01,968 --> 00:30:03,386
I'll shut the blinds.
510
00:30:03,511 --> 00:30:04,762
No, let them watch.
511
00:30:04,887 --> 00:30:07,515
I do my best work on the big stage.
512
00:30:09,058 --> 00:30:11,811
Passing through the superior vena cava.
513
00:30:11,936 --> 00:30:14,021
You're in the atrium. Pull back.
514
00:30:16,065 --> 00:30:18,484
You've hit the wall of the heart.
515
00:30:18,609 --> 00:30:20,277
These procedures would be
so much simpler
516
00:30:20,403 --> 00:30:22,947
if you could do them on healthy people.
517
00:30:23,781 --> 00:30:25,408
And out again.
518
00:30:28,411 --> 00:30:29,704
- V-fib.
- Cardiac arrest.
519
00:30:29,829 --> 00:30:31,414
Chase: Call a code.
520
00:30:32,164 --> 00:30:33,749
Come on, paddles!
521
00:30:35,876 --> 00:30:37,253
- Come on.
- Charge.
522
00:30:37,378 --> 00:30:38,587
Clear!
523
00:30:39,964 --> 00:30:41,757
Woman over P.A.:
Code blue, iso room.
524
00:30:41,882 --> 00:30:44,010
Code blue, iso room.
525
00:30:45,594 --> 00:30:47,013
And again.
526
00:30:50,558 --> 00:30:52,268
- Nothing.
- Again.
527
00:31:07,700 --> 00:31:08,951
You got a clock on this?
528
00:31:09,076 --> 00:31:11,579
How much longer
you gonna keep doing this?
529
00:31:11,704 --> 00:31:12,913
Clear.
530
00:31:16,500 --> 00:31:18,711
Wait. I've got something.
531
00:31:21,881 --> 00:31:23,299
He's back.
532
00:31:30,723 --> 00:31:33,601
- What are you doing?
- I'm doing what we came here to do.
533
00:31:33,726 --> 00:31:35,936
- It almost killed him.
- I know. I was right here.
534
00:31:36,062 --> 00:31:37,188
I need a vacutainer.
535
00:31:37,313 --> 00:31:40,316
His brain's been oxygen deprived
for over eight minutes.
536
00:31:40,441 --> 00:31:42,041
There might be nothing left. He might...
537
00:31:42,109 --> 00:31:45,488
Tell the parents.
Where the hell is that vacutainer?
538
00:31:57,583 --> 00:32:00,544
- So, what's he got?
- Brain damage.
539
00:32:00,669 --> 00:32:02,963
Good chance.
I was talking about before that.
540
00:32:03,089 --> 00:32:05,649
- You're not worried about...
- Things I can't do anything about?
541
00:32:05,716 --> 00:32:07,426
- I try not to.
- Yeah.
542
00:32:07,551 --> 00:32:09,804
Things just roll off you
like water off a duck.
543
00:32:09,929 --> 00:32:11,013
Histiocytosis.
544
00:32:11,138 --> 00:32:13,307
Very unlikely in a 73-year-old.
545
00:32:13,432 --> 00:32:15,935
Whatever this is, it's very unlikely.
546
00:32:16,185 --> 00:32:17,937
Come on. More ideas. Let's go, people.
547
00:32:18,062 --> 00:32:21,482
Genetic disorders could cause
masses everywhere. Tuberous sclerosis.
548
00:32:21,607 --> 00:32:23,567
If it's genetic,
he's had it all his life.
549
00:32:23,692 --> 00:32:25,027
- Why now?
- I don't know.
550
00:32:25,152 --> 00:32:26,612
It sure fits nice enough.
551
00:32:26,737 --> 00:32:28,531
We haven't ruled out leukemia yet.
552
00:32:28,656 --> 00:32:31,408
Or sarcoma. He could have multiple soft
tissue tumors.
553
00:32:31,534 --> 00:32:32,535
Foreman: Or sarcoidosis.
554
00:32:32,660 --> 00:32:34,203
Multiple neurofibromatosis.
555
00:32:34,328 --> 00:32:35,955
Foreman: Chondrocytomas.
556
00:32:37,957 --> 00:32:39,667
How's it going? You win?
557
00:32:39,792 --> 00:32:42,837
I got called away by the angry parents
of a patient.
558
00:32:42,962 --> 00:32:44,338
There are three of you here.
559
00:32:44,463 --> 00:32:47,025
None of you had the sense to stop him,
to pick up a phone and call me.
560
00:32:47,049 --> 00:32:48,489
House: I told them you'd signed off.
561
00:32:48,551 --> 00:32:50,761
The parents are mad
because their kid is dying.
562
00:32:50,886 --> 00:32:52,096
It's understandable.
563
00:32:52,221 --> 00:32:54,181
But if he doesn't die,
they won't be mad anymore.
564
00:32:54,306 --> 00:32:56,642
If he's brain damaged,
they might still be a little ticked.
565
00:32:56,767 --> 00:32:57,810
Had to do it to save him.
566
00:32:57,935 --> 00:33:00,521
You had to do it to diagnose ester.
567
00:33:00,646 --> 00:33:02,523
You may have killed a six-year-old
568
00:33:02,648 --> 00:33:06,026
because you're obsessed with a woman
who's been dead for 12 years.
569
00:33:06,152 --> 00:33:08,362
Sometimes you lose, house!
You're not god!
570
00:33:08,487 --> 00:33:09,487
He's not dead yet.
571
00:33:09,572 --> 00:33:10,715
No, but you're done with him.
572
00:33:10,739 --> 00:33:12,992
It's my case now. Go home.
Go ride your motorcycle.
573
00:33:13,117 --> 00:33:16,662
Go brood in a dark room.
Just don't go near Ian again.
574
00:33:23,919 --> 00:33:27,047
So, anything else
or is it just these seven?
575
00:33:27,173 --> 00:33:28,507
Drop it, house. She's right.
576
00:33:28,632 --> 00:33:30,134
No, she's not!
577
00:33:31,260 --> 00:33:33,387
- You know she's not.
- We should have called her.
578
00:33:33,512 --> 00:33:34,847
I'm surprised you didn't.
579
00:33:34,972 --> 00:33:36,783
You're gonna have to find a way
to let this go.
580
00:33:36,807 --> 00:33:38,309
We can't go near Ian.
581
00:33:38,434 --> 00:33:40,269
We don't need to go near him.
582
00:33:40,686 --> 00:33:42,271
We have his tumor.
583
00:33:42,897 --> 00:33:45,274
Well, cuddy may be right
that we screwed up the protocol.
584
00:33:45,399 --> 00:33:48,027
She may be right
about my screwed up obsession.
585
00:33:48,152 --> 00:33:50,654
But I'm right about the medicine.
586
00:33:50,821 --> 00:33:53,115
How many tests can we do with that?
587
00:33:53,240 --> 00:33:55,659
Look, we cure the kid,
we solve everybody's problems.
588
00:33:55,784 --> 00:33:57,119
How many?
589
00:34:00,080 --> 00:34:01,457
Maybe two good pieces.
590
00:34:01,582 --> 00:34:03,334
How many okay pieces?
591
00:34:04,126 --> 00:34:06,170
Three would be pushing it.
592
00:34:07,838 --> 00:34:10,132
Three tests, seven choices.
593
00:34:11,675 --> 00:34:13,344
Okay, what's first?
594
00:34:13,802 --> 00:34:15,971
Sarcoidosis seems most likely.
595
00:34:16,096 --> 00:34:19,558
Yeah. So likely that cuddy's gonna think
of that all on her own.
596
00:34:19,683 --> 00:34:22,978
She's got the kid's whole body
to play with. Let her do that test.
597
00:34:23,103 --> 00:34:24,480
What's next?
598
00:34:24,605 --> 00:34:26,085
It's moving too fast to be spreading.
599
00:34:26,190 --> 00:34:28,430
It has to be growing from something
that's already there.
600
00:34:28,525 --> 00:34:30,402
Genetic disorder. Tuberous sclerosis.
601
00:34:30,527 --> 00:34:33,530
Or it's his immune system.
Histiocytosis.
602
00:34:34,240 --> 00:34:37,409
Well, there are more documented cases
of histio amongst older people
603
00:34:37,534 --> 00:34:40,162
than tuberous sclerosis.
Let's start with that.
604
00:34:45,751 --> 00:34:47,753
Wing or drumstick?
605
00:34:50,089 --> 00:34:51,632
Gonna need a little more than that.
606
00:34:51,757 --> 00:34:53,109
A little more is more than a third.
607
00:34:53,133 --> 00:34:57,221
If we have to repeat this test
because you didn't cut us enough...
608
00:35:02,726 --> 00:35:05,688
Chase: I'm adding one micro liter
of the immunoperoxidase.
609
00:35:05,813 --> 00:35:07,940
Make it two. I don't want house
biting off our heads
610
00:35:08,065 --> 00:35:11,193
because we weren't sure
if it turned red or not.
611
00:35:16,824 --> 00:35:18,742
Cameron: That's definitely not red.
612
00:35:24,331 --> 00:35:26,583
The problem could still be an abnormal
cell growth
613
00:35:26,709 --> 00:35:27,793
but a different cell line.
614
00:35:27,918 --> 00:35:30,087
Sarcoma?
Muscle cells are throughout his body.
615
00:35:30,212 --> 00:35:31,463
It would explain the geography.
616
00:35:31,588 --> 00:35:34,800
Genetic disorder is far more likely
in a six-year-old. Tuberous sclerosis.
617
00:35:34,925 --> 00:35:36,802
Pretty unlikely to cause a gi bleed.
618
00:35:36,927 --> 00:35:38,012
The time course fits.
619
00:35:38,137 --> 00:35:40,639
Mr. Foreman, you agree with
both of them? Thanks for playing.
620
00:35:40,764 --> 00:35:43,350
If we have enough tissue for two tests,
why not do both?
621
00:35:43,475 --> 00:35:44,915
Then we don't have to think as hard.
622
00:35:44,977 --> 00:35:47,977
Taking the pressure off the choice makes
us less likely to think critically.
623
00:35:48,063 --> 00:35:50,899
Sarcoma is more likely to hit a six
and 70-year-old.
624
00:35:51,025 --> 00:35:52,693
Tuberous sclerosis, it is.
625
00:35:52,818 --> 00:35:54,153
You think sarcoma is less likely?
626
00:35:54,278 --> 00:35:55,404
It's more likely.
627
00:35:55,529 --> 00:35:58,866
The test for it, on the other hand,
is less reliable.
628
00:36:11,003 --> 00:36:13,297
Cameron: Test is negative. Well, that's
okay.
629
00:36:13,422 --> 00:36:17,968
If the tumor cells hadn't matured, the
ki-67 protein wouldn't have turned off.
630
00:36:19,762 --> 00:36:22,222
- What happens if we don't solve this?
- Kid dies.
631
00:36:22,348 --> 00:36:24,600
I mean for the next 12 years.
632
00:36:25,976 --> 00:36:28,020
Ki-67's negative.
633
00:36:31,607 --> 00:36:33,817
And pch antigen is negative.
634
00:36:45,245 --> 00:36:47,873
Mighty Casey's down to his last strike.
635
00:36:47,998 --> 00:36:49,958
Mighty Casey struck out.
636
00:36:50,167 --> 00:36:52,544
Thanks a lot. I was gonna read that this
weekend.
637
00:36:52,669 --> 00:36:56,048
Chondrocytoma. Connective tissue's been
in all the places we've been looking.
638
00:36:56,173 --> 00:36:58,813
The kid is too sick for that.
We're better off testing for sarcoma.
639
00:36:58,842 --> 00:37:01,595
We would've seen signs of that
when we tested for tuberous sclerosis.
640
00:37:01,720 --> 00:37:03,931
The tumor cells looked like muscle
under the microscope.
641
00:37:04,056 --> 00:37:06,892
No, they didn't. They looked like fat.
642
00:37:07,935 --> 00:37:10,020
I vote for neurofibromatosis.
643
00:37:11,105 --> 00:37:13,982
- Why?
- Because the other choices suck worse.
644
00:37:22,574 --> 00:37:24,118
Give me a minute.
645
00:37:53,730 --> 00:37:55,691
You want me out of here?
646
00:37:57,943 --> 00:37:59,987
You come up with anything?
647
00:38:30,100 --> 00:38:32,978
Hey. We can talk about it tomorrow.
648
00:38:43,906 --> 00:38:46,033
I won the poker tournament.
649
00:38:47,993 --> 00:38:50,913
I totally played this guy, berman,
from business affairs.
650
00:38:51,038 --> 00:38:55,000
I got great cards. But I don't bet.
Just call, no raises.
651
00:38:55,125 --> 00:38:57,377
Berman pairs his king on the flop.
652
00:38:57,503 --> 00:38:59,922
I keep calling, the river turns,
653
00:39:00,964 --> 00:39:02,758
I check. He can't stand it.
654
00:39:02,883 --> 00:39:06,011
He goes all in. He's sure he's won.
655
00:39:07,763 --> 00:39:09,890
I call, I flip them.
656
00:39:11,475 --> 00:39:12,768
Pocket aces.
657
00:39:13,060 --> 00:39:14,686
I nailed his ass.
658
00:39:23,654 --> 00:39:26,031
The aces were hiding all along.
659
00:39:34,498 --> 00:39:36,959
Test him for erdheim-Chester disease.
660
00:39:37,084 --> 00:39:39,461
Erdheim-Chester?
That's not even on the list.
661
00:39:39,586 --> 00:39:42,256
Because we already did it.
He tested negative.
662
00:39:42,381 --> 00:39:44,550
- So did ester.
- The disease lied.
663
00:39:44,675 --> 00:39:47,678
Yeah, the tumor's got it in for you.
Diseases don't lie.
664
00:39:47,803 --> 00:39:49,972
Fine, it didn't lie. It slow played us.
665
00:39:50,097 --> 00:39:53,684
We biopsied the colon,
it hadn't reached the gi tract yet.
666
00:39:53,850 --> 00:39:56,645
It's there now.
It's in his liver, his lungs.
667
00:39:56,770 --> 00:39:58,689
You want it to be there.
668
00:39:58,814 --> 00:40:00,857
Because then you didn't screw up
12 years ago.
669
00:40:00,983 --> 00:40:04,820
We can't waste our one test
on the one disease we know it's not.
670
00:40:07,698 --> 00:40:09,324
Run the test.
671
00:40:20,919 --> 00:40:22,588
You sure about this?
672
00:40:22,713 --> 00:40:25,507
Wait. Let me think about that.
Don't pressure me.
673
00:40:25,632 --> 00:40:27,509
Just run the damn test.
674
00:40:30,429 --> 00:40:32,472
Cameron: Cells look like macrophages.
675
00:40:32,598 --> 00:40:34,308
That's a good start.
676
00:40:40,314 --> 00:40:42,733
Take your time, and say it loud.
677
00:40:52,492 --> 00:40:54,202
Cd 68 positive.
678
00:41:06,757 --> 00:41:08,467
Start the treatment.
679
00:42:07,859 --> 00:42:10,362
So, ester can rest peaceful now, huh?
680
00:42:10,987 --> 00:42:12,155
Yeah.
681
00:42:18,870 --> 00:42:19,871
$40.
682
00:42:25,252 --> 00:42:26,878
You got lucky.
683
00:42:27,796 --> 00:42:29,297
You gonna call?
684
00:42:29,464 --> 00:42:30,882
What I do
685
00:42:31,967 --> 00:42:34,636
is not just based on the flip of a card.
686
00:42:34,970 --> 00:42:37,347
You guessed. You got lucky.
687
00:42:37,472 --> 00:42:38,473
It fit.
688
00:42:38,598 --> 00:42:41,685
It could just as easily have been
sarcoma or tuberous sclerosis.
689
00:42:41,810 --> 00:42:44,062
No, not just as easily.
690
00:42:44,187 --> 00:42:46,857
Maybe not. But it wasn't impossible.
691
00:42:50,318 --> 00:42:51,987
Are you gonna call?
692
00:42:53,655 --> 00:42:55,991
You know, relative to its size,
693
00:42:56,658 --> 00:42:59,745
the barnacle has the largest penis
of any animal.
50659
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