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1
00:00:03,671 --> 00:00:06,424
Hey. Thanks.
2
00:00:06,799 --> 00:00:08,384
No, no, no... here.
3
00:00:09,927 --> 00:00:11,345
You got this whole thing
wrong, em.
4
00:00:11,679 --> 00:00:13,514
It's the rock star that's
supposed to be late,
5
00:00:13,639 --> 00:00:14,891
not the rock-star photographer.
6
00:00:15,224 --> 00:00:18,186
Sorry. Morning sickness.
Touch the belly.
7
00:00:18,477 --> 00:00:20,605
It's the first time
I've been asked to do that.
8
00:00:20,730 --> 00:00:22,064
Come on. It's good luck.
9
00:00:22,190 --> 00:00:23,774
Okay.
10
00:00:24,650 --> 00:00:26,569
Hit the kinos behind the drop.
11
00:00:31,866 --> 00:00:33,659
So what do you think?
12
00:00:34,744 --> 00:00:36,454
I think people
aren't gonna get it.
13
00:00:36,579 --> 00:00:38,831
Come on. "All-American rejects."
14
00:00:38,956 --> 00:00:43,544
Juxtaposing a classic image of americana
with modern pop culture youth.
15
00:00:44,045 --> 00:00:45,922
Oh, yeah.
16
00:00:46,047 --> 00:00:48,257
Everyone loves
a good juxtaposition.
17
00:00:48,382 --> 00:00:49,967
My fans were born in the '90s.
18
00:00:50,092 --> 00:00:53,763
You know what? You do this picture,
you'll gain 40 years of fans.
19
00:00:54,138 --> 00:00:55,389
- Yeah?
- Yeah.
20
00:00:55,514 --> 00:00:57,892
- I love the Rockwell thing.
- I thought so.
21
00:00:58,476 --> 00:01:00,853
Okay. Kill the house lights.
Let's go!
22
00:01:07,652 --> 00:01:09,862
Hang on. Hey, who's in charge
of the backdrop?
23
00:01:09,987 --> 00:01:11,697
- Naomi?
- Yeah?
24
00:01:12,156 --> 00:01:13,783
What's wrong with it?
25
00:01:13,908 --> 00:01:16,369
Well, the words are
completely jumbled.
26
00:01:17,328 --> 00:01:19,664
What, you can read that?
27
00:01:20,122 --> 00:01:21,749
Of course.
28
00:01:21,958 --> 00:01:24,377
- You okay?
- No. Oh, god.
29
00:01:24,502 --> 00:01:26,462
I could be having a...
30
00:01:27,004 --> 00:01:29,006
What's the mnemonic?
31
00:01:29,924 --> 00:01:32,843
"F" is for face.
Is my smile crooked?
32
00:01:34,011 --> 00:01:35,263
What are you doing?
33
00:01:35,388 --> 00:01:37,890
"A" is for arms.
34
00:01:38,015 --> 00:01:38,849
Arms.
35
00:01:38,975 --> 00:01:40,351
You should really sit down.
36
00:01:40,476 --> 00:01:41,811
Can someone get her some water?
37
00:01:41,936 --> 00:01:43,521
"S" is speech.
38
00:01:43,646 --> 00:01:45,398
I'm slurring? I'm slurring?
39
00:01:49,193 --> 00:01:51,195
"F-a-s-t."
40
00:01:51,862 --> 00:01:53,447
"T" is for time.
41
00:01:53,572 --> 00:01:58,160
Hurry. Somebody, call 911.
Tell them I'm having a stroke.
42
00:02:40,328 --> 00:02:42,038
Hi. I'm Dr. House.
43
00:02:42,163 --> 00:02:44,040
My boss says you're important.
44
00:02:44,582 --> 00:02:46,059
Personally I don't get
what's so hard about
45
00:02:46,083 --> 00:02:48,002
making Scarlett Johansson
look pretty.
46
00:02:48,127 --> 00:02:49,712
Arms out in front of you.
47
00:02:49,837 --> 00:02:51,881
Palms up like
you're holding a pizza.
48
00:02:52,590 --> 00:02:53,799
Close your eyes.
49
00:02:55,009 --> 00:02:58,346
It's so easy you should
consider a career change.
50
00:02:58,471 --> 00:02:59,847
Probably make a lot more money.
51
00:03:00,598 --> 00:03:02,808
Dr. Mackman tell you
the clot was clear?
52
00:03:02,933 --> 00:03:03,933
Yes.
53
00:03:04,018 --> 00:03:06,145
And he said that you
and the fetus are fine?
54
00:03:06,270 --> 00:03:07,396
Yeah.
55
00:03:07,688 --> 00:03:10,107
He didn't mention
your pronator drift?
56
00:03:10,733 --> 00:03:14,195
- What's that mean?
- Means mackman is an idiot.
57
00:03:14,737 --> 00:03:16,197
- May I?
- Yeah.
58
00:03:19,033 --> 00:03:21,410
You take thousands
of photos of someone,
59
00:03:21,535 --> 00:03:23,871
but only one has to look good.
60
00:03:23,996 --> 00:03:25,182
Kind of the opposite
of my business.
61
00:03:25,206 --> 00:03:26,665
It's not about looking good.
62
00:03:26,791 --> 00:03:27,976
People are always hiding things.
63
00:03:28,000 --> 00:03:31,295
I just keep shooting until I can see
what's really inside them.
64
00:03:32,213 --> 00:03:34,673
- My eyes okay?
- Eyes are gorgeous.
65
00:03:34,799 --> 00:03:36,675
The vessels don't look so hot.
66
00:03:36,884 --> 00:03:39,637
Microaneurysms predict
further strokes.
67
00:03:39,762 --> 00:03:40,781
This is gonna happen again?
68
00:03:40,805 --> 00:03:43,432
Unless I can figure out
the underlying cause.
69
00:03:43,557 --> 00:03:45,226
Puff up your cheeks.
70
00:03:47,061 --> 00:03:50,398
You should be able to keep the air in.
Means there's weakness around the mouth.
71
00:03:50,523 --> 00:03:52,376
So where'd you learn
to self-diag nose a stroke?
72
00:03:52,400 --> 00:03:56,779
Oh, my baby's biological
father is a neurologist.
73
00:03:57,071 --> 00:04:00,533
He once told me the fast mnemonic
could save my life one day. So...
74
00:04:00,825 --> 00:04:02,493
Interesting pet name.
75
00:04:02,827 --> 00:04:05,413
Most people go with
"husband" or "pookie."
76
00:04:05,830 --> 00:04:07,540
He's gay.
77
00:04:07,665 --> 00:04:09,375
Just a sperm donor.
So when you...
78
00:04:09,500 --> 00:04:11,127
You turned him for a night?
79
00:04:11,252 --> 00:04:12,920
Just straight for one date?
80
00:04:13,671 --> 00:04:14,839
Okay.
81
00:04:15,214 --> 00:04:18,843
He took a magazine and a cup
into my bathroom.
82
00:04:18,968 --> 00:04:20,761
A man after my own heart.
83
00:04:20,886 --> 00:04:22,721
Different magazine obviously.
84
00:04:22,930 --> 00:04:25,891
I'm rescinding mackman's
discharge order.
85
00:04:26,016 --> 00:04:27,893
My lackeys will be in
to do some tests,
86
00:04:28,018 --> 00:04:30,896
take some more blood
and empty your catheter bag.
87
00:04:36,402 --> 00:04:39,655
Not a moment you'll
want to Cherish.
88
00:04:41,824 --> 00:04:44,785
This is definitely different.
89
00:04:44,910 --> 00:04:47,079
It looks almost like...
90
00:04:47,288 --> 00:04:48,956
He's caring.
91
00:04:54,920 --> 00:04:58,382
Find anything else in the patient's
folder? Like a diagnosis?
92
00:04:58,507 --> 00:05:01,969
Urinalysis revealed excessive protein
and red blood cells.
93
00:05:02,094 --> 00:05:04,722
Chem panel showed
a creatinine level over 2.5.
94
00:05:04,847 --> 00:05:08,267
So first she strokes,
now her kidneys are shutting down. Why?
95
00:05:08,392 --> 00:05:10,144
Ultrasound showed
no tumors or stones.
96
00:05:10,269 --> 00:05:12,897
No signs of fetal distress.
No urinary tract obstructions.
97
00:05:13,022 --> 00:05:14,857
BP is fine. No pre-eclampsia.
98
00:05:14,982 --> 00:05:17,151
Any of you guys
ever been to the galapagos?
99
00:05:17,276 --> 00:05:18,611
Was our patient there?
100
00:05:18,736 --> 00:05:20,738
Dengue fever, avian pox,
even west nile.
101
00:05:22,072 --> 00:05:23,616
I'm looking for a vacation spot.
102
00:05:23,741 --> 00:05:24,950
That mean we get vacation?
103
00:05:25,075 --> 00:05:27,536
How would that differ
from your current status?
104
00:05:27,661 --> 00:05:28,996
You're gonna do what? Relax?
105
00:05:29,121 --> 00:05:30,122
Visiting family.
106
00:05:30,247 --> 00:05:31,665
My uncle's a giant turtle.
107
00:05:31,790 --> 00:05:33,542
What if the kidney failure
came first?
108
00:05:33,667 --> 00:05:36,067
Kidneys could've caused the stroke,
not the other way around.
109
00:05:36,170 --> 00:05:38,172
Kidneys don't often
get stuck in the brain.
110
00:05:38,297 --> 00:05:39,673
I'm saying it threw a clot.
111
00:05:39,798 --> 00:05:42,559
Early symptoms of kidney failure are
nausea, vomiting, ankle swelling.
112
00:05:42,676 --> 00:05:44,476
She would've mistaken it
for morning sickness.
113
00:05:44,512 --> 00:05:46,639
Heart's way more likely
to throw a clot than a kidney.
114
00:05:46,764 --> 00:05:49,892
Echo was normal. The history indicates
no sign of cardiac problems.
115
00:05:50,017 --> 00:05:52,186
No, but if one were to read
the history closely,
116
00:05:52,311 --> 00:05:54,605
one would notice that she had six cases
of strep.
117
00:05:54,730 --> 00:05:57,525
In her throat. That's the one about
10 inches above her heart.
118
00:05:57,650 --> 00:06:00,402
Let me rephrase,
six cases of untreated strep.
119
00:06:00,528 --> 00:06:01,820
She was prescribed antibiotics.
120
00:06:01,946 --> 00:06:02,988
No one takes them all.
121
00:06:03,280 --> 00:06:06,450
They stop when they start feeling
better. All strep is untreated strep.
122
00:06:06,575 --> 00:06:08,095
What happens when
strep goes untreated?
123
00:06:08,202 --> 00:06:09,328
Leads to rheumatic fever.
124
00:06:09,578 --> 00:06:10,621
Which leads to... Cameron?
125
00:06:10,829 --> 00:06:11,997
Mitral valve stenosis.
126
00:06:12,122 --> 00:06:15,084
Which is a thickening
in the valve of the... kidney?
127
00:06:16,418 --> 00:06:17,938
The kidney doesn't have
a mitral valve.
128
00:06:18,003 --> 00:06:20,089
We'll go look at her heart.
129
00:06:21,757 --> 00:06:23,092
Be easy to find.
130
00:06:23,425 --> 00:06:27,096
It's the big red pumping thing
about 10 inches below her throat.
131
00:06:27,680 --> 00:06:29,139
That was weird.
132
00:06:29,765 --> 00:06:32,810
- He was the way he always is.
- Which is weird.
133
00:06:34,103 --> 00:06:36,063
- Very still, Emma.
- Sorry.
134
00:06:36,188 --> 00:06:37,231
No problem.
135
00:06:37,565 --> 00:06:40,568
He caught us with your hand up my shirt.
He's gotta have a reaction to that.
136
00:06:40,693 --> 00:06:42,087
You think that's what
the vacation is?
137
00:06:42,111 --> 00:06:43,112
Yes.
138
00:06:43,237 --> 00:06:46,782
The pain of losing you
is obviously forcing him away.
139
00:06:46,907 --> 00:06:48,117
Coronal slice appears normal.
140
00:06:48,242 --> 00:06:50,411
There's no way house
just lets this slide.
141
00:06:50,536 --> 00:06:51,816
He's gotta be
planning something.
142
00:06:51,912 --> 00:06:53,998
Maybe he just
doesn't give a crap.
143
00:06:54,123 --> 00:06:55,416
Sagittal slice is clean.
144
00:06:55,541 --> 00:06:57,102
You think he just
stumbled into that closet?
145
00:06:57,126 --> 00:06:59,479
He knew we were there
and he wanted us to know that he knew.
146
00:06:59,503 --> 00:07:01,130
Or you wanted him to know.
147
00:07:01,255 --> 00:07:04,383
Now he does and you're annoyed
because he doesn't care.
148
00:07:04,675 --> 00:07:05,675
Right there.
149
00:07:05,884 --> 00:07:08,429
Trans-axial slice.
Calcified mitral valve.
150
00:07:08,554 --> 00:07:10,723
Barely. That's not big enough
to throw a clot.
151
00:07:10,848 --> 00:07:13,183
Obviously it is, because it did.
152
00:07:13,309 --> 00:07:14,727
House was right.
153
00:07:15,519 --> 00:07:17,855
A valve in your heart
is narrowed.
154
00:07:17,980 --> 00:07:20,649
It caused the clot
which lead to your stroke,
155
00:07:20,774 --> 00:07:24,445
and the reduced circulation
caused the problem with your kidneys.
156
00:07:24,862 --> 00:07:26,071
And this will fix it?
157
00:07:26,196 --> 00:07:29,575
The balloon will force the valve back
open and you'll be fine.
158
00:07:29,700 --> 00:07:31,260
Emma: Can we do this
without a sedative?
159
00:07:31,285 --> 00:07:34,204
It's very mild. There really is no risk
to the fetus.
160
00:07:34,330 --> 00:07:36,540
We'll monitor your baby's
heart rate separately.
161
00:07:36,957 --> 00:07:40,377
We won't allow it to
decrease anywhere near dangerous levels.
162
00:07:43,631 --> 00:07:44,631
Thank you.
163
00:07:44,673 --> 00:07:45,758
You're both gonna be fine.
164
00:07:48,677 --> 00:07:50,054
Go ahead, Dr. Cameron.
165
00:07:51,930 --> 00:07:55,100
Listen to that heartbeat.
It sounds so...
166
00:07:56,560 --> 00:07:58,687
Start threading the catheter.
167
00:08:05,694 --> 00:08:10,658
No, I don't want a layover in Frankfurt,
Taipei, Singapore or London, Ontario.
168
00:08:10,783 --> 00:08:12,863
That's why I asked
for a direct flight to Phnom Penh.
169
00:08:13,327 --> 00:08:16,497
How hard is it to not land?
Does it matter what I answer?
170
00:08:16,872 --> 00:08:19,124
Well, then fine.
I'd be delighted to hold.
171
00:08:19,249 --> 00:08:21,293
- What's new?
- Can cuddy stop interfering?
172
00:08:21,418 --> 00:08:22,670
It's herjob. What's new?
173
00:08:22,795 --> 00:08:24,147
Good news is
Emma's heart is fixed.
174
00:08:24,171 --> 00:08:27,549
Bad news is it's not her underlying
problem. Her kidneys are still failing.
175
00:08:27,675 --> 00:08:29,593
You're vacationing in Cambodia?
176
00:08:29,718 --> 00:08:30,945
You gonna unwind in the killing
fields?
177
00:08:30,969 --> 00:08:31,804
Nope.
178
00:08:31,929 --> 00:08:33,597
Gonna catch me a fish this big.
179
00:08:33,722 --> 00:08:36,100
Mekong giant catfish.
Weighs over 600 pounds.
180
00:08:36,225 --> 00:08:37,702
Aren't those catfish
critically endangered?
181
00:08:37,726 --> 00:08:39,561
That's why it's my last chance
to catch one.
182
00:08:39,687 --> 00:08:41,127
All of our operators
are currently...
183
00:08:41,230 --> 00:08:42,791
If the mitral valve had been properly
fixed
184
00:08:42,815 --> 00:08:44,084
the kidney should be getting better,
185
00:08:44,108 --> 00:08:46,670
which leads us to the conclusion that
you screwed up the procedure.
186
00:08:46,694 --> 00:08:48,112
Or you screwed up the diagnosis.
187
00:08:48,237 --> 00:08:49,923
The mitral valve thickening
was so insignificant
188
00:08:49,947 --> 00:08:52,175
it probably wasn't the cause
of the kidneys or the stroke.
189
00:08:52,199 --> 00:08:53,551
Probably never would've
been a problem.
190
00:08:53,575 --> 00:08:55,828
She needs dialysis
and we need a new theory.
191
00:08:56,203 --> 00:08:57,955
Chase: There are only
a few possibilities.
192
00:08:58,080 --> 00:09:00,249
Patient's pregnant,
could be pre-eclampsia.
193
00:09:00,374 --> 00:09:01,750
We eliminated it
before because...
194
00:09:01,875 --> 00:09:04,086
Re-check for proteinuria
and low platelets. What else?
195
00:09:04,211 --> 00:09:05,295
Hypoperfusion.
196
00:09:05,421 --> 00:09:08,632
The fetus is basically a parasite
stealing nutrients, minerals, blood.
197
00:09:08,757 --> 00:09:09,842
Put her on telemetry.
198
00:09:09,967 --> 00:09:11,301
Or the pregnancy is irrelevant.
199
00:09:11,427 --> 00:09:14,054
Could be infection,
sepsis, husittp.
200
00:09:14,179 --> 00:09:16,140
Chase: A cholesterol embolism
is just as likely.
201
00:09:16,265 --> 00:09:19,727
Tiny particles of cholesterol rain down,
clog up small vessels of the kidneys.
202
00:09:19,852 --> 00:09:21,812
Get a smear and ultrasound
her vessels for plaque.
203
00:09:21,937 --> 00:09:23,731
That's it.
Has to be one of those five.
204
00:09:23,856 --> 00:09:27,860
You know what would be even better? If
we'd narrow it all the way down to one.
205
00:09:28,819 --> 00:09:30,821
Thank you for holding.
206
00:09:30,946 --> 00:09:33,407
We are experiencing
extremely high call volume.
207
00:09:33,532 --> 00:09:35,659
Thank you for your Patience.
208
00:09:41,039 --> 00:09:42,624
She's 0 for five.
209
00:09:44,835 --> 00:09:48,130
Either the differential
was wrong or she's faking it.
210
00:09:48,255 --> 00:09:50,466
Kidney failure has to be
precipitated by...
211
00:09:50,591 --> 00:09:51,985
One of the five
we've already ruled out.
212
00:09:52,009 --> 00:09:54,636
The body only has so many ways
of screwing with the kidneys.
213
00:09:54,762 --> 00:09:56,322
- The labs must be wrong.
- We did the labs.
214
00:09:56,346 --> 00:09:57,848
No one else had access.
215
00:09:57,973 --> 00:09:59,600
That's not quite true.
216
00:10:06,273 --> 00:10:10,486
You put all your patients through this
many tests or just the important ones?
217
00:10:11,779 --> 00:10:14,990
We wanted to explore
all possibilities.
218
00:10:17,659 --> 00:10:18,660
And?
219
00:10:19,286 --> 00:10:21,705
We've eliminated
all the possibilities.
220
00:10:21,830 --> 00:10:23,790
You telling me I'm dying
and you have no idea why?
221
00:10:23,916 --> 00:10:25,918
Your body is
functioning properly.
222
00:10:26,043 --> 00:10:27,503
So why are my kidneys failing?
223
00:10:29,671 --> 00:10:31,381
The other body isn't.
224
00:10:32,674 --> 00:10:35,302
There's something wrong
with the fetus.
225
00:10:44,645 --> 00:10:48,398
Welcome to the world
of maternal mirror syndrome.
226
00:10:49,817 --> 00:10:51,443
Mom's body is like
227
00:10:52,402 --> 00:10:54,738
an intricate
German Metro system.
228
00:10:54,863 --> 00:10:56,365
All the trains run on time.
229
00:10:56,740 --> 00:11:00,869
When she gets pregnant, it's like a new
station opening in dusseldorf.
230
00:11:00,994 --> 00:11:03,831
Bunch or rookies running things.
Bound to be mistakes.
231
00:11:03,956 --> 00:11:05,999
Kids play on the tracks,
get electrocuted.
232
00:11:06,124 --> 00:11:08,724
Before you know it, the trains are
backed up all the way to Berlin
233
00:11:08,752 --> 00:11:10,939
and you've got a bunch of angry Germans
with nowhere to go.
234
00:11:10,963 --> 00:11:12,756
And we all know
that ain't good for the Jews.
235
00:11:12,881 --> 00:11:14,025
Who are the Jews
in this metaphor?
236
00:11:14,049 --> 00:11:15,968
A few things can happen
to a fetus in distress.
237
00:11:16,093 --> 00:11:18,387
It can become a miscarriage,
stillbirth,
238
00:11:18,512 --> 00:11:21,807
a very sick baby
or on rare occasion a time bomb
239
00:11:22,057 --> 00:11:23,892
that kills mom while it's dying.
240
00:11:24,017 --> 00:11:27,062
Good news is,
we fix the fetus, mom gets better.
241
00:11:27,187 --> 00:11:29,273
It's the diagnostic equivalent
of a two-for-one sale.
242
00:11:29,398 --> 00:11:32,484
I have read the outcome of mirror
syndrome is almost always unfavorable.
243
00:11:32,818 --> 00:11:35,612
"Unfavorable."
is that doctor speak for "dead baby"?
244
00:11:35,988 --> 00:11:38,407
You think she'll be less upset
if you phrase it nicely?
245
00:11:38,532 --> 00:11:40,617
We can tell her the truth,
that she'll be fine
246
00:11:40,868 --> 00:11:44,288
as soon as we diagnose
a person who weighs about one pound.
247
00:11:44,663 --> 00:11:47,916
Can't touch it,
can't ask where it hurts, can't see it.
248
00:11:48,166 --> 00:11:52,045
If only there existed giant machines
that could look through human skin.
249
00:11:52,170 --> 00:11:54,548
Mirror syndrome
has a limited number of known causes.
250
00:11:54,965 --> 00:11:57,759
Tachyarrhythmia, fetal anemia,
placental chorioangioma.
251
00:11:57,885 --> 00:11:59,845
All of which are fixable.
252
00:11:59,970 --> 00:12:01,889
Which would be
UN-unfavorable, right?
253
00:12:02,014 --> 00:12:03,765
Could also be trisomy 13.
254
00:12:03,891 --> 00:12:06,602
Ebstein's anomaly,
an aneurysm of galen's vein.
255
00:12:06,727 --> 00:12:10,230
And Dr. Storm cloud
rained all over the differential
256
00:12:10,355 --> 00:12:12,107
and killed
the beautiful little baby.
257
00:12:12,232 --> 00:12:15,444
Heart's easiest to see,
easiest to fix. So let's start there.
258
00:12:15,569 --> 00:12:18,047
When you did mom's mri,
did you get a look at the fetus's heart?
259
00:12:18,071 --> 00:12:21,533
It was in the range but blurry. The
fetus was moving all over the place.
260
00:12:21,658 --> 00:12:23,368
- So we need another scan.
- Yeah.
261
00:12:23,493 --> 00:12:26,038
We'll just ask the fetus
to lie very, very still.
262
00:12:26,163 --> 00:12:29,082
No need. I'm going to
paralyze it.
263
00:12:31,126 --> 00:12:34,004
You wanna paralyze
Emma Sloan's baby?
264
00:12:34,546 --> 00:12:36,089
Let me guess. Cameron?
265
00:12:36,214 --> 00:12:38,258
Cameron and chase
both had their concerns.
266
00:12:38,383 --> 00:12:39,927
No, Cameron had concerns.
267
00:12:40,052 --> 00:12:41,094
Chase just agreed with her
268
00:12:41,219 --> 00:12:44,181
because he didn't want to lose
his all-access pass to her love rug.
269
00:12:44,306 --> 00:12:45,599
They're sleeping together?
270
00:12:45,724 --> 00:12:49,019
If by "sleeping together" you mean
having sex in the janitor's closet.
271
00:12:49,144 --> 00:12:50,144
Here?
272
00:12:50,270 --> 00:12:52,814
No, the janitor's closet
at the local high school.
273
00:12:52,940 --> 00:12:54,650
Go, tiger cats!
274
00:12:55,067 --> 00:12:57,795
Do you have one of those camera phones?
'Cause I got a MySpace account.
275
00:12:57,819 --> 00:12:59,905
I will deal with them
after I deal with you.
276
00:13:00,030 --> 00:13:01,531
Oh, come on.
Let's gossip some more.
277
00:13:01,657 --> 00:13:03,283
I'm sure she's into bondage.
278
00:13:03,408 --> 00:13:05,827
Paralyzing a one-pound baby
risks damaging...
279
00:13:05,953 --> 00:13:09,206
Not paralyzing the thing risks not
getting a clean mri of its heart,
280
00:13:09,331 --> 00:13:13,251
which we need to save its life, which we
need to do to save Emma's life.
281
00:13:14,169 --> 00:13:15,521
You're gonna need to
get her consent.
282
00:13:15,545 --> 00:13:17,130
Well, that shouldn't be
too hard.
283
00:13:17,255 --> 00:13:19,257
"Sign here or you
and your baby both die."
284
00:13:21,009 --> 00:13:22,636
I'm going with you.
285
00:13:24,179 --> 00:13:26,014
Oh, good.
286
00:13:26,640 --> 00:13:29,643
You said sedation was risky.
This sounds insane.
287
00:13:29,768 --> 00:13:32,688
The injection goes into
the umbilical cord.
288
00:13:32,813 --> 00:13:33,981
The baby won't feel a thing.
289
00:13:34,731 --> 00:13:35,857
Fetus.
290
00:13:36,733 --> 00:13:40,654
I'm lowering expectations.
It works here and on dates.
291
00:13:40,779 --> 00:13:42,280
The benefits outweigh the risks
292
00:13:42,406 --> 00:13:45,117
and the paralytic will
wear off in an hour, okay?
293
00:13:45,909 --> 00:13:49,413
Must be easier to hear
you might die than your baby might die.
294
00:13:49,830 --> 00:13:52,833
But if there's anyone
I would trust to save my baby,
295
00:13:53,792 --> 00:13:55,544
it would be Dr. House.
296
00:13:59,715 --> 00:14:01,216
Fetus.
297
00:14:03,093 --> 00:14:04,219
Hold this.
298
00:14:32,456 --> 00:14:34,499
Dr. Cameron.
The mri results back?
299
00:14:34,624 --> 00:14:36,102
The fetus's heart
is structurally sound.
300
00:14:36,126 --> 00:14:38,396
The problem's with the bladder.
It's four times normal size.
301
00:14:38,420 --> 00:14:39,420
Let me see.
302
00:14:39,504 --> 00:14:41,524
The bladder's so engorged
it's taking up the whole torso,
303
00:14:41,548 --> 00:14:42,841
squeezing all the other organs.
304
00:14:42,966 --> 00:14:44,527
There's no room
for the lungs to develop.
305
00:14:44,551 --> 00:14:46,391
The baby has a lower
urinary tract obstruction.
306
00:14:46,470 --> 00:14:47,910
We can fix that
by inserting a shunt.
307
00:14:48,138 --> 00:14:49,306
I'll give Emma the news.
308
00:14:49,431 --> 00:14:51,183
Are you taking over the case?
309
00:14:51,308 --> 00:14:53,310
House won't care.
He has his diagnosis.
310
00:14:55,395 --> 00:14:57,022
Doctor Cameron.
311
00:14:58,565 --> 00:15:01,860
Dating chase can only end
in one of two ways.
312
00:15:01,985 --> 00:15:02,986
House told you?
313
00:15:03,111 --> 00:15:05,489
You get married
and live happily ever after,
314
00:15:05,614 --> 00:15:08,325
or somebody gets hurt
and you two can't work together,
315
00:15:08,450 --> 00:15:09,826
and I have to fire somebody.
316
00:15:09,951 --> 00:15:12,013
I would hate to see my personal life
become such a burden to you.
317
00:15:12,037 --> 00:15:13,181
I'm telling you this
for your own good.
318
00:15:13,205 --> 00:15:15,224
I assume you're gonna have this same
conversation with chase
319
00:15:15,248 --> 00:15:16,083
for his own good.
320
00:15:16,208 --> 00:15:18,710
Chase isn't the one
that's gonna get hurt here.
321
00:15:34,643 --> 00:15:37,646
There's only room for one
but I could scooch over.
322
00:15:37,771 --> 00:15:39,272
My social life
is my social life.
323
00:15:39,689 --> 00:15:41,024
Couldn't agree more.
324
00:15:41,149 --> 00:15:43,527
What goes on in the privacy of a
janitor's closet
325
00:15:43,652 --> 00:15:44,528
is nobody's business except...
326
00:15:44,653 --> 00:15:46,413
She told me to end it.
Is that what you want?
327
00:15:46,696 --> 00:15:48,416
I was actually hoping
she'd fire one of you.
328
00:15:48,532 --> 00:15:51,118
- What are you doing?
- Trying to avoid altitude sickness.
329
00:15:51,243 --> 00:15:52,923
Couldn't score a direct flight
to Cambodia,
330
00:15:52,953 --> 00:15:56,498
so I've decided to scale Argentina's
infamous mount aconcagua.
331
00:15:56,623 --> 00:15:58,543
Perfect, except for the fact
that you can't walk.
332
00:15:58,583 --> 00:16:01,795
There's a tribe of mocovi Indians
who actually carry the elders up...
333
00:16:01,920 --> 00:16:02,920
You're insane.
334
00:16:03,255 --> 00:16:04,756
I'm an insane genius.
335
00:16:04,881 --> 00:16:07,259
I set the chamber to low pressure
instead of high.
336
00:16:07,384 --> 00:16:09,803
Thinner air builds up
the extra red blood cells,
337
00:16:09,928 --> 00:16:11,012
creates new capillaries.
338
00:16:11,138 --> 00:16:14,182
Few more days in here, I can save myself
six weeks at base camp.
339
00:16:14,599 --> 00:16:15,934
Where's my mri?
340
00:16:18,728 --> 00:16:20,897
There's a blockage
in the urinary tract.
341
00:16:21,022 --> 00:16:22,983
Simple terms,
your baby can't pee.
342
00:16:23,108 --> 00:16:25,819
His bladder is swollen
and it's crushing his lungs.
343
00:16:25,944 --> 00:16:27,070
Can you fix it?
344
00:16:27,195 --> 00:16:29,698
We can insert a small tube
in the baby's bladder
345
00:16:29,823 --> 00:16:31,759
that makes the urine
come out straight through his belly
346
00:16:31,783 --> 00:16:33,660
for the duration
of the pregnancy.
347
00:16:33,785 --> 00:16:36,746
The bladder decompresses and the lungs
will be able to develop normally.
348
00:16:37,122 --> 00:16:40,000
When the baby gets better,
you should get better.
349
00:16:40,125 --> 00:16:42,002
First we just have to do a test
350
00:16:42,127 --> 00:16:44,880
to determine whether the baby's kidneys
are functioning properly.
351
00:16:45,005 --> 00:16:46,798
And what if they're not?
352
00:16:46,923 --> 00:16:50,635
If they're already too damaged, then
there's really nothing we can do.
353
00:16:50,760 --> 00:16:53,930
If this doesn't work out,
you can always try again.
354
00:16:57,392 --> 00:17:00,020
I miscarried twice
when I was married.
355
00:17:00,812 --> 00:17:04,274
After the divorce, I tried in vitro like
four times before this.
356
00:17:05,108 --> 00:17:08,653
I'm 42. Maybe it's
just not meant to be.
357
00:17:16,703 --> 00:17:18,038
What are you doing?
358
00:17:18,663 --> 00:17:20,808
You're trying to be me,
so I thought I'd try to be you.
359
00:17:20,832 --> 00:17:22,192
You don't have
the cleavage for it.
360
00:17:22,292 --> 00:17:23,877
But I have a much tighter ass.
361
00:17:24,002 --> 00:17:27,339
Think every day should be
naked Thursday or is that an oxymoron?
362
00:17:29,466 --> 00:17:31,027
Let me see the results
from the bladder tap.
363
00:17:31,051 --> 00:17:32,719
They aren't back yet.
364
00:17:32,844 --> 00:17:34,262
They're gonna be inconclusive.
365
00:17:34,387 --> 00:17:35,931
You think my diagnosis is wrong?
366
00:17:36,056 --> 00:17:38,683
Fetus doesn't pee,
amniotic fluid should be low.
367
00:17:38,808 --> 00:17:39,808
Mom's level is fine.
368
00:17:39,851 --> 00:17:40,977
Doesn't mean I'm wrong.
369
00:17:41,102 --> 00:17:42,955
Could just mean we caught
the obstruction early.
370
00:17:42,979 --> 00:17:44,648
Either way your test
will be inconclusive.
371
00:17:44,773 --> 00:17:45,857
The urine you've collected
372
00:17:45,982 --> 00:17:47,919
has been sitting in that fetus's bladder
for weeks.
373
00:17:47,943 --> 00:17:51,321
As my pappy always said,
"stale pee is useless pee."
374
00:17:51,696 --> 00:17:53,114
Fine. I'll do another tap.
375
00:17:53,240 --> 00:17:54,324
Just as useless.
376
00:17:54,991 --> 00:17:57,744
Old urine drops down from the kidney
right after the first tap
377
00:17:57,869 --> 00:17:58,912
'cause it's so backed up.
378
00:17:59,037 --> 00:18:01,665
Bladder tap number three
will give you the freshest pee.
379
00:18:01,790 --> 00:18:04,510
That's when you'll find out if this
fetus has even a fighting chance.
380
00:18:04,584 --> 00:18:05,627
Thank you.
381
00:18:06,586 --> 00:18:07,754
I'll run two more taps.
382
00:18:07,879 --> 00:18:10,757
Since when does the Dean of medicine
run bladder taps?
383
00:18:10,882 --> 00:18:11,967
She's an important patient.
384
00:18:12,425 --> 00:18:15,595
Because she takes pictures
or because she's you?
385
00:18:17,555 --> 00:18:19,724
Woman in her 40s, single,
386
00:18:20,809 --> 00:18:24,187
using a Turkey baster
as a last gasp at motherhood.
387
00:18:25,105 --> 00:18:29,067
Maybe you want to make sure she succeeds
so you'll still have hope.
388
00:18:29,985 --> 00:18:32,821
You can't be a good doctor
if you're not objective.
389
00:18:33,321 --> 00:18:35,115
- It's your file.
- I don't want it.
390
00:18:35,365 --> 00:18:37,450
Then why did you just
say all that stuff?
391
00:18:37,575 --> 00:18:38,785
To humiliate you.
392
00:18:38,910 --> 00:18:41,246
- You're taking the case back.
- I don't want it.
393
00:18:41,371 --> 00:18:43,331
Your diagnosis is right.
I want to go on vacation.
394
00:18:43,456 --> 00:18:45,959
You can go on vacation
after you've cured her.
395
00:18:51,339 --> 00:18:52,382
Chase: Good news.
396
00:18:52,716 --> 00:18:55,802
The fetus's urine had appropriate levels
of protein and electrolytes,
397
00:18:55,927 --> 00:18:57,804
so its kidneys aren't damaged.
398
00:18:59,472 --> 00:19:00,682
Oh, wow.
399
00:19:01,308 --> 00:19:02,767
We're gonna put the shunt in.
400
00:19:02,892 --> 00:19:04,732
Your baby's lungs
should have more room to grow
401
00:19:04,769 --> 00:19:07,230
and your symptoms
should go away.
402
00:19:08,064 --> 00:19:10,191
But he'll still need surgery,
after he's born?
403
00:19:10,317 --> 00:19:12,694
That's when we'll remove the blockage
in the ureter.
404
00:19:12,819 --> 00:19:14,404
You'll be the only mother on the planet
405
00:19:14,529 --> 00:19:16,489
who appreciates the value of a wet
diaper.
406
00:19:16,614 --> 00:19:18,158
Hey, could you hand me that?
407
00:19:18,283 --> 00:19:19,563
I'm keeping a visual memory book
408
00:19:19,659 --> 00:19:23,038
of this entire surreal process and this
is the best part of the story so far.
409
00:19:23,330 --> 00:19:25,040
- Yeah. Sure.
- Thanks.
410
00:19:26,708 --> 00:19:28,376
When'd you take this?
411
00:19:28,752 --> 00:19:30,170
She did the second bladder tap.
412
00:19:31,421 --> 00:19:32,421
You should keep it.
413
00:19:32,589 --> 00:19:35,216
Oh, I see her all day at work.
I don't need it.
414
00:19:36,509 --> 00:19:38,595
Maybe you want to see her
after work.
415
00:19:39,721 --> 00:19:41,222
I'm right, right?
416
00:19:42,974 --> 00:19:44,976
I saw the way you look at her.
417
00:19:54,152 --> 00:19:55,153
Thanks.
418
00:20:05,789 --> 00:20:07,957
The shunt is
in the right position.
419
00:20:08,083 --> 00:20:09,876
Bladder is starting
to decompress.
420
00:20:10,335 --> 00:20:11,503
No infection.
421
00:20:13,838 --> 00:20:16,216
Did house say anything else?
About us?
422
00:20:16,341 --> 00:20:19,886
I thought you didn't care about his
reaction. Trying to make him jealous?
423
00:20:20,303 --> 00:20:21,596
I like my job.
424
00:20:21,721 --> 00:20:23,681
He can't fire you
just because we're together.
425
00:20:23,807 --> 00:20:26,684
We're not "together,"
and house can do whatever he wants.
426
00:20:30,605 --> 00:20:32,732
- How's my baby?
- Doing just fine, Emma.
427
00:20:32,857 --> 00:20:34,734
- So are you.
- My stomach's killing me.
428
00:20:35,860 --> 00:20:37,737
That's not her stomach.
429
00:20:38,154 --> 00:20:41,366
Can you open your eyes, Emma?
I just need to take a look.
430
00:20:44,953 --> 00:20:46,454
What is it?
431
00:20:48,540 --> 00:20:50,667
Emma's jaundiced.
Her liver's shutting down.
432
00:20:52,961 --> 00:20:55,755
Figures. Just booked my trip
to johnston strait.
433
00:20:55,880 --> 00:20:58,883
I thought you were climbing
mount whatever in Argentina.
434
00:20:59,008 --> 00:21:01,845
Apparently I'd have to live
with the mocovi Indians for 20 years
435
00:21:01,970 --> 00:21:03,763
before they'd consider me
an elder.
436
00:21:03,888 --> 00:21:07,183
Decided to go kayaking
with orca instead. No legs required.
437
00:21:07,308 --> 00:21:10,562
Can't leave yet. Liver failure puts her
case back into the unsolved pile.
438
00:21:10,687 --> 00:21:13,898
Increased ast, alt and her bilirubin's
off the charts.
439
00:21:15,233 --> 00:21:16,860
Even fetuses lie.
440
00:21:19,404 --> 00:21:23,658
We diagnosed a lower urinary tract
obstruction because we saw one.
441
00:21:24,784 --> 00:21:26,995
What if that's not
the whole story?
442
00:21:27,871 --> 00:21:30,915
What if the little bugger
is hiding something?
443
00:21:31,416 --> 00:21:33,918
The real reason
for the mirror syndrome.
444
00:21:34,878 --> 00:21:36,337
Have we looked under its bed?
445
00:21:36,463 --> 00:21:37,630
We checked its diary?
446
00:21:37,755 --> 00:21:39,299
If it's not go,
could be the heart.
447
00:21:39,424 --> 00:21:40,693
Hypoplastic left heart syndrome.
448
00:21:40,717 --> 00:21:42,361
- There were no structural problems.
- The lungs.
449
00:21:42,385 --> 00:21:44,238
We won't be able to
get a good look until they develop.
450
00:21:44,262 --> 00:21:46,222
- It'll be weeks...
- She's not gonna last weeks.
451
00:21:46,347 --> 00:21:47,640
What do you want to do?
452
00:21:47,765 --> 00:21:50,810
Maternal mirror syndrome
has one sure fire cure.
453
00:21:51,603 --> 00:21:52,729
Deliver the fetus.
454
00:21:52,854 --> 00:21:55,023
That's not viable at 21 weeks.
You'll kill the baby.
455
00:21:55,148 --> 00:21:57,400
- Fetus.
- Semantics make you feel better?
456
00:21:57,525 --> 00:21:58,565
Pretend it's not a person?
457
00:21:58,651 --> 00:22:00,695
Can it play catch? Can it eat?
458
00:22:00,820 --> 00:22:02,822
Can it take pretty pictures?
459
00:22:04,073 --> 00:22:05,909
Who wants to tell her?
460
00:22:13,416 --> 00:22:15,835
The swollen bladder
was not the only problem.
461
00:22:17,921 --> 00:22:20,757
We can't leave it inside you.
We have to terminate.
462
00:22:21,466 --> 00:22:22,717
Well, can't you deliver him?
463
00:22:22,842 --> 00:22:26,012
Put him on a respiratory machine
till you figure out what's wrong?
464
00:22:26,137 --> 00:22:28,389
We can. And it won't matter.
465
00:22:29,933 --> 00:22:33,394
The fetus is still at least
two weeks away from being viable.
466
00:22:33,686 --> 00:22:37,357
Well, I'll suffer through this
for two more weeks then.
467
00:22:39,901 --> 00:22:43,071
You're on dialysis for your kidneys.
Your kidneys can wait.
468
00:22:44,072 --> 00:22:46,574
They don't make dialysis
for your liver.
469
00:22:48,326 --> 00:22:50,787
You're not gonna make it
two more days.
470
00:22:57,752 --> 00:22:59,963
I'm not gonna let you
kill my baby.
471
00:23:00,630 --> 00:23:02,257
It's killing you.
472
00:23:03,716 --> 00:23:05,843
I'm not having an abortion.
473
00:23:06,511 --> 00:23:09,389
It's not a baby. It's a tumor.
474
00:23:14,644 --> 00:23:16,521
I understand dying for a cause.
475
00:23:16,646 --> 00:23:18,898
Sacrificing your life
so your child might live.
476
00:23:19,023 --> 00:23:20,692
But that's not the choice here.
477
00:23:23,945 --> 00:23:26,864
Either it dies or you both die.
478
00:23:27,448 --> 00:23:29,659
Or you fix him and we both live.
479
00:23:29,784 --> 00:23:31,035
I can't fix it.
480
00:23:35,832 --> 00:23:37,834
I'm scheduling a d&c.
481
00:23:37,959 --> 00:23:38,959
I won't consent.
482
00:23:41,879 --> 00:23:44,882
So I guess you have two days
to figure it out.
483
00:23:55,018 --> 00:23:56,728
Her kidneys are
almost irreparable.
484
00:23:56,853 --> 00:23:59,856
She's developed severe dic.
You have to force her to terminate.
485
00:23:59,981 --> 00:24:02,900
Did you give corticosteroids
to speed up the baby's lung development?
486
00:24:03,026 --> 00:24:06,613
No. I dropped an anvil on its chest
to prevent lung development.
487
00:24:07,155 --> 00:24:09,907
I'm trying to extinguish
the human race one fetus at a time.
488
00:24:10,033 --> 00:24:13,036
Give the lungs more time
to expand so you can see inside them.
489
00:24:13,161 --> 00:24:14,221
See if they're the problem.
490
00:24:14,245 --> 00:24:16,080
My real patient is dying.
491
00:24:16,205 --> 00:24:19,834
Very quickly. Like I wouldn't
advise her to buy any green bananas.
492
00:24:19,959 --> 00:24:21,979
The fetus is nothing more
than a parasite at this point.
493
00:24:22,003 --> 00:24:23,546
Removing it is an instant cure.
494
00:24:23,671 --> 00:24:25,190
You're not gonna get Emma
to see it that way.
495
00:24:25,214 --> 00:24:26,442
She's probably already
named the baby,
496
00:24:26,466 --> 00:24:28,509
read him books,
had conversations with him.
497
00:24:28,635 --> 00:24:31,179
- See, you get it. She'll listen to you.
- No.
498
00:24:31,638 --> 00:24:33,556
If you let this woman
refuse to terminate,
499
00:24:33,681 --> 00:24:35,391
you're helping her commit suicide.
500
00:24:35,892 --> 00:24:38,186
As her doctor
my recommendation is against suicide.
501
00:24:38,311 --> 00:24:39,812
If the baby had a doctor,
502
00:24:39,937 --> 00:24:42,357
I think she would recommend exhausting
all possibilities
503
00:24:42,482 --> 00:24:44,817
- before taking its life.
- Then she'd be an idiot.
504
00:24:44,942 --> 00:24:46,778
Too bad she's your boss!
505
00:24:48,655 --> 00:24:50,448
What if our original
assumption is wrong?
506
00:24:50,573 --> 00:24:51,866
It isn't.
507
00:24:51,991 --> 00:24:53,719
If we assume
she doesn't have mirror syndrome,
508
00:24:53,743 --> 00:24:56,138
then terminating her pregnancy
isn't gonna help her liver at all.
509
00:24:56,162 --> 00:24:58,247
We eliminated
all other possibilities.
510
00:24:58,373 --> 00:25:00,375
The fetus is hydropic
and in distress.
511
00:25:00,875 --> 00:25:03,711
Emma's kidneys and liver
are failing. The diagnosis is solid.
512
00:25:03,961 --> 00:25:06,798
Wow! The ass-kisser
won't agree with you.
513
00:25:06,923 --> 00:25:08,483
You must be even wronger
than I thought.
514
00:25:09,258 --> 00:25:10,258
Fine.
515
00:25:10,927 --> 00:25:12,762
Let's assume she had
mirror syndrome
516
00:25:12,887 --> 00:25:15,848
but we fixed it when we fixed
the baby's bladder.
517
00:25:15,973 --> 00:25:19,727
That means that her failing liver
would be completely unrelated.
518
00:25:19,977 --> 00:25:23,314
If it is, we can fix it and
we don't have to terminate.
519
00:25:23,439 --> 00:25:26,401
So her theory is
that our patient's liver problems
520
00:25:26,526 --> 00:25:28,319
were just a giant coincidence.
521
00:25:28,820 --> 00:25:30,047
It's not a surprising
coincidence.
522
00:25:30,071 --> 00:25:32,240
Pregnant women
can develop liver problems.
523
00:25:32,365 --> 00:25:36,119
If this is the case,
we can actually do something here.
524
00:25:36,786 --> 00:25:38,996
Don't you guys
think that's worth exploring?
525
00:25:39,122 --> 00:25:41,999
Acute fatty liver of pregnancy
would have the same symptoms.
526
00:25:42,125 --> 00:25:44,627
- Thank you.
- Brownnoser.
527
00:25:45,670 --> 00:25:48,798
- Viral hepatitis, hellp syndrome.
- Oh, look.
528
00:25:49,340 --> 00:25:52,844
Sticking up for your girlfriend.
Who says chivalry's dead?
529
00:25:54,053 --> 00:25:55,847
He's not joking?
530
00:25:57,014 --> 00:25:58,933
Be patient. She's going
through all of us.
531
00:25:59,058 --> 00:26:01,769
She'll get
that jungle fever eventually.
532
00:26:01,894 --> 00:26:05,022
- I'm not going through anyone.
- You love him?
533
00:26:05,148 --> 00:26:07,900
This can probably wait until after you
biopsy Emma's liver, right?
534
00:26:08,025 --> 00:26:09,902
We can't.
Her platelets are too low.
535
00:26:10,027 --> 00:26:13,781
Once we Pierce her liver, it'll be next
to impossible to stop the bleeding.
536
00:26:13,906 --> 00:26:15,158
Come in from above.
537
00:26:16,617 --> 00:26:18,387
Instead of going straight in
through her abdomen,
538
00:26:18,411 --> 00:26:19,871
go in through the veins
in her neck.
539
00:26:19,996 --> 00:26:22,832
Transjugular hepatic biopsy.
540
00:26:22,957 --> 00:26:26,753
If the liver starts to bleed, it'll
bleed right back into her own veins.
541
00:26:36,971 --> 00:26:39,348
Why don't you start
your vacation now?
542
00:26:46,230 --> 00:26:48,858
Threading the guide wire
through the right internal jugular vein.
543
00:26:48,983 --> 00:26:51,694
So, the sleep lab...
544
00:26:52,320 --> 00:26:54,322
You and Cameron not sleeping.
545
00:26:54,989 --> 00:26:57,074
How serious is it?
546
00:26:57,200 --> 00:26:58,200
It's nothing.
547
00:26:58,618 --> 00:27:00,369
She's only doing it
to make house jealous.
548
00:27:00,703 --> 00:27:02,830
- Then why are you doing it?
- You kidding?
549
00:27:02,955 --> 00:27:05,875
You're approaching the inferior
vena cava. Slow down.
550
00:27:07,543 --> 00:27:08,920
You better not hurt her.
551
00:27:09,796 --> 00:27:12,256
- She already has a big brother.
- She does?
552
00:27:12,381 --> 00:27:14,300
You obviously care
very deeply about her.
553
00:27:14,425 --> 00:27:17,011
I'm not protecting her.
I'm protecting myself.
554
00:27:17,470 --> 00:27:19,680
A heartbroken, lovesick Cameron
555
00:27:19,806 --> 00:27:22,767
would be even more unbearable
than she is now.
556
00:27:23,226 --> 00:27:24,727
You're through the hepatic vein.
557
00:27:24,852 --> 00:27:26,437
I'm firing the needle.
558
00:27:27,522 --> 00:27:30,149
Heart rate and BP spiking.
Get that out of her.
559
00:27:30,358 --> 00:27:32,860
Fetus's heart rate
just dropped to 50.
560
00:27:34,529 --> 00:27:36,781
- We've got contractions.
- Pre-terrn labor.
561
00:27:36,906 --> 00:27:38,950
Start a terbutaline drip!
562
00:27:47,792 --> 00:27:50,711
We were able to control
the pre-terrn labor with tocolytics.
563
00:27:50,837 --> 00:27:52,713
The contractions
have subsided for now.
564
00:27:52,839 --> 00:27:55,758
And the liver biopsy was negative.
This is definitely mirror syndrome.
565
00:27:55,883 --> 00:27:56,944
Her baby's doing this to her.
566
00:27:56,968 --> 00:27:57,968
We're out of options.
567
00:27:58,094 --> 00:28:00,781
Did the biopsy cause the pre-terrn labor
or did it happen on its own?
568
00:28:00,805 --> 00:28:01,639
It doesn't make a difference.
569
00:28:01,764 --> 00:28:03,266
Pre-tenn labor
can be a new symptom.
570
00:28:03,391 --> 00:28:05,935
New information gives us
new theories. Isn't that how it works?
571
00:28:06,060 --> 00:28:07,061
Not in this case.
572
00:28:07,186 --> 00:28:10,606
Her body's trying to do what you refuse
to, get the baby out and save itself.
573
00:28:10,940 --> 00:28:13,234
Patient's transaminases
are 10 times normal.
574
00:28:13,359 --> 00:28:15,254
Her liver is on the verge
of shutting down completely.
575
00:28:15,278 --> 00:28:16,404
A torch test could...
576
00:28:16,529 --> 00:28:18,281
We don't have time
for more tests.
577
00:28:18,406 --> 00:28:20,575
We have to terminate
or she'll die.
578
00:28:21,951 --> 00:28:23,744
Then let's work faster.
579
00:28:23,953 --> 00:28:26,831
Medicine doesn't work faster
just because you hope real hard.
580
00:28:26,956 --> 00:28:29,036
But it could help to see
what the baby's been hiding.
581
00:28:29,125 --> 00:28:32,086
The only organ we haven't been able
to look inside is its lungs.
582
00:28:32,211 --> 00:28:33,371
The problem must be in there.
583
00:28:33,421 --> 00:28:36,090
We haven't been able to see inside
because they're underdeveloped.
584
00:28:36,340 --> 00:28:38,134
We've already got her on
corticosteroids,
585
00:28:38,259 --> 00:28:39,444
but it'll take weeks for them...
586
00:28:39,468 --> 00:28:42,430
Then let's drown them
in corticosteroids, multiple courses.
587
00:28:42,555 --> 00:28:43,431
Speed up their development.
588
00:28:43,556 --> 00:28:46,476
Giving the baby more than one course
will suppress adrenal gland function.
589
00:28:46,559 --> 00:28:49,604
Have long-terrn adverse effects
on fetal organ development.
590
00:28:49,729 --> 00:28:51,707
- Worse than death?
- Emma's already on tocolytics.
591
00:28:51,731 --> 00:28:53,816
The combination could put her
into pulmonary edema.
592
00:28:53,941 --> 00:28:55,067
You'll just kill her faster.
593
00:28:55,192 --> 00:28:57,695
It's the only chance we have
to see inside those lungs.
594
00:28:57,820 --> 00:29:01,574
We're just gonna have to make the baby
better faster than we make Emma worse.
595
00:29:02,366 --> 00:29:04,577
Come on! This is the kind
of thing house does every day.
596
00:29:04,785 --> 00:29:07,413
House thought we should
terminate six hours ago.
597
00:29:10,791 --> 00:29:12,043
I'll do it myself.
598
00:29:18,341 --> 00:29:19,341
Anybody gonna stop her?
599
00:29:19,592 --> 00:29:21,010
Stopping the madness is herjob.
600
00:29:21,135 --> 00:29:23,679
Somebody's got to be
cuddy's cuddy.
601
00:29:32,688 --> 00:29:33,688
Nurse!
602
00:29:39,612 --> 00:29:42,406
- Pulmonary edema?
- Who tattled? It doesn't matter.
603
00:29:42,657 --> 00:29:45,534
There's a reason we don't give
multiple courses of corticosteroids.
604
00:29:45,660 --> 00:29:46,994
Gee, thanks.
605
00:29:47,119 --> 00:29:48,412
It's time to terminate.
606
00:29:48,871 --> 00:29:49,890
That's not what she wants.
607
00:29:49,914 --> 00:29:50,915
Look at her.
608
00:29:51,290 --> 00:29:55,670
She didn't want to be an Incubator for a
dead baby, but that's what you've done.
609
00:29:55,795 --> 00:29:58,464
Either get me a iaryngoscope
or get out!
610
00:30:42,466 --> 00:30:43,968
You were right.
611
00:30:44,093 --> 00:30:45,761
You were all right.
612
00:30:45,886 --> 00:30:48,222
Now the mom's lungs
are shutting down.
613
00:30:49,098 --> 00:30:52,268
She's dying faster than the baby's lungs
are developing.
614
00:30:52,560 --> 00:30:54,395
I had to stop
the corticosteroids.
615
00:30:54,603 --> 00:30:56,230
Have you spoken to the family?
616
00:30:56,355 --> 00:30:58,774
The only family she's got
is that baby.
617
00:30:58,899 --> 00:31:00,276
Well, he's biased.
618
00:31:01,485 --> 00:31:03,487
What do you think
house would do?
619
00:31:03,612 --> 00:31:05,031
House wants to terminate.
620
00:31:05,781 --> 00:31:07,158
I mean if he didn't.
621
00:31:07,283 --> 00:31:09,744
If he shared my position,
what do you think he would do?
622
00:31:10,119 --> 00:31:11,787
He wouldn't share your pain.
623
00:31:12,496 --> 00:31:14,373
He'd be objective.
624
00:31:14,999 --> 00:31:16,125
Right.
625
00:31:17,710 --> 00:31:20,463
- He would prioritize his problems.
- He'd terminate.
626
00:31:20,713 --> 00:31:23,650
He wouldn't be afraid of screwing with
her lungs if there was a bigger issue.
627
00:31:23,674 --> 00:31:24,675
There is no bigger issue.
628
00:31:24,800 --> 00:31:26,719
- She needs her lungs.
- Not right now.
629
00:31:26,844 --> 00:31:28,679
She's already on a respirator.
630
00:31:28,804 --> 00:31:30,084
The machine is
breathing for her.
631
00:31:30,139 --> 00:31:31,849
I can do whatever
I want to her lungs.
632
00:31:31,974 --> 00:31:34,974
If you're playing catch in the living
room and you break your mother's vase,
633
00:31:35,019 --> 00:31:37,414
you may as well keep playing catch.
The vase is already broken.
634
00:31:37,438 --> 00:31:41,150
Yeah, except that room
can't breathe without that vase.
635
00:31:41,358 --> 00:31:44,028
I'm putting her back on
corticosteroids.
636
00:31:50,034 --> 00:31:52,328
- It worked.
- What worked?
637
00:31:52,453 --> 00:31:54,121
I got the baby's lungs
to expand.
638
00:31:54,246 --> 00:31:56,099
- We should be able to figure...
- Cab's on its way.
639
00:31:56,123 --> 00:31:58,084
I have to finish packing.
640
00:31:59,710 --> 00:32:02,046
I have a whole new
appreciation for what you do.
641
00:32:02,171 --> 00:32:04,465
How hard it is to believe
when everyone around you
642
00:32:04,590 --> 00:32:05,650
is telling you
that you're wrong.
643
00:32:05,674 --> 00:32:07,510
Helps to know they're idiots.
644
00:32:07,802 --> 00:32:10,054
Do you think I'm an idiot?
645
00:32:10,179 --> 00:32:12,014
You're not objective.
646
00:32:13,808 --> 00:32:15,684
But you're not an idiot.
647
00:32:18,521 --> 00:32:20,856
These lungs are still two weeks away
from being viable.
648
00:32:20,981 --> 00:32:22,441
But big enough for a diagnosis.
649
00:32:22,775 --> 00:32:24,235
These tissue buds are new.
650
00:32:24,360 --> 00:32:26,904
Could indicate
bronchopulmonary sequestration
651
00:32:27,029 --> 00:32:28,823
or diaphragmatic eventration.
652
00:32:28,948 --> 00:32:31,784
I was thinking bronchogenic
cyst or bronchial atresia.
653
00:32:31,909 --> 00:32:33,619
Could be lung lesions, ccam.
654
00:32:33,953 --> 00:32:35,037
What about...
655
00:32:42,795 --> 00:32:43,921
Move.
656
00:32:46,715 --> 00:32:48,217
Thoughtyou
started your vacation.
657
00:32:48,342 --> 00:32:51,345
Somebody had to save
our boss's rotundus ass.
658
00:32:51,470 --> 00:32:53,764
Latest mri of the Sloan fetus.
659
00:32:53,889 --> 00:32:55,450
Small buds in the lungs
could indicate...
660
00:32:55,474 --> 00:32:57,476
Thanks. Got the multiple choice
all worked out.
661
00:32:57,685 --> 00:33:00,938
Question is, how do we pick between
a, b, c, d, and none of the above?
662
00:33:01,063 --> 00:33:03,344
Portable mri is in her room.
We could get a current image.
663
00:33:03,399 --> 00:33:06,402
The fetal lungs are so tiny the mri
won't give us the details we need.
664
00:33:06,527 --> 00:33:10,656
What would we do if this patient
were not just a tadpole?
665
00:33:10,781 --> 00:33:11,907
Say it was an actual person.
666
00:33:12,199 --> 00:33:13,576
He is a person.
667
00:33:13,701 --> 00:33:14,952
Thanks for playing along.
668
00:33:15,369 --> 00:33:17,037
Pretend it's a one-pound adult.
669
00:33:17,163 --> 00:33:19,790
Forget the mom,
forget the womb, the placenta.
670
00:33:20,207 --> 00:33:22,626
How would we get a better look
at what's in the lungs?
671
00:33:22,751 --> 00:33:23,752
Transesophageal echo.
672
00:33:23,878 --> 00:33:25,212
Can't access his esophagus.
673
00:33:25,337 --> 00:33:26,982
High resolution ct
could give us a clearer...
674
00:33:27,006 --> 00:33:29,675
Too much radiation
for a one-pound person.
675
00:33:29,925 --> 00:33:33,053
You can't just shoot
everything down, chase.
676
00:33:33,262 --> 00:33:35,472
You're not me. Collaborate.
677
00:33:36,390 --> 00:33:38,726
A ventilation perfusion scan
would be next.
678
00:33:39,143 --> 00:33:42,438
How do we get a fetus to breathe
in a radioactive isotope, idiot?
679
00:33:43,189 --> 00:33:45,309
If it were really a person
and we had no other options
680
00:33:45,357 --> 00:33:46,901
we'd do an exploratory surgery.
681
00:33:47,026 --> 00:33:49,278
Cut into its chest
and have a look around.
682
00:33:49,403 --> 00:33:50,738
Let's do that.
683
00:33:51,780 --> 00:33:54,617
You're the one who insists
we treat it like a person.
684
00:33:54,742 --> 00:33:56,577
I'll put it back when I'm done.
685
00:33:59,705 --> 00:34:01,040
Me again.
686
00:34:01,165 --> 00:34:03,834
It's your friendly
neighborhood belly squirter.
687
00:34:03,959 --> 00:34:05,961
We're gonna do
open fetal surgery.
688
00:34:06,086 --> 00:34:09,006
Open the uterus,
cut out the fetus so we can look around.
689
00:34:09,548 --> 00:34:13,344
I know you can't talk so I need you
to look petrified if you consent.
690
00:34:13,636 --> 00:34:15,429
The umbilical cord won't be cut.
691
00:34:15,846 --> 00:34:19,225
During surgery, your body will basically
serve as the baby's heart/lung machine.
692
00:34:19,725 --> 00:34:21,977
We find what's wrong
and we fix it.
693
00:34:22,436 --> 00:34:23,270
If we can.
694
00:34:23,395 --> 00:34:26,565
Don't lower expectations
if you want them to do something.
695
00:34:26,941 --> 00:34:29,068
She should know
what she's facing.
696
00:34:32,154 --> 00:34:34,281
This is incredibly dangerous.
697
00:34:34,406 --> 00:34:36,325
It risks both your lives.
698
00:34:36,867 --> 00:34:38,427
The only reason
why we're suggesting it,
699
00:34:38,452 --> 00:34:41,080
is because there's
nothing else we can do.
700
00:35:04,436 --> 00:35:06,647
You all here
for the fetal surgery?
701
00:35:06,897 --> 00:35:08,899
'Cause we're way over capacity.
702
00:35:09,024 --> 00:35:10,651
Mind each other's
personal space.
703
00:35:11,110 --> 00:35:13,195
There are sharp implements
in the room.
704
00:35:13,320 --> 00:35:14,697
Like this one.
705
00:35:22,079 --> 00:35:24,498
Uterus is fully exposed.
706
00:35:33,382 --> 00:35:34,633
And we're in.
707
00:35:34,842 --> 00:35:36,969
Start draining
the amniotic fluid.
708
00:35:39,722 --> 00:35:42,141
Have you never sucked beer
out of the bottom of a keg?
709
00:35:42,474 --> 00:35:44,393
Where'd you go to college?
Give me that.
710
00:36:11,337 --> 00:36:13,297
Affix the pulse ox to the palm.
711
00:36:18,761 --> 00:36:19,762
House?
712
00:36:22,139 --> 00:36:23,140
Sorry.
713
00:36:23,766 --> 00:36:26,018
Just realized
I forgot to TiVo alien.
714
00:36:33,275 --> 00:36:36,195
Fetal heart rate good.
Stats are stable.
715
00:36:36,945 --> 00:36:39,281
Position him for the incision.
716
00:36:44,745 --> 00:36:47,081
I see three well-defined
lesions.
717
00:36:47,206 --> 00:36:50,125
It's definitely ccam.
I should be able to resect them.
718
00:36:53,128 --> 00:36:55,547
It's the mom. She's in v-fib.
719
00:36:57,049 --> 00:36:58,592
Charging.
720
00:37:00,302 --> 00:37:02,429
- Clear!
- I'm clear.
721
00:37:04,556 --> 00:37:06,785
Looks like asystole.
Paddling isn't going to do anything.
722
00:37:06,809 --> 00:37:08,811
It's fine v-fib.
I'm going again. Clear!
723
00:37:11,772 --> 00:37:13,816
We're gonna lose them both.
Clamp!
724
00:37:15,150 --> 00:37:17,277
The surgery's not doing this to her.
The fetus is.
725
00:37:17,403 --> 00:37:18,821
Step away, house.
I'm going again.
726
00:37:18,946 --> 00:37:22,491
The only way to save her is to cut away
the anchor holding her down.
727
00:37:22,616 --> 00:37:25,119
You keep going,
you're gonna get electrocuted.
728
00:37:25,828 --> 00:37:27,830
Clear!
729
00:37:28,664 --> 00:37:31,333
Going again. Clear!
730
00:37:33,794 --> 00:37:36,463
Heart rate's returning
to normal.
731
00:37:39,216 --> 00:37:41,385
Continue with the lobectomy.
732
00:37:50,727 --> 00:37:53,981
So my kidneys, liver and lungs
are all fine just like that?
733
00:37:55,232 --> 00:37:57,609
- Just like that.
- That's amazing.
734
00:37:58,902 --> 00:38:02,406
What's amazing is how blonde
your baby's hair is.
735
00:38:05,033 --> 00:38:06,410
My baby?
736
00:38:06,535 --> 00:38:08,495
The thing in your belly
that tried to kill you.
737
00:38:08,871 --> 00:38:10,956
You've never called him
a baby before.
738
00:38:17,713 --> 00:38:18,714
Any pain?
739
00:38:19,006 --> 00:38:20,507
Nothing I can't deal with.
740
00:38:20,632 --> 00:38:23,051
You can only get out of bed
to pee, pooh or shower.
741
00:38:23,177 --> 00:38:26,555
And absolutely no sex.
So stop flirting with me.
742
00:38:28,182 --> 00:38:29,308
Sorry.
743
00:38:31,977 --> 00:38:35,272
So this really worked?
He'll be normal?
744
00:38:36,690 --> 00:38:39,985
Well, if you call
being born twice normal.
745
00:38:45,324 --> 00:38:46,700
Hey, thank you.
746
00:38:49,953 --> 00:38:53,457
Don't thank me.
I would've killed the kid.
747
00:39:02,299 --> 00:39:04,843
- Wanna grab a bite?
- In a minute.
748
00:39:04,968 --> 00:39:07,054
Emma asked me to
bring up her camera.
749
00:39:07,429 --> 00:39:08,972
I'll walk with you.
750
00:39:11,308 --> 00:39:13,560
When'd she take
this picture of you?
751
00:39:14,770 --> 00:39:16,688
You look so...
752
00:39:17,064 --> 00:39:18,148
I'm smiling.
753
00:39:19,483 --> 00:39:20,984
I have a nice smile.
754
00:39:21,109 --> 00:39:23,445
No, I've never
seen you like this.
755
00:39:23,779 --> 00:39:25,906
She got you to glow.
756
00:39:26,907 --> 00:39:28,742
What were you doing?
757
00:39:29,535 --> 00:39:31,495
What did she say to you?
758
00:39:32,788 --> 00:39:34,373
I always glow.
759
00:39:46,635 --> 00:39:47,761
House.
760
00:39:48,637 --> 00:39:50,305
Need you to take
a look at something.
761
00:39:50,430 --> 00:39:52,849
- I'm off the clock.
- Just open it.
762
00:39:58,897 --> 00:40:01,149
A first-class ticket
to Vancouver island.
763
00:40:01,275 --> 00:40:04,361
Shoot! The wrong envelope.
764
00:40:08,240 --> 00:40:10,659
- I think it's great.
- Yeah.
765
00:40:11,410 --> 00:40:13,954
- Who doesn't like Canadians?
- It's big.
766
00:40:14,079 --> 00:40:17,291
You're trying to have a life.
You're trying to enjoy yourself.
767
00:40:17,416 --> 00:40:19,042
You didn't need to apologize.
768
00:40:19,334 --> 00:40:20,711
I'm not. I told you why I...
769
00:40:20,836 --> 00:40:22,004
Screwed up.
770
00:40:22,129 --> 00:40:23,589
I saved a life.
I saved two lives.
771
00:40:24,089 --> 00:40:25,215
You
772
00:40:25,882 --> 00:40:30,053
let your maternal instinct get the best
of you and nearly kill two people.
773
00:40:30,178 --> 00:40:32,723
Case like this, you terminate,
mom lives 10 times out of 10.
774
00:40:32,848 --> 00:40:33,890
You do what you did
775
00:40:34,016 --> 00:40:36,643
mom and baby both die
9.9 times out of 10.
776
00:40:37,102 --> 00:40:39,771
Sometimes point one
is bigger than 9.9.
777
00:40:39,896 --> 00:40:41,815
No, it's smaller.
778
00:40:42,274 --> 00:40:45,193
Exactly 9.8 smaller.
Always is. Always will be.
779
00:40:45,902 --> 00:40:48,739
Well, not for Emma.
And not for her son.
780
00:40:50,282 --> 00:40:53,243
Now go away and be happy.
58449
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