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1
00:00:03,003 --> 00:00:05,972
On your right.
On your right. On your right.
2
00:00:06,039 --> 00:00:08,132
Back, back, back, back, back.
Come on, buddy.
3
00:00:11,745 --> 00:00:14,077
Yeah, Dan! Yeah!
4
00:00:14,147 --> 00:00:15,876
Yea!
Yea!
5
00:00:15,949 --> 00:00:19,282
Back, back, back, back, back.
Watch the winger!
6
00:00:31,264 --> 00:00:33,425
Yeah!
7
00:00:56,856 --> 00:00:58,847
You okay?
8
00:00:58,925 --> 00:01:00,984
Dan? Dan, talk to me.
9
00:01:01,061 --> 00:01:03,757
Dan. Dan.
10
00:01:03,830 --> 00:01:06,663
Get a doctor!
11
00:01:46,239 --> 00:01:48,537
- Hey.
- Close the door.
12
00:01:48,608 --> 00:01:51,168
Close the door.
13
00:01:53,913 --> 00:01:57,007
Is Cuddy down the hall
counting to 50?
14
00:01:57,083 --> 00:01:59,916
She knows I'm in here,
in the clinic, as she commanded.
15
00:01:59,986 --> 00:02:03,217
- She just doesn't know I'm alone.
- Well, you've got a full waiting room.
16
00:02:03,289 --> 00:02:06,019
- How long do you think you can ignore them?
- I'm off at 4:00.
17
00:02:07,760 --> 00:02:10,024
You're doing this
to avoid five minutes of work?
18
00:02:10,096 --> 00:02:12,724
If I go out there, I get assigned
a kid with a runny nose.
19
00:02:12,799 --> 00:02:16,030
That's 30 seconds looking at the nose,
25 minutes talking to a worried mom...
20
00:02:16,102 --> 00:02:18,900
who won't leave until she's sure
it's not meningitis or a tumor.
21
00:02:18,972 --> 00:02:21,338
Yes. Concerned parents
can be so annoying.
22
00:02:21,407 --> 00:02:25,036
Just tell Cuddy you've got an urgent
case. You had to leave early.
That would be lying.
23
00:02:25,111 --> 00:02:30,014
And that would be wrong. But luckily
the definition of "urgent" is fungible.
24
00:02:30,083 --> 00:02:32,711
Not the definition
of "case" though.
25
00:02:36,122 --> 00:02:38,886
You have no cases?
26
00:02:38,958 --> 00:02:41,017
You have no cases?
27
00:02:41,094 --> 00:02:44,825
You've got handpicked
doctors-- specialists--
28
00:02:44,898 --> 00:02:47,799
working for you,
and they're sitting on their hands?
29
00:02:47,867 --> 00:02:51,701
- Cameron's answering my mail.
- Oh, time well spent, I'm sure.
30
00:02:51,771 --> 00:02:53,762
Foreman and Chase?
31
00:02:53,840 --> 00:02:55,831
Research?
32
00:03:02,515 --> 00:03:05,245
Nine letters.
Iodine deficiency in children.
33
00:03:05,318 --> 00:03:07,479
Cretinism.
34
00:03:16,863 --> 00:03:19,764
So, 4:03 p.m.,
Dr. House checks out.
35
00:03:19,832 --> 00:03:21,766
Please write that down.
36
00:03:21,834 --> 00:03:24,029
Dr. House.
Sorry. Done for the day.
37
00:03:24,103 --> 00:03:27,004
Plenty of docs here
to take care of you.
But we had an appointment.
38
00:03:27,073 --> 00:03:30,406
Nice try, but this is
a walk-in clinic, which means
there are no appointments.
39
00:03:30,476 --> 00:03:32,706
You walk in, sign the chart,
and a doctor will see you.
40
00:03:32,779 --> 00:03:36,271
Just not me.
Your letter says that we'd see you.
41
00:03:37,317 --> 00:03:39,717
Not a big letter writer.
Here.
42
00:03:42,288 --> 00:03:45,780
When did my signature get so girlie?
43
00:03:45,858 --> 00:03:48,053
- I can explain.
- See that "G"?
44
00:03:48,127 --> 00:03:50,561
See how it makes a big loop on top?
45
00:03:50,630 --> 00:03:53,997
Doesn't even look like my handwriting.
Think I have something?
46
00:03:54,067 --> 00:03:57,468
What's the differential diagnosis
for writing G's like
a junior high school girl?
47
00:03:57,537 --> 00:04:01,268
It's impossible to get to you
through normal channels.
They have called, e-mailed.
48
00:04:01,341 --> 00:04:05,243
Perseverance does not equal worthiness.
Next time you want to get my attention,
wear something fun.
49
00:04:05,311 --> 00:04:07,279
Low-rider jeans are hot.
50
00:04:07,347 --> 00:04:12,410
Sixteen-year-old male. Sudden onset
of double vision and night terrors,
with no apparent cause.
51
00:04:12,485 --> 00:04:14,953
The kid's been to
two neurologists, and he--
Night terrors?
52
00:04:15,021 --> 00:04:17,819
- As in big scary monsters?
- Yes.
53
00:04:20,660 --> 00:04:24,152
- Where are you going?
- To see the family.
54
00:04:24,230 --> 00:04:28,291
- You're going to examine a patient?
- Nine times out of 10,
there's no reason to talk to a patient.
55
00:04:28,368 --> 00:04:32,202
But night terrors in a 16-year-old
is a very good reason
to talk to this family.
56
00:04:32,272 --> 00:04:34,206
Good work.
57
00:04:37,176 --> 00:04:39,110
Margins are fine.
58
00:04:39,178 --> 00:04:41,112
No lesions.
59
00:04:42,348 --> 00:04:44,646
Color is good.
60
00:04:44,717 --> 00:04:48,050
How long have you been
having night terrors?
Three weeks.
61
00:04:48,121 --> 00:04:51,318
He's afraid to go to bed.
He's exhausted,
can barely function.
62
00:04:53,393 --> 00:04:56,885
- What does that tell you?
- Nothing. It's just fun
watching him blink.
63
00:04:56,963 --> 00:05:00,455
Name as many animals as you can
that begin with the letter "B". Go.
64
00:05:07,206 --> 00:05:11,302
- Baby elephant?
- Baby elephant is actually
a good answer.
65
00:05:11,377 --> 00:05:13,902
- "B" is a bear of a letter.
- What does that tell you?
66
00:05:13,980 --> 00:05:18,007
Proves two things:
no neurological damage, and your son
is never gonna be chief fry cook.
67
00:05:18,084 --> 00:05:21,815
In teens, there are two
likely causes of night terrors.
68
00:05:21,888 --> 00:05:25,585
- Posttraumatic stress. Any recent
shoot-outs at your high school?
- No.
69
00:05:25,658 --> 00:05:26,886
- Then, Dave--
- Dan.
70
00:05:26,959 --> 00:05:31,020
If there's no trauma,
the other cause is... sexual abuse.
71
00:05:33,733 --> 00:05:37,169
So who's molesting you?
Teacher?
72
00:05:37,236 --> 00:05:40,228
Extra-friendly neighbor?
I'd ask if either of you
were involved, but you'd deny it.
73
00:05:40,306 --> 00:05:42,035
We would never hurt Dan.
74
00:05:42,108 --> 00:05:44,508
I say it here,
it comes out there.
75
00:05:44,577 --> 00:05:47,068
This lack of response
is consistent with abuse.
76
00:05:47,146 --> 00:05:49,944
There's no one, okay?
I-- I swear.
77
00:05:50,016 --> 00:05:53,110
There was trauma.
I got hit in the head
during a lacrosse game.
78
00:05:54,954 --> 00:05:58,321
Did you know
that he got hit in the head?
79
00:05:58,391 --> 00:06:01,918
- They didn't mention it. No.
- Yeah. Why bother?
80
00:06:04,831 --> 00:06:07,356
No, no. We took him
to the E.R. after the game.
81
00:06:07,433 --> 00:06:09,958
He was scanned. They tested him.
They said he was fine.
82
00:06:10,036 --> 00:06:11,970
No concussion.
It's gotta be something else.
83
00:06:12,038 --> 00:06:15,530
You hound me for my opinion,
and then you question my diagnosis.
84
00:06:15,608 --> 00:06:19,009
Cool. E.R. obviously screwed up.
Kid's got a concussion.
85
00:06:19,078 --> 00:06:22,206
I had double vision before I was hit.
Well, that changes everything.
86
00:06:22,281 --> 00:06:25,079
You need glasses.
That's why you had double vision,
87
00:06:25,151 --> 00:06:29,850
which is why you got hit,
which is why you have a concussion,
which is why you have night terrors.
88
00:06:29,922 --> 00:06:32,948
You need to see an ophthalmologist,
which I am not.
89
00:06:33,025 --> 00:06:38,395
You enjoyed that. I brought a reasonable
case to your attention, and you shoved it
in my face just to humiliate me.
90
00:06:38,464 --> 00:06:41,331
You're an only child, aren't you?
Why would you say that?
91
00:06:41,401 --> 00:06:43,130
Because everything is about you.
92
00:06:44,270 --> 00:06:48,570
This may seem incredibly controversial,
but I think sexual abuse is bad.
93
00:06:48,641 --> 00:06:51,633
I just wanted to make sure
he wasn't being diddled
by Daddy-- or Mommy.
94
00:06:51,711 --> 00:06:53,736
Anything else is just a bonus.
95
00:07:04,657 --> 00:07:07,990
I'm not an only child.
Interesting.
96
00:07:08,060 --> 00:07:10,324
What?
Don't move.
97
00:07:11,097 --> 00:07:15,033
- Did I bore you in there?
- What? Uh, no. Not-- Not really.
98
00:07:15,101 --> 00:07:17,467
Are you tired?
99
00:07:17,537 --> 00:07:19,596
- Sometimes.
- He never sleeps.
Ofcourse he's tired.
100
00:07:19,672 --> 00:07:22,140
- Right now. At this moment.
Are you tired?
- No. No.
101
00:07:22,208 --> 00:07:24,438
That twitch in your leg.
Did you feel that?
102
00:07:25,812 --> 00:07:28,042
- Didn't hurt.
- His leg twitched.
I don't see what--
103
00:07:28,114 --> 00:07:31,880
It's called a myoclonic jerk.
It's very common
when you're falling asleep.
104
00:07:31,951 --> 00:07:37,321
Respiration rate falls, and the brain
sometimes interprets this as the body dying,
so it sends a pulse to wake it up.
105
00:07:37,390 --> 00:07:39,585
- So?
- So, he's not asleep.
106
00:07:39,659 --> 00:07:42,389
He's awake.
107
00:07:42,462 --> 00:07:44,453
Admit him.
108
00:07:47,467 --> 00:07:50,868
I recognize that loopy "G".
109
00:07:50,937 --> 00:07:52,928
So, what does the jerk tell us?
110
00:07:53,005 --> 00:07:55,303
Nothing good.
The brain's losing control of the body.
111
00:07:55,374 --> 00:07:59,140
Can't order the eyes to focus,
regulate sleep patterns
or control muscles.
112
00:07:59,212 --> 00:08:01,237
A movement disorder
or a degenerative brain disease.
113
00:08:01,314 --> 00:08:04,841
Either way, this kid's gonna be
picking up his diploma
in diapers and a wheelchair.
114
00:08:04,917 --> 00:08:06,885
Maybe not that bad.
Could be an infection.
115
00:08:06,953 --> 00:08:08,978
You wish.
No fever, no white count.
116
00:08:09,055 --> 00:08:14,493
Anyone think this differential diagnosis
might be compromised because
we don't have an accurate family history?
117
00:08:14,560 --> 00:08:17,825
- I took an accurate family history.
- You didn't even take an accurate family.
118
00:08:18,764 --> 00:08:20,994
- His father's not his father.
- Why would you say that?
119
00:08:21,067 --> 00:08:24,127
Thirty percent of all dads
don't realize they're raising
someone else's kid.
120
00:08:24,203 --> 00:08:27,331
False paternity's more like 10%.
That's what our moms
would like us to believe.
121
00:08:27,406 --> 00:08:29,897
Who cares?
If he got it from his parents,
they'd both be dead.
122
00:08:29,976 --> 00:08:32,843
- Can we get on with
the differential diagnosis?
- Fifty bucks says I'm right.
123
00:08:32,912 --> 00:08:35,472
- I'll take your money.
- Hit a nerve?
124
00:08:35,548 --> 00:08:39,006
- Don't worry. I'm sure the guy who
tucked you in was your daddy.
- Make it a hundred.
125
00:08:39,085 --> 00:08:42,885
What about leukoencephalopathy
in a 16-year-old?
126
00:08:42,955 --> 00:08:45,253
It doesn't necessarily
have to be that bad.
127
00:08:45,324 --> 00:08:48,350
If we exclude the night terrors,
it could be something systemic.
128
00:08:48,427 --> 00:08:50,952
- His liver, kidneys.
Something outside the brain.
- Yes.
129
00:08:51,030 --> 00:08:54,761
- Feel free to exclude any symptom
if it makes your job easier.
- Night terrors were anecdotal.
130
00:08:54,834 --> 00:08:59,567
- He could've had a bad dream.
- No. Parents said he was conscious during
and didn't remember anything afterwards.
131
00:08:59,639 --> 00:09:01,573
- That's a night terror.
- Parents said?
132
00:09:01,641 --> 00:09:03,734
That's a good point.
133
00:09:03,809 --> 00:09:07,074
Before we condemn this kid,
maybe we should entertain
Dr. Chase's skepticism.
134
00:09:07,146 --> 00:09:12,209
I want a detailed polysomnograph.
If he's having night terrors,
I want to see them.
135
00:09:34,740 --> 00:09:36,935
I usually don't move
during night terrors.
136
00:09:37,009 --> 00:09:38,943
I'm not restraining you for them.
137
00:09:41,814 --> 00:09:45,045
E.E.G. revealed abnormalities
in your brain--
138
00:09:45,117 --> 00:09:47,483
caused nerve damage in your toes.
139
00:09:54,160 --> 00:09:57,288
What are you doing?
140
00:09:57,363 --> 00:10:00,457
- Fixing it.
- Can I talk to my parents?
141
00:10:00,533 --> 00:10:02,592
Oh, they know all about this.
142
00:10:02,668 --> 00:10:05,193
I'd really like to see them.
143
00:10:13,713 --> 00:10:17,114
Please. I'd really like them here.
144
00:10:18,884 --> 00:10:20,875
This is gonna hurt, Dan.
145
00:10:20,953 --> 00:10:22,944
Oh. Oh, God.
146
00:10:39,772 --> 00:10:42,297
That's a night terror.
147
00:10:52,451 --> 00:10:56,615
We did a C. T., M.R.I., C.B.C.,
CHEM-7 and chest X-ray.
148
00:10:56,689 --> 00:10:59,749
All the tests came back normal.
There's nothing to explain his symptoms.
149
00:10:59,825 --> 00:11:03,659
Okay, but let's pretend
there's something and go from there.
Who sees something on this M.R.I.?
150
00:11:05,831 --> 00:11:08,629
No lesions in the white matter.
No structural abnormalities.
151
00:11:08,701 --> 00:11:10,669
No space-occupying tumors.
152
00:11:10,736 --> 00:11:15,673
He's 16, so he should have
an absolutely pristine brain.
The smallest thing is abnormal.
153
00:11:16,976 --> 00:11:19,342
Meningeal enhancement.
154
00:11:19,412 --> 00:11:21,972
- My bet is viral meningitis.
- Excellent.
155
00:11:22,048 --> 00:11:23,982
Do you see what he did there?
156
00:11:24,050 --> 00:11:27,816
Took a small clue that
there's a neurological problem
and wasn't afraid to run with it.
157
00:11:27,887 --> 00:11:30,355
There's no evidence
of meningitis on that M.R.I.
158
00:11:30,423 --> 00:11:32,323
No, there's not.
He's completely wrong.
159
00:11:32,391 --> 00:11:34,416
Then what clue
are you talking about?
160
00:11:34,493 --> 00:11:39,294
He knew that I saw something
on the M.R.I., so he figured there must be
something there and took a guess.
161
00:11:39,365 --> 00:11:42,857
- Clever, but also pathetic.
- So what did you find?
162
00:11:42,935 --> 00:11:45,927
Take a close look at the corpus callosum.
163
00:11:48,574 --> 00:11:52,010
- Looks okay.
- Are we all looking at the same thing?
164
00:11:52,078 --> 00:11:54,546
Two hundred million
interhemispheric nerve fibers.
165
00:11:54,613 --> 00:11:57,673
The George Washington Bridge
between the left and right side
of the brain.
166
00:11:59,418 --> 00:12:02,046
It's subtle.
167
00:12:04,123 --> 00:12:06,455
There's some bowing. There.
168
00:12:06,525 --> 00:12:08,516
An upward arch.
Are you guessing?
169
00:12:08,594 --> 00:12:10,494
Yes.
170
00:12:10,563 --> 00:12:14,329
- Too bad. You're right.
- He probably just moved.
171
00:12:14,400 --> 00:12:16,994
Nobody stays perfectly still
for the entire M.R.I.
172
00:12:17,069 --> 00:12:22,564
Yeah. Probably got restless
and shifted one hemisphere of his brain
to a more comfortable position.
173
00:12:22,641 --> 00:12:25,906
Something is pushing on it.
If there was bowing,
could be a tumor.
174
00:12:25,978 --> 00:12:29,436
Do you see a tumor
on this M.R.I.?
No, but I don't see any bowing either.
175
00:12:29,515 --> 00:12:33,042
There's no tumor.
Just a blockage causing pressure
causing symptoms.
176
00:12:33,119 --> 00:12:36,555
Today, night terrors.
Tomorrow, he's bleeding
out of his eyes.
177
00:12:36,622 --> 00:12:41,389
Get him a radionucleotide cisternogram.
I guarantee you'll see a blockage.
178
00:12:47,299 --> 00:12:49,290
Okay.
179
00:12:52,138 --> 00:12:53,867
Easy.
180
00:12:53,939 --> 00:12:56,203
Okay. Squeeze my hand.
181
00:13:00,012 --> 00:13:02,105
All right. Squeeze hard.
182
00:13:04,683 --> 00:13:06,617
All right.
183
00:13:12,825 --> 00:13:16,090
Now I'm injecting a material
that's tagged with a radioisotope.
184
00:13:16,162 --> 00:13:19,996
It's gonna enter your spine
and travel up to your brain.
185
00:13:20,065 --> 00:13:23,967
It'll make you able to
think deep thoughts,
186
00:13:24,036 --> 00:13:25,970
run a hundred miles an hour.
187
00:13:27,239 --> 00:13:29,503
Easy.
188
00:13:42,354 --> 00:13:45,414
Their eyes aren't the same color,
but that fleck in the eyes--
189
00:13:45,491 --> 00:13:48,517
That's maybe a one-in-10 chance
if they're not related?
190
00:13:48,594 --> 00:13:50,994
No. House isn't gonna pay you
based on that.
191
00:13:51,063 --> 00:13:54,931
Any excuse we can give the folks
to justify a D.N.A. test?
192
00:13:55,000 --> 00:13:59,130
We could tell them he's got Huntington's--
whole family should be tested
or they'll all die.
193
00:14:02,675 --> 00:14:04,609
Hey.
194
00:14:04,677 --> 00:14:08,545
There's a lot of blockage.
I've scheduled him for surgery.
195
00:14:08,614 --> 00:14:12,448
We're gonna put a shunt
into one of the ventricles
to give the cerebrospinal fluid an out.
196
00:14:12,518 --> 00:14:15,146
No more pressure,
everything goes back to normal.
197
00:14:15,221 --> 00:14:18,156
He's lucky to have you
as his doctors.
198
00:14:26,866 --> 00:14:29,858
No formula. Just Mommy's
healthy, natural breast milk.
199
00:14:29,935 --> 00:14:31,630
Yummy.
200
00:14:31,704 --> 00:14:34,798
Her whole face just got
swollen like this overnight.
201
00:14:34,874 --> 00:14:37,104
Mm-hmm.
202
00:14:38,110 --> 00:14:40,442
No fever.
203
00:14:40,512 --> 00:14:43,345
Glands normal.
Missing her vaccination dates.
204
00:14:43,415 --> 00:14:46,077
We're not vaccinating.
205
00:14:47,152 --> 00:14:49,643
Gribbet! Gribbet!
206
00:14:49,722 --> 00:14:51,246
Gribbet!
207
00:14:51,323 --> 00:14:53,018
Think they don't work?
208
00:14:53,092 --> 00:14:56,391
I think some multinational
pharmaceutical company
wants me to think they work--
209
00:14:56,462 --> 00:14:59,693
pad their bottom line.
Mm-hmm.
210
00:14:59,765 --> 00:15:02,063
- May I?
- Sure.
211
00:15:03,068 --> 00:15:05,730
Gribbet. Gribbet.
212
00:15:05,804 --> 00:15:08,102
Gribbet.
213
00:15:08,173 --> 00:15:11,074
Yeah. All-natural,
no dyes is a good business.
214
00:15:11,143 --> 00:15:13,270
All-natural children's toys.
215
00:15:13,345 --> 00:15:15,836
Toy companies-- they don't
arbitrarily mark up their frogs.
216
00:15:15,915 --> 00:15:18,941
They don't lie about how much
they spend on research
and development.
217
00:15:19,018 --> 00:15:24,615
The worst that a toy company
could be accused of is making
a really boring frog.
218
00:15:24,690 --> 00:15:27,523
Gribbet, gribbet, gribbet.
219
00:15:27,593 --> 00:15:30,426
You know another
really good business?
220
00:15:30,496 --> 00:15:32,726
Teeny, tiny baby coffins.
221
00:15:34,033 --> 00:15:36,297
You can get 'em
in frog green,
222
00:15:36,368 --> 00:15:38,802
fire-engine red-- really.
223
00:15:38,871 --> 00:15:43,103
The antibodies in yummy Mummy
only protect the kid for six months,
224
00:15:43,175 --> 00:15:45,769
which is why these companies
think they can gouge you.
225
00:15:45,844 --> 00:15:49,575
They think that you'll spend
whatever they ask
to keep your kid alive.
226
00:15:49,648 --> 00:15:51,673
Want to change things?
Prove 'em wrong.
227
00:15:51,750 --> 00:15:56,346
Few hundred parents like you decide
they'd rather let their kid die
than cough up 40 bucks for a vaccination,
228
00:15:56,422 --> 00:15:58,913
believe me,
prices will drop really fast.
229
00:15:58,991 --> 00:16:01,926
Gribbet, gribbet, gribbet,
gribbet, gribbet.
230
00:16:01,994 --> 00:16:03,393
Gribbet.
231
00:16:03,462 --> 00:16:05,293
Tell me what she has.
232
00:16:08,434 --> 00:16:10,959
A cold.
233
00:16:11,036 --> 00:16:13,129
There's a problem.
234
00:16:13,205 --> 00:16:16,333
Complications in surgery?
Surgery went fine.
He's in recovery.
235
00:16:16,408 --> 00:16:18,740
But we took a vial
of C.S.F. and tested it.
Really?
236
00:16:18,811 --> 00:16:21,780
Turns out the bowing
wasn't the cause of his problems.
It was a symptom.
237
00:16:21,847 --> 00:16:23,940
Oligoclonal bands
and increased intrathecal IgG.
238
00:16:24,016 --> 00:16:28,180
Which means multiple sclerosis.
And the reason it takes
three of you to tell me this?
239
00:16:28,253 --> 00:16:30,983
Because we're having a disagreement
about whether or not it is M.S.
240
00:16:31,056 --> 00:16:34,617
No lesions on the M.R.I.
It's early. He's had the disease
for maybe two weeks.
241
00:16:34,693 --> 00:16:38,424
- McDonald criteria requires six months
to make a definitive diagnosis.
- Who cares about MacPhearson?
242
00:16:38,497 --> 00:16:40,431
- I hear he tortured kittens.
- McDonald.
243
00:16:40,499 --> 00:16:42,990
Oh, McDonald.
Wonderful doctor, loved kittens.
244
00:16:43,068 --> 00:16:45,036
The V.E.P. indicates slowing of the brain.
245
00:16:45,104 --> 00:16:47,072
Without the lesions,
we can't be sure.
246
00:16:47,139 --> 00:16:49,573
Well, if it is, it's gone from
zero to 60 in three weeks,
247
00:16:49,641 --> 00:16:51,609
which would indicate
rapidly progressive M.S.
248
00:16:51,677 --> 00:16:55,010
Not the fun M.S.
with the balloons and the bike rides
for cripples in wheelchairs.
249
00:16:55,080 --> 00:16:58,208
- We should wait until--
- Start treating him now,
250
00:16:58,283 --> 00:17:02,549
maybe he can walk
for another couple of years,
maybe live for another five.
251
00:17:02,621 --> 00:17:05,146
Break it to the family.
I'm going home.
252
00:17:05,224 --> 00:17:09,285
It'll take months
for a definitive diagnosis.
What'll happen to me?
253
00:17:10,963 --> 00:17:13,227
M.S. is an incredibly variable disease.
254
00:17:13,298 --> 00:17:16,699
If it is M.S., and we're not
a hundred percent sure.
255
00:17:16,769 --> 00:17:19,237
What do you think is gonna happen?
256
00:17:22,574 --> 00:17:24,872
There are some medications
to manage the symptoms,
257
00:17:24,943 --> 00:17:28,071
but as the disease progresses,
the problems will become more severe.
258
00:17:28,147 --> 00:17:30,479
Bowel and bladder dysfunction,
259
00:17:30,549 --> 00:17:33,143
loss of cognitive function, pain--
260
00:17:33,218 --> 00:17:35,709
So it's gonna hurt?
261
00:17:36,922 --> 00:17:39,356
The brain's like a big jumble of wires.
262
00:17:39,425 --> 00:17:41,985
M.S. strips them of the insulation,
and the nerves die.
263
00:17:42,061 --> 00:17:44,689
Brain interprets it as pain.
264
00:17:44,763 --> 00:17:48,028
But by starting treatment,
we're gonna prevent that
for as long as possible.
265
00:17:49,034 --> 00:17:50,968
We're looking into
a couple of specialists,
266
00:17:51,036 --> 00:17:54,563
and until we get you squared away,
you'll stay here, okay?
267
00:18:15,260 --> 00:18:17,751
Security checked the videotapes
from all perimeter cameras.
268
00:18:17,830 --> 00:18:20,060
He's still gotta be in the hospital.
Where's Chase?
269
00:18:20,132 --> 00:18:22,692
Main floor.
Okay. You take the cafeteria
and administration.
270
00:18:22,768 --> 00:18:25,362
I'll hit the research annex
and work my way back to you.
271
00:19:02,708 --> 00:19:04,699
Dan?
272
00:19:08,947 --> 00:19:11,814
I'm not here. Leave a message.
273
00:19:18,157 --> 00:19:20,955
Dr. Cuddy.
Great outfit.
274
00:19:21,026 --> 00:19:23,290
What are you doing
back here? Patient?
275
00:19:23,362 --> 00:19:26,854
No. Hooker. Went to my office
instead of my home.
276
00:19:37,242 --> 00:19:39,676
Dr. House.
277
00:19:39,745 --> 00:19:42,543
Dan's missing.
Yeah. I got that part from the message.
278
00:19:42,614 --> 00:19:45,845
You said I was needed immediately.
He shouldn't move
after a lumbar puncture.
279
00:19:45,918 --> 00:19:48,614
I agree. He's gonna have
a very nasty headache.
280
00:19:48,687 --> 00:19:51,815
That would also be my opinion
if consulted tomorrow morning.
281
00:19:51,890 --> 00:19:55,053
We wanted to keep you informed.
He heard some pretty heavy news.
282
00:19:56,895 --> 00:19:59,591
This is not a toddler wandering
around a department store.
283
00:19:59,665 --> 00:20:02,862
He's 16. You'll find him.
284
00:20:02,935 --> 00:20:04,869
I'm going home.
285
00:20:04,937 --> 00:20:07,906
So when you say,
"Call me if you need anything",
you mean don't call?
286
00:20:07,973 --> 00:20:10,203
No, I mean call me
if I could do something.
287
00:20:10,275 --> 00:20:14,405
I'm bad at search parties,
and I'm bad at sitting around
looking nervous, doing nothing.
288
00:20:14,479 --> 00:20:16,504
What about his parents?
Should we call them?
289
00:20:16,582 --> 00:20:18,982
Why? Do you think
they're hiding him?
290
00:20:19,051 --> 00:20:21,019
Make sure someone
checks the roof.
291
00:20:22,087 --> 00:20:25,887
Some of the orderlies
keep the door propped open
so they can grab a smoke.
292
00:21:00,425 --> 00:21:03,292
Dan. You okay?
293
00:21:10,035 --> 00:21:13,766
There are experimental treatments.
Ongoing research.
294
00:21:13,839 --> 00:21:16,239
Who knows what they'll discover
in a year or two.
295
00:21:16,308 --> 00:21:18,276
This is where I dropped the ball.
296
00:21:18,343 --> 00:21:20,868
Dan, we're standing
on the roof of the hospital.
297
00:21:23,548 --> 00:21:25,539
Dan.
298
00:21:25,617 --> 00:21:27,642
Dan, you're not on the field.
299
00:21:27,719 --> 00:21:29,880
He doesn't know where he is.
Dan.
300
00:21:29,955 --> 00:21:31,320
Foreman.
301
00:21:32,524 --> 00:21:34,287
Dan.
302
00:21:35,527 --> 00:21:37,461
- Dan?
- Dan, no!
303
00:21:48,140 --> 00:21:50,631
Dr. Foreman.
304
00:21:52,277 --> 00:21:54,268
I assume you found the kid.
305
00:21:54,346 --> 00:21:56,940
He almost walked off
the roof.
Suicidal?
306
00:21:57,015 --> 00:22:00,883
No, he thought he was on his
lacrosse field. Look, I was gonna
run home, shower, change--
307
00:22:00,952 --> 00:22:02,886
Conscious?
Yeah.
308
00:22:03,955 --> 00:22:06,549
How'd you talk him down?
Actually, Chase tackled him.
309
00:22:06,625 --> 00:22:08,559
How come you didn't do it?
310
00:22:08,627 --> 00:22:11,061
Right. Well, I am black,
but he was closer.
311
00:22:13,632 --> 00:22:15,623
Come on.
You can ride up with me.
312
00:22:22,307 --> 00:22:26,038
Anybody tell the family that
their boy almost stepped off a roof?
They must be thrilled.
313
00:22:26,111 --> 00:22:28,306
They're not suing,
but I think only because
Chase asked--
314
00:22:28,380 --> 00:22:30,905
Why does everybody
always think I'm being sarcastic?
315
00:22:30,982 --> 00:22:33,177
This is great news.
He doesn't have M.S.
316
00:22:33,251 --> 00:22:36,948
Parents should be thrilled.
The mom anyway. Ofcourse,
the dad probably doesn't know--
317
00:22:37,022 --> 00:22:41,322
- Why doesn't he have M.S.?
- He was on the roof, thinking
he was on a lacrosse field.
318
00:22:41,393 --> 00:22:45,261
- Conscious, and therefore not
a night terror. You want some of this?
- Yeah, sure.
319
00:22:45,330 --> 00:22:47,423
He was in an acute
confusional state,
320
00:22:47,499 --> 00:22:50,297
which doesn't fit with
a demyelinating disease like M.S.
321
00:22:50,369 --> 00:22:52,428
Oligoclonal bands--
Were real.
322
00:22:52,504 --> 00:22:56,031
They just mean something
other than M.S.
So, what are they telling us?
323
00:22:56,108 --> 00:22:58,099
That the immune system
is working?
Right.
324
00:22:58,176 --> 00:23:00,303
He has an infection in his brain.
325
00:23:00,379 --> 00:23:02,370
What about sex?
326
00:23:02,447 --> 00:23:05,678
Well, it might get complicated.
I mean, we work together.
327
00:23:05,751 --> 00:23:08,811
- I'm older, certainly, but maybe you like that.
- I meant maybe he has neurosyphilis.
328
00:23:08,887 --> 00:23:12,653
- Huh. Nice cover.
- Sorry. R.P.R. was negative.
329
00:23:12,724 --> 00:23:16,182
We don't need
a definitive test to confirm.
Sure. Didn't need one to confirm M.S.
330
00:23:16,261 --> 00:23:20,755
Okay. Let's wait for you to
run titers on 1,400 viruses while
this kid's brain turns to mush.
331
00:23:20,832 --> 00:23:24,427
So the fact that
he doesn't have M.S.,
it's-- it's really not good news after all.
332
00:23:24,503 --> 00:23:26,630
Well, it is if it's neurosyphilis.
333
00:23:26,705 --> 00:23:29,765
The likelihood of a false negative
on an R.P.R. test: 30%.
334
00:23:29,841 --> 00:23:33,333
Likelihood of a 16-year-old having sex:
roughly 120%.
335
00:23:33,412 --> 00:23:35,846
I'll start him on I.V. penicillin.
We're not gonna wait for that.
336
00:23:35,914 --> 00:23:39,441
The most effective way
to deliver the drug is
right into his brain via the spine.
337
00:23:39,518 --> 00:23:41,452
We can't.
In a cramped space like the brain,
338
00:23:41,520 --> 00:23:45,286
increased intracranial pressure
from a high-volume drug like penicillin
could herniate his brain stem.
339
00:23:45,357 --> 00:23:48,383
It'd kill him.
No neurologist in his right mind
would recommend that.
340
00:23:48,460 --> 00:23:51,293
Show of hands.
Who thinks I'm not
in my right mind?
341
00:23:51,363 --> 00:23:55,231
And who thinks I forget this
fairly basic neurological fact?
342
00:23:55,300 --> 00:23:57,530
Who thinks there's a third option?
343
00:23:59,604 --> 00:24:03,540
- Very good. What's the third choice?
- No idea. You just asked
if I thought there was one.
344
00:24:07,345 --> 00:24:10,439
The patient has a shunt in his brain.
There'll be no increased pressure.
345
00:24:10,515 --> 00:24:13,040
We can put as much penicillin
into his body as we want.
346
00:24:13,118 --> 00:24:16,053
Excellent. Inject him through
a lumbar puncture.
347
00:24:18,957 --> 00:24:22,085
One of us is gonna do this to you
twice a day for the next two weeks.
348
00:24:24,896 --> 00:24:27,660
- I'm ready. Go.
- He could get syphilis...
349
00:24:27,732 --> 00:24:30,326
even if he's not sexually active?
350
00:24:31,403 --> 00:24:34,804
Well, it's-- it's unusual,
but it's possible.
351
00:24:35,807 --> 00:24:37,798
Okay. Relax.
352
00:24:50,589 --> 00:24:53,752
It's infected,
with a really big hole,
353
00:24:53,825 --> 00:24:56,191
like you stuck a nail in it
to relieve the pressure.
354
00:24:56,261 --> 00:24:59,253
I wouldn't do that.
Although the wound
is irregular.
355
00:24:59,331 --> 00:25:02,596
It's not cylindrical.
It's shaped like a triangle.
So, not a nail.
356
00:25:02,667 --> 00:25:04,726
- Steak knife?
- Wife's nail file.
357
00:25:04,803 --> 00:25:07,294
Nail file.
358
00:25:07,372 --> 00:25:09,431
Yeah. Pain will make you
do stupid things.
359
00:25:10,509 --> 00:25:13,535
- Something to take the edge off?
- Yeah.
360
00:25:15,680 --> 00:25:17,671
Cheers.
361
00:25:21,486 --> 00:25:24,512
So, you have family here
in Princeton?
362
00:25:24,589 --> 00:25:27,319
No.
Here on work?
363
00:25:27,392 --> 00:25:29,587
- No. Why are you--
- Does your penis hurt?
364
00:25:29,661 --> 00:25:31,822
No. What?
Should it?
365
00:25:31,897 --> 00:25:35,424
No. Just thought I'd toss you
a really inappropriate question.
366
00:25:35,500 --> 00:25:39,630
- Your lawyer's gonna love it.
- Why would I want to sue you?
I want you to treat me.
367
00:25:39,704 --> 00:25:42,172
- You're from Maplewood,
New Jersey, right?
- Yeah.
368
00:25:42,240 --> 00:25:44,504
Now, why would you
drive 70 miles...
369
00:25:44,576 --> 00:25:47,511
to get treatment for a condition
that a nine-year-old could diagnose?
370
00:25:49,047 --> 00:25:51,982
It's the free-flowing pus
that's the tip-off.
371
00:25:52,050 --> 00:25:54,951
I was in town.
Not for family.
Not for work.
372
00:25:55,020 --> 00:25:58,353
You drove 70 miles
to a walk-in clinic.
You passed two hospitals on the road.
373
00:25:58,423 --> 00:26:01,915
Either you've got a problem
with those hospitals,
or they have a problem with you.
374
00:26:01,993 --> 00:26:04,518
My guess is you've sued
half the doctors in Maplewood,
375
00:26:04,596 --> 00:26:06,655
and the rest are now
refusing to help you.
376
00:26:06,731 --> 00:26:10,462
It's ironic, isn't it?
Sort of like the boy who sued wolf.
377
00:26:10,535 --> 00:26:13,766
You know, I bet we have
a doctor here named Wolf.
378
00:26:13,838 --> 00:26:16,272
How perfect would that be?
379
00:26:16,341 --> 00:26:18,639
- I'm gonna page him.
- Okay. You know what?
Thank you.
380
00:26:18,710 --> 00:26:20,974
I'm gonna find a doctor
to take care of this.
381
00:26:21,046 --> 00:26:22,980
I didn't say I wouldn't treat you.
382
00:26:23,048 --> 00:26:26,381
- We'll drain your knee,
run some lab work. Fix you up.
- Why would you do that?
383
00:26:26,451 --> 00:26:28,385
I'm a people person.
384
00:26:28,453 --> 00:26:30,978
You actually treated him?
385
00:26:31,056 --> 00:26:33,024
All I know is he sued some doctors.
386
00:26:33,091 --> 00:26:35,423
Who am I to assume they didn't
have it coming to them?
387
00:26:35,493 --> 00:26:38,826
The cutest little tennis outfit.
My God, I thought I was
gonna have a heart attack.
388
00:26:38,897 --> 00:26:42,128
Oh, my. Didn't see you there.
That is so embarrassing.
How's your hooker doing?
389
00:26:42,200 --> 00:26:44,134
Sweet of you to ask.
Funny story.
390
00:26:44,202 --> 00:26:48,002
She was gonna be hospital
administrator, but just hated
having to screw people like that.
391
00:26:48,073 --> 00:26:50,871
- Heard you found her on the roof.
- You have very acute hearing.
392
00:26:50,942 --> 00:26:52,637
You notify the parents?
393
00:26:52,711 --> 00:26:54,645
In due course, ofcourse.
394
00:26:54,713 --> 00:26:58,205
And is there a paternity bet
on the father of the patient?
395
00:26:58,283 --> 00:27:01,582
Doesn't sound like me.
Well, it does, actually,
but doesn't mean you're guilty.
396
00:27:01,653 --> 00:27:03,644
You think?
I saw the parents in the lobby.
397
00:27:03,722 --> 00:27:08,750
- Smart money's obviously on the father.
- My guy knows a guy who can
get you in for 50 bucks.
398
00:27:08,827 --> 00:27:12,729
Fine. Tell your guy, if I win,
you attend the faculty symposium,
and you wear a tie.
399
00:27:12,797 --> 00:27:15,265
And if I win,
no clinic hours for a week.
400
00:27:15,333 --> 00:27:17,665
My guy will call your guy.
401
00:27:20,171 --> 00:27:22,366
She's very good at her job.
402
00:27:25,744 --> 00:27:29,111
The treatments should
start helping soon.
403
00:27:29,180 --> 00:27:32,547
Let us know if it gets easier
to focus on things,
remember stuff.
404
00:27:34,552 --> 00:27:38,010
Hey, Dan. Isn't Dr. Cameron's
necklace a beauty?
405
00:27:38,089 --> 00:27:40,148
Something South American, I think.
406
00:27:40,225 --> 00:27:42,193
Yeah. Guatemalan.
407
00:27:43,261 --> 00:27:45,286
It's a cool necklace.
408
00:27:47,032 --> 00:27:49,694
- Thank you so much.
- The kid's in pain.
409
00:27:51,302 --> 00:27:53,862
Don't fight it. Just let it happen.
No.
410
00:27:53,938 --> 00:27:55,963
You'll be dead in two days.
No what?
411
00:27:56,041 --> 00:27:58,305
I give it a day.
Dan? You okay?
412
00:27:58,376 --> 00:27:59,536
Dan?
413
00:27:59,611 --> 00:28:02,079
Night terrors.
- Decomposition once he's in the grave.
414
00:28:02,147 --> 00:28:05,048
- Say good-bye to
your mother and father.
- He's hearing voices.
415
00:28:05,116 --> 00:28:07,584
You're dying.
It's all over, Dan.
416
00:28:08,820 --> 00:28:12,051
You're dying.
Dying. Dead!
417
00:28:13,058 --> 00:28:16,118
Push two milligrams
I.V. Ativan, stat.
418
00:28:16,194 --> 00:28:18,822
It's all over.
- Come on, Dan.
419
00:28:18,897 --> 00:28:20,728
Get out of my head!
420
00:28:22,534 --> 00:28:25,526
Auditory hallucination shows
further brain degeneration.
421
00:28:25,603 --> 00:28:29,630
Penicillin's not working.
So either it's
a bad batch of penicillin,
422
00:28:29,708 --> 00:28:31,699
or our diagnosis is wrong.
423
00:28:33,545 --> 00:28:35,536
Square one.
424
00:28:35,613 --> 00:28:39,549
Midnite.
L.F. T.'s, B.U.N. and creatinine are all normal.
425
00:28:39,617 --> 00:28:42,085
- Diabetes is out, and no gap.
- There goes metabolic.
426
00:28:42,153 --> 00:28:44,815
- M.R.A. rules out vasculitis.
- "I" for inflammation.
427
00:28:44,889 --> 00:28:47,517
- Too young for anything
degenerative.
- "D", see ya.
428
00:28:47,592 --> 00:28:49,856
"N" for neoplastic.
M.R.I. was clean.
429
00:28:50,929 --> 00:28:53,557
- "I" for inflammation.
- We already did that.
430
00:28:53,631 --> 00:28:56,896
- Stupid to have two I's in one mnemonic.
What's the other one?
- Infection.
431
00:28:56,968 --> 00:29:01,064
- Oligoclonal bands still have to mean something.
- But no fevers. White count's elevated,
but within range.
432
00:29:01,139 --> 00:29:03,767
We've tested for anything remotely
possible. Everything's negative.
433
00:29:03,842 --> 00:29:07,539
- C.T. scan rules out subdural.
- Trauma. Later much.
434
00:29:12,817 --> 00:29:16,947
You know the problem?
"Midnight" is actually spelled
with a "G" and an "H".
435
00:29:17,956 --> 00:29:20,823
If we could just figure out
what those letters stand for.
436
00:29:24,996 --> 00:29:28,523
It's a sick brain,
having fun,
437
00:29:30,101 --> 00:29:32,262
torturing him, talking to him.
438
00:29:37,809 --> 00:29:39,800
Scaring the hell out of him.
439
00:29:42,280 --> 00:29:47,047
Get him an E.E.G., left and right E.O.G.,
esophageal microphones.
440
00:29:47,118 --> 00:29:50,986
If this thing wants to talk,
let's listen.
441
00:29:52,690 --> 00:29:56,626
We're missing something.
This is screwed-up.
442
00:29:56,694 --> 00:30:00,221
That's why you came up with
the brain talking to the virus thing?
443
00:30:00,298 --> 00:30:02,095
I panicked, okay?
444
00:30:02,167 --> 00:30:05,967
Sounded cool though.
They bought it.
445
00:30:08,540 --> 00:30:11,270
Oh, crap.
446
00:30:11,342 --> 00:30:15,870
Another reason I don't like
meeting patients. If they don't know
what you look like, they can't yell at you.
447
00:30:15,947 --> 00:30:17,938
Here we go.
448
00:30:21,152 --> 00:30:23,586
How can you just sit there?
449
00:30:25,023 --> 00:30:26,991
If I eat standing up, I spill.
450
00:30:27,058 --> 00:30:30,118
Our son is dying,
and you could care less.
451
00:30:31,296 --> 00:30:34,322
We're going through hell.
You're doing nothing?
452
00:30:35,333 --> 00:30:39,133
- I'm sorry. You need to vent.
I understand.
- Don't be condescending.
453
00:30:40,205 --> 00:30:42,605
You haven't checked
in on him once.
454
00:30:42,674 --> 00:30:45,336
Blood pressure is 110 over 70.
455
00:30:45,410 --> 00:30:48,208
His shunt is patent, well-placed
in the right lateral ventricle.
456
00:30:48,279 --> 00:30:52,807
The E.K.G. shows a normal Q.R.S.
with deep-wave inversions throughout
both limb and precordial leads.
457
00:30:52,884 --> 00:30:55,785
L.F. T.'s are elevated,
but only twice the normal range.
458
00:30:55,854 --> 00:30:58,322
Oh, yeah. And he's hearing voices.
459
00:31:02,560 --> 00:31:04,551
Go hold his hand.
460
00:31:06,464 --> 00:31:09,058
Go on. I'll bus your tray.
461
00:31:23,014 --> 00:31:25,915
- Got any sample bags on you?
- I don't believe you.
462
00:31:25,984 --> 00:31:29,647
You're gonna run D.N.A. tests?
Their son is deathly ill.
463
00:31:29,721 --> 00:31:33,851
I know. It's terrible.
But the fact is, if I don't keep busy
with trivial things like this,
464
00:31:33,925 --> 00:31:36,052
I'm afraid
I might start to cry.
You're an ass.
465
00:31:36,127 --> 00:31:39,028
Yeah? You want to double the bet?
466
00:31:49,741 --> 00:31:52,403
General Hospital is on channel 6.
467
00:31:52,477 --> 00:31:56,038
Dan's brain's not showing
channel 6 right now.
Only mush.
468
00:31:56,114 --> 00:31:58,309
No epileptiform activity.
469
00:31:59,984 --> 00:32:02,748
What are you doing?
Waiting for C.B.C. and CHEM-7.
470
00:32:02,820 --> 00:32:05,721
Good. Run D.N.A. on these.
471
00:32:07,292 --> 00:32:10,159
What's this?
Parents' coffee cups.
472
00:32:11,863 --> 00:32:14,263
I can't believe you.
I've had this conversation
once already.
473
00:32:14,332 --> 00:32:16,926
If you've got
something else to do, do it.
Otherwise, do this.
474
00:32:25,176 --> 00:32:28,236
Dr. House.
Hey. Mr. Funsten.
475
00:32:28,313 --> 00:32:31,373
I was wondering
when you'd be back.
You got some papers for me?
476
00:32:31,449 --> 00:32:34,885
You've caused me
considerable mental distress.
I certainly hope so.
477
00:32:35,920 --> 00:32:39,981
What? Too cheap to get
your lawyer to serve it for you,
or is it just more fun this way?
478
00:32:40,058 --> 00:32:42,253
I'm obviously prepared
to consider a settlement.
479
00:32:42,327 --> 00:32:44,420
You have gonorrhea.
480
00:32:46,230 --> 00:32:50,064
No, I don't.
Well, maybe you're right,
but I have the lab result says you do.
481
00:32:50,134 --> 00:32:52,728
Could be a false positive,
and normally I'd run a second test,
482
00:32:52,804 --> 00:32:56,205
but since you're here,
I'll just go with the first.
You're just trying to scare me.
483
00:32:56,274 --> 00:32:59,607
It's reportable, you know.
Public health issue.
I'll be sure to let my wife know.
484
00:32:59,677 --> 00:33:02,305
Don't bother yourself.
The state will call for you.
485
00:33:02,380 --> 00:33:04,940
If you're clean, I'm sure
it'll all blow over. No big deal.
486
00:33:05,016 --> 00:33:08,349
There's an easy way to find out.
Get one of your doctors to run a test.
487
00:33:10,321 --> 00:33:12,255
Uh-uh.
488
00:33:12,323 --> 00:33:15,087
These are mine now.
I'll see you in court.
489
00:33:19,530 --> 00:33:23,398
West Nile negative. Not surprising
since not too many mosquitoes passing
through Jersey in December.
490
00:33:23,468 --> 00:33:25,959
No eastern equine encephalitis.
You guys aren't gonna believe this.
491
00:33:26,037 --> 00:33:29,973
What's that?
House is right.
The father's not the father.
492
00:33:30,041 --> 00:33:33,943
Dude doubled up on me.
493
00:33:34,012 --> 00:33:36,071
You're not gonna believe this.
494
00:33:36,147 --> 00:33:38,638
The mother's not the mother either.
495
00:33:39,917 --> 00:33:42,943
It's not a good idea
to move your son in his condition.
496
00:33:43,021 --> 00:33:45,615
- We just want a second opinion.
We need an answer.
497
00:33:46,424 --> 00:33:49,882
You idiots.
You lied to me.
498
00:33:49,961 --> 00:33:51,895
We didn't lie about anything.
499
00:33:51,963 --> 00:33:55,160
- You, on the other hand,
accused us of molesting our son.
- Perfect.
500
00:33:55,233 --> 00:33:57,997
Can we get off my screwups
and focus on theirs?
501
00:33:58,069 --> 00:34:00,162
Theirs is bigger.
You're not Dan's parents.
502
00:34:00,238 --> 00:34:03,071
We're his parents.
He was adopted.
He doesn't need to know.
503
00:34:03,141 --> 00:34:05,132
- I do.
- Adoption makes us just as much--
504
00:34:05,209 --> 00:34:09,543
Listen. When we were taking
his medical history, were you confused?
505
00:34:09,614 --> 00:34:12,412
Did you think we were looking for
a genetic clue to his condition,
506
00:34:12,483 --> 00:34:16,544
or did you think we were trying to
ascertain who loves him the most
in the whole wide world?
507
00:34:16,621 --> 00:34:18,782
How did you find out about this?
508
00:34:18,856 --> 00:34:22,257
- I sampled their D.N.A.
- We didn't give you any D.N.A.
509
00:34:22,326 --> 00:34:24,760
Your coffee cups from the cafeteria.
510
00:34:24,829 --> 00:34:28,765
- You can't do that.
- Again, why are we getting
hung up on what I did?
511
00:34:28,833 --> 00:34:34,669
- Your medical history is useless.
- No. We gave you a detailed history
of his biological mother.
512
00:34:34,739 --> 00:34:37,902
Her history.
Nonsmoker, good health,
513
00:34:37,975 --> 00:34:40,500
low cholesterol,
no blood pressure problems.
514
00:34:40,578 --> 00:34:42,705
Dan was adopted two weeks
after he was born.
515
00:34:42,780 --> 00:34:47,114
- You have his history. There's nothing
you need to know that we didn't tell you.
- Sounds reasonable.
516
00:34:47,185 --> 00:34:50,245
Well, if you want to transfer
your boy, that is your choice.
517
00:34:50,321 --> 00:34:53,017
I still think it's the wrong--
Was she vaccinated?
518
00:34:55,126 --> 00:34:58,095
The biological mother.
When she was a baby,
did she get her vaccinations?
519
00:34:58,162 --> 00:35:01,154
Dan was vaccinated.
At six months.
520
00:35:01,232 --> 00:35:04,929
Mm-hmm.
Do you know why kids
get vaccinated at six months?
521
00:35:05,002 --> 00:35:07,630
Because before that
they are protected...
522
00:35:07,705 --> 00:35:10,299
by their biological mother's
immune system.
523
00:35:10,374 --> 00:35:13,138
So, was she vaccinated?
524
00:35:16,914 --> 00:35:19,678
An infant picks up
a regular old measles virus.
525
00:35:19,750 --> 00:35:21,684
Gets a rash.
526
00:35:21,752 --> 00:35:25,381
He's extremely uncomfortable,
has a wicked fever, but he lives.
527
00:35:25,456 --> 00:35:29,324
Here's the kicker.
Once every million or so times,
528
00:35:29,393 --> 00:35:31,691
the virus mutates.
529
00:35:31,762 --> 00:35:34,287
Instead of Dan having
a fever and a rash,
530
00:35:34,365 --> 00:35:37,027
the virus travels
to his brain and hides,
531
00:35:37,101 --> 00:35:39,035
like a time bomb.
532
00:35:39,103 --> 00:35:41,469
In this case, for 16 years.
533
00:35:41,539 --> 00:35:44,099
Subacute sclerosing panencephalitis.
534
00:35:45,510 --> 00:35:48,968
I know. There's only been
20 cases in the United States
in the last 30 years.
535
00:35:49,046 --> 00:35:52,379
I suppose you could make
an argument the kid's still in stage I.
536
00:35:52,450 --> 00:35:54,577
Once S.S.P.E. moves
to stage II, it's--
537
00:35:54,652 --> 00:35:57,780
Boom. Stage II is universally fatal.
538
00:35:57,855 --> 00:36:00,824
I assume its impossible to know
when he might move into stage II.
539
00:36:00,892 --> 00:36:05,090
He's already started showing symptoms.
Could be a month. Could be tonight.
540
00:36:05,163 --> 00:36:07,393
Can we treat it?
Ask the neurologist.
541
00:36:07,465 --> 00:36:09,558
Intraventricular interferon.
542
00:36:09,634 --> 00:36:13,502
Not gonna shove a spike
into his brain and drip interferon
without confirming this diagnosis.
543
00:36:13,571 --> 00:36:17,337
- Tap him.
- We won't get a reliable result
for measles antibodies in his C.S.F.
544
00:36:17,408 --> 00:36:19,342
Not after everything
we've given him.
545
00:36:19,410 --> 00:36:22,208
So the wrong treatment kills
any hope of the right diagnosis.
546
00:36:22,280 --> 00:36:25,044
Why do people lie to me?
547
00:36:25,116 --> 00:36:27,050
Could also kill him.
548
00:36:27,118 --> 00:36:31,555
Your ball, Foreman.
Tell me I don't have to
biopsy his brain.
549
00:36:33,124 --> 00:36:35,217
Well, there is one other way.
550
00:36:36,794 --> 00:36:38,785
You sure this isn't gonna hurt?
551
00:36:38,863 --> 00:36:40,854
Yeah. It's just scary as hell.
552
00:36:40,932 --> 00:36:43,059
See, we go through the pupil.
553
00:36:43,134 --> 00:36:45,364
But you won't feel it.
The eye's been paralyzed.
554
00:36:45,436 --> 00:36:47,768
The needle travels
to the back of the eye,
555
00:36:47,838 --> 00:36:50,705
which is where we'll perform
the biopsy on your retina.
556
00:36:56,047 --> 00:36:59,073
So we've confirmed that
the problem is this mutated virus.
557
00:36:59,150 --> 00:37:02,950
The treatment for S.S.P.E.
is intraventricular interferon.
558
00:37:03,020 --> 00:37:05,750
We implant an ommaya reservoir
under the scalp,
559
00:37:05,823 --> 00:37:08,053
which is connected to
a ventricular catheter...
560
00:37:08,125 --> 00:37:10,685
that delivers the antiviral
directly to the left hemisphere.
561
00:37:10,761 --> 00:37:14,595
You want us to consent to this?
I don't even understand
what you're talking about.
562
00:37:14,665 --> 00:37:16,724
Well, the antiviral--
563
00:37:19,503 --> 00:37:21,437
Look. I'm sorry.
564
00:37:21,505 --> 00:37:25,874
I can explain this as best I can,
but the notion that you're gonna fully
understand your son's treatment...
565
00:37:25,943 --> 00:37:30,073
and make an informed decision
is-- is kind of insane.
566
00:37:31,816 --> 00:37:34,080
Here's what you need to know.
567
00:37:35,086 --> 00:37:37,054
It's dangerous.
568
00:37:37,121 --> 00:37:39,351
It could kill him.
569
00:37:39,423 --> 00:37:41,414
You should do it.
570
00:37:52,503 --> 00:37:54,733
Did you need something else?
571
00:38:13,357 --> 00:38:16,485
You can't order a $3,200
D.N.A. test to win a bet.
572
00:38:16,560 --> 00:38:18,721
It's not an actual cost.
573
00:38:18,796 --> 00:38:22,664
I don't know if you know this,
but the hospital actually owns
the sequencing machine.
574
00:38:22,733 --> 00:38:25,327
- I'm serious.
- Tell the parents to submit
the bill to insurance.
575
00:38:25,403 --> 00:38:27,234
Insurance is not gonna
pay for a bet.
576
00:38:27,305 --> 00:38:31,674
Should. We don't make that bet,
the kid dies.
577
00:38:31,742 --> 00:38:34,609
If not for the paternity bet,
I never would have taken their D.N.A.
578
00:38:34,679 --> 00:38:39,480
Without their D.N.A., we never would have
discovered that Dan was adopted,
which was the key to this case.
579
00:38:39,550 --> 00:38:41,518
You just don't want to pay your end.
580
00:38:41,585 --> 00:38:44,486
Big mistake. My guy knows a guy.
581
00:38:44,555 --> 00:38:48,252
Fine. I will let you out of
clinic duty for one week,
582
00:38:48,326 --> 00:38:51,318
after you pay the 3,200
for the P.C.R. test.
583
00:38:59,103 --> 00:39:00,627
Ooh.
584
00:39:00,705 --> 00:39:04,163
Well, now, there's
the hundred you owe me.
585
00:39:05,242 --> 00:39:07,176
Here's a hundred
I won from Cameron.
586
00:39:07,244 --> 00:39:09,804
200 I took off of Foreman.
587
00:39:11,182 --> 00:39:13,650
And 600...
588
00:39:13,718 --> 00:39:16,209
I got from Wilson.
589
00:39:17,421 --> 00:39:18,979
Very bitter.
590
00:39:22,927 --> 00:39:24,952
Hey. Good morning.
591
00:39:25,029 --> 00:39:27,793
Good news on your E.E.G.
Treatment is working.
592
00:39:27,865 --> 00:39:29,958
And your immune system is responding.
593
00:39:30,034 --> 00:39:33,435
I know it's early,
but I just want to take a look.
594
00:39:34,772 --> 00:39:38,674
All right.
Let's see what that brain
of yours can do.
595
00:39:38,743 --> 00:39:42,201
Name as many animals as you can
that start with the letter "O".
596
00:39:42,279 --> 00:39:44,338
Ostrich.
597
00:39:45,116 --> 00:39:47,880
Ox. Old elephant.
598
00:39:47,952 --> 00:39:50,785
Well, that's two better
than last time.
599
00:39:51,856 --> 00:39:54,381
How you doing with
the whole adoption thing?
600
00:39:54,458 --> 00:39:57,256
- I knew since fifth grade.
- How's that?
601
00:39:57,328 --> 00:40:00,263
Cleft chin.
602
00:40:00,331 --> 00:40:02,925
I have one.
My dad doesn't.
603
00:40:03,000 --> 00:40:07,630
Looked it up on the Internet.
It's one of those trait things.
604
00:40:07,705 --> 00:40:10,196
That's right. It's autosomal dominant.
605
00:40:11,208 --> 00:40:15,645
Since neither of your parents have
cleft chins, it's highly unlikely
you're biologically related.
606
00:40:16,981 --> 00:40:21,680
- Are you sure you're okay?
- I've got no problems
with being adopted.
607
00:40:22,686 --> 00:40:24,677
I love my parents.
608
00:40:27,992 --> 00:40:30,426
How's he doing?
He's doing pretty well.
609
00:40:30,494 --> 00:40:32,052
He's a smart kid.
610
00:40:32,129 --> 00:40:34,097
I think he's gonna be fine.
611
00:40:37,868 --> 00:40:40,200
- Hey.
- Thanks.
612
00:41:15,573 --> 00:41:17,837
Wheels, 18. Wheels.
613
00:43:06,917 --> 00:43:08,179
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