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1
00:00:45,462 --> 00:00:47,918
Hannah,you okay?
2
00:00:48,369 --> 00:00:50,725
Still can't sleep?
3
00:00:50,835 --> 00:00:52,790
I'm fine.
4
00:00:55,066 --> 00:00:56,880
Can I do anything to help you?
5
00:00:56,920 --> 00:00:59,275
Just go back to sleep.I wanna go get a glass of wine.
6
00:00:59,345 --> 00:01:00,538
I can keep you company.
7
00:01:00,578 --> 00:01:01,802
You have work in the morning.
8
00:01:01,882 --> 00:01:03,436
Are you sure,you don't want me to...
9
00:01:03,476 --> 00:01:06,482
I'll be right back.Just sleep.
10
00:01:16,727 --> 00:01:17,990
Hannah?
11
00:01:21,800 --> 00:01:23,273
Hannah?
12
00:01:35,042 --> 00:01:36,796
What'd you do?
13
00:01:37,188 --> 00:01:39,723
I just wanted to sleep.
14
00:01:40,034 --> 00:01:42,419
I'm calling an ambulance.
15
00:02:33,894 --> 00:02:37,412
You've seen one patient in the last two hours.
16
00:02:37,433 --> 00:02:39,398
Complicated case.
17
00:02:39,698 --> 00:02:40,991
I'm a night owl.
18
00:02:41,031 --> 00:02:44,550
Wilson's an early bird.We're different species.
19
00:02:44,631 --> 00:02:45,893
Then move him into his own cage.
20
00:02:45,974 --> 00:02:48,439
Who'll clean the droppings from mine?
21
00:02:49,603 --> 00:02:52,870
25-year-old female with sleep issues.
22
00:02:52,990 --> 00:02:56,700
I'm guessing she'S...oh,what's the medical term...
23
00:02:56,780 --> 00:02:58,684
upset.
24
00:02:58,754 --> 00:03:04,057
25-year-old females,they're usually completely rational,they're rocks,really.
25
00:03:05,180 --> 00:03:09,140
my theory seems to be supported by the fact that she swallowed a bottle of sleeping pills.
26
00:03:09,220 --> 00:03:12,006
Get her a shrink.I need some shut-eye.
27
00:03:12,237 --> 00:03:14,774
She's a little bit more than upset.
28
00:03:14,924 --> 00:03:17,169
She hasn't slept in ten days.
29
00:03:17,269 --> 00:03:18,301
She's lying.
30
00:03:18,372 --> 00:03:22,191
Without rem sleep your neurons stop regenerating.
31
00:03:22,261 --> 00:03:24,376
Your brain shuts down,lobe by lobe.
32
00:03:24,456 --> 00:03:27,885
She'd be insane after five days,dead by ten.
33
00:03:27,965 --> 00:03:31,283
Give me a little credit.I know what gets you off.
34
00:03:31,473 --> 00:03:34,180
She took the pills to sleep,not to kill herself.
35
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Clever alibi.
36
00:03:35,634 --> 00:03:36,455
They didn't work.
37
00:03:36,536 --> 00:03:40,385
She stayed awake even though she downed the whole bottle.
38
00:03:43,121 --> 00:03:47,593
And the longest anyone's ever survived without sleep is 11 days.
39
00:03:47,743 --> 00:03:50,861
Which gives you about 22 hours.
40
00:03:54,720 --> 00:03:56,274
You stole my article.
41
00:03:56,314 --> 00:03:57,537
I wouldn't do that.
42
00:03:57,577 --> 00:04:01,075
I wrote up the case where we induced hypothermic cardiac arrest in the terminal cancer girl.
43
00:04:01,155 --> 00:04:03,020
I wrote my own.I didn't steal yours.
44
00:04:03,100 --> 00:04:05,666
You knew I was writing one.You gave me notes.
45
00:04:06,428 --> 00:04:08,383
Got a case.
46
00:04:08,955 --> 00:04:11,350
It can wait.You two finish.
47
00:04:11,430 --> 00:04:14,468
Five bucks says someone loses an eye.
48
00:04:15,410 --> 00:04:18,277
Fine.You're only putting off the inevitable.
49
00:04:18,337 --> 00:04:21,846
25-year-old female,hasn't slept for ten days.
50
00:04:21,926 --> 00:04:24,983
I assume the er tried giving her some sedatives.We should up the dosage.
51
00:04:25,063 --> 00:04:26,627
Sedation isn't the same as sleep.
52
00:04:26,698 --> 00:04:27,610
Thanks for your insight.
53
00:04:27,640 --> 00:04:30,817
For someone who hasn't slept in ten days,sedation is a great start.
54
00:04:30,897 --> 00:04:32,020
Sleep is an active process--
55
00:04:32,060 --> 00:04:34,316
reboots the system,restores the brain.Sedatives don't--
56
00:04:34,346 --> 00:04:36,471
the brain is being stressed;we need to relieve that.
57
00:04:36,551 --> 00:04:38,807
You've had my article on your desk for the last four months.
58
00:04:38,837 --> 00:04:43,407
I'm a very slow reader.No fever,no white count means no infection.
59
00:04:43,487 --> 00:04:44,741
Schizophrenia?
60
00:04:44,862 --> 00:04:47,738
No delusions.--You read his.
61
00:04:47,868 --> 00:04:49,773
Signed it,didn't read it.
62
00:04:49,853 --> 00:04:53,241
Aside from the sleeping pills,tox screen was clean.
63
00:04:53,322 --> 00:04:56,248
No cocaine,methamphetamines,or diet pills.
64
00:04:56,328 --> 00:04:59,988
Only medications she's had recently are steroids for poison ivy
65
00:05:00,028 --> 00:05:02,453
and ibuofen for a knee she hurt skiing.
66
00:05:02,493 --> 00:05:05,742
Nothing that would cause sleep disturbances.When did you get his article?
67
00:05:05,922 --> 00:05:07,826
about three weeks ago.
68
00:05:07,907 --> 00:05:09,912
Let's go back to the beginning.
69
00:05:09,982 --> 00:05:11,275
How far back?
70
00:05:11,385 --> 00:05:12,899
Genesis.
71
00:05:12,939 --> 00:05:17,129
God said let there be light.
72
00:05:17,199 --> 00:05:19,876
Sleep is initially controlled by external light cues.
73
00:05:19,986 --> 00:05:24,527
And if her brain can't interpret those cues...optic nerve disease.
74
00:05:24,747 --> 00:05:27,505
I'm sensing another article.
75
00:05:27,605 --> 00:05:30,040
I'll go run the tests.
76
00:05:31,634 --> 00:05:37,167
I'm injecting a dye which will allow us to take a look at your retina and your optic nerve.
77
00:05:37,278 --> 00:05:38,993
Everything's kinda blurry.
78
00:05:39,063 --> 00:05:42,681
Normal,because of the dye.It's gonna be that way the next few hours.
79
00:05:48,615 --> 00:05:50,028
Need a hand?
80
00:05:50,109 --> 00:05:51,362
No.
81
00:05:51,513 --> 00:05:53,968
We're never going to work together again?
82
00:05:54,049 --> 00:05:57,277
Just don't see the need to make you feel better by forgiving you.
83
00:05:57,537 --> 00:06:00,835
I wasn't asking for forgiveness.I was asking if you needed help.
84
00:06:00,875 --> 00:06:03,271
It's unprofessional to be talking about this in front of the patient.
85
00:06:03,352 --> 00:06:05,486
Maybe that doesn't matter to you,but...
86
00:06:05,657 --> 00:06:09,326
doesn't matter.She's not listening.
87
00:06:09,747 --> 00:06:11,280
She's asleep.
88
00:06:11,431 --> 00:06:14,087
Normal stage one brain waves.
89
00:06:14,999 --> 00:06:17,656
Maybe she'S...better?
90
00:06:18,879 --> 00:06:21,425
Still blurry.
91
00:06:21,576 --> 00:06:23,309
You fell asleep.
92
00:06:23,420 --> 00:06:25,675
No,I didn'T.
93
00:06:26,777 --> 00:06:29,003
Negative for optic nerve disease.
94
00:06:29,114 --> 00:06:30,326
But she sleeps.
95
00:06:30,406 --> 00:06:33,083
For like ten seconds,maximum one minute.
96
00:06:33,243 --> 00:06:36,411
We also checked the ocular pressure.It's normal.
97
00:06:36,772 --> 00:06:38,646
And she doesn't know she sleeps.
98
00:06:38,716 --> 00:06:41,233
Brain is often unaware of stage one sleep.
99
00:06:41,273 --> 00:06:45,382
Ct showed no tumors,no clots,no seizure disorder.
100
00:06:45,462 --> 00:06:49,974
So she sleeps,she just can't stay asleep.
101
00:06:50,354 --> 00:06:52,220
You going somewhere with this?
102
00:06:52,260 --> 00:06:53,984
You know what keeps me awake at night?
103
00:06:54,214 --> 00:06:56,128
Monsters in the closet.
104
00:06:56,249 --> 00:06:58,515
There's no monster in the closet.We looked.
105
00:06:58,545 --> 00:07:01,271
Well,it's certainly not showing up on the scans.
106
00:07:01,331 --> 00:07:03,466
Where's cameron?
107
00:07:04,108 --> 00:07:07,977
She felt I could deliver the news on my own.
108
00:07:09,360 --> 00:07:11,927
Oh,this is going to work out great.
109
00:07:13,661 --> 00:07:15,295
Come on.
110
00:07:18,453 --> 00:07:21,710
If you two guys can't play nice together,I'm taking away your toys.
111
00:07:21,780 --> 00:07:23,615
I don't care whose fault this is.
112
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If you hadn't--especially don't care if it was my fault.
113
00:07:26,582 --> 00:07:31,725
Whatever this woman has it's not showing up on our tests,which means she's sick.
114
00:07:31,765 --> 00:07:34,482
Just not sick enough for us to see it.
115
00:07:34,592 --> 00:07:36,266
You want us to make her sicker?
116
00:07:36,356 --> 00:07:40,747
yes. I want to stress her body.Specifically her brain.
117
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Keep her awake.
118
00:07:42,521 --> 00:07:46,039
Depriving her of even the few minutes of sleep she does have--it's torture.
119
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So is cutting people with knives,
120
00:07:48,285 --> 00:07:50,660
but you can totally get away with that if you have a doctor coat on.
121
00:07:50,700 --> 00:07:53,909
House,those few seconds of sleep are maybe the only reason she's still alive.
122
00:07:53,989 --> 00:07:56,224
The more symptoms we can force out of her,the more tests we can do.
123
00:07:56,324 --> 00:08:00,434
The more tests we do,the more information we get,the quicker we make a diagnosis.
124
00:08:00,585 --> 00:08:03,161
See how much more fun it is when you guys get along?
125
00:08:03,251 --> 00:08:07,070
You two take the first four hours.
126
00:08:12,243 --> 00:08:13,917
Hannah.
127
00:08:15,721 --> 00:08:17,356
Hannah!
128
00:08:18,719 --> 00:08:20,342
You fell asleep.
129
00:08:20,463 --> 00:08:22,598
No,I didn'T.
130
00:08:22,709 --> 00:08:25,645
Your brain doesn't remember,it was just a few seconds.
131
00:08:25,755 --> 00:08:26,908
Is this really necessary?
132
00:08:26,948 --> 00:08:30,678
The sooner we find out what's wrong,the sooner she can get a real night's rest.
133
00:08:30,798 --> 00:08:32,812
Hannah?
134
00:08:32,893 --> 00:08:34,306
Hannah?
135
00:08:34,396 --> 00:08:36,191
Hannah?
136
00:08:40,521 --> 00:08:42,206
What did you do that for?
137
00:08:42,276 --> 00:08:43,478
You fell asleep again.
138
00:08:43,559 --> 00:08:44,581
No,I didn'T.
139
00:08:44,651 --> 00:08:47,178
we're sorry.We have to do this.
140
00:08:47,258 --> 00:08:49,503
We don't have to be cruel.
141
00:08:49,583 --> 00:08:52,299
You know what happens when you're nice.Nothing.
142
00:08:52,410 --> 00:08:54,966
That's how you define nice?Not stealing?
143
00:08:55,047 --> 00:08:56,039
Doctors?
144
00:08:56,139 --> 00:08:59,147
she fall asleep again?
145
00:09:14,934 --> 00:09:16,990
We've got rectal bleeding.
146
00:09:17,030 --> 00:09:18,553
What,all of you?
147
00:09:19,766 --> 00:09:23,315
So the monster is peeking out from under the bed.
148
00:09:23,395 --> 00:09:27,705
Which either means she has a clotting disorder or she has a tumor in her colon.
149
00:09:27,785 --> 00:09:29,380
we'll do a colonoscopy.
150
00:09:29,460 --> 00:09:31,445
Who's keeping her awake now?
151
00:09:31,475 --> 00:09:34,642
We figured once we found another symptom,it really didn't matter.
152
00:09:34,682 --> 00:09:36,246
Yeah,he's got all the ideas.
153
00:09:36,327 --> 00:09:37,359
Who is with her?
154
00:09:37,439 --> 00:09:40,025
Her partner's donating blood,so she's with a nurse.
155
00:09:40,105 --> 00:09:43,534
Probably singing her lullabies.I want her awake.
156
00:09:43,614 --> 00:09:45,899
You have to sedate a patient to do a colonoscopy.
157
00:09:45,969 --> 00:09:48,235
Why? Just because of the pain?
158
00:09:48,576 --> 00:09:52,385
You find a tumor in her colon,you can knock her out.If you don't,
159
00:09:52,485 --> 00:09:54,571
she stays awake.
160
00:09:57,016 --> 00:09:59,813
Oh,god!It hurts!
161
00:09:59,894 --> 00:10:00,786
Can't you hurry?
162
00:10:00,906 --> 00:10:03,131
Trust me,you don't want me to hurry.
163
00:10:03,361 --> 00:10:05,978
God,you're killing me.
164
00:10:06,039 --> 00:10:08,003
Hold my hand.
165
00:10:08,534 --> 00:10:11,562
Keep breathing,nice and steady.
166
00:10:12,534 --> 00:10:15,361
How am I supposed to work with him?
167
00:10:16,403 --> 00:10:19,621
Maybe we shouldn't be talking about this right now?
168
00:10:19,781 --> 00:10:21,886
You think i'm overreacting?
169
00:10:22,848 --> 00:10:26,287
I need you to relax your anus.
170
00:10:27,309 --> 00:10:30,508
We're not here.We're skiing.
171
00:10:30,698 --> 00:10:33,063
It's thanksgiving,at vail.
172
00:10:33,134 --> 00:10:35,951
You want me to think about nearly killing myself on a snowboard?
173
00:10:36,031 --> 00:10:38,888
Come on,you never fell.
174
00:10:39,840 --> 00:10:42,016
You were awesome.
175
00:10:43,359 --> 00:10:47,548
Is that what you told him?I'm hysterical,and I need to relax my anus?
176
00:10:48,311 --> 00:10:52,240
I told him--how many cases do we work up in a year?
177
00:10:52,300 --> 00:10:54,927
They're all weird;he could've written up any one of them.
178
00:10:55,518 --> 00:10:57,011
She's bleeding.
179
00:10:58,435 --> 00:10:59,617
I can't breathe.I can't breathe!
180
00:10:59,687 --> 00:11:01,442
Hold on.
181
00:11:07,708 --> 00:11:11,205
to control the bleed and started transfusing two units of whole blood.
182
00:11:11,235 --> 00:11:14,784
The pathology from the rectal bleed showed traces of nasal epithelium.
183
00:11:14,865 --> 00:11:16,889
So,the butt bleed's just a nose bleed.
184
00:11:16,929 --> 00:11:19,306
That much blood is not a "just a" anything.
185
00:11:19,386 --> 00:11:23,305
When two people fight this much,you know what it means.
186
00:11:23,385 --> 00:11:27,255
It's gotta be a massive sinus hemorrhage that was draining down her throat and out the back.
187
00:11:27,375 --> 00:11:29,009
The question isn't what,it's why.
188
00:11:29,089 --> 00:11:30,353
Oh,get a room.
189
00:11:30,423 --> 00:11:34,642
Rat poison mixed with some sort of neurogenic toxin could cause bleeding and sleep disturbances.
190
00:11:34,682 --> 00:11:36,477
Do you have a specific type of neurogenic toxin in mind,
191
00:11:36,497 --> 00:11:39,073
or should we just start running a thousand different tox screens?
192
00:11:39,143 --> 00:11:41,018
Just pretend I'm not here.I'll be reading.
193
00:11:41,068 --> 00:11:43,003
It could also be some type of coagulopathy.
194
00:11:43,083 --> 00:11:45,489
Or it could be us.Do you have any idea what it feels like
195
00:11:45,569 --> 00:11:48,126
to have a six-foot-long hose shoved into your large intestine?
196
00:11:48,206 --> 00:11:50,872
No,but I now have a much greater respect for
197
00:11:50,912 --> 00:11:53,869
whichever basketball player you dated in college.
198
00:11:54,139 --> 00:11:57,117
We've basically been torturing this girl for the last eight hours.
199
00:11:57,197 --> 00:11:59,442
We've been poking her foot,not punching her face.
200
00:11:59,522 --> 00:12:02,761
Extreme stress can cause high blood pressure,which can cause bleeding.
201
00:12:02,801 --> 00:12:04,324
Wouldn't keep her awake for ten days.
202
00:12:04,394 --> 00:12:08,264
What if the poison ivy wasn poison ivy?
203
00:12:08,344 --> 00:12:10,569
She got the rash
204
00:12:10,639 --> 00:12:14,509
that was diagnosed as poison ivy around the same time the insomnia started.
205
00:12:14,549 --> 00:12:19,571
Rash,plus nose bleed,plus sleep disturbance equals wegener's granulomatosis.
206
00:12:19,652 --> 00:12:21,917
Start corticosteroid treatment.
207
00:12:21,957 --> 00:12:23,791
The poison ivy treatment was steroids.
208
00:12:23,871 --> 00:12:26,999
Much lower dosage.Get her back on the juice,triple the dose.
209
00:12:27,079 --> 00:12:32,092
Get a c-anca and an upper airway biopsy to confirm the wegener'S.
210
00:12:44,181 --> 00:12:49,183
She has,menstrual problems.They're really bad,the pain keeps her in bed all day.
211
00:12:49,243 --> 00:12:52,611
Plus,she's super depressed.
212
00:12:57,042 --> 00:12:59,487
She said super depressed?
213
00:12:59,528 --> 00:13:03,758
She heard that birth control pills can make her feel better.
214
00:13:03,798 --> 00:13:07,888
She wants birth control pills for her pms?
215
00:13:07,928 --> 00:13:09,382
I guess.
216
00:13:10,484 --> 00:13:13,532
Judging by the redness around your mom's nostrils,
217
00:13:13,662 --> 00:13:16,358
and the tissue she's got conveniently stashed inside her wrist band,
218
00:13:16,399 --> 00:13:20,318
I'd say her problem is more likely a uri than a pms.
219
00:13:20,399 --> 00:13:21,732
Uri?
220
00:13:21,842 --> 00:13:24,538
Upper respiratory infection.A cold.
221
00:13:24,648 --> 00:13:26,403
I don't think so.
222
00:13:26,483 --> 00:13:28,859
I also think she's got a problem with sac.
223
00:13:28,939 --> 00:13:29,931
Sac?
224
00:13:30,011 --> 00:13:33,721
Thanks for playing.Stupid american child.
225
00:13:33,861 --> 00:13:35,414
If you want the pill,
226
00:13:35,535 --> 00:13:40,347
all you have to do is to walk into any health clinic in jersey alone and ask for it.
227
00:13:40,838 --> 00:13:42,962
What exactly was your plan?
228
00:13:43,043 --> 00:13:45,459
Were you going to exchange the birth control pills for some
229
00:13:45,539 --> 00:13:49,770
over-the-counter decongestants and hope that your mom's cold lasts another six years?
230
00:13:49,830 --> 00:13:51,013
No.
231
00:13:52,466 --> 00:13:54,320
That for her cold?
232
00:13:54,440 --> 00:13:56,857
No,that's for your ovaries.
233
00:13:57,087 --> 00:14:00,435
I assume you haven't had a stroke.Have you ever had a blood clot?
234
00:14:00,535 --> 00:14:01,759
No.
235
00:14:01,869 --> 00:14:02,992
Super.
236
00:14:03,072 --> 00:14:06,219
In three months when you need a refill,take a bus to a free clinic.
237
00:14:06,329 --> 00:14:09,688
Don't wait around hoping for mom to get another sniffle.
238
00:14:10,229 --> 00:14:14,490
Not the sharpest chopstick in the drawer,is she?
239
00:14:15,983 --> 00:14:17,837
Was this just one of your experiments?
240
00:14:17,917 --> 00:14:20,975
You just wanted to see how I'd react to being screwed over by foreman?
241
00:14:21,967 --> 00:14:23,721
Nice idea,but no.
242
00:14:23,802 --> 00:14:26,940
This was just good old-fashioned laziness.
243
00:14:27,260 --> 00:14:29,114
Gotta hand it to foreman,though.
244
00:14:29,225 --> 00:14:31,741
He knew that you're a suck-up and I don't give a crap.
245
00:14:31,822 --> 00:14:34,047
He successfully exploited us both.
246
00:14:34,127 --> 00:14:35,961
Right.We're both victims.
247
00:14:35,991 --> 00:14:38,057
A simple heads up,that's all I needed.
248
00:14:38,127 --> 00:14:41,795
Maybe between your incredibly witty remarks about anal sex and cuddy's breasts,
249
00:14:41,835 --> 00:14:43,198
you could've tipped me off.
250
00:14:43,369 --> 00:14:45,254
Then I'd have foreman pissed at me,
251
00:14:45,334 --> 00:14:47,168
and as annoying as you could be,
252
00:14:47,228 --> 00:14:50,006
at least I know you're not gonna pop a cap in my ass.
253
00:14:50,086 --> 00:14:52,231
Witty,huh?
254
00:14:55,137 --> 00:14:56,992
You,on the other hand,
255
00:14:57,072 --> 00:15:02,416
continue to be flabbergasted every time someone actually acts like a human being.
256
00:15:02,646 --> 00:15:05,843
Foreman did what he did because it worked out best that way for him.
257
00:15:05,883 --> 00:15:07,849
That's what everyone does.
258
00:15:07,889 --> 00:15:09,944
That is not the definition of being human.
259
00:15:10,024 --> 00:15:13,010
That's the definition of being an ass.
260
00:15:17,441 --> 00:15:19,115
This will numb you up.
261
00:15:21,953 --> 00:15:25,230
And this will keep your tongue out of the way.
262
00:15:26,323 --> 00:15:29,581
Don't worry,you shouldn't feel anything except for a slight pulling.
263
00:15:29,661 --> 00:15:31,395
So you think I was out of line?
264
00:15:31,475 --> 00:15:35,014
That article would've sat on house's desk for the next six years.
265
00:15:35,054 --> 00:15:36,888
I could've told her.
266
00:15:37,269 --> 00:15:39,355
You could've written it for her too.
267
00:15:39,425 --> 00:15:41,419
She knows house as well as any of us.
268
00:15:41,490 --> 00:15:45,359
She should've known she was waiting for him to do something he was never gonna do.
269
00:15:48,927 --> 00:15:50,482
Chase?
270
00:15:52,627 --> 00:15:54,701
Hannah?You still with us?
271
00:15:54,741 --> 00:15:57,028
What's wrong with her eyes?--Looks like rem.
272
00:15:57,108 --> 00:15:58,401
What's that?
273
00:15:58,481 --> 00:16:00,856
Rapid eye movements.It's what your eyes do when you're sleeping.
274
00:16:00,886 --> 00:16:02,301
But she's awake.
275
00:16:02,311 --> 00:16:03,162
Hannah.
276
00:16:03,273 --> 00:16:05,187
Hannah,can you hear me?
277
00:16:05,297 --> 00:16:08,596
Yeah,of course.
278
00:16:09,297 --> 00:16:11,362
Was she sitting up or lying down?
279
00:16:11,432 --> 00:16:13,497
Sitting up.--Then it wasn't rem.
280
00:16:13,617 --> 00:16:15,713
Chase says her eyes were moving the exact way--
281
00:16:15,783 --> 00:16:17,066
did you start her on the steroids?
282
00:16:17,136 --> 00:16:18,479
Not yet,we were still doing the--
283
00:16:18,549 --> 00:16:19,922
then she wasn't sleeping. --How do you know?
284
00:16:20,022 --> 00:16:21,727
'Cause we haven't done anything yet.
285
00:16:21,848 --> 00:16:23,782
She may be able to sleep with her eyes open
286
00:16:23,822 --> 00:16:27,281
but unless you also discovered she's got two extra teats and hooves for feet
287
00:16:27,321 --> 00:16:31,220
there's no way she'd be able to maintain enough muscle tensity during rem sleep to sit upright.
288
00:16:31,300 --> 00:16:35,019
It's a movement disorder,which rules out wegener'S.
289
00:16:35,130 --> 00:16:36,883
Where's foreman?
290
00:16:36,964 --> 00:16:38,417
Keeping her awake.
291
00:16:38,487 --> 00:16:39,160
Good.
292
00:16:39,200 --> 00:16:42,998
Rabies could cause muscle spasms,malaise,anxiety,and wakefulness.
293
00:16:43,078 --> 00:16:45,284
Pretty unlikely she'd forget being bitten by a crazed animal.
294
00:16:45,375 --> 00:16:46,948
She could've been exposed through an open wound.
295
00:16:46,988 --> 00:16:48,091
She have a dog?
296
00:16:48,131 --> 00:16:51,149
For less than a week.She had an allergic reaction,so they had to give it away.
297
00:16:51,259 --> 00:16:51,860
Allergies.
298
00:16:51,900 --> 00:16:54,697
Animal allergies seemed unlikely but it's possible that--
299
00:16:54,807 --> 00:16:56,661
when? --When what?
300
00:16:57,033 --> 00:16:58,486
When did she get rid of the dog?
301
00:16:58,566 --> 00:17:01,924
About a month ago.Her girlfriend gave it to her for her birthday.
302
00:17:02,054 --> 00:17:04,441
Well,then it's not allergies.
303
00:17:04,551 --> 00:17:07,157
She's just leaving her girlfriend.
304
00:17:08,530 --> 00:17:11,728
You...spoke to the dog?
305
00:17:11,808 --> 00:17:15,918
If her birthday was a month ago,she would've still been on steroids for the poison ivy.
306
00:17:15,999 --> 00:17:18,965
Those meds would've suppressed any reaction she might've had to the dog.
307
00:17:19,005 --> 00:17:21,081
Which means she lied about being allergic.
308
00:17:21,201 --> 00:17:22,043
Dog's a commitment.
309
00:17:22,164 --> 00:17:25,070
You pretend to be allergic because you don't want to tell your girlfriend
310
00:17:25,140 --> 00:17:27,116
that you're not planning on being around that long.
311
00:17:27,186 --> 00:17:29,742
So I tnk we can move on to options other than allergies.
312
00:17:29,822 --> 00:17:33,170
We should still do a scratch test.If she's allergic to one thing--
313
00:17:33,210 --> 00:17:35,305
she is not allergic.
314
00:17:35,385 --> 00:17:38,623
Okay,well,we could either base our diagnosis on
315
00:17:38,663 --> 00:17:40,909
your admittedly keen understanding of lesbian relationships,
316
00:17:40,949 --> 00:17:44,156
or we could do a scratch test.
317
00:17:46,252 --> 00:17:48,557
Do a scratch test.
318
00:17:53,509 --> 00:17:55,704
You still feeling a lot of blood in your throat?
319
00:17:55,784 --> 00:17:57,650
No,it's actually getting a little better.
320
00:17:57,730 --> 00:18:00,356
Good,maybe things are just starting to improve on their own.
321
00:18:00,436 --> 00:18:02,490
Just a few more.
322
00:18:03,132 --> 00:18:04,726
You want some water to wash out your mouth?
323
00:18:04,767 --> 00:18:05,558
No,I'm okay.
324
00:18:05,639 --> 00:18:08,254
Come on,that can't taste good.I'm going to get you a soda--
325
00:18:08,335 --> 00:18:10,180
it's okay,isn't it?
326
00:18:14,840 --> 00:18:17,798
You and max seem to have a really nice relationship.
327
00:18:18,940 --> 00:18:21,236
She's very supportive.
328
00:18:24,284 --> 00:18:29,316
When max got you the dog,did you lie about having an allergic reaction?
329
00:18:30,739 --> 00:18:34,889
No. Why?
330
00:18:35,000 --> 00:18:37,385
If you have pre-existing conditions,it's important we know.
331
00:18:37,465 --> 00:18:40,523
But if you don't,it's just as important.
332
00:18:40,794 --> 00:18:45,204
If I'm wasting my time --you're not going to tell her,are you?
333
00:18:46,427 --> 00:18:48,362
It's none of my business.
334
00:18:48,432 --> 00:18:50,156
She's a good person.
335
00:18:50,226 --> 00:18:53,134
We've just been together so long,I...
336
00:18:55,759 --> 00:18:58,266
I'm tired of her.
337
00:19:01,934 --> 00:19:05,113
Sounds terrible,doesn't it?
338
00:19:05,924 --> 00:19:08,390
I guess it happens sometimes.
339
00:19:09,492 --> 00:19:11,628
My back hurts.
340
00:19:17,543 --> 00:19:19,297
Hannah,can you turn over?
341
00:19:19,367 --> 00:19:20,670
What's wrong?
342
00:19:20,740 --> 00:19:22,876
I'm not sure.
343
00:19:27,636 --> 00:19:29,582
Oh,my God.
344
00:19:31,446 --> 00:19:33,360
She has massive internal bleeding.
345
00:19:33,390 --> 00:19:34,764
Did she have access to aspirin?
346
00:19:34,845 --> 00:19:36,168
She'd have to take a hell of a lot.
347
00:19:36,198 --> 00:19:38,864
Why not,considering her current mental state.
348
00:19:39,014 --> 00:19:41,390
What about her mental state?
349
00:19:41,701 --> 00:19:44,377
You were right about her wanting to break up.
350
00:19:44,447 --> 00:19:46,954
That just means I was right,doesn't mean she's suicidal.
351
00:19:46,994 --> 00:19:49,389
Bottle of pills is what landed her here in the first place.
352
00:19:49,510 --> 00:19:50,762
Sleeping pills.
353
00:19:50,843 --> 00:19:53,329
God knows why she'd want them.
354
00:19:53,500 --> 00:19:57,228
What else can cause sleep disorder and internal bleeding?
355
00:19:57,338 --> 00:19:59,935
Drugs or alcohol can mess with the sleeping and compromise the liver.
356
00:20:00,015 --> 00:20:03,102
What are you doing here?Who's keeping her awake?
357
00:20:03,172 --> 00:20:04,285
Doesn't matter.
358
00:20:04,315 --> 00:20:06,611
Liver function tests are through the sky.
359
00:20:06,681 --> 00:20:09,227
Liver's not compromised,it's dead.
360
00:20:09,608 --> 00:20:12,926
She doesn't need a diagnosis,she needs a new liver.
361
00:20:13,247 --> 00:20:16,946
She's not getting a new liver unless we can figure out what's wrong with her.
362
00:20:16,987 --> 00:20:20,885
Test for cirrhosis: 12 hours.Test for hepatitis: 8.Her liver's not gonna last another six.
363
00:20:20,966 --> 00:20:23,101
So your advice is we just give up.
364
00:20:23,322 --> 00:20:25,878
My advice is that we narrow our focus to conditions that
365
00:20:25,958 --> 00:20:29,477
we can diagnose,treat,and cure in less than six hours.
366
00:20:29,908 --> 00:20:32,413
And there's nothing on that list.
367
00:20:33,877 --> 00:20:36,804
The girlfriend donated blood,right?
368
00:20:36,884 --> 00:20:38,488
Yeah,so?
369
00:20:38,598 --> 00:20:41,215
It means that they're the same type.
370
00:20:41,746 --> 00:20:45,595
You can't ask the person she's about to dump to donate half her liver.
371
00:20:45,745 --> 00:20:48,272
It does seem tacky,doesn't it?
372
00:20:56,632 --> 00:21:01,704
I'm dr. House.I'm in charge of your case.
373
00:21:01,985 --> 00:21:03,488
What's going on?
374
00:21:03,559 --> 00:21:05,965
How come no one is keeping her awake anymore?
375
00:21:06,035 --> 00:21:09,122
You're in acute liver failure.
376
00:21:09,433 --> 00:21:13,272
We can continue the transfusions and the lactulose,
377
00:21:13,353 --> 00:21:15,257
but it's only a stopgap.
378
00:21:15,818 --> 00:21:20,780
There's really nothing we can do to stop the toxins from building up in your bloodstream.
379
00:21:20,971 --> 00:21:23,778
Which means that in a few hours
380
00:21:24,169 --> 00:21:26,725
you will lapse into a coma...
381
00:21:27,827 --> 00:21:30,484
and you won't wake up.
382
00:21:35,206 --> 00:21:37,170
I'm sorry.
383
00:21:39,034 --> 00:21:41,782
That's it?You're giving up?
384
00:21:41,892 --> 00:21:44,869
You're not going to try to figure out what's doing this to her?
385
00:21:45,099 --> 00:21:49,260
Even with the right diagnosis,any treatment'sgonna take longer than the time she has left.
386
00:21:49,330 --> 00:21:52,036
If it's her liver,can't she get a transplant?
387
00:21:52,116 --> 00:21:54,703
Wouldn't work without a diagnosis.
388
00:21:54,773 --> 00:21:58,020
Whatever killed the first liver would do the same to the second.
389
00:21:58,090 --> 00:22:04,386
But it would give you more time to make the diagnosis,to get her better.
390
00:22:05,740 --> 00:22:08,887
Well,it might give us an extra day or two,but...
391
00:22:09,127 --> 00:22:13,458
no procurement agency is going to let a liver go to a patient with an undiagnosed,pre-existing--
392
00:22:13,538 --> 00:22:16,635
hannah and I have the samelood type.
393
00:22:16,826 --> 00:22:19,613
Couldn't I be the donor?
394
00:22:26,129 --> 00:22:30,259
It is medically possible for us to take a part of your--
395
00:22:30,319 --> 00:22:33,586
please,I don't care about the risks.
396
00:22:42,869 --> 00:22:46,357
You're very lucky to have such a devoted partner.
397
00:23:00,472 --> 00:23:04,391
i just bought us 36 hours.Differential diagnosis:
398
00:23:04,471 --> 00:23:08,812
Which monster eats your liver,screws up your sleep,and causes bleeding.
399
00:23:08,892 --> 00:23:10,385
Does max know hannah plans to leave her?
400
00:23:10,466 --> 00:23:12,371
Didn't come up.So I guess...no.
401
00:23:12,411 --> 00:23:14,466
If she knew,there's no way she'd go through with this.
402
00:23:14,546 --> 00:23:18,125
And if you didn't have pathological need to create a close personal relationship
403
00:23:18,205 --> 00:23:21,262
with every dying person you meet,we would be blissfully ignorant of
404
00:23:21,302 --> 00:23:24,200
any ethical dilemmas and might be able to actually concentrate on the differential.
405
00:23:24,270 --> 00:23:25,523
Scratch test was negative.--
406
00:23:25,603 --> 00:23:29,762
It's rare,but any of the hepatitis viruses could cause sleep disturbances and liver failure.
407
00:23:29,842 --> 00:23:32,439
No,pcrs were normal.--We have an ethical dilemma.
408
00:23:32,469 --> 00:23:33,622
No,we don'T.
409
00:23:33,652 --> 00:23:35,185
Continue.
410
00:23:35,265 --> 00:23:39,586
what about splenic cancer or non-hodgkin's lymphoma?She's the right age.
411
00:23:39,666 --> 00:23:41,230
Could explain the bleeding.
412
00:23:41,280 --> 00:23:42,564
Maybe the liver failure.
413
00:23:42,604 --> 00:23:45,801
We're withholding information relevant to her decision to risk her life.
414
00:23:45,881 --> 00:23:48,066
How is that not an ethical dilemma?
415
00:23:48,147 --> 00:23:49,821
It's not medical information.
416
00:23:49,901 --> 00:23:51,615
Who cares?--The ama.
417
00:23:51,655 --> 00:23:55,054
Wilson's disease could explain the liver and neurological symptoms.
418
00:23:55,124 --> 00:23:56,698
It also causes eeding disorders.
419
00:23:56,778 --> 00:23:58,612
No kayser-fleischer rings in her eyes.
420
00:23:58,682 --> 00:24:00,858
Rings don't have to be there if there's neurological symptoms.
421
00:24:00,938 --> 00:24:02,031
This is immoral.
422
00:24:02,061 --> 00:24:03,474
Look,let's say you're right.
423
00:24:03,544 --> 00:24:07,675
We tell,she changes her mind,our patient dies.How is that moral?
424
00:24:08,376 --> 00:24:09,438
What else?
425
00:24:09,519 --> 00:24:13,900
Poison mushrooms can cause liver failure,sleep disturbances,and internal bleeding.
426
00:24:13,980 --> 00:24:16,265
She's not 'shrooming;she's a sport's nut.
427
00:24:16,335 --> 00:24:18,229
Right.Skiers never party.
428
00:24:18,269 --> 00:24:20,716
She's doing this out of love,and max doesn't know--
429
00:24:20,786 --> 00:24:23,552
it's only moral to save a person if they love you?
430
00:24:23,653 --> 00:24:26,370
It's kind of a selfish way of looking at life.
431
00:24:26,450 --> 00:24:29,988
I like wilson's disease,like cancer,love mushrooms.
432
00:24:30,068 --> 00:24:31,963
Yeah,but we don't have the time to test for any of it.
433
00:24:32,003 --> 00:24:35,551
Before she can get the transplant,we need to do about 80 procedures.
434
00:24:35,622 --> 00:24:37,978
So do those tests and my tests at the same time.
435
00:24:38,058 --> 00:24:41,867
Use the pet to look for cancer and wilson's while you endoscope her bile ducts,
436
00:24:41,907 --> 00:24:44,844
scrape her stomach for mushroom spores.One of you ct her liver,
437
00:24:44,924 --> 00:24:49,335
while the other two check proteins ca-125 and ca-19.5.
438
00:24:49,416 --> 00:24:54,487
Oh yeah,anyone says anything to max,they're fired.
439
00:24:54,879 --> 00:24:56,082
We have to.
440
00:24:56,192 --> 00:24:58,056
We have to not.
441
00:24:58,206 --> 00:24:59,469
Because she's not our patient.
442
00:24:59,509 --> 00:25:03,008
She's getting surgery,she's someone's patient.
443
00:25:05,143 --> 00:25:07,620
Calvin and sam.Great,thank you.
444
00:25:07,700 --> 00:25:09,454
Need a little help.
445
00:25:09,534 --> 00:25:13,123
Inexplicable rash on a patient's scrotum you need me to look at?
446
00:25:13,183 --> 00:25:17,473
27-year-old female wants to donate half her liver to her dying girlfriend.
447
00:25:17,533 --> 00:25:18,676
That's very generous.
448
00:25:18,756 --> 00:25:21,463
This is sleepless girl?What's she got?
449
00:25:21,503 --> 00:25:22,886
Liver failure.
450
00:25:22,946 --> 00:25:26,325
Sort of figured that out when you said she needed a new liver.
451
00:25:28,630 --> 00:25:30,504
You don't have a diagnosis.
452
00:25:30,544 --> 00:25:32,530
Transplant buys me time.
453
00:25:32,600 --> 00:25:35,256
Let's just skip the part where I say this is insane.
454
00:25:35,296 --> 00:25:38,865
It was her idea. --If she wants to be an idiot,it's her call.You don't need me.
455
00:25:39,055 --> 00:25:41,481
Just have one of your team walk her through the process.
456
00:25:41,561 --> 00:25:44,840
The donor and the donee sort of have opposing interests,right?
457
00:25:44,930 --> 00:25:46,383
You can't really advise them both.
458
00:25:46,463 --> 00:25:49,631
You're concerned about the ethics of this?
459
00:25:49,902 --> 00:25:52,187
What's going on?What do you know?
460
00:25:52,257 --> 00:25:53,951
Nothing medically relevant.
461
00:25:54,031 --> 00:25:57,009
But you know something,and it is relevant.
462
00:25:57,340 --> 00:26:02,332
If I can't tell her,I can't really tell you,can I?Not ifou're advising her.
463
00:26:02,522 --> 00:26:05,389
I assume this information is in the medical file.
464
00:26:05,459 --> 00:26:07,283
My patient's confidential file.
465
00:26:07,363 --> 00:26:09,609
This hospital's file.
466
00:26:11,524 --> 00:26:15,444
You can either satisfy your curiosity,or you can remain ignorant,
467
00:26:15,514 --> 00:26:20,596
do nothing ethically wrong,and my patient doesn't die in three hours.
468
00:26:26,701 --> 00:26:32,445
These tests and the counseling normally happen over weeks.
469
00:26:32,525 --> 00:26:34,509
Sometimes months.
470
00:26:34,620 --> 00:26:36,334
It's okay.
471
00:26:36,755 --> 00:26:40,033
The most important part we're skipping is time--
472
00:26:40,103 --> 00:26:42,358
time for you to change your mind.
473
00:26:42,468 --> 00:26:44,564
I don't want to change my mind.
474
00:26:44,644 --> 00:26:50,549
Not now,but with time and perspective,maybe we learn things--
475
00:26:50,589 --> 00:26:52,693
if we had the time,we'd take the time,but we don'T.
476
00:26:52,764 --> 00:26:55,249
So can you get this over with?
477
00:26:57,024 --> 00:27:01,595
Either I sign off on this,or it doesn't happen.
478
00:27:01,755 --> 00:27:04,021
So I need you to listen to me.
479
00:27:04,091 --> 00:27:08,632
Because there's a chance that you will die on that table.
480
00:27:15,719 --> 00:27:19,538
I just want me and hannah to be able to lie in bed together,
481
00:27:20,221 --> 00:27:25,282
as old ladies.Compare scars.
482
00:27:33,573 --> 00:27:37,161
I need you to lie on your side,and hold your knees.
483
00:27:41,251 --> 00:27:45,902
I'm gonna check for vascular abnormalities that might prevent us from doing the transplant.
484
00:27:46,083 --> 00:27:50,312
At the same time i'm also checking for mushroom spores to see if that's the underlying--
485
00:27:50,383 --> 00:27:51,265
I don't do mushrooms.
486
00:27:51,336 --> 00:27:54,523
You lie about your love life,maybe you lie about drugs.Open.
487
00:27:57,952 --> 00:28:00,748
Aren't you at all concerned about what max is going through right now?
488
00:28:00,828 --> 00:28:02,683
They're shoving a tube up her rectum.
489
00:28:02,763 --> 00:28:05,029
They're gonna swab her stomach,just like I'm doing.
490
00:28:05,099 --> 00:28:07,364
It's going to hurt,just like this hurts.
491
00:28:07,564 --> 00:28:12,867
Which is nothing at all like the risk she's taking on the table.
492
00:28:14,993 --> 00:28:17,509
You really don't love her,do you?
493
00:28:17,619 --> 00:28:19,804
I'm not leaving her because I don't--
494
00:28:19,884 --> 00:28:22,240
I'm not talking about the leaving.I'm talking about this.
495
00:28:22,320 --> 00:28:26,059
If you care for her at all,you won't let her do this blind.
496
00:28:29,838 --> 00:28:32,264
You'd really tell.
497
00:28:34,530 --> 00:28:36,815
You'd die.
498
00:28:45,356 --> 00:28:47,411
Take it you've seen that.
499
00:28:49,987 --> 00:28:54,749
Seen it,digested it,watched it blow up my entire department.
500
00:28:54,819 --> 00:28:56,533
You read cameron's version?
501
00:28:56,603 --> 00:28:57,636
Didn't read either.
502
00:28:57,716 --> 00:28:59,089
It was good.
503
00:28:59,170 --> 00:29:00,693
Better than foreman's?
504
00:29:00,803 --> 00:29:05,395
Maybe.He was more analytical about the diagnostic procedures.
505
00:29:05,735 --> 00:29:09,334
She concentrated more on the ethical dilemmas of informed consent.
506
00:29:09,445 --> 00:29:12,081
How any patient can really be informed without a medical degree.
507
00:29:12,191 --> 00:29:14,225
Same old party lines.
508
00:29:14,576 --> 00:29:16,101
Foreman should've told her.
509
00:29:16,181 --> 00:29:18,055
Oh,shoulda woulda coulda.
510
00:29:18,155 --> 00:29:22,306
If you allow this sort of thing in your department,you're basically saying it's okay.
511
00:29:22,386 --> 00:29:24,811
No,I'm saying that I don't care at they do
512
00:29:24,881 --> 00:29:28,410
as long as my life isn't interrupted by pointless conversations like this one.
513
00:29:28,491 --> 00:29:30,896
They won't trust each other,and they won't trust you.
514
00:29:30,966 --> 00:29:32,550
They shouldn'T.
515
00:29:32,780 --> 00:29:38,574
Deception like this is just one step removed from actively sabotaging one another.
516
00:29:38,655 --> 00:29:40,239
Then what would you do?
517
00:29:40,309 --> 00:29:43,476
I could be the kindest,gentlest boss in the world
518
00:29:43,516 --> 00:29:46,564
and foreman would've still done what he did because that's who he is.
519
00:29:46,604 --> 00:29:49,772
We can only hope that cameron has learned something.
520
00:29:50,573 --> 00:29:53,962
Right,because you're all about the teaching.
521
00:29:54,062 --> 00:29:57,420
Our children are the future.
522
00:30:04,197 --> 00:30:07,084
Cuddy cleared max for surgery.She's okay to go.
523
00:30:07,164 --> 00:30:08,236
How's our patient?
524
00:30:08,276 --> 00:30:09,329
She's also cleared.
525
00:30:09,399 --> 00:30:12,537
I don't care about the prep.I care about the diagnostic tests.
526
00:30:12,617 --> 00:30:15,123
Well,it looks negative for wilson's disease,we'll know for sure in an hour.
527
00:30:15,203 --> 00:30:17,319
Blood proteins are normal,it's not--where's cameron?
528
00:30:17,439 --> 00:30:19,624
Taking a sample of the bile duct.
529
00:30:20,275 --> 00:30:22,822
Surgeries are supposed to start in about 15 minutes.
530
00:30:22,922 --> 00:30:24,446
She had a chance to get one last--
531
00:30:24,526 --> 00:30:25,949
hannah and max will be in the same room.
532
00:30:26,029 --> 00:30:28,015
You wanted us to do as much as we can before--
533
00:30:28,055 --> 00:30:31,503
they're both awake.With cameron.
534
00:30:35,513 --> 00:30:38,790
Maybe we should give these two a minute together before the surgery.
535
00:30:39,722 --> 00:30:41,437
You ready,honey?
536
00:30:43,682 --> 00:30:46,459
Max.It's okay.
537
00:30:46,570 --> 00:30:48,213
I'm right here.
538
00:30:48,253 --> 00:30:50,478
I need you to know something.
539
00:30:50,559 --> 00:30:53,957
I know.I love you,too.
540
00:30:55,110 --> 00:30:57,054
I don't know how to say this.
541
00:30:57,124 --> 00:30:57,896
Good lord.
542
00:30:57,967 --> 00:30:59,491
You can tell me anything.
543
00:30:59,571 --> 00:31:01,365
She hasn't slept in eleven days,
544
00:31:01,445 --> 00:31:03,841
you people trying to torture her?
545
00:31:08,121 --> 00:31:10,908
Ding,ding,let's go.
546
00:31:15,158 --> 00:31:17,865
I told you not--I didn't say a word to max.
547
00:31:17,935 --> 00:31:20,451
This is exactly why you got screwed with foreman.
548
00:31:20,531 --> 00:31:22,617
You're looking for people to do the right thing.
549
00:31:22,727 --> 00:31:26,536
She hasn't slept,her judgment's compromised due to inactivity in her prefrontal cortex.
550
00:31:26,576 --> 00:31:30,566
Oh,she could have the best prefrontal cortex in the history of mankind.
551
00:31:30,606 --> 00:31:35,578
But given the choice of life versus death,those bad,bad people are going to choose life.
552
00:31:35,658 --> 00:31:37,743
Then why'd you sedate her?
553
00:31:37,853 --> 00:31:42,414
If she wasn't gonna tell,if she was never gonna do the right thing,why bother knocking her out?
554
00:31:42,715 --> 00:31:46,625
This isn't about them.If she talks,if she does the decent thing,
555
00:31:46,695 --> 00:31:49,742
then you don't get to solve your puzzle,your game's over,you lose.
556
00:31:49,822 --> 00:31:54,033
Yeah,I want to save her;I'm morally bankrupt.
557
00:32:15,324 --> 00:32:16,336
How's it going?
558
00:32:16,416 --> 00:32:19,003
They're about to remove hannah's liver.
559
00:32:22,641 --> 00:32:25,649
All right,I'm good to go.
560
00:32:25,759 --> 00:32:28,656
You can start removing max's liver.
561
00:32:29,639 --> 00:32:32,836
you want to let me in on what the big secret is between these two?
562
00:32:32,956 --> 00:32:35,433
You read foreman's article?
563
00:32:36,576 --> 00:32:39,101
It was good.
564
00:32:39,642 --> 00:32:42,630
He basically stole it from me.
565
00:32:43,562 --> 00:32:44,915
So?
566
00:32:44,996 --> 00:32:46,629
You're on his side?
567
00:32:46,709 --> 00:32:49,938
Sides?No,this isn't dodgeball.
568
00:32:50,329 --> 00:32:53,256
What am I supposed to do?Just sit back and take it?
569
00:32:53,336 --> 00:32:55,461
No,write another article.
570
00:32:55,541 --> 00:32:58,288
Kick ass,until you're sitting behind some big expensive desk,
571
00:32:58,368 --> 00:33:00,654
and someone from johns hopkins calls and says,
572
00:33:00,694 --> 00:33:04,873
"we're thinking about hiring eric foreman as our head of neurology,"
573
00:33:05,135 --> 00:33:07,420
and you can say whatever you want.
574
00:33:07,500 --> 00:33:11,540
Lovely. Revenge as motive for success.
575
00:33:11,621 --> 00:33:13,896
Well,it doesn't have to be the motive.
576
00:33:13,966 --> 00:33:16,441
But it sure tastes good.
577
00:33:17,023 --> 00:33:18,898
She's in vf.I've got no pulse!
578
00:33:18,968 --> 00:33:20,161
She's arresting.
579
00:33:21,123 --> 00:33:22,576
Paddles.
580
00:33:22,737 --> 00:33:25,895
I am so relieved you two are here.
581
00:33:26,005 --> 00:33:28,661
Without you looking out,they'd be playing foosball down there.
582
00:33:28,731 --> 00:33:29,704
Max's heart stopped.
583
00:33:29,774 --> 00:33:31,609
Your patient is on the other side.
584
00:33:31,689 --> 00:33:37,453
Get yourself upstairs and figure out what hannah has,or max has risked her life for nothing.
585
00:33:39,778 --> 00:33:43,588
Charging.Clear.
586
00:33:48,820 --> 00:33:50,224
We're okay.
587
00:33:55,005 --> 00:33:59,877
max's cardiac arrest was caused by hypoxia from hypoventilation.
588
00:33:59,907 --> 00:34:01,421
They restarted her heart
589
00:34:01,501 --> 00:34:04,979
and the right lobe of her liver was successfully transplanted into hannah.
590
00:34:05,049 --> 00:34:10,202
Now,where were we before we were so rudely interrupted by the liver transplant?
591
00:34:10,272 --> 00:34:12,438
Dopa decarboxylase was processed normally
592
00:34:12,488 --> 00:34:16,036
and the cerolo-plasma and copper levels were normal.So no wilson's disease.
593
00:34:16,116 --> 00:34:19,154
Gastric content was negative for spores,so no mushroom toxicity.
594
00:34:19,224 --> 00:34:21,259
And the initial tests were negative for cancer.
595
00:34:21,339 --> 00:34:22,752
Which cancer were you looking for?
596
00:34:22,822 --> 00:34:23,283
Any of them.
597
00:34:23,363 --> 00:34:26,261
We ran blood tests for ovarian,lung,and lymphomas.
598
00:34:26,301 --> 00:34:27,012
It's not gonna tell you much.
599
00:34:27,093 --> 00:34:29,538
Her blood was taken after she was given immunosuppressants.
600
00:34:29,608 --> 00:34:31,173
They fight rejection.
601
00:34:31,253 --> 00:34:34,781
They also mess up our ability to get any clear readings.
602
00:34:35,463 --> 00:34:39,082
Great battles kick up a lot of dirt.
603
00:34:39,573 --> 00:34:44,244
Obscure the battlefield so generals can't see what's going on.
604
00:34:44,365 --> 00:34:48,124
So what are your orders,general house?
605
00:34:49,076 --> 00:34:51,883
Sound the retreat.
606
00:34:53,647 --> 00:34:55,321
How ya feeling?
607
00:34:55,632 --> 00:34:57,466
Is max okay?
608
00:34:57,506 --> 00:35:00,093
She's still unconscious,but her vitals look good.
609
00:35:00,173 --> 00:35:06,849
We need to stop all the immunosuppressant drugs which are protecting your new liver.
610
00:35:08,272 --> 00:35:10,818
But if you stop the drugs,I'll die.
611
00:35:10,898 --> 00:35:15,369
You're dead anyway if we don't figure out what caused all this.
612
00:35:16,131 --> 00:35:18,568
By removing any outside influences,
613
00:35:18,648 --> 00:35:21,133
it'll help us see what's really going on with your body.
614
00:35:21,244 --> 00:35:25,805
So you did all this to buy me a couple of days,and now you're taking 'em back?
615
00:35:29,764 --> 00:35:31,589
Will it hurt?
616
00:35:32,050 --> 00:35:36,621
As your body goes into acute organ rejection,your liver will begin to swell,
617
00:35:36,682 --> 00:35:38,676
it'll put pressure on--
618
00:35:40,590 --> 00:35:44,300
It'll hurt.We can knock you out.
619
00:35:44,931 --> 00:35:49,823
Mm,no. If max wakes up,I want to talk to her.
620
00:35:56,650 --> 00:36:01,642
She's been taking the decongestants,but she' not getting better.She also says...
621
00:36:01,712 --> 00:36:03,265
what?
622
00:36:03,656 --> 00:36:06,162
Her boobs are bigger.
623
00:36:13,771 --> 00:36:16,227
How could you get them mixed up?
624
00:36:16,297 --> 00:36:19,545
They come in a little wheel,they don't look anything like decongestants.
625
00:36:19,615 --> 00:36:23,845
Oh,god! The cashier put them both in the same bag.I thought I gave her the right ones.
626
00:36:23,925 --> 00:36:26,091
(Ëû˵ʲô²»¶Ô¾¢°¡£¿)
627
00:36:28,406 --> 00:36:31,254
£¨Ëû˵Ëû¿ªÁË´íÒ©¸øÄ㣩
628
00:36:31,324 --> 00:36:34,371
No,you gave her the wrong pills.
629
00:36:34,441 --> 00:36:37,058
You speak mandarin?
630
00:36:37,228 --> 00:36:44,345
I can count to ten,ask to go to the bathroom,and...(¹§Ï²Äã¿ìµ±×æÄ¸ÁË£¡)
631
00:36:44,876 --> 00:36:49,187
I'm not pregnant!We--we haven't even done it yet.
632
00:36:49,257 --> 00:36:50,971
(ËûÔÚ½²Ê²Ã´)
633
00:36:51,051 --> 00:36:51,853
£¨²»ÖªµÀ£©
634
00:36:51,933 --> 00:36:52,955
£¨ÄãÊDz»ÊÇ£©£¨ÎÒ²»ÊÇ¡¡£©
635
00:36:53,036 --> 00:36:55,061
Okay,I'm going to leave you two alone now.
636
00:36:55,131 --> 00:36:57,497
I'm sure you got a lot to talk about.
637
00:37:03,501 --> 00:37:06,247
Fever's 106,she's in full rejection mode.
638
00:37:06,328 --> 00:37:08,433
Is that supposed to surprise me?
639
00:37:08,544 --> 00:37:10,688
Her white count is normal.
640
00:37:10,759 --> 00:37:13,476
Normal is not normal.
641
00:37:13,556 --> 00:37:17,705
She's been on steroids,transplant team gave her a cocktail of immunosuppressants,
642
00:37:17,785 --> 00:37:19,741
she hasn't slept in over a week.
643
00:37:19,851 --> 00:37:21,154
Her white count should be in the tank.
644
00:37:21,234 --> 00:37:23,179
Looks like the problem is some sort of infection.
645
00:37:23,209 --> 00:37:25,385
Probably caused a hypotension,shockethe liver.
646
00:37:25,425 --> 00:37:27,750
We should start broad spectrum antibiotics.
647
00:37:27,830 --> 00:37:30,266
Yeah,you might want to add some chicken soup.
648
00:37:30,346 --> 00:37:33,283
It'd be just as useless,but it's got chicken.
649
00:37:33,474 --> 00:37:35,979
We need to know exactly what kind of infection we're dealing with.
650
00:37:36,060 --> 00:37:38,246
What infection causes sleep disturbance,bleeding,
651
00:37:38,326 --> 00:37:41,834
movement disorder,organ failure,and an abnormally normal white count.
652
00:37:41,864 --> 00:37:43,829
What about tularemia?--Chest was clear.
653
00:37:43,899 --> 00:37:45,733
Tularemia doesn't cause movement disorders.
654
00:37:45,814 --> 00:37:46,866
It would if she developed meningitis.
655
00:37:46,946 --> 00:37:49,201
There was no ulcerations on the skin.
656
00:37:49,301 --> 00:37:52,069
With the bleeding,it looks more like leptospirosis.
657
00:37:52,149 --> 00:37:54,344
Without conjunctivitis and elevated creinine?
658
00:37:54,414 --> 00:37:57,011
What about typhoid or some kind of relapsing fever?
659
00:37:57,091 --> 00:37:58,765
Makes sense,if we were in the sudan.
660
00:37:58,845 --> 00:38:00,338
We sure she hasn't been out of the country?
661
00:38:00,418 --> 00:38:03,196
She hasn't even been out of the state in at least a year.Neither has max.
662
00:38:03,236 --> 00:38:04,789
Maybe she lied.
663
00:38:05,170 --> 00:38:06,964
You talk to her friends,neighbors?
664
00:38:07,044 --> 00:38:08,368
You don't know?
665
00:38:08,449 --> 00:38:10,203
Come on,if you don't stay up to date on my notes,
666
00:38:10,243 --> 00:38:12,688
where's your next article going to come from?
667
00:38:12,959 --> 00:38:14,393
You talk to the dog?
668
00:38:14,503 --> 00:38:17,560
We're not as up on foreign languages as you are.
669
00:38:17,710 --> 00:38:19,725
Has the dog been traveling?
670
00:38:19,806 --> 00:38:21,380
It came from a breeder.
671
00:38:21,460 --> 00:38:22,542
Where?
672
00:38:22,773 --> 00:38:24,547
I don't know.
673
00:38:25,579 --> 00:38:29,198
A place called blue barrel kennels.They only had the thing for like two days.
674
00:38:29,309 --> 00:38:32,106
Blue barrel is a kind of cactus.
675
00:38:32,336 --> 00:38:35,303
You see many cacti in jersey?
676
00:38:42,931 --> 00:38:45,618
Want to see a magic trick?
677
00:38:50,731 --> 00:38:53,848
Oh,no!Where'd it go? Where'd it go?
678
00:38:53,978 --> 00:38:55,953
Is it here?
679
00:38:56,685 --> 00:38:58,519
No.
680
00:38:58,600 --> 00:39:00,163
What about here?
681
00:39:01,005 --> 00:39:03,592
There it is.
682
00:39:04,163 --> 00:39:08,042
that doesn't look anything like a nose.
683
00:39:08,122 --> 00:39:10,639
that wasn't there this morning.
684
00:39:24,743 --> 00:39:27,981
Get that to the lab and call cdc.
685
00:39:28,181 --> 00:39:29,354
And tell them what?
686
00:39:29,424 --> 00:39:32,713
That we have a patient with the plague.
687
00:39:33,284 --> 00:39:36,281
The black plague?
688
00:39:36,601 --> 00:39:37,764
Looks that way.
689
00:39:37,844 --> 00:39:39,699
Plague is carried by rodents,not dogs.
690
00:39:39,779 --> 00:39:42,035
Where there's dogs,there's fleas.
691
00:39:42,275 --> 00:39:45,443
And if they hail from the southwest,and those fleas can't tell the difference
692
00:39:45,523 --> 00:39:47,748
between prairie dogs and puppy dogs...
693
00:39:47,829 --> 00:39:52,831
a small percentage of plague cases present with sleep disturbance.
694
00:39:53,633 --> 00:39:58,054
Imagine an idyllic river of bacteria.
695
00:39:58,595 --> 00:40:00,880
Okay,it's not idyllic for her,but it serves my purposes.
696
00:40:00,960 --> 00:40:06,223
The steroids and immunosuppressants acted like a big,honkin' dam across the river-physics 101.
697
00:40:06,303 --> 00:40:08,680
Put a dam up in front of a raging river,the river rises.
698
00:40:08,760 --> 00:40:12,067
By stopping the immunosuppressants,we blew up the dam
699
00:40:12,187 --> 00:40:15,506
and a 100-foot wall of bacteria flooded her lymph nodes.
700
00:40:15,586 --> 00:40:17,240
We better find out where that dog is now.
701
00:40:17,320 --> 00:40:19,766
After we start the immunosuppressants
702
00:40:19,846 --> 00:40:24,076
and fill her up to the eyeballs with streptomycin sulfate gentamicin and tetracycline.
703
00:40:24,177 --> 00:40:25,961
Use a garden hose if you've got one.
704
00:40:26,071 --> 00:40:29,279
Get yourselves some prophylactic treatments as well.
705
00:40:30,632 --> 00:40:32,817
I've got the plague?
706
00:40:33,550 --> 00:40:35,684
Don't worry,it's treatable.
707
00:40:35,795 --> 00:40:38,250
Being a bitch,though,
708
00:40:38,330 --> 00:40:41,228
nothing we can do about that.
709
00:40:47,754 --> 00:40:49,848
You weren't in your room.
710
00:40:49,999 --> 00:40:52,986
The surgeon said I'd heal faster if I walk.
711
00:40:53,057 --> 00:40:56,093
Got this far,needed a rest.
712
00:40:56,164 --> 00:40:59,272
What you did was crazy,but it was pretty amazing too.
713
00:40:59,382 --> 00:41:02,830
Yeah,I'm a hero.
714
00:41:05,036 --> 00:41:08,664
She's been planning to leave me.
715
00:41:10,419 --> 00:41:11,712
Really?
716
00:41:11,822 --> 00:41:16,062
She told a friend;the friend let it slip.
717
00:41:18,037 --> 00:41:22,498
You knew and you gave up half your liver anyway?
718
00:41:24,432 --> 00:41:26,657
She can't leave me now.
719
00:41:30,928 --> 00:41:34,948
You really want her to stay out of guilt?That's not gonna make either of you happy.
720
00:41:35,028 --> 00:41:37,233
You don't know that.
721
00:41:37,353 --> 00:41:39,178
I love her.
722
00:41:41,143 --> 00:41:44,029
I just want her to stay.
723
00:42:00,610 --> 00:42:03,456
I don't own house's cases.
724
00:42:04,299 --> 00:42:07,416
You had just as much right as I did to write it up.
725
00:42:07,496 --> 00:42:09,100
You shoulda told me,but
726
00:42:09,391 --> 00:42:12,218
i shoulda handled it better too.
727
00:42:14,583 --> 00:42:20,217
If we want this not to get in the way of our friendship,I think we both have to apologize,
728
00:42:20,337 --> 00:42:23,696
and put it behind us.
729
00:42:25,450 --> 00:42:27,525
I like you,really.
730
00:42:27,565 --> 00:42:30,322
We have a good time working together.
731
00:42:30,402 --> 00:42:35,665
But ten years from now,we're not gonna be hanging out,having dinners.
732
00:42:35,775 --> 00:42:41,379
Maybe we'll exchange christmas cards,say hi,give a hug if we're at the same conference.
733
00:42:43,163 --> 00:42:47,343
We're not friends.We're colleagues.
734
00:42:49,027 --> 00:42:53,859
And I don't have anything to apologize for.
59032