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00:00Viewer discretion is advised.
00:07I'm okay. Let's just go home.
00:09You're getting checked out.
00:11I tripped on the ice. Eight other kids tripped.
00:14This is embarrassing.
00:15You said you were just gonna hang with your friends.
00:18I turn around and you're out there on the ice.
00:21I'm fine.
00:22You don't know that.
00:24You fell. Awkwardly.
00:27No, I didn't.
00:28You don't know how to fall.
00:29I'm 16. I've been falling a lot.
00:31I think I'm getting the hang of it.
00:33And I checked.
00:38And now the doctors are gonna check.
00:40You don't think that you're overreacting?
00:42I don't need you to fix every boo-boo.
00:45And stop getting them.
00:46I was just playing around with my friends. I was having fun.
00:49You know you can't do that.
00:50Oh, I can't have fun.
00:52You know what I mean.
00:54I'm gonna have a talk with your friends.
00:56No!
00:56They need to stop.
00:57No!
00:58I don't want you freaking them out.
01:02Fine.
01:03Fine, we'll go to the hospital.
01:05But they're gonna tell you that I'm fine.
01:06And they're gonna tell you that you don't need to worry about...
01:08Again, I won't do the hospital.
01:28Who will you?
01:34Oh...
01:34No!
01:36No!
01:37It's true!
01:38Oh, God.
01:46Mom?
01:49Mom?
01:55Hello?
02:08Mom, we gotta wake up. No one's coming. Mom!
02:21911, what's your emergency?
02:23Got into an accident along the canal road, just outside Kingston.
02:27My mom's unconscious.
02:30Are you hurt?
02:33I'm fine.
02:38Mom?
02:40Mom?
03:21Where's Poorman?
03:22He's down here, somewhere.
03:24Somewhere. Very helpful.
03:26Do you have any idea when he's getting out tonight?
03:30Sometime.
03:30I realize you can't predict, I just thought you might be able to estimate.
03:34It's Valentine's Day, and I've planned a surprise getaway.
03:37Getaway?
03:40Getaway.
03:43Getaway.
03:44Away.
03:50Is my mom okay?
03:52She's gone to surgery.
03:56Foreman.
03:58Your girlfriend wants to know if you're available for Valentine's.
04:01Act surprised.
04:03What are you doing down here?
04:04It was a snowstorm.
04:06You are short-staffed.
04:07We're all supposed to be here.
04:08You're supposed to be here.
04:09You're an ass.
04:10Act surprised.
04:13Let's get this thing a little.
04:17Ow.
04:18Can we hurry this up?
04:20Make sure they take your time.
04:23What's your name?
04:25Hannah Morgenthau.
04:27You have SIPA, Hannah Morgenthau.
04:30Well, I don't.
04:31We have to do x-rays to make sure you don't have internal injuries.
04:35Blood tests to make sure no infections.
04:37EEG for neurological anomalies.
04:39And biopsy a spinal nerve.
04:42Whoa, whoa, whoa.
04:43Congenital insensitivity to pain is one of the rarest conditions on the planet.
04:47There's only been about 60 documented cases?
04:49Yeah.
04:50And I have seven reasons to think that she's one of them.
04:53She says she's not.
04:55And that's reason number one.
04:57She knew what it was without us telling her.
04:59Two, she's still wet from the snow.
05:01She's not shivering.
05:03That's odd.
05:04Unless she can't sweat or feel hot and cold.
05:06The ambulance was warm.
05:08I want to see my mother.
05:10Three, scarring around the lips and tongue.
05:12When she was a baby, she chewed on herself without feeling it.
05:15I fell through a window when I was a kid.
05:17Four, when you cleaned the wound, she flexed into the cleaner instead of away from it.
05:21It's hard to fake pain when you've never felt it.
05:24It takes an imaginative leap, Ms. Morgenthal.
05:27It's one of them Jew names.
05:31Ashkenazi's her higher risk group.
05:33On the other hand, she says she doesn't have it.
05:35And she'd be dead by now if she'd never been diagnosed.
05:38They killed our Lord.
05:40You gonna trust them?
05:42She wants to see her mom.
05:44She admits having Sifa.
05:45She knows we're not letting her go anywhere without a battery of tests.
05:48You said you had seven reasons.
05:50I pulled the number out of the air.
05:52Five isn't enough.
05:53Five lame reasons aren't.
05:55I'm taking her to see her mom.
05:56She's...
05:59I could hate her again if six isn't enough.
06:04Do the tests.
06:09Need to bail on the ER.
06:10I got a case.
06:15Why are you wearing perfume?
06:16Is this a real case or one of those imaginary cases that happen when you're bored?
06:20SIPA.
06:22SIPA is a diagnosis.
06:26Diagnoses happen at the end of cases.
06:28She's got no idea what's going on in her body.
06:30There's bound to be something wrong.
06:32In other words, she could be perfectly healthy,
06:33but you're curious about someone who can't feel pain
06:36because you always feel pain, so you want to go exploring.
06:40She was in a car accident.
06:42She needs x-rays, blood tests, EEG, nerve biopsy.
06:46I also note that, although snow was coming down its sheets this morning,
06:49you left your hat at home and used earmuffs.
06:52Do your test, except for the...
06:54So while everyone else was just worrying about getting in,
06:56you were concerned with...
06:57Hat head.
07:00Blind dates are never a good idea.
07:03Only reason to wear a scarf like that is a beacon to identify you in a crowd.
07:08Do your test, except for the nerve biopsy.
07:11I need the nerve biopsy.
07:11You'd risk paralyzing her.
07:12It's neurological.
07:14You have no evidence of that.
07:16She tripped.
07:18Do you have any evidence other than the fact that a typically clumsy SIPA patient tripped on an icy day?
07:26If the EEG reveals a problem, we can talk then.
07:34You could have left the scarf at home.
07:35Just told him you'd be wearing a look of desperation.
07:42Spiking on leads C3 and O2.
07:44She could be going into a seizure.
07:45I think there's a simpler explanation.
07:48You're not gonna find anything!
07:50I'm fine!
07:51But why don't you see my mom?
07:53So sedate her.
07:54She won't consent.
07:56She's a teenager.
07:57No dad, mom's still in surgery.
08:00What do you want us to do?
08:00Hold her down?
08:01Well, only until you inject her with a sedative.
08:04Then you can let her go.
08:05We tried.
08:06Seriously?
08:07She's strong and doesn't care.
08:09We'd have broken something before we can get her to sit still enough to inject her.
08:12So, break her arm.
08:14She won't mind.
08:15You're cranky.
08:16I'm in pain.
08:19Come on.
08:20Let's go break her arm.
08:24Nurse Shorty.
08:25You're business.
08:26How long are you gonna waste her time?
08:28I'm so glad we're walking somewhere.
08:30Another 60 feet and this conversation is over.
08:32You guys are out of this program.
08:33Cameron will find somebody.
08:34Chase will find eight somebodies and you'll be alone.
08:3830 feet.
08:39Date and you'll date.
08:40You're the ultimate Darwinian.
08:42You had to fight for everything.
08:43Anybody else would just slow you down.
08:44Yeah.
08:45I'm still with her, aren't I?
08:47Yeah.
08:47I can only imagine it's because she hasn't given you an excuse to break up.
08:50And you don't have the guts to recognize your own reality.
08:54I want to see my mother.
08:57Hi again.
08:59I'm sure I could say this without being condescending, but then you get the false impression that I respect you.
09:04So, you're a kid.
09:05You're scared.
09:06You're stalling.
09:07Grow up.
09:08I'm not scared.
09:09I'm never scared.
09:11See?
09:12How juvenile was that?
09:13You can't feel pain.
09:15Nothing left but pleasure.
09:17Why don't you tell me how wonderful that is?
09:19It sucks.
09:19Better than being in pain all the time.
09:22Get in the chair.
09:23Every morning, I have to check my eyes to make sure I didn't scratch a cornea in my sleep.
09:27Oh, God, stop.
09:29I'm in a pool of tears here.
09:31I can't cry.
09:32Neither can I.
09:34Every morning, I check my eyes for jaundice in case the Vicodin's finally shot my liver.
09:40I can't run anywhere without examining all my toes for swelling.
09:44I can't run.
09:45Boys can't hold me for too long because I can overheat.
09:48Girls can't hold me for too long because I only pay for an hour.
09:51I need an alarm on my watch to remind me to go to the bathroom.
09:55Now, how many humiliating experiences before I thought of that?
09:58Bathroom's 50 feet from my office.
09:59Every drink of water, I weigh the pros and cons.
10:02After everything I do, I self-check.
10:04Mouth, tongue, and gums for cuts.
10:06Count teeth, check temperature.
10:07Finger, toes, and joints for swelling.
10:09Skin for bruises.
10:10I got shot.
10:17I sat on the stove when I was three.
10:19Wanna see the coil marks?
10:21Yeah.
10:21You think I'm lying?
10:22You think I just wanna check out your tuchus, as your people would say?
10:34Put her in the chair, we're on the damn chest.
10:37If she moves again, give her nitrous.
10:40You weren't shot because of leg pain.
10:41You were shot because you're a jerk.
10:42Some think the two are connected.
10:52He didn't have to do that.
10:54Yeah, he did.
10:56I'm sick?
10:57No.
10:58Your EEG was normal.
10:59X-ray showed no breaks.
11:01Blood test showed no infections.
11:02Urine indicated no.
11:04Uh-huh.
11:07Call the code.
11:09God.
11:10Need ice packs and cooling blankets.
11:14Got Celia in there?
11:15She's not flushed.
11:16She's not sweating.
11:17You must be...
11:17She has a temperature of 105.
11:34Wow.
11:35She's actually sick.
11:36We got our temperature down below boiling.
11:38Could be infection.
11:38No.
11:39LP showed normal proteins and no white blood cells.
11:42Abilirubin.
11:43Could be a liver problem.
11:44Nope.
11:45Transaminases were normal.
11:46Could be drugs.
11:47She smoked pot since she was 11.
11:48No again.
11:49Tox screen is clean.
11:50We're doing this case backwards.
11:52We do the test and then she gets sick.
11:53Maybe we did something to her.
11:55Maybe she got sick after the test.
11:56We should rerun them.
11:59And biopsy a spinal nerve.
12:03You want to risk paralysis because she's got a fever?
12:06I want to risk paralysis because I don't know what's causing the fever.
12:10If it's neurological...
12:11It's a fever.
12:12In a SEPA patient.
12:13Obviously things are a little different in her upstairs wiring.
12:16And have been since the day she was born.
12:18Yeah.
12:19It's much more likely that whatever it is,
12:21was cleverly waiting and hiding until you guys were done testing.
12:24Where are you going?
12:25You're all against this, right?
12:28And you're all going to stand on principle and refuse to do it, right?
12:33I'm going to get Cuddy's approval.
12:38How long are we going to keep Hannah in the dark about her mother?
12:41As long as possible.
12:44The side hair bag should be standard.
12:46I'm sure she'll agree.
12:49She should know her mother's situation.
12:52Breaking that news is that surgeon's problem.
12:57Any word from house?
12:58No.
13:00Maybe Cuddy will say no.
13:03Cuddy never says no.
13:04That's not true.
13:05Nobody ever says no.
13:07We don't say no.
13:08You don't say no.
13:09He'll come back.
13:11He'll browbeat us.
13:12He'll give us seven reasons.
13:13And eventually we'll fold.
13:14We all will.
13:15Not just me.
13:17The only way we can avoid biopsying this kid's spine
13:20is to find the answer some other way.
13:22All the tests were negative.
13:24We need a better history.
13:25How much more paperwork do you need?
13:27We've got pediatric records, a few dozen ER records,
13:30our own admission questionnaire.
13:32What's the first question?
13:34Insurance coverage.
13:36Okay, second question.
13:37Just make your point.
13:40Where does it hurt?
13:42If we knew where it hurt, we could diagnose her.
13:44You do know Sipa means she can't feel pain.
13:46No.
13:47Sipa means she's insensitive to pain.
13:49She still has scattered nerve fibers that could conduct pain,
13:52but the signals don't make it to the brain.
13:54What if we give her more pain signals?
13:57A lot more pain signals.
13:59Maybe some of them will make it through.
14:01You want to torture her?
14:02No.
14:04Yes, we do this to anybody else, it's torture.
14:07Doing it to her is no different than pricking her finger.
14:10We keep poking sharp sticks into her,
14:12eventually we'll find the part that's already tender.
14:20So, what does a dean of medicine do?
14:22Oh, can we please not talk about that?
14:25I will talk about anything else.
14:26I'm just trying to get away from work.
14:28Metaphorically.
14:30Because geographically, the coffee place around the corner from the hospital
14:34probably isn't the furthest you could get.
14:35Well, the snow.
14:37The roads are clearing.
14:39But it's a good place to be a retreat from.
14:44You usually expect your dates to go wrong.
14:46Experiences taught me to have an escape route.
14:49Well, low expectations, that's in my favor.
15:00Whatever happens, I need you to understand that there are certain aspects to my life,
15:04I'm not happy about.
15:07I need the nerve biopsy.
15:09And you had to come here personally to tell me that.
15:12And how did you even know I was here?
15:14I had to bring the file.
15:16This was the most noncommittal location and walking distance.
15:20You left your car keys in your desk.
15:22Greg House!
15:24You two must have met online.
15:27Either that or you've got a friend who secretly hates you.
15:31Uh, Don Herrick.
15:33Yeah, we connected through single-bone-dance-lovers.com.
15:41Why would he volunteer that information?
15:44Why would I hide it?
15:45You didn't tell him that anything he said would be held against you.
15:48So what line of work are you in?
15:50Uh, auto-maintenance.
15:52Changing oil and filters.
15:54Great.
15:54It's my place overcharges.
15:56Can't trust anything you guys say.
15:58Where are you located?
15:59In 14 states.
16:00I own Eastern Lube.
16:07Most SEPA complications are infection, and she's got a fever.
16:10LP, urine...
16:12Clean. Normal.
16:14Same with the white blood cell count.
16:16Cancer?
16:17Nothing on the scan.
16:18I think it's her nerves messing with the temperature control.
16:21Amyloid, sarcoid.
16:22That's a lot of candidates.
16:23I want a biopsy.
16:25Fine.
16:26If that's what you need, go get it.
16:32It seems a lot nicer than that one from WiccaNeedsADaddyfigure.com.
16:44One of these is warm, and the other is very hot.
16:52Start here, move to the hot one, just a few seconds, then back.
16:56We're going to monitor activity in your brain while you do it.
16:59If you feel any response to the heat, it could indicate a vascular problem.
17:10How's my mom doing?
17:12She's okay.
17:13Do you feel anything?
17:16No.
17:18What does okay mean?
17:20She's still in surgery.
17:21They tell me it's going okay.
17:23You can take your hand out.
17:24And you didn't ask anything else?
17:27Take your hand out of the water.
17:29What's going on with my mother?
17:33Emma.
17:36You just got second degree burns.
17:40I'll be fine.
17:42What's going on with my mother?
17:43Is she gonna die?
17:44They said she's okay.
17:46Surgery this long is typical when there are internal injuries.
17:51Laxone and kinase proteins in.
17:54And that's going to make me feel pain?
17:55I didn't feel anything when you guys screwed this thing into my head.
17:58They'll replace missing chemicals in your nerves.
18:00Heightened sensitivity.
18:02We're going to be drilling directly into your skull.
18:04The response should indicate sarcoma.
18:07What does it feel like?
18:08It hurts.
18:11I'm sorry.
18:16Bone pain is the worst there is.
18:18So you need to let me know as soon as you feel anything.
18:21She's ready.
18:24So what?
18:25I just sit here while you guys drill a hole in me?
18:29You want to talk?
18:32Just you and your mom, huh?
18:34You two must be pretty close.
18:36We were.
18:37Until I got arrested.
18:39Third time.
18:41Drugs.
18:41Fights.
18:43You've got an advantage.
18:44Not really.
18:45Never know when to stop.
18:47You piss a lot of people off or you're just trying to piss off your mom?
18:51Those are pretty much the only two choices you have.
19:12It's okay.
19:13What you feel?
19:15Where did you feel it?
19:17Anna, I need to know how it hurt you.
19:32I am so tired of this.
19:35Did you know that the new nurse from cardiology
19:37is sleeping with that weird lawyer from the board?
19:40The guy with 11 fingers?
19:42He has 11 fingers?
19:44How do you not notice that?
19:47The nurse used to be a man.
19:50She's not anymore.
19:51But we can't talk about that.
19:53I thought we were.
19:53We were supposed to talk about that.
19:55I came here to talk about that,
19:56but on the way up, I ran into Cameron.
19:58You've got a SEPA patient.
20:00Hmm.
20:01Tracking nurse is more interesting.
20:03Oh, it's way more interesting,
20:04but instead, I've got to be your damn conscience.
20:06I'm tired of being your conscience.
20:07I don't enjoy being your conscience.
20:09No one enjoys it.
20:09You're studying her.
20:10She's actually sick.
20:12Which you found out after you took her on.
20:14I'm just curious.
20:15Since I'm not a cat, that's not dangerous.
20:17I don't think that metaphor was designed to actually warn cats.
20:21You don't care about her illness.
20:22You care about SEPA,
20:23which means your focus is going to be on getting your answers, not hers.
20:27Forewarned is forearmed.
20:29What do you think you're going to figure out?
20:31You think her lack of pain is somehow the answer to your pain.
20:34I think if you'd stop talking to Cameron,
20:37then right now we could be ranking nurses in order of doability.
20:42Need you.
20:42What did the nerve biopsy show?
20:43Never did it.
20:44Well, then do it.
20:45Can't.
20:45Why?
20:46She's going to jump off the lobby balcony.
20:49You think I can catch her?
20:55Get away from me!
20:56I'm not going to hurt you.
20:57Yes, you are.
20:58You're just jealous I can do anything.
21:00Hannah, you're having a paranoid delusion.
21:02I don't believe you.
21:03Do you think she would?
21:04This is real.
21:05You want me to be a pain.
21:06You even said so.
21:07If we wanted to hurt you, we'd let you jump.
21:10Just let me see my mother.
21:12Fine.
21:13We'll take you to our observation room.
21:15I don't believe you!
21:16Your mother is fine.
21:17I just spoke to a surgeon.
21:18I don't believe you!
21:19Hannah, what do you want from us?
21:21What do you want us to do?
21:24I can't feel my legs.
21:25You're trying to pull the same stunt twice in ten minutes.
21:28I'm not pretending.
21:29They don't hurt.
21:30They're just...
21:31There.
21:46Anything?
21:47We're not looking for pain.
21:49Anything at all?
21:49Pressure?
21:50Nothing.
21:51You have six broken bones, a fever, a concussion, erratic heart rhythms, and a complete lack
21:56of sensation below the waist.
21:57I feel fine.
22:01Has my mother had a surgery yet?
22:03Not yet.
22:06This is excellent.
22:08The paranoia seems to have dissipated, but her vitals keep getting worse.
22:11She could be dead in hours.
22:13But if you're going to die a miserable, lingering death, pain free is the way to do it.
22:18Are we sure the fall didn't cause the paralysis?
22:20Paralysis caused the fall.
22:22Spine's clean.
22:24No vertebral fractures or spinal cord compression.
22:26Even better.
22:28The nuttiness and paralysis mean there's definitely a neurological component.
22:32Could be a nerve disease.
22:33Which is why we need to look at the nerve that you didn't biopsy.
22:36There are other tests.
22:37HIV.
22:38Syphilis.
22:40She was negative for all STDs.
22:42Vascular?
22:43No.
22:43ANA was negative.
22:44Cerebral clot?
22:45No.
22:46MRI was...
22:47Thyroid storm.
22:50Makes sense, given our glucose reaction's slow and potassium's down.
22:56Yeah.
22:57I'll check with an endocrinologist.
23:00Ben, it's on call.
23:02Perfect.
23:16No.
23:17Need a consult.
23:18I already okayed your nerve biopsy.
23:21Need an endocrinologist.
23:22Ben, it's on call.
23:24Won't pick up.
23:25His cell phone must be broken.
23:26Mine's working.
23:28Had to give you the bile.
23:32I assume you're thinking thyroid storm.
23:35He's on a hormone panel?
23:36Normal.
23:37TSH was on the low side.
23:40Is that a cheery fire I hear crackling nearby?
23:43No.
23:44What about CPK enzymes?
23:46Elevated.
23:47275.
23:49Those people light fires for themselves.
23:51But then they don't deny it.
23:55He's here.
23:56The CPK isn't high enough.
23:58Potassium's what you'd expect because of the bronchodilators.
24:01Oh, my God.
24:03You're not wearing a bra.
24:04It's not thyroid storm.
24:06You just met him.
24:07I like him.
24:08And I like sex.
24:09Do I need to stitch a letter on my tops?
24:12No.
24:13Might be worth taking out an ad in the local papers.
24:20Do you like me, house?
24:23I was on the phone with Ben at 15 minutes ago.
24:26His cell phone's working.
24:27Your MO is to avoid me at all costs.
24:30And suddenly, you need my input on every move you make.
24:34I can only assume it's because I'm on a date.
24:36When we met, I noticed...
24:37You noticed he was a Shriner because the way he parted his hair.
24:40You noticed he was a mama's boy because the way he blinked his left eye.
24:42I'm not interested.
24:43I'm not impressed.
24:45There were only two reasons anyone would want to screw with me tonight.
24:48Either they're an altruistic, decent person who's worried about my well-being...
24:53Or...
24:53They want me for themself.
24:57You left out the third option.
25:00Evil bastard who just wants to mess with other people's happiness.
25:08Good night, house.
25:20You won't be bothered again.
25:25It's late.
25:27I should go.
25:28Why?
25:31I part my hair on the left and I'm a Shriner.
25:33You heard the conversation.
25:36I'm not interested in him.
25:38I don't blame you.
25:39I only said those things so that he wouldn't come back.
25:46I don't really care about my job.
25:48I do it well.
25:50I provide a service.
25:51But my goal was always to make enough money to do the things I really like.
25:56Music.
25:57Travel.
25:58I like those things too.
26:00You like them, but they're not really important to you.
26:04I don't know whether it's house, your job,
26:07or if you just thrive on conflict,
26:09but you should hear yourself when you're talking to him.
26:15Nothing else in the world is going on.
26:17You're focused, confident, compelling.
26:25Don't take this the wrong way,
26:27but I'd like to go out with that woman.
26:32I can get her on the phone.
26:47Where did you go?
26:49She's getting worse.
26:50It's not thyroid storm.
26:51Give me a spinal nerve.
26:53There are still other tests.
26:54She just said the girl's getting worse.
26:56You really want to wait?
27:05We'll be risking infection.
27:06Maybe make the paralysis worse.
27:08It is worse.
27:09If we're making it worse than worse,
27:10do the biopsy.
27:11We could paralyze her and get no useful information.
27:14Do the biopsy.
27:15You're thinking peripheral neuropathy.
27:16We should take a nerve a little further away from the spine.
27:18A little further from the truth.
27:19We're talking paralysis.
27:21A good chance the spine is relevant.
27:22If this thing is progressive,
27:24it could kill her in hours.
27:27Give me back my papers.
27:29Is he asking for a spinal nerve?
27:32How did you know?
27:34Give us a minute.
27:41Did you know they recently found a protein
27:43that speeds up nerve growth?
27:46Fascinating stuff.
27:47If you put that protein with the insulation
27:49from a spinal nerve,
27:50you could grow your own little garden.
27:52If that's spinal nerve...
27:53Yeah, yeah, yeah.
27:54If it happened to come from a person with sepa,
27:56I can grow pain-free nerves
27:58and grab them into my own leg.
27:59What an evil plan.
28:00You'd have to be on immunosuppressors for life.
28:03Risk of infection, shorter lifespan.
28:05Shorter, but normal.
28:08Usually jealousy expresses itself
28:09by trying to destroy what someone has.
28:12You're more ambitious.
28:14You actually want to change medical fact
28:16to get this thing used.
28:17It changes all the time.
28:19You're risking your patient's life.
28:20That's how medical fact changes.
28:23A doctor risks...
28:23To serve their patient's health.
28:26Not their own.
28:27This is medically justified.
28:28Are you sure?
28:30Are you sure
28:32that you're the right one
28:33to be making this call?
28:46Biopsy would have a nerve.
28:47You figure you can safely get it.
28:50God, Wilson's annoying.
28:55Past 3 a.m. on Valentine's Day night.
28:57Assume you had a date with Wendy.
29:00She'll survive.
29:01She knows the deal.
29:02Lucky.
29:03I know.
29:05Someday, when there's time,
29:07I would like to actually have a social life.
29:09Someday?
29:10Come on.
29:11If there's one thing a good-looking woman
29:13can have whenever she wants,
29:14it's a social life.
29:15You mean a sex life.
29:17There's nothing wrong with a little companionship
29:19until the real thing comes along.
29:20I had the real thing.
29:22Forgive me if I don't want to settle.
29:24Right.
29:26What does that mean?
29:27Nothing.
29:28You think I didn't have the real thing?
29:30I have no idea what you had.
29:33And yet you're judging it.
29:37It's late.
29:38I'm cranky.
29:39Sorry.
29:40I didn't have the real thing.
29:41How could you even know?
29:42You married a dying man.
29:45You thought,
29:46six months, a year,
29:48it'll be tough,
29:49but then I'll recover
29:50and I'll have the rest of my life.
29:51It's like willingly getting the flu
29:53or joining the Peace Corps.
29:54Short term.
29:55Wow.
29:56You nailed it.
29:57It's basically like a wasted weekend.
29:59The sacrifices you made were huge,
30:02but they were at the height of your love for him.
30:06Commitment is only commitment
30:07because it has no expiration date.
30:09You stand next to someone
30:11and watch them floss for 30 years,
30:13like my parents have,
30:14then ask for sacrifices.
30:16That's how you know the real thing.
30:27Cameron,
30:29I wasn't criticizing you.
30:32People who avoid commitment
30:34are people who know
30:35what a big thing it is.
30:45This isn't right.
30:51SEPA can't cause this much degeneration.
30:53A few nerve fibers we teased out of the center
30:55have some insulation left,
30:57but the insulation around the bundles
30:58has been stripped bare.
30:59This damage must be coming from the outside in.
31:01Which means it's secondary demyelination,
31:04which means the source is somewhere else,
31:05which tells us it's not a nerve disease.
31:07It's something systemic
31:08that's affecting the nerves,
31:10which means that we need to...
31:13Where are you going?
31:15Kate's mom's finally had a surgery.
31:18I'll be right back.
31:24So what?
31:25Hannah should see her.
31:27Yes, immediately after,
31:28we're done chatting about saving her life.
31:31It most likely causes her metabolic.
31:33They found brain swelling.
31:35They're prepping her mother for another surgery.
31:37Again?
31:37So what?
31:38Get a nurse to take the kid.
31:41There are more than 60 different metabolic conditions
31:43that could account for what she's got.
31:45There's only three of you guys.
31:46She's scared.
31:47She should be.
31:48She'll die if we don't diagnose her.
31:50So diagnose her.
32:02Mom.
32:04Mom.
32:09Mom.
32:11Mom.
32:23How bad is it?
32:25Are you okay?
32:28I'm okay, Mom.
32:31It'll get better. I always get better.
32:34Are you checking yourself?
32:36Your temperature?
32:39Mom, could you just let it go?
32:42You shouldn't be worrying.
32:44Oh, baby.
32:46I'm sorry.
32:48I should have seen that car coming.
32:51No.
32:52Oh, I did this to myself.
32:54I screwed up.
32:56You were right.
32:58You were right and I was wrong.
33:00No.
33:02No.
33:03I shouldn't have gone out on the ice.
33:06I shouldn't have fallen down.
33:10And I shouldn't have made you rush me to an ER for the 10th time this year.
33:20Mom?
33:25Mom?
33:26You okay?
33:28Hannah had to take her back to surgery.
33:30Hannah, your BP is way up.
33:32We need to get you some rest.
33:36My hand's wet.
33:39You're crying.
33:40I can't cry.
33:47Oh, my head is killing me.
33:57So, what does the pain tell us?
34:00No tingling or itching so we can rule out...
34:02It tells us nothing.
34:03It wasn't physical pain.
34:04It was emotional.
34:05Exactly.
34:07What were they doing when she got the headache?
34:09Saying goodbye.
34:10You said they were arguing.
34:11They weren't really arguing.
34:12She was just frustrated.
34:13What were they arguing about?
34:15Whose fault it was?
34:19Peripheral neuropathy.
34:20Fever and intermittent paranoia.
34:23Lots of metabolic conditions can explain those things.
34:25But what if we add guilt?
34:29Guilt as a symptom?
34:31Alzheimer's can cause euphoria.
34:33Pain causes depression.
34:35B12 deficiency causes guilt.
34:37Along with all that other stuff.
34:39If she felt guilty, she wouldn't be making her mother's life miserable.
34:42She wouldn't be getting in fights, getting arrested.
34:44Maybe she's fighting because she feels guilty.
34:46She's showing her mom she can take stupid risks and still be safe.
34:49Means mom can let go.
34:50Which is rational.
34:51If guilt is a symptom, it's caused by the illness, not by a thought process.
34:54And it would have to be new.
34:56A couple years ago, she was a model student.
34:57This is pointless.
34:58If the headache was caused by guilt, she has a B12 deficiency.
35:01If it's just because she was sad, it's meaningless.
35:03How the hell do we test for that?
35:04We don't.
35:05Give her a shot of B12, she gets better.
35:08I was right.
35:09We already did.
35:11The ER gave her B12 when she was admitted.
35:13Part of a multivitamin supplement.
35:16Apparently, she's just sad.
35:24Why are you still here?
35:26Trying to get a couple patients into a drug trial.
35:28Paperwork's due tomorrow.
35:29Why are you here?
35:31I still haven't figured out why.
35:33No, I meant here, in my office.
35:35Just dumped a cool B12 theory.
35:38Moved on to leukemia.
35:41Very pedestrian.
35:42I'm not happy.
35:45Her white blood cell count was low.
35:47The one she's got, there's just a whole lot of eosinophils.
35:51The immunoglobulin E-level's borderline.
35:53If you want to be 100% sure, check the bone marrow.
35:56The team's doing a biopsy right now.
36:01It turns out, the weird lawyer knew that she used to be a man.
36:06And he's cool with that?
36:07Turns out that his previous girlfriend also used to be a man.
36:12Oh!
36:19Is it possible for you to just watch me eat?
36:24Or do you get some primeval thrill out of beating the other hunters to the food?
36:38See you later.
36:40You still haven't figured out that I don't need sedation?
36:43So you don't move during the procedure.
36:46Is that nitrous?
36:48What, you trying to kill her?
36:51I gave her nitrous during the EEG.
36:53That's what made this thing rear its ugly.
36:55What thing?
36:56B12 deficiency.
36:57Are you having deja vu?
36:58We've had this conversation.
37:00She was given B12.
37:01She didn't get better.
37:02Because someone else ate it.
37:04Get an abdominal MRI.
37:05What?
37:07What are you doing?
37:08Don't touch me!
37:10Don't touch me!
37:11See, there she goes.
37:12Don't touch me!
37:12Paranoid delusion.
37:15Richie's going down.
37:16Forget the MRI.
37:17We didn't know her.
37:19Help!
37:22Occupy!
37:22Her hernia can wait.
37:24Help!
37:24They're trying to kill me!
37:26Okay.
37:26You can either believe that we really are trying to kill her.
37:29Or you can assume that she's suffering from a medical condition.
37:32Assuming this is a hospital and we're all dressed like doctors and there are easier ways to kill somebody.
37:36Bev helps them.
37:37I'm going to need iodine, scalpel numbers 10 and 15, forceps and a large-ish solid bowl.
37:44Okay, hold her down.
37:47Come on, weenies.
37:48She's in a cast.
37:50Swap.
37:5515.
37:56You're not going to anesthetize her?
37:58Relax.
37:59It's just a magic trick.
38:05She's speaking.
38:07We're not falling for it this time.
38:10You can keep that retracted.
38:18Forceps.
38:33Lake fishing can be fun.
38:35It can bring the generations together.
38:38If you don't cook that trout or perch well, you'll be giving room and board to this fella.
38:46By free board, I mean, I'll be 12 you can take in.
38:49I can have a taper and me.
38:51Likely.
38:52You'd be in a lot of pain.
39:01It's about to be 25 feet long.
39:03Damn it.
39:04World record's over 60.
39:14Huh?
39:16Wake up.
39:18Somebody here to see you?
39:21She's got limited motion on her left side.
39:25You might have to take care of her for a while.
39:28Whoa, whoa, whoa, whoa.
39:31You don't feel it, but you're about to rip your stitches out.
39:35Take care of yourself.
39:36Then you can take care of her.
39:49You haven't gone home.
39:51Sorry I screwed up Valentine's Day.
39:53I'm dating a doctor.
39:56I'd be an idiot to expect anything else.
39:59I did get you a gift.
40:02MGH.
40:04Best teaching hospital in Boston.
40:07You want to be a nurse practitioner?
40:08That's as good as it gets.
40:11Made a few calls and you're in if you want in.
40:15This is why you've been helping me get my surgical hours for accreditation.
40:19I thought you wanted.
40:20Stupid.
40:25You've got ten feet of personal space around you.
40:28I step forward, you step back.
40:31I've shared a lot of things with you.
40:32Which is why you're breaking up with me.
40:37You can't stand to be close.
40:39Wendy, you think I'll stay with you because you're angry with me?
40:42I'm upset.
40:46Because I care.
40:49Only you'd expect an argument to be rational.
40:53You and that ass-poss of yours.
41:19You can ask her for the spinal nerve.
41:23She's got no reason to give it.
41:25She owes you.
41:27The hospital will send her a bill.
41:31I'm just saying.
41:32If you want to do it, do it while her B12 is still low.
41:36Guilt can be your friend.
41:43Breakfast?
41:46Yeah.
41:52Happy Valentine's Day.
41:54It's a holiday that only applies to people who are already paired up.
41:57For everyone else, it's Wednesday.
41:59Well, thank you for that dash of cold water.
42:02Don't get me wrong, I still think true love's out there, it's just very far away, possibly in another galaxy.
42:08We may need to develop faster than like travel before we can make contact.
42:14So I'm thinking we should have sex.
42:18That makes sense.
42:21That makes sense.
42:46We already had sex once and didn't get weird about it.
42:49I get it.
42:49I get it.
42:52So, what if I'm offended by your judgment?
42:55Then you're not the man I'm looking for.
42:59You hit them brown and brown.
43:04Here we go.
43:05Here we go.
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