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00:00Ready, ready?
00:01Are you right?
00:02Are you right?
00:03Are you right?
00:04Back, back, back, back, back, back, back!
00:10That's it!
00:12That's it!
00:12Hey!
00:15Back, back, back, back!
00:17What's the winger?
00:18Good job.
00:18I'm gonna run!
00:20Back, back, back, back!
00:30Yeah!
00:33You all right?
00:55Okay?
00:57Dan?
00:58Dan, talk to me!
01:00Dan!
01:01Dan!
01:03Get a doctor!
01:44Hey!
01:45Close the door!
01:47Close the door!
01:51Is Cuddy down the hall counting to 50?
01:55She knows I'm in here, in the clinic, as she commanded.
01:58She just doesn't know I'm alone.
01:59Well, you've got a full waiting room.
02:01How long do you think you can ignore them?
02:03I'm off at four.
02:05You're doing this to avoid five minutes of work?
02:07I go out there, I get assigned a kid with a runny nose.
02:11That's 30 seconds looking at the nose, 25 minutes talking to a worried mom who won't leave until she's sure
02:15it's not meningitis or tumor.
02:17Yes, concerned parents can be so annoying.
02:19Just tell Cuddy you've got an urgent case.
02:21You had to leave early.
02:22That would be lying.
02:23And that would be wrong.
02:24But luckily, the definition of urgent is fungible.
02:28Not the definition of case, though.
02:33You have no cases?
02:37You have no cases?
02:39You've got hand-picked doctors, specialists working for you, and they're sitting on their hands?
02:46Cameron's answering my mail.
02:48Time well spent, I'm sure.
02:50Foreman and Chase?
02:52Research.
03:00Nine letters.
03:01Iodine deficiency in children.
03:03Crutinism.
03:15So, 4.03 PM.
03:17Dr. House checks out.
03:18Please write that down.
03:19Dr. House.
03:20Sorry, done for the day.
03:22Plenty of docs here to take care of you.
03:23But we had an appointment.
03:25Huh, nice try.
03:26This is a walk-in clinic, which means there are no appointments.
03:28You walk in, sign the chart, and the doctor will see you, just not me.
03:31Your letter says that we'd see you.
03:35Not a big letter writer.
03:37Here.
03:40When did my signature get so girly?
03:44I can explain.
03:45See that G?
03:46See how it makes a big loop on top?
03:48Doesn't even look like my handwriting.
03:51You think I have something?
03:52What's the differential diagnosis for writing G's like a junior high school girl?
03:55It's impossible to get G's through normal channels.
03:57They have called, you know.
03:58Perseverance does not equal worthiness.
04:00Next time you want to get my attention, wear something fun.
04:03Low-rider jeans are hot.
04:05Sixteen-year-old male.
04:06Sudden onset of double vision and night terrors.
04:09With no apparent cause.
04:10The kid's been to two neurologists.
04:11Night terrors?
04:12Yeah, as in big scary monsters?
04:15Yes.
04:19Where are you going?
04:20See the family.
04:22You're going to examine a patient?
04:23Nine times out of ten there's no reason to talk to a patient.
04:26But night terrors in a sixteen-year-old is a very good reason to talk to this family.
04:30Good work.
04:35Margins are fine.
04:38Lesions.
04:40Color is good.
04:42How long have you been having night terrors?
04:45Three weeks.
04:46He's afraid to go to bed.
04:47It's exhausted.
04:48Can barely function.
04:51What does that tell you?
04:52Nothing.
04:53It's just fun watching him blink.
04:55Name as many animals as you can that begin with the letter B. Go.
05:06Baby elephant?
05:07Baby elephant is actually a good answer.
05:09B is a bear of a letter.
05:11What does that tell you?
05:11Proves two things.
05:12No neurological damage.
05:14And your son is never going to be chief fry cook.
05:16In teens there are two likely causes of night terrors.
05:20Post-traumatic stress.
05:21Any recent shootouts at your high school?
05:23No.
05:23Well then, Dave.
05:24Dan.
05:25There's no trauma.
05:26The other cause is...
05:28sexual abuse.
05:30Oh.
05:32So who's molesting you?
05:34Teacher?
05:34Extra friendly neighbor?
05:36I'd ask if either of you were involved but you'd denied.
05:38No, we would never do anything to hurt Dan.
05:40I said here it comes out there.
05:43This lack of response is consistent with abuse.
05:45There's no one, okay?
05:46I swear.
05:48There was trauma.
05:49I got hit in the head during the lacrosse game.
05:52Did you know that he got hit in the head?
05:56They didn't mention it, no.
05:58Yeah.
05:59Why bother?
06:02No, no.
06:03We took him to the ER after the game.
06:05He was scanned.
06:06They tested him.
06:07He said he was fine.
06:08No concussion.
06:09It's gotta be something else.
06:10You hound me for my opinion and then you questioned my diagnosis.
06:13Cool.
06:14ER obviously screwed up.
06:16Kid's got a concussion.
06:17I had double vision before I was hit.
06:18Well, that changes everything.
06:20You need glasses.
06:22That's why you had double vision, which is why you got hit,
06:24which is why you have a concussion,
06:25which is why you have night terrors.
06:27You need to see an ophthalmologist, which I am not.
06:31You enjoyed that.
06:32I brought a reasonable case to your attention
06:34and you shoved it in my face just to humiliate me.
06:36You're an only child, aren't you?
06:38Why would you say that?
06:39Because everything is about you.
06:42This may seem incredibly controversial,
06:44but I think sexual abuse is bad.
06:46I just wanted to make sure he wasn't being diddled by Daddy or Mommy.
06:49Anything else is just a bonus.
07:02I'm not an only child.
07:04Interesting.
07:06What?
07:07Don't move.
07:09Did I bore you in there?
07:11What?
07:12No, not really.
07:13Are you tired?
07:16Sometimes.
07:16He never sleeps.
07:17Of course he's tired.
07:18Right now, at this moment, are you tired?
07:19No, no.
07:20That twitch in your leg.
07:21Did you feel that?
07:24Didn't hurt.
07:25His leg twitched.
07:26I don't see what...
07:26It's called a myoclonic jerk.
07:28It's very common when you're falling asleep.
07:30Respiration rate falls,
07:31and the brain sometimes interprets this as the body dying,
07:34so it sends a pulse to wake it up.
07:35So?
07:35So, he's not asleep.
07:37He's awake.
07:41Admit him.
07:45I recognize that loopy G.
07:49So, what does the jerk tell us?
07:51Nothing good.
07:52The brain's losing control of the body.
07:54Can't order the eyes to focus, regulate sleep patterns, or control muscles.
07:57A movement disorder or degenerative brain disease.
07:59Either way, this kid's gonna be picking up his diploma in diapers in a wheelchair.
08:02Maybe not that bad.
08:03Could be an infection.
08:04You wish.
08:05No fever, no white count.
08:07Anyone think this differential diagnosis might be compromised
08:10because we don't have an accurate family history?
08:12I took an accurate family history.
08:14You didn't even take an accurate family.
08:16His father's not his father.
08:18Why would you say that?
08:1930% of all dads out there don't realize they're raising someone else's kid.
08:22What I've read, false paternity is more like 10%.
08:24That's what our moms would like us to believe.
08:26Who cares?
08:26If he got it from his parents, they'd both be dead by now.
08:28Can we get on with the differential diagnosis?
08:3050 bucks says I'm right.
08:31I'll take your money.
08:32Hit a nerve?
08:33Don't worry, Foreman.
08:34I'm sure the guy who tucked you in at night was your daddy.
08:36Make it 100.
08:37What about leucoencephalopathy in a 16-year-old?
08:41That doesn't necessarily have to be that bad.
08:43If we exclude the night terrors, it could be something systemic.
08:45His liver, kidneys, something outside the brain.
08:48Yes.
08:49Feel free to exclude any symptom if it makes your job easier.
08:52The night terrors were anecdotal.
08:53He could have had a bad dream.
08:54No.
08:54Parents said he was conscious during the event and didn't remember anything afterwards.
08:58That's a night terror.
08:59Parents said?
09:00That's a good point.
09:01Before we condemn this kid, maybe we should entertain Dr. Chase's skepticism.
09:05I want a detailed polysomnograph.
09:06If he's having night terrors, I want to see them.
09:32They usually don't move during night terrors.
09:35I'm not restraining you for them.
09:39EEG revealed abnormalities in your brain that caused nerve damage in your toes.
09:51What are you doing?
09:55Fixing it.
09:56Can I talk to my parents?
09:58Oh, they know all about this.
10:00I'd really like to see them.
10:12Please.
10:13I'd really like them here.
10:17This is gonna hurt, Dan.
10:19Oh, God.
10:37That's a nut, sir.
10:50We did a CT, MRI, CBC, Chem 7, and chest x-ray.
10:54All the tests came back normal.
10:56There's nothing to explain the symptoms.
10:57Okay, but let's pretend there's something and go from there.
10:59Who sees something on this MRI?
11:03No lesions in the white matter.
11:05No structural abnormalities.
11:07No space-occupying tumors.
11:08He's 16, so he should have an absolutely pristine brain.
11:12The smallest thing is abnormal.
11:15Meningeal enhancement.
11:17My bed is viral meningitis.
11:19Excellent.
11:20Did you see what he did there?
11:22He took a small clue that there's a neurological problem
11:24and wasn't afraid to run with it.
11:26There's no evidence of meningitis on that MRI.
11:28No, there's not.
11:29He's completely wrong.
11:30Then what clue are you talking about?
11:32He knew that I saw something on the MRI,
11:34so he figured there must be something there,
11:36and took a guess.
11:37Clever.
11:38But also pathetic.
11:40So what did you find?
11:41Take a close look at the corpus callosum.
11:46It looks okay.
11:48Are we all looking at the same thing?
11:50200 million interhemispheric nerve fibers,
11:52the George Washington bridge
11:54between the left and right side of the brain.
11:57It's subtle.
12:02There's some Boeing.
12:03There.
12:04And up without you.
12:05Are you guessing?
12:08Yes.
12:09Too bad, you're right.
12:10He probably just moved.
12:12Nobody stays perfectly still for the entire MRI.
12:15Yeah, he probably got restless
12:16and shifted one hemisphere of his brain
12:19to a more comfortable position.
12:21Something is pushing on it.
12:22If there was Boeing, it could be a tumor.
12:24Do you see a tumor on this MRI?
12:25No.
12:26But I don't see any Boeing either.
12:27There's no tumor.
12:28Just a blockage causing pressure, causing symptoms.
12:31Today, night terrors.
12:32Tomorrow, he's bleeding out of his eyes.
12:35Get him a radionucleotide cisternogram,
12:37I guarantee you'll see a blockage.
12:41Mm-hmm.
12:45OK.
12:47All right.
12:49Oh, easy.
12:51OK, swisper.
12:58Swisper.
13:10Now I'm injecting a material that's tied with a radioisotope.
13:14It's going to enter your spine and travel up to your brain.
13:19It'll make you able to think deep thoughts, run 100 miles an hour.
13:25Easy.
13:40Their eyes aren't the same color, but that fleck in the eyes.
13:44It's maybe a one in ten chance if they're not related.
13:46No.
13:47House isn't going to pay you based on that.
13:50Any excuse we can give the folks the justified DNA tests?
13:53We could tell him he's got Huntington's.
13:54The whole family should be tested or they'll die.
14:00Hey, there's a lot of blockage.
14:04I was scheduled in for surgery.
14:06We're going to put a shunt into one of the ventricles to give the cerebrospinal fluid an hour.
14:10No more pressure. Everything goes back to normal.
14:13He's lucky to have you as his doctor.
14:23No formula, just mommy's healthy, natural breast milk.
14:29Yummy.
14:30Her whole face just got swollen like this overnight.
14:33Mm-hmm.
14:35No fever.
14:38Glands normal.
14:39Missing her vaccination dates.
14:41We're not vaccinating.
14:45Gribbit.
14:46Gribbit.
14:47Gribbit.
14:49Think they don't work?
14:51I think some multinational pharmaceutical company wants me to think they work.
14:54Pad their bottom line.
14:56Mm-hmm.
14:57May I?
14:59Sure.
15:01Gribbit.
15:02Gribbit.
15:03Gribbit.
15:22Gribbit.
15:23Gribbit.
15:23Gribbit.
15:25Gribbit.
15:26Gribbit.
15:28Gribbit.
15:33Gribbit.
15:48Gribbit.
15:54Gribbit.
16:08Gribbit.
16:10Gribbit.
16:11Gribbit.
16:13Gribbit.
16:24Gribbit.
16:36Gribbit.
16:37Gribbit.
16:38Gribbit.
16:47Gribbit.
16:50Gribbit.
17:05Gribbit.
17:06Gribbit.
17:09Gribbit.
17:24Gribbit.
17:25Gribbit.
17:25Gribbit.
17:26Gribbit.
17:27estas Ä°nsanoge Hoosier.
17:27A lot of dysfuncion, loss of cognitive function, pain.
17:30What's it gonna hurt?
17:34The brain's like a big jumble of wires.
17:37MS strips them of the insulation and the nerves die.
17:40Brain interprets it as pain.
17:42But by starting treatment, we're gonna prevent that for as long as possible.
17:46We're looking into a couple of specialists,
17:48and until we get you squared away, you'll stay here.
17:50Okay?
17:51Okay.
18:12Security check the videotapes from all the cameras.
18:15He's still got to be in the hospital.
18:16Where's Chase?
18:17Main floor.
18:18Okay, you take the cafeteria and administration.
18:20I'll hit the research annex and work my way back to you.
19:00Don?
19:07I'm not here.
19:08Leave a message.
19:09I got it.
19:09You can use your brick to work.
19:11Ready?
19:15Dr. Cutty.
19:17Great outfit.
19:18What are you doing back here?
19:19Patient?
19:20No, Hooker.
19:22Went to my office instead of my home.
19:34Dr. House, Dan's missing.
19:38Yeah, I got that part from the message.
19:40You said I was needed immediately.
19:41He shouldn't move after a lumbar puncture.
19:43I agree. He's going to have a very nasty headache.
19:45That would also be my opinion if consulted tomorrow morning.
19:49We wanted to keep you informed.
19:50He heard some pretty heavy news.
19:54This is not a toddler wandering around a department store.
19:57He's 16. You'll find him.
20:00I'm going home.
20:02So when you say call me if you need anything, you mean don't call me?
20:05No, I mean call me if I can do something.
20:07I'm bad at search parties and I'm bad at sitting around looking nervous doing nothing.
20:11What about his parents? Should we call them?
20:13Why, do you think they're hiding him?
20:16Make sure someone checks the roof.
20:19Some of the orderlies keep the door propped open so they can grab a smoke.
20:22I'm sorry.
20:23I'm sorry.
20:37You're lying.
20:38I'm sorry.
20:44I'm sorry.
20:47I don't know.
20:47I'm sorry.
20:51I'm sorry.
20:52I'm sorry.
20:58Dan, you okay?
21:07There are experimental treatments, ongoing research.
21:11Who knows what they'll discover in a year or two.
21:14This is where I dropped the ball.
21:16Dan, we're standing on the roof of the hospital.
21:20Dan.
21:22Dan, you're not on the field.
21:25He doesn't know where he is.
21:27There.
21:28Foreman.
21:30Dan.
21:33Dan?
21:33Dan, no!
21:45Dr. Foreman.
21:48I assume you found the kid?
21:50He almost walked off the roof.
21:53Suicidal?
21:53No, he thought he was on his lacrosse field.
21:56Look, I was just going to run home, shower, change.
21:58Conscious?
21:59Yeah.
22:01How'd you talk him down?
22:02Actually, Chase tackled him.
22:03How come you didn't do it?
22:05Right, well, I am black, but he was closer.
22:11Warren, you can ride up with me.
22:13Warren, you can ride up with me.
22:19Anybody tell the family that their boy almost stepped off a roof?
22:21They must be thrilled.
22:22They're not suing, but I think only because Chase asked them.
22:25Why does everybody always think I'm being sarcastic?
22:27This is great news.
22:29He doesn't have MS.
22:30Parents should be thrilled.
22:31Well, a mom, anyway.
22:33Of course, the dad probably doesn't know.
22:34Why doesn't he have MS?
22:36He was on the roof thinking he was on all the cross field, conscious and therefore not a night terror.
22:39You want some of this?
22:41Yeah, sure.
22:42He was in an acute, confusional state, which doesn't fit with a demyelinating disease like MS.
22:47Oh, look at clonal bands.
22:48We're real.
22:49They just mean something other than MS.
22:51So, what are they telling us?
22:53The immune system is working?
22:54Right.
22:55He has an infection in his brain.
22:57What about sex?
22:59Well, it might get complicated.
23:01I mean, we work together.
23:02I'm older, certainly, but maybe you'll like that.
23:04I meant maybe his neurosoplus.
23:05Heh.
23:06Nice cover.
23:07Sorry, RPI was negative.
23:08We don't need a definitive test to confirm this.
23:11Sure.
23:11Didn't need one to confirm MS.
23:12Okay, let's wait for you to run titers on 1,400 viruses while this kid's brain turns to mush.
23:17So, the fact that he doesn't have MS, it's really not good news after all.
23:21Well, it is if it's neurosyphilis.
23:23Likelihood of a false negative on an RPR test, 30%.
23:26Likelihood of a 16-year-old having sex, roughly 120%.
23:30I'll start him on IV penicillin.
23:31No, we're not going to wait for that.
23:32The most effective way to deliver the drug is right into his brain by the spine.
23:35We can't.
23:36In a cramped space like the brain, increased intracranial pressure from a high-volume drug
23:40like penicillin could herniate his brainstem and kill him.
23:43A neurologist in his right mind would recommend that.
23:45Show of hands, who thinks I'm not in my right mind?
23:48And who thinks I forget this fairly basic neurological fact?
23:52Who thinks there's a third option?
23:56Very good.
23:57What's the third choice?
23:58No idea.
23:58You just asked if I thought there was one.
24:04The patient has a shunt in his brain.
24:06There'll be no increased pressure.
24:07We can put as much penicillin into his body as we want.
24:10Excellent.
24:10Inject him through a lumbar puncture.
24:15One of us is going to do this to you twice a day for the next two weeks.
24:21He could get syphilis, even if he's not sexually active.
24:28It's unusual, but it's possible.
24:33Relax.
24:47It's infected with a really big hole like you stuck a nail in it to relieve the pressure.
24:53I wouldn't do that.
24:54Although the wound is irregular.
24:55It's not cylindrical, shaped like a triangle, so not a nail.
24:59Steak knife?
25:00Weiss nail file.
25:01Nail file.
25:04Yeah, well, pain will make you do stupid things.
25:07Something to take the edge off?
25:09Yeah.
25:12Cheers.
25:18So, you got family here in Princeton?
25:21No.
25:23You're on work?
25:24No.
25:25Why are you...
25:25Does your penis hurt?
25:26No.
25:27What?
25:28Should it?
25:28No.
25:29Just thought I'd toss you a really inappropriate question.
25:32Your lawyer's gonna love it.
25:34Why would I want to sue you?
25:35I want you to treat me.
25:36You're from Maplewood, New Jersey, right?
25:38Yeah.
25:38Now, why would you drive 70 miles to get treatment for a condition that a nine-year-old could diagnose?
25:46It's the free-flowing pus that's the tip-off.
25:49I was in town.
25:49Not for family, not for work.
25:51You drove 70 miles to a walk-in clinic.
25:54You passed two hospitals on the road.
25:55Now, either you've got a problem with those hospitals or they have a problem with you.
25:59My guess is you've sued half the doctors in Maplewood and the rest are now refusing to help you.
26:03It's ironic, isn't it?
26:05Sort of like the boy who sued Wolf.
26:08You know, I bet we have a doctor here named Wolf.
26:10How perfect would that be?
26:13I'm gonna page him.
26:14Okay.
26:14You know what?
26:15I'm gonna find a doctor to take care of this.
26:17I didn't say I wouldn't treat you.
26:20We'll drain your knee, run some lab work, fix you right up.
26:22Why would you do that?
26:23I'm a people person.
26:26You actually treated him?
26:28All I know is he sued some doctors.
26:29Who am I to assume they didn't have it coming to them?
26:32The cutest little tennis outfit.
26:34My God, I thought I was gonna have a heart attack.
26:35Oh, my, I didn't see you there.
26:37That is so embarrassing.
26:38How's your hooker doing?
26:39Oh, sweet of you to ask.
26:40Funny story.
26:41She was gonna be hospital administrative,
26:43but just hated having to screw people like that.
26:45I heard you found her on the roof.
26:46You have very acute hearing.
26:48You notify the parents?
26:49In due course, of course.
26:51And is there a paternity bet on the father of the patient?
26:55Doesn't sound like me.
26:56Well, it does, actually, but it doesn't mean you're guilty.
26:58You think?
26:59I saw the parents in the lobby.
27:01Smart money's obviously on the father.
27:03My guy knows a guy who can get you in for 50 bucks.
27:05Fine.
27:06Tell your guy if I win,
27:07you attend the Faculty Symposium and you wear a tie.
27:09And if I win, no clinic hours for a week.
27:13My guy will call your guy.
27:17She's very good at her job.
27:23The treatment should start helping soon.
27:25But it's not if it gets easier to focus on things or other stuff.
27:30Hey, Dan.
27:32Isn't Dr. Cameron's necklace a beauty?
27:35Something South American, I think.
27:37Yeah, Guatemalan.
27:40It's a cool necklace.
27:43Thank you so much.
27:45The kid's in pain.
27:48Don't fight it.
27:49Just let it happen.
27:50No.
27:51No what?
27:53Dan?
27:54You okay?
27:55Dan?
27:55Body decomposition once he's in the room.
28:00He's hearing voices.
28:02It's all over.
28:09Push two milligrams IV out of our stack.
28:14Come on, dear.
28:16Come on, dear.
28:16Come on, dear.
28:19Come on, dear.
28:25Psyllin or our diagnosis is wrong.
28:29Square one.
28:32Midnight.
28:33LFTs, BUN, and creatinine are all normal.
28:36Diabetes is out and no gap.
28:37There goes metabolic.
28:38MRI rules at vasculitis.
28:40I for inflammation.
28:41Too young for anything degenerative.
28:43D-C.
28:44N for neoplastic.
28:45MRI was clean.
28:47I for inflammation.
28:49We already did that.
28:50Stupid to have two eyes and one mnemonic.
28:51What's the other one?
28:52Infection.
28:53Logoclonal bands still have to mean something.
28:55But no fevers.
28:55White count's elevated but within range.
28:57And we've tested for anything remotely possible.
28:59Everything's negative.
29:00CT scan.
29:01Rose, that's a dural.
29:02Oh, my.
29:02Later much.
29:08You know the problem?
29:10Midnight is actually spelled with a G and an H.
29:14You just figure out what those letters stand for.
29:21It's a sick brain.
29:23Having fun.
29:26I'm torturing him.
29:27I'm talking to him.
29:33I'm scaring the hell out of him.
29:38Get him an EEG.
29:39Left and right EOG esophageal microphones.
29:43This thing wants to talk.
29:46Let's listen.
29:49We're missing something.
29:51This is screwed up.
29:53That's why you came up with the brain talking to the virus thing?
29:57I panicked.
29:58I panicked.
29:59Sounded cool.
30:00They bought it.
30:05Oh, crap.
30:07Another reason I don't like meeting patients.
30:09They don't know what you look like.
30:10They can't yell at you.
30:12Here we go.
30:18How can you just sit there?
30:21If I eat standing up, I smell.
30:23Our son is dying.
30:25And you could care less?
30:27We're going through hell.
30:29You're doing nothing?
30:31I'm sorry.
30:32You need to bet.
30:33I understand.
30:34Don't be condescending.
30:36You haven't checked in on him once.
30:39Blood pressure is 110 over 70.
30:42The shot is patent.
30:43Well placed in the right lateral ventricle.
30:44The EKG shows a normal QRS.
30:46With deep wave inversions throughout both limb and precordial leads.
30:49LFTs are elevated, but only twice the normal range.
30:52Oh, yeah.
30:52And he's hearing voices.
30:59Go hold his hand.
31:03Go on.
31:04I'll bust your train.
31:19Got any sample bags on you?
31:20I don't believe you.
31:22Going to run DNA tests?
31:24Your son is deathly ill.
31:26I know.
31:26It's terrible.
31:27The fact is, if I don't keep busy with trivial things like this, I'm afraid I might start to cry.
31:31You're an ass.
31:33Yeah?
31:34You want to double the bet?
31:46General Hospital is on Channel 6.
31:49Dan's brain's not showing Channel 6 right now.
31:51Only mush.
31:52No epileptiform activity.
31:56What are you doing?
31:57Waiting for CVC and Chem 7.
31:59Good.
31:59Run DNA on these.
32:03What's this?
32:04Karen's coffee cups.
32:07I can't believe you...
32:08I've had this conversation once already.
32:10If you've got something else to do, do it.
32:11Otherwise, do this.
32:21Dr. House?
32:23Hey, Mr. Funston.
32:24I was wondering when you'd be back.
32:26You got some papers for me?
32:27You've caused me considerable mental distress.
32:30Certainly hope so.
32:32What?
32:32Too cheap to get your lawyer to serve it for you?
32:34Or is it just more fun this way?
32:36I'm obviously prepared to consider a settlement.
32:38You have gonorrhea.
32:42No, I don't.
32:44Well, maybe you're right.
32:44But I have lab results, as you do.
32:46Could be a false positive.
32:48Normally, I'd run a second test.
32:49But since you're here, I'll just go with the first.
32:51You're just trying to scare me.
32:52It's reportable, you know.
32:53It's a public health issue.
32:54I'll be sure to let my wife know.
32:56Oh, don't bother yourself.
32:57The state will call for you.
32:58Look, if you're clean, I'm sure it'll all blow over.
33:00No big deal.
33:01There's an easy way to find out.
33:02Get one of your doctors to run a test.
33:07Uh-uh.
33:08These are mine now.
33:10I'll see you in court.
33:15West Nile negative.
33:16Not surprising, since not too many mosquitoes
33:18passing through Jersey in December.
33:20No, it's an equine encephalitis.
33:21The mother's not going to believe this.
33:22What's that?
33:23House is right.
33:24The father's not the father.
33:27Dude doubled up on me.
33:30You're not going to believe this.
33:32The mother's not the mother, either.
33:36It's not a good idea to move your son in his condition.
33:39We just want a second opinion.
33:41We need an answer.
33:43You idiots.
33:45You lied to me.
33:46We didn't lie about anything.
33:48You, on the other hand, accused us of molesting our son.
33:51Perfect.
33:51Couldn't we get off my screw-ups and focus on theirs?
33:54Theirs is bigger.
33:55You're not Dan's parents.
33:57We're his parents.
33:58He was adopted.
33:59He doesn't need to know.
34:00I do.
34:01Adoption makes us just as much as...
34:02Listen.
34:03When we were taking his medical history, were you confused?
34:06Did you think we were looking for a genetic clue to his condition,
34:08or did you think we were trying to ascertain who loves him the most
34:11in the whole wide world?
34:13How did you find out about this?
34:15I sampled their DNA.
34:17We wouldn't give you any DNA.
34:19Your coffee cups from the cafeteria.
34:21You can't do that.
34:22Again.
34:23Why are we getting hung up on what I did?
34:25Your medical history is useless.
34:27No.
34:27We gave you a detailed history of his biological mother.
34:31Her history.
34:32Non-smoker.
34:33Good health.
34:34Low cholesterol.
34:35No blood pressure problems.
34:37Dan was adopted two weeks after he was born.
34:39You have his history.
34:40There's nothing you need to know that we didn't tell you.
34:42Sounds reasonable.
34:43Well, if you want to transfer your boy, that is your choice.
34:47I still think it's the wrong...
34:49Was she vaccinated?
34:51The biological mother, when she was a baby, did she get her vaccinations?
34:54Dan was vaccinated at six months.
34:57Mm-hmm.
34:59Do you know why kids get vaccinated at six months?
35:02Because before that, they are protected by their biological mother's immune system.
35:07So, was she vaccinated?
35:13An infant picks up a regular old measles virus.
35:16He gets a rash.
35:17He's extremely uncomfortable.
35:19Has a wicked fever.
35:20But he licks.
35:22Here's the kicker.
35:23Once every million or so times, the virus mutates.
35:27Instead of Dan having a fever and a rash, the virus travels to his brain and hides like a time
35:34bomb.
35:34In this case, for 16 years.
35:38Subacute sclerosing panencephalitis.
35:41I know.
35:42There's only been 20 cases in the United States in the last 30 years.
35:45Suppose you can make an argument the kid's still in stage one.
35:48Once SSP moves to stage two...
35:51Boom.
35:51Stage two is universally fatal.
35:54I assume it's impossible to know when he might move into stage two.
35:57He's already started showing symptoms.
35:59Could be a month.
36:00Could be tonight.
36:01Can we treat it?
36:02Ask the neurologist.
36:04Intraventricular interferon.
36:05Not going to shove a spark into his brain and drip interferon without confirming his diagnosis.
36:10Tapping.
36:11We won't get a reliable result from measles antibodies in his CSF.
36:14Not after everything we've given him.
36:15So the wrong treatment kills any hope of the right diagnosis.
36:18Why do people lie to me?
36:22You could also kill him.
36:23You're a ball, Foreman.
36:25Tell me I don't have to biopsy his brain.
36:29Well, there's one other way.
36:33You sure this isn't going to hurt?
36:35Yeah.
36:35It's just scary as hell.
36:37See, we go through the pupil.
36:39You won't feel it.
36:40The eye's been paralyzed.
36:42The needle travels to the back of the eye, which is where we'll perform the biopsy on your retina.
36:52So we've confirmed that the problem is this mutated virus.
36:55The treatment for SSPE is intraventricular interferon.
36:59We implant an Omeyer reservoir under the scalp, which is connected to a ventricular catheter that delivers the antiviral directly
37:06to the left hemisphere.
37:07You want us to consent to this?
37:08I don't even understand what you're talking about.
37:10Well, the antiviral...
37:15Look, I'm sorry.
37:17I can explain this as best I can, but the notion that you're going to fully understand your son's treatment
37:22and make an informed decision is...
37:24It's kind of insane.
37:28Here's what you need to know.
37:31It's dangerous.
37:33It could kill him.
37:35You should do it.
37:38We're...
37:48Did you need something to know?
38:09You can't order a $3,200 DNA test to win a bet.
38:12It's not an actual cost.
38:15I don't know if you know this, but the hospital actually owns the sequencing machine.
38:18I'm serious.
38:19Tell the parents to submit the bill to insurance.
38:21Insurance is not going to pay for a bet.
38:23It should.
38:24We don't make that bet.
38:26The kid dies.
38:27Not for the paternity bet.
38:29I never would have taken their DNA.
38:30Without their DNA, we never would have discovered that Dan was adopted, which was the key to this case.
38:35You just don't want to pay your end.
38:38Big mistake.
38:39My guy knows a guy.
38:41Fine.
38:41I will let you out of clinic duty for one week after you pay the $3,200 for the PCR
38:47test.
38:56Well, now, there's the $100 you owe me.
39:00There's a $100 I won from Cameron.
39:03$200 I took off of Foreman.
39:08And $600 I got from Wilson.
39:13Very bitter.
39:18Hey, good morning.
39:20Good news on your EEG.
39:22Treatment is working.
39:23And your immune system is responding.
39:26I know it's early, but I just want to take a look.
39:32Let's see what that brain of yours can do.
39:34Name as many animals as you can that start with the letter O.
39:39Ostrich.
39:41Ox.
39:42Old elephant.
39:44Well, it's cheek better than last time.
39:47How are you doing with the whole adoption thing?
39:50And you're since fifth grade.
39:52How's that?
39:53Cleft chin.
39:56I have one.
39:57My dad doesn't.
39:59I looked it up on the Internet.
40:00It's one of those trait things.
40:03That's right.
40:04It's autosomal dominant.
40:06Since neither of your parents have cleft chins, it's highly unlikely it's biologically related.
40:13You sure you're okay?
40:15I've got no problems with being a doctor.
40:19I love my parents.
40:23How's he doing?
40:25He's doing pretty well.
40:26He's a smart kid.
40:28I think he's going to be fine.
40:29I think he's going to be fine.
40:31I think he's going to be fine.
40:33You know.
40:34Most of your life will go.
40:39It's back where you used to go.
40:44If grown up, the life is slow.
40:50Or as you watch the outer snow.
40:55Years may go by
41:02Years may go by
41:07So who wanted a special friend?
41:11Wheels, one-eight wheels.
41:13He'd need something to keep him in
41:17Now you stay inside this foolish grave
41:23Though any day your secrets end
41:28Then again years may go by
41:36Years may go by
41:48You saved your own special friend
41:53Cause here you need something to hide in
41:59And you stay inside that foolish grave
42:04When every day their secrets end
42:09Then again years may go by
42:17Years may go by
42:20Years may go by
42:26Years may go by
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