house m d 1 01 pilot
house m d
1x01 pilot
november 16 2004
written by david shore
directed by bryan singer
transcript written by taru
archived at twiz tv com with permission from house transcripts and more
house and other related entities are owned tm and by heel and toe films and bad hat harry productions in association with nbc universal television all rights reserved this transcript is posted here without their permission approval authorization or endorsement any reproduction duplication distribution or display of this material in any form or by any means is expressly prohibited it is absolutely forbidden to use it for commercial gain
why are you late
you're not going to like the answer
i already know the answer
i missed the bus
i don't doubt it no bus stops near brad's you spent the night the alarm didn't work or maybe it did
i didn't sleep with him
girl there's
i missed the bus
there's something either very wrong with you or there's something very wrong with him
there's nothing wrong with him
please tell me you know that for a fact
melanie i gotta go
you're lying aren't you
i wouldn't lie to you good morning guys
good morning miss rebecca
everybody's in their seats
yes
ok sidney why don't you tell us what you did this weekend come on sidney we know you're not shy
how come we always have to tell you what we did and you never tell us what you did
ok i had a really great weekend but you can't tell miss melanie ok
what did you do
i made a new friend it's so much fun to make new friends isn't it
yeah yes ect
girl 2 did you tell you mom and dad about your new friend
absolutely you should never keep anything from your parents and i told them
wh
class
c a t h
the
we know that word the
evil commercials bane of my existence
29 year old female first seizure one month ago lost the ability to speak babbled like a baby present deterioration of mental status
see that they all assume i'm a patient because of this cane
so put on a white coat like the rest of us
i don't want them to think i'm a doctor
you see where the administration might have a problem with that attitude
people don't want a sick doctor
fair enough i don't like healthy patients the 29 year old female
the one who can't talk i liked that part
she's my cousin
and your cousin doesn't like the diagnosis i wouldn't either brain tumor she's gonna die boring
no wonder you're such a renowned diagnostician you don't need to actually know anything to figure out what's wrong
you're the oncologist i'm just a lowly infectious disease guy
hah yes just a simple country doctor brain tumors at her age are highly unlikely
she's 29 whatever she's got is highly unlikely
protein markers for the three most prevalent brain cancers came up negative
that's an hmo lab you might as well have sent it to a high school kid with a chemistry set
no family history
i thought your uncle died of cancer
other side no environmental factors
that you know of
and she's not responding to radiation treatment
none of which is even close to dispositive all it does is raise one question your cousin goes to an hmo
come on why leave all the fun for the coroner what's the point of putting together a team if you're not going to use them you've go three overqualified doctors working for you getting bored
it's a lesion
and the big green thing in the middle of the bigger blue thing on a map is an island i was hoping for something a bit more creative
shouldn't we be speaking to the patient before we start diagnosing
is she a doctor
no but
everybody lies
dr house doesn't like dealing with patients
isn't treating patients why we became doctors
no treating illnesses is why we became doctors treating patients is what makes most doctors miserable
so you're trying to eliminate the humanity from the practice of medicine
if you don't talk to them they can't lie to us and we can't lie to them humanity is overrated i don't think it's a tumor
first year of medical school if you hear hoof beets you think horses not zebras
are you in first year of medical school no first of all there's nothing on the cat scan second of all if this is a horse then the kindly family doctor in trenton makes the obvious diagnosis and it never gets near this office differential diagnosis people if it's not a tumor what are the suspects why couldn't she talk
aneurysm stroke or some other ischemic syndrome
get her a contrast mri
creutzfeld jakob disease
mad cow
mad zebra
wernickie's encephalopathy
no blood thiamine level was normal
lab in trenton could have screwed up the blood test i assume it's a corollary if people lie that people screw up
re draw the blood tests and get her scheduled for that contrast mri asap let's find out what kind of zebra we're dealing with here
i was expecting you in my office 20 minutes ago
really well that's odd because i had no intention of being in your office 20 minutes ago
you think we have nothing to talk about
no just that i can't think of anything that i'd be interested in
i sign your paychecks
i have tenure are you going to grab my cane now stop me from leaving
that would be juvenile
i can still fire you if you're not doing your job
i'm here from 9 to 5
your billings are practically nonexistent
rough year
you ignore requests for consults
i call back sometimes i misdial
you're 6 years behind on your obligation to this clinic
see i was right this doesn't interest me
6 years times 3 weeks you owe me better then 4 months
it's 5 00 i'm going home
to what
nice
look dr house the only reason that i don't fire you is because your reputation still worth something to this hospital
excellent we have a point of agreement you aren't going to fire me
your reputation won't last up if you don't do your job the clinic is part of your job i want you to do your job
well like the philosopher jagger once said you can't always get what you want
you aren't my doctor are you dr house
thankfully no i'm dr chase
dr house is the head of diagnostic medicine he's very busy but he has taken a keen interest in your case
we inject gadolinium into a vein it distributes itself throughout your brain and acts as a contrast material for the magnetic resonance imagery
basically whatever's in your head lights up like a christmas tree
it might make you feel a little light headed
dr cameron i'm sorry i have to stop you there's a problem
you pulled my authorization
yes why are you yelling
no mris no imaging studies no labs
you also can't make long distance phone calls
if you're gonna fire me at least have the guts to face me
or photocopies you're still yelling
i'm angry you're risking a patient's life
i assume those are two separate points
you showed me disrespect you embarrassed me and as long as i'm still work here you have
is your yelling designed to scare me because i'm not sure what i'm supposed to be scared of more yelling that's not scary that you're gonna hurt me that's scary but i'm pretty sure i can outrun ya
oh i looked into that philosopher you quoted jagger and you're right you can't always get what you want but as it turns out if you try sometimes you get what you need
so because you want me to treat patients you aren't letting me treat patients
i need you to do your job
do the mri she folded i've gotta do four hours a week in this clinic until i make up the time i've missed 2054 i'll be caught up in 2054 you better love this cousin a whole lot
all right rebecca we know you may feel a little claustrophobic in there but we need you to remain still
ok we're gonna begin
i don't feel so good
it's all right just try to relax
rebecca rebecca rebecca get her out of there
ah she probably fell asleep she's exhausted
she was claustrophobic 30 seconds ago she's not sleeping
it'll just be another minute
she's having an allergic reaction to gadolinium she'll be dead in two minutes
hold her neck
oh she's ashen
she's not breathing epi point five
come on i can't ventilate
too much edema where's the surgical airway kit
yep coming
good call
and we're back to commercials blah
we'll get that tube out of your throat later today
just get some rest for now
told you can't trust people
she probably knew she was allergic to gadolinium figured it was an easy way to get someone to cut a hole in her throat
can't get a picture gonna have to get a thousand words
you actually want me to talk to the patient get a history
we need to know if there's some genetic or environmental causes triggering an inflammatory response
i thought everybody lied
truth begins in lies think about it
that doesn't mean anything does it
12 52 pm dr house checks in please write that down do you have cable tv here somewhere general hospital starts in 8 minutes
no tv but we've got patients
can't you give out the aspirin yourself i'll do paperwork
i made sure your first case was an interesting one
cough just won't go away runny nose looks a funny color
patient admitted complaining of back spasms
i think i read about something like that in the new england journal of medicine
patient is orange
the color
no the fruit
you mean yellow it's jaundice
i mean orange
well how orange
exam room 1
i was playing golf and my cleat got stuck i mean it hurt a little but i kept playing the next morning i could barely stand up well you're smiling so i take it that means this isn't serious
what's that what are you doing
painkillers
oh for you for your leg
no cause they're yummy you want one it'll make your back feel better
unfortunately you have a deeper problem your wife is having an affair
what
you're orange you moron it's one thing for you not to notice but if your wife hasn't picked up on the fact that her husband has changed color she's just not paying attention by the way do you consume just a ridiculous amount of carrots and mega dose vitamins
the carrots turn you yellow the niacin turns you red get some finger paints and do the math and get a good lawyer
deep breath
it's cold
has he been using his inhaler
not in the past few days he's um only ten i worry about children taking such strong medicine so frequently
what happened to your leg
your doctor probably was concerned about the strength of the medicine too she probably weighed that danger against the danger of not breathing oxygen is so important during those prepubescent years don't you think ok i'm gonna assume that no body's ever told you what asthma is or if they have you had other things on your mind a stimulant triggers cells in your child's airways to release substances that inflame the air passages and cause them to contract mucus production increases cell lining starts to shed but the steroids the steroids stop the inflammation the more often this happens
what the more often this happens what
forget it if you don't trust steroids you shouldn't trust doctors
my mother passed away three years ago she had a heart attack and my father broke his back doing construction
it's house it's urgent i'm sorry
you couldn't have knocked
steroids give her steroids high doses of prednisone
you're looking for support for a diagnosis of cerebral vasculitus
inflammation of the blood vessels in the brain is awfully rare especially for someone her age
so is a tumor her sed rate was elevated
mildly
that could mean anything or nothing
yeah i know i have no reason to think that it's vasculitus except that it could be
if the blood vessels were inflamed that's gonna look exactly like what we saw on the mri from trenton county and the pressure's gonna cause neurological symptoms
you can't diagnose that without a biopsy
yes we can we treat it if she gets better we know that we're right
and if we're wrong
we learn something else
why steroids
it's par to your treatment you haven't had many visitors no boyfriend
three dates i wouldn't have stood by him if her were vomiting all day
well what abut work you must have friends from work
pretty much everybody i like is 5 years old a nurse said you're stopping my radiation
we're just trying some alternative medications so where's your family from then
steroids aren't an alternative to radiation
the tests weren't really conclusive
we're treating you for vasculitus it's the inflammation of blood vessels in the brain
it's not a tumor i don't have a tumor
you should have told her the truth it's a long shot guess
thank you if house is right no harm if he's wrong we've given a dieing woman a couple days hope
false hope
if there was any other type available i would have given her that
why are you smelling billy's pants
i'm not
looked like you were
i was smelling the floor
oh
do you have any pets in this class
no but we used to have a gerbil but carly l dropped a book on it
careless
do you need to smell it
no i'm smelling for mold i don't need to smell it
you can smell our parrot
you said you didn't have any pets in this class
a parrot is a bird
parrots are the primary source of psitticosis
it's not the parrot
psitticosis can lead to nerve problems and neurological complications
how many kids were there in the class
20
how many are home sick
none but
none but you think that 5 year olds are more serious about bird hygiene then their teacher you've been through her home
she lives in trenton i can go up to her room tomorrow morning and ask her for the key
would the police call for permission before dropping by to check out a crime scene
it's not a crime scene
far as i know she's running a meth lab out of her basement
she's a kindergarten teacher
and if i was a kindergarten student i would trust her implicitly ok i'll give you a for instance the lady back there who made your egg salad sandwich her eyes look glassy did you notice that now hospital policy is to stay home if you're sick but if you're making 8 00 an hour then ya kinda need the 8 00 an hour right the sign in the bathroom says that employees must wash after using the facilities but i figure that somebody who wipes snot on a sleeve isn't hyper concerned about sanitary conditions so what do ya think should i trust her i want you to check the patient's home for contaminants garbage medication
whoa oh i can't just break into someone's house
isn't that how you got into the felker's home yeah i know court records are sealed you were 16 it was a stupid mistake but your old gym teacher has a big mouth you should write a thank you note
i should thank him
well i needed somebody around here with street smarts ok knows when you're being conned knows how to con
i should sue you
i'm pretty sure you can't sue somebody for wrongful hiring
but i'm pretty sure i can sue if you fire me for not breaking into some lady's house
i'm doing research people are fascinating aren't they
why are you giving adler steroids
well she's my patient that's what you do with patients you give them medicine
you don't prescribe medicine based on guesses at least we don't since tuskeegee and mengele
you're comparing me to a nazi nice
i'm stopping the treatment
she's my patient
it's my hospital
i did not get her sick she is not an experiment i have a legitimate theory about what's wrong with her
with no proof
there's never any proof 5 different doctors come up with 5 different diagnoses based on the same evidence
you don't have any evidence and nobody knows anything huh then how is it that you always assume you're right
i don't i just find it hard to operate on the opposite assumption and why are you so afraid of making a mistake
because i'm a doctor because when we make mistakes people die
come on
people used to have more respect for cripples you know they didn't really
cuddy so how ya feeling
much better thanks are you dr house i thought he was a he but
no don't eat too much too fast
thank him for me
right
should i discontinue the treatment boss
you got lucky
cool huh
ok once again
good
am i ever gonna meet dr house
well you might run into him at the movies or on the bus
is he a good man
he's a good doctor
can you be one without the other don't you have to care about people
caring's a good motivator he's found something else feel this
umhmm
how about this
umhmm
ok squeeze harder all right
he's your friend huh
yeah
does he care about you
i think so
you don't know
as dr house likes to say everybody lies
it's not what people say it's what they do
yes he cares about me
i can't see i can't see
a little help in here
commercial again evil
your chest will be sore for a while we needed to shock you to get your heart going ok can you arrange these to tell a story
she couldn't put them in order
could the damage have been caused by a lack of oxygen during her seizure
no i gave her the same test 5 minutes later and she did just fine the altered mental status is intermittent just like the verbal skills
so what now
given the latest symptoms it's clearly growing deeper into the brain stem soon she won't be able to walk she'll go blind permanently and then the respiratory center will fail
how long do we have
if it's a tumor we're talking a month maybe two if it's infectious a few weeks if it's vascular that'll probably be fastest of all maybe a week
we're gonna stop all treatment
i still think it's a tumor i think we should go back to the radiation
she didn't respond to the radiation
well maybe we didn't see the effects until we started steroids
no it's not a tumor the steroids did something i just don't know what
so we're just gonna do nothing we're just gonna watch her die
yeah we're gonna watch her die specifically we're gonna watch how fast she's dieing you just told us each diagnosis has its own timeframe when we see how fast it's killing her we'll know what it is
and by then maybe there's nothing we can do about it
there's go to be something we can do something better then watching her die
well i got nothing how bout you
bastard oh cameron i need you for a couple of hours
what's up
when you break into someone's house it's always better to have a white chick with you
adler's house why don't we just ask her for a key
for all we know she could be running a meth lab out of her basement
i'm tired a lot
any other reason you think you may have chronic fatigue syndrome
it's kinda the definition isn't it
it's kinda the definition of getting older
i had a couple headaches last month mild fever sometimes i can't sleep and i have trouble concentrating
apparently not while researching this stuff on the internet
i was thinking it also might be fibromyalgia
excellent diagnosis
is there anything for that
ya know i think there might just be
i need 36 vicodin and change for a dollar
jumbled i can't tell
exam room 2
house doesn't believe in pretense figures life's too short and too painful so he just says what he thinks
nothing interesting in the garbage i say what i think is just another way of saying i'm an ass
well if you wanted to be judged on your medical prowess only maybe you shouldn't have broken into someone's home
i was 16 don't know about ticks but her dog's definitely got fleas
i managed to make it to 17 without a criminal record
yeah well you obviously didn't grow up in my neighborhood
that's right you stole a loaf of bread to feed your starving family right you always eat during break ins
am i supposed to respect their food more then i respect their dvd players you want some
no
you gonna go hungry until she dies
no
you know what after centuries of oppression decades of civil rights marches and more significantly living like a monk never getting less then a 4 0 gpa you don't think it's kind of disgusting i get one of the top jobs in the country because i'm a delinquent we'll eat then we'll tear up the carpet
you went to hopkins right
yep
so you went to a better school then i did got better grades then i did
so how'd you get the job did you stab a guy in a bar fight
nothing
it's not a tumor she's getting worse too fast she can't stand up
no toxins no medication
nothing that would explain these symptoms
family history of neurological problems
not that i could tell from her underwear drawer
you said nothing that would explain these symptoms what did you find that doesn't explain these symptoms
dr wilson convinced you to treat this patient under false pretenses adler's not his cousin
that's ridiculous you can ask her yourself can we get back to
she's not jewish
rachel adler's not jewish
i had ham at her apartment
dr foreman a lot of jews have non jewish relatives and most of us don't keep kosher i can see getting through high school without learning a thing about jews but medical school
ok maybe she's jewish but she's definitely not your cousin
really this guy's he
you don't even know her name you called her rachel her name is rebecca
yes yes her name is rebecca i call her rachel
while this is going on house is very quiet and you can almost see that he is putting things together
you idiot
hey listen
not you him you said you didn't find anything
everything i found was in
you found ham
so
where there's ham there's pork where there's pork there's neurocysticercosis
tapeworm you think she's got a worm in her brain
it fits could have been living there for years it never occurred to me
millions of people eat ham every day it's quite a leap to think that she's got a tapeworm
ok mr neurologist what happens when you give steroids to a person who has a tapeworm
they they get a little better and then they get worse
just like rebecca adler did
in a typical case if you don't cook pork well enough you ingest live tapeworm larvae they got these little hooks they grab onto your bowel they live they grow up they reproduce
reproduce there's only got one lesion and it's nowhere near her bowel
that's because this is not a typical case tapeworm can produce 20 to 30 000 eggs a day guess where they go
out
not all of them unlike the larvae the egg can pass right through the walls of the intestines and into the blood stream and where does the blood stream go
everywhere
as long as it's healthy the immune system doesn't even know it's there the worm builds a wall uses secretions to shut down the body's immune response and control fluid flow it's really kinda beautiful
as long as it's healthy so what do we do call a vet and nurse the little guy back to health
it's too late for that it's dying and as it dies this parasite loses the ability to control of the host's defenses the immune system wakes up and attacks the worm and everything starts to swell and that is very bad for the brain
it could still be a hundred other things the eosinophil count was normal
it's only abnormal in 30 of cases
proving nothing
no no no no you see it fits it's perfect it explains everything
but it proves nothing
i can prove it by treating it
no you can't i was just with her she doesn't want any more treatments she doesn't want any more experiments she wants to go home and die
commercials gah i wish commercials would go home and die
will you excuse us please
i'm dr house
it's good to meet you
you're being an idiot ahem you have a tapeworm in your brain it's not pleasant but if we don't do anything you'll be dead by the weekend
have you actually seen the worm
when you're all better i'll show you my diplomas
you were sure i had vasculitus too now i can't walk and i'm wearing a
diaper what's this treatment gonna do for me
i'm not talking about a treatment i'm talking about a cure but because i might be wrong you want to die
what made you a cripple
i had an infarction
a heart attack
it's what happens when the blood flow is obstructed if it's in the heart it's a heart attack if it's in the lungs it's a pulmonary embolism if it's in the brain it's a stroke i had it in my thigh muscles
wasn't there something they could do
there was plenty they could do if they made the right diagnosis but the only symptom was pain not may people get to experience muscle death
did you think you were dying
i hoped i was dying
so you hide in your office refuse to see patients because you don't like the way people look at you you feel cheated by life so now you're gonna get even with the world you want me to fight this why what makes you think i'm so much better then you
when you're scared you'll turn into me
i just want to die with a little dignity
there's no such thing our bodies break down sometimes when we're 90 sometimes before we're even born but it always happens and there's never any dignity in it i don't care if you can walk see wipe your own ass it's always ugly always you can live with dignity we can't die with it
no treatment
maybe we can get a court order override her wishes claim she doesn't have the capacity to make this decision
but she does
but we could claim that the illness made her mentally incompetent
pretty common result
that didn't happen here
he's not gonna do it she's not just a file to him anymore he respects her
so because you respect her you're going to let her die
i solved the case my work is done
patients always want proof we're not making cars here we don't give guarantees
i think we can prove it's a worm it's noninvasive it's safe i'm not completely sure but
yeah yeah yeah what's the damn idea
have you ever seen a worm under an x ray a regular old no contrast 100 year old technology x ray they light up like shotgun pellets just like on a contrast mri
which is the same thing as a ct scan which we did which proved nothing
worm cysts is the same density as the cerebrospinal fluid we're not going to see anything in her head but chase is right he's right we should x ray her but we don't x ray her brain we x ray her leg worms love thigh muscle if she's got one in her head i guarantee you there's one in her leg
hold still rebecca
this here is a worm larva
so if it's in my leg it's in my brain
are you looking for a guarantee it's there probably been there 6 to 10 years
could i have more
probably it's good news
what do we do now
now we get you better albendazole
two pills
yeah every day for at least a month with a meal
two pills
yeah possible side effects include abdominal pain nausea headache dizziness fever and hair loss we'll probably make you keep taking the pills even if you get every one of those
why did you hire me
does it matter
kinda hard to work for a guy who doesn't respect you
why
is that rhetorical
no it just seems that way because you can't think of an answer does it make a difference why i think i'm a jerk the only thing that matters is what you think can you do the job
you hired a black guy because he had a juvenile record
no it wasn't a racial thing i didn't see a black guy i just saw a doctor with a juvenile record i hired chase cause his dad made a phone call i hired you because you are extremely pretty
you hired me to get into my pants
i can't believe that that would shock you it's also not what i said no i hired you because you look good it's like having a nice piece of art in the lobby
i was in the top of my class
but not the top
i did an internship at the mayo clinic
yes you were a very good applicant
but not the best
would that upset you really to think that you were hired because of some genetic gift of beauty not some genetic gift of intelligence
i worked very hard to get where i am
but you didn't have to people choose the paths that grant them the greatest rewards for the least amount of effort that's the law of nature and you defied it that's why i hired you you could have married rich could have been a model you could have just show up and people would have given you stuff lots of stuff but you didn't you worked your stunning little ass off
am i supposed to be flattered
gorgeous women do not go to medical school unless they're as damaged as they are beautiful were you abused by a family member
no
sexually assaulted
no
but you are damaged aren't you
i have to go
i followed her i couldn't stop thinking about what that doctor said
i told you not to listen to him he's an idiot
i was orange
i don't want to know what you found out
you don't care
i'm your doctor you've been good to me and good to this hospital of course i care but i don't see how this conversation can end well for me either your wife is having an affair or she's not having an affair and you have come here because you rightly think i should fire him but i can't even if it cost me your money the son of a bitch is the best doctor we have
feeling any better
i can't complain
as you know the hospital has certain rules and as you also know we tend to ignore them but i think this one's gonna be a little obvious unless we get your help
if anyone asks you have 11 daughters and 5 sons
hi you guys
hi
come here
it's so good to see you guys i missed you is this for me
oh i love you guys i wanted to thank dr house but he never visited again
he cured you you didn't cure him
ok i want a hug and a kiss from every single one of you get up here right now
female dr on mini tv there
hold on
female dr on mini tv she's converted
you said she was your cousin why would you lie
it got you to take the case
you lied to a friend to save a stranger you don't think that's screwed up
you've never lied to me
i never lie
oh really
why do we do this
female dr on mini tv because we're doctors when we make mistakes people die
dr house you have a patient
he says he needs a refill
got change for a dollar
no you can't always get what you want you can't always get what you want
the end
house m d 1 02 paternity
house m d
1x02 paternity
november 23 2004
written by lawrence kaplow
directed by peter o'fallon
transcript written by taru
archived at twiz tv com with permission from house transcripts and more
house and other related entities are owned tm and by heel and toe films and bad hat harry productions in association with nbc universal television all rights reserved this transcript is posted here without their permission approval authorization or endorsement any reproduction duplication distribution or display of this material in any form or by any means is expressly prohibited it is absolutely forbidden to use it for commercial gain
player 1 on your right on your right
player 2 back back back
dan's dad yeah dan
player 3 back back back back
player 4 watch the winger
you ok dan dan talk to me dan dan get a doctor
commercial blah i know that we couldn't have tv without them but yuck
hey
close the door close the door
is cuddy down the hall counting to 50
she's knows i'm in here the clinic as she commanded she just doesn't know i'm alone
well you've got a full waiting room how long do you think you can ignore them
i'm off at 4 00
you're doing this to avoid 5 minutes of work
i go out there i get assigned a kid with a runny nose that's 30 seconds looking at the nose 25 minutes talking to a worried mom who won't leave until she sure it's not meningitis or a tumor
yes concerned parents can be so annoying just tell cuddy you've got an urgent case you had to leave early
that would be lying
and that would be wrong but luckily the definition of urgent is fungible
not the definition of case though
you have no cases you have no cases you've got hand picked doctors specialists working for you and they're sitting on their hands
cameron is answering my mail
time well spent i'm sure foreman and chase
research
9 letters iodine deficiency in children
cretinism
huh
so 4 03 pm dr house checks out please write that down
dan's dad dr house from now on he'll just be called dad
sorry done for the day there's plenty of docs here to take care of you
but we had an appointment
hah nice try but this is a walk in clinic which means there are no appointments it means you walk in sign the chart and a doctor will see you just not me
but your letter says that we would see you
not a big letter writer
here
cut onto the letter now in house's office
when did my signature get so girly
i can explain
see that g see how it makes a big loop on top it doesn't even look like my handwriting think i have something what's the differential diagnosis for writing g's like a junior high school girl
it's impossible to get to you through normal channels they have called
perseverance does not equal worthiness next time you want to get my attention wear something fun low rider jeans are hot
16 year old male sudden onset of double vision and night terrors with no apparent cause the kid's been to 2 neurologists
night terrors yeah as in big scary monsters
yeah
where are you going
to see the family
you're going to examine a patient
9 times out of 10 there's no reason to talk to a patient but night terrors in a 16 year old is a very good reason to talk to this family good work
margins look fine no lesions color is good how long have you been having night terrors
three weeks
he's afraid to go to bed he's exhausted he can barely function
what does that tell you
nothing it's just fun watching him blink name as many animals that begin with the letter b go
baby elephant
baby elephant is actually a good answer b is a bear of a letter
what does that tell you
proves two things no neurological damage and your son is never going to be chief fry cook in teens there are two likely causes of night terrors post traumatic stress any recent shootouts at your high school
no
well then dave
dan
if there's no trauma the other cause is sexual abuse so who's molesting you teacher extra friendly neighbor i'd ask if either one of you were involved but you'd deny it
we would never do anything to hurt dan
i say it here it comes out there this lack of response is consistent with abuse
there's no one ok i swear there was trauma i got hit in the head during a lacrosse game
did you know that he got hit in the head
they didn't mention it no
yeah why bother
no no we took him to the er after the game he was scanned they tested him they said he was fine no concussion it's gotta be something else
you hound me for my opinion and then question my diagnosis cool er obviously screwed up kid's got a concussion
i had double vision before i got hit
well that changes everything you need glasses that's why you had double vision which is why you got hit which is why you have a concussion which is why you have night terrors you need to see an ophthalmologist which i am not
you enjoyed that i brought a reasonable case to your attention and you shoved it in my face just to humiliate me
you're an only child aren't you
why would you say that
everything is about you this may seem incredibly controversial but i think sexual abuse is bad i just wanted to make sure he wasn't being diddled by daddy or mommy anything else is just a bonus
i'm not an only child
interesting
what
don't move did i bore you in there
what ah no not not really
are you tired
sometimes
he never sleeps of course he's tired
right now at this moment are you tired
no no
that twitch in your leg did you feel that
didn't hurt
his leg twitched i don't see what
it's called a myoclonic jerk it's very common when you're falling asleep respiration rate falls and the brain interprets this as the body dying so it sends a pulse to wake it up
so
so he's not asleep he's awake admit him
i recognize that loopy g so what does the jerk tell us
nothing good the brain's losing control of the body can't order the eyes to focus regulate sleep patterns or control muscle movements
a movement disorder or degenerative brain disease either way this kid's gonna be picking up his diploma in diapers and a wheelchair
maybe not that bad could be an infection
you wish no fever no white count anyone think this differential diagnosis might be compromised because we don't have an accurate family history
i took an accurate family history
you didn't even take an accurate family his father's not his father
why would you say that
30 of all dads out there don't realize they're raising someone else's kid
from what i've read false paternity is more like 10
that's what our mom's would like us to believe
who cares if he got it from his parents they'd both be dead by now can we get on with the differential diagnosis
50 bucks says i'm right
i'll take your money
hit a nerve don't worry foreman i'm sure the guy who tucked you in at night was your daddy
make it 100
what about leucoencephalopathy in a 16 year old
it doesn't necessarily have to be that bad if we exclude the night terrors it could be something systemic his liver kidneys something outside the brain
yes feel free to exclude any symptom if it makes your job easier
the night terrors were anecdotal he could have had a bad dream
no parents said he was conscious during the event and didn't remember anything afterwards that's a night terror
parents said
that's a good point before we condemn this kid maybe we should entertain dr chase's skepticism i want a detailed polysomnograph if he's having night terrors i want to see them
i usually don't move during night terrors
i'm not restraining you for them eeg revealed abnormalities in your brain caused by nerve damage in your toes
what are you doing
fixing it
can i talk to my parents
oh they know all about this
i'd really like to see them please i'd really like them here
this is gonna hurt dan
oh god
that's a night terror
commercials blah a stupid one about batteries on my tape i don't care about the bloody batteries i want more house
we did a ct mri cbc chem 7 and chest x ray all the tests came back normal there's nothing to explain his symptoms
ok but let's pretend there's something and go from there who sees something on this mri
no lesions no white matter
no structural abnormalities
no space occupying tumors
he's 16 so he should have an absolutely pristine brain the smallest thing is abnormal
meningeal enhancement my bet is viral meningitis
excellent you see what he did there he took a small clue that there's a neurological problem and wasn't afraid to run with it
there's no evidence of meningitis on that mri
no there's not he completely wrong
then what clue are you talking about
he knew that i saw something on the mri so he figured there must be something there and took a guess clever but also pathetic
so what did you find
take a close look at the corpus collosum
it looks ok
are we all looking at the same thing 200 million interhemispheric nerve fibers the george washington bridge between the left and right side of the brain it's subtle
there's some bowing there an upward arch
are you guessing
yes
too bad you're right
he probably just moved nobody stays perfectly still for their entire mri
yeah he probably got restless and shifted one hemisphere of his brain to a more comfortable position something is pushing on it
if there's bowing it could be a tumor
do you see a tumor on this mri
no but i don't see any bowing either
there's no tumor just a blockage causing pressure causing symptoms today
night terrors tomorrow he's bleeding out of his eyes get him a radionucleotide cisternogram i guarantee you'll see a blockage
ok all right easy
now i'm injecting a material that's tagged with a radioactive isotope it's gonna enter your spine and travel up to your brain it'll make you able to think deep thoughts at about 100 miles per hour
easy
their eyes aren't the same color but that fleck in the eyes that's maybe a one in ten chance if they're not related
nah house isn't gonna pay you based on that
any excuse we can give the folks to justify a dna test
we could tell them he's got huntington's the whole family should be tested or they'll all die
hey there's a lot of blockage
i've scheduled him for surgery they're gonna put a shunt into one of the ventricles to give the cerebrospinal fluid an out
no more pressure everything goes back to normal
he's lucky to have you as his doctors
no formula just mommy's healthy natural breast milk
yummy
her whole face just got swollen like this overnight
mmhmm no fever glands normal missing her vaccination dates
we're not vaccinating
gribbit gribbit gribbit
think they don't work
i think some multinational pharmaceutical company wants me to think they work pad their bottom line
mmmm may i
sure
gribbit gribbit gribbit all natural no dies that's a good business all natural children's toys those toy companies they don't arbitrarily mark up their frogs they don't lie about how much they spend in research and development the worst a toy company can be accused of is making a really boring frog
gribbit gribbit gribbit you know another really good business teeny tiny baby coffins you can get them in frog green or fire engine red really the antibodies in yummy mummy only protect the kid for 6 months which is why these companies think they can gouge you they think that you'll spend whatever they ask to keep your kid alive want to change things prove them wrong a few hundred parents like you decide they'd rather let their kid die then cough up 40 bucks for a vaccination believe me prices will drop really fast gribbit gribbit gribbit gribbit gribbit
tell me what she has
a cold
there's a problem
complications in surgery
surgery went fine he's in recovery but we took a vial of csf and tested it
really
turns out the bowing wasn't the cause of his problems it was a symptom
oligoclonal bands and an increase of intrathecal igg
which means multiple sclerosis and the reason it takes three of you to tell me this
because we're having a disagreement about whether or not it is ms
no lesions on the mri
it's early he's had the disease for maybe two weeks
mcdonald criteria requires six months to make a definitive diagnosis
oh who cares about mcpherson i hear he tortured kittens
mcdonald
oh mcdonald wonderful doctor loved kittens
the vep indicates slowing of the brain
without the lesions we can't be sure
well if it is it's gone from 0 to 60 in three weeks which would indicate rapidly progressive ms not the fun ms with the balloons and the bike rides for cripples in wheelchairs
we should wait until we
start treating him now he can walk for another couple of years maybe live for another 5 break it to the family i'm going home
it'll take months for a definitive diagnosis
what'll happen to me
ms is an incredibly variable disease if it is ms and we're not 100 sure
what do you think is gonna happen
there are some medications to manage the symptoms but as the disease progresses the problems will become more severe bowel and bladder dysfunction loss of cognitive function pain
it's gonna hurt
the brain's like a big jumble of wires ms strips them of the insulation and the nerves die the brain interprets it as pain but by starting treatment we're gonna avoid that for as long as possible we're looking into a couple specialists and until we get you squared away you'll stay here ok
security checked the videotapes for all the perimeter cameras he's still gotta be in the hospital
where's chase
main floor
ok you take the cafeteria and administration i'll hit the research annex and work my way back to you
dan
house's answering machine i'm not here leave a message
dr cuddy great outfit
what are you doing back here patient
no hooker went to my office instead of my home
dr house dan's missing
yeah i got that part from the message you said i was needed immediately
he shouldn't move after a lumbar puncture
i agree he's gonna have a very nasty headache that would also be my opinion if consulted tomorrow morning
we wanted to keep you informed he heard some pretty heavy news
this is not a toddler wandering around a department store he's 16 you'll find him i'm going home
so when you say call me if you need anything you mean don't call me
no i mean call me if i can do something i'm bad at search parties and i'm bad at sitting around looking nervous doing nothing
what about his parents should we call them
why you think they're hiding him make sure someone checks the roof some of the orderlies keep the door propped open so they can grab a smoke
dan you ok there are experimental treatments ongoing research who knows what they'll discover in a year or two
this is where i dropped the ball
dan we're standing on the roof of the hospital dan dan you're not on the field
he doesn't know where he is
dan
foreman
dan
dan
dan no
la te da commercials evil
dr foreman i assume you found the kid
he almost walked off the roof
suicidal
no he thought he was on his lacrosse field look look i was just gonna run home shower change
conscious
yeah
how'd you talk him down
actually chase tackled him
how come you didn't do it
right well i am black but he was closer
come on you can ride up with me
anybody tell the family that their boy almost stepped off a roof they must be thrilled
they're not suing but i think only because chase asked them
why does everyone always think i'm being sarcastic this is great news he doesn't have ms the parents should be thrilled well the mom anyway of course the dad probably doesn't know
why doesn't he have ms
he was on the roof thinking he was on the lacrosse field conscious and therefore not a night terror you want some of this
yeah sure
he was in an acute confusional state which doesn't fit with a demyelinating disease like ms
the oligoclonal bands
house were real they just mean something other then ms so what are they telling us
that the immune system is working
right he has an infection in his brain
what about sex
well it might get complicated we work together i am older certainly but maybe you like that
i meant maybe he has neurosyphilis
heh nice cover
sorry rpr was negative
we don't need a definitive test to confirm this
sure didn't need one to confirm ms
ok let's wait for you to run titers on 4000 viruses while this kid's brain turns to mush
so the fact that he doesn't have ms is it's really not good news after all
well it is if it's neurosyphilis the likelihood of a false negative on an rpr test 30 the likelihood of a 16 year old having sex roughly 120
i'll start him on iv penicillin
we're not going to wait for that the most effective way to deliver the drug is right into his brain via the spine
we can't in a cramped space like the brain increased intracranial pressure from a high volume drug like penicillin could herniate his brain stem and kill him no neurologist in his right mind would recommend that
show of hands who thinks i'm not in my right mind
and who thinks i forget this fairly basic neurological fact
who thinks there's a third option
very good what's the third choice
no idea you just asked if i thought there was one
the patient has a shunt in his brain there'll be no increased pressure we can put as much penicillin into his body as we want
excellent inject him through a lumbar puncture
one of us is going to do this to you twice a day for the next two weeks
he could get syphilis even if he's not sexually active
well it's unusual but it's possible relax
geesh it's infected with a really big hole like you stuck a nail in it to relieve the pressure
mr funsten i wouldn't do that
although the wound is irregular not cylindrical it's shaped like a triangle so not a nail steak knife
wife's nail file
nail file yeah pain'll make you do stupid things something to take the edge off
yeah
cheers limps back
over and sits on a rolly stool so do you have family here in princeton
no
here on work
no why are you
does your penis hurt
no what should it
no just thought i'd toss you a really inappropriate question your lawyer's gonna love it
why would i want to sue you i want you to treat me
you're from maplewood new jersey right
funsten yeah
now why would you drive 70 miles to get treatment for a condition that a 9 year old could diagnose it's the free flowing puss that's the tip off
i was in town
not for family not for work you drove 70 miles to a walk in clinic you passed two hospitals on the road now either you have a problem with those hospitals or they have a problem with you my guess is that you've sued half the doctors in maplewood and the rest are now refusing to treat you it's ironic isn't it it's like the boy who sued wolf you know what i bet we have a doctor here named wolfe how perfect would that be i'm gonna page him
ok you know what thank you i'm gonna find a doctor to take care of this
i didn't say i wouldn't treat you we'll drain your knee run some lab work fix you right up
why would you do that
i'm a people person
you actually treated him
all i know is that he sued some doctors who am i to assume that they didn't have it coming to them the cutest little tennis outfit my god i thought i was going to have a heart attack oh my i didn't see you there that is so embarrassing
how's your hooker doing
oh sweet of you to ask funny story she was going to be a hospital administrator but hated having to screw people like that
i heard you found her on the roof
you have very acute hearing
you notify the parents
in due course of course
and is there a paternity bet on the father of the patient
doesn't sound like me
well it does actually but that doesn't mean you're guilty
you think
i saw the parents in the lobby smart money is obviously on the father
my guy knows a guy who can get you in for 50 bucks
fine you tell your guy if i win you attend the faculty symposium and you wear a tie
and if i win no clinic hours for a week
my guy will call your guy
she's very good at her job
the treatments should start helping soon let us know if it gets easier to focus on things remember stuff
hey dan isn't dr cameron's necklace a beauty something south american i think
yeah guatemalan
it's a cool necklace
thank you so much
the kid's in pain
male voice 1 don't fight it
male voice 2 just let it happen
no
no what
female voice 1 you'll be dead in three days
female voice 2 i give it a day
dan you ok
dan
he's hearing voices
dan push three milligrams iv stat
come on dan
get out of my head
commercials
auditory hallucination shows further brain degeneration
penicillin's not working
so either it's a bad batch of penicillin or our diagnosis is wrong square one mignight
lfts bun and creatinine are all normal diabetes is out no gap
there goes metabolic
mri rules out vasculitis
i for inflammation
to young for anything degenerative
d see ya n for neoplastic
mri was clean
i for inflammation
we already did that
stupid to have two i's in one mneumonic what's the other one
infection
oligoclonal bands still have to mean something
but no fevers white count's elevated but within range
and we've tested for anything remotely possible everything is negative
ct scan rules out subdural
trauma later much you know the problem midnight is actually spelled with a g and an h if we could just figure out what those two letters stand for it's a sick brain having fun torturing him talking to him scaring the hell out of him get him an eeg left and right eog esophageal microphones if this thing wants to talk let's listen
we're missing something this is screwed up
that's why you came up with the brain talking to the virus thing
i panicked ok sounded cool though they bought it
oh crap another reason i don't like meeting patients if they don't know that you look like they can't yell at you here we go
how can you just sit there
if i eat standing up i spill
our son is dying and you could care less we're going through hell you're doing nothing
i'm sorry you need to vent i understand
don't be condescending you haven't checked in on him once
blood pressure's 110 70 the shunt is patent well placed in the right lateral ventricle the ekg shows a normal qrs with deep wave inversions throughout both limb and pericardial leads lfts are elevated but only twice the normal range oh yeah and he's hearing voices go hold his hand go on i'll bus your tray
got any sample bags on you
i don't believe you you're gonna run dna tests
their son is deathly ill i know it's terrible but the fact is if i don't keep busy with trivial things like this i'm afraid i might start to cry
you're an ass
yeah you want to double the bet
general hospital is on channel 6
dan's brain's not showing channel 6 right now only mush
no epileptiform activity what are you doing
waiting for cbc and chem 7
good run dna on these
what's this
parents' coffee cups
i can't believe you
i've had this conversation once already if you've got something else to do do it otherwise do this
dr house
hey mr funsten i was wondering when you'd be back got some papers for me
you've caused me considerable mental distress
i certainly hope so what too cheep to have your lawyer serve it for you or is it more fun this way
i'm obviously prepared to consider a settlement
you have gonorrhea
no i don't
well maybe you're right but i have a lab result that says you do it could be a false positive normally i'd run a second test but since you're here i'll just go with the first
you're just trying to scare me
it's reportable you know public health issue
i'll be sure to let my wife know
oh don't bother yourself the state will call for you look if you're clean i'm sure this will all blow over no big deal there's an easy way to find out get one of your doctors run a test
uh uh these are mine now i'll see you in court
west nile negative not surprising since not too many mosquitoes passing through jersey in december
no eastern equine encephalitis
you guys aren't going to believe this
what's that
house was right the father's not the father
dude doubled up on me
you're not gonna believe this the mother's not the mother either
it's not a good idea to move your son in his condition
we just want a second opinion
we need an answer
you idiots you lied to me
we didn't lie about anything you on the other hand accused us of molesting our son
perfect
can we get off my screw ups and focus on theirs theirs is bigger you're not dan's parents
we're his parents
he was adopted he doesn't need to know
i do
adoption makes him just as much his
listen when we were taking his medical history were you confused did you think we were looking for a genetic clue to his condition or did you think we were trying to ascertain who loves him the most in the whole wide world
how did you find out about this
i sampled their dna
we didn't give you any dna
your coffee cups from the cafeteria
you can't do that
again why are we getting hung up on what i did your medical history is useless
no we gave you a detailed history of his biological mother
her history non smoker good health low cholesterol no blood pressure problems
dan was adopted two weeks after he was born you have his history there's nothing you need to know that we didn't tell you
sounds reasonable well if you want to transfer your boy that is your choice but i still think it's the wrong
was she vaccinated the biological mother when she was a baby did she get her vaccinations
dan was vaccinated at 6 months
mm hmm and do you know why kids get vaccinated at 6 months because before that they are protected by their biological mother's immune system so was she vaccinated
an infant picks up a regular old measles virus he gets a rash he's extremely uncomfortable has a wicked fever but he lives here's the kicker once every million or so times the virus mutates instead of dan having a fever and a rash the virus travels to his brain and hides like a time bomb in this case for 16 years
sub acute sclerosing pan encephalitis
i know there's only been 20 cases in the united states in the past 30 years
i suppose you could make an argument that the kid's still in stage one once sspe moves to stage two
boom stage two is universally fatal
i assume it's impossible to tell when he might move into stage two
he's already started showing symptoms it could be a month it could be tonight
can we treat it
ask the neurologist
intraventricular interferon
we're not gonna shove a spike into his brain and drip interferon without confirming this diagnosis
tap him
we won't get a reliable result for measles antibodies in his csf not after everything we've given him
so the wrong treatment kills any hope of the right diagnosis why do people lie to me it could also kill him your ball foreman tell me i don't have to biopsy his brain
well there is one other way
you sure this isn't gonna hurt
yeah it's just scary as hell see we go through the pupil you won't feel it the eye's been paralyzed the needle travels to the back of the eye which is where we perform the biopsy on your retina
cut to the needle entering dan's eye with a really cool sound you can see the measles
virus from the previous cut scene sitting there and then getting sucked up
so we've confirmed that the problem is this mutated virus the treatment for sspe is intra ventricular interferon we implant an ommaya reservoir under the scalp which is connected to a ventricular catheter that delivers the antiviral directly to the left hemisphere
look you want us to consent to this i don't even understand what you're talking about
well the antiviral look i'm sorry i can explain this as best i can but the notion that you're gonna fully understand your son's treatment and make an informed decision is it's kinda insane now here's what you need to know it's dangerous it could kill him you should do it
you can't order a 3 200 dna test to win a bet
it's not an actual cost i don't know if you know this but the hospital actually owns the sequencing machine
i'm serious
well tell the parents to submit the bill to insurance
insurance is not going to pay for a bet
it should if we don't make that bet the kid dies if not for the paternity bet i never would have taken their dna without their dna we never would have discovered that dan was adopted which was the key to this case you just don't want to pay your end big mistake my guy knows a guy
fine i will let you out of clinic duty for one week after you pay the 3 200 for the pcr test
whoo
well now there's the 100 you owe me there's the 100 i won from cameron 200 i took off of foreman and 600 i got from wilson very bitter
hey good morning
good news on your eeg treatment is working
and your immune system is responding
i know it's early but let me take a look let's see what that brain of yours can do name as many animals as you can that start with the letter o
ostrich ox old elephant
well that's 2 better then last time how you doing with the whole adoption thing
i knew since 5th grade
how's that
cleft chin i have one my dad doesn't i looked it up on the internet it's one of those trait things
that's right it's autosomal dominant since neither of your parents have cleft chins it's highly unlikely that you're biologically related
you sure you're ok
i've got no problems with being adopted i love my parents
how's he doing
he's doing pretty well he's a smart kid i think he's gonna be fine
thanks
wheels one eight wheels
the end
house m d 1 03 occam's razor
house m d
1x03 occam's razor
november 30 2004
written by david shore
directed by bryan singer
transcript written by mari
archived at twiz tv com with permission from house transcripts and more
house and other related entities are owned tm and by heel and toe films and bad hat harry productions in association with nbc universal television all rights reserved this transcript is posted here without their permission approval authorization or endorsement any reproduction duplication distribution or display of this material in any form or by any means is expressly prohibited it is absolutely forbidden to use it for commercial gain
i didn't sleep well last night and i woke up with a scratchy throat i just don't feel so good uh cough yeah i'm i'm a bit of an upset stomach too and i think i'm running a fever i'm just worried i might be contagious inventory tomorrow yeah i'm sure i'll be feeling better by then thanks mr nobby
i cannot believe you just did that
i really do have a cough
oh so you weren't lying you'd be curled up in bed with a bowl of chicken soup even if you didn't have a horny girl in your bed
yes because i really do hey i really do have a cough
you also have a little rash
um umm i'm uh not sure that we should be kissing
oh that's ok because i have almost no interest in kissing you
oh brandon singsongy brandon i know i'm good but come on brandon brandon brandon
why do you want me to treat this guy
blood pressure's not responding to iv fluids
no no i didn't ask how you plan to con me into treating him i asked you why you want me to treat him
he's sick i care i'm pathetic
there are about a billion sick people on the planet why this one
because this one's is in our emergency room
ah so it's a proximity issue if somebody was sick in the third floor stairwell that's who we would be talking about
yes i checked the stairwell it's clear
ok then emergency room guy it is
wait how was that so easy
you know why
blood pressure's not responding to iv fluids
yeah that's just weird
cbc was unremarkable abdominal ct scan didn't show anything so people differential diagnosis what's wrong with her
him
him her does it matter does anyone think it is a testicular problem no so chase
absidia infection
no you wouldn't get the rash or cough what about arthritis accompanying vasculitis causes nerve damage
no it wouldn't cause the blood pressure problems allergy
the kid's got abdominal pain maybe carcinoid foreman nah but then you wouldn't get the
foreman if you're going to list all the things it's not it might be quicker to do it alphabetically cameron no condition accounts for all these symptoms
well good cut to the echocardiogram
you all right
yeah
cort stim tests will tell us if your pituitary and adrenal glands are working properly
his glands chase we have a few theories we're working on
you mean you don't know
mindy
i'm just saying if they knew they wouldn't be testing you they'd be treating you
yeah well that's the way it works first you find out what it is then we get you better
you're half an hour late
busy case load
one case is not a load
so how are we doing on cotton swabs today if there's an acute shortage i could run home
no you couldn't
nice hello sick people and their loved ones in the interest of saving time and avoiding a lot of boring chit chat later i'm dr gregory house you can call me gregg i'm one of three doctors staffing this clinic this morning
short sweet house this ray of sunshine is dr lisa cuddy dr cuddy runs this whole hospital so unfortunately she's much too busy to deal with you cuddy jodi matthews
dr chase
i'm not sure scaring your boyfriend is the best medicine for him right now
i know i get stupid when i'm scared
don't go rock climbing
look i was wondering before this happened we were having sex
what you you're wondering if whatever he has you might have gotten it it's unlikely we ran a complete std panel so
no i was wondering if maybe i did this to him i was kind of rough
it was yellow
it was
it's not any more
hmmm that's a shame
i thought that might be a problem so i brought you this
your mucus was pale goldenrod
last week yes house oh yes jodi house and yet here you are jodi you're not a very nice doctor are you
and you are very bad at whatever it is you do
you don't even know me
i know you're going to get fired that's why you got the new glasses that's why your teeth are sparkly white jodi i might be quitting
if you were quitting you would have known that last week when your snot was still pale goldenrod you're getting fired
i just don't like being told what to do
i'll get you in for a full body scan later this week
thanks
it's got to be viral we should start running gels and tiles
we should test the girlfriend's theory she thinks she rode him to death
what did you tell her
well i told her 22 year old men don't die of sex
what'd you ask her
what do you mean
i mean i hope you got some specifics on exactly what was going on it's a girl who thinks it could kill you it's worth knowing about
have you ever taken a life
we should stop the antibiotics
it's too soon to say they're not having an effect
they're having an effect his bp's falling fast there's fluid filling his lungs his creatine's rising his kidneys are shutting down our treatment isn't making him better it's killing him
cut to house's office house so we had six symptoms that didn't add up to anything now we have seven foreman i don't think it complicates things the kidney failure was caused by the antibiotics
maybe
typically low blood pressure and abdominal pain means an infection an abdominal infection causes sepsis low blood pressure
except we checked for abdominal infections
i know but what if it's the other way around what if the low blood pressure is causing the abdominal pain
viral heart infection the intestines aren't getting enough blood and the result is belly pain
i know it's not the standard presentation
it's a 10 million to one shot
i thought that's what we dealt with here it explains the cardiomyopathy pain the low bp the fever
you read the book foreman well anything can cause a rash
okay cardiac infection foreman if you're going to list all of the things it can't be you're gonna need more colors
cameron was right chase orange and green foreman occam's razor house and you think one is simpler than two
pretty sure it is yeah
baby shows up foreman i think your argument is specious
i think your tie is ugly why is one simpler than two chase we'll run the tests
tests take time cameron hypothyroidism
my uncle has hypothyroidism
not like this intravenous levothyroxine is an artificial thyroid medication that should take care of it also the nurses are going to start you on unacin it's a more targeted antibiotic
for the sinus infection
yes
and the other stuff is for something else entirely
bad luck huh mrs merrell brandon
hey
mr merrell we're his parents how's he doing
um brandon is
um mom dad this is mindy i was going to bring her home for christmas so we're engaged
tell the family house's theory
two odd conditions striking completely coincidentally at the exact same time
i didn't phrase it quite that way
they agree to treatment
of course they did we're doctors they believe whatever we tell them so is that our job house's puppets he comes up with an insane idea we get to pretend it's not
his insane ideas are usually right we've been here long enough to
been here long enough to have stockholm syndrome
what foreman he has no idea where the box is if you guys think he's right go home relax
negative for coxsackie b virus
seven down about 5000 to go you really think we're going to come up with your mystery virus by running gels until we guess it right
no i think we're going to get it by standing around watching other people work
i'm waiting for the epstein barr virus she's weird isn't she
bad idea
what
bad idea chase what did i say foreman ghetto euphemism you don't think she's hot
no
wow then you're brilliant and i am using brilliant as an euphemism
obviously the girl is hot you you're not talking about her aesthetics you're talking about if i want to jump her foreman brilliant your epstein barr is ready
what are you doing
level 4
no i mean
i know what you meant patient my throat hurts
so you said
how long are we waiting
two minutes less then when you asked me two minutes ago
hi
hi house dr cuddy thanks for the consult his throat seems to have some condition
say ah
patient ah
he has a sore throat
of course cuddy i was in a board meeting
patients come first right
wouldn't want to prescribe a lozenge if there was any doubt about it's efficacy huh
you once asked why i think i'm always right and i realized that you're right at least i think you're right i don't really know now do i
hey cuddy go home house excellent counsel
cut to the lab cameron negative on parvovirus b19
i'm impressed
thank you i was born to run gels
i meant about chase
what about chase
well the man has no physical interest in you he has a completely professional relationship with you he respects you as a colleague and a doctor and yet he can't look at you without thinking sex
because i asked what kind of sex could kill you
you now have total control over your relationship with him
so a woman can't express her interest in sex without it being some professional powerplay
no if you look the way you do and you say what you said you have to be aware of the effect that it'll have on men
men should grown up
yeah chase what's going on
yeah what are you doing here
looking for you guys
why didn't you page us
cause i knew you'd be here
who told him
no one foreman not yet
talk to me when you have
what did you find out
the kidney failure house i wonder if that's signifigant
you visited a patient
i was sitting by his bed all morning just so he'd know someone was there for him
i looked in on him house ergo the treatment's working ergo me right you wrong
hey i'm glad for the kid
that smugness of yours really is an attractive quality
thank you wilson i get that you're not a big believer in the catching flies with honey' approach but do you honestly think you'll collect a jarful by cleverly taunting them
flies no wilson i think he'd be going home not feeling like a piece of crap
exactly
you want him to feel like a piece of crap
no i don't want him going home
dr foreman
still have the cough
i'm feeling a lot better though
mrs merrell his fever's gone and his rash is going away
i see
is everything okay
just ordering some tests absolutely nothing to worry about
how much longer
9 30 i figure she was on the 8th hole when i paged her probably got another half hour
i ran a tsh t3 and t4 patient's negative for hypothyroidism house foreman if i'm right and it's a viral infection one of two things always happens patient dies or the patient's immune system fights off the invader what's with her
her leg hurts after running six miles who knows it could be anything
he's getting better house i am so glad you work here
if i'm right the antibiotics you prescribed could block his kidneys and liver impeding his ability to fight off the virus could kill him
well that certainly would be a concern fifty bucks foreman you wanna bet on the patient's health
you think that's bad luck do you think that god will smite him because of our insensitivity well if god does you make a quick fifty wilson hey cuddy said you needed a consult what's up i'm busy
ah
i was just being glib
you haven't said anything
no before when i was talking about brandon's girlfriend thinking sex could kill you chase oh i don't even remember what you said
i'm uncomfortable about sex
well we don't have to talk about this
sex could kill you chase hey foreman
hey
white cell count isn't up is it
no
can you walk brandon
yeah a little
all right okay cause we'll need to leave the chair outside thank you where's april april foreman something's made his immune system compromised
his white blood cell count is down which means his body can't fight off infections
if he gets sick he'll die
mrs merrell sick foreman if he gets a cold he'll die
cut to brandon coughing foreman okay brandon that's not so bad
hah that was just the anesthetic the core biopsy needle it's a little bit bigger okay man take a deep breath this is this is gonna hurt a lot marrow makes the blood cells you take a peek of it under a microscope and maybe we find a viral infection brandon what if you don't find one i can't stay here forever
the patient could have died
the one with the pulled muscle
well those symptoms are consistant with a dozen other conditions i you know i i'm entitled to a consult
you are not getting out of clinic duty
oh come on cuddy no i don't but working with people actually makes you a better doctor
when did i sign up for that course
when did i give you the impression that i care
working in this clinic obviously instills a deep sense of compassion i've got your home number right in case anything comes up at 3 o'clock in the morning
it's not going to work you know why wilson uh
is this important
uh no
no
what's with you and her
don't
do you have a thing for her the only people who can get to you
no pharmacist who's the patient
i am
you can't
dr wilson is the prescribing physician
yeah house well we all have our limitations
house house what was the kid's first symptom you did the history of his 800 symptoms which one hit him first
ah the cough
gout
um are we talking about brandon
gout house because he doesn't have gout every day cells die we survive because the remaining cells divide and replace the losses the colchicine a gout medicine blocks mitosis and stops cell division which will result in abdominal pain rash nausea fever kidney failure low blood pressure and will also mess with the bone marrow
but he doesn't have gout why would he have gout medication
because you guys were right he didn't have two medications at the exact same time first he got a cough now because he's an idiot he went to a doctor in order to feel justified charging 200 the doctor felt he should actually do something cameron but once he checked into this hospital he was completely in our control our food our pills our everything so even if you're right no gout medication house okay
he's resting he
i'm dr house mrs merrell oh you're the one we haven't met yet
mr merrell you're the one he hasn't met how can you treat someone without meeting them
it's easy if you don't give a crap about them that's a good thing if emotions made you act rationally then they wouldn't be called emotions would they mindy when we checked in dr foreman said
tuesday he's getting better wednesday he's getting sick again somebody gave him his cough medicine wednesday foreman dr house maybe we should
mrs merrell his throat was sore
page dr occam mrs merrell sorry house i wish you would dare mrs merrell he took the last of them before he was switched into that room
they're all gone
mrs merrell it was just cough medicine
no it wasn't cut to a pharmacy chase we need to know exactly what you put in this bottle we think it was colchicine a gout medication
if the prescription said cough medicine that's what i dispensed
the family is prepared to waive liability all right we just need to know what it was what dosage it was
it was cough medicine
refill it
mrs merrell he's going to be okay
you don't know that
mrs merrell does brandon like that quality in you you're a little negative
things don't always work out for the best
mrs merrell it doesn't hurt to hope they do
no chase this is cough medication this is what brandon was supposed to get they're small round and yellow can you tell this man what the pills in your son's medicine bottle actually looked like
mrs merrell they were small round and yellow exactly like this
those were the pills that brandon was taking
hey i'm just a pharmacist but i know what cough medicine looks like doctor
it was so perfect wilson beauty often seduces us on the road to truth
and triteness kicks us in the nads
so true
this doesn't bother you
that you were wrong house i was not wrong wilson so reality was wrong
reality is almost always wrong the cough medicine did something aggravated the condition it's all over the place must be in his blood
what if it is his blood
lymphoma
unless you've got something better
well we foolishly ruled out lymphoma because his ct scan showed no adenophathy cbc showed a normal diffen smear bone marrow showed no
screw the tests house he has no blood pressure no immune system and no kidneys surgery will kill him
yeah you're right house cut to brandon's clean room foreman okay brandon we're gonna run this tube through your heart and into the pulmonary arteries in your lung
sensors will give us information we need for the exploratory surgery later this afternoon
my fingers are numb
try not to move chase i think the catheter's curling in the atrium
got it chase ectopy foreman it'll calm down
he can't tolerate any cardiac arrhythmia pull back
he needs this surgery
pressure's dropped
you still with us brandon
get the curtains
charging clear sign of rhythm
i got a pulse
yeah but no surgery today
cut back to the clinic house how you doing
okay
great patient i should go
you think it's going to come out on its own are we talking bigger than a breadbasket cause actually it will come out on its own which for small stuff is no problem gets wrapped up in a nice soft package and plop big stuff you're going to rip something which speaking medically is when the fun stops
how did you
you've been here half an hour and haven't sat down that tells me its location patient it's an mp3 player
is it is it because of the size or the shape or the pounding bass line
what are we going to do
i'm gonna wait
for what
okay it's 3 00 i'm off would you tell dr cuddy there's a patient in exam room 2 that needs her attention cameron brandon's not ready for surgery
okay well let's leave it a couple of weeks he should be feeling better by then oh wait which way does time go
he crashed during prep he's also experiencing pain in his fingers i think some bug may have gotten in the clean room i think we should double his dosage of gcsf to temporarily boost his blood cell count
pain in his fingers right
hi again
mrs merrell he can't go in
mr merrell where's he going
hey chase dr house this is a clean room
yeah i read the sign mrs merrell but we went to the pharmacy we saw the pills
colchicine does its damage in a very specific order first of all there's a pain in the abdomen the rash the fever isn't that what you got first then the kidneys go which is exactly what happened to
brandon
right mrs merrell no he's not
ecstasy
mrs merrell no
twice with dan and mike
d'you know what they cut that stuff with apparently colchicine unless you ingested the colchicine through your contact lens solution or skin cream or some other drug you're lying about i don't know how it happened i don't care how it happened it happened start
brandon
lovely name wilson i think you'll remember you know it wouldn't hurt you to be wrong now and then
what you don't care about these people
the colchicine interferes with the ability of the heart muscle to contract pumping blood lowering your blood pressure the antibodies we're giving you should neutralize the colchicine allowing your heart to beat at its normal rate
when will you know
we know now
big weekend
it's not for me i'm fully stocked
cuddy got you doing inventory
nope wilson the gout medicine od
yeah
the fact that i know that it's a gout medicine od would seem to indicate that the case is already solved
well you'd be wrong
what about the fact that the kid is now i believe the technical term is not sick
you know how many forms of colchicine there are on the market
stop it
neither do i but it's a lot pills powders liquids iv fluids somewhere at a party in his coffee up his nose in his ear this kid had some wilson so you're not happy with your ecstasy theory
he said he used it twice
people lie
yeah but if you're gonna lie it's
you know what i'm not interested
not curious
no because i'm well adjusted
right
temperature's normal
i want cousin sharon there
mrs merrell if we invite sharon we have to invite all the cousins
so what brandon don't suppose i could have some of those cough pills huh they're okay right
yes you're doing great
you should invite dr house
will he come
no but he'll send a gift
i'll make sure it's a good one
there's a letter on the back of these pills
your old pills didn't have a letter on them
no cameron well these will help your cough
hey you want to go get some
no
house m d 1 04 maternity
house m d
1x04 maternity
december 7 2004
written by peter blake iv
directed by newton thomas sigel
transcript written by mari
archived at twiz tv com with permission from house transcripts and more
house and other related entities are owned tm and by heel and toe films and bad hat harry productions in association with nbc universal television all rights reserved this transcript is posted here without their permission approval authorization or endorsement any reproduction duplication distribution or display of this material in any form or by any means is expressly prohibited it is absolutely forbidden to use it for commercial gain
amber
no
why not
amber's a stripper name
find me one stripper named amber hartig or not okay non stripper names okay desiree bambi candy cane
max maxine max hartig is a cute name isn't it
if you're a professional boxer maybe
can you believe we made this little creature
i know it's incredible
it's the most amazing thing we've ever done
i almost ran the marathon last year
if we're lucky you won't inherit your daddy's sense of humor
hello say hi to bear
she hasn't even eaten anything what is she spitting up
well honey we can't bug them
just
okay okay
sorry it's our first kid we're both a little panicky i guess
dr lim well you gotta ask the pediatrician next time i just deliver em she spitting up
yeah second time in an hour
you lived underwater for nine months you'd have a lot to spit up too
is something wrong
eh a little lethargic
we didn't think
she's hot
is she uh
what's happening
baby's seizing get the crash cart
what's what's what's what's wrong
can i get some help in here
oh oh god is she all right
iv access
no ativan
what's going on
mri results are back
and
it's what we expected the accident caused serious damage
it's amnesia
i'm sorry
i just can't believe it
enjoying our lounge house
i just came in to get milk for my coffee which you're out of
dr kubisak flat or sparkling
flat
sparkling
so the hartigs
their baby gets a fever
wait don't tell me their kid had a seizure
yep the parents of course start freaking and i have to deal with that for an hour
like it was your fault
she was perfect when i delivered her if you want to blame someone blame the pediatrician
so how's the kid now
bowel obstruction she's under observation she'll be fine
pediatrician'll take all the credit
baby girl hartig term baby 42 hours old went into seizures 6 hours ago brought into the intensive care diagnosed with obstruction of the small bowel
i'm still amazed you're in the same room with a patient
people don't bug me until they get teeth exhibit b baby boy hausen another term baby 48 hours old brought into the nicu before the hartig baby fever of unknown origin 101 degrees trending upwards
wow that is amazing you hung out in the ob gyn lounge and heard about two sick babies it's eerie
don't touch that
all right
we have an infection spreading in the hospital
these kids have totally unrelated illnesses
they fell sick within four hours of each other they had the same delivery rooms maternity rooms are neighboring so transmission's possible they have the same symptoms
the hartig girl has a bowel obstruction no matter how close their beds are i'm pretty sure kids can't share a blockage
what does bowel obstruction on a chart indicate
well normally i'd say it indicates a patient's bowel is obstructed but i'm pretty sure you have some deeper truth to impart
it means that some random doctor of indeterminate skill thinks that the patient's bowel is obstructed
okay you're upset because they threw you out of their lounge
look at the x ray it's a normal gas pattern
you want i can get you a key to the oncology lounge
air air in the column
we're getting tivo
if it's air no bowel obstruction
even if it is air it could have been there before the obstruction
no something's infected both these infants
and you're the only one who put this together because
because i'm the only one who looked at both kids i want them isolated i want the maternity ward shut down
because you're better at reading an x ray than a radiologist
radiologists always over read babies' x rays especially if they're asked to rule out a pathology he read into it what he wanted
which is exactly what you're doing you're finding a cluster because you think it's interesting to find a cluster two plain old sick babies would bore you
see this is why i don't waste money on shrinks cause you give me all these really great insights for free
shrink if you would consider going to a shrink i would pay for it myself the hospital would hold a bake sale for god's sake
we have an epidemic
two sick babies is very sad but it doesn't prove an epidemic
how many do
get up we're going hunting
for what
wabbits
hi bye he's screaming he's fine
good looking baby
oh sorry wrong room
we'll see you later
12 rooms that's it
yep we've definitely checked the whole floor good news no epidemic
tragic huh
overflow rooms third floor
this imaginary infection has spread to the next floor
we were just going to call
did he get hot all of a sudden
yeah
man's voice don't worry we're almost there
excuse me hi intake sent you up here
yeah my wife's contractions are less than
yeah intake messed up i'm very very sorry nurse alpret will arrange for an ambulance to take you to princeton general
wha
the maternity ward is temporarily closed
we have to leave
yes i am very sorry
why are you doing this
you'll be there very very soon happy now
no but i am interested
three sick babies and a fourth showing early symptoms
how bad
spiking fevers
bp's plummeting they're barely able to keep systolic up at this rate they'll be dead in a day
where did this come from
two delivery rooms four different maternity rooms no common personnel and no common equipment
well there's gotta be something in common
yeah that would be the difference between an epidemic and a coincidence
i'm putting a team together we're going to start swabbing
what's she gonna swab every respirator sink vent drain in the entire hospital that'll take months
a needle in a haystack
it's worse than that we don't even know what's the needle we're looking for
then why'd you let her go do it
because the hospital's her baby and her baby's sick if she doesn't solve this soon her head's going to explode and i don't want to get any on me so let's figure out what's in the haystack differential diagnosis people
parasite
spreading too quickly
next
virus
kids are too sick and the blood tests show no lymphocytosis
and they're not responding to a cycle of avirarapovirin if it's some other virus we'll never find it in time anyway
which leads us to bacterial infection it's not responding to broad spectrum antibiotics so we've got something resistant the usual suspects
mrsa it's always mrsa in hospitals
maybe a contaminated food or water source psuedomonas
vre
h flu
okay those are the big ones cultures will take 48 hours might as well be post mortem we'll start them on vancomycin for the mrsa and aztreonam for the rest let's get mris check for abcesses or some occult infection i'll be in the clinic grab me if you find something important or unimportant
cut to a hallway where a nurse is wheeling a sick baby the hartigs look on
close up on karen's face as the nurse rounds the corner
we did a mri on all the babies and unfortunately we didn't find anything so we're starting him on the strongest antibiotics we've got and we're hoping that that'll take care of it
but he's so tiny
how sick is he
his fever's up to 103 5 and his blood pressures 80 over 40
um how bad is that
ah it
it it's low the heart needs to circulate the blood if it's weak oxygen isn't getting to the liver the kidneys the brain
um i have to ask you something
judy
no no kim let me um i had a cold last month and i told the doctors about it and
honey this has nothing to do with you
kim's right your son was born healthy he caught the infection after his birth there's no reason to think he got it from you
but you don't know i mean you don't know how he got sick
how sick is my child you couldn't answer it
i answered
you rattled off numbers bp o2 stats that's not what they need to know
what they need to know is the future got a magic 8 ball
no just eight years of medical training look i realize it's tough to break bad news to family
not as tough as hearing it
and i guess being the poor guy dying is toughest of all
no it's easier to die than to watch someone die
well we're checking the vents it could be airborne somebody get the sinks too and underneath them
i'll get it
how many med students have you got swabbing the decks
oh what else are they going to do it's not like they're delivering babies
find anything yet
ah yeah about half the antibacterial gel dispensers are empty or broken
that's bad and diagnostically completely insignificant
well if the staff can't wash their hands it's no wonder an infection has spread hey tie clip
sorry
we have an epidemic in this hospital and your tie is becoming a petri dish put on a tie clip or take the damn thing off
my joints have been feeling all loose and lately i've been feeling sick a lot maybe i'm overtraining i'm doin' the marathon like ten miles a day but i can't seem to lose any weight
lift up your arms you have a parasite
like a tapeworm or something
lie back and lift up your sweater you can put your arms down
can you do anything about it
only for about a month or so after that it becomes illegal to remove except in a couple of states
illegal
don't worry many women learn to embrace this parasite they name it dress it up in tiny clothes arrange playdates with other parasites
playdates
it has your eyes
but that's impossible
well i assume you weren't getting your period maybe that should have give you an inkling
but i'm on this birth control implant
yeah i know i saw the scar on your arm
and my doctor said i might not get any periods at all if it was working
mm hmm interestingly enough you also don't get any periods if it isn't working which is why you were supposed to get regular pregnancy tests i'm going to send a nurse in here to schedule your prenatal care you're due in about five months so start planning the shower
um doctor please me and my husband wanted to have a kid soon but oh god like four months ago we had this really big fight he moved out i did something stupid
one night stand
ex boyfriend
i'll schedule you a paternity test too
i can't let my husband know
does the old boyfriend look like your husband
yeah
then just have the kid he'll never know the most successful marriages are based on lies you're off to a great start
well you look cheery what's going on
the hartig and chen lupino babies their kidneys are shutting down
and the urine tests show no casts
which means the antibiotics are causing the kidney failure
you're the nephrologist which one did it we'll take em off that one don't tell me both vancomycin and aztreonam can
they both can cause this there's no way to know which one it is no test
we can't take them off the antibiotics they'll die of the infection
if we leave them on both the antibiotics they'll die of kidney failure
so we take our best guess then which drug's causing the kidney failure
it's like i said it's always mrsa in hospitals take em off aztreonam
i still think it's the pseudomonas i vote to take them off the vancomycin
there's no point in guessing take one kid off vancomycin and the other off aztreonam
they have the same disease you want to give them different treatment
what the hell are you doing
theraputic trial to find the cause of the infection
that's wrong
we have four sick kids at least who knows how many more haven't started showing symptoms yet
we have a duty to these two
if these two have different reactions we know how to save the rest
so you're condemning one of these kids to die based on random chance
i guess i am
so you're going to flip a coin that's how you decide which baby lives
can i borrow a quarter
do you want to get sued lose your license house well generally i'd applaud that but my job is to protect this hospital so i strongly advice you to come up with a medical rationale why baby a should get medicine x and vice versa
whoa whoa whoa hold on there slick we didn't all go to law school your advice is that i should use medical reasons to make medical decisions hmm that's not going to be as easy
any medical justification doesn't need to be a good one
well hartig sounds jewish so does aztreonam so we'll take the hartig kid off vancomycin how's that
you can't experiment on babies
doctors experiment all the time
on adults with their consent
fine i'll get the parents' consent
their informed consent they have to know the other kid is getting a different treatment
sorry can't do that it'd be unethical for one patient to know about another patient's treatment
they have a right to know
if they know they won't consent that defeats the whole purpose
that's their right
two more babies have just become symptomatic i defer to your legal wisdom which takes precedence six dying babies or a missing consent form
you can't do it
do what you think is best
your daughter's kidneys are shutting down
your son's kidneys are failing
so we're going to take her of the aztreonam
we're taking him off vancomycin
but uh but what made her sick in the first place
what do you think is causing it
it seems to be a germ called pseudomonas
we think it's mrsa methicillin resistant staph aureus it's a very resistant form of a very common bacteria
we're hoping the aztreonam will clear it up
vancomycin is the best treatment for mrsa so we're gonna keep giving it to her
right is it gonna cure her
your child is very sick you need to know that this is a hail mary' pass it might cure her it might not
so so that'll cure him
we'll know in 24 hours if it's working
what did you tell them
i told them the truth
they seemed relieved you tell them how sick their son is
i explained what was going on
alison their baby's dying if the parents weren't in tears when you left you didn't tell them the truth
that's not how i see it
do you want them blindsided want them coming up and saying my god my baby died why didn't you warn me
so now it's about worrying about them yelling at us
no it's about getting them prepared for the likely death of their child
if their son dies tomorrow do you think they'll give a damn of what i said them today it's not going to matter they're not going to care it's not going to be the same ever again just give those poor women a few hours of hope
dr house dr house this is my husband charlie
who told you where my office was
jill come on he obviously doesn't want us bothering him
ooh i was trying to hide it
look doctor this is about the mono you said you thought i had
the mono
yes you know shouldn't charlie be tested you know the test the blood test
right yeah i'm sorry i sometimes forget patients i thought you were this idiot who doesn't know how to use birth control
i can't have mono i don't even feel sick or anything
that's very often the first sign call my office in the morning i'll schedule him for bloodtests
thank you
i'm not even tired
find anything yet
no just some baby formula being stored under a sink with a dripping faucet
tap water contamination you thinking pseudomonas infection
i was i wasted a couple of hours chasing it down but of course the formula hasn't been anywhere near the babies
huh
whatever idiot stored them there
all right we'll figure it out just just calm down
i am calm
aw could
i warned you i did that calmly
hey
hi
is she any better
her fever's been stable the last hour
we're not going to make it are we
sorry
me and ethan our next door neighbor their little boy died in a car crash and she and her husband split up like four months after the funeral it's just uh what always happens right
um what happens to patients after they leave the hospital i don't know but try not to get ahead of yourself
nurse's voice dr chase activity on the monitor
how long
i don't know it just started
pulse fluid wide open do we have an arterial line
not yet
let's get a bp you can't come in here
is my baby dying
mrs hartig
is she dying
ma'am you'll have to leave
it's not your baby
fenlay bp 60 over 20
heart rate's 180
house they start the levofed
they've got it
kim and judy come to the window
still dropping 50 over 10
can't hold bp with three pressers we're losing pulse
v fib
shut the blinds
charging clear
still v fib
charging clear charging clear
still v fib
charging clear charging
chase time of death 6 57 pm the aztreonam doesn't work double cover all the other babies with vancomycin
i'll do it
cameron you tell the parents tell them their child probably saved five lives
but chase should
chase is busy
you're the attending
make sure she does her job
i asked you to make sure she does her job not do it for her
she froze up
she felt sorry for the parents so she shut up you felt sorry for her so you opened your mouth
she has a problem
yeah she needs to deal with it if you hadn't bailed her out she would have done it
great then she wouldn't have slept for two weeks maybe she should be thinking about a different specialty lab work research
yeah what is it
the hartig baby she's getting sicker too the vancomycin isn't working either
vancomycin doesn't kill it aztreonam doesn't kill it what the hell is this
it's a super bug
it could be vrsa
there's only been two reported cases of it ever in the united states
one of the kids the hausen baby had a skin rash it could be scalded skin syndrome which would be a sign of vrsa
then these kids are dead
this is our fault doctors over prescribing antibiotics got a cold take some penicillin sniffles no problem have some azithromycin is that not working anymore well got your levaquin antibacterial soaps in every bathroom we'll be adding vancomycin to the water supply soon we bred these super bugs they're our babies now they're all grown up and they've got body piercings and a lot of anger on the other hand maybe antibiotics had nothing to do with it did you notice how low his bp was at the end even with three pressers
heart damage
go home there's nothing more you can do tonight
baby boy chen lupino time of death 6 57 pm thursday december 2nd 2004
this is a cross section of the chen lupino boy's myocardium fibrosis lymphocydic infiltrates
there was no sign of lymphcytosis in the blood tests
yes well we all had plenty of good reasons to think bacterial nobody is scolding you unfortunately all of those clever reasons were wrong it is a virus infecting their hearts
we're screwed we can't chase down a virus there's a thousand possibilities
we could run gels antibody tests
a thousand of them the kids don't have enough blood
chase you're the intensivist how many could we do before we risk exsanguinating the kids
you're talking vials not stick tests i wouldn't take more than five or six
okay so we have to narrow the thousand viruses down to six now the autopsy's shown us what the virus does so let's go what do we know
ribavirin and encyclovir don't knock it out
cross out the herpes viruses
also adenovirus what else what else keep talking
well it it only seems to hit children the mothers aren't sick so
no toxoplasmosis no rubella cross out the entire torgh syndrome
you didn't find any lung damage
no
none of the paramyxoviridae
cardiac scarring people
cmv
enteroviruses too i think
echo 11
influenza a
influ a yes and i'm putting rsv down as a yes that makes eight
eight vials of blood is pushing it
pushing it but we love that get the antibody kits start testing the sick kids
all right i'll start looking into whether there are any antivirals for these eight
wait a second the the kids on the floor who didn't get sick are any of them still in the hospital
they got moved to the fifth floor but they're probably all checked out by now
no the lindpert boy had a bit of jaundice he should be checking out today
i want to test his blood too
why
cause we need all the information we can get the healthy kid can be our control group
i'll just tell his parents he can't check out because he has the smallpox
all done all done
what did we get
well the sick babies all tested positive for echovirus 11
great
and cmv and parvovirus b19
three viruses
what's weirder the healthy kid we tested he's positive for echovirus 11 and cmv antibodies as well
they're infants they have their mother's blood their mother's antibodies
so we just learned nothing
uh uh we have half the picture the healthy kids survived because their mothers' antibodies saved them
the mom had cmv in the past she'd have the antibodies for them the kid would be immune from it so we test the sick kids' moms for echovirus cmv and parvovirus
and whichever they don't have the antibodies for that's what's killing their kids
i'll test the mothers
echovirus 11 it's an enterovirus it lodges in the intestinal tract
enteroviruses cause diarrhea and flu like symptoms in adults maybe a rash but for newborns it can be deadly it's damaging her heart
well is there anything you can do
viruses are more difficult to treat than bacterial infections we still haven't found a cure for the common cold
so there's no vaccine or
there's a company in pennsylvania developing an antiviral it got positive results in a lab setting and we managed to get our hands on it
imagine not being able to touch your own baby can i get your guys' help with something
sure
your daughter her
maxine
that's her name
we need someone to hold maxine off of the bed while the nurse changes her sheet
sure they enter the room now in scrubs and hold maxine
hey foreman got a minute
so pulmonary resistance is stabilized for the two kids but bp's still
no news then how's cameron
dr cameron
sure let's start with her and move on to all the other camerons we know
sorry i'm just not used to you asking about someone's well being
i can understand how the question would surprise you i don't quite get how it would confuse you
why do you want to know
why do you want to know why i want to know
just curious
me too
you don't get curious
i'm the most curious man in the world
not about trivialities
well then this must not be trivial how is cameron handling everything
just fine
great glad we talked
your husband is definitely the source of your mono
oh wow oh thank god wow i'm going to be a mom whoa heh heh thank you so much i gotta get you a gift or something
sometimes the best gift is the gift of never seeing you again
okay all right but dr house you've been so awesome i mean i really totally trust you do you think you
no
could do the prenatal
no
or deliver the baby
that would be no
okay
chase take a look at this
oh god it's good news
no it's great
they all gone
hartigs are checking out right now
you look tired
thanks
it's no wonder you've had a hard time the last couple of days
and you haven't
not like you anyone who's that awkward either has no experience around death or too much and i'm pretty sure it's not the former chase told me about that id you had the parents holding the baby where'd you get that did you lose someone did you lose a baby
you can be a real bastard
unfinished business
i'm in the haystack
ah because now you know you're looking for a needle
right
if i tell you to let it go it won't make any difference will it
enteroviruses are spread by humans fecal oral could be respiratory secretions though
so cuddy got stool samples from the whole staff just wait until they come back
that won't do it
why not
the shedder whoever he is is so virulent cuddy must have noticed him
hmmm
and the babies didn't share any common personnel that's what's weird
yeah yeah that's what's weird
can i help you
you saved my life
i just ran some tests your will and determination are what saved your life
i know who i am now
yes you do and i know who i am as well
hey seriously man you're not supposed to be here
i'm performing a delivery
you are
patient who's prenatal care i've been handling just checking her out a couple of minutes ago of course i'll need one of you two guys to supervise
when's she due
late march
that's five months from now
thank god these chairs are comfortable
house m d 1 05 damned if you do
house m d
1x05 damned if you do
december 14 2004
written by sara b cooper
directed by greg yaitanes
transcript written by mari
archived at twiz tv com with permission from house transcripts and more
house and other related entities are owned tm and by heel and toe films and bad hat harry productions in association with nbc universal television all rights reserved this transcript is posted here without their permission approval authorization or endorsement any reproduction duplication distribution or display of this material in any form or by any means is expressly prohibited it is absolutely forbidden to use it for commercial gain
we are condemned to useless labor
fourth circle of hell charting goes a lot faster when you eliminate the whole of classic poetry
writing down what we already know to be read by nobody pretty sure dante would agree that qualifies as useless
you're over two weeks behind on your charting
oops i missed
what are you eight
could an eight year old do this
you better stop or it'll stick that way you have a patient in exam room 1
yeah but see see i'm off at twelve and it's already five of
she's been waiting for you since eleven
melancholy without hope which circle is that
house walks into the exam room sees who's in there and makes a oh no kind of face it's three nuns
hi i'm dr house what seems to be the problem
sr eucharist show him your hands augustine house pops a couple vicodin augustine shows her hands which are red swollen and covered in hives and sores
sr pius it looks like stigmata
sr eucharist shhhh pius
you must be all the talk around the holy water cooler you been washing a lot of dishes recently
sr augustine i help out in the kitchen
anything new in the kitchen
sr pius we just got a donation of saucepans and pots this week
sr augustine i unpacked and washed them
should have spent your time saving souls it's easier on the hands this is contact dermatitis you're allergic to dish soap
sr eucharist nonsense we've always used that soap why is there a problem now
i've been a doctor for years why do i have to keep assuring people that i know what i'm doing a person can become allergic to substances that they've had repeated and prolonged exposure to the good news is free samples diphenhydramine it's an antihistamine it'll stop the allergic reaction take one every eight hours it might make you feel a little sleepy and get some of that over the counter cortisone cream
sr augustine thank you doctor
you want some water
sr augustine i have some tea
well you just relax for a few minutes that stuff works pretty fast
still out by twelve
how do you solve a problem like dermatitis
what
sr eucharist doctor i want to thank you for your patience
she talking to you
i don't know she's certainly looking at me
sr eucharist oh it's good to get a secular diagnosis the sisters tend to interpret their diagnosis as divine intervention
and you don't then you're wearing an awfully funny hat
oooh boy excuse me
sr eucharist if i break my leg i believe it happened for a reason i believe god wanted me to break my leg i also believe he wants me to put a cast on it
sr pius doctor something's wrong
cut to exam room 1 where augustine is having an asthma attack house grabs his stethoscope
lift up your chin sister you're having an asthma attack i need you to relax roll up her sleeve please i'm giving you epinephrine it'll open your lungs and help you breathe
sr eucharist what happened
did she take the pill
sr eucharist yes
it's probably an allergic reaction
sr pius she's allergic to an anti allergy medicine
you figure somebody's out to get her how're you feeling
sr augustine better
i'll put you on some steroids instead
sr augustine is my heart supposed to be feeling so funny
it's called adrenaline it makes your heart beat fast but not this fast get a nurse please lie back
sr pius help somebody help us house opens augustine's shirt and listens to her heartbeat
somebody get in here call a code and charge up a defibrillator she's got no pulse
opening credits
cut to augustine's hospital room her cross and bible are on the table next to her the two sisters are praying at her side cut to cuddy's office
you diagnosed the patient with allergies and prescribed antihistamine she went into respiratory distress and you injected her with epinephrine presumably 1 cc
0 1 cc that is the standard dose that is what i gave her
people don't go into cardiac arrest from 0 1 cc epinephrine
she must have a pre existing heart condition that got exacerbated by the epinephrine
it's too bad you didn't make a notation in the chart
i can make it up right now
the drawer has syringes with both dosages you could have easily reached for the wrong one
but i didn't
everyone makes mistakes this is why doctors pay through the nose for malpractice insurance
relax they're not going to sue worse they'd do is whack my hand with a ruler
and the discipline board are they gonna whack your hand too
you're going to report me
what choice do i have
uh how bout not report me
i can justify keeping her here for 24 hour observation if you haven't found an underlying cause for the cardiac arrest by then i will have to notify our attorneys
cut to house walking down the hall with cameron chase and foreman
her hands were red and swollen maybe she has a skin infection cellulitis that could manifest with tachycardia
there's no history of fever results from the cbc didn't indicate an infection
the eosinophils were mildly elevated sed rate's up a bit could be looking at a systemic allergic response
it's not allergic allergies don't cause cardiac arrest like this could be inflammation of the blood vessels
vasculitis that wouldn't give you an elevated eosinophil count
church strauss vasculitis would blood vessels of the heart lungs and skin become inflamed causing the asthma rash and heart problems covers all her symptoms
need a biopsy to diagnose
chest ct'd be quicker
the lady just came in with a rash
what the hell are those
candy canes
candy canes are you mocking me
no it's christmas and and i i i thought
relax it's a joke
isn't the prognosis for church strauss a bit grim
yeah untreated only 33 of patients survive past a year treated five years
then i'd definitely suggest treatment
if it was any other attending doctor i'd say that he made a mistake and gave her too much epinephrine
saying you wouldn't say it was my mistake is saying it was my mistake
your rule i think you fit inside the subset of everyone
i didn't screw up order a chest ct and start the sister on prednisone 40 mg tid
the sister
oh didn't i mention the patient's a nun sister augustine
aw i hate nuns
who doesn't
cut to a tv showing a man and a women playing in the waves sisters augustine and pius are watching it raptly foreman cameron and chase walk in
sister augustine
we weren't watching
we were trying to see if this was the bed control
oh um this one's the bed control and that one's the tv control i'm dr cameron and that's dr chase and dr foreman
i hadn't seen television in over twenty years
do you consider it the work of the devil or do you just not get cable where you live
um how're you feeling sister
i seem to be a little better they gave me some medication
prednisone it's a steroid to help with the inflammation
has dr house figured out what i have will i be okay
we're not sure what's wrong yet you'll have a chest ct scan this afternoon that will help with the diagnosis
dr house is giving her medication and he doesn't know what she has yet
trust sister pius it all happens for a reason
cut to the ducklings in the hallway
he doesn't know what he's doing the only problem that woman has is that house grabbed the wrong syringe
you don't trust him
i don't trust a man who won't admit he might be wrong i notice you weren't so quick to tell her she has church strauss and only has a couple years to live
i don't tell patients bad news unless it's conclusive
because you know he might be wrong
about church strauss not about what happened in the clinic
what about you chase you think he's infallible too
all i know is if house didn't make a mistake and sister augustine has church strauss he'll be self satisfied and our lives will be good for a few weeks if house did make a mistake he'll be upset and our lives will be miserable for months
there is that
cut to house and wilson walking out of the elevator and into the clinic
if cuddy thinks i made a mistake the least she could do is suspend me from clinic duty
she doesn't confuse making a mistake with being incompetent
oh here we go lesson time i recognize that confidence is not my short suit i also recognize that i am human and capable of error
so you might have screwed this up
no
so it's only a theoretical capacity for error
good point maybe there isn't one maybe that's my error
you know most people who think as much of themselves as you do like to talk about themselves
most people don't like to listen so what's wrong with you
cut to house entering exam room 1 which is occupied by santa claus house makes a point of sniffing the air as he enters
let me guess inflammatory bowel
wow yeah is it that bad
yes it's also written on your chart bloody diarrhea gas pain took sulfasalazine but it didn't work
no then i
next tried steroid enemas oral corticosteroids 5asas 6 mercaptopurine i'm impressed
by my medical history
by how well your last doctor charted
it's one thing to have to go to the bathroom every hour but when the kids sit on my lap it's the store sent me home they're gonna fire me can't you put me back on 5asa maybe it'll work this time
not likely i'm giving you a prescription it's cheap which is good because your insurance company won't pay for it
cojorius
cigarettes one twice a day no more no less studies have shown that cigarette smoking is one of the most effective ways to control inflammatory bowel plus it's been established that you look 30 cooler
are you kidding me
about the looking cooler yeah the rest is true
isn't it addictive and dangerous
pretty much all the drugs i prescribe are addictive and dangerous the difference with this one is that it's completely legal merry christmas
cut to chase wheeling augustine to the ct
i was talking to the nurse arsenio do you know him
not really
he can take pictures with his phone
cool
that woman from the lab was interesting too she studied astrophysics before becoming a nurse
you know the staff better than i do
well i love to hear about people
yet you live in a monastery
it's where i serve our lord and the world best
our lord maybe the rest of the world on the other hand would probably get more out of feeding the homeless or
healing the sick
as an example yeah
did you always want to be a doctor
always you always want to be a nun
my parents died when i was six i was raised in a foster home run by the church when i was eighteen i went to the monastery where they let me take my vows i've known no other life and i haven't wanted to
cut to augustine going into the ct
okay sister we need to you lie as still as possible if you get scared just let us know
as jonah said from inside the whale when i had lost all hope i turned my thoughts to the lord
at least she's got god on her side
i don't believe in god
you're not even a little agnostic
is it supposed to smell funny
someone ralphed in there this afternoon we cleaned it up but
it's normal sister it's just a few more minutes i believe in a higher order that's in control of what happens but not one anthropomorphic entity called god that's concerned with the everyday workings of you and me
what else is there to control but the everyday workings of you and me
it's always about you foreman
what else are you talking about the trees the fish should they be the ones to think it's all about them what about you chase do you believe in god
i believe sister augustine has no vascular pathology which means no church strauss
which means house made a mistake
no not necessarily it could be something else thyrotoxicosis or a carcinoid
i don't get you you don't believe in god but you're willing to put complete faith in one man
please the smell
let's get her out of there
i'm coming sister i gotcha i'm coming
please please the smell i'm sick
there's no smell
no god no oh it's jesus it's jesus he's coming for me he's burning me with his touch
let's get her on some ativan smells religious visions are symptomatic of temporal lobe swelling we don't want her to
oh
she's seizing
help me get her on her side
religious visions
yeah and next comes
cut to the diagnostic office
patient tested positive for herpetic encephalitis
so what's that tell us
her immune system is severely compromised
ooh i know prednisone compromises the immune system isn't that the medicine you gave her for the thing she doesn't have
yeah but hey i'm think that's a trick question
her immune system is severely compromised two doses of prednisone wouldn't do that
are you hanging your diagnosis on an adverb
in ten seconds i'm gonna announce that i gave her the wrong dose in the clinic
you're gonna admit negligence
unless you leave the room if you leave you'll have to testify five four three two so there i was in the clinic drunk i open the drawer close my eyes take the first syringe i can find so what are the options for compromised immune system
mixed connective tissue disease it'd explain why she was feeling better on the prednisone
sure she was feeling better right up to the moment it almost killed her
on the other hand it explains the symptoms swollen hands pulmonary problems cardiac problems it all fits
except her ana was normal
so redraw the blood
but the treatment is cortical steroids prednisone and we can't go there because of the encephalitis
then we'll treat it with something that modulates the immune system but doesn't suppress it hypobaric oxygen chamber
there's no protocol for putting a patient in a high pressure oxygen room to treat autoimmune problems
oh you people always with the protocols prep the nun and discontinue the prednisone i am both amused and annoyed that you think i should be less stubborn than you are
you are aware of the hippocratic oath right
first do no harm then goes on to tell us no abortions no seductions and definitely no cutting of those who labor beneath the stone yeah took a read once wasn't impressed
hypobaric treatments could cause oxygen toxicity lung and eye damage
every treatment has it's dangers
which is why we treat when we're only convinced the patient needs the treatment
i'm convinced you're not question is what are you going to do about it hmm
cut to cuddy's office
i have an opening thursday at three do you have a fourth is he any good can i call you right back okay what's up
cut to chase and cameron putting augustine into the hypobaric chamber
the pressure will force the oxygen into your system and saturate your blood it will enhance white cell activity and reduce the inflammation
and that will help with this mixed connective tissue disease
we'll be doing about ten treatments and then we'll reevaluate
the last treatment with prednisone cause the seizures right how confident is dr house about this
that you reacted so strongly to the prednisone let us know that you had an underlying problem with your immune system
i guess it was a blessing of sorts
cut to the hospital chapel house is sitting in the chapel watching general hospital on his portable tv
so who's your favorite reindeer nurse
rudolph
i would have thought it was vixen
what are you implying
nothing but i saw you at the christmas party with dr
this is a chapel a house of prayer
house of prayer huh that explains the good reception also why nobody's ever here
i need to talk with you dr house sister augustine believes in things that aren't real
i thought that was a job requirement for you people
she's been known to lie to get sympathy she's a hypochondriac
so you're warning me that i may be treating a non existent ailment
sore throats joint pains there's always something wrong and there's never a reason for it mother superior plays right into it lets augustine off work duties treating her as fragile special
that must make you angry
it bothers me it's not really in augustine's best interests
want some
i shouldn't
i guess you've got to be good at reading people to be a good infirmarian huh
mm hmm
so we've got pride anger envy gluttony that's four out of seven deadly sins in two minutes do you people keep records of these things is there a cathlympics
they say you have a gift
they like to talk
you hide behind your intelligence
yeah that's pretty stupid
and you make jokes because you're afraid to take anything seriously because if you take things seriously they matter and if they matter
and when things go wrong i get hurt i'm not tough i'm vulnerable
i barely know you and i don't know if i'm right i just hope i am because the alternative is you really are as miserable as you seem to be
you know from the way you're looking at me right now i'd say you just hit number five lust
dr brown i love you too
cut to cameron and chase opening the hypobaric chamber
how're you feeling
a little week
that's from the oxygen
my mouth is dry
okay well i'll get you some of your tea
cut to house and cuddy walking down a hallway
mixed connective tissue disease her ana is barely elevated
well thanks for checking up on her good to know you've got my back
0 2 stat is down to 83 pulmonary problems breathing problems
irritation from the oxygen is typical
she comes in with a rash and you put her into cardiac arrest
that well just never runs dry does it if there was no underlying problem then why is she still having the rapid heartrate
maybe from the herpetic encephalitis caused by you giving her prednisone
her reaction is a symptom not an error
there's always an explanation isn't there
yes there is and if this one doesn't work will find another
but never one involving you screwing up
one that fits all the facts look we obviously have a difference of opinion and that's fine but unfortunately i've used up all the time i've budgeted today for banging my head against a wall
i am going to do you the biggest favor one doctor can do for another i am going to stop you from killing your patient you're off the case
cut to house standing in his office he gives foreman a look who looks right back at him house then gives him quite an evil grin and foreman well he's got nothing on that
cut to the ducklings talking with cuddy in her office
we're going to treat the symptoms
not the underlying condition
there is no underlying condition what's her status
the sister's breathing is labored
pneumonitis from the hypobaric chamber put her on 40 oxygen until her 0 2 stats increase
bun and creatin's rising alt and ast twice the normal range
could be from the hypertensive episode let's follow them with labs
she still has the rash and the joint pain she came in with
order a non steroidal anti inflammatory
when we were looking at the differential diagnosis with dr house we were considering
i don't need to hear what dr house was considering all of this woman's symptoms can be traced to dr house's considerations okay let's just get this patient healthy i want her going out the front door and not the back
cut to cameron chase and foreman leaving the clinic
hey it's not like i betrayed him cuddy would have found out about the hypobaric treatments eventually
you did what you felt you had to
cut to house in the clinic he's looking through the door with the epinephrine syringes
can't get enough of this place huh
came for my stethoscope
so i shouldn't read too much into the fact that you were looking for it in the drawer with the epinephrine syringes in it
okay yeah i'd like to clear my reputation
oh right i forgot that you care about what people think prescribing cigarettes for inflammatory bowel it could cause lung cancer you know
you know why they have ribbons for breast cancer colorectal cancer prostate cancer and not for lung cancer
they ran out of colors
it's because people blame lung cancer patients they smoked they screwed up they deserve to die the reason people die from lung cancer is guilt
huh well guilt does a lot of damage
you said that with great significance
you're not here to find your stethoscope you're not here to clear your reputation you're here because you're having doubts you might have screwed up
i'm here because if i'm right cuddy is killing that patient
okay but if you're wrong
then she's saving her
fine you're going to have to go through every record of every patient who's been through this clinic in the last two days and you're gonna have to hope that those records can be trusted which by the way yours can't
cut to chase with augustine
these pills will help your kidneys function a little better sister get your wrist
what's that
104
is that good
it's fine
you're a lousy liar dr chase chase's beeper goes off on it is the message call mom
i have to get this excuse me
cut to house's office house is playing with a yo yo chase enters
my mother's been dead for 10 years
but she's always with you in spirit what do you know about the nun
which one
the cute one i think she likes me the sick one obviously
her parents died when she was a child and she's been with the church ever since
what's she lying about
why do you say that
i always say that and the old nun says the sick nun is a big fat nun liar you know nuns what do you think
i don't know nuns
you hate nuns you can't hate someone if you don't know them
know any nazis maybe i hate them on principle
i have a theory on what makes good boys good it's not because of some moral imperative good boys have the fear of god put into them catholic church specializes in that kind of training to make good boys afraid of divine retribution so they will do what their daddies tell them like for example going into medical school when it's the last thing they want to do what do you think
i think if she did have a secret her boss would know
cut to the monastery house is talking to another nun i'm assuming the mother superior
did you paint or put in new carpets recently
no
any way she could have got access to drugs
well we lock all of our medications in the infirmary and we don't keep prescription drugs here why haven't you asked sister augustine about these things directly
i've found that when you want to know the truth about someone that someone is probably the last person you should ask
ah and have you been speaking to sister eucharist
she ratted out her fellow sister pretty quickly if i were you i'd have her repeat a year of nun school
becoming a nun doesn't make you a saint
becoming a doctor doesn't make you a healer
just because we live in a monastery and we spend most of our time in prayer doesn't mean we don't find time for drama
so what is the sick one's drama
sister augustine lived in catholic foster care until she came to us tea
sure do all of you lie it's a good strategy simpler when you all tell the same lie but she has not spent her entire life as a good catholic when she had a cardiac arrest i had to open her blouse to do cpr and i learned two things nuns can have nice breasts and she has a tattoo on her shoulder of a skunk now maybe it's the sacred skunk of joseph but as far as i know catholic foster care and monasteries do not keep tattoo parlors in their refractories
we consider that our life begins when we put on our habits and take our vows what happens before then
is irrelevant to you but it's relevant to me
sister augustine went into foster care when she was six years old but she left when she was twelve she lived on the streets she got into drugs when she was fifteen she became pregnant tried to self abort she lost the child she became ill we took her in when she came back if we had thought it was medically relevant we would have told you
it's not this tea is delicious local herbs
cut to cuddy and the ducklings in a hallway
any change with medication
yeah she's getting worse lung function's deteriorating bun and creatin are continuing to rise she's starting to run a fever and the rash is spreading at this rate she's not going to make christmas
maybe house was right maybe there is an underlying condition that explains the symptoms something we haven't considered
like what
it could be a metabolic disorder
specifically
mitogenetic
specifically
i'm just saying
you're just saying you think house is right
might be right
of course he might be right it might be the hand of god at work don't say it's something else unless you've got something concrete to offer what's this hemlock
i'm going to do you the biggest favor one doctor can do another i'm gonna stop you from killing your patient it's figwort tea great for that little pick me up we're all looking for in the morning opens the lungs increases the blood pressure stimulates the heart unfortunately if you then get injected with even 0 1 cc of epinephrine instant cardiac arrest still what the hell it tastes great
sister augustine
has been drinking it religiously so to speak
take the cardiac arrest out of the equation
all the rest of the symptoms can be explained by a severe long term allergic reaction
that's what cameron said in the beginning
yes she did well done but your unwillingness to stick by your diagnosis almost killed this woman take a lesson from foreman stand up for what you believe okay let's go figure out how to save a nun
damned if you do damned if you don't
cut to house and the ducklings walking to the diagnostic office
because it's been untreated for so long it's gone from a simple watery eyes scratchy throat allergy to a whopping i'm gonna kick your ass allergy compromising her immune system diminishing her ability to heal and breaking down her organs systems so what's the source
the dish soap
no symptoms persisted days after the dishwashing episode it's gotta be something she's been exposed to here in the hospital as well as the monastery
well what about the tea it caused her arrhythmia
could be but it's not definitive
we'll skin test for allergens
not yet she's too reactive she'd test positive for everything we need to stabilize her isolate her from all possible allergens give her system a rest
get her in a clean room
okay and we'll gradually introduce allergens and see how she responds when she reacts to something we'll know that's what killing her
cut to the ducklings helping augustine in the clean room
there you go no television no books
not even my bible
i'm afraid not this room has filtered air filtered water you even have silk sheets very decadent and hypoallergenic you should be feeling better here
we'll be back to check on you in a little while
can the other sisters come in and pray with me
it'd be better if you don't have any visitors once we isolate what's causing your allergy then we can be a little more lax i can pray with you
i want to die why has he left me
i was in seminary school they asked us once what our favorite passage was i chose 1 peter 1 7 these trials only test your faith to see whether or not it is strong and pure your faith is being tested as fire tests gold and purifies it
and your faith is far more precious to the lord than pure gold so if your faith remains strong after being tested it will bring you much praise and glory and honor on the day of his return
he hasn't left you the only thing in the way of your knowing if he's left you is your fear you have a choice faith or fear that's the test
do you think faith doesn't mean i won't die
it will affect how you experience your death and therefore your life it's up to you
why did you leave seminary school
a test you passed i didn't
cut to cameron and foreman talking to pius and eucharist
we'll call you if anything changes
will she be all right
as long as she's not exposed to anything that will aggravate her allergy she'll be fine
need some help in here screw the procedure she's in anaphylactic shock
no way she's in the damn clean room
you kidding me get in here 0 1 cc of epi
gonna have to intubate
i got it i'm in breathing's stabilized
it's a clean room
cut to house and wilson looking through the glass
how do you get an allergic reaction in a clean room
maybe it was the preservatives in the iv
checked that
latex tubing
checked that checked everything
well it could be mast cell leukemia it can cause anaphylaxis
checked the blood levels and it's not
maybe it's just divine will
it's not my will
you do realize if you're wrong about the big picture that is you're going to burn right
what do you want me to do accept it pack it in
yeah i want you to accept that sometimes patients die against all reason sometimes they get better against all reason
no they don't we just don't know the reason
i don't think the nuns would agree with you on that
cut to house pacing in his office cameron knocks on his office door and enters
i just wanted to say that i know that you did everything you could
i don't need verification from you to know that i'm doing my job well that's your problem not mine
i was just being nice
yeah well you don't need to always do that
merry christmas
sister augustine's been extubated
good
she's requested to check out against medical advice she wants to go back to the monastery
well talk her out of it
i think i may have talked her into it
cut to house entering the clean room
room's paid up for the rest of the week you might as well stick around
this illness is a test of my faith if it's his will to take me it doesn't matter where i am i can accept that
does anybody believe anything you say you're not accepting you're running away just like you always do you ran away from the monastery you get laid you ran away from the real world when getting laid didn't work out so good now things aren't working out again so off you go
why is it so difficult for you to believe in god
what i have difficulty with is the whole concept of belief faith isn't based on logic and experience
i experience god on a daily basis and the miracle of life all around the miracle of birth the miracle of love he is always with me
where is the miracle in delivering a crack addicted baby hmmm and watching her mother abandon her because she needs another score the miracle of love you're twice as likely to be killed by the person you love than by a stranger
are you trying to talk me out of my faith
you can have all the faith you want in spirits and the afterlife and heaven and hell but when it comes to this world don't be an idiot cause you can tell me you put your faith in god to put you through the day but when it comes time to cross the road i know you look both ways
i don't believe he is inside me and is going to save me i believe he is inside me whether i live or die
then you might as well live you've got a better shot betting on me than on him
when i was 15 i was on every kind of birth control known to man and i still got pregnant i blamed god i hated him for ruining my life but then i realized something you can't be angry with god and not believe in him at the same time no one can not even you dr house
cut to a hallway wilson meets up with house
how'd it go
she has god inside her it would have been easier to deal with a tumor
maybe she's allergic to god
cut to house walking down the hall with the ducklings in tow
inside her
on her medical history she didn't mention any surgery
she had one
can we get her records what hospital was it at
she didn't have it at a hospital order a full body scan
what if she refuses
tell her i'm looking for a miracle
cut to the imaging center
no piercings no fillings no surgical pins in the arm no implants
it's clean as a whistle what's house looking for
what is that
don't know
lock on it get a 3d representation
oh my god
cut to house looking at the xrays
the copper cross a form of birth control pulled off the market in the 80s
so she's allergic to copper
rare but it happens
wouldn't she know she had an iud
she had an abortion iud must have been left in embedded in the endometrial tissue where it couldn't be detected
so all we have to do is remove the iud
cut to chase talking to augustine
and the symptoms should subside
i got this iud when i was fifteen it's been more than twenty years
prolonged exposure to an allergen with minimal symptoms but at some point all it takes is one last contact to cause a full blown reaction it's like a balloon filled with air one last breath it explodes
the first time i got the rash was when i was washing the copper cookware
and all your subsequent symptoms came from ingesting food prepared in it
dr house found his miracle
i doubt he'll interpret it that way
you told me your favorite passage would you like to hear mine celebrate and be glad for your brother was dead and is alive again
the prodigal son
he'll be waiting for you when you're ready
we'll schedule your surgery for tomorrow
cut to the clinic desk house is again throwing candies wilson enters and sits next to him giving him coffee
the sixth circle of hell
confined in a sweat box with a bloody nose and all the tissues are soggy
i think that's the seventh
nope seventh is
god we must be fun at parties
i think we both know the flaw in that theory
how's the sister
kidneys functioning heart rate is normal you know how it is with nuns you take out their iuds and they bounce right back
great
told you i didn't screw up
you screwed up
i gave her 0 1 cc of epinephrine
yeah and if cuddy hadn't taken you off the case you would have killed her you want to come over for christmas dinner
you're jewish
yeah hanukkah dinner what do you care it's food it's people
no thanks
maybe i'll come to your place
your wife doesn't mind being alone at christmas
i'm a doctor she's used to being alone i don't want to talk about it
neither do i
you did good with the nun congratulations
thank you
merry christmas dr house dr wilson
good night that was sweet
end montage silent night is being played on the piano starts with house and wilson sitting in house's place eating chinese food talking and laughing cuts to the hospital christmas party for the sick kids foreman is dressed up as santa cuts to house now alone playing the piano cuts to cameron in her office with a christmas present snow is falling in the background cuts to cuddy who is tending a patient back to house on the piano cuts to the hospital chapel service the four nuns we've met are present chase is watching through the windows final shot of house at the piano
house m d 1 06 the socratic method
house m d
1x06 the socratic method
december 21 2004
written by john mankiewicz
directed by peter medak
transcript written by cathy
archived at twiz tv com with permission from house transcripts and more
house and other related entities are owned tm and by heel and toe films and bad hat harry productions in association with nbc universal television all rights reserved this transcript is posted here without their permission approval authorization or endorsement any reproduction duplication distribution or display of this material in any form or by any means is expressly prohibited it is absolutely forbidden to use it for commercial gain
cat got your tongue nah you killed the cat cut off its head
need to take a look at this
mom mom mom it's ok
just a couple of questions before i can authorize extending her disability benefits
i don't like her she's fat
i could lose a little weight
you all right
actually before she signs
i killed the cat lots of blood
it's ok
i have a couple of questions about some of these dates the first diagnosis
schizophrenia dr walters may 11th last year the letter's in the medical file
and april 6th that was the last day she worked and she received unemployment benefits for that week
we fixed that i know we did we returned the money that's the canceled check not the real one you know it's a copy
and you're the dependent
no that's my little brother i'm eighteen just helpin' out
you're all set just need a signature
hey i'm talking to you the cat's first now it's
your turn lucy
shhhhh shut up shut up shut up
it's ok she just she just needs a little water is all
i'll go get it
just hold on ok just when she comes back sign it and we're gonna be done we need this ok please ok
the voices
the voices aren't real
mom mom mom mom
er voice over thirty eight year old caucasian woman status post respiratory arrest in the field intubated oxygenating poorly
p a dr gregory house please call dr cuddy at extension 3731
this is a good hospital
depends what you mean by good i like these chairs
how is she
stable ok your mom had a small pulmonary embolism blood clot that got stuck in her lungs blocked the oxygen
but the pain started in her leg
where the clot started her calf it's called a deep vein thrombosis basically a bigger clot
it never hurt there before i would have noticed
piece of that broke off went up the vein through the heart blocked the blood flow to her lungs no blood flow no oxygen
ok
is your dad here i have some things i need to talk to him about
uh my dad's running a little late he's dead just talk to me i take care of her
all right your mom's blood alcohol was 12 ten thirty in the morning
i gave it to her two ounces of vodka it cools her out but that's the first since monday that was three days ago i've been real careful she hears voices
she's schizophrenic explains the dvt the alcohol makes her pass out she's immobile for long periods of time
that doesn't happen she's not an alcoholic
she only drinks when you give it to her we put her on blood thinners you can probably take her home tomorrow
it's not the alcohol it's gotta be something else
of course it's the alcohol hello this guy's a professional doctor plays golf and everything i bet he's not gonna tell you your mom's an alcoholic without proof i'm sure he scoped for varices checked her esophagus ran all kinds of blood tests doctors like this they don't make assumptions they do the work
i'd be happy to refer you the case dr house you seem so interested
what case it's over you're sending her home how old is she
you're a doctor
own my own stethoscope did i ask you how old she was i forget
thirty eight year old woman with no previous symptoms or history presents with deep vein thrombosis how did she get it
oral contraceptives smoking diabetes obesity and what's the point here a dvt's a dvt put her on iv heparin to prevent future clots what's the big mystery
fine you're all sleeping you need a clue she's 38 years old she's 20 years too young to get a deep vein thrombosis
i treated a 12 year old girl once soccer player she got kicked in the leg
there was no trauma none of the risk factors
you took a history
i have some notes they're not mine but they're reliable i think for purposes of this discussion as for the immobility well she's real active right now of course paranoia keeps her limber
paranoia
oh yeah she's schizophrenic and her kid wrote this so it might be a little biased having to take care of his nutso mom and all you think there's a connection do we include schizophrenia in the differential for dvt
well
the answer is no abnormal dopaminergic pathways in the brain do not cause blood clots schizophrenia is not the cause of dvt
on the other hand we don't really know anything about schizophrenia so maybe it is connected
well the schizophrenia explains one mystery why you're so fascinated by a woman with a bump in her leg like picasso deciding to whitewash a fence
thanks i'm more of a leroy neiman man and it is only about the dvt she's 38 years old she should be
right solve this one and you're on your way to stockholm
we don't even know how to treat it come on fumigation of the vagina
a little louder i don't think everyone heard you
two thousand years ago that's how galen treated schizophrenics the marcus welby of ancient greece
oh clearly you're not interested
i'm interested i'm interested in how voices in the head could be caused by malposition of the uterus
there's a better place for it
and now what have we got we've got lobotomies rubber rooms electric shock my galen was so primitive
where are you going
going to see the patient that all important human connection thought i'd give it a whirl
you won't talk to patients because they lie but give you patient with no concept of reality
if it wasn't for socrates that raving untreated schizophrenic we wouldn't have the socratic method the best way of teaching everything apart from juggling chainsaws without isaac newton we'd be floating on the ceiling
dodging chainsaws no doubt
and that guitar player in that english band he was great you think i'm interested because of the schizophrenia
yeah i'm pretty sure
galen was pretty sure about the fumigation thing pink floyd
mom this is dr
gregory house nice to meet you be all right if we spoke alone for awhile
well you're gonna need me to
got your case notes doctor there's a cafeteria downstairs get yourself whatever you want as long as there's enough left over for a reuben sandwich dry no fries hold the pickles should run you about 5 80 with tax i'll page you when we're done
no pickles
nice kid how much do you really drink
he's really talking to a patient
i don't know who i am anymore
it's a blood clot what's so fascinating about that
he likes crazy people likes the way they think
they think badly that's the definition of crazy why would he like
they're not boring he likes that
and the meds
baseball i like baseball
very nice
very sad my boy and me we went to see a game
not mets meds medicine you take what he tells you to take
no one believes me
i do
i thought he liked rationality
he likes puzzles
patients are puzzles
you don't think so
i think they're people
yeah well he hates them and he's fascinated by them tell me you can't relate to that symptom
you told luke it never hurt before
just rough they didn't hurt
didn't
don't lie to him limpie lively lucy never lies to lucas look what i do to him
learn anything from the human connection
yeah the mets suck also for the last two months she hasn't shaved her legs because of the tremors she cuts herself
the tremors aren't new she must always cut herself
exactly something changed in the last two months i'm thinking the amount of blood when she cut herself so let's start with some bloodwork collect and send for clotting studies pt ptt factor 5 protein cns the whole shebang
good luck
no pickles and it's cold now
if it's a reuben that's the way he likes it
everyone this is luke
allison cameron it's nice to
yeah yeah yeah save it we're busy luke give us another half hour with your mom we need to do some tests nice kid take her off the psych meds that way we'll know what's what on the physical side and who knows we might get more out of her don't worry no pickles
happy birthday
ok whose
i was going through your mail and it was on a form happy birthday
oh
no no blood not mine
for the test dr house said
you're gonna steal it sell it no no blood no no blood no no blood no
haldol 5 milligrams stat
no no no no no no
well good news the lab says it's not strep so we're done
wait a second
no really not strep boys in the lab sure they're hard drinkers but they're pros you know plus your kid actually has none of the symptoms of strep i just figured it was quicker running the test than arguing with you my point is go
i just wanted to ask your opinion doctor she's having a birthday party next week and she's upset that i'm getting a sugarless cake
the other kids hate it
this is why you're here
sugar is the leading cause of obesity in america
you want a doctor to scare her about the dangers of sugar
she needs to get her weight under control
well you know i feel sorry for those other kids wendy who don't have a mom like yours a mom who knows that sugar causes heart disease appendicitis and athlete's foot
that's not fair
oh yes it is no i get it you want her to slim down a little so she can wear pretty clothes like yours love the bracelets hey what about matching outfits you could be twins she can't be your daughter it's impossible you look way too young happy birthday get the kid a damned ice cream cake
you drugged her
actually i didn't i've taken her off all medications
your guy foreman gave her haldol
we needed blood for some tests i assume that was the only way to get it
he knocked her out
look i have a cane and i know how to use it
i hired you you work for me
ok can i go now boss
the haldol changes her she says it makes her soul numb don't give it to her
if there be rags enough he will know her name and be well pleased remembering it you ok
old days
for in the old days though she had young men's praise and old men's blame among the poor both old and young gave her praise
help somebody help
so when i said no psych meds i'm just curious which word didn't you understand
the haldol had nothing to do with the bleed you know that i used it purely as a chemical restraint
oh great well that's good to hear so she won't experience any of those pesky little side effects you get when your motives aren't pure
those side effects are so rare
passing out increased confusion depression that's not gonna happen that's not gonna screw up our diagnosis cause you just used it to restrain her i'm so relieved
she spit in my face
it must have been so frightening for you
what was i supposed to do tie her down
yeah anything but give her drugs that's basically my point
the clotting studies pretty fast you promise to date the entire lab
no i save that for emergencies i told them she bled out two units and if it happened again she'd die
if it'd happened at home she would have died that er doc he was gonna send her home
it turns out your best judgment is not good enough here's an idea next time use mine
i think they're choosing a movie
why did the patient bleed out
the clotting studies so far are normal
well cover your ears if you don't want me to spoil the ending everything was normal except for prolonged pt time which means what
usually it means whoever drew the blood didn't do it right
oh that's right cause you drew the blood but you were precise because you knew the tube was purely for the pt study
that's right
and i'm right with you i trust this result for two reasons a because you are a good doctor and b because five milligrams of iv haldol makes for a spectacularly cooperative patient the prolonged pt time makes me think she's got a vitamin k deficiency
vitamin k would explain the bleed but not the clot
without vitamin k protein c doesn't work without protein c she clots clotting and thinning all at the same time
what about another drug interacting with heparin an antibiotic like ampicillin that would
clever but she's not on ampicillin
two months ago she complained of a sore throat and he got her ampicillin
which she refused to take
he just said she didn't take it what is it everybody lies except for schizophrenics and their children
it's more likely than malnourishment why not scurvy or the plague
gee i wish my idea was as cool and with it as yours what is yours by the way do you have one
alcohol simple it causes immobility which explains the dvt it also causes cirrhosis which explains the bleed and the prolonged pt time let's ultrasound the liver
three theories check out her place for ampicillin and diet then ultrasound her liver let's find out who's right before she bleeds to death
101
so house says the kid's sensitive thinks he takes good care of her if we don't find anything why let him know we did it in the first place what's the point why not just make old foreman lift the key from the kid's backpack
looks like luke sleeps in the living room
nothing in there he lays out her clothes
enough organization enough lists you think you can control the uncontrollable fix her meds fix her clothes maybe you can even fix her
pick that up on your psych rotation
trifluo perazine thorazine foziril whew they tried everything the ampicillin never touched it there goes cameron's theory
oh god i hope it's not a vitamin k deficiency
damn
breakfast lunch and dinner house was right
that's the only thing she'll eat
ah problem is you can't actually live on this stuff
i checked it out i looked on the box all the nutritional values were solid
there's plenty of protein and calories
yeah vitamin a and c but no k that's why your mom got sick
so what's the plan
load her up with vitamin k
that's it
if it all checks out you can take her home in a couple of days oh god you're upset about something you're gonna open to me now aren't you
it's all my fault
here we go ok i'm gonna say this once you have done a very good job taking care of your mother if this was all she'd eat then what else could you do gosh just being a kid is a full time job
shut up i'm 18 i should be able to take care of my mom i almost killed her
good example just the time it takes to express those ridiculous self centered teenage ideas i don't envy your schedule no pickles
my mom doesn't like them either
smart woman
before she got sick i didn't like how bossy she was always telling me what to do the right way to do it never thought i'd miss that ah
you should get that looked at
i still don't buy a vitamin k deficiency
house was right that usually makes you happy less work for us
the kid feeds his mum a steady diet of booze and the problem is too many burgers
the kid's in a tough situation you do what you've gotta do to survive
feeding alcohol to an alcoholic is not a survival technique
where i come from if it works
yeah right i'm rich i couldn't possibly understand what this kid is going through just because you're drinking pricier stuff doesn't mean you don't have a problem
you've seen someone stagger down that road
no way vitamin k's the whole story
it's not broken see this right here it's the epiphyseal plate otherwise known as the growth plate
what's wrong with it
amazing thing this bone if you know how to read it it can tell you how old someone really is exactly how old
great
not even fifteen almost though two weeks away maybe a month
last week i was fifteen last week
happy birthday to both of us if you're gonna lie though go big go 21 that way you won't need your crazy mom to help you buy vodka
great thanks for the tip now when i bring my mom home is there anything i need to know about taking care of her
i suppose your biggest worry isn't the booze you're 15 basically no mom child welfare let kids get away with that well they wouldn't need those nice foster homes and that would make them sad
they'd put her someplace too my life is working
not the word i'd use most 15 year old kids are doing what they're supposed to be doing you know they're huffing glue catching crabs
if you turn me in i'll sue you that's privileged information
oh relax it's not even your x ray
she's awfully calm
house write new orders
there's a little bit of scarring not much not enough to con
it's cirrhosis but she doesn't drink
congratulations you win
actually no one wins
a tumor cystic
solid mass cancer
the vitamin k caused the dvt and aggravated the liver but the tumor's the real reason for the bleed the tumor's the problem
mrs palmeiro i'm dr wilson i'm afraid i have some bad news from your ultrasound you have cancer
it's big five point eight centimeters
we do nothing she dies from liver failure within 60 days
she needs a transplant
that's gonna happen
she's a 38 years old she's a mother
she's a schizophrenic mother with no money on the public dole in fact who knocks back vodka every time a breeze blows her way
mickey mantle had a whole bar named after him he got a transplant
yeah well lucy can't switch hit plan b surgery to resect the tumor
joe bergen does the knife thing laser cauterizes while it cuts saves more liver
the tumor's way too big he won't even consider it
not a big risk taker bergen he won't even drink milk on its expiration date
he has no discretion five point eight centimeters is past the surgical guidelines
would he do it at 4 6
why don't we just say it's zero then we don't need him at all tumors grow they don't shrink
this one does
ninety five percent ethanol the ethanol dehydrates the tumor cells literally sucks them dry shrinks the tumor temporarily
how temporarily
well if we're lucky just long enough to fool the surgeon
good morning dr house
good morning dr cuddy love that outfit says i'm professional but i'm still a woman actually it sorta yells the second part
yeah and your big cane is real subtle too
gotta go those running noses aren't just gonna start walking on their own
the clinic can wait
how long maybe we could catch a movie
you should know by now my doctors have no secrets from me
i don't believe it who came running to mommy
it doesn't matter who the point is i know exactly what you did
you have no idea what i'm talking about
somebody knows about a bad thing you did that's a big field but somebody you think might have told me that narrows it down quite a bit someone who views me as a maternal authority figure a young person perhaps how am i doing you think i'm gonna get there presumably hospital business how many patients
it's cameron she found out about my birthday i thought she told you and
i'd have to stand here and smile while you gave me a sweatshirt or a fruit basket you know made me feel that deep sense of belonging
actually i was just gonna remind you you owe me six clinic hours this week
oops
hi this is dr cuddy i need all the charts on dr house's current patients
hiccups i've tried everything
um hmm pulling the tongue icepacks on the throat hitting yourself the groin pinch well you've certainly covered all the normal medical bases uh how are you hitting yourself though is it open hand or fist
open hand
well that's how they teach it at harvard med how hard though
i'm sorry i missed that could could you do that again that's that's very good hiccups
i need to speak with you now
mmhhmmm i need to go peepee dial it up a notch and repeat i'll be back
ooh girl in the boys' bathroom very dramatic must be very important what you have to say to me
yesterday your patient's tumor was 5 8 centimeters today it's 4 6 how did that happen
at a guess i'd say dr house must be really really good why am i wasting him on hiccups i wash before and after
you also requisitioned 20cc of ethanol what patient was that for or are you planning a party
do me a favor
i was gonna say leave but that works
you shrunk the tumor
only way to get the guy to do the surgery
fraud fraud was the only way there is a reason that we have these guidelines
i know to save lives specifically doctors' lives and not just their lives but their lifestyles wouldn't wanna operate on anyone really sick they might die and spoil our stats
bergen has a right to know what he is operating on
true i got all focused on her right to live and forgot you do what you think is right
you really didn't know
no i didn't and frankly i'm angry which i'm guessing is the correct response course i'll know better once you tell me what you're talking about
your birthday
oh anger was a bad guess well normally i'd put on a festive hat and celebrate the fact that the earth has circled the sun one more time i really didn't think it was gonna make it this year but darnit if it wasn't the little planet that could all over again
it's a birthday it's an excuse to be happy you think that's lame
why are you here to buy me a pony
i'm just waiting for the surgery
yeah well go scrub in
all right done close her up that tumor didn't just walk itself into a bar and order up a double shot of ethanol someone shrunk it down
i'm sorry it was very very wrong
house is lucky i didn't just close her up he tries again that's what happens
i'll pass it on
it looks like the surgeon got it all but she's gonna have to have some chemotherapy
what kind is it
luke stop writing if you stop for a second it's not all gonna fall apart give yourself a break once in a while the fact is your mum's gonna have an extra drink every now and then
no no she won't she doesn't
fine there are some things you just can't fix that's all i'm saying
that's how you'd handle it something like this you'd just give up
no i'd do it just like you it's an infusion she's gonna have a drain in her abdomen you're gonna have to check for possible infections
lucas palmeiro trina wyeth child services state of new jersey
can i help you this is a private room
he's only 15 years old a minor he's in a tough living situation we're just here to help
i don't need your help
15
lucas you're gonna have to come with us right now
where are you taking him
until the determination had been made he'll be housed at children's services
i don't wanna be housed i live with my mom
not for the next few days come on let's not make this difficult huh
mom mom i love you
the mets lost you remember
yeah i remember
i love you
cuddy didn't say anything about pushing bergen to finish the surgery
not a word some kind of mind game she's waiting for me to crack
well either that or she's just being nice
yeah well
you said you wouldn't call you're a real bastard you know
yeah i get that a lot i don't think mom's crazy
for in the old days though she had young men's praise and old men's blame among the poor both old and young gave her praise
you called social services it was you
no no no
it's ok it's ok i get it he'll have an easier time dealing with the system sure he won't be with his real mother but his real mother's sick someone needs to take care of him
i'm not gonna live here
what would his future have been taking you to chemo and back on the bus and even if the cancer's in complete remission he'll still have a mother who hears voices
talk no more talk no more
look what i do to him limpie you said that i checked the phone records only one call from this room smart they charge you two bucks a call it was to social services of the state of new jersey you're his mother couldn't do it to him anymore good for you
schizophrenics can make rational decisions
on the small stuff yeah when to sleep what to drink no lemonade but i'll take some hemlock if you've got it
your man socrates
but giving up your son because it's better for him it's so sane so rational self sacrifice is not a symptom of schizophrenia it excludes the diagnosis
she's not schizophrenic
she's 36 years old when she first presents
it's a little late but within the parameters
the internist sends her to a shrink one shrink sends her to the next she tells them all she's not crazy the drugs don't work and why would they if she's not a head case she got clearer when i took her off the psych meds you think i'm crazy
well yeah but that's not the problem didn't we just leave your office
i like to walk
is that dr jeffrey walters hi my name is greg house i'm a doctor oh is that the time yeah i'm sorry my watch must have stopped listen you treated a patient about eighteen months ago a woman named lucille palmeiro i wondered if you recalled running any tests at all oh how terribly foolish of me doctor is it that late yes i'm calling from london you see must have got my times mixed up so
i have a headache it's my only symptom i go to see three doctors the neurologist tells me it's an aneurysm the immunologist says i got hay fever the intensivist can't be bothered sends me to a shrink who tells me that i'm punishing myself cause i wanna sleep with my mommy
maybe you're just not getting enough sleep
pick your specialist you pick your disease if it's not schizophrenia what else presents with psych symptoms
prophyria
the madness of king george
what about that copper thing what's it called it's genetic the body accumulates too much copper
oh uh wilson's disease
very rare nice i like it
if any of us did this you'd fire us
well that's funny i thought i encouraged you to question
you're not questioning you're hoping you want it to be wilson's boom give her a couple of drugs she's ok
july 17 an appointment with a dr carne
she didn't keep it she never kept another appointment with a shrink he made after that
carne is not a shrink i looked him up he's an ophthalmologist now why would she want her eyes checked
wilson's presents with cataracts i think
yes it does it also causes slight cirrhosis which dr chase so eagerly attributed to alcohol so what are we still doing here
lucy i don't think you're crazy
neither do i but i'm crazy
come on
put your hands on the bar and your chin in here thank you
you're gonna see a bright light ok your body might be accumulating too much copper if it is this should help us see something called kaiser fleischer rings copper colored circles around your corneas i guess we should start treating her for wilson's
it's what i'd do
i will talk no more of books or the long war but walk by the dry thorn until i have found some beggar sheltering from the wind and there manage the talk until her name come round and be well pleased remembering it
for in the old days though she had young men's praise and old men's blame among the poor both old and young gave her praise
hi mrs palmeiro ready to go home
almost
mom how are you
i'm good oh oh oh you really need a haircut
dr house luke you're making dr house wait
that's ok we're just here for the music
luke come on i'm being discharged
i heard a rumor
thank god i had cancer huh it's terrible having everybody think you're nuts
really
i called to thank you did you get my message
yes you're welcome
i'm never thanking you you turned me in i told you we were doing ok it was none of your business
look i don't care how you were living i just wanted you out of my life that's why i had dr cuddy call social services
you ok
you were right it wasn't the dvt it was the schizophrenia
i know
she's not nearly as interesting any more
isn't it your birthday around now
the end
house m d 1 07 fidelity
house m d
1x07 fidelity
december 28 2004
written by thomas l moran
directed by bryan spicer
transcript written by celebmir
archived at twiz tv com with permission from house transcripts and more
house and other related entities are owned tm and by heel and toe films and bad hat harry productions in association with nbc universal television all rights reserved this transcript is posted here without their permission approval authorization or endorsement any reproduction duplication distribution or display of this material in any form or by any means is expressly prohibited it is absolutely forbidden to use it for commercial gain
so now the plan is either find ourselves a new counselor stick it out with the old one but go more often or resign ourselves to the fact that she's never gonna be happy no matter what i do so let's just take the money we're wasting and put it towards a membership at lakeview you know
i'm guessing the last option has you present it
yeah jeez what's with you it usually takes about half speed to stay with me
i didn't get a lot of sleep last night
how are things with elise
great
great
yeah
simple answers you're either out of breath or you're lying to me
yeah we have our moments but they usually work out can i get some water
yeah how do you work things out
talk someone apologizes man i shouldn't have drank last night
you mean you apologize
yeah i guess
how often do you guys have sex
enough
you do it this morning you did you did it this morning maybe that's why you can't stand up come on
elise honey i'm dehydrated we have anything with electrolytes sleeping beauty wake up this is an emergency the fridge is empty come on it's almost four elise sweetie
call jacques tell him i'm not feeling well
it's saturday you haven't been to work in three days remember
just let me sleep
come on you haven't been out of bed since wednesday
leave me alone
come on lets go
no leave me alone
honey
i said leve me alone i think there's something wrong with me
she's been averaging 18 hours of sleep a day since her admission
clinical depression incredibly contagious every time i'm around one of them i get blue
it's not clinical depression
great you got it all figured out you don't need me
three er doctors two neurologists and a radiologist have all figured out what its not we need to figure out what it is
well maybe if above mentioned doctors were interested in my opinion they would have asked for it
none of them are willing to subject themselves to you
no pain no gain
the blood work showed no signs of inflammation and no one can figure out what's actually the cause of
huh
what
husband described her as being unusually irritable recently
and
i didn't know it was possible for a woman to be unusually irritable
nice try but you're a misanthrope not a masochist
what's the first thing you ask a doctor who's referring a patient
are you questioning my ability to take a history what's the primary
not what why
diseases don't have motives
no but doctors do why this patient what interests you give me the chart
why
i find your interest interesting
house she's irritable sleeping 18 hours a day
what's interesting about that hypersomnia is usually accompanied by irritability in depressed patients
true but not relevant she's not depressed
hello she's sleeping 18 hours a day
fever clinical depression does not cause fever
she could be sick and depressed
she's sick dammit why didn't i think of that
that's what i mean
elevated sed rate indicates inflammation
hypersomnia and personality changes point toward the brain
not the spleen thank goodness we hired a neurologist brain symptoms hmm could this be a brain problem
no other systemic signs of inflammation probably not vasculitis
what about parasites malaria chagas
patient's never been outside the united states especially the tropics
you mean she claims she's never been outside the u s
very good
doesn't matter blood and c sub smears show no sign of parasites
has to be a tumor then
a tumor sitting directly on top of the brain stem that three er doctors two neurologists and a radiologist missed
partridge in a pear tree missed it too redo the blood work and get a new mri with 2 millimeter cuts through the and check for evil stepmothers this much sleep usually indicates poisoned apples
anything else beside the shortness of breath
mrs campbell not really its actually just kind of a tightness
you smoke
mrs campbell no never
exercise
mrs campbell eight hours a day i teach preschool
sounds fun any history of heart disease in your family
mrs campbell not that i know of
take a deep breath been under a lot of stress lately
mrs campbell none more than usual
you're probably just a little anemic but i'm going to do an ekg just to make sure
mrs campbell do i need to take this off
no you can just pull that down in front good lord are those real
mrs campbell do they look real
they look pretty damn good
mrs campbell they were a present for my husband's 40th i figured he'd enjoy them more than a sweater
that's so sweet i'm afraid the cause of your problem could be staring us right in the face actually i guess i'm the one doing the staring of course i can't be sure i'd like to consult a colleague he's actually somewhat of an expert in these matters can i get a page on dr wilson
a tumor
we don't know we're checking just to be safe
they already checked for that
the previous mri had a broader view
some tumors are almost impossible to see unless we know exactly where to look
that means it would be small right
yes
so you'd be able to operate take it out
if it is a tumor there are a variety of treatment options but there are variables other than just size
don't worry
too late
try to remain as still as possible the less distortion there is the more we'll be able to see
well that's what breasts look like
is a lie a lie if everybody knows it's a lie
well if a tree pretends to fall in a forest house come on they're breasts they're a birthday present not a philosophical treatise
lie number one she did not do that for her husband she did that for herself she thinks if she looks different she'll be different
no she thinks if she looks different she'll be more attractive which i have to say
not to her husband cosmetic surgery is so that everyone else will look at us differently same reason you're wearing that tie
well exactly that was going to be my next point
last three months same five ties thursday should be that paisley thing
it's a gift from my wife
no its not julie hates green you bought that yourself you want to look pretty at work wilson's got a girlfriend
stop stop i don't
it takes two department heads to treat shortness of breath what do the complications increase exponentially with cup size
i want an ekg and blood tests including tox screen on mrs exam room 1
you're ordering tests to cover your lechery interesting
very tricky case you love everybody that's your pathology
there were no lesions and no mass effect that we could see
what does that mean
it means we're still not sure what's causing your neurological problems
i know some thing are hard to cure but what i just don't get is why it's taking so long to figure out what's wrong with her
i know you're scared i would be too
i don't feel good
you feeling nauseous
honey you all right
she's seizing get her on her side i need some ativan
what's happening
she's having a seizure
she's aspirating suction
come on elise
the mri reveals nothing
that we were able to detect
it's not a tumor
a small glioma could hide from contrast we could do a pet scan
yes that's how a responsible doctor would waste his time in the situation
suddenly tests and radiologists aren't capable of error
a glioma not presenting on a contrast mri would have to be smaller than a grain of sand which does not a gravely ill person make
it could be just postictal disorientation
we would have seen improvement by now
late stage lyme disease can cause seizures
does the husband care about her
he hasn't left her bedside
now way it also means she doesn't have lyme disease
what love conquers all
lyme disease initially presents with a rash mr clingy would have noticed
we've looked at everything else
did you look at her breasts
pff men
could be paraneoplastic
she have any family history of breast cancer
her mother died of it
the brain but not the brain clever huh
how can breast cancer cause problems in her brain
there are molecular similarities between brain cells and tumor cells paraneoplastic syndrome causes the body's own antibodies to get thrown off track they end up attacking the brain instead of the tumor
so if you do find the tumor what do you do
we treat the underlying malignancy once there's no tumor to attack there's nothing for the antibodies to get confused about
if the tumor's treatable
exactly
ow
i'm sorry i know it's uncomfortable the tighter we go the better the image will be
least it'll keep me awake
don't worry it's almost over
i wish people would stop telling me not to worry
i'm sorry
my mom was the same age we've been trying to get pregnant for over a year i guess we're lucky we didn't
a lot has changed since your mom died don't worr don't give up
no tumor
the mri and mammogram only showed a few benign calcifications
it's most likely a small cell tumor its no surprise we're having trouble finding it we should do a pet scan start with her lungs and maybe her bones sometimes it presents with no tumor at all
how can a disease caused by a tumor present if there's no tumor
it happens twelve percent of cases
and how do you treat it if there's no tumor
you don't those twelve percent have no treatment they were too busy looking for the tumor right till they put the patient in the ground
what choice do we have
treat the symptoms iv immunoglobulin
so we're just going to ignore the tumor
eventually it'll get bigger then it'll be really easy to find one of you needs to check out where she works
why
cause the husband's not sick
meaning
if it's not paraneoplastic and it is a reaction to some kind of toxic it's obviously not coming from their home
foreman you do it
why are you riding me
it's what i do has it gotten worse lately
yeah seems to me
really well that rules out the race thing cause you were just as black last week
how long has elise worked here
three years she's my best rotisseur
what's that
the rotisseur prepares the roasted meats and gravies
how do you clean your grill
they say elbow grease
do you use chemical cleaners
ah no absolutely no our chefs don't do the cleaning anyway
what about pesticides you must spray for roaches and that sort of thing
nope my kitchen is clean no roaches i need to get back to work
and the fact that i'm here asking you these questions it doesn't worry you
look at me i'm here 18 hours a day that guy practically lives here he does live here i use the same detergents for 15 years and everyone is healthy as a horse whatever elise has she didn't get here tell her i hope she feels better and i had to get a new rotisseur
where's ed
he went down to the gift shop to buy a shirt i told him i'd stay up here in case you woke up
you must have better things to do
i send my laundry out
you're not married
no
waiting for the perfect guy
let me guess you've already found him
he threw my towels out the window
what
it's how we met freshman year he came to a party my roommate and i threw he spent most of the night on the bathroom floor he figured i wouldn't notice vomit on the towels if i didn't have any towels
i'm assuming he came back the next day to apologize
no way we had to track him down conflict resolution has never been one of ed's strong points nobody's perfect right
i guess
oh my neck hurts
you've been in this bed for a really long time we're gonna do the same test we did last night ok do you know what day it is
my arm itches
its probably just a mild skin irritation i'll get you some hydrocortisone in a minute do you know what day it is
tuesday it really itches
i'm gonna get you that cream right now
oh my god get them off someone get them off of me
elise calm down i need some haldol 5 milligrams there's nothing there elise there's nothing there
we had to sedate her
you gave sedatives to a patient who's already sleeping 18 hours a day
it was better than letting her scratch all the skin off her arms
or supposed to be
creepy crawlies are consistent with paraneoplastic syndrome
onset immediately after ivig isn't
there is a simple explanation maybe she really has bugs under her skin
infection
that's what the worsening of symptoms after immunotherapy would suggest
blood cultures and the timeline rule out most bacteria
if a patient throws up on your shoes do you clean up most of it
the symptoms rule out the rest serology rules out viruses css smears rule out parasites
in the final stage of african trypanosomiasis almost all the parasites are inside the brain it's possible they wouldn't show on smears
but it's not possible for a patient who's never been to africa to have african sleeping sickness
i'm just saying it fits the symptoms
she could have got it from a transfusion
or i'm just saying she could have got it from a transfusion
which she never had
okay
what about toxins
no the kitchen she works in is cleaner than some hospitals but they do serve rabbit rabbit fever fits her symptoms
tularemia initially presents with a rash or ulcer near the infection site
not if she inhaled it chopping the meat with a cleaver could easily aerosolize the bacteria
no then she'd have respiratory symptoms
maybe she ignored it figured she had a cold
we rejected lyme disease because the couple would have noticed a rash but a wet hacking cough is just going to slip right by
hey it's either that or she missed her exit on the turnpike and wound up in africa
two lousy ideas unfortunately they're better than all the other ideas tularemia bizarre very nice that's why i ride you
did he just turn on the tv
he needs to think
so this should tell us whether or not she's got rabbit fever
for a diagnosis of tularemia you need a four fold increase in serum antibody levels to measure an increase you need a before all we have is an after
a single titer over 160 would be a big clue
that's why i ride you what does that mean even when i have a good idea it's because of him
actually i think he said your idea was a lousy idea
it has to be one of these two conditions i say we take our best guess and just start treatment or treat both
the treatment for tularemia can cause aplastic anemia
how come he doesn't ride you guys
he's got a crush on you he just doesn't know how to show it
get over it he rides everybody
and the treatment for sleeping sickness kills one in ten patients
so we start with the safer treatment
by safer you mean the one that's slightly less likely to kill her
foreman got the gang testing for tularemia
yep
probably inconclusive but worth doing so what's her name when do i get to meet her
there's nobody give it up
your lips say no your shoes say yes
well they're french you can't trust a word they say
solid yet stylish a professional woman would be impressed i'm thinking accountant actuary maybe it's somebody in the hospital patient no chemo's not sexy daughter of the patient she would certainly have the neediness you need
i'm not gonna date a patient's daughter
very ethical of course most married men would say they don't date at all
there was no date i had lunch with one of the nurses it's her first time in an oncology unit and she's having a tough time emotionally
perfect
i wanted to be nice that's all i mean it
you always do it's part of your charm
hi boys mrs campbell's test results oh you remember her the preschool teacher with the heart of silicon
nope doesn't ring a bell
they came in yesterday i figured you guys would have been all over them i know how concerned you are
she's all upset because we paid more attention to the other girl you check out her ass i've got the chest
the tests were normal course that's just my opinion you may want to call a couple of guys from maintenance in for a consult
you check her ekg results before she left the other day
you ordered it
you're the responsible one
what's wrong they look normal to me
where is she
waiting downstairs why
i was right
mrs campbell do i have to get rid of the implants
surprisingly no but your ekg shows a slightly decreased heart rate
mrs campbell is that a problem
you told me you hadn't changed your diet or exercise were you lying
mrs campbell lying
does your husband have high blood pressure
mrs campbell my husband
yeah see if you're gonna repeat everything i say this conversation is gonna take twice as long
mrs campbell yes he was diagnosed six moths ago
he do a lot of cooking at home
mrs campbell not really other than oatmeal in the morning
did you happen to notice a slightly odd taste to the oatmeal lately
mrs campbell wait are you saying that
that it looks like your husband stirred in some of his blood pressure medication along with brown sugar
mrs campbell you think my husbands trying to poison me
no nothing like that he just doesn't want to have sex with you decreased sex drive is one of the most common side effects of the beta blockers he's been taking i'm guessing he figured if you're both frigid no harm no foul you should have gotten him the sweater
mrs campbell that's ridiculous
fine but if you're still concerned about the shortness of breath i'd start making your own breakfast
mrs campbell wait what should i do
well if you care about your husband at all i'd do the responsible thing buy yourself some condoms go to a bar find huh
lab tests inconclusive
not surprisingly
no too bad luckily i have the answer
to what
thanks for asking the life itself sex anything that can be transmitted via the blood can be transmitted through sex
sleeping sickness from sex
it's not without precedent
i'm pretty sure it is unless you're talking about going to africa and having sex with the tse tse fly
a portuguese man was diagnosed three years ago with cns affected sleeping sickness his only connection with africa was through a girlfriend who served under the military in angola
oi where'd you find that
the journal de instituto de higina y medicina tropical you don't read portuguese
you do
i'm pretty sure that's what it said either that or it was an ad for sunglasses
her husband has never been to africa either
ooh stymied again your logic is bulletproof
i think ignoring respiratory symptoms is more likely than cheating
because
they're completely devoted to each other
because
they love each other
or
they're overcompensating for guilt
find out which it is
you want me to ask a man whose wife is about to die if he cheated on her
no i want you to be polite and let her die actually i don't want you to ask her anything foreman take the husband chase take the wife
you don't trust me to do my job
we all formulate questions based on the answers we want to hear
and how exactly do you re formulate have you screwed around
did you know she's been trying to get pregnant
yes
after you got so freaked about the sick babies a while ago i figured that was your thing but you've never been prescribed folic acid and you can't lose a baby if you've never been pregnant
you pulled my medical records
you coughed the other day i was concerned
you were curious like an eight year old boy with a puzzle that's just a little to grown up for him to figure out
to may to to mah to
so it's either sleeping sickness or this rabbit thing
they're both fatal without treatment and unfortunately the treatment for both is extremely dangerous
are there test you can do
not at this stage but each condition has a unique history we're hoping your answers to a few questions will help us
sure whatever you need to know
before the sleeping problems did you have any trouble breathing a cough that wouldn't go away anything like that
no
are you certain
absolutely i've never been away from her for more than a night if she had breathing troubles i would have noticed
the other condition is significantly more likely if if you've had an affair
have you ever had an affair
of course not
you sure
i think i'd remember cheating on my wife
you might be reluctant to admit it
no
i just want to be perfectly clear if your wife has sleeping sickness and we don't treat her she'll die
i would never do that to ed i love him
absolutely not i love her
alright then they say no cheating we cross of sleeping sickness any new ideas ok we go with foreman's tularemia start her on iv chloramphenicol 25 milligrams per kilogram four times a day good night
where's ed
right next to you two down two to go
two days
no doses you have about twenty more days of this fun
what time is it
about four a m i pulled the short straw flow rate looks good no rash or flushing
what time is it
four a m do you not remember just asking
i don't know
elise elise elise elise
what are you doing
trying to wake her
she fall asleep again
in the middle of a sentence
what's happening
patient's not responding pulse is fine airways open check her blood pressure pupils are reactive
elise wake up you gotta wake up what does that mean what are you doing
she's not responsive to pain come on elise
is she dying
i don't know she's in a coma
there's only one way a tularemia patient goes into a coma while on iv chloramphenicol
the patient doesn't have tularemia
and then there was one patient comes in because she's sleeping too much it takes ten doctors and a coma to diagnose sleeping sickness
and then there was none we still have the problem of explaining how a white chick from jersey who's never traveled south of d c has african sleeping sickness
well the obvious explanation
i made it clear if this guy's lying about sleeping around he knows he's murdering his wife
does seem unlikely go away
what are you doing
checking for lymphadenopothy and waiting for you
who are you
i'm dr house your wife has human african trypanosomiasis sleeping sickness
you mean its not tularemia a virus tumor or or cancer
nope
i've never had an affair
i believe you
and i trust elise
the treatment for this disease is a drug that's fatal on its own ten percent of the time which is why i need your written consent before i can legally prescribe it
why would she lie if she knew it could kill her
i don't ask why patients lie i just assume they all do
but why
to protect you because she didn't think it mattered it just seemed easier because that's what people do now if you're absolutely certain that your wife has never had sex with anyone but you since you've been married then i'm wrong but if you think there's a possibility that just one time she wasn't perfect one weekend you're out of town one fight when she ran to a friend one stupid christmas party then you need to allow me to start treatment because if we don't she's gonna be dead by tomorrow morning do you trust your wife that much
i don't know
i'll start the treatment
glass syringes
and special iv tubing
why do we need this stuff
because melarsoprol melts plastic this stuff's supposedly arsenic mixed with antifreeze
what doesn't kill us makes us stronger huh
at least you wouldn't have been so glib if you'd been prescribed melarsoprol
can cause vomiting abdominal pain blood toxicity neural damage cardiac arrhythmia
forgot to say it's gonna hurt like all hell
she's lucky she's in a coma
how long before we know its working
it's tough to say it's a good sign that she hasn't gotten any worse
does she even know i'm here
she knows you're always there for her
yeah if she gets better it means she wasn't always there for me
it means she made a mistake
i can't help it part of me a big part of me can't handle that doesn't want her to get better
does that make me a terrible person
yes
so we're treating her for african sleeping sickness because you don't think it's possible for someone to be faithful in a relationship
and you do
yes
and you need to tell me that
look i'm not having an affair i had lunch with someone i work with at work once
i believe you what i don't believe is that it'll be just once
i love my wife
you certainly love saying it i'm sorry i know you love your wife you loved all your wives probably still do in fact you probably still love all the women you ever loved who weren't your wives
you can be a real jerk sometimes you know that
yeah and you're the good guy
at least i try
as long as you're trying to be good you can do whatever you want
and as long as you're not trying you can say whatever you want
so between us we can do anything we can rule the world
mixing up some margaritas mines a double senorita that's portuguese you know
spanish
uh oh what's going on
i'm re calibrating the centrifuge
turn around it's a very sad thing an un calibrated centrifuge it makes me cry too
i'm not crying
ok
i told the husband he was a jerk
why
when i was in college i i fell in love and i got married and
at that age the chances of a marriage lasting
it lasted six months thyroid cancer metastasized to his brain there was nothing they could do i was 21 and i watched my husband die
i'm sorry but that's not the whole story it's a symptom not your illness thyroid cancer would have been diagnosed at least a year before his death you knew he was dying when you married him must have been when you first met him and you married him anyway you can't be that good a person and well adjusted
why
because you wind up crying over centrifuges
or hating people
fever spiked at 104 echo shows global hyperkinesis
blood pressure
barely 90 over 40
you give her gilpamine
started 270 micrograms per minute ten minutes ago still no change
killing her parasites isn't gonna do much good if we kill her heart at the same time
a heart can be replaced a brain can't
right now were killing both if she's gonna die we should at least let her do it without that acid flowing through her veins
what's happening
we would have expected your wife's condition to show some improvement by now but it hasn't it's going the other way
please don't die please don't die
she's awake
hey she's gonna be ok
yeah sure what are you gonna do were you always honest with her do you know how lucky you are your wife is alive she loves you
what she did you can't love a person and do that to them
she loves you
i need to know who you had the affair with he has to be notified so he can get treatment as well why did you lie to us you knew your life was at stake
he's not coming back is he
we all make mistakes and we all pay a price i need that name
hi how you doing
fine
do you know where your dad is
can i help you
house m d 1 08 poison
house m d
1x08 poison
january 25 2005
written by matt witten
directed by guy ferland
transcript written by celebmir
archived at twiz tv com with permission from house transcripts and more
house and other related entities are owned tm and by heel and toe films and bad hat harry productions in association with nbc universal television all rights reserved this transcript is posted here without their permission approval authorization or endorsement any reproduction duplication distribution or display of this material in any form or by any means is expressly prohibited it is absolutely forbidden to use it for commercial gain
girl 1
girl 2
you give me that
girl 1 what are you talking about
quiet your phone young lady
i was switching it to silent in case someone called
no you were cheating
please like i need to cheat
lady
i said wait give it here
sure looove the blouse
i need to use the bunkroom
the bathroom sure in 19 minutes
can't do it
you got a friend in the bathroom with answers
fine i'll get you an escort
matt's hallucination of his teacher don't get up till i kill you
don't stand up
hey he's really sick
eyes on your work what is going on
get some help are you all right
credits the dreaded commercials
the kid was just taking his ap calculus exam when all of a sudden he got nauseous and disoriented
that's the way calculus presents
severe bradycardia heart rates down to 48 and falling fast
you know the kid
no
mom real good looking
i didn't notice
then it's a mystery not why he's sick but why you care so much the gift shop's open buy him a card
he's not responding to atropine
boys love fart jokes find him one with a good fart joke he's a teenager it's drugs tell those er geniuses to give him charcoal and naloxone so you'll stop following me
his tox screen was negative he's still whacked out
you don't care about the kid you just find his illness intriguing
his cat scan was clean there's no sign of infection and it's not diabetes
and you don't care about him
that's what you wanna hear not in the slightest
me neither means we'll be objective
maybe its shigellosis
wouldn't account for the bradycardia
viral myocarditis
wouldn't account for the whacked out so what's the differential for the negative tox screen
he was clean
unless someone screwed up the test
that never happens
or he od'd on something we didn't test for 1 4 butenediol would give you these symptoms
that's new
copy machine toner same punch as ghb a little pricier way more dangerous on the other hand it is legal i want you to go to his house and find his stash betcha know all the good hiding spots
actually i never did drugs
better go with him in case he gets high how much atropine is the kid getting
1 milligram
make it 2 in case he needs his heart later on
matt did you take any drugs this morning
pencils down
can you squeeze my fingers for me did anyone give you anything to help with the math test matt
i told you he doesn't take drugs
ms davis all parents think that about their children and they're usually wrong i gave my mum a little trouble when i was his age i turned out ok even she thought so
i know my kid the fact that you did drugs doesn't mean he did
did he go anywhere last night
no he was home studying
any friends come over to help him
and bring him drugs is that what your friends did
ms davis
look i tested him myself the home kit i took some hair off his brush i didn't want him to know about it because i do trust him
then why did you test him
all he did last night was study and argue about his college interviews he wants to be himself no haircut ratty old clothes that'll go over big then we both gave up and went to bed that's it
has he ever had any problems like this before any family history of diazepam 10 milliliters stat
what's going on
just some precautions he's seizing
this room is way too clean for a teenage boy
you know why house thinks i'm a druggie
this is gonna be a racial thing isn't it
same reason he thinks this kid overdosed when you're a drug addict you want to think everyone else is too
he's not addicted he has to take drugs
the definition of addict
he's in pain
and addicted to painkillers what a coincidence
you really never did any drugs
now this is gonna be a racial thing
deflecting a personal question with a joke gee who do i know that does that
yeah i'm just like him except for the angry bitter pompous cripple part
maybe we should all pitch in and get you a nice cane you've already got the matching gym shoes check this out mom's not too careful with the homemade tomato sauce when the top sticks out like that it's a sign of bacterial contamination
this one's open
i am extremely disappointed i send you out for exciting new designer drugs and you come back with tomato sauce betcha paid twice as much i got mine online
matt decided to make himself a homemade pizza for a bedtime snack
source of botulism as well as a million other toxins that cause gastroenteritis cardiac symptoms and mental confusion
i'm not sure about gastroenteritis but mental confusion bring it on
delicious
do you have a death wish
i notice he didn't try to save me
i figured you were trying to make some kind of subtle point
i was kid just started seizing not a symptom of food born toxins
also not a symptom of drug use either not two hours after admission
so what would make him seize in addition to all his other delightful symptoms
pesticide poisoning
carbonates
or organophosphates organochlorines
inhalation or absorption
too soon to tell
we should wash him down the poison could still be on his skin
already told the nurses
i feel good
that's your complaint you major symptom
i told her this was a waste of time
i notice colors more and music i i'm really hearing music i'm eighty two and i'm supposed to be playing canasta with the other old ladies but now when i see a guy with a cute butt i just cant stop looking at him or a sexy beard
and you figure that enjoying cute butts is a sign of disease
it all started a month ago when mark rented gone with the wind for me but it had the wrong dvd in it
oh right i forgot this is all my fault
of course he was too busy to bring it back
yeah like i don't have a life
so i watched it and it had this actor in it this kid called ashton kutcher now i think about ashton all the time all the time
aha
you remind me of him same bedroom eyes
people are always mixing us up
i suppose you'll need to check my heart
no no that won't be necessary
i told you
but i am going to admit you to the hospital for tests
what tests she's just old
and you're just insufferable your mother has had a sudden personality change she should be checked out i'll have a nurse come to admit her i'm too handsome to do paperwork
he's been on this medication for over an hour
pralidoxime is very effective it just takes a little time for it to kick in
maybe you're wrong maybe it's not a pesticide
the blood work was pretty conclusive it's an organophosphate
oh my god
get back ms davis move back please we're at 30 ready cardiac arrest get me the pads
what are you doing
we're going to beat his heart for him set it to sixty
commercials gr
i can't stand this anymore
we'll keep him on the pads for another hour
then what
let's see what happens
well that's not my philosophy especially when it comes to my son and if something bad might happen i'd like to know what our options are
the pralidoxime isn't doing him any good we're going to have to wire his heart
maybe we're wrong about the pesticides
i ran his plasma twice
are there any stronger treatments for the organophosphates
oh damnit you caught me went with the weak stuff just trying to save a little money
actually one of my professors at columbia developed an experimental treatment for the army
what's the success rate
they're targeting there's a different hydrolase treatment for each poison we need to know if
matt got hit with orthene or malathion
what's the success rate
excellent i'm sure it's the us army be all you can be the point is what are the kid's chances without it
minimal at best the poison's broken the blood brain barrier
i assume minimal at best is your stiff upper lip british way of saying no chance in hell
i'm australian
you put the queen on your money you're british call your professor
if we don't know what poison we're dealing with we don't know which hydrolase to ask for there's over forty organophosphates
i'll get all of them
great minds think alike
by the time they get here we better know which one we need
if we figure out how he got exposed we'll figure out what he got exposed to
well the mom had homemade tomato sauce call me crazy but i'm thinking maybe homemade tomatoes
front yard vegetable garden
kid's out there spraying pretty girl walks by hormones raging spray can goes off in his face
i'll check into it
i'll make the call
i'll keep the kid alive for a while at least
i'll have lunch
through the superior vena cava into the right atrium through the tricuspid valve and lodging into the wall of the right ventricle
getting a heart rate of thirty six
that won't do get him to fifty
the healer with his magic powers i could rub his gentle brow for hours his manly chest his stubble jaw everything about him leaves me raw
psych ward's upstairs
with joy oh house your very name will never leave this girl the same not bad for an eighty two year old she asked me to give that to her true love
what can i say chicks with no teeth turn me on
that's fairly disgusting
and that's ageism
you better watch yourself around this babe here are the test results
impressive
i found the pesticide it's disulfoton and it's empty he used the whole can
okay i'll get chase on it
the poison is called disulfoton this should bond with it and neutralize the poison then his nervous system will start sending the right messages to the rest of his body
but there was no disul that stuff in the can
the label says disulfoton i can show you
but you didn't test it
you said matt sprayed with it this morning before school
matt started that garden himself for environmental science class they weren't allowed to use pesticides
apparently he cheated a little
it was orange peel oil totally organic he dumped that other stuff last winter
the symptoms fit there must have been some left in the can
if you're wrong what will this treatment do to him
well theoretically it could increase the toxicity and but we're not wrong
don't
we're not wrong
i can't let you do this
get a court order unless you want to see someone killed by sheer irrationality
maternal instinct is always irrational that doesn't mean it's wrong
actually that's the definition
it doesn't mean she's mentally incompetent
she's risking her son's life based on a teenager's claim that he washed something how mentally incompetent can you get
that's a brilliant legal argument
listen have your harvard law dog whip up some high grade legal sounding psycho babble temporary insanity brought on by acute panic distress syndrome i don't care we have to give him the hydrolase
her only sign of mental illness is that she disagrees with you some would consider that a sign of sanity
not the kid let's ask him oh i forgot we can't he's dying
get the mother to sign off that she's refusing this treatment
goodbye i margo davis have been informed of the risks which may arise from my refusal of advised medical care i here by release
who are you
i work for hospital the princeton plainsboro teaching hospital its employees agents and otherwise from any adverse medical conditions resulting from my refusal it is not the hospital's fault if my son kicks off
kicks off
i punched up the language mostly for clarification i understand my doctors consider my decision to be completely idiotic
why are you doing this
but i am convinced that i know more than they do i took a biology course in high school so yeah besides i enjoy controlling every single aspect of my son's life even if it means his death sign here please i brought a pen
who are you
i'm the doctor who's trying to save your son you're the mom who's letting him die clarification it's a beautiful thing
she rethought her position start him on the hydrolase
no we've got a problem
on three one two three
heart rates 49 o2 stat
saline atropine and diazepam now
his names chi ling he was admitted twelve minutes ago identical symptoms as matt chase isn't sure he's gonna make it
matt's next door neighbor by any chance
they live 10 miles apart apparently they don't even know each other
commercials again too many of these things
chi's dad we live in an apartment we have two bamboo trees no pesticides just dried seaweed for fertilizer
the second kid's heart is almost as weak as matt's were gonna have to get him wired up too and i don't know how long matt's brain's gonna hold up his hearts not pumping enough oxygen
how much are you giving him
eighty percent
make it ninety
we're risking damage to his retina
what the heck do it anyway he's a calculus student he probably likes having a brain i'll have foreman do it
i'm the primary
yeah but the mom wants to get rid of you and you know me i'm a people pleasing kind of guy
she complained about me
she went to the principal told cuddy you did drugs in high school this is gonna go on your permanent record
i was trying to get information it was a strategy
she also used the word slacker want to come in smoke a little weed watch some mtv
high school has no idea what could have happened
you sure chi didn't sneak out of matt's tomato patch maybe they sniffed disulfoton together to get high
same school different grades different cliques different everything
they managed to get poisoned together they must have something in common
their classes aren't in the same building they don't even eat lunch in the same lunchroom
how do they get to school
unless you're with the board the police or the union i don't care who you are
sir we need to test the bus for chemical residue
and i need to pick up the basketball team you got a problem with it call my supervisor
two kids were poisoned on your bus this morning they're dying
my god the things he said
dr house wanted your son to get the medicine he needed he was willing to do whatever it took to make that happen
the wrong kind of medicine
he didn't know that at the time it was our only choice
he would have known if he'd listened to me
he listened he just assumed you were wrong and to be honest that's true of most of our patients
you're just as pompous and superior as he is
matt is back row right the asian kid second or third row left look i've got this rash in kind of my groin region
it's not a symptom
neither is being obnoxious looks like you're in the clear
so who poisoned them
we're not sure yet if it was done on purpose
oh yeah you should see the little bastards screaming and punching each other all day long
did you happen to notice if anyone was doing any spraying near the bus route
oh yeah there was a truck down by the pond or something earlier smelled kinda funny too
oh dr house
well it took you long enough we've been waiting
could you step outside a minute
why
because you irritate me
he is my son doctor he's just a little cranky from not eating
fine mrs adams have you had any recent sexual activity
what
well i don't suppose fantasies count
oh my god
unfortunately i've hit kind of a dry spell only for the last oh i don't know 15 years
she's confused my father died 8 years ago heart attack
not in bed dear why do you ask
because you have tested positive for syphilis
that's impossible and insulting
i don't think it's the first time mom's heard this diagnosis
cupid's disease that what we used to call it
when did you get it
uh 1939 prom night i think he had a chevrolet it was before i met your father
but mom you said dad was your first love
he was we're talking about sex i was treated
which suppressed it in your case for 60 years but now it's back and the spirochetes that cause syphilis are eating away at your brain cells
oh that's revolting
it's not as revolting as chlamydia that's got seepage and it's the 21st century we've got flying cars talking dogs and penicillin high dose regimen for two weeks you're cured
i don't believe it
yeah well pinch yourself
i guess for the next two weeks i'd better practice safe sex
you'll be fine just feed that cranky kid
the county's worried about west nile so they sprayed ethyl parathion right next to the bus route
do you have the hydrolase for ethyl parathion
yep only one problem matt's mom faxed his record to the cdc and she refuses to let us do anything till she hears back from them
you're getting good at this god like doctor thing why don't you talk her out of it
she's not a big fan of mine
or mine
only one man left in the bullpen and he throws like a girl
i hate sports metaphors
give her the high hard one
we really think the hydrolase is the only
i'm thinking about transferring matt out of here
ms davis your son is very sick he won't survive a transfer
i'm getting a second opinion from the center for disease control
right look when my grandmother got sick
what you're gonna tell me some tough decision you had to make
i know how hard this is for you
maybe embroider the story a little make it fit
i can't imagine being in your position
honesty a kind of vulnerable honesty that's your thing and the looks they send a single woman to hustle the single mother
actually they sent a doctor to tell you that if your son doesn't get his treatment there's a good chance he'll die
that's what house said about a treatment that would have killed matt you gotta do better than that
no it's on you you gotta do better right now yes or no
i don't know
figure it out
wait
help
seizing suction
chi's dad my son
diazepam
10 milligrams
not responding another 10
you're killing him
get her outta here get her outta here
commercials evil
their hearts are barely pumping their lungs are shot now they're showing liver toxicity
i guess matt's mom won't nominate us for any doctor of the year awards
only explanation is they got poisoned by something other than ethyl parathion then the hydrolase would release the neurotoxins instead of bonding with them
the only thing they have in common is the bus
except their symptoms given their severity in fact their cardiac symptoms are getting worse much faster than all their other ones what does that tell us
poison was probably absorbed through the skin
they were admitted at 8 45 and 11 00 when were they poisoned
absorption through the skin anywhere from 3 to 8 hours
in a case that bad more like 1 1 2 to 4
so matt was poisoned before 7 15 before he got on the bus
you think each kid got poisoned in his own house two separate exposures
what do teenage boys do in the morning besides the obvious
wake up go to the bathroom and the obvious then check their zits in the mirror
do they use the same acne cream
because acne cream contains lanolin which could have pesticides and you're thinking they both bought the same product which
could be contaminated shaving cream
chi doesn't look like he shaves
he sweats
deodorant could contain lanolin
these people have pets
chi has a dog matt has a cat
fleas flea powder
ok go to their houses check for anything that could have touched their skin between the time they got up and the time they got on the bus and i'm running low on tomato sauce
dr house
i sent you home
i came back i took a cab so my son wouldn't try to chaperone us this time
i'm sorry but the fact that the sexual pleasure center of your cerebral cortex has been over stimulated by spirochetes is a poor basis for a relationship learned that one the hard way
look dr house these feelings that's i've been having is it all because of the syphilis
yes
then here's the prescription you gave me well it's not like i'm going to infect anyone
no but it'll kill you
well you gotta go sometime and i really don't want to play canasta for the rest of my life i i like feeling sexy again and making a fool out of myself with handsome young doctors
do you think i would have given you this if it would stop you from flirting with me
but if i'm cured
the spirochetes will die off but the little pieces of your cerebral cortex that have been destroyed won't grow back you're brain damaged doomed to feeling good for the rest of your life
oh oh thank you
georgia
when i stop being contagious i'll come back for a checkup
yeah
matt uses sure
chi uses old spice
no zit cream
lucky kid floral air freshener
doesn't mater when's the last time you heard of a teenage boy using air freshener pert shampoo
johnson's over here matt's mom would make him use air freshener
there are limits to a mother's power even hers
just check
negative on the floral
matt's alts are up to 800 if they get any higher we can toss his liver
yeah
no matches on flea powder underarm deodorant
or any other kind of deodorant
what about shampoo
no to shampoo bar soap dish soap dish detergent
what about laundry detergent maybe they both washed their clothes this morning
i'll check
if we cure matt he can use his close brush with death on his college essays admission guys love that stuff
that's how you got in right jail house diaries
tko
tko liquid
liquid 128 ounces
128 yellow jug special
environmentally safe formula it's the same
bring in the detergent
so the detergent was contaminated with pesticides
soaked into their clothes and got absorbed into their skin hi look the clothes your son wore today he washed them this morning right
chi's dad what
nice respectful asian kid does the laundry
chi's dad my wife said he didn't
then i'm guessing he washed them last night without you knowing
chi's mom please he doesn't even know how to turn on the machine and besides those clothes were new nobody washed them
his clothes are all new
chi's mom the ones he wore today yes never washed
now what
what about matt's clothes they new
they're ruddy old jeans i think they've been bagged up and taken downstairs
davis
yep they're matt's and they're old
and yet the label isn't faded in the slightest fake old 100 dollars for the homeless look what kids aren't pretentious in england
chi's are a different brand how could they both be contaminated
that is a question for the ages in the meantime get these tests in
i never bother to wash new clothes before i wear them
right your wife does she wants you to feel nice and comfortable
hey i'm a man i don't have time for laundry i'm saving lives here no she doesn't wash them either
so your skin absorbs a little dye the odd chemical here and there
well you know me always living on the edge
judging by the self importance of your strut you have identified the chemical in question
phosmet
hit him with the hydrolase
chi's parents said yes but
mighty mom said no she's gonna feel like million bucks when chi lives and her son dies send cameron she's the only one who's managed to talk her into anything
not this time matt's mom won't do anything until she gets that opinion from the cdc
godot would be faster
what is this
thought i'd hang out in case you change your mind and i can give matt the medicine right away don't worry i've got time
the cdc promised they'd call
they will maybe tomorrow maybe the day after takes time to review faxed records then they'll probably tell you they can't make a decision based on faxed records this is suzy she's never gonna marry him no money
what makes you think you're right this time
same reason as last time you wanna see how the other kid does first that's ok might help you but there's a real good chance that
what matt might kick off
a little blunt i was gonna say run out of time or just sort of let my voice trail off
hello yes this is margo davis but you have his records i sent them yes i understand they can't help me
they haven't seen him can't make a decision based on
give it to him
the cdc is unable to give an opinion at this time and we're gonna have a doctor in your area next week
you fooled her with that
house
so i'm gonna be cured
as long as you don't wear any more poisoned pants
i'm sorry mom i knew the pants were stolen they were only five bucks you're gonna give me hell aren't you
oh honey i'm just glad you're alive let's get you home so you can rest maybe i am too hard on you you don't have to make up that test till next week you can stay in bed and work on your applications
some guy was selling pants off the back of his truck near the school when he wasn't busy as a clothing entrepreneur he did daily at the cornfield over by route one used the same truck for both jobs
spilled pesticides on the pants didn't bother to clean up so why are you still here why aren't you out there making up with the joyful mother
why would i do that
no reason at all you don't care about her or her son
oh dr house the cdc called again
oops
who are they
oh they're the arrogant jerks that saved your life
the end
house m d 1 09 dnr
house m d
1x09 dnr
february 1 2005
written by david foster
directed by fred keller
transcript written by mari
archived at twiz tv com with permission from house transcripts and more
house and other related entities are owned tm and by heel and toe films and bad hat harry productions in association with nbc universal television all rights reserved this transcript is posted here without their permission approval authorization or endorsement any reproduction duplication distribution or display of this material in any form or by any means is expressly prohibited it is absolutely forbidden to use it for commercial gain
this is a really nice room
yeah it sounds thick too bad he's not coming
look i talked to him myself he'll be here
right
you're the one who said the song could use a horn part so i got the best john henry
you think i'm stupid
of course i do but that's not the point he'll be here okay
take a left up ahead
south street i cancelled this gig you said you didn't want to do any sessions for a while
for a while i called her i un cancelled it
but you up to it
let's find out
you lied to me john henry's never gonna show up
will you stop
it's been like two hours
and we will keep waiting i mean you've heard this guy play and you know what he does so can you just shut up tommy
oh my god
am i late
you need to hear it again
nope i get it let's try one see what we get let's do it
john you okay you okay
i can't breathe i can't breathe
call an ambulance now
i want in
john henry giles you a fan of his music
he's a musician that paralysis thing guy can't walk for two years and nobody knows why that seems mildly interesting
forget his paralysis
tell that to the rest of his bowling team
as far as this hospital is concerned this is a simple case of low bar pneumonia boring
but that not walking thing that could turn into something serious
marty hamilton is his primary physician out in california he's dealing with the paralysis
know all about it multiple treatments multiple surgeries making real progress fixed everything but the legs
dr hamilton already called and asked for your team and by team i don't mean you
like i always say there's no i in team there is a me though if you jumble it up
foreman did his residency with hamilton
i know i did accidentally glance at his resume before i hired him
he wants someone he can trust
he must have spoken to foreman's parole officer
someone who will stick to the pneumonia john henry's on an experimental protocol for the paralysis
i respect that i'm not going to get in his way
it's foreman's case
it's pneumonia he can handle it guy's already paralyzed how badly can he screw it up
so what are his stats
staying in the 90s on the nasal canula
coughing up much sputa
almost none he seems to be stabilized
dr house is there anything back from micro
not yet you gonna fire me
you can make up for it by washing my car
oh this is fun
let's keep him on the broad spectrum antibiotics and since he's displaying septic physiology draw blood for adrenal and thyroid function
how about the paralysis
we're sticking to the pneumonia
well you certainly are boss like a wet tongue sticks to dry ice
the paralysis has already been diagnosed by dr hamilton it's als
lou gehrig's disease it's a lovely diagnosis they make movies about it no tests no treatment it's a disease of exclusion
because hamilton has excluded everything else
i haven't what else could it be
guillain barre which would be reversible
excellent
no the progression of the paralysis would be symmetric this wasn't
transverse myelitis
hamilton tested for it negative and he was negative for masses and avm and
antibodies could be attacking the nerve multifocal motoneuropathy
uncommon but it fits it's also treatable did hamilton try putting the guy on ivig
no because the mri showed
well let's do an mri of our own
guys it's my case als fits it even predicts the pneumonia the paralysis is progressive
it's a death sentence
that doesn't make it wrong
so you think the breathing stuff is connected to my als
it makes sense
so it's just gonna get worse huh
well dr hamilton
great guy really smart doctor but his treatment obviously isn't working do you think i'm gonna die here or you think i'm gonna get to go back home first
an mri would give us a better idea
an mri come on for pneumonia
well dr house thinks we should test for
house yeah i heard about him obsessive son of a bitch
that's him
so who do you think is right hamilton or house
they're both excellent physicians
come on one of em says als the other one says not als you gotta pick one son
everything points to als
then no mri and i want one of them papers that say i i don't want nothin' done if something go bad
a dnr mr giles you don't want to rush things
it's been two years i ain't rushing i wanna sign one now while my arm still works
he signed a dnr
he rhymes with dinner
he signed a dnr
oh that makes more sense you tell him it might not be als
no
well no wonder he signed who wouldn't
i started him on iv steroids and ancinthroid sp
great if it was my case i'd be adding a little ivig to the mix
for his pneumonia
that's my story and i'm sticking to it
he doesn't want anything done no treatment
dnr means do not resuscitate not do not treat you do nothing it doesn't matter which one of us is right and hang on to that dnr that signature could be worth a lot of money real soon
this is dr foreman what's mr giles's status okay increase the steroids to 100mg every 12 hours and ah start him on ivig yeah i'm sure one gram per
my nature isn't what it used to be the little man has lost some bounce in his step he needs to crank it up have himself some fun this weekend he wants the blue pills
you're talking about your penis in the third person
me and him two people
separate vacations that'd be a drag for one of you i don't think you need the pills i think you have a conflict of medications you need to up your insulin to chocolate chip ice cream levels
insulin
yeah you remember that's the stuff you take for the diabetes that you forgot to tell the nurse about your hands no hair which means nerve damage and your shoes look about two sizes too small which means you've lost sensation in your feet and then there's your pants
my pants tell you i have diabetes
no they tell me you're an idiot powdered sugar on the right pant leg based on the two napkins in your right pocket i'm willing to bet it's not your first donut of the day
you're giving me the pills
sure why not if you've got heart disease from ignoring the diabetes they'll kill you otherwise you two have a fun weekend
0 2 stats are dropping
breath sounds
junky
mucus plug
no it's our mistake he's sludging from the ivig blood can't get through to his lungs
start heparin 500ccs iv push
he won't last long enough for it to work we've got to intubate him stat
we can't he's dnr
what
someone likes music
oh yeah
his stats are in the 70s how long has he been like this
10 minutes
well why aren't you doing
the ivig put him into respiratory failure
you put him on the ivig
we did this
so undo it chase
it's too late we killed him
nobody killed him he's not dead chase intubate him
he's dnr
what are you doing you can't do this
bag
you can't do this
bag he had a bad reaction to some medicine we gave him
what did you just do
he saved his life
he's stable on the ventilator oxygenating well
the ivig made him worse which means multifocal motoneuropathy was a bad diagnosis okay what's really wrong with him
what's wrong with you
everyone knows what's wrong with me what's wrong with him is much more interesting
you tubed him and he didn't wanna be tubed he has a legal paper saying just that
to intubate or not to intubate that is the big ethical question actually i was hoping we could avoid it maybe just practice some medicine
there's no question it's the patient's decision
if the patient is competent to make it if his thyroid numbers aren't making him sad
oh my god you don't believe that
his thyroid levels were a little
it's nothing do not defend him
why did he sign that dnr
i didn't talk him into
no he signed the dnr cause he didn't want a slow and painful death from als what was happening to him had nothing to do with his als
right exactly it's the ivig you screwed up you're not gonna let him die because you screwed up
technically your case you screwed up is that what this is about looking bad in front of your old boss
you assaulted that man
fine i'll never do it again
yes you will
all the more reason this debate is pointless
his lungs are worse any theories oh i'm sure he just went to the little boys' room come on people
uh vasculitis
wouldn't likely hit both lungs
it could be wegener's granulomatosis
dr house
cuddy sent me a stripper again ah love that woman so thoughtful
sorry
there are case reports of wegener's hitting both the legs and the spine
well it's not great but it's better than als at least it's treatable
it's a restraining order you're not to come within 50 feet of john henry giles and they've asked the da to file criminal charges for battery
cameron test the blood for c anke sp
these are criminal charges they aren't going to let you take blood to make more tests
he has blood left in the lab just add on the c anke foreman's still got you doing bronchioscopic suctioning for the pneumonia
every four hours
well while you're down in his lungs grab a biopsy we'll need it to confirm wegener's and move the patient to the second floor icu
why
it's right about the clinic i'm pretty sure it's 50 feet in any direction it's nice having a court order saying you don't have to work clinic duty
dr cuddy
excuse me
you paged me
why the yelling
his bed is behind that wall the plaintiff's i can't you know come any closer
it's right over the clinic very cute
can we get the lecture over with because i've got a actually i've got nothing to do take your time
you need a lawyer
you don't have a problem with what i did
when i hired you i knew you were insane i will continue to try and stop you from doing insane things but once they're done trying to convince an insane person not to do insane things is in itself insane so when i hired you i also set aside 50 000 a year for legal expenses so far you've come in under budget
great any chance you could help me run some tests
dr foreman called dr hamilton he's flying in from l a
you can talk to him
dr hamilton is flying in as a friend of john henry's to pull the plug
yeah i need a lawyer
house's attorney your honor on behalf of gregory house we have convened an emergency session of this court to bring a motion requesting john henry giles remain on life support
mr house faces criminal charges for battery against john henry giles you beat up a guy in a wheelchair
house's attorney dr house is alleged to have forced a tube down mr giles' throat against his will
a medical tube saving his life
dr house please let your attorney speak for you
i'm sorry your honor i was way out of line
so uh your client forced the patient into this position and now he wants a court order to force the patient to stay that way
house's attorney without the tube there's a high likelihood that mr giles will die
well i assume the patient knows that he had a dnr that's why your client is facing criminal charges right
house's attorney exactly and mr giles' death will violate my client's sixth amendment right
the right to face his accuser that's clever huh
giles' attorney your honor in commonwealth of pennsylvania v hozelton the 3rd district ruled that a defendant may not use that status to rule against a felony charge
why are you doing this it's not going to keep you out of jail
no
even if you win the restraining order and battery charge stay in place what have you gained
time
to diagnose him you can't get near him
i don't want to get near him
you know how some doctors have the messiah complex they need to save the world you've got the rubik's complex you need to solve the puzzle
are you done or do you have more references to 1980s fads i'm trying to listen to this
house's attorney that dnr may not be valid the patient was suffering from depression brought on from a thyroid imbalance
the dnr order was witnessed by dr house's own staff a a dr foreman
my staff are idiots i'm sure you know what it's like your honor
sit down
house's attorney the validity of the dnr is a question of fact dr house should have the opportunity to make his argument at a full trial
and this poor guy has gotta stay on life support until we can schedule a trial
your honor
dr house i will hold you in contempt if you don't sit down
i have a medical issue
if it pertains to this case your attorney should
it doesn't do you have any history of heart disease in your family
giles' attorney your honor
your fingers they show signs of clubbing which indicate a health problem remember bart giamotti same thing just dropped dead one day please see your doctor
giles' attorney he's admitted this isn't relevant can we please get back to the motion
of course i'm sorry
giles' attorney your honor a person's right to control the treatment of their own body is fundamental to understanding this case a long line of
congratulations impressive legal argument
i watched matlock last night
oh say no more i didn't notice any clubbing on the judge's fingers
neither did i
so the family history thing
every family has some history of heart disease
and mental illness
biopsy only shows inflammation
start him on cytoxan
you're diagnosis wegener's based on a little inflammation
well unfortunately i think we've exhausted all the tests we can do in the capacity as the doctors he doesn't want doing tests on him
but you don't
we'll know i'm right if he starts walking
you can't do any more tests but you want me to treat him
the medicine's in the pharmacy patient's immobilized in the icu sounds like a simple geography problem
are you asking us to jeopardize our medical licenses for this treatment
dr hamilton can i help you
uh i'm dr house i'm
gregg right i'm marty hamilton john henry's doctor we should talk
i'd appreciate any list of medications anything like that
i've started him on cytoxan
for wegener's right look gregg i checked you out you know i know you're a good doctor you have to appreciate that i'm a good doctor too
why
wegener's is one of the first things i looked for the biopsy and the blood tests were negative just like yours
there's an error rate marty
and there's a time to let go look i'm gonna take him off the ventilator and john henry's gonna die he's accepted that
dr hamilton hey listen dr hamilton i'm sorry i should have never put your patient on ivig
it's not your fault eric
no it's mine eric
that's not what i said everyone asks about you back in l a
how's the old place doing
oh this is wonderful but before you guys break out the oil i should point out you can't pull the plug i have a court order
you used to but
i have the right to face my accuser judge said so
not if no one's accusing you all the charges have been dropped
he doesn't have to die
it's not wegener's
if it's wegener's his lungs won't be able to handle it as soon as they pull that plug he'll die
that's why they call it pulling the plug
i'm gonna miss you
he's still breathing
his 0 2 stats are holding
he's holding his own
he's still breathing
it's not wegener's wrong again
he's stable but one of his arms is now paralyzed
the real question is why is he still alive
do you think he's just being stubborn
he's alive because you were wrong it's not wegener's
yeah seem to be doing that a lot lately people keep living because of my mistakes
progression of the paralysis pretty much confirms hamilton was right it's als
assuming this is a progression of his paralysis
he can't move his arm
yes his arm is paralyzed yes his legs are paralyzed why is everyone so gung ho to connect those two conditions you could think i'm wrong but that's no reason to stop thinking
how about this one he's not our patient
nope not good enough
he could have suffered a stroke when he was intubated well blood clots are common in intubated patients the inactivity causes
not interested in why let's get an mr angiogram for an embolic stroke
he doesn't want you treating him
they dropped the court order
yeah and that girl dropped the charges against kobe doesn't mean that he should call her and see if she's free to get a sundae
good point but i can go within 50 feet of him now
if you need anything page me any time
okay get outta here
sure that makes sense you hate me for saving your life in fairness to your side you were also dying because of me so
you know i didn't wanna be saved
that's what's interesting your thyroid was low but not low enough to cause depression
so you came here to tell me that even if i can't walk i can still hear the birds sing enjoy the rainbow and feeling the sun shine on my face
those things are fun okay life sucks your life sucks more than most it's not as bad as some which is depressing all by itself but do me a favor just let me find out what's wrong with you and if you still want to kill yourself i'll give you a hand that sound fair
yeah sure i'll stick around to indulge your obsession it's over i lost my air the session the other night with those kids that was a test to see if i could still play i can't
and that's all you are a musician
i got one thing same as you
really apparently you know me better than i know you
i know that limp i know the empty ring finger and that obsessive nature of yours that's a big secret you don't risk jail and your career just to save somebody who doesn't want to be saved unless you got something anything one thing the reason normal people got wives and kids and hobbies whatever that's because they don't got that one thing that hits them that hard and that true i got music you got this the thing you think about all the time the thing that keeps you south of normal yeah makes us great makes us the best all we miss out on is everything else no woman waiting at home after work with the drink and the kiss that ain't gonna happen for us
that's why god made microwaves
yeah but when it's over it's over
yeah
what are you doing
it's not over for me either you're gonna call the cops again or we're doing this if you wanna die you can do it just as easily inside an mri machine
so i go back to l a i'm going the dana lectures again this year
wow that's quite an honor
it's all political
to be honest you've earned it
i got honest on a couple studies i was doing it all sells tickets you remember last year's lectures don't you
i remember the cigar bar afterwards
cigars and pool you enjoy working with dr house
not the word i'd use
we work too hard not to enjoy ourselves right hmm you seeing anybody
kinda sorta
serious
i don't know could be
you think she would enjoy l a
hamilton offered me a job
you gonna take it
i haven't decided
you already have the most prestigious fellowship
it's a partnership three times the money car allowance moving expense pension plan the chance to work for a guy who gives a crap what other people think
so why didn't you just tell him yes
i made a commitment here
right
house would let you out of it in a heartbeat
or he wouldn't just to jerk me around would you guys have taken the job
don't need the money
i'm not like you i don't hate house
you guys really don't have a problem with him with what he did
he knows we disagree with his choice
choice chase it's not apples and oranges its right and wrong and he does it like he doesn't care he assaults the guy and moves on to the next differential diagnosis like it's nothing
what do you want from him more hand wringing more torment you want him to cry himself to sleep at night
yeah yeah i want some clue that he knows it's a big deal that it scares him that it matters
whoa whoa whoa what's that
it was a stroke
well done cameron
house called it the arm and legs are unrelated
you make enough calls one of them is bound to be right
yeah he's just a lucky lucky guy
listen listen i just think it wouldn't hurt him to learn a little humility
so what's the verdict
embolus the arm problem's caused by a clot
there's a good chance we can still bust the clot with tpa
do it see what happens to his arm
we found a blood clot in your brain we'd like to start you on heparin it's a blood thinner
what are the side effects
well your lungs are kind of chewed up from the pneumonia good chance there'll be an infusion
bleeding
into his lungs
it's our best chance to give you back the use of your arm
i don't need my arm without my air
the damage would likely be minimal
no
it's his call
or we could do an embolectomy basically we'd go in and pull the clot out
he's saying no to drugs and you're recommending brain surgery
bypasses risk to the lungs
it'll either help your arm or
or it'll kill me
from your point of view it's a win win
okay
we'll set up the procedure for today
we're in your carotid artery this is going to take us all the way up into your brain
you all right
yes
the sludge is blocking the blood flow to the part of the brain that controls your arm all done you still okay
i think so
i don't know i guess it's just with dr hamilton here i notice a difference in styles
his style involves humility another difference in our styles i don't care much for apologies you can go
i didn't know you were standing there when i said that okay it was completely rude
do you mean genuine humility you know with all the self doubt and the self questioning or hamilton's polite patronizing aw shucks humility
you're both excellent doctors
thank you and humility is an important quality especially if you're wrong a lot
you've been wrong every step of the way
of course when you're right self doubt doesn't help anybody does it we gotta go
congratulations gregg
congratulations why marty
john woke up he can use his arm
thank you
now look i know we've had our differences but i think when a person does something well it ought to be recognized
the phone works next time you want to make me feel all warm and fuzzy leave a message don't get me wrong i'm overcome with joy
doc
yeah
what
you just touched my leg
what you gonna charge me with assault again
no i felt it
he now has feeling all the way up to calf this is the way medicine evolved patients sometimes get better you have no idea why but unless you give a reason they won't pay you anybody notice if there's a full moon
you're saying he just spontaneously got better
no i'm saying let's rule out the lunar god and go from there
something he's on is working
the enzyme replacement protocol is working reversing the als
the timing doesn't suspicious to you
heh heh do you think dr house will see it that way figure it's his medication doing the job
i'm sure he will
it's one of ours
how do we figure out which drug is doing the trick
easy we stop all of them
one of those drugs is helping him
and the rest steroids antibiotics anti inflammatories they're toxic if we leave him on all of them
he'll walk again
yeah to his own funeral
but if we stop everything he'll get worse
true and then we'll add our medications back one at a time if he gets better then we'll have our answer
and if he doesn't get better
then we're in trouble not as much as he is i suppose that was your point
i assume you want me to convince hamilton to stop his treatments too
don't care
you know at least five of the medications are part of his protocol
if his stuff was helping the guy would be playing tennis six months ago it's our round of treatment that's helping
right so that's what you'll stop
so your philosophy is if they don't want treatment they get it shoved down their throat but if it might cure their paralysis whoa better slow down
yeah my old philosophy used to be live and let live but i'm taking this needlepoint class and they gave us these really big pillows
what's your philosophy on employee relations
that's a very tiny pillow
great sounds like you know what you're doing
gregg can i have a word
can it wait for the commercial marty say hi to my friend jimmy
pleasure your diagnostic trial
seriously commercial's in about five minutes
it's a dangerous game
only if we're watching in the bathtub
i need to know exactly what medications you were giving john henry
forget it and if foreman tells you what john henry used to be on
you're gonna fire him
nope make him live out every day of his two year contract
foreman asked to leave
not yet
but how do you know i made him an
you're a polite twit but you're not an idiot
i need to know what medications you've taken him off of
wait a second you're not an idiot you need to know what medications i've stopped because
cut to john's room house is poking john's leg
he's getting worse right now you still work for me come on
no feeling no wiggling the bad news is john henry's back where he started the good news is hamilton looks bad
yeah it's not whether you win or lose it's whether the other guy loses
what was the first thing we put him on
steroids for the pneumonia
well put him back on them give them 24 hours see what happens
his lungs aren't great it might cause another respiratory collapse
sure hope not i didn't much like that lawyer and get an mri
he already got one and an mra
well obviously something is different now do it again chase take care of the scan cameron put him on the steroids we should probably talk huh
thin cuts
what levels
t9 through the quarter equinus same as the last time you really think house would let foreman out of his contract
he has to if he doesn't he's telling foreman he needs him house can't handle that oh my god
i checked him out he's a great doctor you think he's better than i am
this about your ego
answer the question it's not going to change my opinion of myself might affect my opinion of you but that shouldn't affect your opinion of yourself now i'm getting confused if you think he's a better doctor than i am then you should take the job otherwise you should get him to buy you two or three more nostalgic lunches and politely decline
it's that simple i should just ignore the mockery and abuse
oh how do i abuse you
how do you not if i make a mistake
i hold you accountable so what
dr hamilton forgives he's capable of moving on
that is not what he does
i screwed up his case he told me
he never said you were forgiven i was there he said it wasn't your fault
so
so it was you took a chance you did something great you were wrong but it was still great you should feel great that it was great you should feel like crap that it was wrong that's the difference between him and me he thinks you do your job and what will be will be i think that what i do and what you do matters he sleeps better at night he shouldn't
arteriovenous malformation
intradural compressing his spine
causing his paralysis
how could hamilton have missed an avm
well we missed it too cause it wasn't there before
you saying it just grew overnight
no it was on the spine it wasn't on the mri same anatomic location
it's not there
well what is there
nothing
or something that looks like nothing
background noise static
scar tissue inflammation
if it's inflammation the steroids would have shrunk it down
revealing the avm which has always been there hiding behind its own swelling we remove that he'll walk again
dr house cora's meeting me outside with a limo i'm being discharged
fifty bucks says i can beat you to the curb
thanks for sticking with the case
i can't do anything else you're much more easily amused when you can walk
how bizarre i'm guessing you weren't exactly mr sunshine even before your leg got messed up i want you to have this
wow
you can sell it if you want to just promise me you won't play it how many of those pills you taking
i'm in pain
yeah aren't we all so where do you buy these things do they have cane stores
oh don't worry about it you'll be jogging before you need a second one see you tomorrow eric
the end
house m d 1 10 histories
house m d
1x10 histories
february 8 2005
written by joel thompson
directed by daniel attias
transcript written by prettyannamoon
archived at twiz tv com with permission from house transcripts and more
house and other related entities are owned tm and by heel and toe films and bad hat harry productions in association with nbc universal television all rights reserved this transcript is posted here without their permission approval authorization or endorsement any reproduction duplication distribution or display of this material in any form or by any means is expressly prohibited it is absolutely forbidden to use it for commercial gain
hi sounds like a good party
20 bucks
okay no problem i ah i just got it in here somewhere oh god i'm i'm sorry i guess i must have forgotten to go to the machine
yeah and ah brush your teeth lady you don't have two cents
i can i can get it from from my friend who's inside he can give it to me and then i can bring it back out here to you
you don't know anybody here
yes i do james he's blonde and he's really friendly and he's a big talker i need to see him
go on in
james james james
hi
do you know where james is
oh yeah he's he's around here somewhere
let's go find him
where is he
i really need to find him
what are you doing
bitch
no she's trying to help me get off her get off me
policeman 1 settle down
policeman 2 move
policeman 1 geez i didn't touch her
policeman 2 great now we gotta go to the hospital
homeless admitted 24 hours ago with a suspected drug overdose her tox screen's clean but she's still delusional
homeless usually means crazy no money cuddy's not going to like this
we're a teaching hospital no id doesn't even seem to know her name i got called in because of some lesions on her arm
homeless always means no roof at least there's too much sun
the lesions were non cancerous but i noticed a twitch her wrist
mmph
you feel that
sure i'm human
make a fist around my fingers tight as you can squeeze
i am
right all right raise your arms above your head for me
oh
she's seizing get me some ativan
she doesn't want to be discharged she's manipulating me
it's real check her finger sticks
blood sugar's 38
i need d15 iv push stat
fake low blood sugar now that's acting
the blood sugar was real but she's probably diabetic od'd on her own insulin i need 2032 do you have her effects out here look a seizure buys her a place to sleep while the nice doctors run their tests maybe a few free meals 20 says there's insulin in here oh put this back please
what about the twitch
her arm moved
why fake a twitch in case the seizure was too subtle a twitch could indicate a tumor which could indicate
a need to see a neurologist which is why you called me keep an eye on her until 2 00 pm watch her blood sugar give her a nice hot lunch and discharge her
he's wrong
foreman is wrong the neurologist is wrong about a neurological problem
he took one look at her and figured it was a scam
so you figure he's not being objective
house the woman had a twitch she had a seizure
both of which foreman saw
he just wanted her out the door
whoah whoah whoah back up there big fella foreman's the guy you want to take a swing at
i just want her to get some medical attention
that's not even close to being true something else something personal give me the file looks like this will be fun
the twitch could be a mini seizure unrelated to the diabetes
brain tumor
glad you could join us eric what's the differential for a twitch in the wrist
the patient's a thirty ish jane doe i just thought i'd discharge her
well she's my patient no harm in a second opinion
a blow to the head a subdural hematoma
read the file no evidence of cranial trauma
a twitch could indicate a brain tumor
or about a dozen other things come on there's two things homeless people are good at getting sick and running scams if you're so worried about it being a brain tumor get her an mri when she's clear on that then you can bounce her out of here
well you've got her all figured out
i've known a lot more homeless people than you have
yes you've got that going for you how could i have doubted your medical opinion
the big question you're missing it all of you
oh geez
who is she
okay why are we on this case just because wilson asked
do i need a better reason
most people wouldn't you do
the only thing we know for sure about jane doe is that her name isn't jane doe which means no medical history allergies medication previous diagnoses treatment we have no baseline no context for medical treatment
wow looks just like insulin
vomit still moist what do you think a couple of days old
uhhh trying to make me hurl
yeah and here's the big finish
salty chemical imbalance
low magnesium could cause a twitch
or high calcium or it's a coincidence the point is we don't know anything
so do the mri find out
the mri can wait hang a banana bag give her 24 hours to correct the electrolyte imbalance we'll take it from there
great thanks
okay even if she's not faking what's so fascinating about this case
at the moment how much you don't want me to take it that's pretty fascinating
nice likeness of dr foreman in fact he's never looked better
he doesn't like me i can tell
that's okay he doesn't like me either who's james
ow oh
pain in your head
get away from me
all right let's get it out one milligram of ativan push
no no no no
she bit me
good news is she's negative for hiv and hep c
yeah well i'm getting a tetanus shot she's getting an mri
there's a two day wait for non emergency mris
she's getting an mri and then she's out of here
now dr terharg specifically said i'd have the mri at 10 00 it's almost 11 00 and i haven't even had the pretest yet
sorry we're a little backed up
uh
excuse me you're dr terharg's 10 00
i'm angela whitney i'm meeting my decorator at 11 30 she's coming all the way from new york dr terharg promised i'd be home in time
of course
she's just about prepped for her mri mrs whitney
you tried to steal someone else's test
dr terharg is a plastic surgeon the woman was getting a six month checkup on a chin implant
i can't believe you authorized this
really sounds exactly like something i'd do
she can't have an mri the ct scan shows she has a surgical pin in her arm the mri magnet would have ripped it out of her body you like the alien movies you had no medical history what were you thinking
we'll surgically remove the pin then do the mri does that sound good
she has an electrolyte imbalance
dr foreman a neurologist believes this woman has a brain tumor
actually i
hey don't ever apologize for a medical opinion if he's right we don't do this test the patient dies now i realize that you have a specialty of your own but does yours have anything to do with the brain his does
fine but nothing more until you find out who she is
how are we supposed to
hey he knows more homeless people than any of us go check out the hood dawg
i don't know i've seen a lot of faces around here but i don't think i know her
great
hey i ah like that jacket yeah it's all coming to me now i know where she keeps her stuff
just bats i thought the lining would be thicker
no tumor nothing her brain is clear
which means that girl had surgery just so you wouldn't get reamed out by cuddy
not necessarily there could still be something neurological going on
sure she's not conning us the mri is
not wearing a coat in this weather that is so wrong
she drew these they might give us a clue
she sign them her name would be a start
all the mythology the locations they're all dependant on life experience
philadelphia look at that skyline it's very evocative the chrysler building
that's a cloud
and the chrysler building's in new york
mmm i'm getting philly and that cactus well that's a smashed car car accident
a cactus in philadelphia
water well water's october right
obviously
on the page number 22 so that's october 2nd 2002 ergo the patient was in a car accident two years ago last october
my goodness was she okay
broke her arm i think they fixed it with this
surgical pin better than a wallet serial numbers in case of recall tied to a patient's name
that's why you insisted on the mri so you could remove the surgical pin from her arm
you didn't think i was going to do it to save your sorry ass did you you might want to take a look at that her name is victoria matson at least that's the one she used then any hospital with the record of treating her should be sending that information
oh crap
her blood work came back an hour ago magnesium was normal
did you change her banana bag
stopped the magnesium started iron dextran for severe anemia she's allergic to iron dextran
grab some epi off the code cart respiratory arrest call the code
you have an allergic reaction can you speak
she's not getting any air got the epi
stats down in the 80s and dropping
we have about another minute
well we got her sedated and stabilized
and we still think there's nothing wrong with her
well nothing's changed
we almost killed her that's different and we know who she is
so far we've heard from three hospitals with records of victoria matson seven visits going back two years
any home addresses
the pin in her arm went in during an er visit she wasn't conscious so they didn't get an address the other visits she gave fake addresses
any treatment for neurological problems anything that might explain the twitch
last winter jefferson hospital in philly got treated for frostbite
baby it's cold outside
and depression they put her on prozac
well i'd be bummed out too zero degrees living in a box
put her back on it she cheers up she might stop biting people
there's a billing record from hartman hospital last year two appointments ultrasounds doesn't say what for
pregnant
only if she was expecting an elephant the appointments were ten months apart kept the first blew off the second
abdominal pain
the chart doesn't say
wait a minute she goes in the first time they look they can't find anything ten months later why should she subject herself to that again
why make a second appointment
she didn't the nurse made the appointment they were looking they were looking for ovarian cancer
you got all of that from one cancelled appointment
with jerry lousing yeah he's an oncologist
hang on her current blood work doesn't show cancer ca125 is normal
and the cancer wouldn't account for the alleged twitch or any other of her alleged symptoms
actually it would neoplastic syndrome associated with the cancer could cause her to twitch like a bunny on crystal meth ultrasound her ovaries
did you find a brain tumor on her mri
no foreman was wrong i'm starting to wonder about that guy's medical chops
right shelley diamond
yes
dr house is ready to see you now
the little ones are licking each other again and harry's got a seeping wart on his extra toe what room should we go to
you know i think i might be coming down with something hate to give it to you guys sorry
oh yeah just walk out like i'm not going to do anything
bye bye
working hard
this stuff's pretty good calendrica works for the counseled genius bad guy's mr fury fairly generic no special skills but apparently very well organized think you work hard try ruling the universe
you trying to teach me something here
we've got the flowing dress the ring think the patient was married maybe it was a bad break up maybe he dumped her cause she was on drugs
you care about her personal history
nope question is why don't you i hate to cite a clich but dad on the streets
dad's with mom
they're both living on the streets
no on a pension
so who pissed you off
pfft right now you
your turn you gonna tell me why this case
she's my new girlfriend i'm having a tattoo designed i was hoping you could find out her name
so she's just another sick person the kindly dr wilson has made sure doesn't get lost in the big ugly system
yes i forgot i need a reason to give a crap
you're giving two craps
the metric system always confuses me
dr house
time for girl scout cookies already
get me some thin mints
since you're too sick to work in the clinic
okay
i thought you
i thought you could do some teaching patient histories
my specialty
when you teach you learn so much don't you think
it's all about the giving back good old cuddy always thinking she assign you a patient to interview
mmmhmm
then why are you still here
why are we on this case
because wilson asked house to do him a favor
i think house just wants to prove she's sick so foreman will be wrong
oh you boys
hey i'm just doing my job whoah foreman's going to be so embarrassed when he finds out she's got cancer
oh i thought you were too sick to be down here
had to get away from those students so i faked a page foreman's parents happily married 40 years
mazel tov
keinahora so why does he hate homeless people if it's an uncle or a grandparent you'd think he'd use it in his college application essay family struggles beats a 4 0 gpa any day
i think he had a 4 0
maybe he's just a snob
you really don't need to know everything about everybody
i don't need to watch the oc but it makes me happy
yeah delirious what's the other file
wilson james boy wonder oncologist you know him
you know in some cultures it's considered almost rude for one friend to spy on another of course in swedish the word friend can also be translated as limping twerp'
did your pager really just go off or are you ditching the conversation
why can't both be true come on
solid non cystic mass on the left ovary five by three centimeters central necrosis the only question is whether she dies in two months or three
oh god
you were right there's nothing we can do for her here might as well put her back on the street
unless it's not cancer
oh you're joking
well hard not to nothing funnier than cancer but what if it's a tuberculoma she's living out on the streets breathing all kinds of crap 24 7 the odds are she's got tb why can't she have a nice benign growth to go with it
a solid mass on her ovary ovarian cancer's way more likely
you're right it's not even close start her on inh rifampicin and streptomycin
but that's the treatment for a tuberculoma
and what is the treatment for advanced ovarian cancer
pine box
what are you giving me
a second dose of some antibiotics if you've got a tuberculoma it should help
i don't have a tuberculoma do i
probably not
listen i'm sorry i didn't believe you
i'm sorry i lied to you i took too much insulin on purpose i really wanted a place to sleep
were you ever married victoria but in the comic
no it's a comic comics are just made up
so who's james is he real or did you make him up
he's real
can i help you find him
the the light's bright it's getting brighter ow ow
take it easy take it easy everything's fine
mr fury wants to hurt me please help me
wait wait wait hold on
turn it off please turn off the
all right hold on victoria take it easy everything's fine take it easy everything's fine victoria
i'm burning it's burning
hold on take a sip take a sip
it's poison you gave me poison
hold on take it easy
hey turn off that damn light
help me help me please
take it easy take it easy the bad guys can't get you here i've got you covered
mr fury's not the bad guy i'm the bad guy it's me i'm the bad guy
it's not a tuberculoma can't be
i didn't know the biopsy was back
her temperature's 105 treatment's not working it's cancer she's dying
105
good news it's a tuberculoma
how do you figure that her temp's through the roof
it's the lab results from the biopsy it's definitely a tuberculoma
so we're right about the diagnosis and the treatment for that diagnosis is killing her perfect
the lab checked the biopsy again twice
well a tuberculoma doesn't give you a temperature of 105
then it's a tuberculoma and something else
the something else is gonna to melt her brain
poach better metaphor
a fever that high has to be bacterial
maybe the bowel got nicked in the biopsy
i did the biopsy no nick she could have picked up an infection on the streets
well she didn't have a fever when i admitted her
the prozac we've given her could have triggered serotonin syndrome which would explain the fever
no jefferson put her on prozac and it wasn't a problem
she probably never took it most likely they saw her one time and dumped her out of the er with a script
oh just like you were going to do
okay you two grab some scalpels and settle this like doctors send blood and urine cultures and get a chest x ray and fine take her off prozac and put her on bromocryptin for the serotonin syndrome
might want to get her in an ice bath as well assuming we want her to live long enough to see those test results
i said i was sorry
your fever's 105 if we don't bring it down fast
foreman why are you doing this to me
we're saving your life
hey come on you can do this
ple ee ease
student 1 17 year old female presents with abrasions and apparent trauma injury to her wrist dr house
continue
student 1 you're reading a comic book
and you're calling attention to your bosom by wearing a low cut top oh i'm sorry i thought we were having a state the obvious contest i'm competitive by nature
student 2 i thought you were supposed to be listening to our patient histories
nope i'm supposed to be teaching you if i can do that without listening more power to me
student 2 17 year old female
this guy's supposed to have universal power over all of gravity how come his hair won't stay down that's just stupid
student 2 she fell off her horse while riding in the county fair
student 1 no she didn't she fell off the steps of her beach house you must have gone to the wrong room
hard to believe that one patient could slip past cuddy and get herself admitted with a sprained wrist two seems almost impossible what room
room 2106
patients lie but usually only one lie at a time how much does she weigh
student 1 it's her wrist not her
poundage ladies and by the by what color is her nose
student 1 she's thin
student 2 flesh toned
student 1 what does this have to do with her wrist
almost nothing she's either under 90 pounds or she has a red nose i gotta go
student 1 what's wrong with her
that would be telling oh i am just too nice it starts with c'
urine cultures are negative
so's the chest x ray
i assume there's a positive coming
lumbar punctures revealed elevated proteins and white counts
csf cultures
still growing nothing on gram stain it looks like meningitis
we know it's definitely an infection and we know where it is
well meningitis is nice and simple get her in isolation and start her on ceftriaxone either she gets better or she dies let me know which one happens
oh my god she was sedated
it must have worn off
i i did it myself a half hour ago
i'll check the nurse's station
calendrica
she's gonna die out there
you don't walk out of a room with ten milligrams of haldol in your system you don't walk at all
it was ten milligrams i gave it to her
it doesn't matter bacterial meningitis highly contagious if she is out of the hospital we are so liable
not to worry she'll be dead before she can kill anybody
security tape confirms it she stole some clothes and she's gone
wrong coat the cape's in the closet i had it cleaned
funny
you gonna save her
in her comics mr fury lives in sloan harbor the night she came in she was at a rave at 1408 sloan street
you've been reading my how you've changed
you are a doctor do what doctors do pick up the phone dial 911 and a cop on the other end does what cops do and finds the missing person i assume the rest of you have doctor things to do i know you do
student 2 cacchi ricci disease
do you even know what that is or are you just guessing everything that starts with c'
student 2 the kidney problems could result in weight loss
cacchi c a c she's going alphabetically
student 1 doctor why are you wearing that bird pin
it sets off my eyes hi jodi i'm dr house what brings you to the hospital
my wrist
how did that happen
i was riding the ferris wheel and this huge seagull flew right at me
how horrifying
i swung my arm at the bird but i hit the ferris wheel
student 2 she's making it all up
no her wrist really does hurt
i'm not lying
of course you are you have no idea what happened you have no memory korsakoff's syndrome her brain is damaged by excessive drinking or insufficient diet pretty obviously the latter she has no new memories no new ideas can't even process that idea so her brain fills the gaps as best it can using visual clues the horse on your shirt led her to the riding accident and the surf scene on your clipboard led her to the beach
student 2 korsakoff doesn't start with a c'
i didn't say c' or did i lesson to be learned treat everybody as if they have korsakoff's we all lie anyway give her thiamine right away she'll bounce back pretty quickly and then get her to eat some cake and ice cream
student 1
yes
student 1 did you need to be so cruel i think she's crying
hi jodi i'm dr house what happened to your wrist
there was this weird old guy he had a cane
see it's like it never happened perfect forgiveness
pulse is rapid
you got a temp
don't know she's warm but
that's something to look into she has meningitis
sorry i was more worried about her heart blowing up pulse is 150
rhythm regular
yeah
ready one two three
where'd you find her
battlefield state park
something narrow complex she wasn't at sloan
she was just passed out on the grass
foreman i need foreman
all right super ventricular tachycardias get me adenosine one milligram push thank you hang in there
her arrythmia stabilized
it doesn't make sense what would push her heart rate over 150 dehydration fever
unlikely by themselves neither one would do it
we must be wrong about the meningitis maybe it's structural heart disease
her heart rate dropped when you administered the adenosine
two seconds
it's still meningitis
if it is with the delay in treatment she's got almost no chance
start the treatment
read the report i found her lying on the grass
you should read my reports i make up stuff all the time what really happened
oh since it's you i found her lying on the grass
wow that is a great looking gun
it's not a gun it's a taser
it's so cool looking what does it do fire about 60 000 volts at least that's what it would take to jack someone's heart up to 150s
okay okay let's just say i tell you what happened this stays between you and me right i found her lying on the grass
fine don't tell me tell my friend ben franklin i watch a lot of cop shows
the good news is the heart rate thing's not connected to her condition
well then she's dying the meningitis treatment isn't helping her she's getting worse
well that brings us to the bad news the cop tasered her
jerk probably couldn't get to his real gun fast enough
the first time he hit her in the thigh and she just kept going like it was nothing right about here she didn't feel the taser
localized numbness
yeah in that one spot
the diabetes
i don't think so
no alcohol not entrapment syndrome can't be a vitamin deficiency we can't chase down every sensory neuropathy
is that where she bit you
yeah
what the hell
can't get angry if you don't feel anything
first there's localized numbness then sensitivity to light disorientation paranoia ineffectiveness of sedatives and then hydrophobia fear of water
rabies
there've only been what 20 cases in the last ten years
yeah that's because non homeless people when they get bitten they get shots
there were bats
she's dying
there's no treatment
how much time does she have
a day maybe two and if you don't get your shot in say the next three hours i'm going to have to make another affirmative action hire
come on
do it mmmph
you want me to talk to her
and say what there's some experimental treatment but it's not gonna work don't worry we can make you comfortable doesn't matter how she's gonna die
yeah that's what you say to her keep that there and rest for a minute
mmm
whoah whoah whoah
tell house i need to go out for about an hour
she may not have that long
i don't want her to die alone
you're going to find james
i'm gonna try
well i must say he's done a lot with the place
hello
hey this is it
man no one's been in here for a long time
this has got to be james maybe there's another address
it's not james paul paul furia
mr fury
her husband
then who's james
her kid
oh i just want to eat you up you're so delicious
aw look at me you're just like your papa look at you just like your dad
foreman foreman they're dead that car crash two years ago she broke her arm and they were killed
she was driving
james
no it's paul
you've come to take me
no i've come to forgive you it wasn't your fault
i'm so sorry i'm so sorry i'm so sorry
i know it's okay victoria it's okay
oh you followed me
no you were wearing rain boots today but you were parked in the underground garage so the only reason you'd need boots was if you were hitting the streets i followed you
didn't we have a conversation about friendship
yeah i had some follow up questions i've met your parents and your brother
i have two brothers
why wouldn't you tell me
it was irrelevant
why not
because he's not in my life any more
well that's relevant
this was the last place i saw him nine years ago i don't even know if he's alive
the end
house m d 1 11 detox
house m d
1x11 detox
february 15 2005
written by lawrence kaplow thomas l moran
directed by nelson mccormick
transcript written by mari
archived at twiz tv com with permission from house transcripts and more
house and other related entities are owned tm and by heel and toe films and bad hat harry productions in association with nbc universal television all rights reserved this transcript is posted here without their permission approval authorization or endorsement any reproduction duplication distribution or display of this material in any form or by any means is expressly prohibited it is absolutely forbidden to use it for commercial gain
what d'you say now
i don't know
you said your dad wouldn't be home for an hour
i know but it it you know
don't you love me
of course you know i
come on let's do it
all right
where are they
nightstand
gentlemen start your engines
i so want this car woo hoo
oh my god you're bleeding
look out
cut to keith's room in the hospital he's pretty bandaged up pam and keith's dad are standing over him
what lie are they telling you
okay yes
come on
all right thank you okay pharmaceuticals were delivered this morning but shipping accidentally sent the box with vicodin to research
hmmm that's a tough one if only we had some way to communicate with another part of the building
16 year old mva victim he's been in and out of the hospital for three weeks with internal bleeding no one can find the cause
internal bleeding after a car accident wow that's shocking let me talk to shipping i speak their language
it's been three weeks
your hospital doesn't have my pain medication
shipping says it's going to be an hour
this is dr cuddy what's going on
the crash didn't cause the bleed
right the bleed caused the crash blood got on the road it got all slippery anyone here got drugs
she saw his blood she got distracted and she crashed his dad's porsche
dad loved that
he was
don't talk
it's gonna be an hour
well thank god you took control
if you can't wait one hour to get your
kid's got hemolytic anemia
kid how old
he must have inherited it he's gonna die my condolences
it wasn't inherited the problem's outside the red blood cells
this is impossible a 16 year old doesn't get hemolytic anemia
give her back the file you have bigger problems to tend to like my meds
elevated indirect bilirubin low serum haptoglobin
he's got meningitis
uh no
artificial heart valve
no
get everyone in my office
kid's gonna be dead in a matter of days if we don't figure out why his red blood cells are disintegrating so differential diagnosis people
well it's not environmental dad hired a company to clean the house maid washed all the clothes and bought hypoallergenic sheets and pillows
you want us to recheck
no if it's environmental he'll get better just from staying here
it could be an infection
no fever no white count
well he's 99 2
barely above normal
but above his body's reacting to something
we could account for the lack of fever and white count if it's lupus
drugs'll fit just as much as lupus meth'll cause hemolytic anemia
a lot of meth
he also doesn't seem the type
because his dad drives a porsche rich kids do drugs just like poor kids
didn't mean to offend you
okay so it's infection lupus drugs or cancer
cancer
why not great meeting
shouldn't we narrow it down before we finish
my leg gave us till 11 15 i'll talk to wilson about lymphoma ana for lupus radioimmunoassay for drugs and you you test for whatever you thought it was i've got a date with a pharmacist
come on come on come on come on as soon as house gets the bottle he dry swallows a couple pills cuddy catches up to him on his way out the clinic doors
you know there are other ways to manage pain
like what laughter meditation got a guy who can fix my third chakra
you're addicted
if the pills ran my life i'd agree with you but it's my leg busy calendaring what i can't do
you're in denial
right i never had an infarction in my leg no dead muscle no nerve damage doesn't even hurt actually it kind of tickles the chicks dig this better than a puppy
it's not just your leg you wanna get high you're doing what 80 mg a day
oh that's way too much moderation is the key unless there's pain
it's double what you were taking when i hired you
cause you're twice as annoying
i can't always be here to protect you patients talk doctors talk
about how big your ass has gotten lately not me i defend it you got back
you can't go a week without your drugs
no i don't want to go a week without the drugs it'll hurt
no you can't if you're just getting off pain medication it will hurt you won't be having a great time but you'll make it if you're detoxing you'll have chills nausea your pain will magnify five ten times you won't make it
well i guess we'll never know
i'll give you a week off clinic duty if you can go a week off narcotics
no way i love the clinic
you love the pills two weeks
pills don't make me high they make me neutral
a month
you're on mister
drugs could cause this
cocaine and meth are very hard on the blood system has he had any erratic behavior
no but she was in rehab in the 9th grade she's supposedly clean now but
she obviously cares for him
yeah what she cared about was the car anniversary present from my wife we drove it up north to watch the leaves change she was dead a year later cancer
i'm sorry mr foster we're going to test keith for drugs
i don't do drugs
it's not that we don't trust you but
his hair will tell us any drugs he's taken in the past sixty days it's kind of like rings on a tree
negative
have you been sick
no nothing
have you been out of the country
we went to china but we got all of our shots before we left
it could be an infection we're going to give him a gallium scan just to be safe we inject a radioactive isotope into his bloodstream and we check to see if there's inflammation anywhere in the body
has he ever complained of any joint pain sensitivity to light rashes
no no nothing
any relatives ever been diagnosed with lupus
i don't even know that that is
in simple terms the body becomes allergic to itself the immune system attacks healthy cells in the circulatory system and destroys them
would it be treatable
it can be manageable
we can test for the antibodies 95 of patients with lupus test positive for ana
not cloudy negative
what about bruising he ever complain about tenderness under his arms or his groin
i'm not sure he'd tell me if he did i guess i really don't know what's going on in his life
he's a teenager what type of cancer did your wife have
pancreatic
it's his lymph nodes we're concerned about we're going to do a biopsy to check for lymphoma
okay you feel this
no
good
i have cancer don't i
we're just testing
that's what they told my mom
definitely not cancer
nothing
nothing
negative for drugs ana was negative gallium scan was clear
yeah i got that from the nothing where's his hematocrit
thirteen
drops any lower he's not going to have any red blood cells to bring oxygen to his body he'll suffocate with his lungs working perfectly
you okay
excuse me someone help please
polite for a dying kid
how long has it been
i'm fine
there's something in my eye up top
which eye
this one what's happening
it's all right just look down for me it's clear there's nothing in it
it's getting worse
is it fuzzy or
no it's dark i can't see
it's a retinal clot in the left eye
coumadin would dissolve the clot fix his eyesight
you can't use bloodthinners he's got internal bleeding fix the eye you kill everything else
surgery's out for the same reason
we have two hours to figure this out either we restore the blood flow or he loses the eye
forget the eye tell him to use the other one to look on the bright side the clot tells us something it could help us figure out what he has which could mean he gets to live differential diagnosis people how does internal bleeding suddenly start clotting
it makes no sense they're opposing processes
it can happen in lupus increased platelet count can cause blood clots
ana was negative it's not lupus
this is true but why are you the one saying it what are you doing here i thought we ruled out cancer
i was lonely
well go see cuddy she needs a friend
that's funny she said you might need one
that's why you're here she wants you to keep an eye on me make sure i don't cheat
no i want to make sure you don't start firing shots from the clock tower
i'm fine
what's going on
he hasn't had vicodin in over a day
does your leg hurt
you ever been shot
there's gonna be side effects insomnia depression tachycardia
withdrawl symptoms not applicable the only side effects i'm going to have are some pain and thirty days of freedom am i the only one who's concerned about a dying kid if it's not lupus what else
most likely candidate for throwing a clot is infection or cancer
checked the biopsy twice it's not cancer
it's not an infection gallium scan didn't reveal anything
okay what hides from a gallium scan
cardiac
right clot slips off travels through the artery and gets backed up in the eye
i'm sorry i wasn't paying attention what happened
it's an infection in his heart
great echocardiogram for the heart and iv antibiotics for the infection stat
is it my birthday
i'm not lonely my leg hurts
she's a real masseuse
she's five hundred dollars an hour minimum
she's hot so she's a hooker what kind of pathetic logic is that
the envious jealous i never got any in high school kind of logic hello
she's a legitimate masseuse come on god she's beautiful
because she's beautiful i should do it what kind of pathetic logic is that
the envious jealous i'm married and i can't do anything logic hello
hi listen i'm i'm sure you're really good at whatever it is you do
dame su mano
hey no let go of my hand
she doesn't speak english
shhhh
ow ow ah ah oh my god bueno
take off your clothes
not a fan of the stroganoff
i'm not hungry
the antibiotics can cause nausea
so can the food shouldn't you be looking at my eye
the blood clot isn't life threatening we're focusing on figuring out the cause of your problems
so the blindness will be permanent won't it
thank you
bye
i had a massage
looks like you had a masseuse help the pain
i'm fine
i know kid's echo was normal no sign of any vegetations on heart valves
never met a diagnostic study i couldn't refute
and the antibiotics aren't doing anything
so double the dosage 70mg
that'll box his kidneys for sure
oh you're right save the kidney the guy we transplant it into will be grateful
also i have an idea for his eye
nothing we can do about his eye
he's got a clot in his retinal
read the memo
if we remove some of the liquid from the eye itself the vitreous humor it might make some extra room around the retinal artery
if the artery expands the clot might move out on its own that's very creative why didn't you mention this before
well i didn't think of it before
you should have
this isn't going to hurt
your eye's numb you'll only feel pressure give it a minute
i can see
i can see you
i heard congratulations
don't i haven't brushed my teeth in two days
ah i'm so scared they're not gonna find out what's wrong with you
no biggie i'm fine
i feel so bad about this it's all my fault
no no it's not
but your father he hates me
he's just pissed about his car
help help help
what's wrong
ast is 859 we're getting him to the icu
alt and gdt were in the tank our antibiotics
would not have caused this
she must have given him drugs
i wouldn't do that
it's not drugs his liver is shutting down
what what does that mean
it means he's all better he's ready to go home
what
what do you think it means you can't live without a liver he's dying
what is your problem
bum leg what's yours
hey we don't have time for this let's go
his son's dying and you're mocking him
it was a dumb question
no it wasn't
you're right it wasn't
is proving cuddy wrong worth all this she leaves house has to lean against the wall again
you know house shouldn't even be here
because he said something inappropriate if we sent him home every time he did that we wouldn't need this office
he's in pain
what does the man have to do to piss you off
he's been without pain relief for seventy hours
exactly he's detoxing can't you see he's out of his mind
that's what they said about manson do you want to continue talking about me or should we discuss what the liver damage tells us i was born in a log cabin in illinois
hemolytic anemia doesn't cause liver damage add the fact he's coughing blood you've got three of the indicators of organ threatening lupus
it's moving too fast could be hepatitis e
there's only been one case of hep e originating in the us since
its history since he's been in and out of the country four times in the last year
you really think he's got hep e
no i think the lupus is way more likely
all right then let's start him on iv cytoxan and plasmapheresis
no we should rule out hep e
you just said it wasn't hep e
i said lupus was way more likely but if we treat for lupus and it is hep e
he's toast
exactly
but there isn't a treatment for hepatitis e either he'll get better on his own or he'll continue to deteriorate
yeah i went to medical school too start him on solumedrol sp
if he's got hep e that's only going to make him worse
not as much goldilocks people it won't hurt him so much that it'll kill him and it won't hurt him so little that we can't tell it'll hurt him just right and if it does nothing
we'll know it's not hep e and start treating him for lupus
now watch me do it while drinking a glass of water
what do we tell the dad we think your kid has lupus so we're gonna treat him for hepatitis e and oh yeah if it really is hep e we're not actually giving him hep e medication so it's gonna make him worse not better
you think he'll go for that
so you want us to lie
no i want you to lie
why me
because he trusts you
this is a mistake
this is a lawsuit
hep e is possible house always pulls these stunts and he's right more often
he's delaying treatment because of a one in a million chance that even he doesn't think is the problem
i don't want to lie to him
then don't
and get fired
like he's going to fire you he loves you
i've got to do something the kid needs treatment
treat him for lupus
that will get you fired
you really think house is losing it
yeah
he's fine he knows what he's doing
we're recommending a drug called solumedrol
for hepatitis did that show up on his blood tests
the tests are never 100 accurate
well then all the other tests could be wrong too this could still be an infection or cancer
um they don't fit any of the most recent symptoms
well what just hepatitis does i know i know i know you can never be sure when linda was in the hospital the doctor told us there was this aggressive experimental treatment which might extend her life by two or three years we figured if there was any hope at all that we could have her with us a little while longer it would be worth it 3 weeks later she was gone
i don't think it's hepatitis i think your son has lupus
i think it's broken what did you do
accidentally closed the car door on it
no door would have broken the skin this looks like something hard and smooth smashed it
i want my lawyer
the brain has a gating mechanism for pain registers the most severe injury and blocks out the others did it work
well my hand hurts like hell yeah i feel much better
huh
don't splint it i want to be able to bang it against the wall if i need to administer another dose just tape it up
why did you tell cameron to lie to mr foster
make it tight will ya
answer me
nothing i could say is going to change how you feel and nothing could come out of your reaction that is going to change what i plan to do so i prefer to say nothing
so that was you just saying nothing
uh huh
the guy is furious
and scared
so what are you going to do the father's insisting on the lupus treatment
yeah cameron told me and i told her to tell him no
well you can't just sit back and let the kid die
neither can the father
so that's your plan you're gonna play chicken with the kid's life
well he's the dad i should win easily
take the week off
what cause i lied to a patient i take risks sometimes patients die but not taking risks causes more patients to die so i guess my biggest problem is i've been cursed with the ability to do the math
i told him that you wouldn't treat him for the lupus until
what did he say
he said he wanted to transfer keith to another hospital
he's not stable enough he'd never make it through the door
that's what i told him
and that's when he caved
yeah he agreed to do it your way
two plus two equals four
if it is hepatitis e we should begin to see a marked decline in liver function tests within the hour
why bother explaining it to me it's not like i have any choice in the matter
if there's no hep e we'll start treatment for lupus immediately
ouch
keith what's wrong
what's happening
get off
keith it's dr chase where does it hurt
jules no
he's hallucinating
is this from the medicine
we haven't started the medicine
keith we're in the hospital keith there's nothing on you
keith keith keith you okay buddy
i think i wet the bed
don't worry about it it's fine let's get you up
oh god
he's had a major bleed bright red blood per rectum
i didn't mean to i'm sorry
he's going into hypervolemic shock pressure's 60 heart rate's 140
we need an angiography stat
angiography revealed major upper and lower gi bleeding severe hemodynamic compromise and liver failure
he's also hallucinating thinks he's being talked to by someone named jules
hallucinations are a symptom of psychosis which is the fourth diagnostic criterion it's official this is lupus
who's jules any mention of her in the medical history
it doesn't matter what he's hallucinating about it matters why it's lupus
there's no need to get snippy this kind of lupus takes years to get to this point it's been a week
yeah and a 16 year old kid shouldn't have hemolytic anemia or be bleeding out of every orifice but he is we had an opportunity to treat this instead we diddled around with hepatitis e and now it's too late he needs a new liver we screwed up
you're saying i screwed up
yes
then why didn't you just say that
you gonna just blame this on her
did you agree with my recommendation to treat for hep e
no i didn't
and she made herself quite clear
and then she went and lied to the father that's why you're angry
yeah i trusted you
you always trust me big mistake lupus is a bad diagnosis
it's the best diagnosis we've got
that doesn't make it good
no it just makes it this kid's only chance to live
put him on the transplant list and make sure cuddy knows see if she can do anything to get him close to the top cafeteria stay away from the sushi
and what happened to your hand
got stuck in a drawer
yeah right you're going through withdrawl
no i am going through pain pain causes nausea
i took this job to work with you not cover your ass your vicodin
and your solution is to give me drugs it's interesting
no now i'm covering my ass take your pills before you kill this kid
lupus is normally treated with medication but in keith's case the disease is too advanced
because you lied because house wanted to play games with my son's life
there's no way to really tell what progression the disease may take
you're right and i'm sorry
so what do we do
he needs a new liver
there are over 15 000 patients on the transplant list
but how many are about to bleed to death unless they get a new liver
in jersey i'd say uh twenty 2000 patients die each year because a donor liver can't be found that's almost five a day
so he's screwed
i'll see what i can do
could i donate part of my liver
sorry you're a different blood type
so we just wait
i'm afraid so
and hope for someone to die
who's jules
dr house you should get back to your office
jules there's no jules in the history
it was a hallucination
of what
our cat does this matter
no i'm sorry we'll continue the transfusions and the treatment for the anemia and liver failure while we're waiting for a donor
how long can he wait
not long
i don't think this is lupus
i don't think this is lupus come on let's just go
your fourth diagnostic criterion of lupus is psychosis this is just a kid missing his cat
he was being attacked by an animal that wasn't in the room that's psychosis
there's a difference between psychosis and hallucination
so if he was imagining a fake cat it'd be lupus but since it was a real cat it's not take your damn pills
psychosis requires
there's no cat jules is dead
you have a dead family pet and you never mentioned it nice family history
family history is asking about family members meaning people related to the patient let's go
how did the cat die
can you get him out of here
dr house come on let's go
what happened to the cat
old age she was fifteen years old
when
about a month ago
does this have anything to do with
where'd she sleep
with keith
this is not a cat allergy
it's not lupus where is jules
four years of college four at med school two years of residency another four of sub specialty training and where do i end up
talking instead of digging come on the ground's frozen solid
what's that
out of the way we have the liver prep or 4
all right keith start counting backward from ten
ten nine eight
dr hourani scalpel
stop the gases
what the hell are you doing house
saving a sixteen year old kid from a lifetime of immunosuppressant drugs and a very nasty scar this kid doesn't have lupoid hepatitis he has acute naphthalene toxicity
naphthalene you're talking about mothballs
nope termites they create naphthalene to protect their nests which i'm assuming is rather large and is inside all four walls of his bedroom at home
and your assumption is based on what
the autopsy i just conducted on his pet cat
call cuddy and security
you are not removing that kid's liver
now have you completely lost your mind
no but i have been feeling a little sick lately achoo
there's no way we can do this surgery now
you think
you've already cost him his liver don't kill him too
why are you so eager to cut into a healthy kid
healthy he's in the toilet
he just needs some chicken soup
i'm telling hourani to re scrub we're doing this transplant
no you're not
you said it if keith's symptoms had an environmental cause they would have disappeared as soon as he got here
they've only gotten worse
if the food here wasn't one step below riker's island he would've gotten better he's lost fourteen pounds
yeah sure this is nothing but a dietary thing
naphthalene is a gas a fat soluble gas the kid breathes it in it gets stored in his fat cells outside the hospital his body burned protein and carbs for energy and the naphthalene stayed in fat but once the car accident put him in the hospital and he started losing weight his body had to get its energy somewhere else it started to burn fat the floodgates opened the poison poured into his system
so getting away from the poison is what poisoned him
getting him away from his dad's meatloaf is what's killing him
you wanna explain to me why you stopped the surgery n oh my god my god
i want him locked up
hey take it easy
your cat did not die of old age he died of massive internal bleeding and acute liver failure caused by naphthalene poisoning the exact same thing your son has
you lie to me you mess up my son's surgery and now you expect me to trust you
give me twenty four hours we'll pump your son full of calories
that liver is going to somebody right now
we're doing that surgery
if you do the surgery you'll be killing a mother of four
father of three
i was guessing
like you are now
naphthalene poisoning is the best explanation we have for what's wrong with your son it explains the internal bleeding the hemolytic anemia the liver failure it also predicts what'll happen next if you do the surgery he's gonna lay on that table for fourteen hours while his body continues to burn fat and release poison into his system either way i did you a favor he's awake now you've got a chance to say goodbye
i think you should trust dr house
give the liver to the other guy
inr is down and his blood count is climbing it means you made the right call his liver is healing he's gonna be just fine dad hugs his son and pam grabs keith's hand the dad grabs pam's arm too and everyone is happy
you made it a week
and won my prize
congratulations
cuddy's a sucker i would have done it for two weeks off
yeah it was a piece of cake you learn anything
yeah i'm an addict
uh okay
i'm not stopping
there are programs cuddy would give you the time you could get on a different pain management regimen
i don't need to stop
you just said
i said i was an addict i didn't say i had a problem i pay my bills i make my meals i function
is that all you want you have no relationships
i don't want any relationships
you alienate people
i've been alienating people since i was three
oh come on drop it you don't think you've changed in the last few years
well of of course i have i've i've gotten older my hair's gotten thinner sometimes i'm bored sometimes i'm lonely sometimes i wonder what it all means
no i was there you are not just a regular guy who's getting older you've changed you're miserable and you're afraid to face yourself
of course i've changed
and everything's the leg nothing's the pills they haven't done a thing to you
they let me do my job and they take away my pain
how'd it go
he admitted he's addicted to the narcotics
well admitting you have a problem is the first
and he says it's not a problem maybe it's not what do i know
what are you going to do
nothing i've done enough damage
better hope he never finds out that that was your idea
he'd never believe it
the end
house m d 1 12 sports medicine
house m d
1x12 sports medicine
february 22 2005
written by john mankiewicz david shore
directed by keith gordon
transcript written by saki
archived at twiz tv com with permission from house transcripts and more
house and other related entities are owned tm and by heel and toe films and bad hat harry productions in association with nbc universal television all rights reserved this transcript is posted here without their permission approval authorization or endorsement any reproduction duplication distribution or display of this material in any form or by any means is expressly prohibited it is absolutely forbidden to use it for commercial gain
are you thinking about taking drugs well think again because drugs are not the answer take it from me hank wiggen oh don't remember this ugly mug two years ago i was a star i won nine games in a row but by the end of august i was a goner
cut cut
not good huh
well you caught the ball
yeah
look i usually don't give line readings but try this here here
hollywood ain't holding its breath
well they're doing it wrong i mean for hank
tell the director
i thought i'd give the marriage a few months before i'd go for the meddling wife thing
his arm came back day after he hooked up i say meddle
you okay
just gas go help your man give me a little room here to work it out
take it from me hank wiggen like that
no
hey sweetheart
hey hi bryan
hey
you boys having a little trouble with the big speech
yeah you got any ideas
it's your story just be yourself drugs were there you took em simple why'd you get clean
because i was gonna die
and come april 'cause you're clean you're starting opening day against the yanks
try it her way
yeah
let's start with the 2nd part first that'll get him in the groove
okay we'll do the throwing thing first everybody wants to direct
warner alright
yeah he's good you just bring it babe just tell your story
come on kid show em what you're gonna give the yankees
alright action
oh god
it's gonna be okay it's gonna be okay
he's got osteopenia his bones are too thin to fix the arm
no price is not a problem if you have what i need click
osteo
young man
how did you know
well if he's an old man osteopenia would just be a fact of life you make him comfortable send him home which means you're just boring me so he's young which means it's most likely caused by cancer and you're here because you haven't found it have you looked really really hard
mri and pet scan are both negative
well how old is he maybe the osteopenia is just early onset
well let's see born 9 21 77
it's hank wiggen he signed it sweet to jimmy wilson the cy young of medicine you ask for that
i just the jimmy part the bone's too thin to support the kind of surgery that would let him pitch again but if we figure out what's causing the osteopenia we can reverse the bone damage then do the surgery
beat the yankees and save the free world
it was a working dinner my work company pays
i i dunno i just feel kinda weird after what it turned into
well then it stopped being work you know if it'll solve your ethics problem you can reimburse me for these what are they five dollars and fifty seven cents i believe you let me know about friday
mm hm
none of the usual suspects age isn't right in apparent perfect health before this incident mri and pet scan negative for tumors
test him again it's gotta be cancer
sorry i'm late car broke down on the interstate
don't believe you chem 7 also shows a poor kidney function now why would a guy in his twenties have a poor kidney
cancer it first attacks the bones and then the kidneys
come on people he was 17 and 7 his era was 2 1
you want it to be his kidneys because if it's his kidneys then maybe we can treat it maybe we can fix it and if it's cancer then he'll never pitch again if this were a regular guy who came in and broke his arm lifting a box you would've packed him up and sent him home
my god you're right i lost my head all life is equally sacred and i promise you the next knitting injury that comes in here we're on it like stink on cheese he weighed 175 his rookie year
stop
now he's 195 after playing a year in japan why
he let himself go
steroids i mean the guy was a drug user i'm sure he wouldn't have balked at pumping up through chemicals
that'd explain the weight gain and the kidney problems
and the bone loss go ask him what he's on when he says nothing have him pee in a cup if your car breaks down you're an hour late not two minutes and two minutes isn't late enough to use a clever excuse like car trouble
i was coming in early
huh unprompted lies that's a bad sign either a guilty conscience or something personal's going on see that's all you had to do just walk in sit down do your job
no no i never took them
we're gonna need a urine sample
oh no you don't trust me baby i'm worried about taking this morphine
you're in pain the doses are monitored it's not a slip besides opiates weren't your thing
they should've been woah
mr wiggen the urine sample
i wanna say no so i am no
trust is a big issue in early recovery he really did gain the weight honestly
if you say so
you're not getting it he thinks i'm an idiot
he sure does
should we save the sample dr sportsfan can put it in lucite and hang it around his neck
hey friday night can you cover for me
i think so oh friday no i'm sorry i have to go to that oncology thing that seminar
oh
what's going on
dinner with the drug rep casting pharmaceuticals
arnie claims he has 500 lawyer jokes only tells one
uh new guy
you need cash ah no i i don't have that much on me no no it's not a problem no i'll be over by 6 kay click 5 p m dr house checks out
it's 4 45
i was rounding up
carol moffett please see dr house in exam room 1
whoa whoa not so fast kathy
it's carol
ah uh trouble with the leg when's the wedding
this saturday
not much time to fit into that pretty dress and no time for practical shoe shopping you're running two miles a day further than you should be
it hurts right here
new shoes less miles and ex nay on the afternoon cokes you're gonna look beautiful what's wrong with you
i can't get my contact lenses out
out of what they're not in your eyes
but they're red
that's because you're trying to remove your corneas what's wrong with you
uh lately my wife has noticed that
yeah yeah symptoms we're working on a personal best here
numbness in my feet and hands constipation
and
maybe he doesn't feel comfortable talking about his private matters
well neither would i if i was having trouble controlling my pee pee you're a dentist nitrous oxide poisoning which means you're either dipping into your own supply or you've got a bad valve in the office laughing gas rehab's probably more expensive than the plumber meanwhile get yourself some b12 who's left
i can't see nah i'm just screwing with you it's a hangover my english lit prof told me he'd fail me next time if i didn't show up with a doctor's note
well make friends with the dentist he can give you a note and maybe a little nitrous to take the edge off
dr house he tested negative for steroids
elevated beta 2 proteins though could be cancerous amyloidosis or lymphoma
or steroids you guys got any money on you
he tested negative for steroids i um i have a couple 20s on me
50 of them foreman
the fat pad biopsy and abdominal ct scan were negative for the cancers but
well that just leaves us with steroids
he tested negative for steroids
less money is made by biochemists working on a cure for cancer than by their colleagues struggling valiantly to find ways to hide steroid use but there's one thing they can't hide
hi i'm dr house and this is the coolest day of my life see steroid use shrinks the testicles
i am clean man no steroids no nothing
your lips say no your prunes say yes hypogonadism isn't that a great word thanks we don't get to say it nearly enough start him on lupron right away
these freaks are willing to defile themselves for mass entertainment for money i feel sorry for them
he drops a clean urine denies using steroids then you're giving him a drug for what steroid abuse
no no it's not it it's got calcium in it it's i very i good for the bones basically on a molecular level it's just milk how long do you figure before i get a call from cuddy
you put him on lupron
uh huh
and you told them it was like milk
yes
is there any way in which that is not a lie
it's creamy but i had 3 reasons
good ones
well we'll see in a minute i'm just making them up now he lied to me first
your mother did teach you 2 wrongs don't make a right
if he lies to me about not taking steroids then i lie to him about not treating steroids he's cured adds up for me
second reason
if i told him the truth he wouldn't have taken the stuff
and if he told you the truth what would this stuff do to him
severe respiratory problems
third reason
i wanted to eliminate the placebo effect
excellent you and your lawyer can write a paper
which brings me to my fourth reason
i thought you said there were only three
i thought you'd buy one of them
seriously
he's not gonna sue
because his lawyer is a nice guy who realizes it's unfair to blame us for ruining this kid's hundred million dollar career
good guess but no if the lupron causes respiratory problems it means he's not on steroids which means there's something else wrong with him and the choices for that something else are almost universally very bad
osteopenia messing his bones up hypogonadism impaired liver function kidney function and we have managed to find the only professional athlete in the galaxy who is not on steroids and it's not cancer so what's killing him who shares my suspicions that the yankees were somehow involved
shrunken testicles indicate his body's not putting out enough testosterone
throw out the lungs that was the lupron my fault don't worry i'll send him a nice note
what about something environmental arsenic mercury the symptoms could indicate
pretty small environment wife's fine no one else is sick
if you throw out the kidneys everything else adds up the testicles the bones the impaired liver function could all be caused by a breakdown of his adrenal glands
addison's disease i like it mainly of course because the treatment is
steroids
enough irony for all of us
treatment would cause him to retain fluid with the kidneys almost shut down already he'll die
well we'll get him a new kidney
your theory is that addison's is causing all the symptoms except for the kidney problems what's causing the kidney problems
cameron if you could make an ironic guess right about now
he tested nega
negative for steroids
agreed he's not on steroids now if he was on them anytime in the last five years it could've caused the kidney damage
you see kidneys don't wear watches sure gallbladders do but it doesn't matter cuz kidneys can't tell time steroid damage could take years
no steroids how many times does he have to tell you
i don't know how many times did he lie about cocaine before coming clean with the league
that is completely different
oh that's right i remember you never did come clean the league was out to get you they faked the blood tests you had to get yourself a lawyer
if hank says he never used steroids that's the truth
that's too bad because our theory is that the kidney damage is caused by a and everything else is caused by b the beauty of this theory is that we can treat a and b but if you add the kidney symptoms back into the mix then we are looking at another letter altogether one that is apparently not in the alphabet can't fix the bones no more baseball no more breathing no more brain function
get another explanation
okay yeah think i've got one in my other pants
hold on five years ago bangor maine my pitching coach had me on something i never knew what it was
and you never tried too hard to find out either
i gained 12 pounds of muscle in like 4 weeks i'm sorry baby
how you doin' doc
good very good yeah
you want me to put hank wiggen on the transplant list
he needs a new kidney i was thinking the kidney people might have some
well they like to save them for people who have how do i put this kidney problems
he's a professional ballplayer brings joy to millions do you really want to be known as the hospital that sent him home to die
that's a great idea we can be the hospital that killed two people the guy who deserved the kidney and the ballplayer we bumped up the list when we weren't even sure what was wrong with him
everything else is related to the addison's
the test for addison's was inconclusive
the test for addison's is always inconclusive
why do we do it at all we should just ask you
you're not putting him on the list
your powers of deduction are breathtaking
you take a perverse pleasure at turning me down
it's what i live for once in a while though try to ruin my day ask me something i can say yes to
oh i'm sorry doctor i didn't know you were busy want me to come back
is he on the list
no
then i'm giving him one of mine
okay
you're not gonna tell me it's a bad idea why give a kidney to someone who might not be able to use it
not my area that is however my chair
when do we do it
very noble gesture my favorite kind dramatic yet completely empty the chances of non identical twins being a match
do you live alone
you writing a book
i made it a question just because it's more polite you got a big keep out sign stapled on your forehead
that explains it i told them to put it on my door
even if real human contact is something you don't have or even want or need you should at least be able to see it in other people
yeah right true love that's just how we match organs these days there's a couple in france high school sweethearts they're trading brains
we're a match run your tests
hey the lab call is she a match
haven't heard yet
you got a text message though friday night very cryptic
gee thanks for checking can you cover for me
oncology seminar friday night the same thing as the car trouble
i had car trouble
house says you were lying i believe him
what's that you got a little wet smudge at the end of your nose
hey i like the guy he says what he wants does what he wants
he won't talk to anyone unless he can jerk them around
or needs a thousand bucks what is with that
i scored it's a brave new world doc and we are at the cutting edge you are looking at two all access passes to paradise itself
how much
true cost no man can say
could that man's accountant say
one thousand dollars friday night the biggest official monster truck jam in the history of new jersey
okay please tell me you didn't just say friday night
whatever you've got you cancel
i i can't do it
listen they only give these tickets to owners anytime we wanna be in the middle of the track we're in the middle of the track these tickets are so good we have to sign a release i mean it we do this we could die
i've got the oncology thing i i the rectal cancer lecture they booked me a year ago i i i i i can't get out there's no way out
fine i'll ask one of my other friends what you're saying i've only got one friend
uh and who
kevin in bookkeeping
okay well first of all his name's carl
i call him kevin it's a secret friendship club name
it's hookers
oh my god
multiple hookers but house is house right he's gotta have his way four or five of em
that's not even funny
what you don't think he has sex
no of course he
of course not he doesn't have sex he makes love
i didn't say that
it's the lab dr foreman
if you have the results i'd like you to talk to both of us if you don't wait for me to
believe me i'd much rather be with your better half and by better half of course i mean the one who struck out sammy sosa on three pitches and talks a lot less but i thought i would talk to you first and alone i got your results back from the lab you do match
i i do
you're also pregnant you can't be a donor not in your current condition
um excuse me i have to go talk to my husband
heart looks good we can schedule the transplant
no transplant lola's not gonna have an abortion
actually your wife just told me that she was making an appointment
well i don't care what she said
i think you two need to discuss this further
we've been trying to get pregnant almost since we met
well it's your wife's decision whether or not she
she wants to trade a child for a kidney that's murder i'm not gonna let her do that
foreman says we've got a problem with the transplant
if she terminates the pregnancy he's not going to let himself die on principle
would you give up a baby for someone you love
please tell me i don't have to decide depends how long would they live
is this a pragmatic question for you
fifty years no problem six months i say let em die well i've actually given this a lot of thought and my personal tipping point is seven years eight months and 14 days
i couldn't do it
you found religion
do you have to be religious to believe a fetus is a life
there seems to be a correlation i'm uh do you like monster trucks
i don't know what they are
right i got two tickets friday night
you asking me to go with you
sure sounds good
like a date
exactly except for the date part forget it
no i i was gonna go to the oncology dinner
course you have to hear wilson's lecture
no i just found out he canceled like two weeks ago so what do we wear
still with us hank
yeah my chest feels funny
tachycaridia your heart's beating too fast we're sorting it out but you stay with us alright keep talking to us hank
where's lola
10 units of insulin sub q an iv push didn't catch it
it's still dropping
why's his potassium up
damned if i know
wee've got to suck the potassium out of him we gotta get his heart rate down
need a crash cart
it's definitely not addison's
it's not steroids either
his heart rate is 130 and rising like a randy johnson line drive
a for effort
there's no point in doing the transplant even if he was stable enough it's obvious that we have no idea what's wrong with him
first it's too high and now it's too low
his heart's not responding to the atropine
heart rate's down to 40
i thought it was up
now it's down last time he went out at 35
what's wrong
i have no idea hit him with the atropine sp before he gets to 35 again
we've already given him 3 ml
apparently that's not enough
we can't stabilize his heart rate
what did you do to him
kayexolate
his pulse was through the roof so is his potassium
it wouldn't do this
but something did call me when he's stable or dead
i remember the first time you weren't even supposed to be pitching that day i'd flown all the way to tokyo to watch this kid and he gets tossed for arguing a call in the first inning ah your pitches perfect ball seemed to go faster than your arm it was like the rules didn't apply like physics couldn't slow you down goddamn it was beautiful
hey warner
hey kid how ya feelin'
i hurt my arm my head everywhere
they must have dialed down the morphine that's just wrong you're in pain hey i got something for ya
no
a doc in st louis gave em to me for a migraine
i'm an addict i i can't take that
even lola was okay with the morphine this stuff's just a little stronger go on
i'll just try one warner
three more symptoms heart rate up heart rate down now he's hallucinating
you gotta promise not to tell lola
he's not just dreaming
no rem he's actually awake
drugs
not psychedelics not with the heart symptoms
all hallucinations would point to digitalis it would also mess up his heart but he's not on it and why would he take it
yeah pithy analysis i can see why they asked you to speak at the cancer dinner i'm sorry i'm gonna miss it
i'm sorry about the monster trucks
no i think it's great you're giving back
the only thing is the digitalis it would only explain the later symptoms not the original ones
sure it's got a lotta movement problem is everybody sees the movement yer throwing yer curve ball like yer throwing a curve ball deception that's it same motion less movement so it won't come back at ya how'd you get in here
spoke spanish told them i was the new shortstop from the dominican
how's hank doin'
lousy around your fingernails that swelling it's called clubbing hippocrates noticed that a lot of his friends who also had that tended to frequently grab their chests and die
yeah i got a heart condition what's wrong with hank
what do you take for it
digitalis
got em with you
that's weird i just filled this prescription a couple days ago there's another bottle here
don't bother hank wiggen stole your pills he tried to kill himself
so what happened he left the bottle open while he went to get some water next time just take the whole bottle
hey man you got no right
see people remember how many they've got date's right on the label number of pills regular person can do the math but a junkie doesn't have to it's how many pills he's got left that's all he's thinking about bought a big insurance policy
this isn't about the money
not for you no most reputable stores won't cash your checks after you're dead but for lola well girls like that they're all about the money
don't you say that she already saved my life i was dead in japan and she brought me back everything since then that's gravy it's more than i deserve
you owe her
everything
so the attempted suicide the scaring her to death that's what is that that's gratitude love yeah i get that we'll take out what you did to yourself yesterday we're back to the kidneys and the bones i'm scheduling the transplant never visit a patient
i want that baby even if i'm gone that's a piece of me and lola breathing walkin' around town goin' to baseball games if there's any more transplant talk from you or lola or anybody else i won't screw it up this time i'll take myself out for good
i'll start treating the addison's which will most likely destroy what's left of your kidneys
fine start the treatment
hey
hank wiggen peed on me what d'you think these pants are worth on ebay
i've got some big boy diapers in my office the rep hands them out like candy
is it that bad
no not if you like the smell of urine
course why should i trust someone who lies about what he's doing friday night question is what are you really doing friday night or more to the point what could possibly be better than monster trucks or are we breaking up
stacy's coming into town this weekend we're having dinner just catching up
i definitely had pants here wait a second is that stacy the stripper i heard she's playing atlantic city
no stacy the constitutional lawyer
you thought i couldn't handle this news you talk to her a lot
no it's been a long time if you don't want me to see her
what is this eighth grade i'm fine
it's fine if you're upset
no it's i have no right to be upset you two are friends you should see her say hi for me
so you're okay
i'm not the cancer doctor who's lying about the cancer dinner i'm not the one who's betraying all those bald headed dying kids i'm gonna go get some pants i stink
you're treating him for addison's and you don't think it's gonna work
he tried to kill himself
i know he's confused we can have another baby i can make him understand that i'm having an abortion we do the trans
no
i can make decisions about my body
and he can make decisions about his he doesn't want your kidney
so he'll die
probably
if you keep that appointment he'll also probably die keep the baby
are you just being polite see my pants are
oh they're all wet
you can't smell that
think she'll abort anyway try to force his hand
no she's not gonna risk losing him
that's funny
n no the monster trucks house asking you that's that's funny
i was the first person he ran into he just asked me
yeah like a date
exactly except for the date part
if the patient decides to go the dialysis route we got some product you should check out hey dr foreman
courtesy of the generous sharon and the good folks at casting pharmaceuticals
i was just telling the guys about the bermuda conference in april
three days of sun and scuba and one hour of lecture
oh god do we have to go to the lecture
so you're the new arnie
dr house it's uh good to see you
would you get me a coffee black no sugar okay so who is it come on she's sleeping with one of you oh god please tell me it's you
she buys lunches she doesn't
don't worry you're not gay you're adventurous
you think she's gonna prostitute herself the three of us are that important to her
i'm afraid not no the groupies sleep with the roadies in order to get to mick
and you're mick
that was the metaphor i was making yes
why are you here
damn it's you it's not addison's new symptom the inability to smell
i was just in hank's room and he said it smelled like the men's room at veteran's stadium he was right
we rejected environmental causes because the wife was healthy well she's not last six months she can't smell a thing if you think of them as one single patient add her symptoms to his
cadmium poisoning
it explains everything even why they had so much trouble getting pregnant
how could they have gotten exposed to that much cadmium
unless they were eating steel and batteries for breakfast
so where else is cadmium
some foods polluted groundwater we should check their home
i think i know how it happened
i'm gonna need another urine sample
what for
sure whatever you want
why wouldn't you give it to me before but now it's no problem
i'm dyin' right
so you've got nothing to lose this time begs the question what were you worried about last time the funny thing is when we tested you before we were just looking for steroids what should we look for now hank
hank what's the story
a little weed every now and then when no one was looking
i don't believe this we quit
you did if you'd kept going you wouldn't have just lost your sense of smell
no i quit the hard stuff i just needed to relax
based on the symptoms you're a lot more than a social user
so you've been lying to me all this time
i'm sorry
there must've been cadmium in the soil where the marijuana was grown some people get bone loss kidney failure some people's testes shrink and some people lose their sense of smell we'll start treating it right away you should be fine by opening day baseball's in the summer right
it didn't hurt the baby did it the cadmium
if you've been clean the baby should be fine
okay
please i'll stop everything i'll i'll go to meetings every day lola
twice a day
how'd the ballplayer doing
much better
too bad about his career
what d'you mean
major league baseball's collective bargaining agreement requires medical reports on all treatment even hank's history is not likely to get much leniency
why should they care that he's being treated for addison's
you're not treating him for addison's
my report says i am
you're lying on the report
everybody does stupid things it shouldn't cost them everything they want in life
no it shouldn't but it usually does on the other hand it means someone can actually beat the yankees
so what about house any way to get him down there
you really wanna talk about work
no not at all
that was amazing
i'm telling you gravedigger never disappoints
you ever been married
well now let's not ruin a lovely night out by getting personal
i lived with someone for a while you gonna finish that
cameron's voice i'll race you to the car
the end
house m d 1 13 cursed
house m d
1x13 cursed
march 1 2005
written by matt witten peter blake
directed by daniel sackheim
transcript written by mari
archived at twiz tv com with permission from house transcripts and more
house and other related entities are owned tm and by heel and toe films and bad hat harry productions in association with nbc universal television all rights reserved this transcript is posted here without their permission approval authorization or endorsement any reproduction duplication distribution or display of this material in any form or by any means is expressly prohibited it is absolutely forbidden to use it for commercial gain
it's all about the tongue man you stick it in their mouth not all the way
they like that
dude they love it
what're you doing
climbing just deep enough to lick her teeth slow one at a time like you're painting them this girl rachel she's a junior she's experienced
mom says i gotta be home by five
just chill okay and hop the fence before someone sees you
are you sure this is okay
dave's mom's a realtor if it's for sale and empty it's a clubhouse and if you say anything you're dead i told them you were cool these are very serious dudes
cub scout meeting's down the street boys
gabe's cool man he's one of us
he better be
uh i'm not thirsty what's this
club business little man
put your hands on
oh dark spirit will any of us die in the year to come gabe backs away
you're moving it
put your hands back now
who among us will die g a
oh man
b e
gabe
that blows
that's it we're going to the hospital
no mom i'm too tired
come on sweetie you've had a fever for almost a week now oh my god gabe are you okay baby what's wrong
i'm dying
male spiking fever congested chest and coughing up green sputum pain in breathing
baffling though i vaguely recall a disease called noomonia numania
but his x ray and ct scan show an atypical patten for pneumonia
pneumonia that's it just a guess here but are his parents big donors
no infiltrate just enlarged hilar lymph nodes
tiny unicorns goring his bronchial tubes would be cooler and the way you're ignoring my question wow they're extremely big donors
he's not responding to cefuroxime his pulsox is dropping much faster than it should for pneumonia and plus he's got an odd little rash
excessive irritation he's 12 he's on auto stroke
on his arm papular lesion one centimeter on top of a long thin scab
ah you need a dermatologist if it's dry keep it wet if it's wet keep it dry if it's not supposed to be there cut it off i never could master all of that there you are it's okay you're home now
fine
cuddy as a special favor to you
no admit it i got you with the rash
the rash is a total snooze unless it's connected to the pneumonia then it's party time
purulent sputum dyspnea bronchi bilaterally what causes this kind of rash
legionnaire's disease
usually means industrial ventilation systems convention centers he's twelve years old
send off a urine antigen and check if he's joined the elks next
fungal
excellent maybe the elks went spelunking
chlamydia and pneumonia
twelve year olds don't have sex
your mistake that's it other possibilities
what if you're thinking about this backwards
the rash came first caused the pneumonia nice
rickettsial tick bites nymphal ticks are out now they're bloodthirsty little bastards
rash would be more pustular
not always and there's only one rash which fits
new jersey it's most likely lyme disease
all right let's keep him on fluids and cefuroxime to be safe and biopsy that rash and take another history even if we don't learn out what's causing this we definitely need to know if twelve year olds are getting any action
what are you doing now
we're collecting fluids from the rash
why
they know what they're doing jeffery
oh great endorsement coming from the woman who thought it was a nasty cold if i'd had him last week and
this isn't helping
we're checking to see if your son has a tick bite
gabe have you been camping recently playing sports outside anything like that
i'm not that good at sports
no hanging out anywhere new strange places
we've been through this we don't let him run wild through the neighborhood right
okay this might be a bit delicate we need to know if you're sexually active
i beg your pardon who do you think my son
mr reillich we need to
no nothing like that
we've got to get another ct scan check his lungs again
third floor right
yeah radiology is just
sorry medical personnel only
where's the machine
we passed it actually little tension in the room back there thought you could use a break your dad's a pretty high powered guy
yeah he was an air force test pilot real top gun stuff flew a mach 3
hard to deal with sometimes
i guess i'm more like my mom
listen i promised to keep my mouth shut but i need to know you definitely haven't had any sexual contact of any kind
i wish
know what girls like the cool guys now you give it a few years they start liking the smart guys you'll be all right
can you keep a secret
i have to it's my job
i'm cursed i'm not kidding this seance thing the kids did it spelled out my name said i was gonna die
first name and last name we've got a gabe upstairs he's very old very sick
no it's me i have the worst luck one time i broke this mirror the next week my parents got separated
my parents got split up too every kid thinks like it's his fault it never is so what about the rest of the stuff any playing outside that your parents don't know about anything like that maybe you were somewhere you weren't supposed to be
oh man
gabe it's important
secret club what's the secret they're all morons
he fell on something in the attic scraped his arm got the rash the next day said it smelled really moldy up there
fungal pneumonia without the cave clever
i'm gonna get a sample
dr chase you have a few moments
sorry i've gotta go
these young doctors it's like they don't care about people no manners
my fault probably
that's an interesting accent you have there i'd say czech with about thirty years of aussie
you have quite an ear
you're chase's dad hard to miss you know the big hug and how happy he was to see you
need a consult
with a patient
urgent doctor stuff
26 year old male sudden loss of the ability to speak
just because you got out of clinic duty doesn't mean everybody did
to his father differential diagnosis
chase
dad swoops in chase swoops out
dad say why he was here
see you asked dad comes 5000 miles and you're more curious than junior is can't just be about the divorce it's been fifteen years and mom's been dead for ten of them you think daddy murdered her
you want to get to the bottom of this you're doing it exactly right don't talk to the people involved drag your buddy away from work for some pointless speculation
you want to know how two chemicals interact do you ask them no they're going to lie through their lying little chemical teeth throw them in a beaker and apply heat
even i don't like you
you know words can hurt
whoa whoa whoa hold on guys i don't care that you're up here
you a cop
doctor i'm treating gabe reillich he said he fell over near some pipes
yeah over there
what here
yeah
right any of you guys been feeling sick lately rash cold anything
no
oh crap he is a cop
damn it
he fell on it some weird kind of insulation it's old house was built in the sixties
what's it made of
felt fibers are made of what cotton
hah hah hah sorry forgotten how funny your dad was
not as funny as you
high praise i know how protective kids can be of their parents not cotton animal hair get me the ct scan first find the company who made the insulation and second tell me what i'm seeing that makes me want to short their stock
uh enlarged hilar lymph nodes
parabronchial thickening
purile effusions
less obvious more scary
well the mediastinum doesn't look right
slightly widened oh god it can be transmitted through infected animal hair but the gram stain would have shown
no the cefuroxime would have killed some of it clouded the result
we've gotta get this kid on levaquin
what does he have
anthrax this house belonged to old man hussein
maybe he is cursed
anthrax so what you think there were terrorists in that attic
it's a naturally occurring bacteria we believe it was in the insulation
how sick is he
anthrax is very dangerous but we've caught it early he's on levaquin it's the best antibiotic we have
lisa you buy this
jeff you've helped our hospital a lot i wouldn't have assigned dr house to your case if i didn't have every confidence in
but who's this guy
jeffery
there's all these weird diseases that can cause a rash what about leishmaniasis and filariasis
where'd you hear about those
the internet i did some research
well those are very rare conditions
oh and anthrax grows along the interstate
leishmaniasis doesn't cause pneumonia and filariasis
just look into everything this is my son all right and i'm going to stay on top of you until i know he's safe
i wouldn't expect anything else everyone's a doctor
breathe baby it's okay breathe honey
his breathing it's on the inhale
what does that mean
it means his airway's closing up
is the anthrax doing it
all right hold still gabe this is going to be a little uncomfortable
we've got you it's okay
two nodules in his throat
airway's inhibited
we've got to intubate ativan
pushing 3 ccs
airway's too tight
what's wrong what's wrong you're killing him
jeffery jeffery let them do their job
airway's too tight get me a smaller tube
we're traching
smaller tube
his lips are cyanotic
oh my god he's not breathing
foreman we're traching
no i can do it i'll get it
foreman you're not getting through
he's not getting air oh we have to trach him right now
no i can do it
betadine i'm doing this
got it
he's okay
allergic reaction to the antibiotics
i don't think so we switched him to rifampin and there was no change in swelling
we should try another antibiotic
you really think he's allergic to two antibiotics
i want to know what dr chase thinks
it's possible to think he's allergic to both anti
oh i'm sorry not you understandable mistake the other dr chase
boy gets anthrax but happens to be allergic to two antibiotics hate to step on anybody's toes but is it possible that your guys got this one wrong
the rash is classic anthrax
except the color
the rash hasn't turned black yet no necrosis no anthrax
necrosis can theoretically take as long as two weeks
whoa whoa whoa guys it's not a competition it's a diagnosis okay who thinks junior wins four to one it's not anthrax so we start over what's changed what do the nodules tell us
sarcoidosis
excellent send an ace level if it comes back positive put him on methotrexate
we ran some tests and the results point toward sarcoidosis it makes the body's tissue swell up it seems to have gone after gabriel's skin and lungs and given him this fever
doctor
we don't know what causes it
but you're sure he has this one
we have a world renowned doctor consulting he's convinced this is sarcoidosis
is it treatable
very actually see this is iv methotrexate it's an anti inflammatory which should make all the swelling go down and get you all better
stop
my god it's black
necrosis
it's definitely anthrax and it definitely can't be anthrax it doesn't cause throat nodules
the only explanation is this kid has got anthrax and sarcoidosis
right two incredibly rare diseases just happening to strike at once
unless you've got a better theory
anthrax plus an allergic reaction
because that's one bizarre allergic reaction
come on there's no reason you both can't be wrong it's not allergy but it's not coincidence either disease number one set off disease number two
anthrax weakened his immune system
and triggered a dormant sarcoidosis keep him on antibiotics for the anthrax and start him on methotrexate for the sarcoidosis
fine
better go with him make sure he doesn't snap and hurt somebody
you you're treating him for both diseases
we're covering all the bases
what throw everything against the wall and see what sticks
works for spaghetti
you're being funny
apparently not
you know why i give money to this hospital it's the only way to get attention you see this
is this a magic trick because i am a total david copperfield fan although that tornado of fire that seemed a little fake
pain in the wrist won't go away for months six doctors' brilliant conclusion is to take it easy i write a check name goes on a plaque and forty eight hours later i've got two mris a bone scan and a diagnosis carpal tunnel i'm in surgery that afternoon
fascinating story you thought of adapting it for the stage
i love my look at me love my son love him more than anything else in the world and you're going to start paying attention to this case or i'm going to make things miserable for
go back to your son's room
i'm not leaving here until you get your ass in gear
there's a problem
what is it
i don't know
skin lesions are spreading all over his body they're opening and the fatty tissues are oozing out he'll be septic in a matter of days
death by dermatitis
where's robert
uh he has clinic duty this morning
no he doesn't i rescheduled you guys so you'd be free
yeah but he re rescheduled himself
it doesn't hurt yet
keep going
you page me
no i don't need you
oh come on we all need help now and again you're getting a consult okay we've got new skin lesions bigger and uglier what would cause that
my hand hurts
what if his body worked so hard attacking the anthrax that it started attacking itself
auto immune
wouldn't present this aggressively
it's not likely but it is possible
what in a twelve year old male
this isn't about me is it
gabe's dad found leishmaniasis and filariasis on the internet yesterday they didn't fit then but now they kind of do
sure except for the nodules and we're not working out of calcutta general
multiple neurofibromatosis
you think this is neurological
the only reason you're thinking auto immune is because you're a rheumatologist if you were a proctologist you'd think rectal cancer
gotta go with senior he literally wrote the book with this one
auto immune is a big universe it could be anything from scleroderma to churg strauss
whatever it is we should start him on steroids keep the swelling down
and 100 mg of cytoxan it treats most auto immunes
we'll give it to him now before the fat starts dripping out his eyeballs
hey my fingers are numb
your watch is on too tight
you're messing with my head
your relationship with your dad is messing with your ability to do your job
only because you made my dad part of my job
good point haven't seen him in years he flies across the atlantic to see you
pacific
you breeze by him like he's a hare krishna at the airport you don't even ask why he's in town
it's probably a conference
probably i was hoping to do this by sheer manipulation but if you insist on talking fine talk what did he do to you
how would you feel if i interfered in your personal life
i'd hate it that's why i cleverly have no personal life
i'm going to biopsy his skin lesions
good thinking prove your dad wrong that'll solve everything
who extubated him
i did temperature's down two degrees and the swelling's almost gone
and his skin looks better too
the cytoxan is working
feeling better gabe
yup a lot
dr chase can you and i have a word
cut to chase and rowan walking down a hallway
your diagnosis is wrong no auto immune disease the swelling's probably just down because we've got him on steroids it's masking whatever's wrong
anas are unreliable
phospholipid antibodies are negative so no lupus same for churg strauss
you're arguing with a rheumatologist there's about twenty distinct auto immune diseases
why are you here
sle conference
you were in new york last year for the scleroderma conference i didn't hear anything from you
just wanted to say hi this time
you said it you're still here
i miss you
i was 15 years old when you walked out now you're walking back in
i left your mother i didn't leave you
mum was living on gin and tonics how was i supposed to take care of her
she wasn't your responsibility
i know she was yours
i'm sorry she died i'm sorry you had to deal with that but she was falling apart long before
i've got to talk to house about this treatment
but the patient's getting better
in spite of the cytoxan
on the other hand getting better
cytoxan makes him more susceptible to infection the anthrax could relapse and be more resistant
better
you want a negative test for every auto immune disease known to man fine i'll get them
be home by midnight or he can't have the car this weekend you guys talk did he tell you why he's here
the sle conference
going back to the conference
afternoon panel i hope i can stay awake
i hope you can get in you're not registered i get it you had to make up a lie can't just tell your kid you're here to see him what father does that that little blue dot under your collar it's a tattoo for guiding radiation treatment i was looking for it after i saw what you had for breakfast brown rice and vegetables macrobiotic diet popular with hollywood starlets and cancer patients
lungs stage four
you look good
i'm not came to the states to go to sloan kettering and to see dr wilson
what'd he say
three months
but you haven't told robert you don't want to burden him because you were such a lousy dad
i'd prefer you not tell him
yeah it's better i'll get to see his face when he reads his dad's obituary
it's not your business
i suppose it isn't
you sure do a lot a tests
if we figure out exactly which auto immune condition it is we can get you better quicker
was that your dad before
yeah
that's so cool do you guys work together a lot
not really
when can i go home
we'll see looks like you got your appetite back that's a good sign want some water
yes
okay whoops it's all right water's cheap
oh god
what
i can't i can't move my hand
squeeze my fingers for me gabe
he's getting worse now his entire right hand and forearm are paralyzed
and his fever's back it's back over 105
if we don't stop the nerve deterioration quickly he'll be paralyzed for life
well luckily at this rate that should only last about a week okay so
i told you we should get him off the cytoxan this is toxic neuropathy we've been shoving drugs into his system for a disease he doesn't have
you know it could be neurological
what kind of brain process would cause a paralyzed hand skin lesions and swollen throat nodules
robert was right you said multiple neurofibromatosis
are you saying that for the chance of a beautiful family moment or is there some medicine involved
fits better
too bad i was hoping for the other reason i was gonna go get my camera get a ct scan his brain this time
you think three copies will be enough right
one's always been more than enough for me
why didn't you tell me that rowan chase was in to see you
excuse me ethics confidentiality does any of this ring a bell
you could have covered yourself called me in for a consult
it is a juicy piece of gossip you know what happened i got all focused on his cancer and lost perspective
you can't tell chase but i can what should i do
oh this is where i give you advice and pretend you're going to listen to it i like this part did rowan ask you not to tell
i promised i wouldn't my fingers were crossed though so i'm wide open
i was wrong this is the musing out loud part do i actually need to be here
telling him now that's got real entertainment value
hmmm he might even cry on the other hand there is the do unto others thingy
then i should definitely tell him i'd want to know
you want to know everything there's also the keeping your promises thingy
oh you never run out of thingies like that blonde thing you were chatting up
she's the hospital accountant we were going over billing procedures
double entry bookkeeping
what are you going to do
billing procedures they're so complicated aren't they
you know parents are never as bad as kids think they are
you like my dad so much ask him out
i'd make an excellent step mom i'm very lenient he's your father you never see him and he's here unless he's done some unspeakable thing you should lighten up
right thanks for the tip
okay he beat your mom he beat you what did he do
really don't push it
all this hate it's toxic
then stay away there's nothing there
no masses no fibrous tangles nothing it's not neurofibromatosis
drs chase are 0 3 even when they agree they're wrong so next what else could cause neural damage as well as all the nodules
burger's disease
he's never been out of the country
have his parents they could have brought it back
i don't think so
doesn't matter his lesions are in the wrong place his feet are the one clear spot
kid's dad mentioned leishmaniasis
yeah and filariasis but the throat nodules still don't fit with that
two diseases pretty much exclusive to southeast asia what if the anthrax didn't set off the second disease
we're back at coincidence again
no what if something else was the trigger
nothing else happened
we happened
antibiotics
we've been through this it's not an allergy
i've gotta pee
what did the ct scan tell you
nothing
ow
on a scale of one to ten how painful
about half as painful as when i punch you in the face
don't do that it'll hurt you carpal tunnel surgery obviously didn't work
who are you
the little ones call me uncle gregg your dad never had carpal tunnel you mentioned two obscure diseases to dr chase how'd you know about them
i read about them on the internet
so what'd you search for diseases from asia that don't match my son's symptoms you heard about them in asia
i've never been there
well you probably just forgot let me refresh your memory some remote dusty village close quarters at least a year starting to come back
i'm calling dr cuddy
excuse me what does this have to do with our son
your dad's pissed off he should be comes here expecting us to do an extra good job because he gives a whole lot of money to this hospital
don't talk to my son like that
just telling him my job my obligation to this
stop what's going on
there's only one thing that you guys have got to do tell the truth or your son will die how long were you in asia
jeff it's a simple question
two years in india
why would you lie about something like that
it was '87 and '88 this uh this guru i thought he had some answers i went to his ashram and um ended up with no money and no answers i was embarrassed i didn't want anybody to know
no no you were a test pilot
i'm so sorry gabe
what does this have to do with my son
if i were jesus curing this kid would be as easy as turning water into wine
demonic possession
close but no wafer clue number two rheumatology rowan was almost right it causes auto immune symptoms
leprosy
yeah that's real big in the jersey suburbs
it's leprosy run a fite stain it'll be positive daddy hung out on the wrong kind of indian ashram
but it's obviously dormant in the dad how could the kid catch it
it's not dormant in the dad it's just slow damaged his ulnar nerve was misdiagnosed as carpal tunnel never trust doctors run a fite stain
no wonder he got anthrax the leprosy weakened his immune system
vicious circle the leprosy made him vulnerable to the anthrax and the anthrax treatment put the leprosy in overdrive
but the antibiotics we gave him they cure leprosy
yeah that's where the trouble starts the antibiotics hit the nerve strands they kill the leprosy bacteria the corpses get tossed into the system and as fascinating as our bodies are they're also stupid they produce antibodies to beat dead bacteria and these aren't the polite antibodies they're the ones that won't sit still kick during naptimes they attack his neural and fat cells cause some inflammation and all the rest of his symptoms
so the cure's killing him
i want you to call down to carville louisiana home of the last leper colony in the lower 48 get them to send up some thalidomide
thalidomide
twelve year olds don't have sex right so he can't be pregnant make the call i need to speak to your boy
why does everybody need to know my business
people like talking about people makes us feel superior makes us feel in control and sometimes for some people knowing some things makes them care
i'd tell you my dad left my mum drank herself to death you gonna care about me more
cameron would me i just like knowing stuff i know you hate your dad but i'm gonna tell you something
i don't hate him i loved him until i figured out it hurts a lot less to just not care you don't expect him to turn up to your football match no disappointments you don't expect a call on your birthday don't expect to see him for months no disappointments you want us to go make up sink a few beers together nice family hug i've given him enough hugs he's given me enough disappointments
okay
that's it
that's it
breathe breathe again breathe again
you gonna have to tell my friends i'm a leper
you had the antibiotics you're not contagious any more
what if they already caught it
leprosy is incredibly hard to catch even your mum didn't get it all right i want you to make a fist
it's still kinda stiff
it'll get back to normal in a month or two your skin two or three weeks you haven't asked about your dad
he lied about everything he lied to my mom he lied to his boss he's just a liar
he loves you
i don't love him
yeah you do nothing you can do about it he's your dad it doesn't matter what he does you're gonna love him
thanks
hey when's your flight you got time for a drink
wish i did
dr chase
i've got it
you're going to be getting down to oz any time soon
not too long next autumn i hope i'll call you well you're all set i'll see you
yeah i'll see you
house m d 1 14 control
house m d
1x14 control
march 15 2005
written by lawrence kaplow
directed by randall zisk
transcript written by mari
archived at twiz tv com with permission from house transcripts and more
house and other related entities are owned tm and by heel and toe films and bad hat harry productions in association with nbc universal television all rights reserved this transcript is posted here without their permission approval authorization or endorsement any reproduction duplication distribution or display of this material in any form or by any means is expressly prohibited it is absolutely forbidden to use it for commercial gain
where are those projections
3 6 and 9 are in your folders
can i have some more
tea's at your seat
excellent
hello oh hold on ben federman again another pre call
we did the pre call this is the post pre call call
board's gonna want some specifics for the push into the asian market
ben there are no specifics about asia we came up with that as a hail mary at three in the morning to placate the board about international
carly i'm just giving you a heads up about asia
there is no asia
let's talk about asia we're in the preliminary stages of forming a strategic alliance with credit lyonnais within three months you won't be able to walk four feet in kyung hong south korea without seeing one of our beautiful models smiling at you from billboards and drugstore windows inviting you in
that's incredible news carly we'd hoped to hear something about asia but had no idea plans were so far along
well you know asia nothing's done until it's done
carly i was wondering could you walk us through what you were thinking for other asian territories
absolutely india has over half a billion women in terms of spending power it's the single largest potential market in the world um we have retained a local firm to ensure that cultural differences are respected um however i can't go into the specifics of my plan with you until tomorrow right now i have a meeting and i need the room
boardmember 2 we were just getting started
i know and i do apologize it's last minute but the meeting is with three state department officials to smooth the way for china
china this is just incredible
we'll be in touch
thank you
what is it
i need a doctor i can't move my leg
quick cut to carly lying in a bed at ppth before house walks into the diagnostic offices
32 year old female paralysis and severe pain in her right quad go
how'd she get to you
she's the ceo of sonyo cosmetics three assistants and fifteen vps checked out who should be treating her who da man i da man i always suspected
dr house i know the chances are very slim but i'm sure you recognize that she may have what you had a clot in her thigh
a bit of a long shot
what about a disc herniation
i don't know eric if her disc were herniated she'd present with pain elsewhere wouldn't she
yeah i suppose
you're right a clot's also the most deadly right robert
true the clot breaks off she could stroke and die
dr house i believe that they're right and
stop talking
what
you read one of those negotiating books didn't you getting to yes fifty ways to win an argument the hitchhiker's guide to being a pal in five seconds you just manipulated these two into agreeing with your point of view fellas this is known as soft positional bargaining it's not gonna work
dr house are you saying that she doesn't have a clot or are you saying that if she does have a clot she doesn't need blood thinners and an angiogram
chase put her on blood thinners do an angiogram when that comes back negative mri the spine if that's clean cut her open and biopsy the leg
excellent suggestion
read less more tv
it's rare for an individual to make a donation significant enough to impact an organization as large and unwieldy as a hospital this donation does come with one string that he be made chairman of the board i think that's a reasonable request i think he should have the right to know what it is we do with his 100 million please welcome our new chairman of the board edward vogler
thank you thank you when i was eighteen my dad loaned me 20 000 for a college tuition which he would have known was a mistake had he known that i wasn't actually in college i took his money and invested in a friend who had a little business and when my dad found out what i had done with his money he and i didn't talk much after that but my friend's business took off and i used the profits from that to buy another company and another and i must have been pretty good at it had a good eye because before i knew it people were making offers for my company and uh about a year ago i went public and overnight i was worth a billion dollars so i went to see my dad i'll admit i wanted a little payback you know kind of shove the wind in his face so i went upstate and sat in the kitchen i grew up in and uh he had no reaction it wasn't his fault he didn't even know who i was because his alzheimer's had taken a turn for the worse despite the best drugs and care out there and that is why i'm here what if my contribution to this hospital is the difference between no cure and a cure for cancer the difference between a man not recognizing his wife of 35 years and being able to look at her and say good morning honey i love you if there's a disease out there killing people i am writing you a blank check to fight back so things are going to change a lot
i'm gonna have to ask you for the cell phone
do what you need to do i'm okay
pretty sure my x ray machine can take your phone in a fight it'll fry it
fine
how old is she
32
wow she's already the ceo of a public company
she's a workaholic okay carly hold still the x ray machine is gonna pass over your leg
okay
what'd you do with your time off
snowboarding in stadt
switzerland
do you ski or board you can come with if you like
maybe we should start with a drink before we go round the world
oh you want to have a drink with me oooh very aggressive i like that
i want to run this place like a business
what you want to put more vending machines in the hallway maybe a roulette wheel
nice one but i'm serious the product that you're selling is good health it shouldn't be a tough sell you don't want to sell it means people don't care about your product you care if people are healthy or are you too proud for that who's that
that's uh just one of our doctors
aren't doctors supposed to wear lab coats
he's different
everyone's buddy
no not exactly
then why does he get away with it
it's just a coat he's very good
hmm
say ah
ah
no really belt it out like you're gonna throw up
ah
perfect okay that's it we should know in a couple of days what's growing in your son's throat hello
he can't talk
excuse me
he had knee surgery
right
about a year ago and then he couldn't talk
right yeah well that happens you know it's very dangerous operating so close to the vocal chords okay well we'll send your kid's culture to the lab and somebody will call you boo
aah
just wanted to see if your dad uh sorry
i need you to wear your lab coat
i need two days of outrageous sex with someone obscenely younger than you like half your age
wear the coat
man oh man someone got spanked real good this morning
guy gives 100 million to cure cancer pretty small concession to wear a lab coat
cure cancer is the hospital getting out of the dull business of treating patients
you know that's not what he's doing
i know exactly what he's doing he's using us to run clinical trials
oh shame on him saving lives like that
it's unethical oh are you coming in too i thought i had you convinced
clinical trials save thousands of lives
he's using patients as guinea pigs
pharmaceutical companies do that every day
are we a pharmaceutical company we're gonna wind up pressuring desperate patients into choices that are bad for them good for us you're gonna compromise patient care
who the hell am i talking to suddenly ethical lapses are a major concern for you
what's interesting is it suddenly doesn't bother you
so if you ignore ethics to save one person it's admirable but if you do it to save a thousand you're a bastard all he's done is taken your game and gone pro
he's not going to kill a few patients he's going to kill this hospital
it took him three seconds to size you up and surprise he doesn't like you wear the damn coat
hello i'm dr foreman i work with dr house our initial tests say you're fine we think you may have had a clot but it resolved on its own so we're gonna keep you overnight to be safe and you can go back home tomorrow or back to work hey you okay get in here i need a line in her iv morphine stat
get any read on the new chairman of the board
yeah he took your parking space
it's not necessarily bad news
do you ever watch gilligan's island reruns and really really think they're gonna get off the island this time
we should introduce ourselves it couldn't hurt
make him a bundt cake patient hit a ten on the pain scale what would explain that
there was no clot in her leg the angio was totally clean
what about the muscle biopsy
no neurogenic or myopathic abnormalities
she's also negative for trichinosis no toxoplasmosis or polyarteritis nodosa
robert what was her sedimentation rate
normal allison therefore no inflammation no immunologic response
do you mind sharing that number with me
fifteen allison
are you mocking me
duh allison
i'm just suggesting we look outside the box what if her sed rate is elevated
well let's go further outside the box let's say the angio revealed a clot and let's say we treated that clot and now she's all better and personally thanked me by performing
my aunt elisa lives in philiadelphia
oh it's storytime let me get my baba
her normal temperature is 96 2 not 98 6 like you and me if her temperature were 98 6 she'd have a fever i'm just wondering if you think we could apply the same logic to carly's sed rate
that's absurd i love it
if 15 is high for carly then she has inflammation
which could in turn mean cancer i'll talk to wilson next time skip aunt elisa
you're probably talking about a primary bone cancer can be tricky to detect you'll need a bone scan
that's why i'm talking to an oncologist
sure i've nothing better to do besides departmental meetings and budget reports new chairman of the board you know
oh i hadn't heard
right clinical trials
completely unethical
and a very bad omen for you there's not much money in curing african sleeping sickness
no i have seen every scary movie ever made six year old twins in front of an elevator of blood boys' choirs those are bad omens this is much more mundane a billionaire wants to get laid
billionaires buy movie studios to get laid they buy hospitals to get respect
and the reason you want respect
to get laid
okay then you've just gotta think like a billionaire let's see big scary changes and then oh dr cameron we should have dinner to discuss your future on my g 5 private jet
oh come on you know how good you have it here
yes i'm the big poobah the big cheese the go to guy
you do the cases you want to do when you want to do them you're not going to get that anywhere else
relax i've been through three regime changes in this hospital every time same story
just keep your head down that's all i'm saying and put on your coat
it itches so are you going to do this bone scan for me or what
yes
dr simpson did you hear new management i'm thinking about switching to orthopedics how much do you guys get for massage now without the happy ending
dr house what do you want
you remember a guy named van der meer not a big talker you fixed his acl
well not according to my medical malpractice premiums
didn't get hypertensive during surgery no strokes maybe some connectivity loss
what you're going to get involved now
i'm not involved guy brought his son into the clinic
i didn't touch the son i'm not taking any responsibility there
the son's fine can't shut him up the dad show any signs of cortical disease wernicke's
no nothing and that's why we settled because we couldn't find anything the guy got over a million dollars don't tell me he's complaining
he's not saying boo
your father wants to know when you'll be back from your trip
email back it's taking longer than i thought he doesn't need to see me like this
what about your brother
no
hello i'm dr wilson i was
robin i'm going to need a minute
oh
thank you there are two dr wilsons in the hospital one in ophthalmology and one in cancer my eyes are fine so you're here to tell me i have cancer
there's no cancer in your bone
you're not smiling
there's something called referred pain you could have cancer in one part of your body that presents in another given your age and your family history i'm thinking your colon
great i was at columbia when my mom died now there's a blast cleaning up her vomit and running to my econ final look if i'm a short timer give me drugs i'll go back to work i'll die there
whoa there's a quick test to see if you even have it a colonoscopy
i know how you do that test
if you have colon cancer we can treat it it's early
that's what they told my mom she was dead six months later
you're a smart person about to make a very bad decision you know cancer treatment's come a long way in twelve years but if you don't do this now
i don't want to be looked at
there is another way we could do a virtual colonoscopy basically we do a ct scan of your colon it's non evasive but it's very expensive i assume that's not a problem say yes
mr van der meer what relax ricky's going to be just finkf strep throat here's a prescription for an antibiotic he should be all better in a few days although this might sting a little i want to see you again real soon
virtual colonoscopy was clean no colon cancer
what happened to a regular old fashioned colonoscopy
she was uncomfortable doing any more tests i had to convince her to do that one
do you get that often women would rather die than get naked with you
she's scared
but not of tests just embarrassing ones
yeah
it's not an inflammatory process it's not a clot because chase's angio says so and it's not cancer because her toosh is perfect anybody else got an aunt elisa with weird stuff
maybe it's worth looking into
i thought you said carly's angio was clean
it was clean
you guys see the problem here
there's no indication of any abnormalities no lesions no spurs no masses
her toes are screwed up they're backwards do you guys know how much surgery it's going to take to swap them back
what are you talking about
either she literally has two left feet or you angio ed the wrong leg
that's impossible it can't be the wrong
or maybe it was jenny how come some resident signed this radiology form were you even in the room
i'll redo her angio straight away
you'll do nothing foreman you do the angiogram
i can't believe i did that
why do we have to redo the angiogram
there was a shadow on the first test
a shadow a shadow means there could be a blood clot right i read colin's current therapy
real page turner no it's not that kind of shadow
my chest hurts
it's from the tracer i injected might also get a little nauseous or have a metallic taste all normal
i'm a runner i shouldn't feel like this
carly i'm looking at your vitals right now and
i can't breathe
carly
my chest my chest
respiratory arrest call the code
what've you got
she's drowning
foreman did a thoracentesis to drain the fluid from her lungs they sent the fluid to the lab it'll be back in a few hours you'll be happy to know that chase's mistake didn't cost her angio revealed no clot
i'm thrilled
okay see now you're just being stubborn it's cold perfectly good excuse to wear your lab coat
carly needs a heart transplant
thoracentesis revealed a transudate
haven't gotten it back yet
her muga scan what was the ejection fracture maybe you could treat it surgically
haven't done the muga
how do you know she needs a heart transplant
i got my aura read today it said someone close to me had a broken heart
since when do i need the secret pass code to talk to you
i can't tell you anything professional responsibility
like that matters to you
not my professional responsibility yours new regime you gotta keep your head down too
now that's good thinking because i was going to go right to cuddy and rat you out as soon as you were done talking
i'm not saying you want to i'm saying you'd be obligated to
because of my position on the board because of my position on the transplant committee hey you brought this up for a reason you need to talk to me
i can't
you sure you're doing the right thing
i've come up with a few really great rationalizations
sorry to interrupt we have a problem
thoracentesis revealed a transudate we did an echo she's in severe congestive heart failure she needs a heart transplant we'll get her on the list immediately
she's already on the list
come in
thanks what is a department of diagnostic medicine
that's dr house's department they deal with cases that other doctors can't figure out
it's a financial black hole department costs us 3 million a year treat one patient a week
he saves one patient per week
what about everyone else his department's not going to find the cure for breast cancer
uh maybe not but
are you sleeping with house
what no
but you did right a long time ago
that's an incredibly inappropriate question
if your judgment is compromised by prior or current relationship that is my business
i respect him that is all you need to know
he's still not wearing a coat
well i told him
i'm sure you did and yet he's not wearing it i'm just wondering if that's a reflection on him or on you
you're dr house i found a picture of you online at a conference
you need a heart transplant
i run i work out i
you cut yourself probably highly ritualized you play the same sarah maclaughlin song over and over while you do it probably works better than anti depressants
i don't understand how that has to
you're a high powered bulimic you make yourself throw up you have to find the most efficient way to vomit without revealing the tell tale signs of bulimia which is all eugh very unseemly for a ceo so you found a common antidote for accidental poisoning to do the job ipecac which is great if your kid's just swallowed a bottle of aspirin but really really bad if it's a habit it causes muscle damage it caused the pain in your leg and it destroyed your heart how often do you do it
three times a week
in about an hour there's going to be an emergency meeting of the transplant committee to discuss where you fall on the list should a new heart become available problem is i am required to tell the committee of your bulimia it's a major psychiatric condition ranks right up there with suicidal makes you a very bad risk
so you're here to tell me i have just a few hours to live
unless i lie to the committee but if they find out i lose my medical license this would be a very good time to offer me a bribe how much is your life worth how much is my job worth
why are you here doing this to me what do you want
i want to know what's right
am i worth it you think i'm pathetic has a good job everything in the world but she just doesn't like the way that she looks
oh stop hiding i'm asking you if you want to live or die you can't even say that
what do you want me to do cry
yes i want you to tell me that your life is important to you because i don't know because that's what's on the table right now your life
i don't want to die i don't
this 32 year old female was admitted by my staff because of paralysis and pain in her right thigh patient rapidly deteriorated and now has severe congestive heart failure pressers and vasodilators have not improved her conditions whatsoever pulmonary function tests show an fvc of over 3 liters with edd 1 of at least 90 of predicted and preserved feb fec ratio and preserved dlco as well her muga had an ejection fraction of 19 with no focal wall or motion abnormalities heart catheterization revealed clean left right and circumflex arteries and subsequent biopsy revealed irreversible cardial myopathy which is why we're here
uh dr house i'm confused by your time and date stamps it appears that you put carly on the transplant list before you did these tests
i had a hunch
you don't have hunches you know
look if the tests had come back differently obviously i would have taken her off the lists but on the long shot on the long shot i was right i didn't want to waste time
is there any exclusion criteria we should know about
cat scan revealed no tumors and dr wilson found no trace of cancer
what about any other criteria
no atherosclerotic vascular disease
are there any
no pneumonia no bacteriemia no hep b or c or any other letters
substance abuse any history of
no alcohol no drugs
any psychiatric conditions history of depression
she's a little blue but turns out she needs a heart transplant
dr house if you subvert or mislead this committee you will be subject to disciplinary action
dr cuddy do you have any reason to think that i would lie
i simply want you to answer the question is there anything on the recipient exclusion criteria that would disqualify your patient from getting a heart
no
beautiful organ donor weather
you lied didn't you
i never lie
big mistake
then you should have voted against putting her on the list
you're my friend
oh jeez have some backbone if you think i'm wrong do something
wait you're getting mad at me for sticking up for you
you value our friendship more than your ethical responsibilities
our friendship is an ethical responsibility what is it
my patient's getting a heart
he's not gonna fire you
i'd fire you bye bye
if i screw up the patient dies i'll never get another job
so go stick your head between your legs and lick your wounds in stadt
well i like it here you guys don't think it's weird house knew the patient needed a heart transplant before we did any heart tests
that's house he knows things
but usually he's putting it in our face telling us how cleverly he figured it out this time nothing just i had a hunch
it is weird
okay ready for the donor heart
they just stopped carly's heart and your dumb patient
they're all oh the guy who can't talk
mr van der meer he scheduled an appointment to see you
oooh goody
i wanted you to know chase is worried you're going to fire him
it's bad enough that screw ups cost lives now we've got vogler screw ups cost jobs i want chase scared i want him doing everything he can to protect his job
dr house if you were in his position wouldn't you be more likely to perform well if you were reassured and
oh will you stop it with the book why are you doing this
i'm not doing anything
you're manipulating everyone
people dismiss me because i'm a woman because i'm pretty because i'm not aggressive my opinions shouldn't be rejected just because people don't like me
they like you everyone likes you
do you i have to know
no
okay
5 hours 23 minutes that's fast
is that good or bad
it depends either surgery went really well or it ended really abruptly
textbook she'll outlive us all
thank you
so sing for me oh no no no no come on look when you had your surgery you were intubated surgeon stuck a tube down your throat now it never happens and it's never caught but it happens your vocal chords were paralyzed i treated the spastic dysphonia with botox ironically a substance that tightens every other corner of your face actually loosens the tongue i have healed you you can talk oh well boooo okay you don't have to say anything it can be our little secret if you can talk blink twice but you're not going to because you think you won't be entitled to the money you won in the settlement with simpson yesterday i would have said you'd have to give the money back today hospital's come into a lot of money mum's the word
hey
hey
i know the cardiologist has given you some guidelines schedule of medications and a strict diet just what someone with an eating disorder needs so i thought i'd get you started fried chicken from the carnegie deli
you're kidding
yeah actually i got it downstairs
why did you fight for me you risked so much and you hardly know me
you're my patient don't screw it up
love this part okay he ruined it
just wanted to stop by and introduce myself i'm edward vogler new chairman of the board in a way i guess that makes me your boss
i am sorry about the lab coat thing the dry cleaners destroyed it
that was my very first heart transplant meeting very exciting
trust me six flags way more exciting
patient's very lucky to have such a passionate doctor who stands up for what he believes in
sweet of you to say
yeah fraid you've been duped though the nurse found this in the patient's purse
oh my if only i'd known
tough being a doctor you've got all that power the power to play god
yes i don't envy the transplant committee their responsibility they basically would have been forced to kill that poor girl i'm not sure i could have done that
this is not a game to me dr house
no this is actually more like we're dancing right now so let's get to the point you don't like me i'm pretty sure i'm not going to like you it's nothing personal i don't like anybody but none of that really matters does it because you've got money and i've got tenure you need full board approval to get rid of me i've got cuddy
right
and wilson so as long as we're stuck with each other we might as well ignore each other that wasn't nearly as dramatic as i was hoping
i looked into that tenure thing and you're right it's actually easier for me to get rid of a board member like cuddy or wilson than to get rid of a doctor that's interesting isn't it
the end
house m d 1 15 mob rules
house m d
1x15 mob rules
march 22 2005
written by david foster john mankiewicz
directed by tim hunter
transcript written by mari
archived at twiz tv com with permission from house transcripts and more
house and other related entities are owned tm and by heel and toe films and bad hat harry productions in association with nbc universal television all rights reserved this transcript is posted here without their permission approval authorization or endorsement any reproduction duplication distribution or display of this material in any form or by any means is expressly prohibited it is absolutely forbidden to use it for commercial gain
if you testify no one can protect you especially the feds
we'll keep you safe joey
right witness protection this great new life he's giving you you're sacking groceries at some goat town stop and shop when one of the talli guys comes up and puts two in the back of your skull
counselor are you advising a witness to withhold evidence from a federal grand jury
he came forward he volunteered i'm advising him not to testify until i'm satisfied you can protect him
hey you guys mind i got money on this
what do you want we gave you everything you asked for
i asked for pasta
you got steak enjoy it
what are you doing where's your quit candy i just gave you a pack
yeah sorry i forgot
joey whatever they give us what they tell you you get popped what am i going to do sue them
that's not what this is about you're gonna miss me
i'm your lawyer joey
you're my brother and i do this you know go into witness protection we're never gonna see each other again
that doesn't bother you
kills me hey i gotta take a leak
you all right
yeah yeah just uh little dizzy
get some air
and hot
joey
what did you say to him
yeah nice try
let go of me let go of me can't you see he's sick
joey joey
something's wrong with him
come on you're not getting out of this that easy either you're dead or you're testifying
don't have it
budget
nope
revenue statement list of expenses
house has been very busy
saving new jersey from leprosy yes i know getting me his numbers that's your job
we're in a meeting
need the lawyer
who'd you kill
nobody but it's not even lunch got served with a federal court order some witness went into a coma and they want me to take a look at it
what they want you to examine a sick person this is a public relations nightmare don't think our staff do that kind of thing around here this place would be crawling with sick people
i'm a doctor i'm not a lapdog for the feds i don't play fetch
nobody tells you what to do am i right dr cuddy
hire a lawyer to fight the order treat the guy or go to jail for contempt up to you
jail you'd like that no more naughty schoolgirl conjugal visit that's her new fantasy
we're not leaving until he's gone or you show me one good reason for keeping him
he's really out of it huh
metabolic structural
he had his stomach pumped why would they do that
rule out poisoning
huh not the typical first guess
no the first guess was faking it patient's a federal witness reluctant i'm assuming he's also an 8 on the glasgow coma scale
that's barely alive pretty tough to fake it
any recent history of head trauma bad car accident fall
they tell me no but do an mri to be sure
metabolic causes liver kidney diabetes
check for everything feds are paying we're gonna turn a profit on this one boys
dr house bill arnello i'm a lawyer i represent mr smith what's wrong with him
do i come to you with my problems
he's also my brother
what you changed your name smith wasn't good enough for you
his name's joey he's my only brother
he's important to you got it so no placebos for him we'll use the real medicine well this was fun let's do it again soon brother in the mafia so just joey i was hoping for a nickname joey mango joey the wrench people know where i am
i want you to do your job diagnose him fix him and keep him here
we're a bit of a specialized hospital we generally only deal with patients when they're actually sick
if you release my brother to the government and he does what they want even if you fix him he's dead i need time to convince him of that good news is if you screw up you don't have to worry about a malpractice suit if he's dead one by one i'll take away the things you love till there's nothing left
so on the mafia thing that's a yes
did house seem weird to you
are you expecting him to be weird
we spoke about how we felt
you told him you liked him
no of course not
what are you talking about then
i asked him if he liked me
why would you do that
because i like him
you like him like him
doesn't matter he doesn't like me
hey he doesn't like anybody and nobody likes him
mri showed a subdural hematoma
bleeding around his brain caused pressure inside his head which caused the coma
these look like pseudomembranes those take time to form if it was an old injury it wouldn't have caused the coma
patient history indicates he was hit with a tire iron in 1996 brother says he was changing a tire and it slipped
subdural hematoma placed where this one is it could have caused his coma
what about his liver
lfts are slightly elevated
key word is slightly as in not high enough to cause the coma it's the subdural
i say we evacuate the cavity see if he wakes up
the neurologist thinks it's his brain wants to open up his head frankly i'm shocked you get to use the big boy drill and daddy's big red toolbox
no drilling hi
mr smith
call me joe can you not do that so we're clear about the no drilling
he's okay now he can leave
i'm not releasing him
because the brother doesn't want you to
or because he had an unexplained coma which sounds better
the hematoma caused the coma
that's a catchy diagnosis you could dance to that
i think chase is right it still should be evacuated but it's not an immediate threat
cameron's my girl
i'd release him
are you disagreeing with me because
i'm disagreeing because that's my medical opinion
of course it is but unless i've been named as the fourth part of the axis of evil invaded and occupied this is still not a democracy he's staying send for hepatitis serologies and an autoimmune panel
hey i'm with you old enough to drink old enough to do something really stupid and make yourself a baby
he's my brother i'm watching him while my parents are in barbados he's having trouble breathing and there's a lot of wheezing
whistling technically upper airways nose
if he's got the croup that could become meningitis right
absolutely
i was just studying and all of a sudden i hear him crying and sounding all weird my parents are going to kill me
i doubt it
you don't know them
no i doubt you were studying while your parents were away hello officer you might want to rinse this off before you let him play with it again
what happened where is he
vogler called admitting admitting called justice justice came and took him away
and who called vogler
he loses money
so does ophthalmology who cares this is a hospital you can't just cut a department
you can't control him
i am the only one that can control him
d d d d dr house in the house impeccable timing as always
you had no authority to release my patient
my colleague has just informed me that she has a singular talent you are just in time for a demonstration
dr house from what i understand your
from what you understand he's not your patient how the hell do you understand anything
that's sad
you're not even a doctor
john smith is here only because of court order i had the records faxed to the judge she recinded the order
why bother just to piss me off
keeping the government off our ass hmm yeah that makes no sense for a public institution
okay
okay what
okay sir carry on
he really cares about his patients
yeah and he just walked out of here with nothing something's up
he just started vomiting and passed out
35 year old male vital signs are stable now gave him 2 liters en route just released from here two hours ago
everhardt you said he was good to go
so your junior g man badge isn't looking so good
his liver's worse
comatose
no completely different symptoms than the first time
serology tests came back positive for hep c
hep c is a chronic condition you don't think this is an acute situation
coma vomiting abdominal pain hep c explains everything
except for the suddenness of the onset
what's wrong with the timing
you get home one night your wife hits you with a baseball bat likely cause is the fact you haven't thanked her for dinner in eight years or the receipt for fur handcuffs she found in your pants sudden onset equals proximate cause
he also has high estrogen levels in his blood that's indicative of a chronic condition not acute
one test what do his other liver tests tell us
normal albumen levels point toward acute
uh huh and why is her test better than mine
because she's cuter though it's close do a liver biopsy when the results come back we'll know what we're looking at
why wait to treat the hep c if i'm right joey gets better that much faster
right then he gets to testify and you get a gold star a cuddy
then what's the downside or is that the downside
do i have a reason for not wanting you to get any stars fine start the treatment it's all your idea don't even mention my name there's nothing wrong with your theory go but in the humor me department get a biopsy while you're at it foreman we need to talk you're off the case
what why
somebody told vogler that i lied to the transplant committee
you think i did
you're too careful you wouldn't jump ship unless you knew what was in the water
stop you're embarrassing me
but i want vogler to think i think it's you and i want cameron and chase and cuddy and wilson and the nursing staff and the cashier in the parking lot to think that too
right
the bloodtests show you have hepatitis c it's a virus that infects the liver
no way
well it's not all bad news it can often be cured and even if not it's manageable
how'd my brother get this
usually it involves the exchange of bodily fluids the uh
bodily fluids what are you talking about
there are many ways the virus can be transmitted sharing needles blood transfusions
hey nobody talks to my brother like this okay
fine i've no idea how he got it but he has hepatitis c we're going to start him on interferon
he doesn't have it don't mention it again don't treat him for it
house has some directed donations foundation support it's around here
he makes you miserable eight years he's worked here never made a dime for you never listened to you
he can changed he's
he hasn't changed in eight years either he can't change or you can't change him you have no idea how many times he's lied to you undercut your authority made you look like crap to other doctors
yes i hate him and here i am desperately trying to protect his job what does that tell you
that you don't hate him
i do not protect people i like i protect people who are assets to this hospital
no that's me you you're softer
right there are three female chiefs of medicine at major hospitals in this country and we all got there using our feminine wiles
it's human nature to wanna protect people we like
i don't like him
we think if we can just form the right team we'll all get along be able to pull the boat
i don't get along with him
well this is not a team it's not a boat it's not a machine that has a lot of parts that have to work together the metaphors are all crap this is a business that's all it is you like him that's bad for business
ah this is all my fault
took another homework break with betty lou
no last week i showed him a magic trick
pulled a quarter out of his nose it's a classic
yeah now he won't stop shoving stuff up there
dr house
got a crisis here
it's okay
stop
it's a neat trick
you have to believe you'll actually hurt them
ah
your people insulted my brother
what they put romano in the parmesan cheese shaker again
said he was a crackhead or a homo or something
those idiots how many times am i going to have to send them through sensitivity training nobody's saying he's a homo that would be really really bad so let's put a nice friendly spin on it let's go with he got raped in prison i saw the jailhouse tats put it together with the blood tests
there were rumors but joey never said anything about if people find out he's being treated for hep c feds get that chart someone says something to somebody word'll get out and then joey's manhood his rep is destroyed
you're worried about how his coworkers will react in the walmart in demoyne
he's not going into witness protection i won't let that happen
listen i don't know if you know about this but mob businesses sometimes keep two sets of books
one legit one not
exactly
you jerking my chain
doctors are busy sometimes they forget to write things down it happens all the time
thanks oh and whatever you're not giving him for whatever he doesn't have is that going to fix him
i doubt it
on your way to polish vogler's car
gone are the days of the grumpy old docs seeing patients in the basement of his house getting paid a few chickens
how will i eat
you know what cuddy has been locked in with vogler about all day today and yesterday
floor polish costs through the roof
you her secretary's been to the photocopier all day with your records it's all they're looking at in there
my car has been stolen
or rein car nated pink slip a gift from the arnello brothers
you know they're gangsters sure but they're thoughtful too
you can't keep it it's graft
no no no no uh uh graft is if i tell them i'll only make it better if he slips me a couple bucks a payoff for something i'm not supposed to do if i'd asked for the payoff which i didn't i would have done the bad thing anyway so there's nothing wrong with this
right
damn '65 perfectly restored what do you think a guy like joey would do if someone turned down a gift that's kind of an insult isn't it
he might hurt you it's definitely possible
i'm screwed gotta take the car
did you see house's new car
joey he obviously can't keep it
you don't mind the hospital taking money from vogler
that's different vogler's legit
that's worse vogler's money came with strings
vogler doesn't set me up to have a mobster take a swing at me
i'm sure house didn't know
joey's pressure dropped pushed iv fluids now he's holding 100 systolic
septic
no looks like he's bleeding into his liver
varices you see it with chronic hep c all the time
biopsy's back two findings number one lymphoctic infiltrate and no bridging fibrosis
well whatever's killing him is not hep c it's acute
who said that i forget what are you doing here i told you you were off the case
right your diabolic plan to convince the evil genius he's in the clear so he'll let his guard down and make a fatal mistake sure
well it's clearly not going to work now
what evil genius
if we knew that then we wouldn't need a diabolic plan now would we
house thinks someone ratted him out to vogler
oh what one of us
no you guys love me too much
all right look if it's not the hep c then what's the problem what's causing the liver failure
toxins
no he's only 30 years old and his job doesn't expose him to heavy metals or environmental
he's a 30 year old mobster he doesn't have a job that results in accidental exposure to toxins he has a job that results in intentional exposure to toxins someone's poisoned him
whatever this toxin is it's doing its job and fast how long do we have until the next round of test results
about four hours
too bad his liver's only going to last another two
we're going to have to get him a new one
what in two hours
there is another way relax it's kosher
this is so bizarre
not really we just take the blood out of joey's body and run it through a pig the pig's liver does what joey's can't cleans the blood which we send right back to him
and the pig makes him better
no just buys us some time to figure out what's poisoning your brother
like you do this all the time
oh we've basically got a barn in the basement
cross off hemlock
you thought he was being poisoned by hemlock dr euripides tell you to check for that
grows wild by the highways out here
how much do you like house
chase has a big mouth
yeah he's probably the one who ratted to vogler
i don't think that he would
does it hurt when you're with house little pain in the tummy but it sort of feels good too
i don't have the right to show interest in someone
you absolutely do and i absolutely have the right to humiliate you for it
anything
white blood count's low probably a result of the illness nothing to connect to the liver
is he a smoker
let me check
early signs of emphysema he's been smoking at least a dozen years
18 you got that from the white count
nope got that from the chest x ray white count just tells me he's quitting
two weeks ago
how's your tummy
flat and taut
i've been on the job for 12 years
you put 3 000 in your wife's checking account this morning i want to know where it came from
i got a perfect record
where did you get the money
cancel the thumb screws i've got our culprit
who
not who hu
huh
thanks for playing along chai hu a chinese herb in his quit smoking candy reduces cravings also reduces his white blood count oh yeah he also took enough of them to poison himself we'll keep him on the pig for a few more hours then take him off the candy he'll be fine pig won't be oh no
hey
hey you feeling better
famished
i think they've got fish sticks on the menu
makes me miss prison
so the mobster's good to go
i'll keep him over night then let the fed's know he's good to rat out whoever he wants
brother won't be happy
maybe have to give back the car
you should let vogler tell the feds
why
because it matters to him because you humiliated him the first time joey was released you think you should still be in third there ace
he humiliated himself
and because your job depends on the kind of mood vogler's in at the end of his marathon with cuddy seriously man have you ever driven an automobile before there are four gears you know
the '66 came with a shut up button
it is my medical opinion that the patient is healthy and can be released
thanks for letting us know give me the u s attorney's office
i see you've found out what we're meeting about
you're having a meeting
well whatever the reason the coat looks good on you chai hu lozenges cause this kind of liver failure no way
not by themselves but in combination with the interferon it's like gas to a flame
what interferon
for the hep c
what hep c
oops
is hidind a mobster's hep c that important
is letting the feds know everything that important
you know you are a piece of work even now
ed
edward
joey's back in a coma
cut to the team in the diagonstic office gathered around the whiteboard
he's stable but comatose
worse than before he's on a ventilator
question is why it's not his brain it's not a toxin our friend babe helped with that one so what else
the hep c we never really treated it we stopped the interferon when it started poisoning his liver
am i going to have to write a song about it his chronic hep c was not bad enough to produce these symptoms
the estrogen level indicates it is
indicates something else entirely
we can't give him interferon now there's still traces of the lozenges in his system it'll just poison him again
genetics we don't just treat the virus we change it a non nucleoside allosteric inhibitor
it's never been tried on a human being it could kill him
well what's the difference he's dead without it
they're running a trial on dogs at st sebastians in philadelphia i'll make the call
what else could cause his estrogen level to be that high
nothing
we're going to put the medicine here we don't want it to burn his veins when it goes in
you have no idea if it will work
it's shown promise in testing
maybe there's nothing up there i watched him like a hawk
pretty sure you didn't
i didn't let him play with any more little toys
thus forcing him to shove a big one up there stop or i snap your nose off
he's not too smart
genetics is a powerful force on the other hand maybe he's smarter than you think
what's going on
just give me a second always wanted to use one of these tilt his head back
i don't know
just tilt his head back nice grasp of concepts relationships very smart very cool first the policeman fireman fire truck your brother was sending in teams to save the cat
wow
sometimes the simplest answer
most types of coma you just don't snap out of
he's not snapping out of this one he's not improving you crossed out estrogen you've got an explanation
yes i have a very simple one
and
it's private
you think i'm the one running to vogler
you're currently top of the list toxic comas person's away from the cause long enough and they recover
the feds checked for poisons we checked for poisons i didn't do it
it's not a poison then
an allergy then did you hear me
how about a food sensitivity
all of his food is strictly controlled there's no correlation between his meals and his condition he had steak and potatoes before the first coma and the hospital served fish sticks before the second one you can trust me
problem is if i can't trust you i can't trust your statement that i can trust you but thanks anyway you've been a big help
so where did you get the money
what
someone paid you off
what are you talking about it wasn't poison you told us that it
you're talking about poison i'm talking about payoff graft
leave him alone
you paid the marshall off
i didn't pay him to poison my brother
no it just worked out that way
i gave the guy some money to get him some decent food
better than fish sticks i'm thinking steak
we asked for pasta those stupid feds could care less
he had steak before both comas your brother has ornithine transcarbamylase deficiency you want me to write it down good because it takes a while it's genetic it can present at any time the patient eats a large amount of protein especially if he's not used to it
that's it he stays off the red meat and he's going to be fine
yes if i'm right and we stop the current treatment he gets better if we stop the current treatment and i'm wrong he dies
why would you be wrong
his estrogen level otd doesn't explain his estrogen level but i have a theory there is one chemical that if ingested can cause a person's estrogen level to increase dramatically
what is it
it's called estrogen
joey's taking estrogen what he wants a sex change
no nothing like that it's called male flame it's probably more consumer friendly in the original chinese it's an herbal aphrodisiac marketed to gay men
oh here we go
and sold on the same website that sells his chai hu lozenges guess what's in it starts with an e
you want to get hit too
that would be quite a trick he slapped me so hard his brother turned straight joey's a big time mobster guys like that don't get raped in prison they get gifts they get food drugs cigarettes cable tv
joey is not gay
well maybe not gay but certainly delightful you on the other hand hitting a doctor even if it was only chase and asking another one to keep his chart fresh and homo free well that's a bit of an overreaction wouldn't you say it's almost like you're scared that it might be true
you're wrong
okay then don't stop the treatment but if you're wrong he dies
okay he never said anything to me about it not once
that's what i love about you mob guys so tolerant of others so accepting only way he was coming out was way way out lose the tattoos change his name move to another town how's a guy like him going to do that witness protection it's not just for witnesses any more
you can go in now sit with him if you want
how much longer
it's only been three hours if it's the otd
if it's the otd what if house is wrong huh
that severe a reaction it'll take some time
he makes assumptions about people talks you into things
mr arnello he's awake he wants to see you
you look like crap that's a joke see i'm sick i said you look like crap
you have no idea what i just went through out there you kept getting worse and dr house kept saying all this crap if i think you're normal then he's going to keep giving you the medicine and if you weren't
weren't what normal
yeah he said you were a fag witness protection that's your big chance to be one
you believe him
i don't know what to believe you were sick i had to make a decision i thought you were gonna die
you believed him he stopped the medicine here i am i wanted to talk to you about this
there's nothing to talk about you uh ordered some chinese internet health crap they sent the wrong pills you took em
yeah yeah that uh that must be it
you want to testify go ahead i told the doc he said it's okay
i don't expect you to understand
i don't all i need to know is you're my brother joey if you think this thing whatever is going to make you happy i think you should do it you should
vogler wants to fire you lose the whole department
good thing you fought for me though right the dress was a nice move but you've got to follow it up nasty weekend in vegas something that shows off your real administrative skills
he threatened to fire me
i'm sorry so how long do i have i've a lot of personal stuff to pack up i assume you're going to want to throw a party
i told him i know where the bodies are buried the stuff he needs to know that's not in the books told him he can't ditch me
he's only keeping you on because you know the secret handshakes he's a quick study six months he'll have the moves down then he won't need you any more
i'll deal with that then
so i stay
yes but some things are going to change
profits new world order
huh
everything's about profits
yeah that's real new you could rent out the corvette every once in a while or lend it to a friend
that would be easy and it would be wrong
but cuddy stood up for you
to a point
to what point
i gotta do six more clinic hours a month so do two of them
why only two
cause one of them's gone i gotta fire somebody good morning
house m d 1 16 heavy
house m d
1x16 heavy
march 29 2005
written by thomas l moran
directed by fred gerber
transcript written by mari
archived at twiz tv com with permission from house transcripts and more
house and other related entities are owned tm and by heel and toe films and bad hat harry productions in association with nbc universal television all rights reserved this transcript is posted here without their permission approval authorization or endorsement any reproduction duplication distribution or display of this material in any form or by any means is expressly prohibited it is absolutely forbidden to use it for commercial gain
mom's voice jessica jessica come on we've gotta go move it or lose it sister
i don't feel good
oh you don't feel warm
my stomach hurts
honey if you don't have a fever
i don't want to go to school i can do my work at home
jessica what's wrong
everybody hates me
oh they don't hate you they don't even know you because they're too ignorant to try
i hate myself
jessica don't say that oh honey look at me look at me you are a wonderful beautiful little girl don't let a few bad apples
a few try my whole class
remember the story where the guy keeps saying that he hates green eggs and ham and then at the end he realized he really loved them one day they're gonna realize what a great kid you really are you've just gotta be like sam i am and don't give up
okay
come on jessica hurry
mr conroy that's it keep going good nice you're doing great jessica hey hey seth you want to spend the rest of class sitting on the bench
no
mr conroy keep going jess you've got 40 more seconds
my arm hurts
mr conroy come on tough it up you can do it
my chest hurts
how do you think the ground feels
mr conroy hey seth two laps bye hey jess it's just a stitch okay just keep breathing you got it
i can't
mr conroy only 10 more seconds you got it jessica jessica jessica oh my god hey go to the office get miss parsons now i'm on a playground at finley elementary one of my students is having a heart attack yeah she's ten don't you think i know that just send the damn ambulance come on wake up sweetie
you ever see an infected pierced scrotum
um no but i know a few people on whom i'd like to see it happen we need to talk
well if pain's what you're after the penis is really the way to go i'd recommend the abadirabia sp
we're not talking
oh sounded like we were
no you're attempting to avoid talking because you know what i want to talk about
nipples
you need to get rid of one of your people
absolutely as soon as i do performance reviews and then review the reviews of course because a decision like this can't be made without proper you know review shouldn't take longer than a month maybe two four at the most unless it gets complicated
there's no way out on this you may as well get it over with as fast as you can like ripping off a band aid
only instead of a two cent piece of tape and gauze it's a human being
like you care
like you don't
you have a week get it done
we have a referral from dr linkowitz
don't know him
he knows you
what's the problem
heart attack
definitely don't know him
the patient's ten
ten year olds do not have heart attacks it's gotta be a mistake
right the simplest explanation is she's a forty year old lying about her age maybe an actress trying to hang on
i meant maybe the tests were wrong
that's what the er thought three ckmbs were positive the ekg shows classic signs of st elevation it's a heart attack
she's morbidly obese the morbid part of that raises alarms
come on it takes decades to eat your way into a heart attack
doesn't take decades to kill yourself if i was that fat i'd be pretty tempted to knock back a bottle of pills
it's not a drug overdose the fatigue muscle pain and difficulty concentrating have been bothering her for over a year
that's because of her depression
that's what five pediatricians two nutritionists and a psychologist said the heart attack would seem to indicate that they missed something
it's got to be something genetic
what about metabolic syndrome x
insulin resistance
syndrome x could cause a stroke but i don't know about a heart attack
could if her blood pressure was high enough
which is likely considering her weight
it fits the symptoms me likee do a hyperinsulinemic euglyemic clamp oh and one more thing i've been told that i've got to get rid of one of you guys by the end of the week new sheriff belt tightening you know how it goes okay carry on
it's some kind of game house's own version of punk'd
it's not house it's vogler we can't let it get to us we've got to stick together
why
what are you suggesting we start slashing each other's throats
i'm suggesting it's a zero sum game your loss is my win that's not conducive to team play
which is what house seems to want come with cameron may be a bad strategy but i don't want to give house his satisfaction come on sick kid remember
she's diabetic
no but it's similar msx patients don't respond normally to insulin which causes her body to create too much which causes metabolic abnormalities we're going to do a test to be sure but there are certain dangers
is this thing treatable
it's controllable through proper diet and exercise
wait jessica already eats right and she exercises every day
i know you've already seen several nutritionists
and we've done everything they recommended
i understand but
why can't any of you doctors see past her weight if diet and exercise are the treatment then the diagnosis is wrong
it might be but the only way we'll know is if you'll let us do this test
it's really bad especially at night it's like my heart is on fire like it's uh oh i don't know like it's
burning
exactly
hmm sounds almost like heartburn
so can you give me something
like a thesaurus
what
i take it you never mentioned this during any of your prenatal visits
prenatal i'm not pregnant
sorry you don't get to make that call unless you have a stethoscope union rules
i know when i'm pregnant all right i have six kids that's why my husband had a vasectomy and we use condoms
vasectomies can reverse themselves condoms break
okay this is what a woman is supposed to look like okay we're not just skin and bones we have flesh we have curves
you have little people inside you okay okay i'm sorry i guess i must have just been brainwashed by the media and all those years of medical training
damn right
let's see if i can find some antacids while the nurse gets some blood
blood why
the heartburn gotta make sure it's not spreading
i don't want to
the test involves some pretty precise measurements if we don't know exactly how much you weigh we won't get the right answers
tell you a secret when i was your age i was heavy too
were you over 100
way over the kids in my neighborhood used to call me rerun
rerun
he was a heavy guy from tv i used to pretend i liked it but i didn't
how come you're not heavy any more
ninth grade grew five inches everything kind of evened out
you think that'll happen to me
well yeah i mean your mom's tall and you are a little short for your age you'll probably spring right up
obesity isn't something you just grow out of
take it you've never seen a baby
she's not a baby she's ten
and you figure making her feel like crap would do her a world of good
yeah if it gets her off the couch
i'm sure she's already under enough pressure
enough from mummy
everything in society tells us we have to be thin to be successful
no society tells you you have to be thin to be attractive and guess what that's what attractive means that society likes looking at you
i think we should be telling our kids it's fine as long as they're healthy
all right you weigh 90 pounds because it makes you healthier
forget it he's just cranky because he knows he's the one to get the axe
so any thoughts
on what sharon's plan for gaza
who you're gonna let go
i'm thinking i can convince vogler it would be more cost efficient to let me keep all of them
yeah you should be able to pull that off most billionaires aren't very good with numbers
it will be more cost efficient once i've grabbed cameron's ass called foreman a spade and chase well i can grab his ass too
you are uniquely talented in many areas but office politics is not one of them don't take vogler on
separate or together
together
increasing glucose to 6 9 milligrams per milligrams per minute
are you okay
i'm thirsty
just a little bit longer and you'll be done
like dr chase
wanna put some money on it
i said i'm thirsty
just five more minutes okay sweetheart
i'm not your sweetheart don't call me that
jessica that's not nice
you're the ones who aren't nice
jessica
you're not either i don't want to do this anymore she rips off the nasal prongs to help her breathe
jessica jessica you have to calm down
let me go
she's gotta be getting hypoglycemic
what's wrong
hey calm down
let go of me get it out of me you son of a bitch bastards
she's sedated mrs simms don't worry hypoglycemia can cause temporary psychosis and it's a common complication during a hec procedure
i never wanted it done in the first place
we understand you're upset but
you were supposed to be monitoring her condition but instead you were bickering and placing bets
i apologize if we weren't paying full attention to your daughter but i assure you that
oh please save your pathetic insincerity for your boyfriend
you're wrong she is in face pathetically sincere and they didn't screw it up
who are you
i'm from the lab the blood tests showed your daughter wasn't hypoglycemic which means her psychosis wasn't caused by anything these doctors did
so then what was it caused by
i have no idea but you'll be happy to hear it can't be cured by diet or exercise
what else could cause uncontrollable rage in a ten year old
nothing that could also cause a heart attack
i assume i don't have to point out that now would be an extremely good time for one of you to distinguish yourself with a brilliant idea
a hypocoaguable state could cause a blood clot blood clots can cause a heart attack
more likely to cause a stroke not the psychosis
no you're wrong if the clot made it to the amicdal area of the brain it might cause uncontrollable rage
right because anything's possible but nothing's going to cause multiple clots in a kid this age
she's fat
obesity doesn't cause blood clots
extremely obese patients can get a fat embolus
right after they get liposuction which she's clearly never had
how do you know
because we have her medical records and because no plastic surgeon in his right mind is going to give a ten year old liposuction
have you ever met a plastic surgeon who was in their right mind
she hasn't had liposuction
thank you
but what about some other ridiculous obesity treatment
like what
diet pills can cause heart attacks and blood clots
her tox screen was negative
wouldn't show over the counter weight loss drugs
her mother wouldn't give her diet pills
yeah she thinks her daughter's perfect just the way she is
she's lying okay you two heparin and warfarin to prevent further clotting and you find those pills
not diet pills you might want to broaden the search just a little and don't just ask the mom if she hasn't mentioned yet she's not gonna
if you're gonna fire someone go ahead and do it but don't treat us like lab rats testing how long it takes us to get us at one another's throats
so what should i do
i don't give a damn what you do
yes i had noticed your complete indifference you don't even offer a medical opinion any more who would you fire
not my call
i want your opinion fine it's you either way you're making a choice
chase
wh because he screwed up an angio a month ago
anyone can make a mistake
right it's the money you resent it but you're going to tell me he doesn't need the job
he doesn't appreciate the job
he was ready to go three rounds with cameron for it
he wants the job he just doesn't appreciate it there's nothing wrong with just wanting to hang out but this is not the place to do it
i'm surprised
you thought i'd pick cameron
i didn't think you'd pick at all
i guess he's not the rise above the fray guy he likes to think he is
you practically forced it out of him
he's scared of losing his job just like everyone else
i've been thinking you've made it quite clear that you're miserable here
i am not miserable
you're not happy
and you are
with my job yes
i am exactly where i want to be doing exactly what i want to do
i think i sense a hint of sarcasm there why don't you pick yourself quit
hmmm i was wrong
about vogler or foreman
mrs hernandez's pregnancy tests
who's mrs hernandez
either a woman carrying an alien baby or your newest patient
so you never saw her with any pills she never mentioned anything
ms ayers no of course not
would it be all right if i talked to a couple of her friends
ms ayers her friends
well i'm not going to interrogate them but i just want to ask if jessica ever mentioned anything it's pretty important she's very sick
ms ayers i understand it's just well jessica really doesn't have any friends
not one
ms ayers i've tried to help make the kids include her more but kids can be
kids
ms ayers heh i was going to say jerks all the fifth graders are assigned an eighth grade buddy maybe you could talk to her's
what's the status on house
he asked for time to complete performance reviews on everyone in his department
and you told him no and gave him how long
a week he'll do it
guy's never done what he's told don't see why he's going to start now hi edward vogler is dr house claiming that i'm forcing him to get rid of one of you i assume his goal is to stir up antagonism toward me
and your goal is
i am forcing him i'll do whatever i can to ease the transition for whoever he chooses
if you're feeling guilty about your decision there is an easy solution
i don't feel guilty
then why approach me and tell me all this
i don't feel guilty that doesn't mean i don't feel bad i'm rich but i'm still human i just wanted you to know that if there's anything i can do for you my door's open
thank you
you looking for info thought you already had house all figured out
i do don't know his team though
the ultrasound and biopsy confirmed our worry the tumor is extremely large at least thirty pounds
oh god
it's actually a personal record for this clinic
but it's completely benign there's no sign of cancer at all i've already spoken with dr bergin and he's available first thing in the morning
for what
for the surgery
but if it's not cancer it can't kill me right
no
i'll have a huge scar i won't be able to wear a bikini
you wear a bikini now
yeah you got a problem with that
nope but i've never gone swimming with you
i knew it that's what this is all about you are trying to force me to have cosmetic surgery
yeah that's exactly why i planted a thirty pound tumor on your ovary
it's not gonna kill me the only thing surgery is going to do is change the way i look that is the definition of cosmetic surgery
uh it would also relieve your heartburn and discomfort
yeah right why give an antacid when you can cut someone up and make them look a little easier on your eyes my husband loves my body he can't get enough of it you think he's gonna want to touch me if i look like i've been gutted like a fish
that was unexpected
yeah it was
all she does during recess is run laps around the playground she says she's exercising but everyone knows it's just because no one wants to play with her i mean i'm only her buddy because ms ayers assigned her to me that does not mean i am her friend
i'll make sure her doctors are all clear on that
thanks
so has she ever said anything to you about diet pills
heh she told you that too
what do you mean
i totally busted her for taking drugs one day she totally lied said they were diet pills her mom had given her come on get real no way a girl like that is taking diet pills
i didn't give her diet pills i would never do that
right so it was her imaginary mom
she didn't take any pills the girl's lying
why would she lie
because she's another mean little jerk
mom
i'm sorry honey
clemmie didn't lie i did i took the pills i told her you gave them to me cause i didn't want to get in trouble
where did you get them
i took them from the store
why why would you do that
because i didn't want to be ugly anymore
oh baby you're not ugly
yes i am i know you don't think so but i am i'm disgusting
jessica please don't say that
i just just wanted to fit in you know have friends or at least have one person my age be nice to me
listen the pills cause blood clots heart attacks and insomnia it explains everything we'll keep her overnight to make sure but she'll be fine
thank you
i can't believe she was that desperate
yeah i'm sure that if everyone i knew hated me i couldn't bear to look at me i wouldn't go so far as to shoplift
i'm not talking about the shoplifting
i'm sure she didn't even know they were dangerous she probably saw them advertised on tv or over the internet
right so i guess it's the media and pharmaceutical companies' fault now not the fact that she can't stop shoving food down her throat no one forced her to get fat
no one forced a cancer patient to get cancer
give me a break it's not a disease
have you seen the latest research
yes i have what i haven't seen lately is a kid eating an apple or riding a bike you americans can't even compete with the rest of the world in basketball anymore unless of course it's the type you play with a remote control on a big screen tv
right
wait are you going to let him say that he insulted our basketball teams
oh my god mommy they hurt so bad
what happened
please help me
she's bleeding
from where
oh my god just please stop it please
diet pills don't cause skin necrosis
could be something related to the pills
or not
or both diet pills brought her to us we gave her the sores
you think she got a staff infection from something here
i'm not saying the hospital gave the sores i'm saying we did by treating her warfarin induced skin necrosis
highly unlikely we started her on heparin before the warfarin
who gave her the heparin
i gave warfarin she gave heparin
sure you didn't both give her warfarin
yes i did not screw up
did you actually see her prepare and administer the heparin enough said
you were standing right there
i was preparing my own dose
yeah right there's gotta be some other cause
none that i can think of let's fix the mistake give her unfractionated iv heparin and low molecular weight heparin by subcutaneous injection stat
making me look bad is not going to save your job
you think you're incapable of making a mistake
you think that i am that weak that i am just going to roll over and take this
house isn't just going to protect you because you kiss his ass
vogler wants to know what he can do for me
hey stop worrying about your asses and start worrying about the patient's
she sleeping
as a result of the sedatives yeah can't let her wake up too much pain
warfarin induced skin necrosis i have no idea what that means but it says here we gave her the warfarin and i do know what induced means we did this
at this point it's not exactly clear you know i should probably talk to dr house
oh you two need time to get your story straight
he doesn't tell me what to do
so you don't just blindly follow his commands you're your own man and yet here you are working for a man you can't stand
i respect him
what exactly is it you respect his attitude toward humanity he thinks we're all idiots and liars how bout his attitude toward you plays with you like a cat with a ball of string
what do you want
i want to know if you want to keep your job
if he chooses to let me go i can live with that
that's not an answer
you offering to protect me
still not an answer
i want my job
dr chase
boss what was that about
wanted to know what warfarin is i don't know
brrrr icy definitely think twice before correcting one of your mistakes again
correct all you want of course it's a bit more productive if there's an actual mistake
right i always forget that part
i gave her the heparin which means the necrosis is not a reaction to the warfarin which is probably why she's not responding to your treatment
yet if you didn't screw up then what is it you don't have an answer
yet
when you come up with something let me know i'll be in the clinic warming up
i'm the only one who's always stood behind you when you've screwed up
why why would you support someone who screws up
because i'm not insanely insecure and because i can actually trust in another human being and i am not an angry misanthropic son of a bitch
i'm sorry you said you weren't angry who would you fire
no one
not an option
if everyone took a paycut and put in a few more hours we could all stay for the same amount of money
figures you'd try and come up with a solution where no one gets hurt the problem is the world doesn't work that way just cause you want it to
figures you'd stall and refuse to deal with the issue problem is the world doesn't go away just because you want it to
mr hernandez excuse me dr house my wife saw you yesterday lucille hernandez
uh he's not in today
mr hernandez my wife said he walked with a cane
he's also got a bit of a drug problem sometimes doesn't show up for weeks
the mris are rented but did you make a decision
he's not gonna fire anybody
yes i'm going to cut the pay of all four of us 17 across the board will allow you to keep us all for the same amount of money i believe it's what you suits call win win
all right if you can
no
if he can work it so we can keep the current staff for the same amount of money what difference does it make
it's not about the money
this is not a negotiation it never was i need to know that whatever i ask you to do no matter how distasteful you find it you'll do it and just as importantly you need to know that
mr hernandez what's going on with my wife
even if i was dr house physician patient confidentiality protects me from annoying conversations
mr hernandez but she told me about the tumor
yeah she also tell you why she's refusing to have it removed
mr hernandez i don't care about a scar and she can always gain the weight back
you want her to regain the weight
mr hernandez yeah i mean only if she wants to
why
mr hernandez i've always thought she's looked sexiest when she was pregnant something bout knowing she's a mother makes me want to
yeah tell her that and leave me alone
mr hernandez i did you gotta talk to her i couldn't bear it if something happened to her
the tumor is benign nothing's gonna happen except maybe some more heartburn
mr hernandez what if it gets even bigger or if it changes
you know where to find us building's not going anywhere
mr hernandez tell her it's cancer you obviously don't have a problem with lying
oh way to win me over
mr hernandez we have six kids she can't afford to take a chance
you have kids how novel that changes everything so if mommy has heartburn one of them might catch on fire
mr hernandez please i don't know what we'd do
they are cute have her come back in
mr hernandez what
your plight has moved me tell your wife to come back
her necrosis is getting worse
maybe because we're treating her for the wrong thing
have you found the right thing
no
then we continue the treatment hope it's just taking longer than it should
at this point it doesn't matter what caused the necrosis
or who
if we don't stop it from spreading it will kill her before the end of the day
what else can we do
get rid of it remove the dying flesh before it penetrates the abdominal wall
do it
there's still a chance that the heparin treatment could start to take effect
we're gonna wait as long as we can but if there's no change in the next few hours we're gonna have to treat the symptoms directly
so you can get rid of the sores
through surgery technically it's an amputation
amputation but the sores are
warfarin induced necrosis attacks fatty tissue mainly in the breasts
wait are you talking about cutting off my daughter's breasts she's ten years old
a radical mastectomy may be her only chance of survival
i'm sorry but i'm gonna have to ask you to sign this
can we talk
what no roses no chocolates if you're here to apologize
i'm not here to apologize
uh oh that means you're here for something more complicated
do you want to fire me
yes i was just waiting for an excuse thank god vogler came along phew
it's the only reason i can think of that you're insisting that i made a mistake
really because there is another explanation perhaps not as much fun as your freudian analysis but maybe you actually made a mistake
you're doing this because you can't deal with your feelings for me
i believe that you are the only one to express feelings and if we're going to look at this from a first year psych point of view maybe you want me to fire you maybe that's why you're acting weird you
you're the one being different you're always pushing things pushing the rules pushing us but not this time you just jumped on this idea like a life raft not one question about what else it could be no riding us for other answers
i have the answer
then why aren't you watching tv or playing your damn game boy or whatever else you have fun doing by yourself maybe i should just quit make it easy for everyone
maybe you should
men are pigs
you call me in to tell me
i should have realized the vasectomy and condoms was overkill but this was too obvious cute kids love her green eyes and his baby blues of course since you and your husband have brown eyes
where'd you get that
from the father of three maximum four of your six children so i'm thinking maybe the reason you don't want surgery is while your husband may find you attractive no matter what all the other men you're sleeping with might not be so open minded which brings me back to my original thesis men are pigs you got nothing to worry about you know pretty much have sex with anyone fat skinny married single complete strangers relatives
you you're sick
so are you i'm sure there are websites full of men looking for married women with surgical scars so have the surgery please
okay
why have you been talking to cameron
well if house picks you i'll be needing a new source in that room
if he picks me
sure foreman's smarter house has got a thing for cameron
i've been feeding you information so you'll protect me
i will protect you as long as i need you and you will feed me information as long as you need me i spoke with cameron because if i have alternatives i don't need you
she's not gonna rat on house
foreman ever said anything about talking to me interesting
it's been almost three hours still no change in her condition
i think we should get her into surgery
so what do you want to do
assume that cameron didn't screw up what if it's not the warfarin
it has to be the sores presented right after we
right right right but let's just say it's not come on come on what have you got
can i have a second to think
no there's no time to think say the first thing that comes to you head
she's fat
enough already okay we've got it you hate fat people
that's not what i meant
we already considered obesity as a cause
so did all her other doctors
no what if it's not a cause what if it's a symptom
okay so what could cause obesity and skin necrosis listen i don't care if it makes sense just give me something
ulcers secondary to vaculitis
no that's just sores not obesity
pyoderma gangrenosum
more sores okay let's look at it from the other side what has obesity as a symptom
hypothyroidism
genetics are more likely her mom's heavy too
she's not just heavy she's tall we have any history on the dad
yeah 6'1
kid's short we've got stunted growth high blood pressure blood clots obesity it's cushing's
no necrosis doesn't present in
in rare cases cushing's can cause hypercalcemia which can lead to the same skin necrosis as warfarin it's perfect it explains everyting
except it's not cushing's she's had multiple blood tests and none show abnormal cortisol levels
the hypercortisolism could be cyclical we just didn't catch it in the right phase
we'll have to do another ufc
there's no time we've got less than an hour to make the call
if we treat for cushing's and we're wrong she's dead
if we assume it's not cushing's she'll lose her breasts and may still be sick
do an mri
you want us to look for hypercortisolism with an mri
no i want you to look for what could cause hypercortisolism with an mri
nothing on the adrenals heard cameron went home she sick
go back to the pituitary views she seemed okay
think she's got another reason for leaving
i hope so wait stop there what's that
a tumor
it's cushing's
the tumor causes cushing's cushing's messes with hormone production hormones control everything growth weight
can you fix it
she'll need surgery to remove the tumor once it's gone everything will get normal very fast
no mastectomy
no
thank god
the surgery's dangerous the pituitary is located between the caverns of the sinuses basically right between the eyes the area contains the nerves that control eye movement and the major arteries that feed the brain
oh my god
your surgeon will approach the gland transphenoidally an incision will be made under the lip in which he'll insert a fiberoptic microscope once the tumor's found he'll cut it into small pieces and remove it from the same hole under the lip the whole procedure should take about three hours and your daughter should be able to go home in a few days the sores will go away as well as her fatigue and her muscle pain she'll even start losing weight
jessica
hi
is that really you
yeah it's me
you look fantastic
she always looked fantastic
yeah
it's been a week
actually it's over a week where have you guys been
who is it
chase
no chase stays pick someone else
the deal was
deal's changed pick someone else
no
pick someone else or it'll be the whole department
house m d 1 17 role model
house m d
1x17 role model
april 12 2005
written by matt witten
directed by peter o'fallon
transcript written by mari
archived at twiz tv com with permission from house transcripts and more
house and other related entities are owned tm and by heel and toe films and bad hat harry productions in association with nbc universal television all rights reserved this transcript is posted here without their permission approval authorization or endorsement any reproduction duplication distribution or display of this material in any form or by any means is expressly prohibited it is absolutely forbidden to use it for commercial gain
and the only thing wrong the only thing wrong with the american dream is people too many people too many of us telling young people that the dream is dead they told me that when i was growing up in the slums of trenton and they were wrong they told me that when i decided to run for senator with only 58 in my savings account and they were wrong and they are still telling me that now that i don't have a chance because i'm black because i don't have the right nose because i still have only 58 in my savings account with your help we can keep that dream alive and in closing just let me say
let me say that you should all donate the legal maximum to the next president of the united states are you okay do you need some water or something
no no i'm fine i'm fine really
a handsome guy like you i bet you get 70 of the women
heh here's hoping
of course it helps your wife died of cancer i mean i'm sorry but the sympathy vote's in your pocket
yeah i appreciate your support
listen senator my union has a hell of a war chest
um i've always been strong on the union
the thing is you always go on in your speeches about the workers in indonesia cambodia timbuktu
because i think we have a moral uh
my union members are hurting they don't care about moral this or moral that are you all right
senator
hey the guys are gonna love that
tell him to breathe give him some room senator are you all right
the senator's suffering from nausea headache and mental confusion
yeah bad sushi is so hard to diagnose
you're being childish look if his case is as trivial as you think it'll take you three minutes to diagnose him
uh huh three minutes that i could spend sitting on the toilet with the funny pages
you're mad at me
nope i never liked cameron or foreman
do you know why i'm forcing you to fire one of them because you need to prove to me that you're a team player now if you did that you wouldn't need to go through this exercise
fine i'll hold the senator's hair while he upchucks
oh and by the way i need you to give a speech at the national cardiology conference next week
i don't do speeches i'm shy
eastbrook pharmaceuticals has developed a new ace inhibitor i would like you to extol the virtues of this breakthrough medication
eastbrook pharmaceuticals wait a second don't i own that company oh no that's right you do
viopril is a significant improvement over the old version all there in study
i know its price tag is significantly improved
you can either give one ten minute talk and one three minute diagnosis or you can fire one of your pets my understanding was that you believed in rationality above all else
viopril
i appreciate your keeping the media way
we're keeping your staff away as well you're taking it easy now
i'm in the middle of a campaign
the fast we can get you better the faster you can get out of here anyone else at the fundraiser get sick
i don't think so and i don't think that's it i've been under the weather for weeks you know lots of traveling supposed to be in the sudan next week
helps me concentrate even better than drugs
open your mouth please that's quite a scar
when i was six i fell off the swings and bit my tongue couldn't talk right for the longest time lots of teasing but you know it just made me fight harder speak up for those who can't
yeah yeah yeah tongues heal too fast your political consultants have written you a nice story in a tight race the lispers alone could put you over the top
you a republican or you just hate all politicians
i just find being forced to sit through drivel annoying
you find sincerity annoying
you're a black kid from the ghetto who made it to yale law and the united states senate that's a sufficiently mythical story you don't need to lie about your tongue must have missed it
what's wrong what is it
it's not the food it's your brain get an mri and a lumbar puncture cancel your travel plans
the lp showed no sign of infection and the mri was fairly clean
i guess we can tell him he's fairly healthy and can go home
well there is something in broca's area but it's small low intensity
most likely just background nose
care to bet your job on that what was that
what was what
you got annoyed that was clearly an annoyed face
i get annoyed by glib remarks about our futures
but last week you didn't get annoyed you made poopie in your pants it's weird it's almost like now you know you have nothing to worry about
chase has nothing to worry about
none of you has anything to worry about
what happened
vogler saw the error of his ways and repented the lesion could be nothing it could also be a brain tumor or infection there's only one way to find out which
you wanna cut into his brain
dangerous i know especially as he's a politician his brain's all twisted but i weighed that against the risk of him stroking out before lunch call surgery get it scheduled
you're not pregnant
well i told you that but there's gotta be some other reason i'm still spotting
sure you were pregnant based on your hormone levels you had a miscarriage
i haven't even been on a date
right since it's physically impossible to have sex without someone buying you dinner
i haven't had sex since i split up with my husband that was almost a year ago
fine have it your way immaculate conception
um what do i do
well it's obvious start a religion he leaves as he walks out cuddy storms past him
in my office
afternoon delight she just loves the hard wood
you're not doing a brain biopsy on a spot on a mri
where'd you get that
not on an united states senator
oh just so i'm clear if he was a janitor that would be okay do you have a list
a brain biopsy can cause permanent neurological damage
uh huh whereas tumors are really good for brains make em grow big and strong it's my call
no it's not
you're pulling rank on patient care
it's not my call either
it's up to you
either it's a tumor or it's an infection that the lumbar puncture didn't pick up either way if we don't treat it immediately it could kill you
or it could be nothing reading brain mris is not an exact science
w what caused my s symptoms
wow excellent question many doctors wouldn't have gone there
it could be a transient ischemic attack you could make the argument for watching carefully for the time being
mmm but you'd only make that argument if you were an administrator covering your own ass
that's absurd and insulting
insulting yes
w what will the voters think if they find out i've had a b brain biopsy
this could leave you b b b b brain damaged and you're worried about nascar dads
it's not a brain tumor
it's not a bacterial infection either
so you biopsied his brain for nothing
if that were true would dr wilson's mouth be contorted into that ugly little shape
it's toxoplasmosis
you sure
which means the great black hope has full blown aids they're gonna love that in dubuque
toxoplasmosis is a fairly common fungus you can get from eating undercooked meat or touching cat feces in rare cases the fungi travel up the blood stream and into the brain causing a lesion or inflammation
so what's the prognosis
toxo usually responds to treatment but it only causes a lesion in your brain if your immune system is extremely weak to begin with senator i'm afraid you have aids as i'm sure
no
as i'm sure you know people with hiv can live a long time
what else could do this to me
theoretically certain cancers
if you have toxo in your brain you have aids
i do not have aids i don't sh sh shoot up drugs i don't sl sleep with
this is very bad news i get that and i sympathize but we've gotta speed through the denial phase because you need antiretrovirals and you need them fast
you haven't even tested me for hiv
we will
but the toxo drugs are going to piss off your fungi and when fungi get pissed
i am not gonna take the pills
you're afraid word will leak out trust me you're not going to become president either way they don't call it the white house because of the paint job
here's what you're gonna do you're going to give me the drugs for the toxo only you are going to test me for hiv under a false name you are going to test me for cancer and anything else that could have done this to me if i have cancer i will deal with it but i do not have aids
eastbrook pharmaceuticals are pleased to announce that dr gregory house will present the latest research on their exciting new ace inhibitor
you're making that up that's vogler's company
press release doing an address at the north american cardiology conference
house never gives speeches
but when i really believe in something gosh dang it i've got a chance to make a difference here
you made a deal with vogler
it's all the rage everybody's doing it
so what's the deal you get to keep all of us if you flog his products
one speech no biggie foreman's doing a bone marrow biopsy to check for cancer
cancer the senator's got aids
cancer sounds better on a press release i need you guys to rush the elisa test for hiv
thank you for the speech
when i said rush i meant you know fast stat's the word you doctors use right
i know it's hard for you
double stat
this may sting a little sorry
it wasn't the shot it's um my head it's killing me
you know senator we don't have to do this now we can wait until your hiv test comes back
guess you figure it's gonna come back positive
well in my experience
patients lie politicians lie more and black politicians
whoa i don't think black politicians lie more than white politicians
we lie less
you figure we're morally superior
i've got my theories no we we just can't get away with it no one's gonna gi give us the benefit of the doubt no one's gonna cut us a second chance and and when it happens it's not just a bad politician it's it's it's a bad role model it's a dis discredit to the race you ready
yeah yeah take a deep breath
dr house i just wanted to
you're welcome again
i want you to know how much i
got it you're grateful apparently you seem to think it'll mean a lot to me to know that
do you know why people believe in god
i thought you didn't believe in god
i don't
well then you better be making a very good point
do you think they pray to him and praise him because they want him to know how great he is god already knows that
are you comparing me to god i mean that's great but just so you know i've never made a tree
i thank you because it means something to me to be grateful for what i receive
you are the most na ve atheist i've ever met
dr house you have a patient in room one
thank god people pray so that god won't crush them like bugs i'm not gonna crush you
petechial bruising i don't know if i'm pronouncing that right
gosh the internet is such a wonderful tool
it could be leukemia
definitely possible the more likely diagnosis is hickey
well it can't be a hickey
why is everybody so ashamed of sex all of a sudden
i'm not having sex i've barely even thought about sex since my marriage ow
i say you're having sex you say you're not either you're lying or i'm wrong or there's some middle ground
you mean like oral
i mean you're having sex without knowing it i'm testing you for booze drugs and ghb
i don't drink and what's ghb
the date rape drug
it's positive your t cell count is eight which means there's a good chance you'll die i'm telling you this because we need to contact your sexual partners
i've only had two girlfriends two after my wife died i used c c condoms
you know the chances of you getting hiv from heterosexual sex with a condom
yes
some day there will be a black president some day there will be a gay president maybe there will even be a gay black president but one combination i do not see happening is gay black and dead you need to stop lying to me
it must be miserable always assuming the worst in people
oh cut the crap you're dying
you're clever you're witty and you are a coward you're scared of taking chances
i take chances all the time it's one of my worst qualities
on people
wanting to believe the best about people doesn't make it true
being afraid to believe it doesn't make it false
well that's very moving it's a shame i don't vote
this is who i am i believe in people i'm not hiply cynical and i don't make easy snide remarks i would rather think that people are good and be disappointed once and again
i need to draw some more blood
nurse
the antiretrovirals aren't working
that's not surprising
he's just going to keep getting worse you realize that right
why are you spying on my case
why are you giving that speech next week we're both just doing what we have to do
and you don't see a problem with that
checking in on a patient yeah wow how do i look myself in the mirror
you're not the one being asked to perpetrate a fraud on the american people
it's a ten minute speech
that i've been ordered to give
vogler's drug works
don't care
oh why do you have to make everything so dramatic
because i'm a very high strung little lapdog ruff ruff ruff rarr ruff
nuh uh no pills
what's going on
the antiretrovirals aren't working
why not
because you don't have aids the first test was a false positive happens one time in every five thousand
you r ran a second test
yeah you're still dying the only difference is now we don't know why
he's continuing to lose control of the muscles on his right side his brain is getting foggier and his t cells are in the single digits
why are we doing this here
so cuddy can't find us unless we find out the underlying disease this guy's lied to his last constituent
false negative on the pcr aids test
ran it twice
immunoglobulin deficiency
no history of respiratory problems
ideopathic t cell deficiency
ideopathic from the latin meaning we're idiots cause we can't figure out what's causing it give him a whole body scan
you hate whole body scans
cause they're useless could probably scan everyone of us and find five different doodads that look like cancer but when you're 4th down 100 to go in the snow you don't call a running play up the middle unless you're the jets
i hate sports metaphors
why did you order the second aids test
standard procedure
oh well that's you mr standard procedure you suspected the first test was a false positive
i knew he was going to africa and i figured he was vaccinated for hep a and b that could cause a false positive
yeah but you knew that before you ordered the first test what changed
i should have ordered both
you were sure he had aids then you talked to him then you had doubts what what did he say
he said he had not engaged in any risky behavior
huh and you believed him
well he didn't have any reason to lie
everybody lies except politicians house i do believe you're a romantic you just didn't believe him you believed in him do you want to come over tonight and watch old movies and cry dr cameron's getting to you well i guess you can't be around that much niceness and not get any one you
is that why you haven't put the moves on her
what makes you think i haven't put the moves on her oh oh boy you're in trouble
you have restored my faith in the human race you're lying
no i'm not lying
i just got your results back no ghb no nothing it means you're having sex and you're lying about it
no and i have a new symptom i have a rash on my butt do you want to what is it
it's a carpet burn
no it can't be doctor i love sex i miss it i haven't had any in over a year
house well you managed to keep this appointment so you have no short term memory problem multiple personalities do you find yourself losing chunks of time do you wake up and you don't remember falling asleep
no i just wake up really exhausted
is something upsetting you
no my ex lives in the apartment downstairs he's always calling me always wanting to get back together complaining about mixed signals get out of my life how much clearer can you get
we have a sleep lab in the basement if nothing else it'll get you away from your ex for a night
slightly enlarged lymph node in his left armpit
how slightly
quarter mil
lymphoma
sure or he's had a cold in the last six months what you've got her on speed dial
i just follow the scent of arrogance
another slightly enlarged node over here two more in his neck and one in his groin
and there's a cyst in his liver
looks complex central necrosis
spontaneous bleeding it's benign i was rooting for a really cool tumor instead we're stuck with this crap
doesn't matter once you find em you've gotta check em
well knock yourselves out
i just saw senator wright he looks like hell that sushi must have been a lot worse than you thought
mr vogler would you like a free whole body scan a man of your stature should get himself checked at least three times a year
here's a few key points i want you to cover during your speech
fourteen pages the audience will be comatose by paragraph two
throw in a joke
dr chase we need to talk
how do you see this ending
what ending
i can't fire you so you have no reason to fear me and therefore no reason to lie to me you told cuddy where i was you told vogler what i was doing
yeah
so how can i work with you
well you don't have a choice
this might hurt a little
lie to me
okay it'll uh feel like a gentle massage
house is a lousy teacher you can't lie for beans
have you ever told any really big ones
oh ho i might be messed up but i'm not that out of it no no no no no
strap his arm down
am i gonna be okay
i hope so
i am selling my soul
just a little piece and you are getting something in return
i said i was selling it i didn't say i was giving it away that would be immoral and stupid all they've done is added antacid
does it work
that's not the point
well of course it's the point he's not asking you to lie he's not asking you to do something illegal
he's not asking me to do anything
he's not ordering you he gave you a choice you chose your staff i know this isn't easy for you you'll suffer vicodin sales in jersey will triple but you are doing a good thing only you could feel like crap for doing something good
kidney and liver cysts are both benign and lymph nodes all came back clean
his left armpit node has antibodies for cb 11
well not enough to indicate lymphoma
we never tested for hairy cell leukemia
no but we would have picked it up somewhere besides one lymph node
and his spleen isn't enlarged
size isn't everything the spleen is the mother load for hairy cells let's cut it open
you can't biopsy his spleen it'll bleed like
in the senator's condition a spleen biopsy could easily cause sepsis and kill him
why do you do this to me now if i kill him i can't tell the judge i had no idea of the risks involved
his brain's turning into mush and he's at risk for more infections so we have to do it
see that'll sound much better in court okay go tell our human pincushion we'll be sticking him one more time cuddy don't you hate doing this
yeah
what's up
you like me why
that's kind of a sad question
just trying to figure out what makes you tick i am not warm and fuzzy and you are basically a stuffed animal made by grandma
i don't think that's why you're asking i think it's because of the speech
oh god don't try and pick me apart
then why are you asking what do you want to hear
hey senator we need to do one more biopsy on your spleen
i'll have to sign lefty my fingers aren't working
you've been coughing a lot does it hurt
it's like i can't get air is that from the toxo
no this is this is new you don't need to sign we can't do the biopsy
the senator's breathing is severely impaired his o2 stat levels are at 89 his silver stain indicates pneumocystis carinii pneumonia
another killer fungus it's consistent with hairy cell leukemia
but we can't biopsy his spleen respiratory distress his platelets are 20 and dropping his blood won't clot worth a damn
there's gotta be another way to diagnose hairy cell
no his bone marrow's indeterminate spleen's the only way to go
you know when the inuit go fishing they don't look for fish
why dr house
they look for the blue heron because there's no way to see the fish but if there's fish there's gonna be birds fishing now if he's got hairy cell what else are we gonna see circling overhead
he should have all sorts of weird viruses
htlv and atlv
we can test for them run the titers
these were your brain waves at 2 45 am now here it comes there's an abrupt jump from slow wave sleep this indicates partial sleep arousal the most common type is somnambulism sleepwalking
that would explain why i'm so tired when i wake up
yes and also why you were pregnant and the hickies and the carpet burn
i had sex in my sleep
sexsomnia is a documented disorder you said your ex lives downstairs
i'll kill him
okay but he probably didn't know that you were asleep sexsomniacs can act pretty normal i'm going to write you a prescription for a low dose antidepressant it'll let you sleep better if you want to save yourself the 15 co pay you can have sex while you're awake
he's my ex i
you live in the same building you haven't had sex with anyone else for a year you sleepwalk right into his arms call me crazy but i'm sensing unresolved issues
negative for htlv 1 and 2 and atlv and everything else it's not hairy cell hey you really gonna give that speech
you've got an opinion too
i'm a little surprised frankly i thought you were too much of a self absorbed ass to do this for us
you're welcome he's positive for epstein barr
so what it doesn't point to hairy cell it's irrelevant
hey
you didn't fall off the swings when you were eight
six
ever
give that back
uh uh we have to talk you had an epileptic seizure that's how you bit your tongue
i haven't had a seizure since i was
what medication did you take
no seizure since i was six no drugs since i was ten
yeah that's it don't worry about what the question is don't worry that you're starting to feel dizzy just stay on message
my mother used to call it physofin
phenytoin
yeah okay okay you're okay it's okay everybody lies
senator gary h wright of new jersey had childhood epilepsy he took phenytoin that drug with the epstein barr virus is associated with common variable immunodeficiency disease t cells down b cells down it keeps you from forming enough antibodies see antibodies are basically your defensive line and your brain is like the quarterback and then the fungi are like blitzing linebackers plunging up the middle your lungs are like okay you've got two quarterbacks
cvid that's a type of immunoglobulin deficiency i said that
yeah well it was a stupid idea when you said it then he got the respiratory problem and tested positive for epstein barr
that's pretty much a childhood disease
another reason why chase's suggestion was idiotic he got it when he was a kid didn't get any symptoms until now it happens it gets triggered by stress like public speaking
so you're basing your diagnosis on a disease that's relatively common and a drug he took thirty years ago
start the senator on iv immunoglobulin stat if he gets better i'm right if he dies you're right
dr house
you faked that
no
say antiretroviral
antiretroviral
now say it three times fast
we just got back your latest blood results your white cells are up your t cells are back over 100
well that's good right
in a week that's terrific you'll need medication for the rest of your life but other than that you're fine
am i well enough to run for president
well why not run for pope while you're at it
oh come on kennedy had addison's fdr had polio two of the best presidents in the last hundred years
if they were running today they wouldn't stand a chance
so you figure you'd be surgeon general if you didn't have the limp
no there's things i can't do and like you said i have to live with reality
well then i'm running
good for you
no don't get excited he's right i uh i won't win
then why run
oh i see your point being the only way to make a difference is to win every fight
but hey why listen to me i own the company i'm certainly not to be trusted right dr gregg house on the other hand has a reputation for integrity among other things ladies and gentlemen dr gregg house
eastbrook pharmaceuticals' extraordinary commitment to research excellence is exemplified by their new ace inhibitor a breakthrough medical approach that will protect millions from heart disease
that's not a speech
i thought it was pithy you got enough for a press release anyhow
foreman or cameron
a few things i forgot to mention ed vogler is a brilliant businessman a brilliant judge of people and a man who has never lost a fight you know how i know the new ace inhibitor is good because the old one was good the new one is really the same it's just more expensive a lot more expensive see that's another example of ed's brilliance whenever one of his drugs is about to lose its patent he has his boys and girls alter it just a tiny bit and patent it all over again making not just a pointless new pill but millions and millions of dollars which is good for everbody right the patients pish who cares they're just so damn sick god obviously never liked them anyway all the healthy people in the room let's have a big round of applause for ed vogler i threw in a joke
i'm sorry i should have taken a couple of extra vicodin and just held my nose
i'm guessing you did take a couple extra vicodin
true
you don't need to worry about firing anyone i'm leaving
why is this another noble self sacrificing gesture you trying to protect foreman
no
so this is just don't fire me i quit
i'm protecting myself you asked me why i like you you're abrasive and rude but i figured everything you do you do it to help people but i was wrong you do it because it's right there are only two ways i can deal with things one is in my control that's to leave goodbye house
the end
house m d 1 18 babies bathwater
house m d
1x18 babies bathwater
april 19 2005
written by peter blake dave shore and directed by bill johnson
transcript written by mari
archived at twiz tv com with permission from house transcripts and more
house and other related entities are owned tm and by heel and toe films and bad hat harry productions in association with nbc universal television all rights reserved this transcript is posted here without their permission approval authorization or endorsement any reproduction duplication distribution or display of this material in any form or by any means is expressly prohibited it is absolutely forbidden to use it for commercial gain
did i say anything stupid i had two drinks three okay there was that last one
that's okay some day you'll be pregnant and you can return the favor
i feel like such an idiot sometimes
oh
you know when the baby comes
you know what you are going to be so great you are
hey
oh
you all right
uh uh huh oh no
you know why i pulled you over
i i'm so sorry officer i must have uh dozed off
have you been drinking
no
of course she hasn't
somebody has
i've been drinking you all right
i i'm not i uh
how far along are you
uh almost um
ma'am step out of the vehicle ma'am walk to the rear of the car
naomi are you naomi naomi
sir remain in the car
hey listen she's not drunk all right
i will arrest you sir
she's sick
badge 302 could you roll me another unit
she's not looking
get back in the car
naomi call an ambulance
well the good news is it doesn't look like a stroke no bleeds no clots
thank god
it sounds like there's bad news
we got your blood work back some things are a little off your liver and kidneys aren't working so well
why what would cause that
it's preeclampsia isn't it i'm gonna miscarry aren't i
preeclampsia is a possibility but let's not get ahead of ourselves
i've miscarried three times i'm 39 we had to use in vitro you've gotta make sure that the baby's okay
let's make sure that you're okay first
how about we take care of both of you at the same time the nurse will be in soon to draw some blood i'd like to run some more tests
thank you doctor
thank you
where is everybody
no one's in the office
no haven't heard from cameron all day you seen house
heh look for a shallow grave with vogler standing over it
you have a stage 4 cancer it's metastasized to your liver there's a new drug called 8c 12 that's shown promise in phase 2 trials it's your best shot
thank you doctor you've been so good to me
well i did publicly bash your company's drug
when i think about how i treated you
oh hey come on there there there
so um there is some hope
always but just in case i special order an extra jumbo size coffin
hey
don't thank me it's just who i am
foreman's voice hey
up and at em big guy
sorry up late internet porn
how come you're not in your office
because there is a computer in my office if i log on romance will ensue my wrist might fall off
hiding because vogler's looking for you that's just pathetic
i don't like loud angry giants threatening me with violence how is that pathetic
you think you can avoid firing one of us by hiding out here he'll find you sooner or later
i'm okay with later
39 year old female 28 weeks pregnant g 4 p 0
three miscarriages gimme
altered mental status and complete loss of coordination
tox screen
negative for alcohol and drugs she was on oxybutynin
for incontinence
we took her off but no change bun creatinine are up lft slightly elevated
preeclampsia call the ob gyn service and rub some prayer beads
bp's normal no preeclampsia in other pregnancies
because she didn't carry long enough
the three miscarriages make me think it's an underlying physiology
pregnancy related autoimmunity too bad that cameron quit i could use an immunologist right now we'll see if you're right check the blood
cameron quit
last night and do an mra for vasculitis too
there is no way she quit she got fired because you couldn't swallow your pride
an ultrasound excellent thought and put her on magnesium too in case it is preeclampsia
sure
here pussy pussy pussy
i didn't do anything
exactly my point
you wanted me to yell at him what the hell would that have achieved what is he going to jump into his time machine and fix everything
when a dog dumps on the floor do you pat its head and call it a genius no you smack it in the nose with a newspaper
dogs can learn things house can't
coward
child
hey there i brought my colleague along to help out
hi i'm dr chase
hi
well ultrasound looks good no sign of fetal distress
so it's not preeclampsia
well it still could be but it hasn't progressed at least we're gonna put you on bed rest and monitor the baby
okay
we'll give you some potassium and magnesium as well so we should keep the fluids running for now and check her again in an hour unless there are signs of fetal distress or
honey wha uh she's choking
lean forward
what is is she all right
it's probably just some muscle weakness
what do you mean probably
naomi open up
people choke it could be nothing you all right
i can't i can't i can't even swallow
she gets sick a lot but this this cold got really bad all of a sudden and the fever shhhh it's okay
it's not a cold it's pneumonia
pneumonia
relax pneumonia's her second biggest problem she has gone from the twenty fifth weight percentile to the third in one month now i'm not a baby expert but i'm pretty sure they're not supposed to shrink
well there's this diet we put her on when we stopped breastfeeding
but it's healthy raw food we're vegans almond milk tofu vegetables
raw food if only her ancestors had mastered the secret of fire babies need fat proteins calories less important sprouts and hemp starving babies is bad and illegal in many cultures i'm having her admitted
is she gonna be all right
antibiotics for the pneumonia iv feeding to get the weight up don't worry it's a vegan iv
don't see any signs of vasculitis odd since you're always right about everything
could be a different auto immunity or you could bite me
oh no
naomi you okay
i'm getting cramps
strong
yeah feels like my miscarriage
it's preterm labor
he's too little he won't survive
she's on magnesium already
fuse interbutoline then we're going to give you some medicine okay try to stop your labor
okay
whoa there you are i've been looking everywhere for you uh listen you said i had to cut one of my people if i didn't give that speech about your drug and in fairness to your point of view my speech really wasn't the one you had in mind so i've cut cameron now we're all squared away right
in the morning i expect you in my office with your letter of resignation and plans for a public apology otherwise i'll destroy you
so that's a no' on us being squared away
she might make it to full term contractions are less frequent and not well organized
great to see you back in the office i guess vogler found you
yeah we had a nice little chat i really should have kept cameron she knew where to find the sugar
it's what i said preeclampsia a little stress from the mra she pops straight into labor
ah ha
what about the myasthenia
come on she didn't seem that weak
she choked she couldn't even swallow
what did she choke on
her food the muscle weakness isn't a symptom of preeclampsia
what kind of food
a little bit of cooked pear it doesn't matter it shows weakness
she choked on soft wet pear did she forget to take the bones out that's way past muscle weakness did you do an upper endoscopy
you think there's something obstructing her esophagus
we've gotta talk
oooh we've gotta talk and check her eyelids
check her eyelids
special board meeting today only one item on the agenda you
well enjoy the bagels i'm untouchable
huh right
any vote to revoke my tenure has to be unanimous i've got you and maybe even cuddy
oh well that settles it mr ruthless corporate raider will be stymied go home curl up on the floor of his shower and weep
what can he do i've got a contract
does it say how much your team gets paid where your parking space is if your car should be filled with horse manure vogler's smart he's got some plan to get you
does it involve candy because i'm a sucker for chocolates
she's doing better
oh thank god
technically alexander fleming he developed antibiotics pneumonia's under control and from now on what say you stick with human food
absolutely swear to god
this time that's your guy
ms friedman rachel and joel kaplan
yes
you're under arrest you have the right to remain silent
what did we do
ms friedman you're being charged with child endangerment
what how we
ms friedman starving your kid i'm from social services we're taking responsibility for your baby
this is how vogler's gonna destroy me
what did he do grease your cane
he had my patients arrested
he didn't i did the nurses were concerned and they called me there was evidence of abuse you took a big legal risk by not calling social services
those parents were not abusive they're idiots
oh well that's certainly a relief
it was my call
you made the wrong one
you know there's a new biography of quisling i think you might like it
sure no idea who that is
uh norwegian guy world war ii traitor the fact that i have to explain this kind of takes the edge off my flow
i was protecting you
from what cops aren't gonna bust me disiplinary committee maybe gives me a slap on the wrist
and vogler has an excuse to get rid of you
if i don't give him one he makes one up
vogler's just one vote he's gotta convince the other eleven of us i'm just trying to stop you from making that extra easy
sean do your wife's eyelids look any different than usual
um maybe one is drooping a little bit but you know she's tired so
naomi can you open your mouth for me and tilt your head back this is gonna be a little uncomfortable yeah there's swelling indenting the esophagus
is that why she choked
we'll need to do an x ray
what no the baby you said no x rays
it's important
three centimeter mass in her right upper lobe
maybe it's a granuloma
no there's no calcification
it's small cell lung cancer the tumor's starting to press against your esophagus it hasn't metastasized but it has spread to other parts of your lungs so we can't operate
wait that doesn't make sense she had kidney failure and brain problems
some cancer patients get what are called paraneoplastic syndromes you were making antibodies to fight the tumor it attacked other cells your brain first then your liver kidneys even the nerves that control your eyelids that's called lambert eaton syndrome it told us the tumor was in the lungs
how bad is it
small cell is the most aggressive kind of lung cancer the five year survival rate is only about ten to fifteen percent which is why we need to start you on chemo and radiation right away
not radiation what about the baby
you'll need a c section before you can start the treatment i can get you in first thing tomorrow morning
what are the chances my baby will survive
pretty good twenty eight weeks so about eighty percent
no wait that's one in five chance he'll die
i really wouldn't advise waiting
naomi you've got to start this treatment right away
what happens if i wait
twenty nine weeks survival rate is closer to ninety percent
i'm not doing the radiation
you'll die
listen you know the chances they're nothing but a few more weeks will save the baby
listen you're depressed right now and you're not thinking right
sweetie
could you just tell her please
this cancer moves quick the median survival's two to four months if you postpone even for a week
i'm sorry honey
as most of you know gregory house recently gave a speech about me i'd like to return the favor
sorry
dr wilson i was hoping you were going to miss this one a man is the sum of his actions here are a few of dr house's he violated a dnr and was charged with assault he brought a termite into the or and spat on a surgeon he accepted a corvette from a patient who was a known member of the new jersey mafia
dr simpson ed look
edward
dr simpson edward you look at anyone's career you can find things that are
these are the last three months he's personally had more complaints filed against him than any department in this hospital
okay he's screwed up he's miserable and he should probably reread the ethics code but it works for him he's saved hundreds of lives
he is a drug addict who flaunts his addiction and refuses to get treatment he is a disgrace and an embarrassment to this hospital i'd go on but it gets kinda mean so i'm gonna keep this simple house goes or i go
you shouldn't personalize this
and by i i mean my 100 million how's that for personalizing
you gave us that money for a reason are you really willing to throw it all away because of one doctor
gregory house is a symbol of everything wrong with the healthcare industry waste insubordination doctors preening like they're kings and the hospital their own private fiefdom healthcare is a business i'm gonna run it like one i hereby move to revoke the tenure of dr gregory house and terminate his employment at this hospital effective immediately
don't you think we should discuss this
we just did
we need time
the vote is on the table all in favor dr wilson
opposed
the motion is defeated dr wilson would you mind leaving the room please
excuse me
we're gonna take another vote
well first of all you can't void my vote by making me stand in the hallway and second you should check the by laws you need notice and at least one business day before you can reconsider any matter
we're voting on a different matter which you are conflicted out of
how can i be conflicted
this vote is whether to dismiss dr james wilson
naomi is refusing to have the c section her odds aren't good enough
they do suck where's wilson
paged him twice
she does this she knows she's gonna die
she's saving her child cameron would point out that people are capable of sacrifice
cameron isn't here
perhaps proving her point
you think this woman is making a rational decision
i think people can overcome their baser drives
pretty damn rarely and not this time this is purely biological in evolutionary terms the needs of the next generation are more important
you're saying she's making the right call
darwin is i'm not the next generation is not my patient we have to raise the odds for mommy and where the hell is wilson he's the oncologist
good plan cure cancer surprised no one ever thought of that before
there he is dr house
you guys bust out
we made bail they won't let us in our baby's room
weird you'd think they'd let you take her home while they figured out if you tried to kill her
we're good parents we fed her whenever she was hungry
big meals we had no idea that diet was so bad for her
the nutritionist said it had everything she needed
the kid who stacks the free range grapefruit in your health food store is not a nutritionist
but my uncle is he went to college and everything
foreman i need a ct scan on
olive kaplan
seriously olive kaplan check for abscesses or occult infections bu bye
listen vogler's all about clinical trials the hospital's chock full of them there's got to be something for small cell lung cancer what are you doing
i got sacked
did you make a pass at cuddy told you she only has thighs for me
i voted to keep you
so he's getting rid of every board member who votes to keep me around
yeah every one of us
just you
yeah
but you're only off the board right they couldn't have got unanimous approval for you
brown from oncology voted no so did cuddy taylor and peevey
eh so you're off the board big deal frees up wednesday nights for bowling you're still a doctor
yeah getting dumped looks great in who's who vogler gave me the option of resigning and i took it
big of him
i've got no kids my marriage sucks i've only got two things that work for me this job and this stupid screwed up friendship and neither mattered enough to you to give one lousy speech
they mattered if i could do it all again
you'd do the same thing well you'll be gone soon too
those clinical trials
i'll make some calls
thanks
it's not cancer
it's not gonna kill me
it's hemorrhoids
but all that blood that can't be right
looks worse than it is
nice job of protecting me
can this wait
his ass can wait you saved my job by sacking wilson
what did you think would happen when you made that speech you think he would just pout for a little while and we'd all forgive you you don't spit on the man who signs your paycheck first cameron then wilson you're next pull your pants up
so it's about the money
of course it's about the money the money vogler gave he could have bought a few jets maybe a baseball team or just stuck it in chase manhattan and collected interested but he gave it to us to buy equipment to do research you are a great doctor house but you are not worth 100 million
we've sequenced the dna of the tumor cells p53 gene mutation and codon 55 she's perfect for your trial
she's pretty far advanced
well you want easy cases you picked the wrong speciality
otherwise in good health
excellent
when can she start
middle of next week
cancer's already stage 3 it'd be a waste of time
she can start in two days
she can't start in two days she's pregnant
she won't be in two days i've scheduled a c section
she'd still have to wait a month you can't take part in an trials until 30 days after major sugery
well it's definitely surgery but major
it's not your call
again a question of interpretation
you're scamming a doctor now come on vogler's looking for any excuse to can you
oh i think he's got a big bag of those already
these regulations aren't just here to annoy you okay doing this is dangerous to the patient
well i'll be sure to let her know that care to join me
angiogenesis inhibitors prevent the tumors from creating blood vessels without blood the tumor starves
that sounds great
what about the baby
the treatment would be fatal to the baby i've scheduled a c section for later this afternoon it's in the trial phase right now but so far complete remission in more than thirty percent of subjects
i told dr foreman i didn't want a c section
when your chances of living were less than a third of what they are now
well the baby's premature that
our pediatrics department has the best neonatal icu in the state
no his lungs his brain he's not ready
and he could be fine
you don't know what it's like raising a sick child
his odds are much better than yours are you have to let them at least try this talk to her
okay leave the room how long have you been taking oxybutynin
uh since i was about twenty
incontinence is pretty uncommon in a woman of your age it's even more bizarre in a woman in her twenties
i guess i haven't had the best luck when it comes to my health
seems that way you said to your husband you don't know what it's like raising a sick child you didn't say you don't know what it would be like this is not your first child is it and he doesn't know
i was eighteen got pregnant got married i had the most beautiful little girl grace she had infantile alexander's disease
i'm sorry
for two years we watched her die my husband was uh my first husband was a a great guy but after that i couldn't even look at him without thinking of her i left him i left my job i left everthing
very moving story explains why you're being so selfish
i'm willing to die to protect my husband
because it's what you want your husband wants you to live
well he doesn't understand
oh who the hell does tragedies happen you think that turning yourself into a disposable incubator for a few weeks is going to protect your baby from all the crap in this world go ahead die happy i got no problems with people killing themselves but don't think it makes you a hero
okay
you're scheduled for 4 p m
yes this is dr lim
count down from ten
okay ten nine eight
that seemed kind of fast is she all right
she's fine
wake her up that was vogler surgery's off
hey you're killing her
really see i thought you were the one trying to ram her into a drug trial five minutes after surgery
she knows the risks she was fully informed
well the guy running the study sure wasn't
not his life not his call
his study his call
right so she kicks off his number look bad
the numbers look bad the study looks bad
which would cost you money
and keep a life saving protocol off the market
one person one blip in the data
you ever heard of the fda they eat blips for breakfast one person should never endanger thousands
well thank god you were here to save all those lives
the board's meeting again this evening why don't you settle down play some game boy why don't you watch your soap i hear they're firing the handsome doctor today boy that should be a good one
if we had the c section anyway we could still do the experimental treatment right we'd just have to wait thirty days
assuming the doctor running the trial isn't too pissed off to let her in yeah
and assuming i'm even healthy enough to
honey are you okay
stats are dropping down to the 80s stay with us naomi
what's going on
we need you to leave the room
respiratory distress
could you just tell me what's going on
we're trying to find out
still kicking
flash pulmonary edema
lungs are clear there it is
pulmonary embolus
gotta get her to an or
what happened
it's an embolism a blood clot it's fairly common with lung cancer it's not a embolism so blood's still trickling through we've been able to get naomi breathing a little but we need to remove the clot and we need you to approve the treatment
yeah whatever you have to do just do it
it's not that simple okay the best course for the baby would be an immediate c section the longer we postpone the greater chance it'll have brain damage from lack of oxygen
fine whatever just do it
here's the problem the c section would be very very dangerous for naomi
dangerous like
in her current condition there's a real chance she wouldn't survive i'm sorry look your wife's unconscious we need you to make a decision
i just want her to live no c section
stats are still way down we've got to push the streptokinase
too risky even if it dissolves the clot she could still bleed out anyway
she's hemodynamically compromised
it's not good for the baby
dad doesn't care
embolcine 250 000 units
bp's dropping pressers
we don't have time we've gotta suck it out
systolic bp's 80 bp's stabilizing o2 stats rising
did you get the clot
i think so she's stabilized
how long was her oxygen at that level
ten minutes
brain function compromised
bp's dropping up the dopamine she's not responding how much
she's up to 30 micrograms
is she septic
she's bleeding into her abdomen
we won't be able to stop it i'll go talk to the husband
no you stay here keep her as stable as you can for as long as you can she had trauma during the procedure she's bleeding into her abdomen there's nothing we can do i'm sorry
um no
i need you to okay the c section
yeah that's gonna kill her right
it probably will
i can't do that
she's dying either way
i'm sorry i'm
stay with me sean i need your okay on this
she makes the decisions and i'm
right and that's gonna be tough from now on but this decision is easy you know what she'd want
i can't do it
you make this call only two things change one yeah you feel guilty for killing your wife two your baby lives naomi's baby lives
okay okay
he's out umbilical cord's clamped
no respiration
his lungs aren't opening up
they aren't mature
come on take a breath you know you can do it what've you got
looks like v fib
pulse
no paddles
come on come on
clear
nothing
charging
come on open up
how's he doing
he's still not breathing we've got to intubate
clear
thank you i'm late for the board meeting
we need to talk
i don't want to hear it
it's about a patient
the pregnant woman she wasn't qualified for that trial and i'm not going to apologize
i'm not talking about her at this point i think it's best that i concentrate on patients who are still alive pulmonary embolism she bled out saved her son this is olive kaplan's ct scan the incredible shrinking baby
her thymus gland
digeorge syndrome it's genetic can cause the gland to wither to nothing
this is why she couldn't gain weight
yeah
i'll call the police and social services and have all the charges withdrawn
i've sent a test down to confirm when it comes back you should start olive on immunoglobulin replacement
you're not going to do it
i assume i won't be here
your boy's doing good
it's the same motion as yesterday people same reasons all those in favor of dismissing gregory house raise a hand dr cuddy you realize this is going to happen
i can't do it
you can't abstain
i'm not abstaining i'm voting no
you've changed your mind since yesterday what did he do buy you dinner and roses threaten to drown your dog
he did his job
right he saved another life
maybe
good for him it's great it's not the point
it's what we do
and you could do it a lot better if you didn't have to worry about some madman running around the hospital accountable to no one
but that's not the choice you're giving us
house won't listen to anyone
and you're not accountable to anybody either because you think you own us
i move for the immediate dismissal of dr lisa cuddy
dr simpson she's upset we all are why would you risk your career to save him
if you think house deserves to go if you think i deserve to go wilson deserved to go then vote yes but if you're doing this because you are afraid of losing his money then he's right he does own you you have a choice maybe the last real one you'll have here
cuddy is a genius convincing four people to give up a fortune to save our sorry asses dr cuddy the man of the hour
what are you doing
we're drinking i would have thought that was pretty obvious
well to the great champion saved you saved wilson saved the whole team of course none of them would have needed saving if you could actually get along with another human being
well thank you miss buzzkill
well you only cost us 100 million could have saved some lives could have made a few jobs helped a few people yippee
you voted to get rid of him
the lesser of two evils you should be mourning i know i am
house m d 1 19 kids
house m d
1x19 kids
may 3 2005
written by thomas l moran lawrence kaplow directed by deran sarafian
transcript written by mari
archived at twiz tv com with permission from house transcripts and more
house and other related entities are owned tm and by heel and toe films and bad hat harry productions in association with nbc universal television all rights reserved this transcript is posted here without their permission approval authorization or endorsement any reproduction duplication distribution or display of this material in any form or by any means is expressly prohibited it is absolutely forbidden to use it for commercial gain
visualizing all right you're up tiger you feel all right you look a little pale
i'm fine
does your neck still hurt
it'll be fine
you know maybe you should do the two and a half instead
i'm gonna do the three
well it's better to nail the two and a half than
i'm gonna nail the three
all right well let's show these senior citizens what a well coached twelve year old can do huh
two time national junior champion mary carroll
damn it you can do this come on just see it see it big jump let it count rip it
call 911 we need an ambulance
i saw the light on
it's daytime
yeah it's a figure of speech always so literal
got a new cane
yeah guy in the store said it was slimming vertical stripe
why are you here
vogler is dead
what what happened
again with the literal translation vogler the idea mr destructo mr moneybags bow down before me he is gone from the hospital so things can go back to the way they were
the way they were was kind of weird
weird works for me
what are you saying literally
i want you to come back
why
please unclench you're not on the clock and when you do that i clench and then it's the whole thing
could you look at your pager
it's no big deal some sort of epidemic not my area
you should go it's important
what i'm doing now is important
why do you want me back
because you're a good doctor
that's it
that's not enough
not for me go deal with your plague
you are in a quarantined area please remain calm and stay in line a doctor will see you shortly when you see a doctor you will receive a blue or yellow form patients with blue forms must immediately enter the parking lot
dr house we need you here
sorry lot of sick people i might catch something
a judge at the campus pool center collapsed lp revealed a virulent form of bacterial meningitis
great got it diagnosed you don't need me
2500 people at the pool center were exposed they're being bused to all the neighboring hospitals
that's a problem of resources not diagnostics no i'd be completely lost get in everyone's way
joe dr house doesn't have a blue slip no one leaves the quarantine area without a blue slip you are a doctor at this hospital act like one and take these
102 you win a trip to the second floor next
all right no fever no rash you're fine take these two pills and show this blue slip to security on your way out next
take these go home talk to your daughter
what
your pants your blouse your scarf are all freshly dry cleaned everything except your jacket it's got a smudge on it probably two days old which means you didn't know the jacket had been worn so either your husband is a crossdresser or your daughter has been borrowing your clothes without telling you probably wants to look older to get into bars
i don't have a daughter
next
so i have it
yellow form to the second form you're gonna be fine
i'm gonna die
it's treatable as long as you go to the second floor next
yow
fever does that mean i have it
you have a rash come on
it's from my new bathing suit i've had it a week
yeah does your neck hurt if it does you get the trifecta
it's nothing i pulled it trying to do a three and a half tuck
where are your parents
we live in chicago i'm here with my coach i wanted to see what you were writing
go like this now like this
take these pills a blue slip will get you out of here next
you're coming with me
you're going to need a ct scan second floor take the elevators follow the parade next
maybe something systemic
or maybe it's meningitis
she's had the rash a week if it was this meningitis she'd be dead by now
you guys figure we're done down there the 800 people milling around are just waiting for the bathroom
12 year old female fever rash neck pains not meningitis
it's the definition of meningitis
sure pus in the spinal canal makes it hurt to move your head up and down but her head only hurts moving side to side
oh side to side
doesn't fit
the three of you lobby now
those little pills you're passing out so efficiently aren't going to do miss louganis squat
you just don't want to deal with the epidemic
that's right i'm subjecting a 12 year old to a battery of dangerous and evasive tests to avoid being bored okay maybe i would do that but i'm not if it turns out she does have meningitis you're right you win but if we go back downstairs and she dies your face will be so red
you have one hour
get a lumbar puncture some brain infections can be pretty clever at hide and seek
i'll get on her bloodwork
no you won't you sir will research all the causes in the universe of neck pain
the list is like two miles long
start with the letter a and put her on rifampin
rifampin is for meningitis you just said
in case i'm wrong it has happened
doctor 1 brenda i need a cbc count 7 and 2046
hold on
doctor 2 hey hey there's a line here
that's why i said excuse me ' brenda i need a bed and
doctor 3 we all need stuff
push me again brenda i need a bed and a nurse for a lumbar puncture
no beds no nurses for at least 4 hours
i've only got one
your patient only has an hour to live unless she gets a lumbar puncture
cuddy only gave us an hour to work on the patient
back of the line
this novocaine will numb you for the lumbar puncture sorry this has to be so public mary
normally i'm in a bathing suit with 5000 people staring at my butt i can block this out
these kids are all very mature travel around the country from event to event
okay i need you to hold your knees and tuck your head
like a dive
exactly good great don't forget to breathe
sorry
geez coach help me out here play a little defense before i poke the wrong thing okay here we go
ow i feel ow i feel it ow
try to relax mary try to relax
what letter are you up to
a
torture combing through all that stuff ain't it real dull awful
it's no problem
well thank goodness a lot of people would resent having to do this
where's the 12 year old girl that was here
needed the gurney
she just had a lumbar puncture she's not supposed to be moved
sorry we needed the gurney
hey
hey
you okay how's your head feeling
she's got a headache and she's dizzy
she shouldn't have been moved after the procedure i'm sorry
i'm fine what did the test show
no meningitis no other infections
but you're not carrying a blue form i have something else don't i
something's causing your symptoms we're going to keep you overnight i know it's a little crazy here but hopefully things will settle down and we'll get you a room
i'm sorry i'm not usually all emotional like this
you're doing great your folks will land in a few hours
i just i haven't slept i'm so tired oh my god my eye's bleeding what is it what's happening
oh don't worry the antibiotic we gave you in case you had meningitis can turn your tears reddish that's not blood but that that's blood
that's going into my stomach
the vials showed blood in your gi tract we need to find out where it's coming from you won't feel it i'm going to numb the back of your throat and dr foreman is going to give you a sedative open swallow now lay on your side for me and here we go yell fire or something
people this area is highly contagious please step back highly contagious
all right try to relax mary this shouldn't take too long
don't see any tears or lesions
all right i'm in her stomach there's no bleeding
there was more than a tablespoon of blood in her stomach so it's got to be there maybe her small intestine
30 feet of digestive tract it could be anywhere in there we're not going to see it with this
believe it or not this is a camera you swallow it and it goes all the way through your system the antennae pick up the signal from the pill we're going to look at the video of your intestines see where the blood is coming from and fix it water down the hatch
think i've seen this movie the ending's kind of dark want one how come you did the endoscopy
he asked for help
her blood pressure was high i was worried
foreman is not your boss when i tell you to do something whoa hold it there back it up a couple of frames oh yeah that's your money shot
i don't see anything
really ginormous thing on the right side of her intestine doesn't even intrigue you
does ginormous mean really big or really really big cause i don't see anything
there a dieulafoy
oh well we can burn off the swollen blood vessel but it still doesn't account for her other symptoms
no but it does tell us something though i have no idea what
could be a precursor to intestinal intussusception
precursor isn't causing all of her other symptoms what else
you in the lobby now
i hurt my leg i have a note
you had your hour three actually
dr chase i told you to tell us when our time was up she has intestinal bleeding
she'll wait two more buses just arrived we need you downstairs
no you need more nurses but you cut back on the nursing staff so you have doctors doing what the nurses should be doing
that's true i wonder if that has anything to do you with you costing us 100 million
go be free
it's not the intussusception what about stomach cancer
does she have any abdominal pain
no
then it's not stomach cancer have you ruled out sepsis
the lp and blood smear showed no signs of infection here take these two pills and you can go
well the lab's working at double their capacity maybe someone screwed up
no fever no neck pain take the elevator to the third floor
whoa whoa whoa wrong form no fever no neck pain she's fine
smell her hair no chlorine which means she wasn't at the pool which means she's come to a quarantined area because she's a idiot or she's insane no one is that stupid east wing psych ward bye bye
neck pain could be a symptom for bone cancer
you up to bs well done
it would account for all her meningial symptoms rash fever you're fine take these two pills
get a sample of her bone marrow
from here
break time
need more than 15 minutes
use chase's break too go
you should just fire chase
what and miss out on all this fun
so you're going to torture him for a while and then fire him that's cold
you don't think he has it coming
hey i said fire him
that's cold all he did was save his job
what he completely screwed you over
right rudder bank bank bank
good coffee the rest of this hospital is busting it's tail and what are you doing
trying to think of anything except the produce department at whole foods
i am working it got hot stop acting like a 13 year old
sorry you just don't usually see breasts like that on deans of medicine
oh women can't be heads of hospitals or just ugly ones
no they can be babes you just don't usually see their funbags
your 3 o'clock interview for dr cameron's position is in your office
ah not interviewing today i don't know if you've heard but there's this big time epidemic many sick people puking in the hallways it's crazy
i'll send the interview home we can reschedule
no you won't you will interview this person and if he can put two sentences together you will send him to the lobby where he will do his job unlike the two of you
come on you know i can't do a bone marrow aspiration in the hallway
and i can't give you a procedure room
i just need something at least close to a sterile environment
i need 10 more nurses
brenda listen listen she'll die
at least she'll have a bed then put that over there
are there dead people in those cabinets
i hope that's who's in there just be calm relax
ow ow
hang on hang on almost done
dr spain you know i really admire the way you don't care what anyone thinks you just do what you want the way you want
so you went to hopkins for both undergrad and med school
dr spain that's right
he's in a band
dr spain you into music
totally what kind of music do you play
dr spain um mostly blues you know james cotton some original stuff
oh dude you are so hired
dr spain really
not a chance
dr spain why
tattoo
dr spain wow i thought you'd be the last person to have a problem with nonconformity
nonconformity right i can't remember the last time i saw a 20 something kid with a tattoo of an asian letter on his wrist you are one wicked free thinker you want to be a rebel stop being cool wear a pocket protector like he does and get a haircut like the asian kids who don't leave the library for 20 hours stretches they're the ones who don't care what you think sayonara
so should i go through all the resumes looking for asian names
actually the asian kids are probably just responding to parental pressure but my point is still valid
teammate 1 so when do they think you're getting out of here
i don't know
teammate 2 you don't look sick
teammate 1 better hope you're not this equipment looks like it's 100 years old
just got it out of storage it is the previous generation but it works just fine could you guys give us a second
if it's good news you can tell them
okay we're pretty sure it's not cancer
teammate 2 hey that's great
i'll call your parents
well we still can't release her we still don't know yet exactly what's causing the mary
what's wrong
she's having an absence seizure mary you okay
she looks fine
i need some help over here push two milligrams ativan stat
are you sure it was an absence seizure
absolutely she was totally unresponsive and unaware of what was going on around her
do you mind we're trying to work
we should get back out there cuddy's going to be looking for us
looking but not finding you do an eeg
seizure frequency's increasing they're almost constant now 5 in the last half hour
which tells us
it's definitely in the brain
and it's getting worse
and good lord are you having a bowel movement or a baby
could be barbiturate withdrawal
no can't be drugs she's tested at every meet she competes in
a bleed in the brain can cause seizures
rat poison could also cause the neck pain
you think she's eating off the floor of her folks' garage
doesn't have to be
who would poison a 12 year old
well let's see now there's the 18 year old has been that she beat out to make nationals the has been's parents jealous siblings sociopathic swim fan and then there's just your plain old garden variety whack job hey you know what a hemorrhoid is
no
well google it and try some raisin bran instead of the donuts okay do a ct scan check for intercranial bleeding
not a chance radiology's totally swamped
if our patient's bleeding into her brain she's gonna be dead in 8 hours
she could be but a meningitis patient will be without a ct scan
when i was in med school i had this old professor
who touched you in the naughty place
before the ct scan was introduced he specialized in transcranial ultrasound
hmm ancient but if there's enough bleeding it might work okay do what the guy who didn't specialize in neurology said
it was my idea
you've still got to cover q z
sorry i'm late i was taking a dump
dr gilmar i'm guessing i'm better off interviewing right after than right before
dr petra gilmar dr gregory house
you actually speak four languages or you just banking on never being interviewed by anyone who does
dr gilmar it's true and i can swear in two more
why are you leaving dr hazel did you fall for him and can't handle it or is it the other way around
yes well pretty much every fellowship ends that way
dr gilmar no it was nothing like that
you jewish
dr gilmar yes
is it true what they say about jewish foreplay
uh uh
dr gilmar two hours of begging
i heard four
dr gilmar well actually i'm only half jewish look i know you like to play games with people i know you like to say outrageous things and study how they react what you should know about me is that i grew up with four brothers keep your hands to yourself i'm okay with anything that comes out of your mouth
well that's great i think that's all we'll need thank you for coming by
dr gilmar thank you
that's our hitler
no way
are you kidding her background's perfect she's smart she can obviously deal with your insanity
did you see her shoes
her shoes what did your horoscope in vogue tell you to avoid women wearing green shoes
the eyes can mislead the smile can lie but the shoes always tell the truth
they were prada it means she has good taste
they were not prada you wouldn't know prada if one stepped on your scrotum
okay well they were nice pointy
exactly they were stylish and very painful to wear only an incredibly shallow and insecure woman would rather be in pain all day then wear a decent looking comfortable shoe and that's exactly the type i don't need around here
no someone who can handle a lot of pain is exactly the type you do need
excuse me
what are you doing
i'm ultrasounding your head you're still having seizures this should help us figure out what's going on
blue form to the security guard
you're not going to be happy with anyone
so what your advice is hire someone i'm not happy with and be happy
no my advice is much more subtle stop being an ass you always find some tiny little flaw to push people away
now it's people i thought we were talking about fellowship applicants
you have a history of this
well when i do decide to push you away i hope there's a small person kneeling behind you so you fall down and hurt your head
take these there's water over there blue form to the guard and you're done you had the perfect person and you blew it
you saw the shoes
i'm not talking about her
you're talking about cameron
i'm talking about every woman you've ever given a damn about
cameron is so not perfect
well nobody's perfect
mother teresa
dead
angelina jolie
no medical degree
now who's being picky
you're going to wind up alone house
you were right there's a significant bleed in her temporal lobe
no poisons did a tox screen on her blood urine and hair nothing did em twice
he's a little dehydrated put him on a saline drip and give him some orange juice
i need an operating room and a surgeon
oh well given the current crisis i'm tempted to say no but since you've been so sweet to me today
our little mermaid is bleeding into her temporal lobe
how fast can you have her prepped
20 minutes
you'll have a surgeon in the room in 10
mr and mrs carroll
mr carroll are you dr house
this is dr foreman
mr carroll is mary all right
the operation went well the intercranial pressure's been relieved and the swelling's already going down
mr carroll thank god
mrs carroll well what happened did she bang her head at a meet or did she
no nothing like that
mrs carroll then why is she bleeding is she going to be all right
we're sorry we still don't know
no toxins no tumor no bone cancer
adrenal failure could cause the rash fever and muscle pain maybe it's some sort of genetic kidney disorder
no family history and no blood in her urine or
not yet
you want to do a differential based on symptoms that might happen
got a better idea
stop it stop looking for things we don't know and focus on what we do know what do we actually know besides what's up there come on how hard can it be to tell me what you already know
she's 12
she spends a lot of time at the pool so exposure to chemicals
she travels a lot
but never out of the country
what else come on
we're missing something
what
well if i knew that it wouldn't be missing
maybe she's adopted and we've got the wrong history
no she's got her mom's eyes and a red patch of hair just like dad
what about an allergic reaction
could explain the rash and muscle pain but not the bleeding or seizures
that's a lot of balloons
think she's allergic to polyester
not unless she's been competing in the nude all these years
then what are you thinking what do the balloons mean
what if the rash isn't a rash
what are you talking about
who gave her the balloons
some of the girls from her team they've been visiting her pretty regularly but none of them are sick
what about the guys
none of them are sick either
which guys visited her
actually none
she's cute she's nice she's a kick ass diver you'd think the guys would be falling over themselves to get close to her
she's 12 the youngest guy on her team is 16
okay so maybe they're just not interested or
they're avoiding her
there any cell fragments in her blood smears
no red blood cells were intact
check em again
blood looks like it's been put through the blender now
you done yet
you were right rash wasn't a rash she's bleeding into her skin it's purpura
thrombocytopenia purpura
starts with t you were so close
what could have set it off she had no trace of e coli in her cultures she's obviously not menopausal so no estrogen
there is one other possible cause
oh god
pregnancy cause all kinds of chemical and biological changes in a woman's body or a girl's body as the case may be in extremely rare cases everything goes haywire it's called ttp blood starts clotting like crazy clogs the vessels in your brain and kidneys red blood cells end up getting shredded as they squeeze past the clot like a fat guy in a crowed bar i'm sure you know what that's like you're only 12 but you're all grown up right travel on your own hang out in hotel rooms getting room service with your teammates maybe someone sneaks in a couple of beers you start playing spin the bottle next thing you know you're waking up in nothing but your socks
it wasn't like that
of course not you wanted it
yeah i did he turned out to be a jerk but
actually under new jersey law the term is felon '
i knew what i was doing
we're going to have to do something called plasmapheresis it cleans the antibodies from your blood we're also going to have to terminate the pregnancy
you're going to tell my parents
someone should rock paper scissors
they don't need to know i'll be all right
of course you will if you're old enough to bleed out of your vagina obviously you're old enough to handle a simple thing like an abortion without mommy and daddy's help
you're going to tell my parents
under new jersey law you're the boss
your daughter has ttp don't worry it's curable she'll be fine
mrs carroll well wait what does ttp stand for
some really big words that you've never heard before and when we're done we'll never hear again have a nice day
mr carroll well when can we take her home
uh in a few days she needs some minor surgery to remove the underlying cause before we can do the another really big word
mr carroll what's the underlying cause
she has an abnormal growth in her abdomen
mrs carroll what kind of surgery
it's very simple we do it here all the time
mr carroll could you be a little more specific
actually no i'm sorry
you're doing good
feeling okay
yeah
you should be your platelet count's up
how's your neck looks good anything else we can get you
no thanks
okay
yeah can i see my mom and dad
plasmapheresis is working she's going to be fine
i know
dr marks i can't even tell you how much i appreciate the opportunity to meet with you the moment i heard you had another fellowship opening i
there is no opening
house you have to hire someone
i know the position's been filled
dr marks why am i interviewing for a position that's already been filled
exactly
dr marks i called to confirm the interview this morning
you figure if you keep arguing i'm going to cave admit it's all a lie and hire you
do you need your parking validated
i don't want to interview anyone else
you're interviewing i thought you'd just have them send a headshot along with their cv
hah that's good and why i need you around to keep me in my place
i can't come back i told you that
wasn't listening
right
you want me to listen to you more i can do that
right i already accepted a position somewhere else
with who
yule at jefferson
unaccept it
why
because yule is boring he's pedantic and preachy because he's short because i want you to come back
not good enough
want more money a car allowance better parking space
dinner and not just a meal between two colleagues a date
you'll come back to work if i go out on a date with you
yes
okay it's a deal
see you tomorrow morning
don't be late
i won't
house m d 1 20 love hurts
house m d
1x20 love hurts
may 10 2005
written by sara b cooper directed by bryan spicer br transcript written by mari
archived at twiz tv com with permission from house transcripts and more
house and other related entities are owned tm and by heel and toe films and bad hat harry productions in association with nbc universal television all rights reserved this transcript is posted here without their permission approval authorization or endorsement any reproduction duplication distribution or display of this material in any form or by any means is expressly prohibited it is absolutely forbidden to use it for commercial gain
will it be much longer
we'll call you when we're ready
i've been waiting almost an hour
we'll call you when we're ready
i'm sorry
so she's really coming back
who's coming back
you don't know her
you give her a raise increase her benefits
don't have tivo on this thing can't rewind shut up
you lower her hours
you don't even know her
who is this guy
he's a patient
he's examining me
he's got to go back to work as soon as i'm done with the examination guess i do too
it's got to be something i mean she didn't come back because she likes you wait a minute she did come back because she likes you
heh heh you dog you slept with her
keep talking i'll finish your exam with a prostate check i've agreed to take her on one date
what
so you in to this girl
yes
no she's not giving me any choice
wait she's making you do her
date her
young ing nue doctor falling in love with gruff older mentor her sweet gentle nature bringing him to a closer fuller understanding of his wounded heart
do her or you're gay
for god's sake
sitting in a tree k i s s i n g
grow up and learn to harmonize damn it
i'm sorry i'm sorry
who the hell walks around with an open urine sample
i'm sorry i didn't uh i didn't
you think that was a bit of an overreaction
well he peed on me i'm not into that
it's apple juice now go find that man and apologize one more patient complaint and you're looking at a suspension
i forgive you for ruining my jacket look you seem like a regular kind of guy not the type to get another regular guy into trouble am i right twenty bucks cash if you'll stop crying forgive me yell at me just give me something i can work with okay
game's over you two make nice
get a wheelchair and get this guy into the er
what happened
right pupil's blown
holy you gave the guy a stroke
so the bear wipes himself with the rabbit
lame
hey
yo
what are you doing here
i work here
what here in this office
house practically begged me to come back
please tell me you took him to the cleaners
same lousy salary
then why'd you do it
cause this is the happiest place on earth 21 year old male comes in with grinding of the teeth
and house gives him a stroke totally blows out his pupil
you scared a guy into stroking out
does that surprise anyone here
blown pupils usually means brain stem edema
sure but since he's not dead or in a coma i'm going with stroke to the optic nerve ct scan shows two things
ischemia death of brain tissue means there's been some damage hopefully not permanent
and
that's it there's nothing there to tell us what the underlying cause is we've got to do an mri
you're looking at the wrong part of the scan
i'm looking at the brain what else is there
the jaw
the jaw tells us why he stroked
no the jaw tells us why we can't do an mri unless we want his jawbone flying across the room
metal plate he's had major reconstruction and there's no way we're removing it so we're forced to be clever angiogram to rule out vascultis emg for peripheral neuropathy tox screen to eliminate drugs an echo to rule out cardiac emboli dr cameron i'd appreciate you keeping the terms of your new contract to yourself don't want everyone clamoring for the same perks
what perks
nothing you'd be interested in
so it's not money then office space insurance parking anything he could offer you we'd be interested in
he agreed to go on a date with me
a date date dinner and a movie naked and sweaty date
he only committed to the first two
he's so he's so old
and you're so young
it's a big mistake
it's my boss i'm allowed to sexually harass my boss i'll arrange for the emg you want to set up the angiogram and you get the blood samples patient history patient consent
like watching an accident about to happen
morning harvey i'm dr foreman i'm here to discuss your case
i'm annette i'm harvey's friend
nice to meet you i need your next of kin you didn't fill that out on your intake form
harvey's parents are dead they died two years ago in a car crash
i see so harvey you have any siblings
no and no grandparents or uncles or aunts
annette i don't want to have to ask you to leave
i want her to stay
well she can stay you do the talking why'd you come to the clinic this morning
uh about six months ago i started grinding my my you know in your mouth you get you chew with them
teeth harvey's experiencing a little nominal aphasia you know when you can't remember nouns
yeah i think i know what nominal aphasia is have you had any treatment for the teeth grinding
i went to a you know they do that thing with sharp uh pointy things
needles someone took your blood
no they make you breathe
pulmonologist
no she had this uh electrical machine
he saw an acupuncturist
uh huh do you know what the acupuncturist did
she diagnosed liver qi stagnation and sent harvey to a shen balancer he referred him to a homeopathic doctor who sent him to chiropractor
naturally
well the chiropractor thought it might be food sensitivity and sent harvey to a naturopath
the naturopath sent me back to the
back to the acupuncturist
yes
okay well we'll need to see the records from all of those uh practitioners
thanks
everything set for the angiogram
cameron's got the emg first who's that
harvey's guru
that's what she called herself
that's what she acted like
hi i'm having vaginal pain
pleasure to meet you
my ob gyn died recently he's a nice man warm hands
not anymore so does it hurt when you tinkle
yeah it's when it's worse
you have some vaginal tearing no sign of brusing no indication of trauma forced entry ramona you naughty girl you've either got yourself an 18 year old boyfriend or an 80 year old with some little blue pills
myron thought he'd just try them out
lucky you
i guess
prefer it if myron was a little droopier
maybe a little we used to hold hands read together or watch jeopardy i haven't seen jeopardy in almost a month
have you talked to him about this
you try talking a 73 year old out of sex with all these male enhancements the pressure to put out's incredible it's worse than high school he doesn't get what he wants from me he'll get it from connie in the corner condo she's dying her hair red major league slut
here's a prescription for vaginal estrogen suppositories it'll help with the lubrication
thank you maybe you could give myron a prescription something weaker than he's got now tell him it's better for his heart he'd buy that
you can't tell him the truth so you want me to lie to him
would you
close your legs
nerves stimulate muscles to move by creating a small electrical current the machine will measure that and i will insert this needle into various muscles and ask you to flex sometimes it can be painful let me know and i can pull back
no i mean it's okay
okay put your arm out to the side you all right
i'm good you don't have to stop
raise your arm up over your head
the emg was clean
well based on this history it's either toxic herbs from the homeopath spinal damage from the chiropractor infection from the needle that the acupuncturist accidentally let sit in eye of newt or the shen balancer what the hell is a shen and how come it's lopsided
the only abnormal test result we found was on the echo report mitral valve prolapse
hang up a shingle and condemn the narrowness and greed of western medicine you'd make a damn fine living
clot's formed on a faulty valve gets sent to the brain voila stroke
of course no harm no foul it's just taking a few bucks from superstitious idiots right
could also be an aneurysm due to trauma
trauma from what the chiropractic treatments it's bacterial endocarditis an infected valve we should do blood cultures
except the six months that he had with these charlatans might have been spent going to someone who looks at things that exist in the real world but that's just me being all narrow again
i noticed a small bruit when i listened to harvey's left carotid you could hear that if you had an aneurysm from trauma
aneurysm would have shown on the angiogram
no not necessarily
hmm quite a dilemma oh great pool hall oracle grant me guidance do we go with foreman's theory which is at least marginally supported by medical test results or chase's theory which is completely unsupported by medical evidence what to do
the guy obviously broke his jaw somehow who knows what other trauma he's suffered we should do the angiogram again
and all signs point to sorry chase the gods have spoken start harvey on blood thinners and antibiotics
wow yeah i get it house is adorable i just want to hold him and never let go
oh my god what the hell are you doing
you're choking him
foreman stop let her go
she was trying to kill him
no no she wasn't
his vitals seem okay
please please don't hurt her
what the hell is going on in here
she's she's a dominatrix right annette
the patient asked you to strangle him
harvey is an asphyxiaphyliac he likes to be strangled or smothered
that's just sick
well that's an intriguing legal opinion geez what kind of a lawyer is he
you want a legal opinion call the cops
i was careful i watched the monitors made sure his o2 stats were over 90 i would never hurt him
then what was the point
harvey was upset he needed to calm down to feel in control by being controlled
eh um he pays you for this
in return he does my taxes and cleans my house
we're not done here we have to talk
call the cops bar her from the hospital force her to pierce your nipples not really medical decisions
it was a long time ago i was seeing this woman a banker and turns out she liked to be burned
you actually dated someone who likes to get burned
yeah why would you want to be in a