1 00:00:03,003 --> 00:00:05,971 On your right. On your right. On your right. 2 00:00:06,039 --> 00:00:08,132 Back, back, back, back, back. Come on, buddy. 3 00:00:11,745 --> 00:00:14,077 Yeah, Dan! Yeah! 4 00:00:14,147 --> 00:00:15,876 Yea! Yea! 5 00:00:15,949 --> 00:00:19,282 Back, back, back, back, back. Watch the winger! 6 00:00:31,264 --> 00:00:33,425 Yeah! 7 00:00:56,856 --> 00:00:58,847 You okay? 8 00:00:58,925 --> 00:01:00,984 Dan? Dan, talk to me. 9 00:01:01,061 --> 00:01:03,757 Dan. Dan. 10 00:01:03,830 --> 00:01:06,663 Get a doctor! 11 00:01:46,239 --> 00:01:48,537 - Hey. - Close the door. 12 00:01:48,608 --> 00:01:51,168 Close the door. 13 00:01:53,913 --> 00:01:57,007 Is Cuddy down the hall counting to 50? 14 00:01:57,083 --> 00:01:59,916 She knows I'm in here, in the clinic, as she commanded. 15 00:01:59,986 --> 00:02:03,217 - She just doesn't know I'm alone. - Well, you've got a full waiting room. 16 00:02:03,289 --> 00:02:06,019 - How long do you think you can ignore them? - I'm off at 4:00. 17 00:02:07,760 --> 00:02:10,024 You're doing this to avoid five minutes of work? 18 00:02:10,096 --> 00:02:12,724 If I go out there, I get assigned a kid with a runny nose. 19 00:02:12,799 --> 00:02:16,030 That's 30 seconds looking at the nose, 25 minutes talking to a worried mom... 20 00:02:16,102 --> 00:02:18,900 who won't leave until she's sure it's not meningitis or a tumor. 21 00:02:18,972 --> 00:02:21,338 Yes. Concerned parents can be so annoying. 22 00:02:21,407 --> 00:02:25,036 Just tell Cuddy you've got an urgent case. You had to leave early. That would be lying. 23 00:02:25,111 --> 00:02:30,014 And that would be wrong. But luckily the definition of "urgent" is fungible. 24 00:02:30,083 --> 00:02:32,711 Not the definition of "case" though. 25 00:02:36,122 --> 00:02:38,886 You have no cases? 26 00:02:38,958 --> 00:02:41,017 You have no cases? 27 00:02:41,094 --> 00:02:44,825 You've got handpicked doctors-- specialists-- 28 00:02:44,898 --> 00:02:47,799 working for you, and they're sitting on their hands? 29 00:02:47,867 --> 00:02:51,701 - Cameron's answering my mail. - Oh, time well spent, I'm sure. 30 00:02:51,771 --> 00:02:53,762 Foreman and Chase? 31 00:02:53,840 --> 00:02:55,831 Research? 32 00:03:02,515 --> 00:03:05,245 Nine letters. Iodine deficiency in children. 33 00:03:05,318 --> 00:03:07,479 Cretinism. 34 00:03:16,863 --> 00:03:19,764 So, 4:03 p.m., Dr. House checks out. 35 00:03:19,832 --> 00:03:21,766 Please write that down. 36 00:03:21,834 --> 00:03:24,029 Dr. House. Sorry. Done for the day. 37 00:03:24,103 --> 00:03:27,004 Plenty of docs here to take care of you. But we had an appointment. 38 00:03:27,073 --> 00:03:30,406 Nice try, but this is a walk-in clinic, which means there are no appointments. 39 00:03:30,476 --> 00:03:32,706 You walk in, sign the chart, and a doctor will see you. 40 00:03:32,779 --> 00:03:36,271 Just not me. Your letter says that we'd see you. 41 00:03:37,317 --> 00:03:39,717 Not a big letter writer. Here. 42 00:03:42,288 --> 00:03:45,780 When did my signature get so girlie? 43 00:03:45,858 --> 00:03:48,053 - I can explain. - See that "G"? 44 00:03:48,127 --> 00:03:50,561 See how it makes a big loop on top? 45 00:03:50,630 --> 00:03:53,997 Doesn't even look like my handwriting. Think I have something? 46 00:03:54,067 --> 00:03:57,468 What's the differential diagnosis for writing G's like a junior high school girl? 47 00:03:57,537 --> 00:04:01,268 It's impossible to get to you through normal channels. They have called, e-mailed. 48 00:04:01,341 --> 00:04:03,292 Perseverance does not equal worthiness. Next time 49 00:04:03,293 --> 00:04:05,243 you want to get my attention, wear something fun. 50 00:04:05,311 --> 00:04:07,279 Low-rider jeans are hot. 51 00:04:07,347 --> 00:04:09,878 Sixteen-year-old male. Sudden onset of double 52 00:04:09,879 --> 00:04:12,410 vision and night terrors, with no apparent cause. 53 00:04:12,485 --> 00:04:14,953 The kid's been to two neurologists, and he-- Night terrors? 54 00:04:15,021 --> 00:04:17,819 - As in big scary monsters? - Yes. 55 00:04:20,660 --> 00:04:24,152 - Where are you going? - To see the family. 56 00:04:24,230 --> 00:04:26,260 - You're going to examine a patient? - Nine times 57 00:04:26,261 --> 00:04:28,291 out of 10, there's no reason to talk to a patient. 58 00:04:28,368 --> 00:04:32,202 But night terrors in a 16-year-old is a very good reason to talk to this family. 59 00:04:32,272 --> 00:04:34,206 Good work. 60 00:04:37,176 --> 00:04:39,110 Margins are fine. 61 00:04:39,178 --> 00:04:41,112 No lesions. 62 00:04:42,348 --> 00:04:44,646 Color is good. 63 00:04:44,717 --> 00:04:48,050 How long have you been having night terrors? Three weeks. 64 00:04:48,121 --> 00:04:51,318 He's afraid to go to bed. He's exhausted, can barely function. 65 00:04:53,393 --> 00:04:56,885 - What does that tell you? - Nothing. It's just fun watching him blink. 66 00:04:56,963 --> 00:05:00,455 Name as many animals as you can that begin with the letter "B". Go. 67 00:05:07,206 --> 00:05:11,302 - Baby elephant? - Baby elephant is actually a good answer. 68 00:05:11,377 --> 00:05:13,902 - "B" is a bear of a letter. - What does that tell you? 69 00:05:13,980 --> 00:05:18,007 Proves two things: no neurological damage, and your son is never gonna be chief fry cook. 70 00:05:18,084 --> 00:05:21,815 In teens, there are two likely causes of night terrors. 71 00:05:21,888 --> 00:05:25,585 - Posttraumatic stress. Any recent shoot-outs at your high school? - No. 72 00:05:25,658 --> 00:05:26,886 - Then, Dave-- - Dan. 73 00:05:26,959 --> 00:05:31,020 If there's no trauma, the other cause is... sexual abuse. 74 00:05:33,733 --> 00:05:37,169 So who's molesting you? Teacher? 75 00:05:37,236 --> 00:05:40,228 Extra-friendly neighbor? I'd ask if either of you were involved, but you'd deny it. 76 00:05:40,306 --> 00:05:42,035 We would never hurt Dan. 77 00:05:42,108 --> 00:05:44,508 I say it here, it comes out there. 78 00:05:44,577 --> 00:05:47,068 This lack of response is consistent with abuse. 79 00:05:47,146 --> 00:05:49,944 There's no one, okay? I-- I swear. 80 00:05:50,016 --> 00:05:53,110 There was trauma. I got hit in the head during a lacrosse game. 81 00:05:54,954 --> 00:05:58,321 Did you know that he got hit in the head? 82 00:05:58,391 --> 00:06:01,918 - They didn't mention it. No. - Yeah. Why bother? 83 00:06:04,831 --> 00:06:07,356 No, no. We took him to the E.R. after the game. 84 00:06:07,433 --> 00:06:09,958 He was scanned. They tested him. They said he was fine. 85 00:06:10,036 --> 00:06:11,970 No concussion. It's gotta be something else. 86 00:06:12,038 --> 00:06:15,530 You hound me for my opinion, and then you question my diagnosis. 87 00:06:15,608 --> 00:06:19,009 Cool. E.R. obviously screwed up. Kid's got a concussion. 88 00:06:19,078 --> 00:06:22,206 I had double vision before I was hit. Well, that changes everything. 89 00:06:22,281 --> 00:06:25,079 You need glasses. That's why you had double vision, 90 00:06:25,151 --> 00:06:27,500 which is why you got hit, which is why you have a 91 00:06:27,501 --> 00:06:29,850 concussion, which is why you have night terrors. 92 00:06:29,922 --> 00:06:32,948 You need to see an ophthalmologist, which I am not. 93 00:06:33,025 --> 00:06:35,710 You enjoyed that. I brought a reasonable case to your 94 00:06:35,711 --> 00:06:38,395 attention, and you shoved it in my face just to humiliate me. 95 00:06:38,464 --> 00:06:41,331 You're an only child, aren't you? Why would you say that? 96 00:06:41,401 --> 00:06:43,130 Because everything is about you. 97 00:06:44,270 --> 00:06:48,570 This may seem incredibly controversial, but I think sexual abuse is bad. 98 00:06:48,641 --> 00:06:51,633 I just wanted to make sure he wasn't being diddled by Daddy-- or Mommy. 99 00:06:51,711 --> 00:06:53,736 Anything else is just a bonus. 100 00:07:04,657 --> 00:07:07,990 I'm not an only child. Interesting. 101 00:07:08,060 --> 00:07:10,324 What? Don't move. 102 00:07:11,097 --> 00:07:15,033 - Did I bore you in there? - What? Uh, no. Not-- Not really. 103 00:07:15,101 --> 00:07:17,467 Are you tired? 104 00:07:17,537 --> 00:07:19,596 - Sometimes. - He never sleeps. Ofcourse he's tired. 105 00:07:19,672 --> 00:07:22,140 - Right now. At this moment. Are you tired? - No. No. 106 00:07:22,208 --> 00:07:24,438 That twitch in your leg. Did you feel that? 107 00:07:25,812 --> 00:07:28,042 - Didn't hurt. - His leg twitched. I don't see what-- 108 00:07:28,114 --> 00:07:31,880 It's called a myoclonic jerk. It's very common when you're falling asleep. 109 00:07:31,951 --> 00:07:34,636 Respiration rate falls, and the brain sometimes interprets 110 00:07:34,637 --> 00:07:37,321 this as the body dying, so it sends a pulse to wake it up. 111 00:07:37,390 --> 00:07:39,585 - So? - So, he's not asleep. 112 00:07:39,659 --> 00:07:42,389 He's awake. 113 00:07:42,462 --> 00:07:44,453 Admit him. 114 00:07:47,467 --> 00:07:50,868 I recognize that loopy "G". 115 00:07:50,937 --> 00:07:52,928 So, what does the jerk tell us? 116 00:07:53,005 --> 00:07:55,303 Nothing good. The brain's losing control of the body. 117 00:07:55,374 --> 00:07:59,140 Can't order the eyes to focus, regulate sleep patterns or control muscles. 118 00:07:59,212 --> 00:08:01,237 A movement disorder or a degenerative brain disease. 119 00:08:01,314 --> 00:08:04,841 Either way, this kid's gonna be picking up his diploma in diapers and a wheelchair. 120 00:08:04,917 --> 00:08:06,885 Maybe not that bad. Could be an infection. 121 00:08:06,953 --> 00:08:08,978 You wish. No fever, no white count. 122 00:08:09,055 --> 00:08:11,774 Anyone think this differential diagnosis might be compromised 123 00:08:11,775 --> 00:08:14,493 because we don't have an accurate family history? 124 00:08:14,560 --> 00:08:17,825 - I took an accurate family history. - You didn't even take an accurate family. 125 00:08:18,764 --> 00:08:20,994 - His father's not his father. - Why would you say that? 126 00:08:21,067 --> 00:08:24,127 Thirty percent of all dads don't realize they're raising someone else's kid. 127 00:08:24,203 --> 00:08:27,331 False paternity's more like 10%. That's what our moms would like us to believe. 128 00:08:27,406 --> 00:08:29,897 Who cares? If he got it from his parents, they'd both be dead. 129 00:08:29,976 --> 00:08:32,842 - Can we get on with the differential diagnosis? - Fifty bucks says I'm right. 130 00:08:32,912 --> 00:08:35,472 - I'll take your money. - Hit a nerve? 131 00:08:35,548 --> 00:08:39,006 - Don't worry. I'm sure the guy who tucked you in was your daddy. - Make it a hundred. 132 00:08:39,085 --> 00:08:42,885 What about leukoencephalopathy in a 16-year-old? 133 00:08:42,955 --> 00:08:45,253 It doesn't necessarily have to be that bad. 134 00:08:45,324 --> 00:08:48,350 If we exclude the night terrors, it could be something systemic. 135 00:08:48,427 --> 00:08:50,952 - His liver, kidneys. Something outside the brain. - Yes. 136 00:08:51,030 --> 00:08:52,895 - Feel free to exclude any symptom if it makes 137 00:08:52,896 --> 00:08:54,761 your job easier. - Night terrors were anecdotal. 138 00:08:54,834 --> 00:08:57,200 - He could've had a bad dream. - No. Parents said he was 139 00:08:57,201 --> 00:08:59,567 conscious during and didn't remember anything afterwards. 140 00:08:59,639 --> 00:09:01,573 - That's a night terror. - Parents said? 141 00:09:01,641 --> 00:09:03,734 That's a good point. 142 00:09:03,809 --> 00:09:07,074 Before we condemn this kid, maybe we should entertain Dr. Chase's skepticism. 143 00:09:07,146 --> 00:09:12,209 I want a detailed polysomnograph. If he's having night terrors, I want to see them. 144 00:09:34,740 --> 00:09:36,935 I usually don't move during night terrors. 145 00:09:37,009 --> 00:09:38,943 I'm not restraining you for them. 146 00:09:41,814 --> 00:09:45,045 E.E.G. revealed abnormalities in your brain-- 147 00:09:45,117 --> 00:09:47,483 caused nerve damage in your toes. 148 00:09:54,160 --> 00:09:57,288 What are you doing? 149 00:09:57,363 --> 00:10:00,457 - Fixing it. - Can I talk to my parents? 150 00:10:00,533 --> 00:10:02,592 Oh, they know all about this. 151 00:10:02,668 --> 00:10:05,193 I'd really like to see them. 152 00:10:13,713 --> 00:10:17,114 Please. I'd really like them here. 153 00:10:18,884 --> 00:10:20,875 This is gonna hurt, Dan. 154 00:10:20,953 --> 00:10:22,944 Oh. Oh, God. 155 00:10:39,772 --> 00:10:42,297 That's a night terror. 156 00:10:52,451 --> 00:10:56,615 We did a C. T., M.R.I., C.B.C., CHEM-7 and chest X-ray. 157 00:10:56,689 --> 00:10:59,749 All the tests came back normal. There's nothing to explain his symptoms. 158 00:10:59,825 --> 00:11:01,742 Okay, but let's pretend there's something and go 159 00:11:01,743 --> 00:11:03,659 from there. Who sees something on this M.R.I.? 160 00:11:05,831 --> 00:11:08,629 No lesions in the white matter. No structural abnormalities. 161 00:11:08,701 --> 00:11:10,669 No space-occupying tumors. 162 00:11:10,736 --> 00:11:15,673 He's 16, so he should have an absolutely pristine brain. The smallest thing is abnormal. 163 00:11:16,976 --> 00:11:19,342 Meningeal enhancement. 164 00:11:19,412 --> 00:11:21,972 - My bet is viral meningitis. - Excellent. 165 00:11:22,048 --> 00:11:23,982 Do you see what he did there? 166 00:11:24,050 --> 00:11:27,816 Took a small clue that there's a neurological problem and wasn't afraid to run with it. 167 00:11:27,887 --> 00:11:30,355 There's no evidence of meningitis on that M.R.I. 168 00:11:30,423 --> 00:11:32,323 No, there's not. He's completely wrong. 169 00:11:32,391 --> 00:11:34,416 Then what clue are you talking about? 170 00:11:34,493 --> 00:11:36,893 He knew that I saw something on the M.R.I., so he 171 00:11:36,894 --> 00:11:39,294 figured there must be something there and took a guess. 172 00:11:39,365 --> 00:11:42,857 - Clever, but also pathetic. - So what did you find? 173 00:11:42,935 --> 00:11:45,927 Take a close look at the corpus callosum. 174 00:11:48,574 --> 00:11:52,010 - Looks okay. - Are we all looking at the same thing? 175 00:11:52,078 --> 00:11:54,546 Two hundred million interhemispheric nerve fibers. 176 00:11:54,613 --> 00:11:57,673 The George Washington Bridge between the left and right side of the brain. 177 00:11:59,418 --> 00:12:02,046 It's subtle. 178 00:12:04,123 --> 00:12:06,455 There's some bowing. There. 179 00:12:06,525 --> 00:12:08,516 An upward arch. Are you guessing? 180 00:12:08,594 --> 00:12:10,494 Yes. 181 00:12:10,563 --> 00:12:14,329 - Too bad. You're right. - He probably just moved. 182 00:12:14,400 --> 00:12:16,994 Nobody stays perfectly still for the entire M.R.I. 183 00:12:17,069 --> 00:12:19,816 Yeah. Probably got restless and shifted one hemisphere 184 00:12:19,817 --> 00:12:22,564 of his brain to a more comfortable position. 185 00:12:22,641 --> 00:12:25,906 Something is pushing on it. If there was bowing, could be a tumor. 186 00:12:25,978 --> 00:12:29,436 Do you see a tumor on this M.R.I.? No, but I don't see any bowing either. 187 00:12:29,515 --> 00:12:33,042 There's no tumor. Just a blockage causing pressure causing symptoms. 188 00:12:33,119 --> 00:12:36,555 Today, night terrors. Tomorrow, he's bleeding out of his eyes. 189 00:12:36,622 --> 00:12:41,389 Get him a radionucleotide cisternogram. I guarantee you'll see a blockage. 190 00:12:47,299 --> 00:12:49,290 Okay. 191 00:12:52,138 --> 00:12:53,867 Easy. 192 00:12:53,939 --> 00:12:56,203 Okay. Squeeze my hand. 193 00:13:00,012 --> 00:13:02,105 All right. Squeeze hard. 194 00:13:04,683 --> 00:13:06,617 All right. 195 00:13:12,825 --> 00:13:16,090 Now I'm injecting a material that's tagged with a radioisotope. 196 00:13:16,162 --> 00:13:19,996 It's gonna enter your spine and travel up to your brain. 197 00:13:20,065 --> 00:13:23,967 It'll make you able to think deep thoughts, 198 00:13:24,036 --> 00:13:25,970 run a hundred miles an hour. 199 00:13:27,239 --> 00:13:29,503 Easy. 200 00:13:42,354 --> 00:13:45,414 Their eyes aren't the same color, but that fleck in the eyes-- 201 00:13:45,491 --> 00:13:48,517 That's maybe a one-in-10 chance if they're not related? 202 00:13:48,594 --> 00:13:50,994 No. House isn't gonna pay you based on that. 203 00:13:51,063 --> 00:13:54,931 Any excuse we can give the folks to justify a D.N.A. test? 204 00:13:55,000 --> 00:13:59,130 We could tell them he's got Huntington's-- whole family should be tested or they'll all die. 205 00:14:02,675 --> 00:14:04,609 Hey. 206 00:14:04,677 --> 00:14:08,545 There's a lot of blockage. I've scheduled him for surgery. 207 00:14:08,614 --> 00:14:10,531 We're gonna put a shunt into one of the ventricles 208 00:14:10,532 --> 00:14:12,448 to give the cerebrospinal fluid an out. 209 00:14:12,518 --> 00:14:15,146 No more pressure, everything goes back to normal. 210 00:14:15,221 --> 00:14:18,156 He's lucky to have you as his doctors. 211 00:14:26,866 --> 00:14:29,858 No formula. Just Mommy's healthy, natural breast milk. 212 00:14:29,935 --> 00:14:31,630 Yummy. 213 00:14:31,704 --> 00:14:34,798 Her whole face just got swollen like this overnight. 214 00:14:34,874 --> 00:14:37,104 Mm-hmm. 215 00:14:38,110 --> 00:14:40,442 No fever. 216 00:14:40,512 --> 00:14:43,345 Glands normal. Missing her vaccination dates. 217 00:14:43,415 --> 00:14:46,077 We're not vaccinating. 218 00:14:47,152 --> 00:14:49,643 Gribbet! Gribbet! 219 00:14:49,722 --> 00:14:51,246 Gribbet! 220 00:14:51,323 --> 00:14:53,018 Think they don't work? 221 00:14:53,092 --> 00:14:56,391 I think some multinational pharmaceutical company wants me to think they work-- 222 00:14:56,462 --> 00:14:59,693 pad their bottom line. Mm-hmm. 223 00:14:59,765 --> 00:15:02,063 - May I? - Sure. 224 00:15:03,068 --> 00:15:05,730 Gribbet. Gribbet. 225 00:15:05,804 --> 00:15:08,102 Gribbet. 226 00:15:08,173 --> 00:15:11,074 Yeah. All-natural, no dyes is a good business. 227 00:15:11,143 --> 00:15:13,270 All-natural children's toys. 228 00:15:13,345 --> 00:15:15,836 Toy companies-- they don't arbitrarily mark up their frogs. 229 00:15:15,915 --> 00:15:18,941 They don't lie about how much they spend on research and development. 230 00:15:19,018 --> 00:15:24,615 The worst that a toy company could be accused of is making a really boring frog. 231 00:15:24,690 --> 00:15:27,523 Gribbet, gribbet, gribbet. 232 00:15:27,593 --> 00:15:30,426 You know another really good business? 233 00:15:30,496 --> 00:15:32,726 Teeny, tiny baby coffins. 234 00:15:34,033 --> 00:15:36,297 You can get 'em in frog green, 235 00:15:36,368 --> 00:15:38,802 fire-engine red-- really. 236 00:15:38,871 --> 00:15:43,103 The antibodies in yummy Mummy only protect the kid for six months, 237 00:15:43,175 --> 00:15:45,769 which is why these companies think they can gouge you. 238 00:15:45,844 --> 00:15:49,575 They think that you'll spend whatever they ask to keep your kid alive. 239 00:15:49,648 --> 00:15:51,673 Want to change things? Prove 'em wrong. 240 00:15:51,750 --> 00:15:54,048 Few hundred parents like you decide they'd rather let 241 00:15:54,049 --> 00:15:56,346 their kid die than cough up 40 bucks for a vaccination, 242 00:15:56,422 --> 00:15:58,913 believe me, prices will drop really fast. 243 00:15:58,991 --> 00:16:01,926 Gribbet, gribbet, gribbet, gribbet, gribbet. 244 00:16:01,994 --> 00:16:03,393 Gribbet. 245 00:16:03,462 --> 00:16:05,293 Tell me what she has. 246 00:16:08,434 --> 00:16:10,959 A cold. 247 00:16:11,036 --> 00:16:13,129 There's a problem. 248 00:16:13,205 --> 00:16:16,333 Complications in surgery? Surgery went fine. He's in recovery. 249 00:16:16,408 --> 00:16:18,740 But we took a vial of C.S.F. and tested it. Really? 250 00:16:18,811 --> 00:16:21,780 Turns out the bowing wasn't the cause of his problems. It was a symptom. 251 00:16:21,847 --> 00:16:23,940 Oligoclonal bands and increased intrathecal IgG. 252 00:16:24,016 --> 00:16:28,180 Which means multiple sclerosis. And the reason it takes three of you to tell me this? 253 00:16:28,253 --> 00:16:30,983 Because we're having a disagreement about whether or not it is M.S. 254 00:16:31,056 --> 00:16:34,617 No lesions on the M.R.I. It's early. He's had the disease for maybe two weeks. 255 00:16:34,693 --> 00:16:36,558 - McDonald criteria requires six months to make a 256 00:16:36,559 --> 00:16:38,424 definitive diagnosis. - Who cares about MacPhearson? 257 00:16:38,497 --> 00:16:40,431 - I hear he tortured kittens. - McDonald. 258 00:16:40,499 --> 00:16:42,990 Oh, McDonald. Wonderful doctor, loved kittens. 259 00:16:43,068 --> 00:16:45,036 The V.E.P. indicates slowing of the brain. 260 00:16:45,104 --> 00:16:47,072 Without the lesions, we can't be sure. 261 00:16:47,139 --> 00:16:49,573 Well, if it is, it's gone from zero to 60 in three weeks, 262 00:16:49,641 --> 00:16:51,609 which would indicate rapidly progressive M.S. 263 00:16:51,677 --> 00:16:55,010 Not the fun M.S. with the balloons and the bike rides for cripples in wheelchairs. 264 00:16:55,080 --> 00:16:58,208 - We should wait until-- - Start treating him now, 265 00:16:58,283 --> 00:17:02,549 maybe he can walk for another couple of years, maybe live for another five. 266 00:17:02,621 --> 00:17:05,146 Break it to the family. I'm going home. 267 00:17:05,223 --> 00:17:09,285 It'll take months for a definitive diagnosis. What'll happen to me? 268 00:17:10,963 --> 00:17:13,227 M.S. is an incredibly variable disease. 269 00:17:13,298 --> 00:17:16,699 If it is M.S., and we're not a hundred percent sure. 270 00:17:16,769 --> 00:17:19,237 What do you think is gonna happen? 271 00:17:22,574 --> 00:17:24,872 There are some medications to manage the symptoms, 272 00:17:24,943 --> 00:17:28,069 but as the disease progresses, the problems will become more severe. 273 00:17:28,146 --> 00:17:30,479 Bowel and bladder dysfunction, 274 00:17:30,549 --> 00:17:33,143 loss of cognitive function, pain-- 275 00:17:33,218 --> 00:17:35,709 So it's gonna hurt? 276 00:17:36,922 --> 00:17:39,356 The brain's like a big jumble of wires. 277 00:17:39,425 --> 00:17:41,985 M.S. strips them of the insulation, and the nerves die. 278 00:17:42,061 --> 00:17:44,689 Brain interprets it as pain. 279 00:17:44,763 --> 00:17:48,028 But by starting treatment, we're gonna prevent that for as long as possible. 280 00:17:49,034 --> 00:17:50,968 We're looking into a couple of specialists, 281 00:17:51,036 --> 00:17:54,563 and until we get you squared away, you'll stay here, okay? 282 00:18:15,260 --> 00:18:17,751 Security checked the videotapes from all perimeter cameras. 283 00:18:17,830 --> 00:18:20,060 He's still gotta be in the hospital. Where's Chase? 284 00:18:20,132 --> 00:18:22,692 Main floor. Okay. You take the cafeteria and administration. 285 00:18:22,768 --> 00:18:25,362 I'll hit the research annex and work my way back to you. 286 00:19:02,708 --> 00:19:04,699 Dan? 287 00:19:08,947 --> 00:19:11,814 I'm not here. Leave a message. 288 00:19:18,157 --> 00:19:20,955 Dr. Cuddy. Great outfit. 289 00:19:21,026 --> 00:19:23,290 What are you doing back here? Patient? 290 00:19:23,362 --> 00:19:26,854 No. Hooker. Went to my office instead of my home. 291 00:19:37,242 --> 00:19:39,676 Dr. House. 292 00:19:39,745 --> 00:19:42,543 Dan's missing. Yeah. I got that part from the message. 293 00:19:42,614 --> 00:19:45,845 You said I was needed immediately. He shouldn't move after a lumbar puncture. 294 00:19:45,918 --> 00:19:48,614 I agree. He's gonna have a very nasty headache. 295 00:19:48,687 --> 00:19:51,815 That would also be my opinion if consulted tomorrow morning. 296 00:19:51,890 --> 00:19:55,053 We wanted to keep you informed. He heard some pretty heavy news. 297 00:19:56,895 --> 00:19:59,591 This is not a toddler wandering around a department store. 298 00:19:59,665 --> 00:20:02,862 He's 16. You'll find him. 299 00:20:02,935 --> 00:20:04,869 I'm going home. 300 00:20:04,937 --> 00:20:07,906 So when you say, "Call me if you need anything", you mean don't call? 301 00:20:07,973 --> 00:20:10,203 No, I mean call me if I could do something. 302 00:20:10,275 --> 00:20:14,405 I'm bad at search parties, and I'm bad at sitting around looking nervous, doing nothing. 303 00:20:14,479 --> 00:20:16,504 What about his parents? Should we call them? 304 00:20:16,582 --> 00:20:18,982 Why? Do you think they're hiding him? 305 00:20:19,051 --> 00:20:21,019 Make sure someone checks the roof. 306 00:20:22,087 --> 00:20:25,887 Some of the orderlies keep the door propped open so they can grab a smoke. 307 00:21:00,425 --> 00:21:03,292 Dan. You okay? 308 00:21:10,035 --> 00:21:13,766 There are experimental treatments. Ongoing research. 309 00:21:13,839 --> 00:21:16,239 Who knows what they'll discover in a year or two. 310 00:21:16,308 --> 00:21:18,276 This is where I dropped the ball. 311 00:21:18,343 --> 00:21:20,868 Dan, we're standing on the roof of the hospital. 312 00:21:23,548 --> 00:21:25,539 Dan. 313 00:21:25,617 --> 00:21:27,642 Dan, you're not on the field. 314 00:21:27,719 --> 00:21:29,880 He doesn't know where he is. Dan. 315 00:21:29,955 --> 00:21:31,320 Foreman. 316 00:21:32,524 --> 00:21:34,287 Dan. 317 00:21:35,527 --> 00:21:37,461 - Dan? - Dan, no! 318 00:21:48,140 --> 00:21:50,631 Dr. Foreman. 319 00:21:52,277 --> 00:21:54,268 I assume you found the kid. 320 00:21:54,346 --> 00:21:56,940 He almost walked off the roof. Suicidal? 321 00:21:57,015 --> 00:22:00,883 No, he thought he was on his lacrosse field. Look, I was gonna run home, shower, change-- 322 00:22:00,952 --> 00:22:02,886 Conscious? Yeah. 323 00:22:03,955 --> 00:22:06,549 How'd you talk him down? Actually, Chase tackled him. 324 00:22:06,625 --> 00:22:08,559 How come you didn't do it? 325 00:22:08,627 --> 00:22:11,061 Right. Well, I am black, but he was closer. 326 00:22:13,632 --> 00:22:15,623 Come on. You can ride up with me. 327 00:22:22,307 --> 00:22:26,038 Anybody tell the family that their boy almost stepped off a roof? They must be thrilled. 328 00:22:26,111 --> 00:22:28,306 They're not suing, but I think only because Chase asked-- 329 00:22:28,380 --> 00:22:30,905 Why does everybody always think I'm being sarcastic? 330 00:22:30,982 --> 00:22:33,177 This is great news. He doesn't have M.S. 331 00:22:33,251 --> 00:22:36,948 Parents should be thrilled. The mom anyway. Ofcourse, the dad probably doesn't know-- 332 00:22:37,022 --> 00:22:41,322 - Why doesn't he have M.S.? - He was on the roof, thinking he was on a lacrosse field. 333 00:22:41,393 --> 00:22:45,261 - Conscious, and therefore not a night terror. You want some of this? - Yeah, sure. 334 00:22:45,330 --> 00:22:47,423 He was in an acute confusional state, 335 00:22:47,499 --> 00:22:50,297 which doesn't fit with a demyelinating disease like M.S. 336 00:22:50,369 --> 00:22:52,428 Oligoclonal bands-- Were real. 337 00:22:52,504 --> 00:22:56,031 They just mean something other than M.S. So, what are they telling us? 338 00:22:56,108 --> 00:22:58,099 That the immune system is working? Right. 339 00:22:58,176 --> 00:23:00,303 He has an infection in his brain. 340 00:23:00,379 --> 00:23:02,370 What about sex? 341 00:23:02,447 --> 00:23:05,678 Well, it might get complicated. I mean, we work together. 342 00:23:05,751 --> 00:23:08,811 - I'm older, certainly, but maybe you like that. - I meant maybe he has neurosyphilis. 343 00:23:08,887 --> 00:23:12,653 - Huh. Nice cover. - Sorry. R.P.R. was negative. 344 00:23:12,724 --> 00:23:16,182 We don't need a definitive test to confirm. Sure. Didn't need one to confirm M.S. 345 00:23:16,261 --> 00:23:20,755 Okay. Let's wait for you to run titers on 1,400 viruses while this kid's brain turns to mush. 346 00:23:20,832 --> 00:23:24,427 So the fact that he doesn't have M.S., it's-- it's really not good news after all. 347 00:23:24,503 --> 00:23:26,630 Well, it is if it's neurosyphilis. 348 00:23:26,705 --> 00:23:29,765 The likelihood of a false negative on an R.P.R. test: 30%. 349 00:23:29,841 --> 00:23:33,333 Likelihood of a 16-year-old having sex: roughly 120%. 350 00:23:33,412 --> 00:23:35,846 I'll start him on I.V. penicillin. We're not gonna wait for that. 351 00:23:35,914 --> 00:23:39,441 The most effective way to deliver the drug is right into his brain via the spine. 352 00:23:39,518 --> 00:23:41,452 We can't. In a cramped space like the brain, 353 00:23:41,520 --> 00:23:43,403 increased intracranial pressure from a high-volume 354 00:23:43,404 --> 00:23:45,286 drug like penicillin could herniate his brain stem. 355 00:23:45,357 --> 00:23:48,383 It'd kill him. No neurologist in his right mind would recommend that. 356 00:23:48,460 --> 00:23:51,293 Show of hands. Who thinks I'm not in my right mind? 357 00:23:51,363 --> 00:23:55,231 And who thinks I forget this fairly basic neurological fact? 358 00:23:55,300 --> 00:23:57,530 Who thinks there's a third option? 359 00:23:59,604 --> 00:24:03,540 - Very good. What's the third choice? - No idea. You just asked if I thought there was one. 360 00:24:07,345 --> 00:24:10,439 The patient has a shunt in his brain. There'll be no increased pressure. 361 00:24:10,515 --> 00:24:13,040 We can put as much penicillin into his body as we want. 362 00:24:13,118 --> 00:24:16,053 Excellent. Inject him through a lumbar puncture. 363 00:24:18,957 --> 00:24:22,085 One of us is gonna do this to you twice a day for the next two weeks. 364 00:24:24,896 --> 00:24:27,660 - I'm ready. Go. - He could get syphilis... 365 00:24:27,732 --> 00:24:30,326 even if he's not sexually active? 366 00:24:31,403 --> 00:24:34,804 Well, it's-- it's unusual, but it's possible. 367 00:24:35,807 --> 00:24:37,798 Okay. Relax. 368 00:24:50,589 --> 00:24:53,752 It's infected, with a really big hole, 369 00:24:53,825 --> 00:24:56,191 like you stuck a nail in it to relieve the pressure. 370 00:24:56,261 --> 00:24:59,253 I wouldn't do that. Although the wound is irregular. 371 00:24:59,331 --> 00:25:02,596 It's not cylindrical. It's shaped like a triangle. So, not a nail. 372 00:25:02,667 --> 00:25:04,726 - Steak knife? - Wife's nail file. 373 00:25:04,803 --> 00:25:07,294 Nail file. 374 00:25:07,372 --> 00:25:09,431 Yeah. Pain will make you do stupid things. 375 00:25:10,509 --> 00:25:13,535 - Something to take the edge off? - Yeah. 376 00:25:15,680 --> 00:25:17,671 Cheers. 377 00:25:21,486 --> 00:25:24,512 So, you have family here in Princeton? 378 00:25:24,589 --> 00:25:27,319 No. Here on work? 379 00:25:27,392 --> 00:25:29,587 - No. Why are you-- - Does your penis hurt? 380 00:25:29,661 --> 00:25:31,822 No. What? Should it? 381 00:25:31,897 --> 00:25:35,424 No. Just thought I'd toss you a really inappropriate question. 382 00:25:35,500 --> 00:25:39,630 - Your lawyer's gonna love it. - Why would I want to sue you? I want you to treat me. 383 00:25:39,704 --> 00:25:42,172 - You're from Maplewood, New Jersey, right? - Yeah. 384 00:25:42,240 --> 00:25:44,504 Now, why would you drive 70 miles... 385 00:25:44,576 --> 00:25:47,511 to get treatment for a condition that a nine-year-old could diagnose? 386 00:25:49,047 --> 00:25:51,982 It's the free-flowing pus that's the tip-off. 387 00:25:52,050 --> 00:25:54,951 I was in town. Not for family. Not for work. 388 00:25:55,020 --> 00:25:58,353 You drove 70 miles to a walk-in clinic. You passed two hospitals on the road. 389 00:25:58,423 --> 00:26:01,915 Either you've got a problem with those hospitals, or they have a problem with you. 390 00:26:01,993 --> 00:26:04,518 My guess is you've sued half the doctors in Maplewood, 391 00:26:04,596 --> 00:26:06,655 and the rest are now refusing to help you. 392 00:26:06,731 --> 00:26:10,462 It's ironic, isn't it? Sort of like the boy who sued wolf. 393 00:26:10,535 --> 00:26:13,766 You know, I bet we have a doctor here named Wolf. 394 00:26:13,838 --> 00:26:16,272 How perfect would that be? 395 00:26:16,341 --> 00:26:18,639 - I'm gonna page him. - Okay. You know what? Thank you. 396 00:26:18,710 --> 00:26:20,974 I'm gonna find a doctor to take care of this. 397 00:26:21,046 --> 00:26:22,980 I didn't say I wouldn't treat you. 398 00:26:23,048 --> 00:26:26,381 - We'll drain your knee, run some lab work. Fix you up. - Why would you do that? 399 00:26:26,451 --> 00:26:28,385 I'm a people person. 400 00:26:28,453 --> 00:26:30,978 You actually treated him? 401 00:26:31,056 --> 00:26:33,024 All I know is he sued some doctors. 402 00:26:33,091 --> 00:26:35,423 Who am I to assume they didn't have it coming to them? 403 00:26:35,493 --> 00:26:38,826 The cutest little tennis outfit. My God, I thought I was gonna have a heart attack. 404 00:26:38,897 --> 00:26:42,128 Oh, my. Didn't see you there. That is so embarrassing. How's your hooker doing? 405 00:26:42,200 --> 00:26:44,134 Sweet of you to ask. Funny story. 406 00:26:44,202 --> 00:26:48,002 She was gonna be hospital administrator, but just hated having to screw people like that. 407 00:26:48,073 --> 00:26:50,871 - Heard you found her on the roof. - You have very acute hearing. 408 00:26:50,942 --> 00:26:52,637 You notify the parents? 409 00:26:52,711 --> 00:26:54,645 In due course, ofcourse. 410 00:26:54,713 --> 00:26:58,205 And is there a paternity bet on the father of the patient? 411 00:26:58,283 --> 00:27:01,582 Doesn't sound like me. Well, it does, actually, but doesn't mean you're guilty. 412 00:27:01,653 --> 00:27:03,644 You think? I saw the parents in the lobby. 413 00:27:03,722 --> 00:27:06,236 - Smart money's obviously on the father. - My guy 414 00:27:06,237 --> 00:27:08,750 knows a guy who can get you in for 50 bucks. 415 00:27:08,827 --> 00:27:12,729 Fine. Tell your guy, if I win, you attend the faculty symposium, and you wear a tie. 416 00:27:12,797 --> 00:27:15,265 And if I win, no clinic hours for a week. 417 00:27:15,333 --> 00:27:17,665 My guy will call your guy. 418 00:27:20,171 --> 00:27:22,366 She's very good at her job. 419 00:27:25,744 --> 00:27:29,111 The treatments should start helping soon. 420 00:27:29,180 --> 00:27:32,547 Let us know if it gets easier to focus on things, remember stuff. 421 00:27:34,552 --> 00:27:38,010 Hey, Dan. Isn't Dr. Cameron's necklace a beauty? 422 00:27:38,089 --> 00:27:40,148 Something South American, I think. 423 00:27:40,225 --> 00:27:42,193 Yeah. Guatemalan. 424 00:27:43,261 --> 00:27:45,286 It's a cool necklace. 425 00:27:47,032 --> 00:27:49,694 - Thank you so much. - The kid's in pain. 426 00:27:51,302 --> 00:27:53,862 Don't fight it. Just let it happen. No. 427 00:27:53,938 --> 00:27:55,963 You'll be dead in two days. No what? 428 00:27:56,041 --> 00:27:58,305 I give it a day. Dan? You okay? 429 00:27:58,376 --> 00:27:59,536 Dan? 430 00:27:59,611 --> 00:28:02,079 Night terrors. - Decomposition once he's in the grave. 431 00:28:02,147 --> 00:28:05,048 - Say good-bye to your mother and father. - He's hearing voices. 432 00:28:05,116 --> 00:28:07,584 You're dying. It's all over, Dan. 433 00:28:08,820 --> 00:28:12,051 You're dying. Dying. Dead! 434 00:28:13,058 --> 00:28:16,118 Push two milligrams I.V. Ativan, stat. 435 00:28:16,194 --> 00:28:18,822 It's all over. - Come on, Dan. 436 00:28:18,897 --> 00:28:20,728 Get out of my head! 437 00:28:22,534 --> 00:28:25,526 Auditory hallucination shows further brain degeneration. 438 00:28:25,603 --> 00:28:29,630 Penicillin's not working. So either it's a bad batch of penicillin, 439 00:28:29,708 --> 00:28:31,699 or our diagnosis is wrong. 440 00:28:33,545 --> 00:28:35,536 Square one. 441 00:28:35,613 --> 00:28:39,549 Midnite. L.F. T.'s, B.U.N. and creatinine are all normal. 442 00:28:39,617 --> 00:28:42,085 - Diabetes is out, and no gap. - There goes metabolic. 443 00:28:42,153 --> 00:28:44,815 - M.R.A. rules out vasculitis. - "I" for inflammation. 444 00:28:44,889 --> 00:28:47,517 - Too young for anything degenerative. - "D", see ya. 445 00:28:47,592 --> 00:28:49,856 "N" for neoplastic. M.R.I. was clean. 446 00:28:50,929 --> 00:28:53,557 - "I" for inflammation. - We already did that. 447 00:28:53,631 --> 00:28:56,896 - Stupid to have two I's in one mnemonic. What's the other one? - Infection. 448 00:28:56,968 --> 00:28:59,016 - Oligoclonal bands still have to mean something. - But 449 00:28:59,017 --> 00:29:01,064 no fevers. White count's elevated, but within range. 450 00:29:01,139 --> 00:29:03,767 We've tested for anything remotely possible. Everything's negative. 451 00:29:03,842 --> 00:29:07,539 - C.T. scan rules out subdural. - Trauma. Later much. 452 00:29:12,817 --> 00:29:16,947 You know the problem? "Midnight" is actually spelled with a "G" and an "H". 453 00:29:17,956 --> 00:29:20,823 If we could just figure out what those letters stand for. 454 00:29:24,996 --> 00:29:28,523 It's a sick brain, having fun, 455 00:29:30,101 --> 00:29:32,262 torturing him, talking to him. 456 00:29:37,809 --> 00:29:39,800 Scaring the hell out of him. 457 00:29:42,280 --> 00:29:47,047 Get him an E.E.G., left and right E.O.G., esophageal microphones. 458 00:29:47,118 --> 00:29:50,986 If this thing wants to talk, let's listen. 459 00:29:52,690 --> 00:29:56,626 We're missing something. This is screwed-up. 460 00:29:56,694 --> 00:30:00,221 That's why you came up with the brain talking to the virus thing? 461 00:30:00,298 --> 00:30:02,095 I panicked, okay? 462 00:30:02,167 --> 00:30:05,967 Sounded cool though. They bought it. 463 00:30:08,540 --> 00:30:11,270 Oh, crap. 464 00:30:11,342 --> 00:30:13,606 Another reason I don't like meeting patients. If they 465 00:30:13,607 --> 00:30:15,870 don't know what you look like, they can't yell at you. 466 00:30:15,947 --> 00:30:17,938 Here we go. 467 00:30:21,152 --> 00:30:23,586 How can you just sit there? 468 00:30:25,023 --> 00:30:26,991 If I eat standing up, I spill. 469 00:30:27,058 --> 00:30:30,118 Our son is dying, and you could care less. 470 00:30:31,296 --> 00:30:34,322 We're going through hell. You're doing nothing? 471 00:30:35,333 --> 00:30:39,133 - I'm sorry. You need to vent. I understand. - Don't be condescending. 472 00:30:40,205 --> 00:30:42,605 You haven't checked in on him once. 473 00:30:42,674 --> 00:30:45,336 Blood pressure is 110 over 70. 474 00:30:45,410 --> 00:30:48,208 His shunt is patent, well-placed in the right lateral ventricle. 475 00:30:48,279 --> 00:30:50,543 The E.K.G. shows a normal Q.R.S. with deep-wave 476 00:30:50,544 --> 00:30:52,807 inversions throughout both limb and precordial leads. 477 00:30:52,884 --> 00:30:55,785 L.F. T.'s are elevated, but only twice the normal range. 478 00:30:55,854 --> 00:30:58,322 Oh, yeah. And he's hearing voices. 479 00:31:02,560 --> 00:31:04,551 Go hold his hand. 480 00:31:06,464 --> 00:31:09,058 Go on. I'll bus your tray. 481 00:31:23,014 --> 00:31:25,915 - Got any sample bags on you? - I don't believe you. 482 00:31:25,984 --> 00:31:29,647 You're gonna run D.N.A. tests? Their son is deathly ill. 483 00:31:29,721 --> 00:31:33,851 I know. It's terrible. But the fact is, if I don't keep busy with trivial things like this, 484 00:31:33,925 --> 00:31:36,052 I'm afraid I might start to cry. You're an ass. 485 00:31:36,127 --> 00:31:39,028 Yeah? You want to double the bet? 486 00:31:49,741 --> 00:31:52,403 General Hospital is on channel 6. 487 00:31:52,477 --> 00:31:56,038 Dan's brain's not showing channel 6 right now. Only mush. 488 00:31:56,114 --> 00:31:58,309 No epileptiform activity. 489 00:31:59,984 --> 00:32:02,748 What are you doing? Waiting for C.B.C. and CHEM-7. 490 00:32:02,820 --> 00:32:05,721 Good. Run D.N.A. on these. 491 00:32:07,292 --> 00:32:10,159 What's this? Parents' coffee cups. 492 00:32:11,863 --> 00:32:14,263 I can't believe you. I've had this conversation once already. 493 00:32:14,332 --> 00:32:16,926 If you've got something else to do, do it. Otherwise, do this. 494 00:32:25,176 --> 00:32:28,236 Dr. House. Hey. Mr. Funsten. 495 00:32:28,313 --> 00:32:31,373 I was wondering when you'd be back. You got some papers for me? 496 00:32:31,449 --> 00:32:34,885 You've caused me considerable mental distress. I certainly hope so. 497 00:32:35,920 --> 00:32:39,981 What? Too cheap to get your lawyer to serve it for you, or is it just more fun this way? 498 00:32:40,058 --> 00:32:42,253 I'm obviously prepared to consider a settlement. 499 00:32:42,327 --> 00:32:44,420 You have gonorrhea. 500 00:32:46,230 --> 00:32:50,064 No, I don't. Well, maybe you're right, but I have the lab result says you do. 501 00:32:50,134 --> 00:32:52,728 Could be a false positive, and normally I'd run a second test, 502 00:32:52,804 --> 00:32:56,205 but since you're here, I'll just go with the first. You're just trying to scare me. 503 00:32:56,274 --> 00:32:59,607 It's reportable, you know. Public health issue. I'll be sure to let my wife know. 504 00:32:59,677 --> 00:33:02,305 Don't bother yourself. The state will call for you. 505 00:33:02,380 --> 00:33:04,940 If you're clean, I'm sure it'll all blow over. No big deal. 506 00:33:05,016 --> 00:33:08,349 There's an easy way to find out. Get one of your doctors to run a test. 507 00:33:10,321 --> 00:33:12,255 Uh-uh. 508 00:33:12,323 --> 00:33:15,087 These are mine now. I'll see you in court. 509 00:33:19,530 --> 00:33:21,464 West Nile negative. Not surprising since not too 510 00:33:21,465 --> 00:33:23,398 many mosquitoes passing through Jersey in December. 511 00:33:23,468 --> 00:33:25,959 No eastern equine encephalitis. You guys aren't gonna believe this. 512 00:33:26,037 --> 00:33:29,973 What's that? House is right. The father's not the father. 513 00:33:30,041 --> 00:33:33,943 Dude doubled up on me. 514 00:33:34,012 --> 00:33:36,071 You're not gonna believe this. 515 00:33:36,147 --> 00:33:38,638 The mother's not the mother either. 516 00:33:39,917 --> 00:33:42,943 It's not a good idea to move your son in his condition. 517 00:33:43,021 --> 00:33:45,615 - We just want a second opinion. We need an answer. 518 00:33:46,424 --> 00:33:49,882 You idiots. You lied to me. 519 00:33:49,961 --> 00:33:51,895 We didn't lie about anything. 520 00:33:51,963 --> 00:33:55,160 - You, on the other hand, accused us of molesting our son. - Perfect. 521 00:33:55,233 --> 00:33:57,997 Can we get off my screwups and focus on theirs? 522 00:33:58,069 --> 00:34:00,162 Theirs is bigger. You're not Dan's parents. 523 00:34:00,238 --> 00:34:03,071 We're his parents. He was adopted. He doesn't need to know. 524 00:34:03,141 --> 00:34:05,132 - I do. - Adoption makes us just as much-- 525 00:34:05,209 --> 00:34:09,543 Listen. When we were taking his medical history, were you confused? 526 00:34:09,614 --> 00:34:12,411 Did you think we were looking for a genetic clue to his condition, 527 00:34:12,483 --> 00:34:16,543 or did you think we were trying to ascertain who loves him the most in the whole wide world? 528 00:34:16,621 --> 00:34:18,782 How did you find out about this? 529 00:34:18,856 --> 00:34:22,257 - I sampled their D.N.A. - We didn't give you any D.N.A. 530 00:34:22,326 --> 00:34:24,760 Your coffee cups from the cafeteria. 531 00:34:24,829 --> 00:34:28,764 - You can't do that. - Again, why are we getting hung up on what I did? 532 00:34:28,833 --> 00:34:31,751 - Your medical history is useless. - No. We gave 533 00:34:31,752 --> 00:34:34,668 you a detailed history of his biological mother. 534 00:34:34,739 --> 00:34:37,902 Her history. Nonsmoker, good health, 535 00:34:37,975 --> 00:34:40,500 low cholesterol, no blood pressure problems. 536 00:34:40,578 --> 00:34:42,705 Dan was adopted two weeks after he was born. 537 00:34:42,780 --> 00:34:44,947 - You have his history. There's nothing you need to 538 00:34:44,947 --> 00:34:47,114 know that we didn't tell you. - Sounds reasonable. 539 00:34:47,185 --> 00:34:50,245 Well, if you want to transfer your boy, that is your choice. 540 00:34:50,321 --> 00:34:53,016 I still think it's the wrong-- Was she vaccinated? 541 00:34:55,126 --> 00:34:58,095 The biological mother. When she was a baby, did she get her vaccinations? 542 00:34:58,162 --> 00:35:01,154 Dan was vaccinated. At six months. 543 00:35:01,232 --> 00:35:04,929 Mm-hmm. Do you know why kids get vaccinated at six months? 544 00:35:05,002 --> 00:35:07,630 Because before that they are protected... 545 00:35:07,705 --> 00:35:10,299 by their biological mother's immune system. 546 00:35:10,374 --> 00:35:13,138 So, was she vaccinated? 547 00:35:16,914 --> 00:35:19,678 An infant picks up a regular old measles virus. 548 00:35:19,750 --> 00:35:21,684 Gets a rash. 549 00:35:21,752 --> 00:35:25,381 He's extremely uncomfortable, has a wicked fever, but he lives. 550 00:35:25,456 --> 00:35:29,324 Here's the kicker. Once every million or so times, 551 00:35:29,393 --> 00:35:31,691 the virus mutates. 552 00:35:31,762 --> 00:35:34,287 Instead of Dan having a fever and a rash, 553 00:35:34,365 --> 00:35:37,027 the virus travels to his brain and hides, 554 00:35:37,101 --> 00:35:39,035 like a time bomb. 555 00:35:39,103 --> 00:35:41,469 In this case, for 16 years. 556 00:35:41,539 --> 00:35:44,099 Subacute sclerosing panencephalitis. 557 00:35:45,510 --> 00:35:48,968 I know. There's only been 20 cases in the United States in the last 30 years. 558 00:35:49,046 --> 00:35:52,379 I suppose you could make an argument the kid's still in stage I. 559 00:35:52,450 --> 00:35:54,577 Once S.S.P.E. moves to stage II, it's-- 560 00:35:54,652 --> 00:35:57,780 Boom. Stage II is universally fatal. 561 00:35:57,855 --> 00:36:00,824 I assume its impossible to know when he might move into stage II. 562 00:36:00,892 --> 00:36:05,090 He's already started showing symptoms. Could be a month. Could be tonight. 563 00:36:05,163 --> 00:36:07,393 Can we treat it? Ask the neurologist. 564 00:36:07,465 --> 00:36:09,558 Intraventricular interferon. 565 00:36:09,634 --> 00:36:13,502 Not gonna shove a spike into his brain and drip interferon without confirming this diagnosis. 566 00:36:13,571 --> 00:36:17,337 - Tap him. - We won't get a reliable result for measles antibodies in his C.S.F. 567 00:36:17,408 --> 00:36:19,342 Not after everything we've given him. 568 00:36:19,410 --> 00:36:22,208 So the wrong treatment kills any hope of the right diagnosis. 569 00:36:22,280 --> 00:36:25,044 Why do people lie to me? 570 00:36:25,116 --> 00:36:27,050 Could also kill him. 571 00:36:27,118 --> 00:36:31,555 Your ball, Foreman. Tell me I don't have to biopsy his brain. 572 00:36:33,124 --> 00:36:35,217 Well, there is one other way. 573 00:36:36,794 --> 00:36:38,785 You sure this isn't gonna hurt? 574 00:36:38,863 --> 00:36:40,854 Yeah. It's just scary as hell. 575 00:36:40,932 --> 00:36:43,059 See, we go through the pupil. 576 00:36:43,134 --> 00:36:45,364 But you won't feel it. The eye's been paralyzed. 577 00:36:45,436 --> 00:36:47,768 The needle travels to the back of the eye, 578 00:36:47,838 --> 00:36:50,705 which is where we'll perform the biopsy on your retina. 579 00:36:56,047 --> 00:36:59,073 So we've confirmed that the problem is this mutated virus. 580 00:36:59,150 --> 00:37:02,950 The treatment for S.S.P.E. is intraventricular interferon. 581 00:37:03,020 --> 00:37:05,750 We implant an ommaya reservoir under the scalp, 582 00:37:05,823 --> 00:37:08,053 which is connected to a ventricular catheter... 583 00:37:08,125 --> 00:37:10,685 that delivers the antiviral directly to the left hemisphere. 584 00:37:10,761 --> 00:37:14,595 You want us to consent to this? I don't even understand what you're talking about. 585 00:37:14,665 --> 00:37:16,724 Well, the antiviral-- 586 00:37:19,503 --> 00:37:21,437 Look. I'm sorry. 587 00:37:21,505 --> 00:37:23,689 I can explain this as best I can, but the notion that 588 00:37:23,690 --> 00:37:25,874 you're gonna fully understand your son's treatment... 589 00:37:25,943 --> 00:37:30,073 and make an informed decision is-- is kind of insane. 590 00:37:31,816 --> 00:37:34,080 Here's what you need to know. 591 00:37:35,086 --> 00:37:37,054 It's dangerous. 592 00:37:37,121 --> 00:37:39,351 It could kill him. 593 00:37:39,423 --> 00:37:41,414 You should do it. 594 00:37:52,503 --> 00:37:54,733 Did you need something else? 595 00:38:13,357 --> 00:38:16,485 You can't order a $3,200 D.N.A. test to win a bet. 596 00:38:16,560 --> 00:38:18,721 It's not an actual cost. 597 00:38:18,796 --> 00:38:22,664 I don't know if you know this, but the hospital actually owns the sequencing machine. 598 00:38:22,733 --> 00:38:25,327 - I'm serious. - Tell the parents to submit the bill to insurance. 599 00:38:25,403 --> 00:38:27,234 Insurance is not gonna pay for a bet. 600 00:38:27,305 --> 00:38:31,674 Should. We don't make that bet, the kid dies. 601 00:38:31,742 --> 00:38:34,609 If not for the paternity bet, I never would have taken their D.N.A. 602 00:38:34,679 --> 00:38:37,079 Without their D.N.A., we never would have discovered 603 00:38:37,080 --> 00:38:39,480 that Dan was adopted, which was the key to this case. 604 00:38:39,550 --> 00:38:41,518 You just don't want to pay your end. 605 00:38:41,585 --> 00:38:44,486 Big mistake. My guy knows a guy. 606 00:38:44,555 --> 00:38:48,252 Fine. I will let you out of clinic duty for one week, 607 00:38:48,326 --> 00:38:51,318 after you pay the 3,200 for the P.C.R. test. 608 00:38:59,103 --> 00:39:00,627 Ooh. 609 00:39:00,705 --> 00:39:04,163 Well, now, there's the hundred you owe me. 610 00:39:05,242 --> 00:39:07,176 Here's a hundred I won from Cameron. 611 00:39:07,244 --> 00:39:09,804 200 I took off of Foreman. 612 00:39:11,182 --> 00:39:13,650 And 600... 613 00:39:13,718 --> 00:39:16,209 I got from Wilson. 614 00:39:17,421 --> 00:39:18,979 Very bitter. 615 00:39:22,927 --> 00:39:24,952 Hey. Good morning. 616 00:39:25,029 --> 00:39:27,793 Good news on your E.E.G. Treatment is working. 617 00:39:27,865 --> 00:39:29,958 And your immune system is responding. 618 00:39:30,034 --> 00:39:33,435 I know it's early, but I just want to take a look. 619 00:39:34,772 --> 00:39:38,674 All right. Let's see what that brain of yours can do. 620 00:39:38,743 --> 00:39:42,201 Name as many animals as you can that start with the letter "O". 621 00:39:42,279 --> 00:39:44,338 Ostrich. 622 00:39:45,116 --> 00:39:47,880 Ox. Old elephant. 623 00:39:47,952 --> 00:39:50,785 Well, that's two better than last time. 624 00:39:51,856 --> 00:39:54,381 How you doing with the whole adoption thing? 625 00:39:54,458 --> 00:39:57,256 - I knew since fifth grade. - How's that? 626 00:39:57,328 --> 00:40:00,263 Cleft chin. 627 00:40:00,331 --> 00:40:02,925 I have one. My dad doesn't. 628 00:40:03,000 --> 00:40:07,630 Looked it up on the Internet. It's one of those trait things. 629 00:40:07,705 --> 00:40:10,196 That's right. It's autosomal dominant. 630 00:40:11,208 --> 00:40:13,426 Since neither of your parents have cleft chins, 631 00:40:13,427 --> 00:40:15,645 it's highly unlikely you're biologically related. 632 00:40:16,981 --> 00:40:21,680 - Are you sure you're okay? - I've got no problems with being adopted. 633 00:40:22,686 --> 00:40:24,677 I love my parents. 634 00:40:27,992 --> 00:40:30,426 How's he doing? He's doing pretty well. 635 00:40:30,494 --> 00:40:32,052 He's a smart kid. 636 00:40:32,129 --> 00:40:34,097 I think he's gonna be fine. 637 00:40:37,868 --> 00:40:40,200 - Hey. - Thanks. 638 00:41:15,573 --> 00:41:17,837 Wheels, 18. Wheels. 639 00:43:06,917 --> 00:43:08,179 Ripped by phaelox for divxstation.com