1 00:00:00,000 --> 00:00:02,515 The human heart is a giant muscle 2 00:00:02,555 --> 00:00:05,874 squeezing our contracting over 60 times each minute. 3 00:00:06,103 --> 00:00:07,391 That's 3,600... 4 00:00:07,471 --> 00:00:10,837 At this point, your blood is a deep purple. 5 00:00:10,917 --> 00:00:15,375 Because it's just finished dropping off oxygen for all the parts of your body. 6 00:00:17,837 --> 00:00:19,782 Come on, follow me. 7 00:00:21,184 --> 00:00:22,066 Come on. 8 00:00:26,956 --> 00:00:28,064 Ian. 9 00:00:28,184 --> 00:00:30,627 I have a question, and I need to go to the bathroom. 10 00:00:30,707 --> 00:00:32,429 Which would you like to do first? 11 00:00:32,620 --> 00:00:34,264 - The question. - Okay. 12 00:00:34,417 --> 00:00:35,949 Where's the bathroom? 13 00:00:36,919 --> 00:00:38,607 Who knows where the bathroom is? 14 00:00:38,645 --> 00:00:39,489 I do. 15 00:00:39,675 --> 00:00:41,090 Go with Ian to the bathroom. 16 00:00:41,245 --> 00:00:42,465 I don't have to go. 17 00:00:42,545 --> 00:00:44,878 We're not at school. Nobody goes anywhere by themselves. 18 00:00:44,878 --> 00:00:45,527 Why? 19 00:00:45,674 --> 00:00:46,860 In case you get lost. 20 00:00:46,930 --> 00:00:48,720 Or in case somebody kidnaps us. 21 00:00:48,800 --> 00:00:51,245 If somebody kidnaps Ian, they'll kidnap me too. 22 00:00:51,434 --> 00:00:52,498 I want to stay with the class. 23 00:00:52,578 --> 00:00:54,916 Michael, go with Ian-- [Sharp gasp] Aah! 24 00:00:54,926 --> 00:00:56,082 Do you need help? 25 00:00:56,233 --> 00:00:57,611 I need you to find a grown-up. 26 00:00:57,611 --> 00:00:58,598 Is the baby coming? 27 00:00:58,638 --> 00:00:59,551 Aah! Aah! 28 00:00:59,654 --> 00:01:00,984 Who should I take with me? 29 00:01:01,064 --> 00:01:03,225 You're fine. Go to the front desk, or-- 30 00:01:03,305 --> 00:01:04,684 Or find a security guard. 31 00:01:04,724 --> 00:01:06,531 I really have to pee. 32 00:01:08,553 --> 00:01:09,740 God. 33 00:01:10,304 --> 00:01:11,882 Is--is the baby coming? 34 00:01:11,962 --> 00:01:13,596 I don't know how to do this. 35 00:01:13,789 --> 00:01:15,525 Are you okay, Ian? 36 00:01:15,525 --> 00:01:17,203 Yeah, sure. 37 00:01:19,480 --> 00:01:21,660 I don't think you are. 38 00:01:24,357 --> 00:01:26,040 You're bleeding. 39 00:01:29,127 --> 00:01:30,305 Help! 40 00:01:30,755 --> 00:01:31,466 Help! 41 00:01:32,361 --> 00:01:36,847 2X17 - All In 42 00:01:58,955 --> 00:02:02,291 Original Airdate (FOX): 11 APR-2006 43 00:02:04,003 --> 00:02:07,950 "Deed I do" 44 00:02:12,185 --> 00:02:16,058 # Do I love you? Oh my do I " 45 00:02:16,059 --> 00:02:20,231 # Honey, indeed I do # 46 00:02:22,177 --> 00:02:26,548 # Do I want you? Oh my do I # 47 00:02:26,549 --> 00:02:28,652 # Honey, deed I do # 48 00:02:28,741 --> 00:02:30,465 - 20. - Call. 49 00:02:31,336 --> 00:02:32,834 You'll call anything. 50 00:02:32,940 --> 00:02:35,015 My stack is bigger than your stack. 51 00:02:36,536 --> 00:02:37,679 You in or out? 52 00:02:37,760 --> 00:02:42,927 You know that relative to their size, gorillas have smaller testicles than humans. 53 00:02:43,189 --> 00:02:46,714 Well, then you'd probably have an edge over a gorilla. But not over me. 54 00:02:46,794 --> 00:02:52,721 The reason is, primate teste size inversely corresponds to the fidelity of our females. 55 00:02:54,233 --> 00:02:56,983 Do you think there might be a better time to annoy me about my wife? 56 00:02:57,103 --> 00:02:58,622 - I'm talking about poker. - Right. 57 00:02:58,702 --> 00:03:00,568 Women are evil. You're right to drive them away. 58 00:03:00,648 --> 00:03:03,094 Call, fold, or raise. Story time can wait. 59 00:03:03,174 --> 00:03:05,452 We're smaller and better than chimps, 60 00:03:06,201 --> 00:03:08,189 bigger and worse than gorillas. 61 00:03:08,270 --> 00:03:13,005 For all our rationality, supposed trust and fealty to a higher power, 62 00:03:13,187 --> 00:03:16,978 our ability to create a system of rules and laws, 63 00:03:17,171 --> 00:03:20,380 our baser drives are more powerful than any of that. 64 00:03:20,460 --> 00:03:24,099 We want to control our emotions, but we can't. 65 00:03:24,162 --> 00:03:27,050 If we're happy, things don't annoy us. 66 00:03:27,471 --> 00:03:30,772 If, on the other hand, we're sitting on crappy hole cards, 67 00:03:30,844 --> 00:03:34,331 little tiny things annoy us a whole lot more. 68 00:03:38,717 --> 00:03:39,556 I raise. 69 00:03:39,628 --> 00:03:41,963 So are you going to tell me an annoying story every time I raise? 70 00:03:42,037 --> 00:03:43,909 God, that would be annoying. 71 00:03:45,108 --> 00:03:46,329 I call. 72 00:03:46,694 --> 00:03:49,132 Dr. Cuddy? Got one of your patients in the E.R. 73 00:03:49,196 --> 00:03:50,692 Ian Alston. Six years old. 74 00:03:50,773 --> 00:03:53,673 Ah... Oh, I know him. What's the problem? I'm all in. 75 00:03:53,762 --> 00:03:57,943 Bloody diarrhea, hemodynamically stable, but he's been developing some coordination problems. 76 00:03:58,023 --> 00:03:59,929 It sounds like gastroenteritis and dehydration. 77 00:04:00,010 --> 00:04:02,183 Order fluids, and I'll take it on my service. 78 00:04:02,268 --> 00:04:03,213 Cuddy: Bet's to you, House. 79 00:04:03,293 --> 00:04:04,238 They scan his head? 80 00:04:04,318 --> 00:04:06,088 - No, why would they scan-- - Don't play games. 81 00:04:06,153 --> 00:04:08,327 - You gonna call? - How's the heart rate? 82 00:04:08,631 --> 00:04:09,310 Stable. 83 00:04:09,375 --> 00:04:12,593 I'm sorry. House? It's gastroenteritis. 84 00:04:12,673 --> 00:04:14,233 I'm not going anywhere. 85 00:04:14,314 --> 00:04:18,173 Put the order in, and have someone tell Alan and Sarah that I'll be up when I'm done. 86 00:04:19,691 --> 00:04:21,032 You in or out? 87 00:04:24,988 --> 00:04:26,556 I'm out. 88 00:04:30,578 --> 00:04:31,997 Stone cold bluff. 89 00:04:32,085 --> 00:04:36,090 You might want to spend a little more time paying attention to your cards, 90 00:04:36,171 --> 00:04:38,819 and a little less time staring at my breasts. 91 00:04:39,002 --> 00:04:40,534 They don't match, either. 92 00:04:40,832 --> 00:04:42,381 I'm going to take some air. 93 00:05:02,843 --> 00:05:05,289 Follow my finger with your eyes. 94 00:05:11,087 --> 00:05:13,191 How much longer will Dr. Cuddy be? 95 00:05:13,311 --> 00:05:14,995 Well, given the number of Mojitos 96 00:05:14,996 --> 00:05:19,734 she's knocking back at the party, I'd say it's gonna be at least three hours before she's even conscious. 97 00:05:20,487 --> 00:05:22,199 Weren't you at the same party? 98 00:05:22,552 --> 00:05:23,891 I don't drink. 99 00:05:26,065 --> 00:05:28,863 I want you to reach out and grab my cane. 100 00:05:34,615 --> 00:05:35,415 What's wrong? 101 00:05:35,495 --> 00:05:38,791 Your son's brain is losing control of his muscles. 102 00:05:38,871 --> 00:05:42,514 Dr. Cuddy's message said it was just dehydration from the diarrhea. 103 00:05:42,594 --> 00:05:43,894 She's wrong. 104 00:05:45,571 --> 00:05:47,194 Is he going to be all right? 105 00:05:50,615 --> 00:05:52,261 I don't know. 106 00:06:20,833 --> 00:06:22,592 So were you in one of those cages? 107 00:06:23,897 --> 00:06:24,778 No. 108 00:06:25,077 --> 00:06:28,525 No, no, no. Those are for tourists. 109 00:06:28,748 --> 00:06:30,574 You were in the water with a great white. 110 00:06:30,638 --> 00:06:31,314 Sure. 111 00:06:31,398 --> 00:06:34,715 It's no big deal. You just have to keep an eye on them. 112 00:06:34,799 --> 00:06:37,822 If they get too close, punch 'em in the nose. 113 00:06:38,210 --> 00:06:39,877 Send them on their way. 114 00:06:41,957 --> 00:06:44,139 - I had you going. - You are mean. 115 00:06:44,785 --> 00:06:47,457 Hey, how's that anal fissure? 116 00:06:47,889 --> 00:06:50,261 Did it heal yet, or is it still draining? 117 00:06:50,413 --> 00:06:53,233 Oh, I'm sorry. I didn't realize you came back for seconds. 118 00:06:53,317 --> 00:06:56,348 I figured that after that girl in the stairwell, you'd be done for the night. 119 00:06:56,449 --> 00:06:57,417 He's joking. 120 00:06:57,479 --> 00:07:01,440 No Adam's apple, small hands. It's no surprises this time. 121 00:07:02,142 --> 00:07:04,726 I'll, uh, see you later. 122 00:07:06,812 --> 00:07:08,019 Got a case. 123 00:07:08,145 --> 00:07:10,802 Well, you could've just said that. You didn't have to screw with me. 124 00:07:10,886 --> 00:07:13,795 Yeah, but if I didn't screw with you, you'd spend the whole night thinking you might get laid. 125 00:07:13,879 --> 00:07:16,589 Which means you'd be useless. Better to extinguish all hope. 126 00:07:16,678 --> 00:07:19,568 Get Foreman and Cameron and meet me upstairs, stat. 127 00:07:25,347 --> 00:07:26,462 What's so urgent? 128 00:07:26,526 --> 00:07:30,107 Two cases, same symptoms. 129 00:07:30,191 --> 00:07:33,364 What do 6-year-olds and 70-year-olds have in common? 130 00:07:33,448 --> 00:07:35,800 Their immune systems don't work as well. Could be listeria. 131 00:07:35,884 --> 00:07:37,145 I already checked for that. 132 00:07:37,229 --> 00:07:39,839 Leukemia has a higher prevalence in both the young and old. 133 00:07:39,906 --> 00:07:40,890 Cameron: So does asthma. 134 00:07:40,974 --> 00:07:42,337 House: No, no, no. 135 00:07:42,463 --> 00:07:44,098 They can both get diabetes. 136 00:07:44,177 --> 00:07:45,243 N o. 137 00:07:47,918 --> 00:07:52,737 The nearly dead and the newly bred have more in common with each other than with people in the middle. 138 00:07:53,294 --> 00:07:54,581 It's weird. 139 00:07:54,665 --> 00:07:56,668 Some kind of circle of life thing. 140 00:07:56,739 --> 00:07:58,570 This kid doesn't have kidney failure. 141 00:07:58,654 --> 00:07:59,239 He will. 142 00:07:59,323 --> 00:08:02,363 Based on this file, the kid just ate some bad food. 143 00:08:02,448 --> 00:08:03,127 Was the old man-- 144 00:08:03,209 --> 00:08:06,517 They were nowhere near each other in any of the four dimensions. 145 00:08:07,643 --> 00:08:09,584 - This case is 12 years old. - Yep. 146 00:08:09,653 --> 00:08:12,956 - And this case is Cuddy's. - She assigned it to me. 147 00:08:13,038 --> 00:08:16,805 She agrees with you that this is something more than gastroenteritis? 148 00:08:16,913 --> 00:08:19,483 She wouldn't have assigned it to me if she did, now would she? 149 00:08:19,566 --> 00:08:21,939 Gohhh. 150 00:08:27,703 --> 00:08:29,259 What were we talking about? 151 00:08:29,433 --> 00:08:31,565 Two patients with two symptoms in common. 152 00:08:31,649 --> 00:08:34,302 And five symptoms not in common. 153 00:08:34,386 --> 00:08:37,137 While you were all wearing your "Frankie says relax" t-shirts, 154 00:08:37,221 --> 00:08:39,322 I was treating a 73-year-old woman 155 00:08:39,407 --> 00:08:41,382 who went through this progression of symptoms. 156 00:08:41,451 --> 00:08:43,442 The last of which was... 157 00:08:46,707 --> 00:08:50,972 In case any of you missed that class in med school, that one's untreatable. 158 00:08:51,085 --> 00:08:52,494 Kid's got the first two. 159 00:08:52,603 --> 00:08:55,901 Took Esther an hour and 20 minutes to go from two to three. 160 00:08:56,591 --> 00:08:59,007 And less than a day to make it all the way to the rear exit. 161 00:08:59,091 --> 00:09:02,981 This is all because a child has some blood in his diarrhea. 162 00:09:03,065 --> 00:09:04,209 He's got a tummy ache. 163 00:09:04,293 --> 00:09:07,600 If there was any reason to think it was anything worse, Cuddy would be all over it. 164 00:09:07,660 --> 00:09:09,438 Great. Do a colonoscopy. 165 00:09:09,532 --> 00:09:12,208 On a six-year-old kid who probably has nothing worse than some food poisoning? 166 00:09:12,278 --> 00:09:16,087 If you happen to find any purple papules, do me a favor and grab a slice. 167 00:09:16,171 --> 00:09:18,465 I want to check for Erdheim Chester. 168 00:09:18,549 --> 00:09:22,858 A disease that there have been what, maybe 200 reported cases of? Ever? 169 00:09:22,920 --> 00:09:25,503 If Esther's family had let me do an autopsy, 170 00:09:25,922 --> 00:09:27,878 there'd be 201. 171 00:09:40,231 --> 00:09:41,878 Foreman: See anything? 172 00:09:41,962 --> 00:09:44,102 Chase: No, and I don't expect to. 173 00:09:45,497 --> 00:09:47,372 House usually avoids cases. 174 00:09:47,477 --> 00:09:50,628 If he's actually stealing a case from Cuddy, there's got to be a reason. 175 00:09:50,712 --> 00:09:53,105 It's not the first time I've seen this file. 176 00:09:54,191 --> 00:09:56,123 About a month before Cameron was hired, 177 00:09:56,209 --> 00:09:58,386 some trucker came in here with these symptoms. 178 00:09:58,471 --> 00:10:00,057 House decided he was dying. 179 00:10:00,141 --> 00:10:04,515 Two days and a spinal tap, bone marrow extraction, and three colonoscopies later, 180 00:10:04,599 --> 00:10:09,274 we sent the guy home with a bunch of pain killers and a diagnosis of a bad cheese sandwich. 181 00:10:10,364 --> 00:10:15,538 One of the guys who worked here before me said House tried to cure Esther at least three other times. 182 00:10:16,163 --> 00:10:20,366 You know how people see the Virgin Mary in Danishes and stuff? 183 00:10:20,967 --> 00:10:23,957 Someone died 12 years ago, and House doesn't know why. 184 00:10:24,057 --> 00:10:31,178 House sees that case now in paint peeling, in clouds, and now in this poor kid. 185 00:10:31,358 --> 00:10:34,736 Erdheim Chester is an abnormal growth of some of the cells that fight infection. 186 00:10:34,825 --> 00:10:37,103 Is that cancer? 'Cause he seems okay now. 187 00:10:37,187 --> 00:10:39,409 Yeah, the other doctor kind of scared us about that. 188 00:10:39,493 --> 00:10:42,402 He shouldn't have. We're just testing. It'll probably be negative. 189 00:10:42,486 --> 00:10:43,336 Alan: I don't understand. 190 00:10:43,440 --> 00:10:44,966 You don't think that's what it is, but you want to-- 191 00:10:45,051 --> 00:10:46,431 you want to do this thing to him anyway? 192 00:10:46,581 --> 00:10:47,379 We need to be sure. 193 00:10:47,463 --> 00:10:48,916 Isn't there any other way? 194 00:10:49,000 --> 00:10:50,530 It shouldn't take long. 195 00:10:51,670 --> 00:10:52,658 All right. 196 00:10:52,949 --> 00:10:55,865 Those ridges look a lot like purple papules. 197 00:10:55,949 --> 00:10:58,885 They're not purple, they're red. They're probably just blood blisters. 198 00:11:01,591 --> 00:11:03,269 Give me the biopsy needle. 199 00:11:13,881 --> 00:11:15,126 How long is this going to take? 200 00:11:15,197 --> 00:11:19,322 Forget it, Chase. Your punching-out-the-shark story's good, but she's not waiting for you. 201 00:11:20,893 --> 00:11:21,611 So? 202 00:11:21,802 --> 00:11:23,466 We couldn't confirm the source of the bleeding. 203 00:11:23,466 --> 00:11:25,632 - But we did biopsy some-- - Blood blisters. 204 00:11:25,716 --> 00:11:27,066 You mean papules. 205 00:11:27,711 --> 00:11:29,451 Come on, Cameron. Who's right? 206 00:11:31,289 --> 00:11:32,370 Chase is. 207 00:11:32,534 --> 00:11:34,065 Negative for Erdheim Chester. 208 00:11:34,149 --> 00:11:35,371 Let me see. 209 00:11:43,223 --> 00:11:46,478 - If it's not Erdheim Chester-- - It's exactly what we said before. 210 00:11:46,563 --> 00:11:50,065 Garden variety viral gastroenteritis. Can we go back to the party? 211 00:11:50,149 --> 00:11:51,835 Do a kidney biopsy. 212 00:11:53,027 --> 00:11:54,847 Esther's shut down in exactly-- 213 00:11:54,931 --> 00:11:56,244 Chase: This kid is not Esther. 214 00:11:56,329 --> 00:11:58,005 You screwed up, she died. I'm sorry. 215 00:11:58,090 --> 00:12:00,236 But that does not mean this kid is dying as well. 216 00:12:00,254 --> 00:12:01,255 Jeez. 217 00:12:01,356 --> 00:12:03,551 You get testy when you don't get any fuzz. 218 00:12:03,682 --> 00:12:04,715 Come on. 219 00:12:19,232 --> 00:12:20,343 What did the test say? 220 00:12:20,442 --> 00:12:21,984 Chase: Colonoscopy was clean. 221 00:12:22,083 --> 00:12:24,421 And the biopsy was negative for Erdheim Chester. 222 00:12:24,489 --> 00:12:27,071 Alan: So Ian's going to be all right. It was just some sort of virus. 223 00:12:28,381 --> 00:12:29,604 What's that? 224 00:12:30,503 --> 00:12:31,544 Urine. 225 00:12:31,759 --> 00:12:33,188 But it's brown. 226 00:12:34,451 --> 00:12:36,480 Ian's kidneys are shutting down. 227 00:12:36,542 --> 00:12:39,228 Still think it's not the same case? 228 00:12:54,316 --> 00:13:00,180 House: So, what can cause bloody diarrhea, ataxia, and kidney failure? 229 00:13:00,264 --> 00:13:02,334 - I'll go do a biopsy. - House: Forget it. 230 00:13:02,427 --> 00:13:03,818 That battle's over. 231 00:13:03,902 --> 00:13:07,980 His rising creatinine is his kidneys' way of saying, "Go on without me." 232 00:13:08,809 --> 00:13:11,601 What explains everything? 233 00:13:12,607 --> 00:13:18,330 E. Coli HO:157 causes bloody diarrhea and leads to hemolytic uremic syndrome. 234 00:13:18,414 --> 00:13:20,925 Toxins from the bacteria cause his kidneys to shut down. 235 00:13:21,009 --> 00:13:22,655 We should start him on plasmaphoresis. 236 00:13:22,755 --> 00:13:26,421 Clear, concise, and completely plausible. 237 00:13:26,505 --> 00:13:29,529 And exactly what I did last time. Didn't work. 238 00:13:29,678 --> 00:13:31,687 - What else? - Good Pasture's syndrome. 239 00:13:31,797 --> 00:13:34,348 Circulating antibodies cause kidney failure and bleeding. 240 00:13:34,432 --> 00:13:35,903 But not the purple papules. 241 00:13:36,004 --> 00:13:37,762 If you throw in Esther's next symptom-- 242 00:13:37,846 --> 00:13:40,109 brain--makes me think heavy metal toxicity. 243 00:13:40,193 --> 00:13:42,286 His hematocrit would have to be low. It's at 44, and 244 00:13:42,371 --> 00:13:44,862 - Esther's never dropped below... - 42. 245 00:13:44,925 --> 00:13:46,172 You have the file memorized? 246 00:13:46,238 --> 00:13:47,797 It's my lucky number. 247 00:13:47,881 --> 00:13:48,991 What about lymphoma? 248 00:13:49,100 --> 00:13:52,964 Causes kidney failure, GI bleed, and can infiltrate the base of the brain. 249 00:13:55,019 --> 00:13:56,465 You check Esther for that? 250 00:13:56,549 --> 00:13:58,934 She never showed any signs of... 251 00:14:00,411 --> 00:14:04,229 If he has lymphoma this far advanced, we should be able to see it in his blood and brain. 252 00:14:04,308 --> 00:14:08,829 Chase, run a blood smear and immunochemistries. Foreman, get an MRI. 253 00:14:09,787 --> 00:14:11,988 - I'll page Cuddy. - No, you won't. 254 00:14:12,072 --> 00:14:13,563 She thinks the kid has a stomach ache. 255 00:14:13,673 --> 00:14:15,580 She'll come right up here and do one of two things. 256 00:14:15,664 --> 00:14:17,150 If she agrees with me, I don't need her. 257 00:14:17,234 --> 00:14:18,571 If she disagrees, I don't want her. 258 00:14:18,655 --> 00:14:20,624 Can't handle people disagreeing with you? 259 00:14:20,708 --> 00:14:21,968 She might have a different take on this. 260 00:14:22,052 --> 00:14:25,342 Subordinates can disagree with me all they want. It's healthy. 261 00:14:25,493 --> 00:14:28,062 People who can shut me down, on the other hand... 262 00:14:28,475 --> 00:14:31,076 Forget Cuddy. I'll have Wilson keep her busy. 263 00:14:31,161 --> 00:14:34,237 [Phone rings] 264 00:14:38,764 --> 00:14:42,482 Keep your answers short and discreet. Is Cuddy still playing? 265 00:14:43,195 --> 00:14:46,056 The chicken... is still in Piccadilly Square. 266 00:14:46,140 --> 00:14:46,867 Brilliant. 267 00:14:46,977 --> 00:14:49,153 She'll never suspect that Normandy is our target. 268 00:14:49,237 --> 00:14:50,505 Is that House? 269 00:14:50,831 --> 00:14:54,476 Tell him that the blinds just went to 20/40, and he's running out of chips. 270 00:14:54,518 --> 00:14:55,315 House: How's she doing? 271 00:14:55,466 --> 00:14:56,584 Well, what's going on? 272 00:14:56,626 --> 00:14:58,549 The way you took off, something's obviously-- 273 00:14:58,633 --> 00:15:00,368 Love to chat. But got a game to play. 274 00:15:00,452 --> 00:15:01,577 How's she doing? 275 00:15:01,751 --> 00:15:04,406 The patient is on life support. We're about to pull the plug. 276 00:15:04,490 --> 00:15:05,334 Are you talking about me? 277 00:15:05,444 --> 00:15:06,594 What have you got? 278 00:15:06,739 --> 00:15:09,942 Mmm... Those sound like high-dose cardio meds. 279 00:15:10,048 --> 00:15:11,247 Two hearts. 280 00:15:11,947 --> 00:15:13,200 You got the flush? 281 00:15:13,311 --> 00:15:14,379 Still waiting on the final labs. 282 00:15:14,486 --> 00:15:16,217 She drinking her seltzer? 283 00:15:16,931 --> 00:15:19,577 No. Hydration is not a problem. 284 00:15:19,661 --> 00:15:22,302 House: Means she's bluffing. Push her all in. 285 00:15:24,791 --> 00:15:26,171 Call. 286 00:15:26,427 --> 00:15:27,538 Two pair. 287 00:15:27,917 --> 00:15:29,676 Show me your hearts. 288 00:15:34,328 --> 00:15:35,620 Seven of clubs. 289 00:15:35,936 --> 00:15:38,831 Oh, dear. Sounds like I messed up. 290 00:15:38,896 --> 00:15:40,812 You're gonna be stuck with her for a while. 291 00:15:41,180 --> 00:15:42,547 Talk to you soon. [Hangs up] 292 00:15:43,620 --> 00:15:46,071 Oh... Yes. 293 00:16:00,426 --> 00:16:02,455 Why are you taking a picture of his head? 294 00:16:02,602 --> 00:16:04,074 We're looking for lymphoma, but-- 295 00:16:04,158 --> 00:16:06,857 So it's not Erdheim something. 296 00:16:06,964 --> 00:16:09,554 And it's not his kidneys. But his kidneys are failing. 297 00:16:09,638 --> 00:16:11,105 What-- Where's Dr. Cuddy? 298 00:16:11,168 --> 00:16:12,849 Dr. House mentioned another case. 299 00:16:12,933 --> 00:16:15,197 Is there another patient with the same-- same thing that Ian has? 300 00:16:15,261 --> 00:16:17,739 - Not...exactly. - What does that mean? 301 00:16:17,824 --> 00:16:22,221 Dr. House had a patient a while back who exhibited the same symptoms as your son. 302 00:16:22,305 --> 00:16:24,359 Then you know what's wrong? 303 00:16:24,667 --> 00:16:25,608 No. 304 00:16:25,734 --> 00:16:27,023 So what do you know? 305 00:16:27,107 --> 00:16:29,600 We know the likely course the disease will take. 306 00:16:30,008 --> 00:16:31,038 Alan: Which is? 307 00:16:31,122 --> 00:16:34,523 - She had multiple system failures-- - What happened to her? 308 00:16:38,554 --> 00:16:42,159 She died 24 hours after her admission. 309 00:16:48,552 --> 00:16:51,790 Mr. or Mrs. Alston, would you mind giving me a hand? 310 00:16:54,041 --> 00:16:56,144 He's having trouble sitting still. 311 00:16:56,244 --> 00:16:58,587 It's impossible to get the detail we need. 312 00:16:58,671 --> 00:17:01,514 So I figured he might feel more comfortable hearing your voices. 313 00:17:07,325 --> 00:17:08,814 Ian, honey? 314 00:17:10,282 --> 00:17:11,617 Just sit still. 315 00:17:11,680 --> 00:17:14,782 You'll be done in a moment. We're here with you. 316 00:17:14,866 --> 00:17:16,552 I'm scared. 317 00:17:17,695 --> 00:17:19,567 It's okay, honey. It's... 318 00:17:19,758 --> 00:17:23,425 It's only a big camera. It's going to take a picture of your head. 319 00:17:24,657 --> 00:17:27,214 You love it when I take your picture at home, don't you? 320 00:17:27,298 --> 00:17:28,324 Yeah. 321 00:17:29,400 --> 00:17:32,579 And you have to hold still for that too, right? 322 00:17:32,925 --> 00:17:35,333 But this isn't like that. 323 00:17:37,167 --> 00:17:39,358 I know it's scary, Ian. 324 00:17:39,540 --> 00:17:41,247 But you can do it. 325 00:17:42,192 --> 00:17:44,609 You're getting to be so grown up. 326 00:17:46,790 --> 00:17:48,446 So just... 327 00:17:48,699 --> 00:17:51,957 hold perfectly still. Just for a little bit. 328 00:17:52,210 --> 00:17:55,179 Mommy, are you crying? 329 00:17:55,787 --> 00:18:00,112 No. No, honey. I'm just tired. 330 00:18:00,914 --> 00:18:03,685 Okay. I'll try. 331 00:18:32,613 --> 00:18:35,183 The base of his brain has been infiltrated by a small mass. 332 00:18:35,183 --> 00:18:36,553 - We think-- - Pituitary? 333 00:18:36,619 --> 00:18:37,333 Looks that way. 334 00:18:37,438 --> 00:18:39,193 Explains the low blood pressure. 335 00:18:41,699 --> 00:18:44,197 Pretty much confirms the lymphoma. 336 00:18:49,001 --> 00:18:51,143 If we'd started Esther on prednisone... 337 00:18:51,228 --> 00:18:53,750 Uh, did anyone see the lymphoma? 338 00:18:53,834 --> 00:18:56,497 C ameron: No, we saw a mass. The location was consistent with-- 339 00:18:56,581 --> 00:18:58,332 Didn't see any in the blood, either. 340 00:18:58,540 --> 00:19:01,686 White blood cells show no spindling or abnormal nuclei. 341 00:19:01,770 --> 00:19:04,841 Nothing on immunochemistries, either. It's not lymphoma. 342 00:19:37,813 --> 00:19:39,155 Foreman: House. 343 00:19:40,837 --> 00:19:42,408 It's a train. 344 00:19:43,509 --> 00:19:44,765 We don't know what kind of train. 345 00:19:44,849 --> 00:19:46,293 - Whoa, whoa, whoa. - I'm thirsty. 346 00:19:46,378 --> 00:19:47,689 It's closed. 347 00:19:52,106 --> 00:19:53,328 It's not now. 348 00:19:59,903 --> 00:20:01,470 We got one advantage. 349 00:20:01,554 --> 00:20:03,120 We know where the tracks are going. 350 00:20:03,204 --> 00:20:05,506 The fact that the end of the line is death... 351 00:20:05,911 --> 00:20:07,012 is an advantage? 352 00:20:07,097 --> 00:20:09,629 The fact that we know is an advantage. 353 00:20:10,024 --> 00:20:11,820 Means maybe we can get ahead of it. 354 00:20:12,421 --> 00:20:16,477 Next station is the liver. We've got... About 90 minutes before it gets there. 355 00:20:16,576 --> 00:20:19,662 Maybe we can cut down a tree across the line just outside of town. 356 00:20:19,747 --> 00:20:20,835 I'll do an ultrasound. 357 00:20:20,898 --> 00:20:23,037 No, treatment will tell us more, faster. 358 00:20:23,121 --> 00:20:25,417 How can we start treatment if we have no idea what we'retreating for? 359 00:20:25,512 --> 00:20:27,235 [Dishes clatter] Treat him for everything. 360 00:20:27,907 --> 00:20:31,197 Give him acetylcysteine. And interferon. And silymarin. 361 00:20:31,282 --> 00:20:33,893 And whatever else you can think of to protect the liver. 362 00:20:42,464 --> 00:20:45,096 [Phone rings] 363 00:20:48,253 --> 00:20:48,976 What's going on? 364 00:20:49,061 --> 00:20:51,649 Oh, just catching up on some TV. 365 00:20:51,766 --> 00:20:52,587 How are you doing? 366 00:20:52,717 --> 00:20:54,397 Well, thanks to your last consult, 367 00:20:54,481 --> 00:20:56,145 the patient has improved dramatically. 368 00:20:56,229 --> 00:20:58,520 Tell House the patient is about to kill the doctor. 369 00:20:58,604 --> 00:21:01,252 - She says the pa-- - I heard. What d'ya got? 370 00:21:01,312 --> 00:21:03,078 Well, Cuddy just raised, and, uh... 371 00:21:03,162 --> 00:21:04,446 - You're paired. - What? 372 00:21:04,446 --> 00:21:05,379 Nines? 373 00:21:08,233 --> 00:21:09,105 How do you know? 374 00:21:09,190 --> 00:21:11,997 Anything lower, you wouldn't sound so excited. 375 00:21:12,207 --> 00:21:13,411 Jacks or higher, 376 00:21:13,560 --> 00:21:16,977 your voice sounds like Debbie from accounting is sitting in your lap. 377 00:21:17,068 --> 00:21:19,127 Ask Cuddy if she can beat a pair of threes. 378 00:21:19,211 --> 00:21:20,696 Wait, what's--What's going on? 379 00:21:20,780 --> 00:21:22,741 If you're going to mess with me, wouldn't it be more fun to do it in person? 380 00:21:22,825 --> 00:21:24,279 Yes, it would. 381 00:21:25,791 --> 00:21:28,289 Um, can you beat a pair of threes? 382 00:21:28,589 --> 00:21:29,535 House: What did she do? 383 00:21:29,619 --> 00:21:31,824 I left orders for PO fluids, doctor. 384 00:21:31,908 --> 00:21:34,161 Enough with the codes. She obviously knows it's me. 385 00:21:34,245 --> 00:21:35,863 She's drinking her seltzer. 386 00:21:36,768 --> 00:21:38,222 Did she stop? 387 00:21:38,413 --> 00:21:39,907 - Yes. - Go all in. 388 00:21:39,970 --> 00:21:42,385 - Um...but... - Just do it. 389 00:21:43,364 --> 00:21:45,157 You couldn't care less about this charity event. 390 00:21:45,241 --> 00:21:47,069 You claim not to be messing with me. 391 00:21:47,172 --> 00:21:48,961 Obviously, you're either trying to keep me-- 392 00:21:49,045 --> 00:21:49,952 Shut up. 393 00:21:50,036 --> 00:21:52,618 Look, last time, I wanted the game to go on. 394 00:21:52,702 --> 00:21:53,698 I still do. 395 00:21:53,772 --> 00:21:55,779 That means that this time, you get to win. 396 00:21:55,947 --> 00:21:56,894 Hold on. 397 00:22:04,030 --> 00:22:05,413 I fold. 398 00:22:07,434 --> 00:22:09,471 Ho, ho, ho. 399 00:22:13,669 --> 00:22:16,286 House, are you sure you're okay? 400 00:22:47,807 --> 00:22:51,065 Meds seem to be working. Liver's holding its own. 401 00:22:51,700 --> 00:22:52,668 Good. 402 00:22:52,752 --> 00:22:54,126 But the platelets are dropping. 403 00:22:54,385 --> 00:22:55,215 Even better. 404 00:22:55,299 --> 00:22:56,787 Why? It means he's getting sicker. 405 00:22:56,871 --> 00:22:59,449 It's new. New is good. 406 00:23:00,251 --> 00:23:02,838 Because old ended in death. 407 00:23:05,325 --> 00:23:07,240 I can't breathe. 408 00:23:08,353 --> 00:23:08,994 Chase! 409 00:23:09,414 --> 00:23:10,193 What? 410 00:23:11,928 --> 00:23:13,038 What's happening? 411 00:23:18,327 --> 00:23:19,357 Ian. Come on. 412 00:23:20,018 --> 00:23:21,475 Honey, just relax. 413 00:23:22,713 --> 00:23:24,493 Ian, breathe. Come on, honey. 414 00:23:24,494 --> 00:23:27,217 Breathe, please, honey. 415 00:23:52,188 --> 00:23:54,330 [Crash!] 416 00:24:18,971 --> 00:24:20,613 We had to put him on a ventilator. 417 00:24:20,723 --> 00:24:22,870 He's back on Esther's path. 418 00:24:23,528 --> 00:24:26,324 And we managed to make the train skip a few stations. 419 00:24:26,408 --> 00:24:30,406 Which means that instead of 12 hours, he's probably got less than two. 420 00:24:30,508 --> 00:24:32,257 Which begs the question, why? 421 00:24:32,362 --> 00:24:33,385 What did we do? 422 00:24:33,469 --> 00:24:35,075 Acetylcysteine could mess with the lungs. 423 00:24:35,159 --> 00:24:37,840 Mess with them. Not shut them down in 20 minutes. 424 00:24:37,924 --> 00:24:40,040 Interferon modulates the immune system. 425 00:24:40,191 --> 00:24:43,054 It could affect cancer of the blood, like one of the leukemias. 426 00:24:43,138 --> 00:24:44,904 It doesn't speed them up, it slows them down. 427 00:24:45,008 --> 00:24:46,811 It slows down all 500 of them? 428 00:24:46,902 --> 00:24:50,394 Anybody know where we can find an oncologist at this hour? 429 00:24:55,186 --> 00:24:58,711 What effects would interferon have on leukemia? 430 00:24:58,795 --> 00:25:01,250 Depends on what type. Could make it better, could make it worse. 431 00:25:01,362 --> 00:25:03,237 Four-year fellowship to learn that. 432 00:25:03,387 --> 00:25:07,882 Cuddy: Tell House if he wants to play cards, he should get his ass back down here and play. 433 00:25:07,990 --> 00:25:08,758 You hear that? 434 00:25:08,842 --> 00:25:11,086 She wants me off the phone. Means she's vulnerable. 435 00:25:11,170 --> 00:25:11,804 Go all in. 436 00:25:11,888 --> 00:25:16,171 But, um, the party's over in less than three hours. 437 00:25:16,256 --> 00:25:18,182 Cuddy: It's over in less than two hours. 438 00:25:18,266 --> 00:25:24,068 Which means you either have three of a kind, or just 3s. 439 00:25:24,316 --> 00:25:26,386 I'm guessing 3s. 440 00:25:27,033 --> 00:25:29,871 I bet 500. 441 00:25:31,112 --> 00:25:32,100 Go all in. 442 00:25:32,230 --> 00:25:34,759 You obviously want to bust me. Why would you-- 443 00:25:34,843 --> 00:25:36,016 Either you go all in, or 444 00:25:36,124 --> 00:25:39,044 I tell everybody in the building that you wear toenail polish. 445 00:25:40,821 --> 00:25:42,356 I'm all in. 446 00:25:44,126 --> 00:25:45,861 I'll call. 447 00:25:46,110 --> 00:25:51,797 I'm betting you have a pair of threes, but even if you have three... 448 00:25:52,549 --> 00:25:55,696 it's not going to beat trip nines. 449 00:25:57,396 --> 00:25:59,697 Oh. Oh, oh no. 450 00:25:59,957 --> 00:26:00,613 Oh, no. 451 00:26:00,697 --> 00:26:03,368 Oh, oh. That's gotta hurt. 452 00:26:03,452 --> 00:26:04,095 What happened? 453 00:26:04,179 --> 00:26:06,180 I just killed two birds with one straight. 454 00:26:06,333 --> 00:26:07,219 Good-bye. 455 00:26:08,388 --> 00:26:09,857 Fine. Keep playing. 456 00:26:09,941 --> 00:26:11,473 But I need you to recommend a good oncologist. 457 00:26:11,557 --> 00:26:15,149 Because if I don't get one up here in the next few minutes, I got a dead six-year-old. 458 00:26:17,909 --> 00:26:19,377 Wilson: If you need help, ask. 459 00:26:19,462 --> 00:26:21,462 These games are insane. 460 00:26:21,949 --> 00:26:23,829 Games have a higher success rate. 461 00:26:23,896 --> 00:26:26,154 Well, I don't see anything that looks like leukemia. 462 00:26:26,238 --> 00:26:27,809 You do a bone marrow biopsy? 463 00:26:27,893 --> 00:26:28,760 No time. 464 00:26:28,844 --> 00:26:30,770 Even if there is an occult blood cancer, 465 00:26:30,874 --> 00:26:33,226 you wouldn't expect interferon to make it worse. 466 00:26:33,298 --> 00:26:34,744 Certainly not this fast. 467 00:26:34,828 --> 00:26:36,605 What would move this fast? 468 00:26:36,690 --> 00:26:37,753 Cameron: Autoimmune diseases. 469 00:26:37,838 --> 00:26:41,552 If his body's own defenses are attacking him, then beefing them up is just going to put fuel on the fire. 470 00:26:41,636 --> 00:26:43,668 Sarcoidosis could be in his brain and lungs. 471 00:26:43,752 --> 00:26:46,400 No, no enlarged hilar lymph nodes on his chest x-ray. 472 00:26:46,485 --> 00:26:49,515 The systemic nature suggests Juvenile Rheumatoid Arthritis. 473 00:26:49,599 --> 00:26:50,907 Or Kawasaki's disease. 474 00:26:50,991 --> 00:26:52,172 Can't be Kawasaki's. 475 00:26:52,282 --> 00:26:54,052 Doesn't affect the elderly. 476 00:26:54,356 --> 00:26:57,313 Uh, these... This is a kid's x-ray. 477 00:26:57,417 --> 00:26:59,410 House had another patient... 478 00:27:01,295 --> 00:27:03,108 Who may or may not have had Kawasaki's. 479 00:27:03,192 --> 00:27:04,563 This kid, on the other hand... 480 00:27:04,647 --> 00:27:08,234 He makes antibodies that are eating the inside of his arteries. 481 00:27:08,319 --> 00:27:11,239 Choking off blood to his major organs one by one. 482 00:27:11,323 --> 00:27:15,323 First the GI tract, then the kidneys, then the brain, now the lungs. 483 00:27:16,615 --> 00:27:20,727 Can anyone think of a reason why Kawasaki's can't affect the elderly? 484 00:27:21,232 --> 00:27:22,992 Other than that it doesn't? 485 00:27:26,164 --> 00:27:26,712 Nice. 486 00:27:26,796 --> 00:27:28,362 Foreman: We can confirm with blood work. 487 00:27:28,447 --> 00:27:30,087 We need an ANA, sed rate-- 488 00:27:30,172 --> 00:27:31,729 Labs will take two hours. 489 00:27:32,321 --> 00:27:33,778 What was the old lady's sed rate? 490 00:27:33,970 --> 00:27:35,520 House: Elevated. 98. 491 00:27:35,604 --> 00:27:39,380 You can't use another patient's labs to diagnose Kawasaki's disease. 492 00:27:39,464 --> 00:27:40,762 Is that like a dare or something? 493 00:27:40,846 --> 00:27:42,378 You don't have time to be wrong. 494 00:27:42,481 --> 00:27:43,167 Fine. 495 00:27:43,279 --> 00:27:45,379 We'll look for Kawasaki where he lives. 496 00:27:45,670 --> 00:27:47,775 Ian's coronary arteries. 497 00:27:53,744 --> 00:27:55,623 This other patient. 498 00:27:57,771 --> 00:28:01,027 The old lady. Esther? 499 00:28:04,054 --> 00:28:06,013 Have you read Moby Dick? 500 00:28:06,073 --> 00:28:07,260 It was a book? 501 00:28:07,493 --> 00:28:09,983 It was 10 years ago. 12. 502 00:28:10,080 --> 00:28:11,654 Obsessionis dangerous. 503 00:28:11,758 --> 00:28:14,559 Only if you're on a wooden ship and your obsession is a whale. 504 00:28:14,643 --> 00:28:15,944 I think I'm in the clear. 505 00:28:16,028 --> 00:28:17,619 You do realize it's a metaphor? 506 00:28:17,703 --> 00:28:21,586 You do realize that the point of metaphors is to scare people from doing things by telling them that 507 00:28:21,670 --> 00:28:24,741 something much scarier is going to happen than what will really happen. 508 00:28:25,752 --> 00:28:28,476 God, I wish I had a metaphor to explain that better. 509 00:28:28,920 --> 00:28:30,182 Go back to the game. 510 00:28:30,328 --> 00:28:32,542 Don't worry. I'm not going to get eaten by witches. 511 00:28:37,474 --> 00:28:40,601 Chase: Coronary arteries clear. No aneurysms. 512 00:28:40,748 --> 00:28:42,741 Flip the mode. Let's see the flow. 513 00:28:46,696 --> 00:28:48,798 How did that other woman die? 514 00:28:49,428 --> 00:28:52,728 She went into respiratory distress. 515 00:28:53,056 --> 00:28:54,558 Her heart and liver were already com-- 516 00:28:54,660 --> 00:28:55,522 No. 517 00:28:57,271 --> 00:28:59,095 Did she suffer? 518 00:29:00,201 --> 00:29:01,523 Was she in pain? 519 00:29:01,946 --> 00:29:03,489 I don't know. 520 00:29:06,812 --> 00:29:07,957 Laminar flow. 521 00:29:08,041 --> 00:29:10,701 No blood clots, no ragged edges. 522 00:29:10,887 --> 00:29:12,601 Cameron: Damn. Shut it down. 523 00:29:12,685 --> 00:29:14,368 We're just wasting time. 524 00:29:20,066 --> 00:29:21,589 Look at the right atrium. 525 00:29:21,674 --> 00:29:23,161 That's not Kawasaki's. 526 00:29:23,245 --> 00:29:24,185 No. 527 00:29:24,538 --> 00:29:26,648 Chase: It's small. But it's there. 528 00:29:26,754 --> 00:29:28,976 Esther didn't have a mass in her heart. 529 00:29:29,060 --> 00:29:30,428 Ian's younger. 530 00:29:30,512 --> 00:29:31,616 He can take more of a pounding. 531 00:29:31,700 --> 00:29:33,769 Esther died before the disease reached her heart. 532 00:29:33,838 --> 00:29:35,721 The disease made a mass and made it fast. 533 00:29:35,832 --> 00:29:36,933 Could be bacteria. 534 00:29:37,017 --> 00:29:38,621 - Muscle. - Connective tissue. 535 00:29:38,705 --> 00:29:40,624 Hosue: The kid can't take any more theories. 536 00:29:40,708 --> 00:29:43,789 Only thing we know is that whatever that mass is, that's what he's got. 537 00:29:44,237 --> 00:29:45,877 We need a piece of it. 538 00:29:46,145 --> 00:29:47,909 I'm doing a biopsy. 539 00:30:02,374 --> 00:30:03,614 I'll shut the blinds. 540 00:30:03,673 --> 00:30:05,136 No, let them watch. 541 00:30:05,220 --> 00:30:08,133 I do my best work on the big stage. 542 00:30:09,291 --> 00:30:11,964 Passing through the superior vena cava. 543 00:30:12,203 --> 00:30:14,694 You're in the atrium. Pull back. 544 00:30:16,244 --> 00:30:17,909 You hit the wall of the heart. 545 00:30:18,629 --> 00:30:22,761 These procedures would be so much simpler if we could do them on healthy people. 546 00:30:24,099 --> 00:30:26,436 And out again. 547 00:30:26,995 --> 00:30:28,260 [Monitors start beeping] 548 00:30:28,491 --> 00:30:30,864 - V. Fib. - Cardiac arrest. Call it. 549 00:30:32,376 --> 00:30:33,940 Come on. Paddles. 550 00:30:36,249 --> 00:30:37,692 - Come on. - Charging. 551 00:30:37,776 --> 00:30:38,648 Clear. 552 00:30:40,164 --> 00:30:44,408 [Overhead speaker] "Code blue. ISO room." 553 00:30:46,104 --> 00:30:47,439 And again. 554 00:30:50,951 --> 00:30:52,829 - Nothing. - Again. 555 00:31:08,176 --> 00:31:09,326 Have you got a clock on this? 556 00:31:09,407 --> 00:31:11,254 How much longer you going to be doing this? 557 00:31:12,154 --> 00:31:12,875 Clear. 558 00:31:16,988 --> 00:31:19,245 Wait. Got something. 559 00:31:22,236 --> 00:31:23,418 He's back. 560 00:31:30,987 --> 00:31:32,043 Chase: What are you doing? 561 00:31:32,350 --> 00:31:33,761 I'm doing what we came here to do. 562 00:31:33,911 --> 00:31:36,321 - It almost killed him. - I know. I was right here. 563 00:31:36,403 --> 00:31:37,505 Give me a vacutainer. 564 00:31:37,589 --> 00:31:40,943 His brain's been oxygen-deprived for over eight minutes. 565 00:31:41,027 --> 00:31:42,311 There might benothing left. You might be-- 566 00:31:42,396 --> 00:31:45,178 Tell the parents. Where the hell is that vacutainer? 567 00:31:56,757 --> 00:31:58,503 So. What's he got? 568 00:31:58,688 --> 00:31:59,709 Brain damage. 569 00:31:59,793 --> 00:32:02,049 Good chance. I was talking about before that. 570 00:32:02,133 --> 00:32:03,158 You're not worried about-- 571 00:32:03,158 --> 00:32:05,839 Things I can't do anything about? I try not to. 572 00:32:06,402 --> 00:32:08,922 Things just roll off you like water off a duck. 573 00:32:09,006 --> 00:32:10,203 Histiocytosis. 574 00:32:10,287 --> 00:32:12,347 Very unlikely in a 73-year-old. 575 00:32:12,431 --> 00:32:14,717 Whatever this is, is very unlikely. 576 00:32:15,200 --> 00:32:17,191 Come on, more ideas. Let's go, people. 577 00:32:17,249 --> 00:32:19,546 Genetic disorders could cause masses everywhere. 578 00:32:19,654 --> 00:32:20,715 Tuberous sclerosis. 579 00:32:20,799 --> 00:32:23,090 If it's genetic, he's had it all his life. Why now? 580 00:32:23,174 --> 00:32:25,508 I don't know. It sure fits nice enough. 581 00:32:25,592 --> 00:32:27,391 We haven't ruled out leukemia yet. 582 00:32:27,537 --> 00:32:30,418 Or sarcoma. He could have multiple soft tissue tumors. 583 00:32:30,502 --> 00:32:31,723 Foreman: Or sarcoidosis. 584 00:32:31,807 --> 00:32:34,895 - Multiple neurofibromatosis. Foreman: Chondrocytomas. 585 00:32:37,037 --> 00:32:38,608 How's it going? You win? 586 00:32:38,761 --> 00:32:41,996 I got called away by the angry parents of a patient. 587 00:32:41,996 --> 00:32:45,065 There are three of you here. None of you had the sense to stop him. 588 00:32:45,149 --> 00:32:47,412 - To pick up a phoneand call me. - House: I told them you'd signed off. 589 00:32:47,470 --> 00:32:50,054 The parents are mad because their kid is dying. 590 00:32:50,138 --> 00:32:51,295 It's understandable. 591 00:32:51,380 --> 00:32:53,500 But if he doesn't die, they won't be mad anymore. 592 00:32:53,592 --> 00:32:55,850 If he's brain-damaged, they might still be a little ticked. 593 00:32:55,934 --> 00:32:59,162 - I had to do it to save him. - You had to do it to diagnose Esther. 594 00:32:59,614 --> 00:33:01,652 You may have killed a six-year-old 595 00:33:01,716 --> 00:33:05,059 because you're obsessed with a woman who's been dead for 12 years. 596 00:33:05,154 --> 00:33:07,329 Sometimes you lose, House. You're not God. 597 00:33:07,413 --> 00:33:08,407 He's not dead yet. 598 00:33:08,489 --> 00:33:11,048 No, but you're done with him. It's my case now. Go home. 599 00:33:11,132 --> 00:33:13,785 Go ride your motorcycle. Go brood in a dark room. 600 00:33:13,869 --> 00:33:15,782 Just don't go near Ian again. 601 00:33:23,029 --> 00:33:26,355 So, anything else? Or is it just these seven? 602 00:33:26,440 --> 00:33:27,704 Drop it, House. She's right. 603 00:33:27,770 --> 00:33:29,038 No, she's not. 604 00:33:30,296 --> 00:33:32,550 - You know she's not. - We should have called her. 605 00:33:32,634 --> 00:33:33,936 I'm surprised you didn't. 606 00:33:34,086 --> 00:33:37,426 You're going to have to find a way to let this go--we can't go near Ian. 607 00:33:37,510 --> 00:33:39,003 We don't need to go near him. 608 00:33:39,687 --> 00:33:41,214 We have his tumor. 609 00:33:42,008 --> 00:33:44,392 Cuddy may be right that we screwed up the protocol. 610 00:33:44,499 --> 00:33:46,712 She may be right about my screwed-up obsession. 611 00:33:47,273 --> 00:33:49,186 But I am right about the medicine. 612 00:33:49,864 --> 00:33:51,509 How many tests can we do with that? 613 00:33:51,594 --> 00:33:52,237 [Sighs] 614 00:33:52,615 --> 00:33:54,955 Look, we cure the kid, we solve everybody's problems. 615 00:33:55,039 --> 00:33:56,261 How many? 616 00:33:59,253 --> 00:34:02,356 - Maybe two good pieces. - How many okay pieces? 617 00:34:03,229 --> 00:34:04,845 Three would be pushing it. 618 00:34:06,987 --> 00:34:09,909 Three tests, seven choices. 619 00:34:10,818 --> 00:34:12,220 Okay, what's first? 620 00:34:12,282 --> 00:34:15,123 Uh...sarcoidosis seems most likely. 621 00:34:15,190 --> 00:34:18,565 Yeah, so likely that Cuddy's going to think of that all on her own. 622 00:34:18,747 --> 00:34:20,824 She's got the kid's whole body to play with. 623 00:34:20,908 --> 00:34:23,202 Let her do that test. What's next? 624 00:34:23,577 --> 00:34:25,582 It's moving too fast to be spreading. 625 00:34:25,689 --> 00:34:27,477 It has to be growing from something that's already-- 626 00:34:27,561 --> 00:34:29,368 Genetic disorder-- Tuberous sclerosis. 627 00:34:29,554 --> 00:34:32,512 Or it's his immune system. Histiocytosis. 628 00:34:33,381 --> 00:34:37,609 There are more documented cases of histio amongst older people than tuberous sclerosis. 629 00:34:37,694 --> 00:34:38,843 Let's start with that. 630 00:34:44,841 --> 00:34:47,216 Wing or drumstick? 631 00:34:49,378 --> 00:34:50,740 Gonna need a little more than that. 632 00:34:50,801 --> 00:34:52,331 A little more is more than a third. 633 00:34:52,415 --> 00:34:55,779 If we have to repeat this test because you didn't cut us enough... 634 00:35:02,013 --> 00:35:04,797 Chase: I'm adding one microliter of the immunoperoxidase. 635 00:35:04,881 --> 00:35:05,681 Make it two. 636 00:35:05,765 --> 00:35:09,454 I don't want House biting off our heads because we weren't sure if it turned red or not. 637 00:35:15,987 --> 00:35:18,137 Cameron: That's definitely not red. 638 00:35:23,420 --> 00:35:26,849 The problem could still be an abnormal cell growth, but a different cell line. 639 00:35:26,933 --> 00:35:29,403 Foreman: Sarcoma? Muscle cells are throughout his body. 640 00:35:29,461 --> 00:35:30,604 Would explain the geography. 641 00:35:30,688 --> 00:35:32,735 Cameron: Genetic disorder is far more likely in a six-year-old. 642 00:35:32,840 --> 00:35:33,906 Tuberous sclerosis. 643 00:35:34,160 --> 00:35:35,956 Pretty unlikely to cause a GI bleed. 644 00:35:36,067 --> 00:35:37,408 The time course fits. 645 00:35:37,485 --> 00:35:40,106 So, Foreman, you agree with both of them. Thanks for playing. 646 00:35:40,190 --> 00:35:42,694 If we have enough tissue for two tests, why not do both? 647 00:35:42,778 --> 00:35:44,109 Then we don't have to think as hard. 648 00:35:44,193 --> 00:35:47,325 Taking the pressure off the choice makes us less likely to think critically. 649 00:35:47,409 --> 00:35:50,268 Sarcoma is more likely to hita 6- and a 70-year-old. 650 00:35:50,352 --> 00:35:51,774 Tuberous sclerosis it is. 651 00:35:51,842 --> 00:35:53,728 You think sarcoma is less likely? 652 00:35:53,728 --> 00:35:54,722 It's more likely. 653 00:35:54,787 --> 00:35:57,875 The test for it, on the other hand, is less reliable. 654 00:36:10,220 --> 00:36:11,406 Cameron: Nestin's negative. 655 00:36:11,469 --> 00:36:12,515 Well, that's okay. 656 00:36:12,599 --> 00:36:16,900 If the tumor cells haven't matured, the Ki-67 protein wouldn't have turned off. 657 00:36:18,899 --> 00:36:20,556 What happens if we don't solve this? 658 00:36:20,658 --> 00:36:23,505 - The kid dies. - I mean for the next 12 years. 659 00:36:25,298 --> 00:36:27,486 Ki-67's negative. 660 00:36:30,773 --> 00:36:33,667 And PCH antigen is negative. 661 00:36:44,496 --> 00:36:47,168 Mighty Casey's down to his last strike. 662 00:36:47,252 --> 00:36:49,017 Mighty Casey struck out. 663 00:36:49,600 --> 00:36:51,897 Thanks a lot. I was going to read that this weekend. 664 00:36:51,997 --> 00:36:53,006 Cameron: Chondrocytoma. 665 00:36:53,090 --> 00:36:55,546 Connective tissue has been in all the places we've been looking. 666 00:36:55,631 --> 00:36:58,191 The kid is too sick for that. We're better off testing for sarcoma. 667 00:36:58,275 --> 00:37:00,927 We would have seen signs of that when we tested for tuberous sclerosis. 668 00:37:01,011 --> 00:37:03,313 Tumor cells look like muscle under the microscope. 669 00:37:03,397 --> 00:37:05,372 No, they didn't. They looked like fat. 670 00:37:07,044 --> 00:37:09,497 I vote for neurofibromatosis. 671 00:37:10,363 --> 00:37:11,048 Why? 672 00:37:11,048 --> 00:37:13,360 Because the other choices suck worse. 673 00:37:21,874 --> 00:37:22,939 Give me a minute. 674 00:37:53,126 --> 00:37:55,088 You want me out of here? 675 00:37:57,139 --> 00:37:58,976 You come up with anything? 676 00:38:01,688 --> 00:38:02,846 No. 677 00:38:29,679 --> 00:38:30,598 Hey. 678 00:38:30,682 --> 00:38:32,791 We can talk about it tomorrow. 679 00:38:40,224 --> 00:38:41,883 I, um... 680 00:38:43,204 --> 00:38:46,087 I won the poker tournament. 681 00:38:47,542 --> 00:38:50,263 I totally played this guy Berman from business affairs. 682 00:38:50,328 --> 00:38:54,541 I got great cards. But I don't bet. Just call, no raises. 683 00:38:54,625 --> 00:38:56,899 Berman pairs his King on the flop. 684 00:38:57,006 --> 00:39:01,114 I keep calling, the river turns, I check. 685 00:39:01,219 --> 00:39:05,728 He can't stand it. He goes all in. He's sure he's won. 686 00:39:07,685 --> 00:39:11,031 I call, I flip 'em. Pow! 687 00:39:11,212 --> 00:39:12,391 Pocket aces. 688 00:39:12,947 --> 00:39:15,176 I nailed his ass. 689 00:39:23,625 --> 00:39:26,755 The aces were hiding all along. 690 00:39:34,275 --> 00:39:36,912 Test him for Erdheim Chester disease. 691 00:39:36,996 --> 00:39:39,299 Erdheim Chester? That's not even on the list. 692 00:39:39,384 --> 00:39:41,025 Because we already did it. 693 00:39:41,110 --> 00:39:42,208 He tested negative. 694 00:39:42,293 --> 00:39:43,108 So did Esther. 695 00:39:43,192 --> 00:39:44,411 The disease lied. 696 00:39:44,521 --> 00:39:47,632 Yeah, the tumor's got it in for you. Diseases don't lie. 697 00:39:47,716 --> 00:39:50,046 Fine, it didn't lie. It slow played us. 698 00:39:50,130 --> 00:39:53,649 We biopsied the colon, but it hadn't reached the GI tract yet. 699 00:39:53,791 --> 00:39:55,128 It's there now. 700 00:39:55,228 --> 00:39:56,709 It's in his liver, his lungs... 701 00:39:56,793 --> 00:39:58,532 You want it to be there. 702 00:39:58,616 --> 00:40:00,917 Because then you didn't screw up 12 years ago. 703 00:40:01,001 --> 00:40:05,154 We can't waste our one test on the one disease we know it's not. 704 00:40:07,846 --> 00:40:09,416 Run the test. 705 00:40:20,892 --> 00:40:22,202 You sure about this? 706 00:40:22,760 --> 00:40:24,139 Wait, let me think about that. 707 00:40:24,286 --> 00:40:25,432 Don't pressure me. 708 00:40:25,579 --> 00:40:27,616 Just run the damn test. 709 00:40:30,276 --> 00:40:32,407 Cameron: Cells look like macrophages. 710 00:40:32,491 --> 00:40:33,910 That's a good start. 711 00:40:40,237 --> 00:40:43,285 Take your time and say it loud. 712 00:40:52,505 --> 00:40:54,454 CD 68 positive. 713 00:41:06,699 --> 00:41:08,698 Start the treatment. 714 00:42:07,832 --> 00:42:10,595 So Esther can rest peaceful now, huh? 715 00:42:11,236 --> 00:42:12,273 Yeah. 716 00:42:18,817 --> 00:42:20,159 40. 717 00:42:25,384 --> 00:42:27,186 You got lucky. 718 00:42:28,010 --> 00:42:29,427 You gonna call? 719 00:42:29,616 --> 00:42:31,493 What I do... 720 00:42:32,017 --> 00:42:34,725 is not just based on the flip of a card. 721 00:42:34,977 --> 00:42:37,659 You guessed. You got lucky. 722 00:42:37,743 --> 00:42:38,693 It fit. 723 00:42:38,801 --> 00:42:41,778 It could just as easily have been sarcoma or tuberous sclerosis. 724 00:42:41,862 --> 00:42:44,255 No, not just as easily. 725 00:42:44,339 --> 00:42:47,125 Maybe not. But it wasn't impossible. 726 00:42:50,512 --> 00:42:51,813 Are you going to call? 727 00:42:53,742 --> 00:42:54,614 You know, 728 00:42:54,951 --> 00:42:56,641 relative to its size, 729 00:42:56,743 --> 00:43:00,281 the barnacle has the largest penis of any animal.