1 00:00:02,169 --> 00:00:03,670 He is not sick. 2 00:00:03,796 --> 00:00:06,673 Dr. Riley is throwing up. He obviously can't lecture. 3 00:00:06,799 --> 00:00:09,425 You witnessed the spew or do you just have his word for it? 4 00:00:09,551 --> 00:00:11,344 I think I'm coming down with a little bit of the clap. 5 00:00:11,470 --> 00:00:12,887 I may have to go home for a few days. 6 00:00:13,013 --> 00:00:15,515 Dr. Riley doesn't have a history of lying to me. 7 00:00:15,641 --> 00:00:18,309 You said this is the fifth time he's missed a class this year. 8 00:00:18,435 --> 00:00:19,769 Either he's dying or he's lying. 9 00:00:19,895 --> 00:00:21,854 I'll give you two hours off clinic duty. 10 00:00:21,980 --> 00:00:24,899 Fine. I'll have Cameron do it. She loves inspiring the inspired. 11 00:00:25,025 --> 00:00:26,359 You'll do it. 12 00:00:26,527 --> 00:00:27,860 Why is it always me? 13 00:00:27,986 --> 00:00:29,278 Because the world hates you. 14 00:00:29,405 --> 00:00:31,489 Or because it's a class on diagnostics. 15 00:00:31,615 --> 00:00:34,909 Pick whichever reason feeds your narcissism better. 16 00:00:35,035 --> 00:00:37,078 I'm not doing it. 17 00:00:48,924 --> 00:00:51,884 You're supposed to stop me. Renegotiate. 18 00:00:52,010 --> 00:00:53,594 And you were supposed to keep on walking. 19 00:00:53,721 --> 00:00:56,681 Sorry. I guess we both screwed up. Go on. Do it again. 20 00:00:57,850 --> 00:00:59,851 I'll do the lecture for four hours off clinic. 21 00:00:59,977 --> 00:01:03,312 Two. I know you'd rather spend a couple of hours 22 00:01:03,439 --> 00:01:05,857 listening to yourself than listening to patients. 23 00:01:07,860 --> 00:01:09,986 Class starts in 20 minutes. 24 00:01:12,448 --> 00:01:13,614 Dr. House, there's a patient. 25 00:01:13,741 --> 00:01:15,616 I'm outta here. Take it up with Cuddy. 26 00:01:15,743 --> 00:01:17,660 Greg. 27 00:01:23,459 --> 00:01:25,418 Hi, Stacy. 28 00:01:26,336 --> 00:01:27,920 How you doing? 29 00:01:29,047 --> 00:01:31,507 How am I doing? 30 00:01:31,967 --> 00:01:34,844 Well, the last five years have been like... 31 00:01:34,970 --> 00:01:37,764 You ever see those "Girls Gone Wild" videos? 32 00:01:37,890 --> 00:01:41,893 Your life's been like that, or your life's been spent watching them? 33 00:01:46,023 --> 00:01:47,857 I have missed you. 34 00:01:49,234 --> 00:01:51,402 Is that why you're here? 35 00:01:56,158 --> 00:01:57,992 I need your help. 36 00:02:08,378 --> 00:02:10,254 Who am I looking at? 37 00:02:10,380 --> 00:02:12,048 My husband. 38 00:02:15,469 --> 00:02:19,180 Who is suffering abdominal pain and fainting spells. 39 00:02:20,224 --> 00:02:23,476 No sign of tumors, no vasculitis. 40 00:02:23,602 --> 00:02:26,103 Could be indigestion. 41 00:02:26,230 --> 00:02:28,189 Or maybe a kidney stone. 42 00:02:28,357 --> 00:02:30,316 Little one can pack a lot of wallop. 43 00:02:30,442 --> 00:02:33,361 Did you think I wasn't going to get married? 44 00:02:34,696 --> 00:02:36,906 Not to someone so poorly endowed. 45 00:02:37,032 --> 00:02:39,367 This guy's pancreas is pathetic. 46 00:02:43,747 --> 00:02:45,915 There is no kidney stone, no indigestion. 47 00:02:46,041 --> 00:02:49,544 Three hospitals, five doctors. Not one of them found anything. 48 00:02:49,670 --> 00:02:51,170 Maybe there's nothing to be found. 49 00:02:51,296 --> 00:02:52,713 Right. You suddenly trust doctors, 50 00:02:52,840 --> 00:02:54,507 love puppies and long walks in the rain. 51 00:02:54,633 --> 00:02:56,634 Walks are out. 52 00:02:57,177 --> 00:03:00,555 I was around you long enough to know when something's not right. 53 00:03:00,681 --> 00:03:01,931 Mark's had personality changes. 54 00:03:02,057 --> 00:03:04,684 He's acting strange, disconnected. 55 00:03:04,810 --> 00:03:06,394 Interesting. 56 00:03:06,520 --> 00:03:08,437 Means there's either a neurological component, 57 00:03:08,564 --> 00:03:10,189 or he's having an affair. 58 00:03:10,315 --> 00:03:12,859 No affair. No nothing. He's sick. 59 00:03:14,152 --> 00:03:17,238 I know you're not too busy. You avoid work like the plague. 60 00:03:17,364 --> 00:03:19,740 Unless it actually is the plague. 61 00:03:19,867 --> 00:03:21,868 I'm asking you a favor. 62 00:03:22,828 --> 00:03:24,829 I'm not too busy. 63 00:03:26,582 --> 00:03:29,625 But I'm not sure I want him to live. 64 00:03:31,753 --> 00:03:33,880 It's good seeing you again. 65 00:04:24,806 --> 00:04:28,517 Three guys walk into a clinic. 66 00:04:28,810 --> 00:04:32,438 Their legs hurt. What's wrong with them? 67 00:04:34,942 --> 00:04:36,651 I'm not gonna like you, am I? 68 00:04:36,777 --> 00:04:39,403 The most likely cause of leg pain is muscle strain. 69 00:04:39,529 --> 00:04:42,114 Apply heat and rest affected areas. 70 00:04:42,240 --> 00:04:44,784 Statistically, you're right. Very good. 71 00:04:44,910 --> 00:04:47,954 My experience, over half of leg pain is musculoskeletal, 72 00:04:48,080 --> 00:04:50,247 generally from excessive exercise, 73 00:04:50,374 --> 00:04:53,918 12 percent is varicose veins brought on by pregnancy, 74 00:04:54,044 --> 00:04:57,421 and most of the rest is the result of vehicular accidents. 75 00:04:57,547 --> 00:04:59,966 I said three people. That's six legs. 76 00:05:00,092 --> 00:05:02,551 So you've got three hurt jogging, 77 00:05:02,678 --> 00:05:05,346 two in collisions, and one of the legs is pregnant. 78 00:05:06,807 --> 00:05:08,224 What were they doing when pain presented? 79 00:05:08,350 --> 00:05:09,350 I have no idea. 80 00:05:09,476 --> 00:05:11,394 You didn't ask? You didn't take a history? 81 00:05:11,520 --> 00:05:15,898 Of course. But all that told us is what they said happened. 82 00:05:16,024 --> 00:05:19,902 Person A, farmer, says he was fixing a fence. 83 00:05:22,906 --> 00:05:25,449 Tightness in the ankle, loss of muscle control. 84 00:05:27,452 --> 00:05:30,871 Person B, volleyball practice. 85 00:05:35,711 --> 00:05:38,295 Coach figured it was a pulled muscle. 86 00:05:38,422 --> 00:05:42,383 And C, we've got Carmen Electra golfing. 87 00:05:43,218 --> 00:05:44,427 Yes! 88 00:05:44,553 --> 00:05:47,346 Whoa. You treated the "Baywatch" chick? 89 00:05:47,472 --> 00:05:50,391 The "Baywatch" thespian. And no. 90 00:05:51,059 --> 00:05:53,728 I gotta disguise the identity of each of the patients, 91 00:05:53,854 --> 00:05:55,813 and I got tired of using the middle-aged man. 92 00:05:55,939 --> 00:05:59,150 Carmen seemed like a pleasant alternative. 93 00:05:59,276 --> 00:06:01,694 Also, she's apparently quite the golfer. 94 00:06:01,820 --> 00:06:04,905 In less than two hours, one of these three 95 00:06:05,032 --> 00:06:06,782 will be tossed out of the hospital because 96 00:06:06,908 --> 00:06:08,743 they were faking it to score narcotics, 97 00:06:08,869 --> 00:06:12,872 and one will be very close to death. 98 00:06:13,832 --> 00:06:16,625 Any guesses on which is which? 99 00:06:17,961 --> 00:06:20,629 Okay, I say we start with the farmer. 100 00:06:22,257 --> 00:06:25,634 Did you hike to the fence, and how far? 101 00:06:25,761 --> 00:06:29,180 Yes. It's about a half a mile from my farmhouse. 102 00:06:29,306 --> 00:06:31,015 And where is the pain localized? 103 00:06:31,141 --> 00:06:34,894 It started just above my ankle, and it's radiating up. 104 00:06:35,020 --> 00:06:36,896 So, what should we do first? 105 00:06:37,022 --> 00:06:38,355 Family history? 106 00:06:38,482 --> 00:06:40,900 Indicative of leg pain? That's a very short list. 107 00:06:41,026 --> 00:06:44,028 Any history of bone cancer, osteogenesis imperfecta 108 00:06:44,154 --> 00:06:46,238 or multiple myeloma? 109 00:06:46,364 --> 00:06:47,698 Could be a blood issue. 110 00:06:47,824 --> 00:06:49,909 We should run a CBC and a D-Dimer. 111 00:06:50,035 --> 00:06:51,202 And get an MRI. 112 00:06:51,328 --> 00:06:52,661 MRI or a PET scan? 113 00:06:52,788 --> 00:06:53,746 If the problem's vascular, he's better off... 114 00:06:53,872 --> 00:06:56,832 Sorry. Thanks for playing. 115 00:06:56,958 --> 00:06:59,585 Patient's dead. You killed him. 116 00:07:01,171 --> 00:07:03,798 We had no time to run any tests. There was nothing we could do. 117 00:07:03,924 --> 00:07:06,383 You had time to look at the leg. 118 00:07:11,223 --> 00:07:13,766 I thought we were starting with the farmer's case first. 119 00:07:13,892 --> 00:07:17,019 We are. But if we're gonna look at a leg... 120 00:07:17,145 --> 00:07:19,980 I need you to take off your pants. 121 00:07:48,051 --> 00:07:49,260 Puncture. 122 00:07:49,386 --> 00:07:50,386 Snake bite. 123 00:07:50,512 --> 00:07:51,720 That would be my guess. 124 00:07:51,847 --> 00:07:53,139 Farmer didn't know he'd been bitten by a snake? 125 00:07:53,265 --> 00:07:54,265 That's what he said. 126 00:07:54,391 --> 00:07:56,642 Sudden shooting pain, tall grass. 127 00:07:56,768 --> 00:07:58,227 Never saw a thing. 128 00:07:58,353 --> 00:07:59,395 What kind of snake? 129 00:07:59,521 --> 00:08:00,896 You want me to tell you what kind of snake it was 130 00:08:01,022 --> 00:08:02,606 from the shape of the hole in the leg? 131 00:08:02,732 --> 00:08:04,650 Well, how are we supposed to know what kind of antivenom to use 132 00:08:04,776 --> 00:08:05,943 if we don't know what kind of snake it is? 133 00:08:06,069 --> 00:08:09,113 Oh, there are people to find those things out. 134 00:08:09,239 --> 00:08:11,448 Shouldn't we wait for the Humane Society or something? 135 00:08:11,575 --> 00:08:14,076 Guy might only have a couple of hours. 136 00:08:21,126 --> 00:08:24,753 And while we wait for the Humane Society to show up, 137 00:08:24,880 --> 00:08:27,715 let's say we check in on the volleyball player. 138 00:08:28,508 --> 00:08:30,926 You have tendinitis. 139 00:08:31,344 --> 00:08:33,304 How old is this person? 140 00:08:33,430 --> 00:08:35,723 I mean, it's not really a 40-year-old man 141 00:08:35,849 --> 00:08:36,891 on a girls' volleyball team, right? 142 00:08:37,017 --> 00:08:39,018 It's a leg. A leg is a leg is a leg. 143 00:08:39,144 --> 00:08:40,644 Well, I was just worried that... 144 00:08:40,770 --> 00:08:44,023 Would you worry about her more if she was younger? 145 00:08:44,608 --> 00:08:47,735 Well, obviously, we should care about all our patients, no matter what age... 146 00:08:47,861 --> 00:08:49,278 Yeah, right. 147 00:08:49,404 --> 00:08:51,280 I saw the way you were looking at Carmen. 148 00:08:51,406 --> 00:08:52,907 She's mine. Stay away. 149 00:08:54,242 --> 00:08:55,868 Would you operate on your mother? 150 00:08:56,661 --> 00:08:58,245 Of course not. 151 00:08:58,371 --> 00:09:00,956 I'd be too nervous. Couldn't be objective. 152 00:09:01,082 --> 00:09:05,002 Then why are you so anxious to treat every patient like they're family? 153 00:09:05,253 --> 00:09:07,504 The actual patient is 16. 154 00:09:07,631 --> 00:09:11,008 Here's what happens when doctors care too much. 155 00:09:11,134 --> 00:09:14,011 I need to know everything about you. 156 00:09:15,889 --> 00:09:17,306 I went back three generations. 157 00:09:17,432 --> 00:09:20,935 No history of cancer, Parkinson's or any other degenerative condition, 158 00:09:21,061 --> 00:09:23,103 but there's this boy at school, and he's on the boys' volleyball team 159 00:09:23,230 --> 00:09:25,231 and they made out at a party, and now he won't call her back. 160 00:09:25,357 --> 00:09:26,440 And this friend of hers at school 161 00:09:26,566 --> 00:09:29,193 said this boy didn't like her and never did. 162 00:09:29,319 --> 00:09:30,986 You got all this from an examination of the knee? 163 00:09:31,112 --> 00:09:32,154 I think she's depressed. 164 00:09:32,280 --> 00:09:33,364 She doesn't have tendinitis? 165 00:09:33,490 --> 00:09:34,573 She has tendinitis. 166 00:09:34,699 --> 00:09:35,699 She's depressed about having tendinitis? 167 00:09:35,825 --> 00:09:37,243 She's depressed for the same reason that she has tendinitis. 168 00:09:37,369 --> 00:09:39,453 - Not the boy? - No, the boy's a jerk. 169 00:09:39,579 --> 00:09:41,747 She knows that, and yet she's depressed. 170 00:09:41,873 --> 00:09:43,582 I found a nodule. 171 00:09:43,708 --> 00:09:44,708 Ah. 172 00:09:45,085 --> 00:09:48,045 Problems with the thyroid gland causes depressed mental state, 173 00:09:48,171 --> 00:09:50,798 can cause inflammation of the tendons. 174 00:09:50,924 --> 00:09:52,841 I'll run the tests. 175 00:09:52,968 --> 00:09:55,719 So because she took such an extreme interest, 176 00:09:55,845 --> 00:09:58,180 she found out that the person had a thyroid condition. 177 00:09:58,306 --> 00:10:03,310 No. Because she took such an interest, she discovered a tiny nodule, 178 00:10:03,436 --> 00:10:06,730 which in reality signified nothing, but gave us no choice 179 00:10:06,856 --> 00:10:11,318 but to put a person with tendinitis through an expensive and painful test. 180 00:10:17,909 --> 00:10:20,911 Here's how a well-adjusted doctor handles a case. 181 00:10:27,252 --> 00:10:28,877 Can I put my pants back on now? 182 00:10:29,045 --> 00:10:30,921 I'd rather you didn't. 183 00:10:31,047 --> 00:10:33,132 Which Carmen Electra is this? 184 00:10:33,258 --> 00:10:35,509 The first one, the golfer. 185 00:10:35,635 --> 00:10:38,762 Then why isn't she wearing pants? 186 00:10:39,889 --> 00:10:43,183 You have decreased reflexes in your patellar tendon. 187 00:10:43,310 --> 00:10:44,393 Anyone? 188 00:10:44,519 --> 00:10:45,728 Slipped disc. 189 00:10:45,854 --> 00:10:48,272 Could be. How bad does it hurt? 190 00:10:48,398 --> 00:10:49,982 It hurts really, really bad. 191 00:10:50,108 --> 00:10:51,317 Yeah? 192 00:10:51,443 --> 00:10:54,820 It doesn't seem real. Is she the one faking? 193 00:10:54,946 --> 00:10:57,406 Oh, for God's sake. She's here to play into my fantasy, 194 00:10:57,532 --> 00:10:59,199 not 'cause she's Meryl Streep. 195 00:11:02,412 --> 00:11:03,495 Fine. 196 00:11:03,621 --> 00:11:05,956 What the hell is wrong with me! 197 00:11:06,458 --> 00:11:07,791 Do something! 198 00:11:09,836 --> 00:11:11,587 Too much pain to be a slipped disc. 199 00:11:11,713 --> 00:11:13,339 Could be herniated and impinging the nerve root. 200 00:11:13,465 --> 00:11:15,799 Or it could be referred pain from his groin. 201 00:11:15,925 --> 00:11:17,676 Sir, are you getting pain anywhere else? 202 00:11:19,346 --> 00:11:20,929 He's curling. It's not the back. 203 00:11:21,056 --> 00:11:23,766 - Sir, where are you getting pain? - Help me! 204 00:11:23,892 --> 00:11:26,560 He's not gonna tell us anything if we don't get him out of pain. 205 00:11:26,686 --> 00:11:27,853 Give him 50 milligrams of Demerol. 206 00:11:27,979 --> 00:11:30,022 We have no history. He could be allergic. 207 00:11:30,148 --> 00:11:31,190 What do I do? 208 00:11:31,316 --> 00:11:32,775 We can't diagnose him while he screams. 209 00:11:32,901 --> 00:11:34,985 Better than killing him with painkillers. 210 00:11:44,537 --> 00:11:47,081 Apparently, he's not allergic. 211 00:11:48,208 --> 00:11:52,044 Thank you. I feel a lot better now. 212 00:11:55,507 --> 00:11:57,341 We screwed up. 213 00:11:57,467 --> 00:12:00,219 No. You did exactly what his attending did. 214 00:12:00,345 --> 00:12:01,929 And that was the proper way to handle the case? 215 00:12:02,055 --> 00:12:03,013 Yeah. 216 00:12:03,139 --> 00:12:04,556 The guy used him as a dealer. 217 00:12:04,682 --> 00:12:07,851 You're gonna see a lot of drug-seeking behavior in your practice. 218 00:12:07,977 --> 00:12:10,896 And there's a reason. It works. 219 00:12:11,022 --> 00:12:13,774 Meanwhile, back on the farm... 220 00:12:18,613 --> 00:12:21,281 Yeah, timber rattlesnake. 221 00:12:21,783 --> 00:12:25,285 Four vials of the CroFab antivenom. 222 00:12:25,412 --> 00:12:26,495 Hey, how you doing? 223 00:12:26,621 --> 00:12:28,997 - All right. - Thank you. 224 00:12:29,124 --> 00:12:32,084 This will start making you feel better really fast. 225 00:12:39,467 --> 00:12:42,845 He's having an allergic reaction. Bag. 226 00:12:44,973 --> 00:12:46,390 Paddles and epi. 227 00:12:46,516 --> 00:12:48,851 His heart's fine. It's not gonna stay that way. 228 00:12:50,228 --> 00:12:51,979 Paddles! 229 00:12:59,070 --> 00:13:04,158 What say we take five, get some coffee, go pee. 230 00:13:12,083 --> 00:13:15,002 You didn't think she was gonna get married? 231 00:13:16,004 --> 00:13:18,172 She asked me the same question. 232 00:13:20,717 --> 00:13:23,969 And what? You're not gonna treat him? 233 00:13:26,139 --> 00:13:28,390 There's probably nothing wrong with him. 234 00:13:28,516 --> 00:13:29,766 Oh, sure, that makes sense. 235 00:13:29,893 --> 00:13:32,227 She's just using the old sick-husband routine 236 00:13:32,353 --> 00:13:35,105 as an excuse to get back in touch with you. 237 00:13:35,231 --> 00:13:37,232 You think this is easy for her? 238 00:13:37,358 --> 00:13:39,985 The only reason she'd be anywhere near you is if she was desperate. 239 00:13:40,111 --> 00:13:42,654 So I should help her because she hates me? 240 00:13:42,780 --> 00:13:45,824 She doesn't hate you. She loves you. 241 00:13:45,950 --> 00:13:51,872 She just can't stand to be around you. 242 00:13:55,502 --> 00:13:59,379 Dr. House, it's been almost six minutes. 243 00:14:07,889 --> 00:14:10,057 Found him. 244 00:14:11,100 --> 00:14:13,310 The volleyball player 245 00:14:14,312 --> 00:14:16,563 was responding to the anti-inflammatories 246 00:14:16,731 --> 00:14:18,982 as you'd expect in a case of tendinitis. 247 00:14:19,108 --> 00:14:20,776 Whoa, whoa, whoa. 248 00:14:20,944 --> 00:14:22,110 What about the snake-bite guy? 249 00:14:22,237 --> 00:14:24,821 I don't really care about the volleyball player. 250 00:14:24,948 --> 00:14:28,158 What if I told you the volleyball player had a sudden massive stroke? 251 00:14:28,284 --> 00:14:30,619 - Really? - No. 252 00:14:30,745 --> 00:14:32,955 But that would make you interested, right? 253 00:14:33,081 --> 00:14:35,040 What if her T4 came back low? 254 00:14:35,166 --> 00:14:36,375 It's not quite as interesting, 255 00:14:36,501 --> 00:14:37,876 but it has the benefit of being true. 256 00:14:38,002 --> 00:14:40,754 You said the thyroid biopsy was a wasted test. 257 00:14:40,880 --> 00:14:44,091 No, I didn't. I said she put a person with tendinitis 258 00:14:44,217 --> 00:14:46,176 through an expensive and painful test. 259 00:14:46,302 --> 00:14:49,763 Apparently, the patient had tendinitis and a thyroid condition. 260 00:14:49,889 --> 00:14:51,223 We're gonna start you on thyroxine. 261 00:14:51,349 --> 00:14:54,059 It'll make you feel better and level your moods. 262 00:14:56,020 --> 00:14:57,563 Thank you. 263 00:15:08,032 --> 00:15:09,992 So that's it? 264 00:15:10,410 --> 00:15:11,910 You were right the first time. 265 00:15:12,036 --> 00:15:14,413 Snake-bite guy's way more interesting. 266 00:15:14,539 --> 00:15:16,331 Gross, actually. 267 00:15:18,876 --> 00:15:20,544 The patient responded to epinephrine, 268 00:15:20,670 --> 00:15:22,963 and the allergic reaction was arrested. 269 00:15:23,089 --> 00:15:25,632 Unfortunately, the patient continues to deteriorate. 270 00:15:25,758 --> 00:15:27,801 Maybe the snake wrangler was wrong about the type we caught. 271 00:15:27,927 --> 00:15:29,595 He faxed us a venom test. 272 00:15:29,721 --> 00:15:32,055 Confirmed. It's a timber rattlesnake. 273 00:15:33,725 --> 00:15:36,310 No, it's not. Notice the volume? 274 00:15:36,436 --> 00:15:38,937 I skimmed over that and the gender and the coloring. 275 00:15:39,063 --> 00:15:40,772 Jumped right to the name of the snake. 276 00:15:40,898 --> 00:15:42,983 Two hundred milligrams. 277 00:15:43,109 --> 00:15:45,319 Our guy got bit less than four hours ago. 278 00:15:45,570 --> 00:15:48,864 There's no way a snake regenerates that much venom that quickly. 279 00:15:48,990 --> 00:15:50,949 We're supposed to know how fast snakes make their venom? 280 00:15:51,075 --> 00:15:52,200 No. 281 00:15:52,327 --> 00:15:55,787 Unless you've got a patient bit by one. Then it might be helpful. 282 00:15:55,955 --> 00:15:56,997 So what do we do now? 283 00:15:57,123 --> 00:15:59,458 He must have been bitten by a different snake. 284 00:15:59,584 --> 00:16:01,001 We go back and find it. 285 00:16:01,127 --> 00:16:02,586 Or you go online, and you find 286 00:16:02,712 --> 00:16:04,713 there's only three poisonous snakes common in New Jersey, 287 00:16:04,839 --> 00:16:07,799 the copperhead, timber rattler and the coral. 288 00:16:07,925 --> 00:16:09,801 Copperhead and timber rattler both respond 289 00:16:09,927 --> 00:16:11,678 to the antivenoms we gave the guy. 290 00:16:11,804 --> 00:16:13,972 So we give him the antivenom for the other one. 291 00:16:14,140 --> 00:16:15,098 Is that a question? 292 00:16:15,224 --> 00:16:17,351 Well, we can't just blindly give him another antivenom, 293 00:16:17,477 --> 00:16:19,436 especially after the first one almost killed him. 294 00:16:19,562 --> 00:16:20,812 You said only three types of 295 00:16:20,938 --> 00:16:23,315 poisonous snakes commonly found in New Jersey. 296 00:16:23,441 --> 00:16:25,400 Well, what if this is an uncommon one? 297 00:16:25,526 --> 00:16:26,526 Very good. 298 00:16:26,653 --> 00:16:27,653 We gotta find the right snake. 299 00:16:27,779 --> 00:16:30,322 No need. Odds are by the time you get back, 300 00:16:30,448 --> 00:16:32,866 the autopsy results will tell you what kind of snake it was. 301 00:16:32,992 --> 00:16:33,825 But you said... 302 00:16:33,951 --> 00:16:37,287 So we do give him the antivenom for the other one? 303 00:16:37,413 --> 00:16:40,290 Again, was that a question? I asked what you would do. 304 00:16:40,416 --> 00:16:43,794 It seems unfair for you to ask me what you would do. 305 00:16:43,920 --> 00:16:47,172 Who gives the guy the other antivenom? 306 00:16:48,508 --> 00:16:51,426 And who goes looking for the snake? 307 00:16:52,011 --> 00:16:54,805 I assume that one choice kills him, the other one saves him. 308 00:16:54,931 --> 00:16:58,809 That's usually the way it works at the leg-turning-black stage. 309 00:16:58,935 --> 00:17:02,938 So half of us killed him, and half of us saved his life. 310 00:17:03,064 --> 00:17:05,899 - Yeah. - We can't be blamed... 311 00:17:06,025 --> 00:17:08,402 I'm sure this goes against everything you've been taught, 312 00:17:08,528 --> 00:17:11,071 but right and wrong do exist. 313 00:17:11,739 --> 00:17:13,990 Just because you don't know what the right answer is, 314 00:17:14,117 --> 00:17:15,951 maybe there's even no way you could know what the right answer is, 315 00:17:16,077 --> 00:17:18,787 doesn't make your answer right or even okay. 316 00:17:18,913 --> 00:17:20,831 It's much simpler than that. 317 00:17:20,957 --> 00:17:23,125 It's just plain wrong. 318 00:17:26,129 --> 00:17:27,713 We gave the guy the antivenom. 319 00:17:27,839 --> 00:17:29,423 What if I'm allergic again? 320 00:17:30,133 --> 00:17:31,967 That's why these people are here. 321 00:17:32,093 --> 00:17:35,095 If you have a reaction, we're ready to do whatever's necessary 322 00:17:35,221 --> 00:17:38,265 to ensure your airways stay open and your heart keeps beating. 323 00:17:38,391 --> 00:17:41,101 My wife's on her way in. Can't this wait? 324 00:17:41,227 --> 00:17:43,854 I'm sorry. It can't. 325 00:18:14,135 --> 00:18:15,844 It hurts again. 326 00:18:15,970 --> 00:18:17,596 He came back? 327 00:18:18,848 --> 00:18:21,933 On average, drug addicts are stupid. 328 00:18:22,602 --> 00:18:23,894 I'd call the cops. 329 00:18:24,020 --> 00:18:25,479 Good for you. 330 00:18:25,605 --> 00:18:28,148 A lot of doctors wouldn't risk their careers on a hunch. 331 00:18:28,274 --> 00:18:30,692 It's not a hunch. I mean, I know he wants drugs. 332 00:18:30,818 --> 00:18:32,986 Well, even drug addicts get sick. 333 00:18:33,112 --> 00:18:35,280 Actually, for some reason, 334 00:18:35,406 --> 00:18:38,533 they tend to get sick more often than non-drug addicts. 335 00:18:39,952 --> 00:18:42,954 Luckily, you don't have to play your hunch. 336 00:18:43,080 --> 00:18:44,331 There's a faster way. 337 00:18:44,457 --> 00:18:45,624 Actually, there are several. 338 00:18:45,750 --> 00:18:47,626 My preference is urine testing. 339 00:18:47,752 --> 00:18:49,961 But you already know he has drugs in his system. 340 00:18:50,087 --> 00:18:51,880 That's not what I'm testing for. 341 00:18:52,006 --> 00:18:53,882 We're gonna put this hard rubber tube 342 00:18:54,008 --> 00:18:56,343 up your urethra and into your bladder. 343 00:18:56,677 --> 00:18:57,844 It may be a little uncomfortable. 344 00:18:57,970 --> 00:18:59,930 Shouldn't I be getting some sort of anesthetic? 345 00:19:01,140 --> 00:19:03,850 We're concerned about allergic reactions today. 346 00:19:11,901 --> 00:19:13,819 If the guy can handle a rod in his penis 347 00:19:13,945 --> 00:19:16,363 for half an hour, he's really sick. 348 00:19:16,489 --> 00:19:18,448 Or he's really jonesing. 349 00:19:18,574 --> 00:19:20,492 There's easier ways to get a hold of drugs. 350 00:19:20,618 --> 00:19:21,868 Other hospitals, for example. 351 00:19:25,164 --> 00:19:28,291 The volleyball player is not responding to treatment. 352 00:19:31,003 --> 00:19:32,587 At least we think it's not working 353 00:19:32,713 --> 00:19:35,507 on account of the fact that she's getting worse. 354 00:19:35,633 --> 00:19:37,050 Can you still hear me? 355 00:19:37,176 --> 00:19:38,510 No. 356 00:19:38,636 --> 00:19:39,636 A little! 357 00:19:39,762 --> 00:19:40,929 Not really! 358 00:19:42,765 --> 00:19:45,100 Well, if you can't hear me, how do you know what I asked? 359 00:19:46,352 --> 00:19:47,561 I'm sorry. What did I do? 360 00:19:47,687 --> 00:19:49,187 I don't know. It really hurts. 361 00:19:49,313 --> 00:19:51,398 I promise to be very careful. 362 00:19:52,149 --> 00:19:53,066 Susan... 363 00:19:53,192 --> 00:19:54,860 Not her real name! 364 00:19:54,986 --> 00:19:56,862 Susan, I barely touched you. 365 00:19:58,155 --> 00:20:00,282 - It hurts so much! - I'm sorry. 366 00:20:00,408 --> 00:20:02,951 I have to get this blood. Just hold on. 367 00:20:03,077 --> 00:20:04,995 Hypersensitivity to touch. 368 00:20:05,121 --> 00:20:06,079 Her calcium up? 369 00:20:06,205 --> 00:20:07,372 Lab over 16. 370 00:20:07,498 --> 00:20:09,791 Question is why. Likely suspects? 371 00:20:09,917 --> 00:20:10,959 Parathyroid adenoma. 372 00:20:11,085 --> 00:20:12,419 - Kidney problems. - Vit D intoxication. 373 00:20:12,545 --> 00:20:13,962 - Hyperthyroid. - Caused by our treatment? 374 00:20:14,088 --> 00:20:16,882 Whoa, whoa, whoa. Can you please slow down? 375 00:20:21,888 --> 00:20:24,806 The adenoma is most likely. 376 00:20:24,932 --> 00:20:30,270 Check her PTH, phosphorus and ionized calcium. 377 00:20:30,396 --> 00:20:33,148 And do a technetium sestamibi. 378 00:20:33,274 --> 00:20:36,192 Okay, that's enough about the volleyball player. 379 00:20:36,319 --> 00:20:38,028 What's up with the farmer? 380 00:20:39,030 --> 00:20:40,363 What farmer? 381 00:20:40,489 --> 00:20:42,657 Snake-bite guy. 382 00:20:42,783 --> 00:20:44,743 Oh, right, you guys don't know about him. 383 00:20:44,869 --> 00:20:46,036 He doesn't get bitten until three months 384 00:20:46,162 --> 00:20:48,288 after we treat the volleyball player. 385 00:20:48,414 --> 00:20:52,542 Luckily, it's been well-established that time is not a fixed construct. 386 00:20:52,668 --> 00:20:55,295 His condition's not improving. Double the dosage. 387 00:20:55,421 --> 00:20:56,379 Already did. 388 00:20:56,505 --> 00:20:58,465 There's another antivenom. It's not as effective... 389 00:20:58,591 --> 00:20:59,591 Already tried it. 390 00:20:59,717 --> 00:21:01,176 The first stuff, the stuff he was allergic to. 391 00:21:01,302 --> 00:21:03,053 Gave it to him with high-dose steroids. 392 00:21:03,179 --> 00:21:04,804 Nothing's working. 393 00:21:05,014 --> 00:21:06,306 What does it all mean? 394 00:21:06,432 --> 00:21:07,974 Wrong snake? 395 00:21:08,100 --> 00:21:10,018 We tried every other antivenom we had. 396 00:21:10,144 --> 00:21:10,977 We're too late? 397 00:21:11,103 --> 00:21:14,814 Yep. He's dying. His wife's here. 398 00:21:14,941 --> 00:21:16,691 Finally found a babysitter. 399 00:21:16,859 --> 00:21:18,610 Who wants to let them know? 400 00:21:19,612 --> 00:21:20,904 Actually, I'm kidding. 401 00:21:21,030 --> 00:21:22,364 He's not dying? 402 00:21:22,740 --> 00:21:25,659 Oh, yeah, he's dying, but there's no wife and kid, 403 00:21:25,785 --> 00:21:27,327 which is great. 404 00:21:27,453 --> 00:21:31,414 Makes the breaking-the-news thing way easier. 405 00:21:31,791 --> 00:21:34,000 Oh, yeah. One more piece of news. 406 00:21:39,465 --> 00:21:42,676 The drug addict is peeing blood. 407 00:21:48,057 --> 00:21:52,060 How do they teach you how to tell someone that they're dying? 408 00:21:54,897 --> 00:21:56,690 It's kind of like teaching architects 409 00:21:56,816 --> 00:21:59,651 how to explain why their building fell down. 410 00:22:00,653 --> 00:22:02,862 Do you role-play and stuff? 411 00:22:02,989 --> 00:22:06,241 Yeah. One of us gives the bad news, and one of us gets the bad news. 412 00:22:06,367 --> 00:22:10,704 What do you have to do to get an A in You're-Dying 101? 413 00:22:10,830 --> 00:22:14,457 They grade you on gentleness and supportiveness? 414 00:22:14,583 --> 00:22:18,128 Is there a scale for measuring compassion? 415 00:22:20,047 --> 00:22:21,923 This buddy of mine, 416 00:22:22,049 --> 00:22:25,969 I gotta give him 10 bucks every time someone says thank you. 417 00:22:26,679 --> 00:22:30,140 Imagine that. This guy's so good, 418 00:22:30,266 --> 00:22:33,977 people thank him for telling them hat they're dying. 419 00:22:37,773 --> 00:22:39,441 Needs brown. 420 00:22:40,359 --> 00:22:42,652 I don't get thanked that often. 421 00:22:43,529 --> 00:22:44,988 You're dying. 422 00:22:46,824 --> 00:22:48,324 In a few hours. 423 00:22:50,494 --> 00:22:53,872 There's nothing we can do except deal with the pain. 424 00:22:55,166 --> 00:22:56,916 Well, I need to go home. 425 00:22:57,043 --> 00:22:58,960 You're not going home. 426 00:23:00,337 --> 00:23:04,507 But my dog. What will happen to my dog? 427 00:23:10,723 --> 00:23:12,599 Her neck looks clean. No adenoma. 428 00:23:12,725 --> 00:23:14,976 Wait, wait, wait. The guy's dying, 429 00:23:15,102 --> 00:23:17,228 and all he cares about is his dog? 430 00:23:19,815 --> 00:23:24,152 Any of you guys go the dog route in your improv sessions? 431 00:23:24,695 --> 00:23:29,532 It's a basic truth of the human condition that everybody lies. 432 00:23:31,077 --> 00:23:33,495 The only variable is about what. 433 00:23:34,163 --> 00:23:36,039 The great thing about telling someone they're dying 434 00:23:36,165 --> 00:23:39,751 is that it tends to focus their priorities. 435 00:23:40,377 --> 00:23:43,338 You find out what matters to them, 436 00:23:43,506 --> 00:23:46,674 what they're willing to die for. 437 00:23:48,135 --> 00:23:50,345 What they're willing to lie for. 438 00:23:50,471 --> 00:23:51,971 You must have a neighbor who can... 439 00:23:52,098 --> 00:23:54,057 Neighbors don't like him. 440 00:23:55,017 --> 00:23:57,143 So the Humane Society will take him in and find him a home. 441 00:23:57,269 --> 00:23:58,937 No, they won't. 442 00:24:03,192 --> 00:24:04,943 Yeah, but maybe, maybe my aunt... 443 00:24:05,069 --> 00:24:07,320 It wasn't a snakebite, was it? 444 00:24:09,615 --> 00:24:11,282 I said I don't remember being bit. 445 00:24:11,408 --> 00:24:13,993 Sure you do. Just not by a snake. 446 00:24:15,037 --> 00:24:19,082 I assume that Cujo bit one of your neighbors a while back. 447 00:24:19,208 --> 00:24:21,876 You tell me that he bit you, and I gotta report it. 448 00:24:22,002 --> 00:24:25,046 Cujo's got a record. He gets the chair. 449 00:24:27,550 --> 00:24:30,885 The good news is you might just live. 450 00:24:31,011 --> 00:24:33,096 The bad news is your dog's gonna die. 451 00:24:34,515 --> 00:24:37,058 Guy risked his life to save this thing? 452 00:24:40,104 --> 00:24:42,814 I'll hold him. You swab the mouth. 453 00:24:42,940 --> 00:24:44,399 I think I've got a better grip here. 454 00:24:44,525 --> 00:24:46,359 You go for the mouth. 455 00:24:46,861 --> 00:24:48,444 All right. I'm odds. 456 00:24:48,571 --> 00:24:49,821 Are you serious? 457 00:24:49,947 --> 00:24:51,281 Come on, one, two, three! 458 00:24:51,407 --> 00:24:52,574 Damn. 459 00:24:53,993 --> 00:24:55,952 I don't care if he's scratching your nads off, you don't let go. 460 00:24:56,078 --> 00:24:57,620 Just do it! 461 00:25:01,667 --> 00:25:02,917 I say we let the guy die. 462 00:25:03,043 --> 00:25:04,335 I got his head. Just do it. 463 00:25:04,503 --> 00:25:06,045 Got it. 464 00:25:10,843 --> 00:25:12,802 What would you call that? 465 00:25:13,888 --> 00:25:15,805 It's tea-colored, right? 466 00:25:17,016 --> 00:25:20,143 The guy who we thought was just after the drugs... 467 00:25:21,312 --> 00:25:25,773 What's the differential diagnosis for urine that's tea-colored? 468 00:25:25,900 --> 00:25:27,734 Kidney stone. 469 00:25:27,860 --> 00:25:29,944 Kidney stones would cause what? 470 00:25:30,070 --> 00:25:31,362 Blood in urine. 471 00:25:31,488 --> 00:25:34,282 - What color is your pee? - Yellow. 472 00:25:34,408 --> 00:25:36,451 - What color is your blood? - Red. 473 00:25:36,577 --> 00:25:39,704 - What colors did I use? - Red, yellow and brown. 474 00:25:39,830 --> 00:25:41,748 And brown. What causes brown? 475 00:25:41,874 --> 00:25:42,916 Waste. 476 00:25:43,042 --> 00:25:45,335 Which means the kidneys are shutting down. Why? 477 00:25:45,461 --> 00:25:47,128 - Trauma. - None that his history would indicate. 478 00:25:47,254 --> 00:25:49,839 Could be damage done by the self-injection of the Demerol. 479 00:25:49,965 --> 00:25:51,466 - Treatment? - Heat and rest... 480 00:25:51,592 --> 00:25:52,550 Other possible causes? 481 00:25:52,676 --> 00:25:53,593 Infection. 482 00:25:53,719 --> 00:25:56,012 Start him on antibiotics. What else? 483 00:25:56,889 --> 00:25:58,264 Come on! Come on! 484 00:25:58,432 --> 00:25:59,766 I don't know. 485 00:25:59,892 --> 00:26:03,728 You're useless, but at least you know it. 486 00:26:03,854 --> 00:26:06,564 Blood tests show elevated creatine kinase. What does that tell you? 487 00:26:06,690 --> 00:26:08,149 The trauma diagnosis was right. 488 00:26:08,275 --> 00:26:09,776 He takes it easy for a few days, he'll be fine. 489 00:26:09,902 --> 00:26:10,985 You sure? 490 00:26:11,111 --> 00:26:12,403 The elevated CK rules out infection. 491 00:26:12,529 --> 00:26:14,405 You know what's worse than useless? 492 00:26:14,531 --> 00:26:16,699 Useless and oblivious. 493 00:26:17,826 --> 00:26:19,911 What are they missing? 494 00:26:20,037 --> 00:26:22,705 You know, it's kind of hard to think when you're in our face like... 495 00:26:22,831 --> 00:26:23,915 Yeah? You think it's gonna be easier 496 00:26:24,041 --> 00:26:26,751 when you got a real patient really dying? 497 00:26:26,877 --> 00:26:28,044 What are you missing? 498 00:26:28,587 --> 00:26:29,796 Muscle death. 499 00:26:34,510 --> 00:26:36,177 Not your case. 500 00:26:36,470 --> 00:26:38,137 Nothing wrong with a consult. 501 00:26:40,224 --> 00:26:44,477 Dying muscle leaks myoglobin. It's toxic to the kidneys. 502 00:26:45,145 --> 00:26:46,938 Brilliant. 503 00:26:47,856 --> 00:26:51,025 MRI his leg. See what's killing it. 504 00:26:57,032 --> 00:26:58,366 Why is the girl getting the MRI? 505 00:26:58,492 --> 00:27:00,034 Because the neck scan revealed nothing, 506 00:27:00,160 --> 00:27:03,746 and her doctor's way more obsessive than she thinks she is. 507 00:27:03,872 --> 00:27:05,248 But you said the guy needed the MRI. 508 00:27:05,374 --> 00:27:07,583 Because Dr. Cameron back there said muscle death. 509 00:27:07,710 --> 00:27:09,335 Not one of you said it. 510 00:27:09,670 --> 00:27:11,379 Not one of this guy's doctors said it. 511 00:27:12,131 --> 00:27:15,633 They gave him bed rest and antibiotics, just like you guys would have. 512 00:27:15,843 --> 00:27:17,385 Did he get better? 513 00:27:17,511 --> 00:27:18,511 No. 514 00:27:18,762 --> 00:27:21,180 - How long... - Three days. 515 00:27:22,308 --> 00:27:26,227 It is in the nature of medicine that you are gonna screw up. 516 00:27:26,353 --> 00:27:28,104 You are gonna kill someone. 517 00:27:29,023 --> 00:27:32,358 If you can't handle that reality, pick another profession. 518 00:27:32,484 --> 00:27:35,278 Or finish medical school and teach. 519 00:27:35,404 --> 00:27:36,529 Three days 520 00:27:36,655 --> 00:27:38,406 before they thought it might have been muscle death? 521 00:27:38,532 --> 00:27:40,658 No, three days before the patient 522 00:27:40,784 --> 00:27:42,952 suggested it might have been muscle death. 523 00:27:46,915 --> 00:27:50,793 The MRI revealed an osteosarcoma. 524 00:27:50,919 --> 00:27:53,212 A cancerous tumor on your femur. 525 00:27:53,756 --> 00:27:55,923 It needs to be removed surgically. 526 00:27:56,050 --> 00:27:59,802 With chemo, she has an excellent chance of survival. 527 00:27:59,928 --> 00:28:01,846 But I have to warn you, depending on 528 00:28:01,972 --> 00:28:05,266 how large the tumor is and how ingrained it is, 529 00:28:07,269 --> 00:28:10,146 the surgeon may need to amputate your leg. 530 00:28:11,565 --> 00:28:13,566 I'm sorry. 531 00:28:14,985 --> 00:28:16,152 It's okay. 532 00:28:22,493 --> 00:28:25,703 Dogs' mouths are pretty filthy, but they have natural antibodies 533 00:28:25,829 --> 00:28:27,914 to fight off most of the stuff. We don't. 534 00:28:28,040 --> 00:28:30,166 That's why dog bites can be so nasty. 535 00:28:30,292 --> 00:28:34,087 The lab tests of your dog's saliva revealed a type of strep bacteria. 536 00:28:34,213 --> 00:28:37,673 It's commonly known as the flesh-eating disease. 537 00:28:37,800 --> 00:28:40,718 We'll need to operate immediately to remove the damaged tissue. 538 00:28:40,844 --> 00:28:43,137 We may need to remove the leg. 539 00:28:51,855 --> 00:28:53,981 The MRI revealed a problem. 540 00:28:54,108 --> 00:28:55,191 No kidding. 541 00:28:55,317 --> 00:28:57,360 I'm sorry none of your doctors found it earlier. 542 00:28:57,486 --> 00:28:59,821 I am personally gonna oversee your treatment from now on. 543 00:28:59,947 --> 00:29:02,573 You're gonna cut me open, aren't you? 544 00:29:04,868 --> 00:29:07,161 We may need to remove the leg. 545 00:29:17,673 --> 00:29:22,802 His MRI showed that the leg pain wasn't caused by the self-injection. 546 00:29:22,928 --> 00:29:25,555 It wasn't caused by an infection. 547 00:29:27,683 --> 00:29:33,354 It was an aneurysm that clotted, leading to an infarction. 548 00:29:34,106 --> 00:29:37,108 My God, you were right. It's House. 549 00:29:38,694 --> 00:29:40,820 We have to do the surgery. 550 00:29:40,946 --> 00:29:43,281 The necrotic tissue has to be removed. 551 00:29:43,407 --> 00:29:44,490 If there's too much... 552 00:29:44,616 --> 00:29:46,451 I don't care what you find. 553 00:29:46,577 --> 00:29:48,870 It may become necessary in order to save your life. 554 00:29:48,996 --> 00:29:51,539 I like my leg. 555 00:29:51,957 --> 00:29:53,916 I've had it for as long as I can remember. 556 00:29:54,042 --> 00:29:55,960 Honey, I love your leg as much as you do. 557 00:29:56,086 --> 00:29:58,212 They're not cutting it off. 558 00:30:02,468 --> 00:30:05,344 The patient made the right choice. 559 00:30:05,471 --> 00:30:08,222 Tell a surgeon that it's okay to cut a leg off, 560 00:30:08,348 --> 00:30:11,058 and he's gonna spend the night polishing his good hacksaw. 561 00:30:11,185 --> 00:30:14,270 Right. Surgeons could care less about saving limbs. 562 00:30:14,396 --> 00:30:16,105 Of course they care about their patients, 563 00:30:16,231 --> 00:30:18,274 they just care about themselves more, 564 00:30:18,734 --> 00:30:21,235 which is not an unreasonable position. 565 00:30:21,361 --> 00:30:23,488 Trying to maximize the tissue you save 566 00:30:23,614 --> 00:30:26,407 also maximizes the chances of something going wrong, 567 00:30:26,533 --> 00:30:28,826 which means you've gotta be extra careful, 568 00:30:28,994 --> 00:30:31,078 which is such a pain in the ass. 569 00:30:32,539 --> 00:30:34,749 Amazing advances have been made. 570 00:30:34,875 --> 00:30:38,377 Kids with prosthetic legs are running the 100-meter dash in 12 seconds. 571 00:30:38,504 --> 00:30:41,005 Yeah, they're just not as pretty. 572 00:30:42,633 --> 00:30:44,842 Do a bypass. Restore the circulation. 573 00:30:44,968 --> 00:30:46,344 Amputation is safer. 574 00:30:46,470 --> 00:30:47,803 For you or me? 575 00:30:47,930 --> 00:30:49,055 The blockage of blood flow... 576 00:30:49,181 --> 00:30:50,848 Four-day blockage. 577 00:30:50,974 --> 00:30:53,809 Yes. It caused muscle cell death. 578 00:30:53,936 --> 00:30:56,604 When those cells die, they release cytokines and potassium. 579 00:30:56,730 --> 00:30:59,524 And if you restore the blood flow instead of just lopping it all off, 580 00:30:59,650 --> 00:31:01,651 then all that crap gets washed back into my system. 581 00:31:01,777 --> 00:31:03,986 The cytokines could cause organ failure. 582 00:31:04,112 --> 00:31:05,947 The potassium could cause cardiac arrest. 583 00:31:06,073 --> 00:31:09,700 On the other hand, I may just get the use of my leg back. 584 00:31:10,369 --> 00:31:11,953 The postoperative pain alone... 585 00:31:12,079 --> 00:31:12,912 I'll get through it. 586 00:31:13,038 --> 00:31:14,872 I understand the risks. You're in the clear. 587 00:31:15,040 --> 00:31:16,916 Go schedule an OR. 588 00:31:23,674 --> 00:31:25,758 God, you're an idiot. 589 00:31:25,884 --> 00:31:28,135 I think I'm more of a jerk. 590 00:31:28,262 --> 00:31:30,930 I'm not being glib, and I'm not being cute. 591 00:31:31,056 --> 00:31:33,266 I don't want you to kill yourself. 592 00:31:34,768 --> 00:31:35,893 I'm not gonna die. 593 00:31:36,019 --> 00:31:37,228 Oh. 594 00:31:37,688 --> 00:31:39,647 I feel completely reassured. 595 00:32:08,176 --> 00:32:09,760 More suction. 596 00:32:55,015 --> 00:32:56,932 Inserting now. 597 00:33:21,083 --> 00:33:24,168 They gotta up the morphine. 598 00:33:24,294 --> 00:33:25,836 Doctors say they can't. 599 00:33:25,962 --> 00:33:29,215 Doctors who recommended bed rest and antibiotics. 600 00:33:29,341 --> 00:33:31,342 They screwed up. It doesn't mean they're wrong this time. 601 00:33:31,468 --> 00:33:32,843 Sure doesn't mean they're right. 602 00:33:32,969 --> 00:33:33,928 Morphine will kill you. 603 00:33:34,054 --> 00:33:35,096 I can handle it. 604 00:33:35,222 --> 00:33:36,597 You're in pain. You're not thinking right. 605 00:33:36,723 --> 00:33:38,683 That's why I need the damn morphine! 606 00:33:38,809 --> 00:33:41,227 Okay. I'll talk to them. 607 00:33:44,856 --> 00:33:47,817 Oh, my God. How much longer is the pain gonna last? 608 00:33:47,943 --> 00:33:49,944 It depends on how much muscle cell death there was. 609 00:33:50,070 --> 00:33:51,779 He could be right. He could come out of this 610 00:33:51,905 --> 00:33:53,614 with almost full use of his leg. 611 00:33:53,740 --> 00:33:54,990 Or? 612 00:33:56,034 --> 00:33:58,953 He could be in pain for the rest of his life. 613 00:34:01,581 --> 00:34:04,542 There's a third option, surgically. 614 00:34:04,668 --> 00:34:08,087 A middle ground between what we did and amputation. 615 00:34:11,383 --> 00:34:13,676 He's not big on middle ground. 616 00:34:14,761 --> 00:34:15,886 Yeah. 617 00:34:40,412 --> 00:34:44,123 Nurse. 618 00:34:44,499 --> 00:34:45,875 I need more calcium gluconate. 619 00:34:46,001 --> 00:34:47,626 You just had five mls. 620 00:34:47,753 --> 00:34:50,171 The QRS is getting wider. My potassium is rising. 621 00:34:50,297 --> 00:34:51,380 I'll talk to your doctor. 622 00:34:51,506 --> 00:34:52,506 Well, you better make it fast, 623 00:34:52,632 --> 00:34:54,759 'cause I'm about to go into cardiac arrest. 624 00:34:54,885 --> 00:34:58,929 You give me the dose, or I go into wide complex tachycardia. 625 00:34:59,055 --> 00:35:00,097 I could get in trouble. 626 00:35:00,223 --> 00:35:01,223 Listen, it's not a narcotic! 627 00:35:01,349 --> 00:35:03,559 I'm not looking for a buzz. 628 00:35:03,685 --> 00:35:05,311 You got about 20 seconds. 629 00:35:11,443 --> 00:35:14,028 I was wrong. 630 00:35:19,951 --> 00:35:20,910 What do you got? 631 00:35:21,036 --> 00:35:22,203 Wide complex tachycardia. 632 00:35:22,329 --> 00:35:23,913 - Who diagnosed... - He did. 633 00:35:24,039 --> 00:35:26,207 - Defibrillator. - Paddles. 634 00:35:26,333 --> 00:35:27,875 Charge. Clear. 635 00:35:33,465 --> 00:35:36,759 The patient was technically dead for over a minute. 636 00:36:11,795 --> 00:36:12,962 He's back. 637 00:36:19,261 --> 00:36:21,262 Do you think he was dead? 638 00:36:22,055 --> 00:36:24,807 Do you think those experiences were real? 639 00:36:26,059 --> 00:36:27,977 Define "real." 640 00:36:28,687 --> 00:36:31,146 They were real experiences. 641 00:36:31,273 --> 00:36:33,774 What they meant... 642 00:36:33,900 --> 00:36:35,025 Personally, I choose to believe 643 00:36:35,151 --> 00:36:37,570 that the white light people sometimes see, 644 00:36:37,696 --> 00:36:40,614 the visions this patient saw, 645 00:36:40,740 --> 00:36:42,116 they're all just chemical reactions 646 00:36:42,242 --> 00:36:44,660 that take place while the brain shuts down. 647 00:36:45,745 --> 00:36:47,746 You choose to believe that? 648 00:36:48,039 --> 00:36:50,082 There's no conclusive science. 649 00:36:50,750 --> 00:36:53,168 My choice has no practical relevance to my life. 650 00:36:53,295 --> 00:36:56,171 I choose the outcome I find more comforting. 651 00:36:56,298 --> 00:36:59,967 You find it more comforting to believe that this is it? 652 00:37:00,093 --> 00:37:06,015 I find it more comforting to believe that this isn't simply a test. 653 00:37:12,230 --> 00:37:14,356 How bad is the pain right now? 654 00:37:15,150 --> 00:37:16,609 It's bad. 655 00:37:16,735 --> 00:37:17,860 It's not getting any better. 656 00:37:17,986 --> 00:37:20,029 If you were right, the pain would be subsiding. 657 00:37:20,155 --> 00:37:21,405 You'd be getting better. 658 00:37:21,531 --> 00:37:23,157 It's just taking longer. 659 00:37:23,283 --> 00:37:25,242 No, it's not. 660 00:37:26,036 --> 00:37:29,121 We've gotta let them cut the leg off. 661 00:37:31,291 --> 00:37:35,002 It's my leg. It's my life. 662 00:37:36,379 --> 00:37:38,047 Would you give up your leg to save my life? 663 00:37:38,173 --> 00:37:40,007 Of course I would. 664 00:37:40,133 --> 00:37:43,677 Then why do you think your life is worth less than mine? 665 00:37:44,930 --> 00:37:46,347 If this were any other patient, 666 00:37:46,473 --> 00:37:48,432 what would you tell them to do? 667 00:37:53,146 --> 00:37:54,730 I would say it's their choice. 668 00:37:54,856 --> 00:37:56,398 For... Not a chance. 669 00:37:56,524 --> 00:37:58,651 You'd browbeat them until they made the choice 670 00:37:58,777 --> 00:38:00,861 you knew was right. 671 00:38:00,987 --> 00:38:05,032 You'd shove it in their face that it's just a damn leg. 672 00:38:06,201 --> 00:38:08,827 You don't think you deserve to live? 673 00:38:09,663 --> 00:38:12,331 You don't think you deserve to be happy? 674 00:38:13,750 --> 00:38:16,126 Now let them cut off your leg. 675 00:38:19,172 --> 00:38:21,465 I can't. I can't. 676 00:38:23,259 --> 00:38:24,885 I'm sorry. 677 00:38:32,644 --> 00:38:34,812 The pain alone is gonna kill you. 678 00:38:35,522 --> 00:38:37,731 I know. I know. 679 00:38:42,654 --> 00:38:45,614 I need you to talk to the doctor. 680 00:38:54,165 --> 00:38:55,958 He change his mind? 681 00:38:56,084 --> 00:38:57,459 No. 682 00:38:58,837 --> 00:39:01,964 He's asked to be put in a chemically-induced coma 683 00:39:02,090 --> 00:39:05,259 so that he can sleep through the worst part of the pain. 684 00:39:06,928 --> 00:39:08,637 We can do that. 685 00:39:11,057 --> 00:39:14,018 What happens after he's in the coma? 686 00:39:14,144 --> 00:39:16,478 We'll obviously monitor his condition closely, 687 00:39:16,604 --> 00:39:18,689 and if he can get through the next 48 hours 688 00:39:18,815 --> 00:39:19,940 without another cardiac incident... 689 00:39:20,066 --> 00:39:21,567 I meant, I'm his health-care proxy. 690 00:39:21,693 --> 00:39:26,071 I get to make medical decisions for him if he's not able to. 691 00:39:28,199 --> 00:39:30,617 You should talk to him about what he wants to do. 692 00:39:30,744 --> 00:39:34,496 I know what he wants, but if he's out, it's my call, right? 693 00:39:51,514 --> 00:39:53,766 You'll be out in less than a minute. 694 00:39:58,521 --> 00:40:00,439 Thank you. 695 00:40:04,611 --> 00:40:06,862 Hey. 696 00:40:07,989 --> 00:40:10,240 I'll see you when I wake up. 697 00:40:12,410 --> 00:40:14,119 We'll go golfing. 698 00:40:18,083 --> 00:40:20,125 I love you. 699 00:40:22,587 --> 00:40:24,505 I love you, too. 700 00:40:27,383 --> 00:40:28,801 I'm sorry. 701 00:40:32,847 --> 00:40:35,641 You've got nothing to be sorry about. 702 00:40:53,743 --> 00:40:56,245 The middle ground you were talking about... 703 00:40:56,371 --> 00:40:59,081 We go in, take out the dead muscle. 704 00:40:59,207 --> 00:41:01,750 There's still some risk of reperfusion injury, but... 705 00:41:01,876 --> 00:41:04,294 Give me the forms you need signed. 706 00:41:08,049 --> 00:41:10,175 You're saving his life. 707 00:41:11,427 --> 00:41:13,428 He won't see it that way. 708 00:41:31,948 --> 00:41:36,118 Because of the extent of the muscle removed, 709 00:41:36,911 --> 00:41:40,747 the utility of the patient's leg was severely compromised. 710 00:41:40,874 --> 00:41:43,959 Because of the time delay in making the diagnosis, 711 00:41:44,085 --> 00:41:47,379 the patient continues to experience chronic pain. 712 00:41:53,970 --> 00:41:55,888 She had no right to do that. 713 00:41:56,014 --> 00:41:56,930 She had the proxy. 714 00:41:57,056 --> 00:41:58,140 She knew he didn't want the surgery. 715 00:41:58,266 --> 00:41:59,224 She saved his life. 716 00:41:59,350 --> 00:42:00,976 Well, we don't know that. Maybe he would've been fine. 717 00:42:01,102 --> 00:42:03,437 It doesn't matter. It's the patient's call. 718 00:42:03,563 --> 00:42:05,355 The patient's an idiot. 719 00:42:06,649 --> 00:42:08,192 They usually are. 720 00:42:09,986 --> 00:42:11,236 Do you have a buzzer or something? 721 00:42:11,362 --> 00:42:12,738 What time does this class end? 722 00:42:12,864 --> 00:42:15,199 20 minutes ago. 723 00:42:20,747 --> 00:42:22,956 I'm not doing this again. 724 00:42:23,082 --> 00:42:25,792 And this guy is not the world's greatest dad. 725 00:42:25,919 --> 00:42:27,794 Not even ranked. 726 00:42:27,921 --> 00:42:30,255 Who the hell lets their kids play with lead-based paint? 727 00:42:30,381 --> 00:42:31,882 That's why he's always sick. 728 00:42:32,008 --> 00:42:35,719 Find him some plastic cups, and the class is all his again. 729 00:43:03,790 --> 00:43:05,958 Stacy, it's Greg. 730 00:43:06,084 --> 00:43:10,128 I've got an opening in my calendar for 10:00 tomorrow morning. 731 00:43:10,255 --> 00:43:13,340 Make sure your husband isn't late.