1 00:00:00,000 --> 00:00:02,293 The human heart is a giant muscle 2 00:00:02,419 --> 00:00:05,713 squeezing or contracting over 60 times each minute. 3 00:00:05,839 --> 00:00:07,423 That's 3,600... 4 00:00:07,549 --> 00:00:10,677 At this point, your blood is a deep purple 5 00:00:10,803 --> 00:00:13,680 because it's just finished dropping off oxygen 6 00:00:13,806 --> 00:00:15,306 for all the parts of your body. 7 00:00:17,685 --> 00:00:19,394 Come on, follow me. 8 00:00:22,022 --> 00:00:23,189 Come on. 9 00:00:26,777 --> 00:00:27,902 Ian. 10 00:00:28,028 --> 00:00:30,279 I have a question and I need to go to the bathroom. 11 00:00:30,406 --> 00:00:31,989 Which would you like to do first? 12 00:00:32,825 --> 00:00:33,658 The question. 13 00:00:33,784 --> 00:00:36,077 - Okay. - Where's the bathroom? 14 00:00:37,246 --> 00:00:38,830 Who knows where the bathroom is? 15 00:00:38,956 --> 00:00:39,956 I do. 16 00:00:40,082 --> 00:00:41,624 Go with Ian to the bathroom. 17 00:00:41,750 --> 00:00:42,750 I don't have to go. 18 00:00:42,876 --> 00:00:45,378 We're not at school, nobody goes anywhere by themselves. 19 00:00:45,504 --> 00:00:47,296 - Why? - In case you get lost. 20 00:00:47,423 --> 00:00:49,006 Or in case somebody kidnaps us. 21 00:00:49,133 --> 00:00:51,509 If somebody kidnaps Ian, they'll kidnap me, too. 22 00:00:51,635 --> 00:00:52,802 I want to stay with the class. 23 00:00:52,928 --> 00:00:54,262 Michael, go with Ian... 24 00:00:55,514 --> 00:00:56,556 Do you need help? 25 00:00:56,682 --> 00:00:57,849 I need you to find a grown-up. 26 00:00:57,975 --> 00:00:58,933 Is the baby coming? 27 00:01:00,144 --> 00:01:02,228 - Who should I take with me? - You're fine. 28 00:01:02,354 --> 00:01:05,064 Go to the front desk or find a security guard. 29 00:01:05,190 --> 00:01:06,941 I really have to pee. 30 00:01:08,944 --> 00:01:10,319 Oh, God. 31 00:01:10,696 --> 00:01:13,823 Is the baby coming? I don't know how to do this. 32 00:01:14,116 --> 00:01:15,783 Are you okay, Ian? 33 00:01:15,909 --> 00:01:17,160 Yeah. Sure. 34 00:01:19,997 --> 00:01:21,789 I don't think you are. 35 00:01:24,835 --> 00:01:26,335 You're bleeding. 36 00:01:29,339 --> 00:01:30,548 Help! 37 00:01:31,049 --> 00:01:32,216 Help! 38 00:02:29,274 --> 00:02:30,942 - $20. - Call. 39 00:02:31,819 --> 00:02:33,277 You'll call anything. 40 00:02:33,403 --> 00:02:35,571 My stack is bigger than your stack. 41 00:02:36,824 --> 00:02:37,824 You in or out? 42 00:02:37,950 --> 00:02:39,784 You know that relative to their size, 43 00:02:39,910 --> 00:02:42,829 gorillas have smaller testicles than humans. 44 00:02:43,539 --> 00:02:46,916 Well, then you'd probably have an edge over a gorilla, but not over me. 45 00:02:47,042 --> 00:02:49,794 Reason is, primate testes' size 46 00:02:49,920 --> 00:02:53,005 inversely corresponds to the fidelity of our females. 47 00:02:54,550 --> 00:02:57,301 You think there might be a better time to annoy me about my wife? 48 00:02:57,427 --> 00:02:58,761 - I'm talking about poker. - Right. 49 00:02:58,887 --> 00:03:00,972 Women are evil, you're right to drive them away. 50 00:03:01,098 --> 00:03:03,307 Call, fold or raise. Story time can wait. 51 00:03:03,433 --> 00:03:05,977 We're smaller and better than chimps, 52 00:03:06,687 --> 00:03:08,563 bigger and worse than gorillas. 53 00:03:08,689 --> 00:03:10,022 For all our rationality, 54 00:03:10,148 --> 00:03:13,401 our supposed trust and fealty to a higher power, 55 00:03:13,527 --> 00:03:17,280 our ability to create a system of rules and laws, 56 00:03:17,573 --> 00:03:20,741 our baser drives are more powerful than any of that. 57 00:03:20,868 --> 00:03:23,870 We want to control our emotions, but we can't. 58 00:03:24,580 --> 00:03:27,123 If we're happy, things don't annoy us. 59 00:03:27,708 --> 00:03:30,918 If, on the other hand, we're sitting on crappy hole cards, 60 00:03:31,044 --> 00:03:34,046 little tiny things annoy us a whole lot more. 61 00:03:38,886 --> 00:03:39,760 I raise. 62 00:03:39,887 --> 00:03:42,305 So, are you gonna tell me an annoying story every time I raise? 63 00:03:42,431 --> 00:03:44,599 God, that would be annoying. 64 00:03:45,225 --> 00:03:46,475 I call. 65 00:03:46,894 --> 00:03:49,145 Dr. Cuddy, I got one of your patients in the ER. 66 00:03:49,271 --> 00:03:50,938 Ian Alston, six-years-old. 67 00:03:51,398 --> 00:03:53,816 Oh, I know him. What's the problem? I'm all in. 68 00:03:53,942 --> 00:03:55,735 Bloody diarrhea. Hemodynamically stable, 69 00:03:55,861 --> 00:03:57,945 but he's been developing some coordination problems. 70 00:03:58,071 --> 00:04:00,031 It sounds like gastroenteritis and dehydration. 71 00:04:00,157 --> 00:04:02,283 Order fluids and I'll take it on my service. 72 00:04:02,409 --> 00:04:03,534 Bet's to you, House. 73 00:04:03,660 --> 00:04:05,536 - They scan his head? - No, why would they scan... 74 00:04:05,662 --> 00:04:07,455 Don't play games. You gonna call? 75 00:04:07,581 --> 00:04:09,624 - How's the heart rate? - Stable. 76 00:04:09,750 --> 00:04:14,170 I'm sorry. House, it's gastroenteritis. I'm not going anywhere. 77 00:04:14,296 --> 00:04:15,379 Put the order in, 78 00:04:15,505 --> 00:04:19,008 and have someone tell Alan and Sarah that I'll be up when I'm done. 79 00:04:19,885 --> 00:04:21,260 You in or out? 80 00:04:25,265 --> 00:04:26,557 I'm out. 81 00:04:30,979 --> 00:04:32,355 Stone cold bluff. 82 00:04:32,481 --> 00:04:36,233 You might want to spend a little more time paying attention to your cards 83 00:04:36,360 --> 00:04:39,111 and a little less time staring at my breasts. 84 00:04:39,237 --> 00:04:40,863 They don't match either. 85 00:04:40,989 --> 00:04:42,949 I'm gonna take some air. 86 00:05:02,928 --> 00:05:04,929 Follow my finger with your eyes. 87 00:05:11,395 --> 00:05:13,396 How much longer will Dr. Cuddy be? 88 00:05:13,522 --> 00:05:16,440 Well, given the number of Mojitos she's knocking back at the party, 89 00:05:16,566 --> 00:05:20,569 I'd say it's gonna be at least three hours before she's even conscious. 90 00:05:20,696 --> 00:05:22,363 Weren't you at the same party? 91 00:05:22,489 --> 00:05:23,823 I don't drink. 92 00:05:26,159 --> 00:05:29,120 I want you to reach out and grab my cane. 93 00:05:34,626 --> 00:05:35,710 What's wrong? 94 00:05:35,836 --> 00:05:39,046 Your son's brain is losing control of his muscles. 95 00:05:39,172 --> 00:05:42,550 Dr. Cuddy's message said it was just dehydration from diarrhea. 96 00:05:42,676 --> 00:05:44,176 She's wrong. 97 00:05:45,804 --> 00:05:47,680 Is he gonna be all right? 98 00:05:50,767 --> 00:05:52,101 I don't know. 99 00:06:21,048 --> 00:06:23,424 So, were you in one of those cages? 100 00:06:24,009 --> 00:06:28,220 No. No, no, no, no. No, those are for tourists. 101 00:06:28,889 --> 00:06:30,848 You were in the water with the great white? 102 00:06:30,974 --> 00:06:34,935 Sure, it's no big deal. You just have to keep an eye on them. 103 00:06:35,062 --> 00:06:38,064 If they get too close, punch them in the nose. 104 00:06:38,315 --> 00:06:40,191 Send them on their way. 105 00:06:41,818 --> 00:06:43,027 I had you going. 106 00:06:43,153 --> 00:06:44,195 You are mean. 107 00:06:44,905 --> 00:06:47,156 Hey. How's that anal fissure? 108 00:06:47,991 --> 00:06:50,117 Did it heal yet? Or is it still draining? 109 00:06:50,243 --> 00:06:51,577 Oh, I'm sorry. 110 00:06:51,703 --> 00:06:53,370 I didn't realize you'd come back for seconds. 111 00:06:53,497 --> 00:06:56,415 I figured that after that girl in the stairwell you'd be done for the night. 112 00:06:56,541 --> 00:06:57,541 He's joking. 113 00:06:57,667 --> 00:06:59,460 No Adam's apple, small hands. 114 00:06:59,586 --> 00:07:01,462 It's no surprises this time. 115 00:07:02,464 --> 00:07:04,173 I'll see you later. 116 00:07:07,052 --> 00:07:08,010 Got a case. 117 00:07:08,136 --> 00:07:09,470 Well, you could've just said that. 118 00:07:09,596 --> 00:07:10,846 You didn't have to screw with me. 119 00:07:10,972 --> 00:07:11,972 If I didn't screw with you, 120 00:07:12,099 --> 00:07:14,225 you'd spent the whole night thinking you might get laid, 121 00:07:14,351 --> 00:07:16,894 which means you'd be useless. Better to extinguish all hope. 122 00:07:17,020 --> 00:07:20,147 Get Foreman and Cameron and meet me upstairs. Stat. 123 00:07:25,320 --> 00:07:26,654 What's so urgent? 124 00:07:26,780 --> 00:07:29,907 Two cases, same symptoms. 125 00:07:30,242 --> 00:07:33,285 What do six-year-olds and 70-year-olds have in common? 126 00:07:33,411 --> 00:07:34,995 Their immune systems don't work as well. 127 00:07:35,122 --> 00:07:37,123 - Could be listeria. - I already checked for that. 128 00:07:37,249 --> 00:07:39,959 Leukemia has a higher prevalence in both young and old. 129 00:07:40,085 --> 00:07:42,461 - So does asthma. - No, no, no. 130 00:07:42,587 --> 00:07:44,004 They can both get diabetes. 131 00:07:44,131 --> 00:07:45,297 No! 132 00:07:48,009 --> 00:07:49,927 The nearly dead and the newly bred 133 00:07:50,053 --> 00:07:53,222 have more in common with each other than with people in the middle. 134 00:07:53,348 --> 00:07:56,600 It's weird. It's kind of a circle of life thing. 135 00:07:56,726 --> 00:07:59,270 - This kid doesn't have kidney failure. - He will. 136 00:07:59,396 --> 00:08:02,148 Based on this file, the kid just ate some bad food. 137 00:08:02,274 --> 00:08:03,315 Was the old man... 138 00:08:03,441 --> 00:08:07,403 They were nowhere near each other in any of the four dimensions. 139 00:08:07,779 --> 00:08:09,572 - This case is 12 years old. - Yep. 140 00:08:09,698 --> 00:08:11,657 And this case is Cuddy's. 141 00:08:11,783 --> 00:08:13,033 She assigned it to me. 142 00:08:13,160 --> 00:08:16,871 She agrees with you that this is something more than gastroenteritis? 143 00:08:16,997 --> 00:08:19,707 She wouldn't have assigned it to me if she didn't, would she? 144 00:08:27,507 --> 00:08:29,258 What were we talking about? 145 00:08:29,384 --> 00:08:31,635 Two patients with two symptoms in common. 146 00:08:31,761 --> 00:08:34,096 And five symptoms not in common. 147 00:08:34,222 --> 00:08:37,016 While you were all wearing your "Frankie Says Relax" t-shirts, 148 00:08:37,142 --> 00:08:39,185 I was treating a 73-year-old woman 149 00:08:39,311 --> 00:08:41,395 who went through this progression of symptoms. 150 00:08:41,521 --> 00:08:43,522 The last of which was... 151 00:08:46,818 --> 00:08:49,111 And in case any of you missed that class in med school, 152 00:08:49,237 --> 00:08:50,946 that one's untreatable. 153 00:08:51,072 --> 00:08:52,489 Kid's got the first two. 154 00:08:52,616 --> 00:08:56,202 It took Ester an hour and 20 minutes to go from two to three. 155 00:08:56,328 --> 00:08:58,495 And less than a day to make it all the way to the rear exit. 156 00:08:58,622 --> 00:09:02,333 This is all because a child has some blood in his diarrhea? 157 00:09:02,542 --> 00:09:03,459 He's got a tummy ache. 158 00:09:03,585 --> 00:09:05,669 If there was any reason to think it was anything worse, 159 00:09:05,795 --> 00:09:07,046 Cuddy would be all over it. 160 00:09:07,172 --> 00:09:08,547 Great. Do a colonoscopy. 161 00:09:08,673 --> 00:09:11,717 On a six-year-old kid who probably has nothing worse than some food poisoning? 162 00:09:11,843 --> 00:09:13,969 And if you happen to find any purple papules, 163 00:09:14,095 --> 00:09:15,638 do me a favor and grab a slice. 164 00:09:15,764 --> 00:09:17,765 I wanna check for Erdheim-Chester. 165 00:09:17,891 --> 00:09:22,311 A disease that there have been, what, maybe 200 reported cases of ever? 166 00:09:22,437 --> 00:09:26,815 If Ester's family had let me do an autopsy, there'd be 201. 167 00:09:39,746 --> 00:09:41,247 See anything? 168 00:09:41,373 --> 00:09:43,415 No, and I don't expect to. 169 00:09:44,751 --> 00:09:46,585 House usually avoids cases. 170 00:09:46,711 --> 00:09:50,005 If he's actually stealing a case from Cuddy, there's gotta be a reason. 171 00:09:50,131 --> 00:09:53,050 It's not the first time I've seen this file. 172 00:09:53,510 --> 00:09:55,427 About a month before Cameron was hired, 173 00:09:55,553 --> 00:09:57,554 some trucker came in here with these symptoms. 174 00:09:57,681 --> 00:09:59,431 House decided he was dying. 175 00:09:59,557 --> 00:10:01,267 Two days and a spinal tap, 176 00:10:01,393 --> 00:10:03,602 bone marrow extraction, and three colonoscopies later, 177 00:10:03,728 --> 00:10:05,938 we send the guy home with a bunch of painkillers 178 00:10:06,064 --> 00:10:08,816 and a diagnosis of a bad cheese sandwich. 179 00:10:09,609 --> 00:10:11,110 One of the guys who worked here before me 180 00:10:11,236 --> 00:10:14,863 said House tried to cure Ester at least three other times. 181 00:10:15,615 --> 00:10:19,410 You know how people see the Virgin Mary in danishes and stuff? 182 00:10:20,287 --> 00:10:23,330 Someone died 12 years ago and House doesn't know why. 183 00:10:23,456 --> 00:10:26,709 House sees that case now in paint peeling, 184 00:10:27,794 --> 00:10:30,212 in clouds, and now in this poor kid. 185 00:10:30,505 --> 00:10:33,841 Erdheim-Chester is an abnormal growth of some of the cells that fight infection. 186 00:10:33,967 --> 00:10:36,260 Is that cancer? Cos he seems okay now. 187 00:10:36,386 --> 00:10:38,679 The other doctor kind of scared us about that. 188 00:10:38,805 --> 00:10:41,557 He shouldn't have. We're just testing. It'll probably be negative. 189 00:10:41,683 --> 00:10:42,558 I don't understand. 190 00:10:42,684 --> 00:10:45,686 You don't think that's what it is but you want to do this thing to him anyway? 191 00:10:45,812 --> 00:10:48,147 - We need to be sure. - Isn't there any other way? 192 00:10:48,273 --> 00:10:50,149 It shouldn't take long. 193 00:10:50,817 --> 00:10:52,026 All right. 194 00:10:52,152 --> 00:10:55,112 Those ridges look a lot like purple papules. 195 00:10:55,238 --> 00:10:58,657 They're not purple. They're red. Probably just blood blisters. 196 00:11:00,785 --> 00:11:02,661 Give me the biopsy needle. 197 00:11:13,048 --> 00:11:15,215 - How long is this gonna take? - Forget it, Chase. 198 00:11:15,342 --> 00:11:19,428 Your punching out the shark story's good, but she's not waiting for you. 199 00:11:19,554 --> 00:11:20,596 So? 200 00:11:20,722 --> 00:11:22,556 We couldn't confirm the source of the bleeding, 201 00:11:22,682 --> 00:11:23,891 but we did biopsy some... 202 00:11:24,017 --> 00:11:26,643 - Blood blisters. - You mean papules. 203 00:11:26,770 --> 00:11:28,645 Come on, Cameron. Who's right? 204 00:11:30,565 --> 00:11:33,192 Chase is. Negative for Erdheim-Chester. 205 00:11:33,318 --> 00:11:34,777 Let me see. 206 00:11:42,494 --> 00:11:44,119 If it's not Erdheim-Chester... 207 00:11:44,245 --> 00:11:47,873 It's exactly what we said before, a garden-variety viral gastroenteritis. 208 00:11:47,999 --> 00:11:49,208 Can we go back to the party? 209 00:11:49,334 --> 00:11:51,251 Do a kidney biopsy. 210 00:11:52,087 --> 00:11:53,962 Ester's shut down in exactly... 211 00:11:54,089 --> 00:11:55,381 This kid is not Ester. 212 00:11:55,507 --> 00:11:57,216 You screwed up. She died. I'm sorry. 213 00:11:57,342 --> 00:11:59,468 But that does not mean this kid is dying as well. 214 00:11:59,594 --> 00:12:03,764 Jeez, you're testy when you don't get any fuzz. Come on. 215 00:12:18,488 --> 00:12:19,530 What'd the test say? 216 00:12:19,656 --> 00:12:21,031 Colonoscopy was clean. 217 00:12:21,157 --> 00:12:23,700 And the biopsy was negative for Erdheim-Chester. 218 00:12:23,827 --> 00:12:27,204 So Ian's going to be all right? It was just some sort of virus. 219 00:12:27,580 --> 00:12:28,789 What's that? 220 00:12:29,499 --> 00:12:30,624 Urine. 221 00:12:30,750 --> 00:12:32,459 Yeah, but it's brown. 222 00:12:33,670 --> 00:12:35,504 Ian's kidneys are shutting down. 223 00:12:35,630 --> 00:12:38,048 Still think it's not the same case? 224 00:12:54,190 --> 00:12:56,984 So, what can cause bloody diarrhea, 225 00:12:57,110 --> 00:12:59,862 ataxia and kidney failure? 226 00:12:59,988 --> 00:13:02,114 - I'll go do a biopsy. - Forget it! 227 00:13:02,240 --> 00:13:03,699 That battle's over. 228 00:13:03,825 --> 00:13:06,076 His rising creatinine is his kidneys' way of saying, 229 00:13:06,202 --> 00:13:07,911 "Go on without me." 230 00:13:08,705 --> 00:13:10,914 What explains everything? 231 00:13:12,625 --> 00:13:15,919 E. coli HO-157 causes bloody diarrhea 232 00:13:16,045 --> 00:13:17,963 and leads to Hemolytic-uremic Syndrome. 233 00:13:18,089 --> 00:13:20,757 Toxins from the bacteria cause his kidneys to shut down. 234 00:13:20,884 --> 00:13:22,426 We should start him on plasmapheresis. 235 00:13:22,552 --> 00:13:25,804 Clear, concise and completely plausible. 236 00:13:25,930 --> 00:13:29,099 And exactly what I did last time. Didn't work. 237 00:13:29,350 --> 00:13:31,477 - What else? - Goodpasture's Syndrome. 238 00:13:31,603 --> 00:13:33,896 Circulating antibodies cause kidney failure and bleeding. 239 00:13:34,022 --> 00:13:35,856 But not the purple papules. 240 00:13:35,982 --> 00:13:37,691 If you throw in Ester's next symptom, 241 00:13:37,817 --> 00:13:39,610 brain, makes me think heavy metal toxicity. 242 00:13:39,736 --> 00:13:42,154 His hematocrit would have to be low. It's at 44, 243 00:13:42,280 --> 00:13:43,697 and Ester's never dropped below... 244 00:13:43,823 --> 00:13:45,741 - 42. - You have the file memorized? 245 00:13:45,867 --> 00:13:47,534 It's my lucky number. 246 00:13:47,660 --> 00:13:48,744 What about lymphoma? 247 00:13:48,870 --> 00:13:53,499 Causes kidney failure, GI bleed, and can infiltrate the base of the brain. 248 00:13:54,876 --> 00:13:56,001 You check Ester for that? 249 00:13:56,127 --> 00:13:58,545 She never showed any signs of... 250 00:13:59,964 --> 00:14:01,798 If he has lymphoma this far advanced, 251 00:14:01,925 --> 00:14:04,051 we should be able to see it in his blood and brain. 252 00:14:04,177 --> 00:14:06,803 Chase, run a blood smear and immunochemistries. 253 00:14:06,930 --> 00:14:08,889 Foreman, get an MRI. 254 00:14:09,307 --> 00:14:11,683 - I'll page Cuddy. - No, you won't. 255 00:14:11,809 --> 00:14:13,227 She thinks the kid has a stomachache. 256 00:14:13,353 --> 00:14:15,395 Then she'll come right up here and do one of two things. 257 00:14:15,522 --> 00:14:18,315 If she agrees with me, I don't need her. If she disagrees, I don't want her. 258 00:14:18,441 --> 00:14:20,108 Can't handle people disagreeing with you? 259 00:14:20,235 --> 00:14:21,735 She might have a different take on this. 260 00:14:21,861 --> 00:14:25,197 Subordinates can disagree with me all they want. It's healthy. 261 00:14:25,323 --> 00:14:27,950 People who can shut me down on the other hand... 262 00:14:28,076 --> 00:14:30,744 Forget Cuddy. I'll have Wilson keep her busy. 263 00:14:38,586 --> 00:14:41,880 Keep your answers short and discreet. Is Cuddy still playing? 264 00:14:42,966 --> 00:14:45,884 The chicken is still in Piccadilly Square. 265 00:14:46,010 --> 00:14:48,887 Brilliant. She'll never suspect that Normandy is our target. 266 00:14:49,013 --> 00:14:50,389 Is that House? 267 00:14:50,557 --> 00:14:53,809 Tell him that the blinds just went to 20-40 and he's running out of chips. 268 00:14:53,935 --> 00:14:56,186 - How's she doing? - What's going on? 269 00:14:56,312 --> 00:14:58,105 The way you took off, something's obviously... 270 00:14:58,231 --> 00:15:01,191 Love to chat but got a game to play. How's she doing? 271 00:15:01,609 --> 00:15:03,902 The patient is on life support. We're about to pull the plug. 272 00:15:04,028 --> 00:15:05,028 Are you talking about me? 273 00:15:05,154 --> 00:15:06,613 What've you got? 274 00:15:06,906 --> 00:15:09,700 Those sounds like high-dose cardio meds. 275 00:15:09,826 --> 00:15:11,577 Two hearts. 276 00:15:11,703 --> 00:15:12,661 You got the flush? 277 00:15:12,787 --> 00:15:14,162 Still waiting on the final labs. 278 00:15:14,289 --> 00:15:16,081 Is she drinking her seltzer? 279 00:15:16,583 --> 00:15:19,126 No, hydration is not a problem. 280 00:15:19,252 --> 00:15:21,712 She's bluffing. Push her all in. 281 00:15:24,299 --> 00:15:25,465 Call. 282 00:15:25,925 --> 00:15:28,885 Two pair. Show me your hearts. 283 00:15:33,933 --> 00:15:35,309 Seven of clubs. 284 00:15:36,019 --> 00:15:38,186 Oh, dear. Sounds like I messed up. 285 00:15:38,313 --> 00:15:40,814 You're gonna be stuck with her for a while. 286 00:15:40,940 --> 00:15:42,149 Talk to you soon. 287 00:15:43,443 --> 00:15:45,360 Oh, yes! 288 00:16:00,084 --> 00:16:02,044 Why are you taking a picture of his head? 289 00:16:02,170 --> 00:16:04,046 We're looking for lymphoma, but... 290 00:16:04,172 --> 00:16:07,799 So, it's not Erdheim-something and it's not his kidneys, 291 00:16:07,925 --> 00:16:09,551 but his kidneys are failing. 292 00:16:09,677 --> 00:16:10,844 Where's Dr. Cuddy? 293 00:16:10,970 --> 00:16:12,304 Dr. House mentioned another case. 294 00:16:12,430 --> 00:16:14,973 Is there another patient with the same thing that Ian has? 295 00:16:15,099 --> 00:16:17,309 - Not exactly. - What does that mean? 296 00:16:17,435 --> 00:16:19,561 Dr. House had a patient a while back 297 00:16:19,687 --> 00:16:21,855 who exhibited the same symptoms as your son. 298 00:16:21,981 --> 00:16:25,067 - Then you know what's wrong? - No. 299 00:16:25,193 --> 00:16:26,610 So what do you know? 300 00:16:26,736 --> 00:16:29,446 We know the likely course the disease will take. 301 00:16:29,572 --> 00:16:30,572 Which is? 302 00:16:30,698 --> 00:16:32,574 She had multiple system failures affecting... 303 00:16:32,700 --> 00:16:34,159 What happened to her? 304 00:16:38,081 --> 00:16:41,083 She died 24 hours after her admission. 305 00:16:48,216 --> 00:16:51,343 Mr. or Mrs. Alston, would you mind giving me a hand? 306 00:16:53,471 --> 00:16:55,722 He's having trouble sitting still. 307 00:16:55,848 --> 00:16:57,933 It's impossible to get the detail we need. 308 00:16:58,059 --> 00:17:02,145 So I figured he might feel more comfortable hearing your voices. 309 00:17:07,110 --> 00:17:08,318 Ian, honey. 310 00:17:09,987 --> 00:17:14,199 Just sit still. They'll be done in a moment. We're here with you. 311 00:17:14,325 --> 00:17:15,784 I'm scared. 312 00:17:17,286 --> 00:17:19,037 It's okay, honey. It's... 313 00:17:19,163 --> 00:17:23,083 It's only a big camera. It's gonna take a picture of your head. 314 00:17:24,168 --> 00:17:26,837 You love it when I take your picture at home, don't you? 315 00:17:26,963 --> 00:17:28,088 Yeah. 316 00:17:29,090 --> 00:17:32,175 And you have to hold still for that, too, right? 317 00:17:32,468 --> 00:17:34,469 But this isn't like that. 318 00:17:36,723 --> 00:17:40,183 I know it's scary, Ian, but you can do it. 319 00:17:41,561 --> 00:17:43,979 You're getting to be so grown-up. 320 00:17:46,274 --> 00:17:51,194 So just hold perfectly still, just for a little bit. 321 00:17:51,863 --> 00:17:54,197 Mommy, are you crying? 322 00:17:55,199 --> 00:17:58,994 No. No, honey, I'm just tired. 323 00:18:00,496 --> 00:18:02,664 Okay. I'll try. 324 00:18:31,903 --> 00:18:34,988 The base of his brain's been infiltrated by a small mass. We think... 325 00:18:35,114 --> 00:18:36,907 - Pituitary? - Looks that way. 326 00:18:37,033 --> 00:18:39,201 Explains the low blood pressure. 327 00:18:41,120 --> 00:18:43,663 And pretty much confirms the lymphoma. 328 00:18:48,419 --> 00:18:50,629 If we'd started Ester on prednisone... 329 00:18:50,755 --> 00:18:53,173 Did anyone see the lymphoma? 330 00:18:53,299 --> 00:18:55,967 No, we saw a mass. The location is consistent with... 331 00:18:56,093 --> 00:18:58,011 Didn't see any in the blood either. 332 00:18:58,137 --> 00:19:01,223 White blood cells show no spindling or abnormal nuclei. 333 00:19:01,349 --> 00:19:04,768 Nothing on immunochemistries either. It's not lymphoma. 334 00:19:37,176 --> 00:19:38,552 House! 335 00:19:40,304 --> 00:19:41,638 It's a train. 336 00:19:42,640 --> 00:19:44,975 - We don't know what kind of train... - Whoa. Whoa. Whoa. 337 00:19:45,101 --> 00:19:47,143 - I'm thirsty. - It's closed. 338 00:19:51,274 --> 00:19:52,649 It's not now. 339 00:19:59,323 --> 00:20:02,325 We got one advantage. We know where the tracks are going. 340 00:20:02,451 --> 00:20:06,162 The fact that the end of the line is death is an advantage? 341 00:20:06,289 --> 00:20:08,623 The fact that we know is an advantage. 342 00:20:08,749 --> 00:20:11,084 It means maybe we can get ahead of it. 343 00:20:11,711 --> 00:20:13,128 Next station is the liver. 344 00:20:13,254 --> 00:20:15,755 We got about 90 minutes before it gets there. 345 00:20:15,882 --> 00:20:19,175 Maybe we can cut down a tree across the line just outside of town. 346 00:20:19,302 --> 00:20:20,302 I'll do an ultrasound. 347 00:20:20,428 --> 00:20:22,220 No, treatment will tell us more, faster. 348 00:20:22,346 --> 00:20:25,181 How can we start treatment if we have no idea what we're treating for? 349 00:20:25,308 --> 00:20:27,183 Treat him for everything. 350 00:20:27,310 --> 00:20:30,186 Give him acetylcysteine, and interferon, and silymarin, 351 00:20:30,313 --> 00:20:33,565 and whatever else you can think of to protect the liver. 352 00:20:47,455 --> 00:20:48,288 What's going on? 353 00:20:48,414 --> 00:20:51,917 Oh, just catching up on some TV. How're you doing? 354 00:20:52,043 --> 00:20:55,253 Well, thanks to your last consult, the patient has improved dramatically. 355 00:20:55,379 --> 00:20:57,923 Tell House the patient is about to kill the doctor. 356 00:20:58,049 --> 00:20:59,549 - She says the patient... - I heard. 357 00:20:59,675 --> 00:21:02,469 - What've you got? - Well, Cuddy just raised and... 358 00:21:02,595 --> 00:21:03,720 - You're paired. - What? 359 00:21:03,846 --> 00:21:05,055 Nines. 360 00:21:07,433 --> 00:21:08,516 How do you know? 361 00:21:08,643 --> 00:21:11,186 Anything lower, you wouldn't sound so excited. 362 00:21:11,312 --> 00:21:12,812 Jacks or higher, 363 00:21:12,939 --> 00:21:16,191 your voice sounds like Debbie from accounting is sitting in your lap. 364 00:21:16,317 --> 00:21:18,443 Ask Cuddy if she can beat a pair of threes. 365 00:21:18,569 --> 00:21:20,320 What's going on? If you're gonna mess with me, 366 00:21:20,446 --> 00:21:21,988 wouldn't it be more fun to do it in person? 367 00:21:22,114 --> 00:21:23,698 Yes, it would. 368 00:21:25,868 --> 00:21:27,577 Can you beat a pair of threes? 369 00:21:27,703 --> 00:21:28,745 What'd she do? 370 00:21:28,871 --> 00:21:30,997 I left orders for PO fluids, Doctor. 371 00:21:31,123 --> 00:21:33,375 Enough with the codes. She obviously knows it's me. 372 00:21:33,501 --> 00:21:35,627 She's drinking her seltzer. 373 00:21:36,170 --> 00:21:37,462 Did she stop? 374 00:21:37,672 --> 00:21:39,172 - Yes. - Go all in. 375 00:21:40,257 --> 00:21:41,967 - But... - Just do it. 376 00:21:42,385 --> 00:21:44,302 You couldn't care less about this charity event. 377 00:21:44,428 --> 00:21:46,388 You claim not to be messing with me. 378 00:21:46,514 --> 00:21:47,847 You're either trying to keep me... 379 00:21:47,974 --> 00:21:49,224 Shut up. 380 00:21:49,350 --> 00:21:52,811 Look, last time I wanted the game to go on. I still do. 381 00:21:52,937 --> 00:21:55,146 It means that this time you get to win. 382 00:21:55,272 --> 00:21:56,314 Hold on. 383 00:22:03,155 --> 00:22:04,406 I fold. 384 00:22:12,957 --> 00:22:15,375 House, are you sure you're okay? 385 00:22:46,949 --> 00:22:50,160 Meds seem to be working. Liver's holding its own. 386 00:22:50,828 --> 00:22:51,828 Good. 387 00:22:51,954 --> 00:22:54,372 - But the platelets are dropping. - Even better. 388 00:22:54,498 --> 00:22:55,957 Why? It means he's getting sicker. 389 00:22:56,083 --> 00:22:58,418 It's new. New is good. 390 00:22:59,545 --> 00:23:01,504 Because old ended in death. 391 00:23:04,675 --> 00:23:06,217 I can't breathe. 392 00:23:07,595 --> 00:23:08,553 Chase! 393 00:23:11,057 --> 00:23:12,682 What's happening? 394 00:23:17,313 --> 00:23:18,688 Ian, come on. 395 00:23:19,315 --> 00:23:21,232 Honey, just relax. 396 00:23:21,692 --> 00:23:24,527 Ian, breathe. Come on, honey. Please. 397 00:23:25,112 --> 00:23:26,446 Please, honey. 398 00:24:19,625 --> 00:24:21,334 We had to put him on a ventilator. 399 00:24:21,460 --> 00:24:23,503 He's back on Ester's path 400 00:24:24,213 --> 00:24:26,756 and we managed to make the train skip a few stations. 401 00:24:26,882 --> 00:24:30,844 Which means that instead of 12 hours, he's probably got less than two. 402 00:24:30,970 --> 00:24:33,680 Which begs the question, why? What did we do? 403 00:24:33,806 --> 00:24:35,473 Acetylcysteine could mess with the lungs. 404 00:24:35,599 --> 00:24:38,309 Mess with them, not shut them down in 20 minutes. 405 00:24:38,435 --> 00:24:40,478 Interferon modulates the immune system. 406 00:24:40,604 --> 00:24:43,523 It could affect a cancer of the blood, like one of the leukemias. 407 00:24:43,649 --> 00:24:45,525 It doesn't speed them up. It slows them down. 408 00:24:45,651 --> 00:24:47,277 It slows down all 500 of them? 409 00:24:47,403 --> 00:24:50,947 Anybody know where we can find an oncologist at this hour? 410 00:24:55,494 --> 00:24:58,830 What effects would interferon have on leukemia? 411 00:24:59,123 --> 00:25:01,791 Depends on what type. Could make it better. Could make it worse. 412 00:25:01,917 --> 00:25:03,793 A four-year fellowship to learn that. 413 00:25:03,919 --> 00:25:05,545 Tell House if he wants to play cards, 414 00:25:05,671 --> 00:25:07,547 he can get his ass back down here and play. 415 00:25:07,673 --> 00:25:10,592 You hear that. She wants me off the phone. 416 00:25:10,718 --> 00:25:12,260 Means she's vulnerable. Go all in. 417 00:25:12,386 --> 00:25:16,139 But the party's over in less than three hours. 418 00:25:16,599 --> 00:25:18,600 It's over in less than two hours, 419 00:25:18,726 --> 00:25:20,894 which means you either have 420 00:25:21,645 --> 00:25:24,022 three of a kind or just threes. 421 00:25:24,732 --> 00:25:26,691 I'm guessing threes. 422 00:25:27,610 --> 00:25:29,861 I bet $500. 423 00:25:31,614 --> 00:25:34,115 - Go all in. - You obviously want to bust me. 424 00:25:34,241 --> 00:25:35,241 Why would you... 425 00:25:35,367 --> 00:25:36,409 Either you go all in, 426 00:25:36,535 --> 00:25:39,954 or I tell everybody in the building that you wear toenail polish. 427 00:25:41,123 --> 00:25:42,582 I'm all in. 428 00:25:44,210 --> 00:25:45,835 I'll call. 429 00:25:46,462 --> 00:25:49,005 I'm betting you have a pair of threes, 430 00:25:49,131 --> 00:25:51,799 but even if you have three, 431 00:25:52,968 --> 00:25:55,720 it's not gonna beat trip nines. 432 00:25:57,806 --> 00:25:59,557 Oh! Oh! Oh, no! 433 00:26:00,309 --> 00:26:03,686 Oh, no! Oh! Oh, that's gotta hurt. 434 00:26:03,812 --> 00:26:04,771 What happened? 435 00:26:04,897 --> 00:26:06,522 I just killed two birds with one straight. 436 00:26:06,649 --> 00:26:07,732 Goodbye. 437 00:26:08,609 --> 00:26:11,236 Fine, keep playing. But I need you to recommend a good oncologist 438 00:26:11,362 --> 00:26:13,488 because if I don't get one up here in the next few minutes, 439 00:26:13,614 --> 00:26:15,657 I got a dead six-year-old. 440 00:26:18,410 --> 00:26:21,663 If you need help, ask. These games are insane. 441 00:26:22,248 --> 00:26:24,207 The games have a higher success rate. 442 00:26:24,333 --> 00:26:26,626 Well, I don't see anything that looks like leukemia. 443 00:26:26,752 --> 00:26:29,045 - You do a bone marrow biopsy? - No time. 444 00:26:29,171 --> 00:26:31,339 Even if there is an occult blood cancer, 445 00:26:31,465 --> 00:26:33,508 you wouldn't expect interferon to make it worse. 446 00:26:33,634 --> 00:26:35,134 Certainly not this fast. 447 00:26:35,261 --> 00:26:37,845 - What would move this fast? - Autoimmune diseases. 448 00:26:37,972 --> 00:26:39,722 If his body's own defenses are attacking him, 449 00:26:39,848 --> 00:26:41,724 beefing them up is just gonna put fuel on the fire. 450 00:26:41,850 --> 00:26:43,977 Sarcoidosis could be in his brain and lungs. 451 00:26:44,103 --> 00:26:46,646 No. No enlarged hilar lymph nodes on his chest x-ray. 452 00:26:46,772 --> 00:26:49,774 The systemic nature suggests Juvenile Rheumatoid Arthritis. 453 00:26:49,900 --> 00:26:51,150 Or Kawasaki's Disease. 454 00:26:51,277 --> 00:26:52,610 Can't be Kawasaki's. 455 00:26:52,736 --> 00:26:54,654 That doesn't affect the elderly. 456 00:26:55,990 --> 00:26:57,573 This is a kid's x-ray? 457 00:26:57,700 --> 00:26:59,742 House had another patient. 458 00:27:01,787 --> 00:27:03,579 Who may or may not have had Kawasaki's. 459 00:27:03,706 --> 00:27:04,872 This kid on the other hand, 460 00:27:04,999 --> 00:27:08,543 he makes antibodies that are eating the inside of his arteries, 461 00:27:08,669 --> 00:27:11,629 choking off blood to his major organs, one by one. 462 00:27:11,755 --> 00:27:15,633 First the GI tract, then the kidneys, then the brain, now the lungs. 463 00:27:16,969 --> 00:27:21,264 Can anyone think of a reason why Kawasaki's can't affect the elderly, 464 00:27:21,640 --> 00:27:26,436 other than that it doesn't? Nice. 465 00:27:26,562 --> 00:27:28,521 We can confirm with blood work. 466 00:27:28,647 --> 00:27:30,481 We need an ANA, sed rate... 467 00:27:30,607 --> 00:27:32,233 Labs will take two hours. 468 00:27:32,860 --> 00:27:34,277 What was the old lady's sed rate? 469 00:27:34,403 --> 00:27:35,778 Elevated, 98. 470 00:27:35,904 --> 00:27:39,699 You can't use another patient's labs to diagnosis Kawasaki's disease. 471 00:27:39,825 --> 00:27:41,075 Is that like a dare or something? 472 00:27:41,201 --> 00:27:42,660 You don't have time to be wrong. 473 00:27:42,786 --> 00:27:45,788 Fine. We'll look for Kawasaki where he lives, 474 00:27:45,914 --> 00:27:47,874 Ian's coronary arteries. 475 00:27:53,964 --> 00:27:55,882 This other patient, 476 00:27:58,135 --> 00:28:00,803 the old lady, Ester? 477 00:28:04,475 --> 00:28:06,017 Have you read Moby Dick? 478 00:28:06,143 --> 00:28:07,435 It was a book? 479 00:28:07,686 --> 00:28:10,104 - It was ten years ago. - Twelve. 480 00:28:10,439 --> 00:28:11,981 Obsession is dangerous. 481 00:28:12,107 --> 00:28:14,776 Only if you're on a wooden ship, and your obsession is a whale. 482 00:28:14,902 --> 00:28:16,194 I think I'm in the clear. 483 00:28:16,320 --> 00:28:17,570 You do realize it's a metaphor. 484 00:28:17,696 --> 00:28:20,865 You realize the point of metaphors is to scare people from doing things 485 00:28:20,991 --> 00:28:23,368 by telling them that something much scarier is gonna happen 486 00:28:23,494 --> 00:28:25,787 than what will really happen. 487 00:28:25,996 --> 00:28:29,165 God, I wish I had a metaphor to explain that better. 488 00:28:29,291 --> 00:28:33,127 Go back to the game. Don't worry, I'm not gonna get eaten by witches. 489 00:28:37,925 --> 00:28:40,802 Coronary arteries clear. No aneurysms. 490 00:28:40,969 --> 00:28:43,513 Flip the mode. Let's see the flow. 491 00:28:46,934 --> 00:28:49,185 How did that other woman die? 492 00:28:49,728 --> 00:28:52,772 She went into respiratory distress. 493 00:28:53,232 --> 00:28:55,942 - Her heart and liver were already... - No. 494 00:28:57,152 --> 00:28:58,569 Did she suffer? 495 00:29:00,072 --> 00:29:01,656 Was she in pain? 496 00:29:01,782 --> 00:29:03,199 I don't know. 497 00:29:06,578 --> 00:29:10,373 Laminar flow. No blood clots, no ragged edges. 498 00:29:10,791 --> 00:29:13,668 Damn. Shut it down. We're just wasting time. 499 00:29:19,967 --> 00:29:21,384 Look at the right atrium. 500 00:29:21,510 --> 00:29:23,636 - That's not Kawasaki's. - No. 501 00:29:24,555 --> 00:29:26,264 It's small, but it's there. 502 00:29:26,390 --> 00:29:28,808 Ester didn't have a mass in her heart. 503 00:29:28,934 --> 00:29:31,269 Ian's younger. He can take more of a pounding. 504 00:29:31,395 --> 00:29:33,438 Ester died before the disease reached her heart. 505 00:29:33,564 --> 00:29:35,565 The disease made a mass and made it fast. 506 00:29:35,691 --> 00:29:37,275 - Could be bacteria. - Muscle. 507 00:29:37,401 --> 00:29:38,317 Connective tissue. 508 00:29:38,444 --> 00:29:40,403 The kid can't take any more theories. 509 00:29:40,529 --> 00:29:42,405 Only thing we know is that whatever that mass is, 510 00:29:42,531 --> 00:29:43,948 that's what he's got. 511 00:29:44,074 --> 00:29:47,410 We need a piece of it. I'm doing a biopsy. 512 00:30:01,967 --> 00:30:03,384 I'll shut the blinds. 513 00:30:03,510 --> 00:30:04,760 No, let them watch. 514 00:30:04,887 --> 00:30:07,513 I do my best work on the big stage. 515 00:30:09,057 --> 00:30:11,809 Passing through the superior vena cava. 516 00:30:11,935 --> 00:30:14,020 You're in the atrium. Pull back. 517 00:30:16,064 --> 00:30:18,483 You've hit the wall of the heart. 518 00:30:18,609 --> 00:30:20,276 These procedures would be so much simpler 519 00:30:20,402 --> 00:30:22,945 if you could do them on healthy people. 520 00:30:23,780 --> 00:30:25,406 And out again. 521 00:30:28,410 --> 00:30:29,702 - V-fib. - Cardiac arrest. 522 00:30:29,828 --> 00:30:31,412 Call a code. 523 00:30:32,164 --> 00:30:33,748 Come on, paddles! 524 00:30:35,876 --> 00:30:37,251 - Come on. - Charge. 525 00:30:37,377 --> 00:30:38,586 Clear! 526 00:30:39,963 --> 00:30:41,756 Code blue, ISO room. 527 00:30:41,882 --> 00:30:44,008 Code blue, ISO room. 528 00:30:45,594 --> 00:30:47,011 And again. 529 00:30:50,557 --> 00:30:52,266 - Nothing. - Again. 530 00:31:07,699 --> 00:31:08,950 You got a clock on this? 531 00:31:09,076 --> 00:31:11,577 How much longer you gonna keep doing this? 532 00:31:11,703 --> 00:31:12,912 Clear. 533 00:31:16,500 --> 00:31:18,709 Wait. I've got something. 534 00:31:21,880 --> 00:31:23,297 He's back. 535 00:31:30,722 --> 00:31:33,599 - What are you doing? - I'm doing what we came here to do. 536 00:31:33,725 --> 00:31:35,935 - It almost killed him. - I know. I was right here. 537 00:31:36,061 --> 00:31:37,186 I need a Vacutainer. 538 00:31:37,312 --> 00:31:40,314 His brain's been oxygen deprived for over eight minutes. 539 00:31:40,440 --> 00:31:41,983 There might be nothing left. He might... 540 00:31:42,109 --> 00:31:45,486 Tell the parents. Where the hell is that Vacutainer? 541 00:31:57,583 --> 00:32:00,543 - So, what's he got? - Brain damage. 542 00:32:00,669 --> 00:32:02,962 Good chance. I was talking about before that. 543 00:32:03,088 --> 00:32:05,590 - You're not worried about... - Things I can't do anything about? 544 00:32:05,716 --> 00:32:07,425 - I try not to. - Yeah. 545 00:32:07,551 --> 00:32:09,802 Things just roll off you like water off a duck. 546 00:32:09,928 --> 00:32:11,012 Histiocytosis. 547 00:32:11,138 --> 00:32:13,306 Very unlikely in a 73-year-old. 548 00:32:13,432 --> 00:32:15,933 Whatever this is, it's very unlikely. 549 00:32:16,184 --> 00:32:17,935 Come on. More ideas. Let's go, people. 550 00:32:18,061 --> 00:32:21,480 Genetic disorders could cause masses everywhere. Tuberous sclerosis. 551 00:32:21,607 --> 00:32:23,566 If it's genetic, he's had it all his life. 552 00:32:23,692 --> 00:32:25,026 - Why now? - I don't know. 553 00:32:25,152 --> 00:32:26,611 It sure fits nice enough. 554 00:32:26,737 --> 00:32:28,529 We haven't ruled out leukemia yet. 555 00:32:28,655 --> 00:32:31,407 Or sarcoma. He could have multiple soft tissue tumors. 556 00:32:31,533 --> 00:32:32,533 Or sarcoidosis. 557 00:32:32,659 --> 00:32:34,201 Multiple neurofibromatosis. 558 00:32:34,328 --> 00:32:35,953 Chondrocytomas. 559 00:32:37,956 --> 00:32:39,665 How's it going? You win? 560 00:32:39,791 --> 00:32:42,835 I got called away by the angry parents of a patient. 561 00:32:42,961 --> 00:32:44,337 There are three of you here. 562 00:32:44,463 --> 00:32:46,922 None of you had the sense to stop him, to pick up a phone and call me. 563 00:32:47,049 --> 00:32:48,424 I told them you'd signed off. 564 00:32:48,550 --> 00:32:50,760 The parents are mad because their kid is dying. 565 00:32:50,886 --> 00:32:52,094 It's understandable. 566 00:32:52,220 --> 00:32:54,180 But if he doesn't die, they won't be mad anymore. 567 00:32:54,306 --> 00:32:56,641 If he's brain damaged, they might still be a little ticked. 568 00:32:56,767 --> 00:32:57,808 Had to do it to save him. 569 00:32:57,934 --> 00:33:00,519 You had to do it to diagnose Ester. 570 00:33:00,646 --> 00:33:02,521 You may have killed a six-year-old 571 00:33:02,648 --> 00:33:06,025 because you're obsessed with a woman who's been dead for 12 years. 572 00:33:06,151 --> 00:33:08,361 Sometimes you lose, House! You're not God! 573 00:33:08,487 --> 00:33:09,445 He's not dead yet. 574 00:33:09,571 --> 00:33:10,613 No, but you're done with him. 575 00:33:10,739 --> 00:33:12,990 It's my case now. Go home. Go ride your motorcycle. 576 00:33:13,116 --> 00:33:16,661 Go brood in a dark room. Just don't go near Ian again. 577 00:33:23,919 --> 00:33:27,046 So, anything else or is it just these seven? 578 00:33:27,172 --> 00:33:28,506 Drop it, House. She's right. 579 00:33:28,632 --> 00:33:30,132 No, she's not! 580 00:33:31,259 --> 00:33:33,386 - You know she's not. - We should have called her. 581 00:33:33,512 --> 00:33:34,845 I'm surprised you didn't. 582 00:33:34,971 --> 00:33:36,681 You're gonna have to find a way to let this go. 583 00:33:36,807 --> 00:33:38,307 We can't go near Ian. 584 00:33:38,433 --> 00:33:40,267 We don't need to go near him. 585 00:33:40,686 --> 00:33:42,269 We have his tumor. 586 00:33:42,896 --> 00:33:45,272 Well, Cuddy may be right that we screwed up the protocol. 587 00:33:45,399 --> 00:33:48,025 She may be right about my screwed up obsession. 588 00:33:48,151 --> 00:33:50,653 But I'm right about the medicine. 589 00:33:50,821 --> 00:33:53,114 How many tests can we do with that? 590 00:33:53,240 --> 00:33:55,658 Look, we cure the kid, we solve everybody's problems. 591 00:33:55,784 --> 00:33:57,118 How many? 592 00:34:00,080 --> 00:34:01,455 Maybe two good pieces. 593 00:34:01,581 --> 00:34:03,332 How many okay pieces? 594 00:34:04,126 --> 00:34:06,168 Three would be pushing it. 595 00:34:07,838 --> 00:34:10,131 Three tests, seven choices. 596 00:34:11,675 --> 00:34:13,342 Okay, what's first? 597 00:34:13,802 --> 00:34:15,970 Sarcoidosis seems most likely. 598 00:34:16,096 --> 00:34:19,557 Yeah. So likely that Cuddy's gonna think of that all on her own. 599 00:34:19,683 --> 00:34:22,977 She's got the kid's whole body to play with. Let her do that test. 600 00:34:23,103 --> 00:34:24,478 What's next? 601 00:34:24,604 --> 00:34:26,063 It's moving too fast to be spreading. 602 00:34:26,189 --> 00:34:28,399 It has to be growing from something that's already there. 603 00:34:28,525 --> 00:34:30,401 Genetic disorder. Tuberous sclerosis. 604 00:34:30,527 --> 00:34:33,529 Or it's his immune system. Histiocytosis. 605 00:34:34,239 --> 00:34:37,408 Well, there are more documented cases of Histio amongst older people 606 00:34:37,534 --> 00:34:40,161 than tuberous sclerosis. Let's start with that. 607 00:34:45,751 --> 00:34:47,752 Wing or drumstick? 608 00:34:50,088 --> 00:34:51,630 Gonna need a little more than that. 609 00:34:51,757 --> 00:34:53,007 A little more is more than a third. 610 00:34:53,133 --> 00:34:57,219 If we have to repeat this test because you didn't cut us enough... 611 00:35:02,726 --> 00:35:05,686 I'm adding one micro liter of the immunoperoxidase. 612 00:35:05,812 --> 00:35:07,938 Make it two. I don't want House biting off our heads 613 00:35:08,064 --> 00:35:11,192 because we weren't sure if it turned red or not. 614 00:35:16,823 --> 00:35:18,741 That's definitely not red. 615 00:35:24,331 --> 00:35:26,582 The problem could still be an abnormal cell growth 616 00:35:26,708 --> 00:35:27,792 but a different cell line. 617 00:35:27,918 --> 00:35:30,085 Sarcoma? Muscle cells are throughout his body. 618 00:35:30,212 --> 00:35:31,462 It would explain the geography. 619 00:35:31,588 --> 00:35:34,799 Genetic disorder is far more likely in a six-year-old. Tuberous sclerosis. 620 00:35:34,925 --> 00:35:36,801 Pretty unlikely to cause a GI bleed. 621 00:35:36,927 --> 00:35:38,010 The time course fits. 622 00:35:38,136 --> 00:35:40,638 Mr. Foreman, you agree with both of them? Thanks for playing. 623 00:35:40,764 --> 00:35:43,349 If we have enough tissue for two tests, why not do both? 624 00:35:43,475 --> 00:35:44,850 Then we don't have to think as hard. 625 00:35:44,976 --> 00:35:47,937 Taking the pressure off the choice makes us less likely to think critically. 626 00:35:48,063 --> 00:35:50,898 Sarcoma is more likely to hit a six and 70-year-old. 627 00:35:51,024 --> 00:35:52,691 Tuberous sclerosis, it is. 628 00:35:52,818 --> 00:35:54,151 You think sarcoma is less likely? 629 00:35:54,277 --> 00:35:55,402 It's more likely. 630 00:35:55,529 --> 00:35:58,864 The test for it, on the other hand, is less reliable. 631 00:36:11,002 --> 00:36:13,295 Test is negative. Well, that's okay. 632 00:36:13,421 --> 00:36:17,967 If the tumor cells hadn't matured, the Ki-67 protein wouldn't have turned off. 633 00:36:19,761 --> 00:36:22,221 - What happens if we don't solve this? - Kid dies. 634 00:36:22,347 --> 00:36:24,598 I mean for the next 12 years. 635 00:36:25,976 --> 00:36:28,018 Ki-67's negative. 636 00:36:31,606 --> 00:36:33,816 And PCH antigen is negative. 637 00:36:45,245 --> 00:36:47,872 Mighty Casey's down to his last strike. 638 00:36:47,998 --> 00:36:49,957 Mighty Casey struck out. 639 00:36:50,166 --> 00:36:52,543 Thanks a lot. I was gonna read that this weekend. 640 00:36:52,669 --> 00:36:56,046 Chondrocytoma. Connective tissue's been in all the places we've been looking. 641 00:36:56,172 --> 00:36:58,716 The kid is too sick for that. We're better off testing for sarcoma. 642 00:36:58,842 --> 00:37:01,594 We would've seen signs of that when we tested for tuberous sclerosis. 643 00:37:01,720 --> 00:37:03,929 The tumor cells looked like muscle under the microscope. 644 00:37:04,055 --> 00:37:06,891 No, they didn't. They looked like fat. 645 00:37:07,934 --> 00:37:10,019 I vote for neurofibromatosis. 646 00:37:11,104 --> 00:37:13,981 - Why? - Because the other choices suck worse. 647 00:37:22,574 --> 00:37:24,116 Give me a minute. 648 00:37:53,730 --> 00:37:55,689 You want me out of here? 649 00:37:57,943 --> 00:37:59,985 You come up with anything? 650 00:38:02,113 --> 00:38:03,238 No. 651 00:38:30,100 --> 00:38:32,977 Hey. We can talk about it tomorrow. 652 00:38:40,986 --> 00:38:42,069 I... 653 00:38:43,905 --> 00:38:46,031 I won the poker tournament. 654 00:38:47,993 --> 00:38:50,911 I totally played this guy, Berman, from business affairs. 655 00:38:51,037 --> 00:38:54,999 I got great cards. But I don't bet. Just call, no raises. 656 00:38:55,125 --> 00:38:57,376 Berman pairs his king on the flop. 657 00:38:57,502 --> 00:38:59,920 I keep calling, the river turns, 658 00:39:00,964 --> 00:39:02,756 I check. He can't stand it. 659 00:39:02,882 --> 00:39:06,010 He goes all in. He's sure he's won. 660 00:39:07,762 --> 00:39:09,888 I call, I flip them. 661 00:39:11,474 --> 00:39:12,766 Pocket aces. 662 00:39:13,059 --> 00:39:14,685 I nailed his ass. 663 00:39:23,653 --> 00:39:26,030 The aces were hiding all along. 664 00:39:34,497 --> 00:39:36,957 Test him for Erdheim-Chester disease. 665 00:39:37,083 --> 00:39:39,460 Erdheim-Chester? That's not even on the list. 666 00:39:39,586 --> 00:39:42,254 Because we already did it. He tested negative. 667 00:39:42,380 --> 00:39:44,548 - So did Ester. - The disease lied. 668 00:39:44,674 --> 00:39:47,676 Yeah, the tumor's got it in for you. Diseases don't lie. 669 00:39:47,802 --> 00:39:49,970 Fine, it didn't lie. It slow played us. 670 00:39:50,096 --> 00:39:53,682 We biopsied the colon, it hadn't reached the GI tract yet. 671 00:39:53,850 --> 00:39:56,643 It's there now. It's in his liver, his lungs. 672 00:39:56,770 --> 00:39:58,687 You want it to be there. 673 00:39:58,813 --> 00:40:00,856 Because then you didn't screw up 12 years ago. 674 00:40:00,982 --> 00:40:04,818 We can't waste our one test on the one disease we know it's not. 675 00:40:07,697 --> 00:40:09,323 Run the test. 676 00:40:20,919 --> 00:40:22,586 You sure about this? 677 00:40:22,712 --> 00:40:25,506 Wait. Let me think about that. Don't pressure me. 678 00:40:25,632 --> 00:40:27,508 Just run the damn test. 679 00:40:30,428 --> 00:40:32,471 Cells look like macrophages. 680 00:40:32,597 --> 00:40:34,306 That's a good start. 681 00:40:40,313 --> 00:40:42,731 Take your time, and say it loud. 682 00:40:52,492 --> 00:40:54,201 CD 68 positive. 683 00:41:06,756 --> 00:41:08,465 Start the treatment. 684 00:42:07,859 --> 00:42:10,360 So, Ester can rest peaceful now, huh? 685 00:42:10,987 --> 00:42:12,154 Yeah. 686 00:42:18,870 --> 00:42:19,870 $40. 687 00:42:25,251 --> 00:42:26,877 You got lucky. 688 00:42:27,795 --> 00:42:29,296 You gonna call? 689 00:42:29,464 --> 00:42:30,881 What I do 690 00:42:31,966 --> 00:42:34,635 is not just based on the flip of a card. 691 00:42:34,969 --> 00:42:37,346 You guessed. You got lucky. 692 00:42:37,472 --> 00:42:38,472 It fit. 693 00:42:38,598 --> 00:42:41,683 It could just as easily have been sarcoma or tuberous sclerosis. 694 00:42:41,809 --> 00:42:44,061 No, not just as easily. 695 00:42:44,187 --> 00:42:46,855 Maybe not. But it wasn't impossible. 696 00:42:50,318 --> 00:42:51,985 Are you gonna call? 697 00:42:53,655 --> 00:42:55,989 You know, relative to its size, 698 00:42:56,658 --> 00:42:59,743 the barnacle has the largest penis of any animal.