1 00:00:03,671 --> 00:00:06,422 Hey. Thanks. 2 00:00:06,799 --> 00:00:08,383 No, no, no... Here. 3 00:00:09,927 --> 00:00:11,344 You got this whole thing wrong, Em. 4 00:00:11,679 --> 00:00:13,513 It's the rock star that's supposed to be late, 5 00:00:13,639 --> 00:00:14,889 not the rock-star photographer. 6 00:00:15,224 --> 00:00:18,184 Sorry. Morning sickness. Touch the belly. 7 00:00:18,477 --> 00:00:20,603 It's the first time I've been asked to do that. 8 00:00:20,729 --> 00:00:22,063 Come on. It's good luck. 9 00:00:22,189 --> 00:00:23,773 Okay. 10 00:00:24,650 --> 00:00:26,567 Hit the Kinos behind the drop. 11 00:00:31,865 --> 00:00:33,658 So what do you think? 12 00:00:34,743 --> 00:00:36,452 I think people aren't gonna get it. 13 00:00:36,578 --> 00:00:38,830 Come on. "All-American Rejects." 14 00:00:38,956 --> 00:00:43,543 Juxtaposing a classic image of Americana with modern pop culture youth. 15 00:00:44,044 --> 00:00:45,920 Oh, yeah. 16 00:00:46,046 --> 00:00:48,256 Everyone loves a good juxtaposition. 17 00:00:48,382 --> 00:00:49,966 My fans were born in the '90s. 18 00:00:50,092 --> 00:00:53,761 You know what? You do this picture, you'll gain 40 years of fans. 19 00:00:54,138 --> 00:00:55,388 - Yeah? - Yeah. 20 00:00:55,514 --> 00:00:57,890 - I love the Rockwell thing. - I thought so. 21 00:00:58,475 --> 00:01:00,852 Okay. Kill the house lights. Let's go! 22 00:01:07,651 --> 00:01:09,861 Hang on. Hey, who's in charge of the backdrop? 23 00:01:09,987 --> 00:01:11,696 - Naomi? - Yeah? 24 00:01:12,156 --> 00:01:13,781 What's wrong with it? 25 00:01:13,907 --> 00:01:16,367 Well, the words are completely jumbled. 26 00:01:17,327 --> 00:01:19,662 What, you can read that? 27 00:01:20,122 --> 00:01:21,748 Of course. 28 00:01:21,957 --> 00:01:24,375 - You okay? - No. Oh, God. 29 00:01:24,501 --> 00:01:26,461 I could be having a... 30 00:01:27,004 --> 00:01:29,005 What's the mnemonic? 31 00:01:29,923 --> 00:01:32,842 "F" is for face. Is my smile crooked? 32 00:01:34,011 --> 00:01:35,261 What are you doing? 33 00:01:35,387 --> 00:01:37,889 "A" is for arms. 34 00:01:38,015 --> 00:01:38,848 Arms. 35 00:01:38,974 --> 00:01:40,349 You should really sit down. 36 00:01:40,476 --> 00:01:41,809 Can someone get her some water? 37 00:01:41,935 --> 00:01:43,519 "S" is speech. 38 00:01:43,645 --> 00:01:45,396 I'm slurring? I'm slurring? 39 00:01:49,193 --> 00:01:51,194 "F-A-S-T." 40 00:01:51,862 --> 00:01:53,446 "T" is for time. 41 00:01:53,572 --> 00:01:58,159 Hurry. Somebody, call 911. Tell them I'm having a stroke. 42 00:02:40,327 --> 00:02:42,036 Hi. I'm Dr. House. 43 00:02:42,162 --> 00:02:44,038 My boss says you're important. 44 00:02:44,581 --> 00:02:45,957 Personally I don't get what's so hard about 45 00:02:46,083 --> 00:02:48,000 making Scarlett Johansson look pretty. 46 00:02:48,126 --> 00:02:49,710 Arms out in front of you. 47 00:02:49,837 --> 00:02:51,879 Palms up like you're holding a pizza. 48 00:02:52,589 --> 00:02:53,798 Close your eyes. 49 00:02:55,008 --> 00:02:58,344 It's so easy you should consider a career change. 50 00:02:58,470 --> 00:02:59,846 Probably make a lot more money. 51 00:03:00,597 --> 00:03:02,807 Dr. Mackman tell you the clot was clear? 52 00:03:02,933 --> 00:03:03,891 Yes. 53 00:03:04,017 --> 00:03:06,143 And he said that you and the fetus are fine? 54 00:03:06,270 --> 00:03:07,395 Yeah. 55 00:03:07,688 --> 00:03:10,106 He didn't mention your pronator drift? 56 00:03:10,732 --> 00:03:14,193 - What's that mean? - Means Mackman is an idiot. 57 00:03:14,736 --> 00:03:16,195 - May I? - Yeah. 58 00:03:16,780 --> 00:03:18,072 So, 59 00:03:19,032 --> 00:03:21,409 you take thousands of photos of someone, 60 00:03:21,535 --> 00:03:23,870 but only one has to look good. 61 00:03:23,996 --> 00:03:25,079 Kind of the opposite of my business. 62 00:03:25,205 --> 00:03:26,664 It's not about looking good. 63 00:03:26,790 --> 00:03:27,874 People are always hiding things. 64 00:03:28,000 --> 00:03:31,294 I just keep shooting until I can see what's really inside them. 65 00:03:32,212 --> 00:03:34,672 - My eyes okay? - Eyes are gorgeous. 66 00:03:34,798 --> 00:03:36,674 The vessels don't look so hot. 67 00:03:36,884 --> 00:03:39,635 Microaneurysms predict further strokes. 68 00:03:39,761 --> 00:03:40,595 This is gonna happen again? 69 00:03:40,804 --> 00:03:43,431 Unless I can figure out the underlying cause. 70 00:03:43,557 --> 00:03:45,224 Puff up your cheeks. 71 00:03:47,060 --> 00:03:50,396 You should be able to keep the air in. Means there's weakness around the mouth. 72 00:03:50,522 --> 00:03:52,273 So where'd you learn to self-diagnose a stroke? 73 00:03:52,399 --> 00:03:56,777 Oh, my baby's biological father is a neurologist. 74 00:03:57,070 --> 00:04:00,531 He once told me the FAST mnemonic could save my life one day. So... 75 00:04:00,824 --> 00:04:02,491 Interesting pet name. 76 00:04:02,826 --> 00:04:05,411 Most people go with "husband" or "pookie." 77 00:04:05,829 --> 00:04:07,538 He's gay. 78 00:04:07,664 --> 00:04:09,373 Just a sperm donor. So when you... 79 00:04:09,499 --> 00:04:11,125 You turned him for a night? 80 00:04:11,251 --> 00:04:12,919 Just straight for one date? 81 00:04:13,670 --> 00:04:14,837 Okay. 82 00:04:15,213 --> 00:04:18,841 He took a magazine and a cup into my bathroom. 83 00:04:18,967 --> 00:04:20,760 A man after my own heart. 84 00:04:20,886 --> 00:04:22,720 Different magazine obviously. 85 00:04:22,930 --> 00:04:25,890 I'm rescinding Mackman's discharge order. 86 00:04:26,016 --> 00:04:27,892 My lackeys will be in to do some tests, 87 00:04:28,018 --> 00:04:30,895 take some more blood and empty your catheter bag. 88 00:04:36,401 --> 00:04:39,654 Not a moment you'll want to cherish. 89 00:04:41,823 --> 00:04:44,784 This is definitely different. 90 00:04:44,910 --> 00:04:47,078 It looks almost like... 91 00:04:47,287 --> 00:04:48,955 He's caring. 92 00:04:54,920 --> 00:04:58,381 Find anything else in the patient's folder? Like a diagnosis? 93 00:04:58,507 --> 00:05:01,968 Urinalysis revealed excessive protein and red blood cells. 94 00:05:02,094 --> 00:05:04,720 Chem panel showed a creatinine level over 2.5. 95 00:05:04,846 --> 00:05:08,265 So first she strokes, now her kidneys are shutting down. Why? 96 00:05:08,392 --> 00:05:10,142 Ultrasound showed no tumors or stones. 97 00:05:10,268 --> 00:05:12,895 No signs of fetal distress. No urinary tract obstructions. 98 00:05:13,021 --> 00:05:14,855 BP is fine. No pre-eclampsia. 99 00:05:14,982 --> 00:05:17,149 Any of you guys ever been to the Galápagos? 100 00:05:17,275 --> 00:05:18,609 Was our patient there? 101 00:05:18,735 --> 00:05:20,736 Dengue fever, avian pox, even West Nile. 102 00:05:20,862 --> 00:05:21,946 No. 103 00:05:22,072 --> 00:05:23,614 I'm looking for a vacation spot. 104 00:05:23,740 --> 00:05:24,949 That mean we get vacation? 105 00:05:25,075 --> 00:05:27,535 How would that differ from your current status? 106 00:05:27,661 --> 00:05:28,995 You're gonna do what? Relax? 107 00:05:29,121 --> 00:05:30,121 Visiting family. 108 00:05:30,247 --> 00:05:31,664 My uncle's a giant turtle. 109 00:05:31,790 --> 00:05:33,541 What if the kidney failure came first? 110 00:05:33,667 --> 00:05:36,043 Kidneys could've caused the stroke, not the other way around. 111 00:05:36,169 --> 00:05:38,170 Kidneys don't often get stuck in the brain. 112 00:05:38,296 --> 00:05:39,672 I'm saying it threw a clot. 113 00:05:39,798 --> 00:05:42,550 Early symptoms of kidney failure are nausea, vomiting, ankle swelling. 114 00:05:42,676 --> 00:05:44,385 She would've mistaken it for morning sickness. 115 00:05:44,511 --> 00:05:46,637 Heart's way more likely to throw a clot than a kidney. 116 00:05:46,763 --> 00:05:49,890 Echo was normal. The history indicates no sign of cardiac problems. 117 00:05:50,017 --> 00:05:52,184 No, but if one were to read the history closely, 118 00:05:52,310 --> 00:05:54,603 one would notice that she had six cases of strep. 119 00:05:54,730 --> 00:05:57,523 In her throat. That's the one about 10 inches above her heart. 120 00:05:57,649 --> 00:06:00,401 Let me rephrase, six cases of untreated strep. 121 00:06:00,527 --> 00:06:01,819 She was prescribed antibiotics. 122 00:06:01,945 --> 00:06:02,987 No one takes them all. 123 00:06:03,280 --> 00:06:06,449 They stop when they start feeling better. All strep is untreated strep. 124 00:06:06,575 --> 00:06:07,867 What happens when strep goes untreated? 125 00:06:08,201 --> 00:06:09,326 Leads to rheumatic fever. 126 00:06:09,578 --> 00:06:10,619 Which leads to... Cameron? 127 00:06:10,829 --> 00:06:11,996 Mitral valve stenosis. 128 00:06:12,122 --> 00:06:15,082 Which is a thickening in the valve of the... Kidney? 129 00:06:15,208 --> 00:06:16,292 No. 130 00:06:16,418 --> 00:06:17,877 The kidney doesn't have a mitral valve. 131 00:06:18,003 --> 00:06:20,087 We'll go look at her heart. 132 00:06:21,757 --> 00:06:23,090 Be easy to find. 133 00:06:23,425 --> 00:06:27,094 It's the big red pumping thing about 10 inches below her throat. 134 00:06:27,679 --> 00:06:29,138 That was weird. 135 00:06:29,765 --> 00:06:32,808 - He was the way he always is. - Which is weird. 136 00:06:34,102 --> 00:06:36,062 - Very still, Emma. - Sorry. 137 00:06:36,188 --> 00:06:37,229 No problem. 138 00:06:37,564 --> 00:06:40,566 He caught us with your hand up my shirt. He's gotta have a reaction to that. 139 00:06:40,692 --> 00:06:41,984 You think that's what the vacation is? 140 00:06:42,110 --> 00:06:43,110 Yes. 141 00:06:43,236 --> 00:06:46,781 The pain of losing you is obviously forcing him away. 142 00:06:46,907 --> 00:06:48,115 Coronal slice appears normal. 143 00:06:48,241 --> 00:06:50,409 There's no way House just lets this slide. 144 00:06:50,535 --> 00:06:51,786 He's gotta be planning something. 145 00:06:51,912 --> 00:06:53,996 Maybe he just doesn't give a crap. 146 00:06:54,122 --> 00:06:55,414 Sagittal slice is clean. 147 00:06:55,540 --> 00:06:56,999 You think he just stumbled into that closet? 148 00:06:57,125 --> 00:06:59,376 He knew we were there and he wanted us to know that he knew. 149 00:06:59,503 --> 00:07:01,128 Or you wanted him to know. 150 00:07:01,254 --> 00:07:04,381 Now he does and you're annoyed because he doesn't care. 151 00:07:04,674 --> 00:07:05,549 Right there. 152 00:07:05,884 --> 00:07:08,427 Trans-axial slice. Calcified mitral valve. 153 00:07:08,553 --> 00:07:10,721 Barely. That's not big enough to throw a clot. 154 00:07:10,847 --> 00:07:13,182 Obviously it is, because it did. 155 00:07:13,308 --> 00:07:14,725 House was right. 156 00:07:15,519 --> 00:07:17,853 A valve in your heart is narrowed. 157 00:07:17,979 --> 00:07:20,648 It caused the clot which lead to your stroke, 158 00:07:20,774 --> 00:07:24,443 and the reduced circulation caused the problem with your kidneys. 159 00:07:24,861 --> 00:07:26,070 And this will fix it? 160 00:07:26,196 --> 00:07:29,573 The balloon will force the valve back open and you'll be fine. 161 00:07:29,699 --> 00:07:31,158 Can we do this without a sedative? 162 00:07:31,284 --> 00:07:34,203 It's very mild. There really is no risk to the fetus. 163 00:07:34,329 --> 00:07:36,539 We'll monitor your baby's heart rate separately. 164 00:07:36,957 --> 00:07:40,376 We won't allow it to decrease anywhere near dangerous levels. 165 00:07:43,630 --> 00:07:44,547 Thank you. 166 00:07:44,673 --> 00:07:45,756 You're both gonna be fine. 167 00:07:48,677 --> 00:07:50,052 Go ahead, Dr. Cameron. 168 00:07:51,930 --> 00:07:55,099 Listen to that heartbeat. It sounds so... 169 00:07:56,560 --> 00:07:58,686 Start threading the catheter. 170 00:08:05,694 --> 00:08:10,656 No, I don't want a layover in Frankfurt, Taipei, Singapore or London, Ontario. 171 00:08:10,782 --> 00:08:12,825 That's why I asked for a direct flight to Phnom Penh. 172 00:08:13,326 --> 00:08:16,495 How hard is it to not land? Does it matter what I answer? 173 00:08:16,872 --> 00:08:19,123 Well, then fine. I'd be delighted to hold. 174 00:08:19,249 --> 00:08:21,292 - What's new? - Can Cuddy stop interfering? 175 00:08:21,418 --> 00:08:22,668 It's her job. What's new? 176 00:08:22,794 --> 00:08:24,044 Good news is Emma's heart is fixed. 177 00:08:24,171 --> 00:08:27,548 Bad news is it's not her underlying problem. Her kidneys are still failing. 178 00:08:27,674 --> 00:08:29,592 You're vacationing in Cambodia? 179 00:08:29,718 --> 00:08:30,843 You gonna unwind in the Killing Fields? 180 00:08:30,969 --> 00:08:31,802 Nope. 181 00:08:31,928 --> 00:08:33,596 Gonna catch me a fish this big. 182 00:08:33,722 --> 00:08:36,098 Mekong giant catfish. Weighs over 600 pounds. 183 00:08:36,224 --> 00:08:37,600 Aren't those catfish critically endangered? 184 00:08:37,726 --> 00:08:39,560 That's why it's my last chance to catch one. 185 00:08:39,686 --> 00:08:41,020 All of our operators are currently... 186 00:08:41,229 --> 00:08:42,688 If the mitral valve had been properly fixed 187 00:08:42,814 --> 00:08:43,981 the kidney should be getting better, 188 00:08:44,107 --> 00:08:46,567 which leads us to the conclusion that you screwed up the procedure. 189 00:08:46,693 --> 00:08:48,110 Or you screwed up the diagnosis. 190 00:08:48,236 --> 00:08:49,820 The mitral valve thickening was so insignificant 191 00:08:49,946 --> 00:08:52,072 it probably wasn't the cause of the kidneys or the stroke. 192 00:08:52,199 --> 00:08:53,449 Probably never would've been a problem. 193 00:08:53,575 --> 00:08:55,826 She needs dialysis and we need a new theory. 194 00:08:56,203 --> 00:08:57,953 There are only a few possibilities. 195 00:08:58,079 --> 00:09:00,247 Patient's pregnant, could be pre-eclampsia. 196 00:09:00,373 --> 00:09:01,749 We eliminated it before because... 197 00:09:01,875 --> 00:09:04,084 Re-check for proteinuria and low platelets. What else? 198 00:09:04,211 --> 00:09:05,294 Hypoperfusion. 199 00:09:05,420 --> 00:09:08,631 The fetus is basically a parasite stealing nutrients, minerals, blood. 200 00:09:08,757 --> 00:09:09,840 Put her on telemetry. 201 00:09:09,966 --> 00:09:11,300 Or the pregnancy is irrelevant. 202 00:09:11,426 --> 00:09:14,053 Could be infection, sepsis, HUS/TTP. 203 00:09:14,179 --> 00:09:16,138 A cholesterol embolism is just as likely. 204 00:09:16,264 --> 00:09:19,725 Tiny particles of cholesterol rain down, clog up small vessels of the kidneys. 205 00:09:19,851 --> 00:09:21,810 Get a smear and ultrasound her vessels for plaque. 206 00:09:21,937 --> 00:09:23,729 That's it. Has to be one of those five. 207 00:09:23,855 --> 00:09:27,858 You know what would be even better? If we'd narrow it all the way down to one. 208 00:09:28,818 --> 00:09:30,819 Thank you for holding. 209 00:09:30,946 --> 00:09:33,405 We are experiencing extremely high call volume. 210 00:09:33,531 --> 00:09:35,658 Thank you for your patience. 211 00:09:41,039 --> 00:09:42,623 She's 0 for five. 212 00:09:44,834 --> 00:09:48,128 Either the differential was wrong or she's faking it. 213 00:09:48,255 --> 00:09:50,464 Kidney failure has to be precipitated by... 214 00:09:50,590 --> 00:09:51,882 One of the five we've already ruled out. 215 00:09:52,008 --> 00:09:54,635 The body only has so many ways of screwing with the kidneys. 216 00:09:54,761 --> 00:09:56,220 - The labs must be wrong. - We did the labs. 217 00:09:56,346 --> 00:09:57,846 No one else had access. 218 00:09:57,973 --> 00:09:59,598 That's not quite true. 219 00:10:06,273 --> 00:10:10,484 You put all your patients through this many tests or just the important ones? 220 00:10:11,778 --> 00:10:14,989 We wanted to explore all possibilities. 221 00:10:17,659 --> 00:10:18,659 And? 222 00:10:19,286 --> 00:10:21,704 We've eliminated all the possibilities. 223 00:10:21,830 --> 00:10:23,706 You telling me I'm dying and you have no idea why? 224 00:10:23,915 --> 00:10:25,916 Your body is functioning properly. 225 00:10:26,042 --> 00:10:27,501 So why are my kidneys failing? 226 00:10:29,671 --> 00:10:31,380 The other body isn't. 227 00:10:32,674 --> 00:10:35,301 There's something wrong with the fetus. 228 00:10:44,644 --> 00:10:48,397 Welcome to the world of maternal mirror syndrome. 229 00:10:49,816 --> 00:10:51,442 Mom's body is like 230 00:10:52,402 --> 00:10:54,737 an intricate German metro system. 231 00:10:54,863 --> 00:10:56,363 All the trains run on time. 232 00:10:56,740 --> 00:11:00,868 When she gets pregnant, it's like a new station opening in Düsseldorf. 233 00:11:00,994 --> 00:11:03,829 Bunch or rookies running things. Bound to be mistakes. 234 00:11:03,955 --> 00:11:05,998 Kids play on the tracks, get electrocuted. 235 00:11:06,124 --> 00:11:08,625 Before you know it, the trains are backed up all the way to Berlin 236 00:11:08,752 --> 00:11:10,836 and you've got a bunch of angry Germans with nowhere to go. 237 00:11:10,962 --> 00:11:12,755 And we all know that ain't good for the Jews. 238 00:11:12,881 --> 00:11:13,922 Who are the Jews in this metaphor? 239 00:11:14,049 --> 00:11:15,966 A few things can happen to a fetus in distress. 240 00:11:16,092 --> 00:11:18,385 It can become a miscarriage, stillbirth, 241 00:11:18,511 --> 00:11:21,805 a very sick baby or on rare occasion a time bomb 242 00:11:22,057 --> 00:11:23,891 that kills mom while it's dying. 243 00:11:24,017 --> 00:11:27,061 Good news is, we fix the fetus, mom gets better. 244 00:11:27,187 --> 00:11:29,271 It's the diagnostic equivalent of a two-for-one sale. 245 00:11:29,397 --> 00:11:32,483 I have read the outcome of mirror syndrome is almost always unfavorable. 246 00:11:32,817 --> 00:11:35,611 "Unfavorable." Is that doctor speak for "dead baby"? 247 00:11:35,987 --> 00:11:38,405 You think she'll be less upset if you phrase it nicely? 248 00:11:38,531 --> 00:11:40,616 We can tell her the truth, that she'll be fine 249 00:11:40,867 --> 00:11:44,286 as soon as we diagnose a person who weighs about one pound. 250 00:11:44,662 --> 00:11:47,915 Can't touch it, can't ask where it hurts, can't see it. 251 00:11:48,166 --> 00:11:52,044 If only there existed giant machines that could look through human skin. 252 00:11:52,170 --> 00:11:54,546 Mirror syndrome has a limited number of known causes. 253 00:11:54,964 --> 00:11:57,758 Tachyarrhythmia, fetal anemia, placental chorioangioma. 254 00:11:57,884 --> 00:11:59,843 All of which are fixable. 255 00:11:59,969 --> 00:12:01,887 Which would be un-unfavorable, right? 256 00:12:02,013 --> 00:12:03,764 Could also be trisomy 13. 257 00:12:03,890 --> 00:12:06,600 Ebstein's anomaly, an aneurysm of Galen's vein. 258 00:12:06,726 --> 00:12:10,229 And Dr. Storm Cloud rained all over the differential 259 00:12:10,355 --> 00:12:12,106 and killed the beautiful little baby. 260 00:12:12,232 --> 00:12:15,442 Heart's easiest to see, easiest to fix. So let's start there. 261 00:12:15,568 --> 00:12:17,945 When you did Mom's MRI, did you get a look at the fetus's heart? 262 00:12:18,071 --> 00:12:21,532 It was in the range but blurry. The fetus was moving all over the place. 263 00:12:21,658 --> 00:12:23,367 - So we need another scan. - Yeah. 264 00:12:23,493 --> 00:12:26,036 We'll just ask the fetus to lie very, very still. 265 00:12:26,162 --> 00:12:29,081 No need. I'm going to paralyze it. 266 00:12:31,126 --> 00:12:34,002 You wanna paralyze Emma Sloan's baby? 267 00:12:34,546 --> 00:12:36,088 Let me guess. Cameron? 268 00:12:36,214 --> 00:12:38,257 Cameron and Chase both had their concerns. 269 00:12:38,383 --> 00:12:39,925 No, Cameron had concerns. 270 00:12:40,051 --> 00:12:41,093 Chase just agreed with her 271 00:12:41,219 --> 00:12:44,179 because he didn't want to lose his all-access pass to her love rug. 272 00:12:44,305 --> 00:12:45,597 They're sleeping together? 273 00:12:45,723 --> 00:12:49,017 If by "sleeping together" you mean having sex in the janitor's closet. 274 00:12:49,144 --> 00:12:50,018 Here? 275 00:12:50,270 --> 00:12:52,813 No, the janitor's closet at the local high school. 276 00:12:52,939 --> 00:12:54,648 Go, Tiger Cats! 277 00:12:55,066 --> 00:12:57,693 Do you have one of those camera phones? 'Cause I got a MySpace account. 278 00:12:57,819 --> 00:12:59,903 I will deal with them after I deal with you. 279 00:13:00,029 --> 00:13:01,530 Oh, come on. Let's gossip some more. 280 00:13:01,656 --> 00:13:03,282 I'm sure she's into bondage. 281 00:13:03,408 --> 00:13:05,826 Paralyzing a one-pound baby risks damaging... 282 00:13:05,952 --> 00:13:09,204 Not paralyzing the thing risks not getting a clean MRI of its heart, 283 00:13:09,330 --> 00:13:13,250 which we need to save its life, which we need to do to save Emma's life. 284 00:13:14,169 --> 00:13:15,335 You're gonna need to get her consent. 285 00:13:15,545 --> 00:13:17,129 Well, that shouldn't be too hard. 286 00:13:17,255 --> 00:13:19,256 "Sign here or you and your baby both die." 287 00:13:21,009 --> 00:13:22,634 I'm going with you. 288 00:13:24,179 --> 00:13:26,013 Oh, good. 289 00:13:26,639 --> 00:13:29,641 You said sedation was risky. This sounds insane. 290 00:13:29,767 --> 00:13:32,686 The injection goes into the umbilical cord. 291 00:13:32,812 --> 00:13:33,979 The baby won't feel a thing. 292 00:13:34,731 --> 00:13:35,856 Fetus. 293 00:13:36,733 --> 00:13:40,652 I'm lowering expectations. It works here and on dates. 294 00:13:40,778 --> 00:13:42,279 The benefits outweigh the risks 295 00:13:42,405 --> 00:13:45,115 and the paralytic will wear off in an hour, okay? 296 00:13:45,909 --> 00:13:49,411 Must be easier to hear you might die than your baby might die. 297 00:13:49,829 --> 00:13:52,831 But if there's anyone I would trust to save my baby, 298 00:13:53,791 --> 00:13:55,542 it would be Dr. House. 299 00:13:59,714 --> 00:14:01,215 Fetus. 300 00:14:03,092 --> 00:14:04,218 Hold this. 301 00:14:32,455 --> 00:14:34,498 Dr. Cameron. The MRI results back? 302 00:14:34,624 --> 00:14:35,999 The fetus's heart is structurally sound. 303 00:14:36,125 --> 00:14:38,293 The problem's with the bladder. It's four times normal size. 304 00:14:38,419 --> 00:14:39,378 Let me see. 305 00:14:39,504 --> 00:14:41,421 The bladder's so engorged it's taking up the whole torso, 306 00:14:41,548 --> 00:14:42,839 squeezing all the other organs. 307 00:14:42,966 --> 00:14:44,174 There's no room for the lungs to develop. 308 00:14:44,551 --> 00:14:46,343 The baby has a lower urinary tract obstruction. 309 00:14:46,469 --> 00:14:47,844 We can fix that by inserting a shunt. 310 00:14:48,137 --> 00:14:49,304 I'll give Emma the news. 311 00:14:49,430 --> 00:14:51,181 Are you taking over the case? 312 00:14:51,307 --> 00:14:53,308 House won't care. He has his diagnosis. 313 00:14:55,395 --> 00:14:57,020 Doctor Cameron. 314 00:14:58,565 --> 00:15:01,858 Dating Chase can only end in one of two ways. 315 00:15:01,985 --> 00:15:02,985 House told you? 316 00:15:03,111 --> 00:15:05,487 You get married and live happily ever after, 317 00:15:05,613 --> 00:15:08,323 or somebody gets hurt and you two can't work together, 318 00:15:08,449 --> 00:15:09,825 and I have to fire somebody. 319 00:15:09,951 --> 00:15:11,910 I would hate to see my personal life become such a burden to you. 320 00:15:12,036 --> 00:15:13,078 I'm telling you this for your own good. 321 00:15:13,204 --> 00:15:15,122 I assume you're gonna have this same conversation with Chase 322 00:15:15,248 --> 00:15:16,081 for his own good. 323 00:15:16,207 --> 00:15:18,709 Chase isn't the one that's gonna get hurt here. 324 00:15:34,642 --> 00:15:37,644 There's only room for one but I could scooch over. 325 00:15:37,770 --> 00:15:39,271 My social life is my social life. 326 00:15:39,689 --> 00:15:41,023 Couldn't agree more. 327 00:15:41,149 --> 00:15:43,525 What goes on in the privacy of a janitor's closet 328 00:15:43,651 --> 00:15:44,526 is nobody's business except... 329 00:15:44,652 --> 00:15:46,361 She told me to end it. Is that what you want? 330 00:15:46,696 --> 00:15:48,238 I was actually hoping she'd fire one of you. 331 00:15:48,531 --> 00:15:51,116 - What are you doing? - Trying to avoid altitude sickness. 332 00:15:51,242 --> 00:15:52,826 Couldn't score a direct flight to Cambodia, 333 00:15:52,952 --> 00:15:56,496 so I've decided to scale Argentina's infamous Mount Aconcagua. 334 00:15:56,623 --> 00:15:58,457 Perfect, except for the fact that you can't walk. 335 00:15:58,583 --> 00:16:01,793 There's a tribe of Mocoví Indians who actually carry the elders up... 336 00:16:01,919 --> 00:16:02,794 You're insane. 337 00:16:03,254 --> 00:16:04,755 I'm an insane genius. 338 00:16:04,881 --> 00:16:07,257 I set the chamber to low pressure instead of high. 339 00:16:07,383 --> 00:16:09,801 Thinner air builds up the extra red blood cells, 340 00:16:09,927 --> 00:16:11,011 creates new capillaries. 341 00:16:11,137 --> 00:16:14,181 Few more days in here, I can save myself six weeks at base camp. 342 00:16:14,599 --> 00:16:15,932 Where's my MRI? 343 00:16:18,728 --> 00:16:20,896 There's a blockage in the urinary tract. 344 00:16:21,022 --> 00:16:22,981 Simple terms, your baby can't pee. 345 00:16:23,107 --> 00:16:25,817 His bladder is swollen and it's crushing his lungs. 346 00:16:25,943 --> 00:16:27,069 Can you fix it? 347 00:16:27,195 --> 00:16:29,696 We can insert a small tube in the baby's bladder 348 00:16:29,822 --> 00:16:31,657 that makes the urine come out straight through his belly 349 00:16:31,783 --> 00:16:33,659 for the duration of the pregnancy. 350 00:16:33,785 --> 00:16:36,745 The bladder decompresses and the lungs will be able to develop normally. 351 00:16:37,121 --> 00:16:39,998 When the baby gets better, you should get better. 352 00:16:40,124 --> 00:16:42,000 First we just have to do a test 353 00:16:42,126 --> 00:16:44,878 to determine whether the baby's kidneys are functioning properly. 354 00:16:45,004 --> 00:16:46,797 And what if they're not? 355 00:16:46,923 --> 00:16:50,634 If they're already too damaged, then there's really nothing we can do. 356 00:16:50,760 --> 00:16:53,929 If this doesn't work out, you can always try again. 357 00:16:57,392 --> 00:17:00,018 I miscarried twice when I was married. 358 00:17:00,812 --> 00:17:04,272 After the divorce, I tried in vitro like four times before this. 359 00:17:05,108 --> 00:17:08,652 I'm 42. Maybe it's just not meant to be. 360 00:17:16,703 --> 00:17:18,036 What are you doing? 361 00:17:18,663 --> 00:17:20,706 You're trying to be me, so I thought I'd try to be you. 362 00:17:20,832 --> 00:17:22,165 You don't have the cleavage for it. 363 00:17:22,291 --> 00:17:23,875 But I have a much tighter ass. 364 00:17:24,001 --> 00:17:27,337 Think every day should be naked Thursday or is that an oxymoron? 365 00:17:29,465 --> 00:17:30,924 Let me see the results from the bladder tap. 366 00:17:31,050 --> 00:17:32,718 They aren't back yet. 367 00:17:32,844 --> 00:17:34,261 They're gonna be inconclusive. 368 00:17:34,387 --> 00:17:35,929 You think my diagnosis is wrong? 369 00:17:36,055 --> 00:17:38,682 Fetus doesn't pee, amniotic fluid should be low. 370 00:17:38,808 --> 00:17:39,725 Mom's level is fine. 371 00:17:39,851 --> 00:17:40,976 Doesn't mean I'm wrong. 372 00:17:41,102 --> 00:17:42,853 Could just mean we caught the obstruction early. 373 00:17:42,979 --> 00:17:44,646 Either way your test will be inconclusive. 374 00:17:44,772 --> 00:17:45,856 The urine you've collected 375 00:17:45,982 --> 00:17:47,816 has been sitting in that fetus's bladder for weeks. 376 00:17:47,942 --> 00:17:51,319 As my pappy always said, "Stale pee is useless pee." 377 00:17:51,696 --> 00:17:53,113 Fine. I'll do another tap. 378 00:17:53,239 --> 00:17:54,322 Just as useless. 379 00:17:54,991 --> 00:17:57,743 Old urine drops down from the kidney right after the first tap 380 00:17:57,869 --> 00:17:58,910 'cause it's so backed up. 381 00:17:59,036 --> 00:18:01,663 Bladder tap number three will give you the freshest pee. 382 00:18:01,789 --> 00:18:04,458 That's when you'll find out if this fetus has even a fighting chance. 383 00:18:04,584 --> 00:18:05,625 Thank you. 384 00:18:06,586 --> 00:18:07,753 I'll run two more taps. 385 00:18:07,879 --> 00:18:10,756 Since when does the Dean of Medicine run bladder taps? 386 00:18:10,882 --> 00:18:11,965 She's an important patient. 387 00:18:12,425 --> 00:18:15,594 Because she takes pictures or because she's you? 388 00:18:17,555 --> 00:18:19,723 Woman in her 40s, single, 389 00:18:20,808 --> 00:18:24,186 using a turkey baster as a last gasp at motherhood. 390 00:18:25,104 --> 00:18:29,065 Maybe you want to make sure she succeeds so you'll still have hope. 391 00:18:29,984 --> 00:18:32,819 You can't be a good doctor if you're not objective. 392 00:18:33,321 --> 00:18:35,113 - It's your file. - I don't want it. 393 00:18:35,364 --> 00:18:37,449 Then why did you just say all that stuff? 394 00:18:37,575 --> 00:18:38,784 To humiliate you. 395 00:18:38,910 --> 00:18:41,244 - You're taking the case back. - I don't want it. 396 00:18:41,370 --> 00:18:43,163 Your diagnosis is right. I want to go on vacation. 397 00:18:43,456 --> 00:18:45,957 You can go on vacation after you've cured her. 398 00:18:51,339 --> 00:18:52,380 Good news. 399 00:18:52,715 --> 00:18:55,801 The fetus's urine had appropriate levels of protein and electrolytes, 400 00:18:55,927 --> 00:18:57,803 so its kidneys aren't damaged. 401 00:18:59,472 --> 00:19:00,680 Oh, wow. 402 00:19:01,307 --> 00:19:02,766 We're gonna put the shunt in. 403 00:19:02,892 --> 00:19:04,643 Your baby's lungs should have more room to grow 404 00:19:04,769 --> 00:19:07,229 and your symptoms should go away. 405 00:19:08,064 --> 00:19:10,190 But he'll still need surgery, after he's born? 406 00:19:10,316 --> 00:19:12,692 That's when we'll remove the blockage in the ureter. 407 00:19:12,819 --> 00:19:14,402 You'll be the only mother on the planet 408 00:19:14,529 --> 00:19:16,488 who appreciates the value of a wet diaper. 409 00:19:16,614 --> 00:19:18,156 Hey, could you hand me that? 410 00:19:18,282 --> 00:19:19,533 I'm keeping a visual memory book 411 00:19:19,659 --> 00:19:23,036 of this entire surreal process and this is the best part of the story so far. 412 00:19:23,329 --> 00:19:25,038 - Yeah. Sure. - Thanks. 413 00:19:26,707 --> 00:19:28,375 When'd you take this? 414 00:19:28,751 --> 00:19:30,168 She did the second bladder tap. 415 00:19:31,420 --> 00:19:32,254 You should keep it. 416 00:19:32,588 --> 00:19:35,215 Oh, I see her all day at work. I don't need it. 417 00:19:36,509 --> 00:19:38,593 Maybe you want to see her after work. 418 00:19:39,720 --> 00:19:41,221 I'm right, right? 419 00:19:42,974 --> 00:19:44,975 I saw the way you look at her. 420 00:19:54,151 --> 00:19:55,151 Thanks. 421 00:20:05,788 --> 00:20:07,956 The shunt is in the right position. 422 00:20:08,082 --> 00:20:09,875 Bladder is starting to decompress. 423 00:20:10,334 --> 00:20:11,501 No infection. 424 00:20:13,838 --> 00:20:16,214 Did House say anything else? About us? 425 00:20:16,340 --> 00:20:19,885 I thought you didn't care about his reaction. Trying to make him jealous? 426 00:20:20,303 --> 00:20:21,595 I like my job. 427 00:20:21,721 --> 00:20:23,680 He can't fire you just because we're together. 428 00:20:23,806 --> 00:20:26,683 We're not "together," and House can do whatever he wants. 429 00:20:30,605 --> 00:20:32,731 - How's my baby? - Doing just fine, Emma. 430 00:20:32,857 --> 00:20:34,733 - So are you. - My stomach's killing me. 431 00:20:35,860 --> 00:20:37,736 That's not her stomach. 432 00:20:38,154 --> 00:20:41,364 Can you open your eyes, Emma? I just need to take a look. 433 00:20:44,952 --> 00:20:46,453 What is it? 434 00:20:48,539 --> 00:20:50,665 Emma's jaundiced. Her liver's shutting down. 435 00:20:52,960 --> 00:20:55,754 Figures. Just booked my trip to Johnston Strait. 436 00:20:55,880 --> 00:20:58,882 I thought you were climbing Mount Whatever in Argentina. 437 00:20:59,008 --> 00:21:01,843 Apparently I'd have to live with the Mocoví Indians for 20 years 438 00:21:01,969 --> 00:21:03,762 before they'd consider me an elder. 439 00:21:03,888 --> 00:21:07,182 Decided to go kayaking with orca instead. No legs required. 440 00:21:07,308 --> 00:21:10,560 Can't leave yet. Liver failure puts her case back into the unsolved pile. 441 00:21:10,686 --> 00:21:13,897 Increased AST, ALT and her bilirubin's off the charts. 442 00:21:15,232 --> 00:21:16,858 Even fetuses lie. 443 00:21:19,403 --> 00:21:23,657 We diagnosed a lower urinary tract obstruction because we saw one. 444 00:21:24,784 --> 00:21:26,993 What if that's not the whole story? 445 00:21:27,870 --> 00:21:30,914 What if the little bugger is hiding something? 446 00:21:31,415 --> 00:21:33,917 The real reason for the mirror syndrome. 447 00:21:34,877 --> 00:21:36,336 Have we looked under its bed? 448 00:21:36,462 --> 00:21:37,629 We checked its diary? 449 00:21:37,755 --> 00:21:39,297 If it's not GU, could be the heart. 450 00:21:39,423 --> 00:21:40,507 Hypoplastic left heart syndrome. 451 00:21:40,716 --> 00:21:42,258 - There were no structural problems. - The lungs. 452 00:21:42,385 --> 00:21:44,135 We won't be able to get a good look until they develop. 453 00:21:44,261 --> 00:21:46,221 - It'll be weeks... - She's not gonna last weeks. 454 00:21:46,347 --> 00:21:47,639 What do you want to do? 455 00:21:47,765 --> 00:21:50,809 Maternal mirror syndrome has one sure fire cure. 456 00:21:51,602 --> 00:21:52,727 Deliver the fetus. 457 00:21:52,853 --> 00:21:55,021 That's not viable at 21 weeks. You'll kill the baby. 458 00:21:55,147 --> 00:21:57,399 - Fetus. - Semantics make you feel better? 459 00:21:57,525 --> 00:21:58,525 Pretend it's not a person? 460 00:21:58,651 --> 00:22:00,694 Can it play catch? Can it eat? 461 00:22:00,820 --> 00:22:02,821 Can it take pretty pictures? 462 00:22:04,073 --> 00:22:05,907 Who wants to tell her? 463 00:22:13,416 --> 00:22:15,834 The swollen bladder was not the only problem. 464 00:22:17,920 --> 00:22:20,755 We can't leave it inside you. We have to terminate. 465 00:22:21,465 --> 00:22:22,716 Well, can't you deliver him? 466 00:22:22,842 --> 00:22:26,011 Put him on a respiratory machine till you figure out what's wrong? 467 00:22:26,137 --> 00:22:28,388 We can. And it won't matter. 468 00:22:29,932 --> 00:22:33,393 The fetus is still at least two weeks away from being viable. 469 00:22:33,686 --> 00:22:37,355 Well, I'll suffer through this for two more weeks then. 470 00:22:39,900 --> 00:22:43,069 You're on dialysis for your kidneys. Your kidneys can wait. 471 00:22:44,071 --> 00:22:46,573 They don't make dialysis for your liver. 472 00:22:48,325 --> 00:22:50,785 You're not gonna make it two more days. 473 00:22:57,752 --> 00:22:59,961 I'm not gonna let you kill my baby. 474 00:23:00,629 --> 00:23:02,255 It's killing you. 475 00:23:03,716 --> 00:23:05,842 I'm not having an abortion. 476 00:23:06,510 --> 00:23:09,387 It's not a baby. It's a tumor. 477 00:23:14,643 --> 00:23:16,519 I understand dying for a cause. 478 00:23:16,645 --> 00:23:18,897 Sacrificing your life so your child might live. 479 00:23:19,023 --> 00:23:20,690 But that's not the choice here. 480 00:23:23,944 --> 00:23:26,863 Either it dies or you both die. 481 00:23:27,448 --> 00:23:29,657 Or you fix him and we both live. 482 00:23:29,784 --> 00:23:31,034 I can't fix it. 483 00:23:35,831 --> 00:23:37,832 I'm scheduling a D&C. 484 00:23:37,958 --> 00:23:38,917 I won't consent. 485 00:23:41,879 --> 00:23:44,881 So I guess you have two days to figure it out. 486 00:23:55,017 --> 00:23:56,726 Her kidneys are almost irreparable. 487 00:23:56,852 --> 00:23:59,854 She's developed severe DIC. You have to force her to terminate. 488 00:23:59,980 --> 00:24:02,899 Did you give corticosteroids to speed up the baby's lung development? 489 00:24:03,025 --> 00:24:06,611 No. I dropped an anvil on its chest to prevent lung development. 490 00:24:07,154 --> 00:24:09,906 I'm trying to extinguish the human race one fetus at a time. 491 00:24:10,032 --> 00:24:13,034 Give the lungs more time to expand so you can see inside them. 492 00:24:13,160 --> 00:24:14,119 See if they're the problem. 493 00:24:14,245 --> 00:24:16,079 My real patient is dying. 494 00:24:16,205 --> 00:24:19,833 Very quickly. Like I wouldn't advise her to buy any green bananas. 495 00:24:19,959 --> 00:24:21,876 The fetus is nothing more than a parasite at this point. 496 00:24:22,002 --> 00:24:23,545 Removing it is an instant cure. 497 00:24:23,671 --> 00:24:25,004 You're not gonna get Emma to see it that way. 498 00:24:25,214 --> 00:24:26,339 She's probably already named the baby, 499 00:24:26,465 --> 00:24:28,508 read him books, had conversations with him. 500 00:24:28,634 --> 00:24:31,177 - See, you get it. She'll listen to you. - No. 501 00:24:31,637 --> 00:24:33,555 If you let this woman refuse to terminate, 502 00:24:33,681 --> 00:24:35,390 you're helping her commit suicide. 503 00:24:35,891 --> 00:24:38,184 As her doctor my recommendation is against suicide. 504 00:24:38,310 --> 00:24:39,811 If the baby had a doctor, 505 00:24:39,937 --> 00:24:42,355 I think she would recommend exhausting all possibilities 506 00:24:42,481 --> 00:24:44,816 - before taking its life. - Then she'd be an idiot. 507 00:24:44,942 --> 00:24:46,776 Too bad she's your boss! 508 00:24:48,654 --> 00:24:50,446 What if our original assumption is wrong? 509 00:24:50,573 --> 00:24:51,865 It isn't. 510 00:24:51,991 --> 00:24:53,616 If we assume she doesn't have mirror syndrome, 511 00:24:53,742 --> 00:24:55,869 then terminating her pregnancy isn't gonna help her liver at all. 512 00:24:56,162 --> 00:24:58,246 We eliminated all other possibilities. 513 00:24:58,372 --> 00:25:00,373 The fetus is hydropic and in distress. 514 00:25:00,875 --> 00:25:03,710 Emma's kidneys and liver are failing. The diagnosis is solid. 515 00:25:03,961 --> 00:25:06,796 Wow! The ass-kisser won't agree with you. 516 00:25:06,922 --> 00:25:08,381 You must be even wronger than I thought. 517 00:25:09,258 --> 00:25:10,091 Fine. 518 00:25:10,926 --> 00:25:12,760 Let's assume she had mirror syndrome 519 00:25:12,887 --> 00:25:15,847 but we fixed it when we fixed the baby's bladder. 520 00:25:15,973 --> 00:25:19,726 That means that her failing liver would be completely unrelated. 521 00:25:19,977 --> 00:25:23,313 If it is, we can fix it and we don't have to terminate. 522 00:25:23,439 --> 00:25:26,399 So her theory is that our patient's liver problems 523 00:25:26,525 --> 00:25:28,318 were just a giant coincidence. 524 00:25:28,819 --> 00:25:29,944 It's not a surprising coincidence. 525 00:25:30,070 --> 00:25:32,238 Pregnant women can develop liver problems. 526 00:25:32,364 --> 00:25:36,117 If this is the case, we can actually do something here. 527 00:25:36,785 --> 00:25:38,995 Don't you guys think that's worth exploring? 528 00:25:39,121 --> 00:25:41,998 Acute fatty liver of pregnancy would have the same symptoms. 529 00:25:42,124 --> 00:25:44,626 - Thank you. - Brownnoser. 530 00:25:45,669 --> 00:25:48,796 - Viral hepatitis, HELLP syndrome. - Oh, look. 531 00:25:49,340 --> 00:25:52,842 Sticking up for your girlfriend. Who says chivalry's dead? 532 00:25:54,053 --> 00:25:55,845 He's not joking? 533 00:25:57,014 --> 00:25:58,932 Be patient. She's going through all of us. 534 00:25:59,058 --> 00:26:01,768 She'll get that jungle fever eventually. 535 00:26:01,894 --> 00:26:05,021 - I'm not going through anyone. - You love him? 536 00:26:05,147 --> 00:26:07,899 This can probably wait until after you biopsy Emma's liver, right? 537 00:26:08,025 --> 00:26:09,901 We can't. Her platelets are too low. 538 00:26:10,027 --> 00:26:13,780 Once we pierce her liver, it'll be next to impossible to stop the bleeding. 539 00:26:13,906 --> 00:26:15,156 Come in from above. 540 00:26:16,617 --> 00:26:18,284 Instead of going straight in through her abdomen, 541 00:26:18,410 --> 00:26:19,869 go in through the veins in her neck. 542 00:26:19,995 --> 00:26:22,830 Transjugular hepatic biopsy. 543 00:26:22,957 --> 00:26:26,751 If the liver starts to bleed, it'll bleed right back into her own veins. 544 00:26:36,971 --> 00:26:39,347 Why don't you start your vacation now? 545 00:26:46,230 --> 00:26:48,856 Threading the guide wire through the right internal jugular vein. 546 00:26:48,983 --> 00:26:51,693 So, the sleep lab... 547 00:26:52,319 --> 00:26:54,320 You and Cameron not sleeping. 548 00:26:54,989 --> 00:26:57,073 How serious is it? 549 00:26:57,199 --> 00:26:58,032 It's nothing. 550 00:26:58,617 --> 00:27:00,368 She's only doing it to make House jealous. 551 00:27:00,703 --> 00:27:02,829 - Then why are you doing it? - You kidding? 552 00:27:02,955 --> 00:27:05,873 You're approaching the inferior vena cava. Slow down. 553 00:27:07,543 --> 00:27:08,918 You better not hurt her. 554 00:27:09,795 --> 00:27:12,255 - She already has a big brother. - She does? 555 00:27:12,381 --> 00:27:14,299 You obviously care very deeply about her. 556 00:27:14,425 --> 00:27:17,010 I'm not protecting her. I'm protecting myself. 557 00:27:17,469 --> 00:27:19,679 A heartbroken, lovesick Cameron 558 00:27:19,805 --> 00:27:22,765 would be even more unbearable than she is now. 559 00:27:23,225 --> 00:27:24,726 You're through the hepatic vein. 560 00:27:24,852 --> 00:27:26,436 I'm firing the needle. 561 00:27:27,521 --> 00:27:30,148 Heart rate and BP spiking. Get that out of her. 562 00:27:30,357 --> 00:27:32,859 Fetus's heart rate just dropped to 50. 563 00:27:34,528 --> 00:27:36,779 - We've got contractions. - Pre-term labor. 564 00:27:36,905 --> 00:27:38,948 Start a terbutaline drip! 565 00:27:47,791 --> 00:27:50,710 We were able to control the pre-term labor with tocolytics. 566 00:27:50,836 --> 00:27:52,712 The contractions have subsided for now. 567 00:27:52,838 --> 00:27:55,757 And the liver biopsy was negative. This is definitely mirror syndrome. 568 00:27:55,883 --> 00:27:56,841 Her baby's doing this to her. 569 00:27:56,967 --> 00:27:57,800 We're out of options. 570 00:27:58,093 --> 00:28:00,511 Did the biopsy cause the pre-term labor or did it happen on its own? 571 00:28:00,804 --> 00:28:01,637 It doesn't make a difference. 572 00:28:01,764 --> 00:28:03,264 Pre-term labor can be a new symptom. 573 00:28:03,390 --> 00:28:05,933 New information gives us new theories. Isn't that how it works? 574 00:28:06,060 --> 00:28:07,060 Not in this case. 575 00:28:07,186 --> 00:28:10,605 Her body's trying to do what you refuse to, get the baby out and save itself. 576 00:28:10,939 --> 00:28:13,232 Patient's transaminases are 10 times normal. 577 00:28:13,359 --> 00:28:15,151 Her liver is on the verge of shutting down completely. 578 00:28:15,277 --> 00:28:16,402 A torch test could... 579 00:28:16,528 --> 00:28:18,279 We don't have time for more tests. 580 00:28:18,405 --> 00:28:20,573 We have to terminate or she'll die. 581 00:28:21,950 --> 00:28:23,743 Then let's work faster. 582 00:28:23,952 --> 00:28:26,829 Medicine doesn't work faster just because you hope real hard. 583 00:28:26,955 --> 00:28:28,498 But it could help to see what the baby's been hiding. 584 00:28:29,124 --> 00:28:32,085 The only organ we haven't been able to look inside is its lungs. 585 00:28:32,211 --> 00:28:33,294 The problem must be in there. 586 00:28:33,420 --> 00:28:36,089 We haven't been able to see inside because they're underdeveloped. 587 00:28:36,340 --> 00:28:38,132 We've already got her on corticosteroids, 588 00:28:38,258 --> 00:28:39,258 but it'll take weeks for them... 589 00:28:39,468 --> 00:28:42,428 Then let's drown them in corticosteroids, multiple courses. 590 00:28:42,554 --> 00:28:43,429 Speed up their development. 591 00:28:43,555 --> 00:28:46,432 Giving the baby more than one course will suppress adrenal gland function. 592 00:28:46,558 --> 00:28:49,602 Have long-term adverse effects on fetal organ development. 593 00:28:49,728 --> 00:28:51,604 - Worse than death? - Emma's already on tocolytics. 594 00:28:51,730 --> 00:28:53,815 The combination could put her into pulmonary edema. 595 00:28:53,941 --> 00:28:55,066 You'll just kill her faster. 596 00:28:55,192 --> 00:28:57,693 It's the only chance we have to see inside those lungs. 597 00:28:57,820 --> 00:29:01,572 We're just gonna have to make the baby better faster than we make Emma worse. 598 00:29:02,366 --> 00:29:04,575 Come on! This is the kind of thing House does every day. 599 00:29:04,785 --> 00:29:07,412 House thought we should terminate six hours ago. 600 00:29:10,791 --> 00:29:12,041 I'll do it myself. 601 00:29:18,340 --> 00:29:19,257 Anybody gonna stop her? 602 00:29:19,591 --> 00:29:21,008 Stopping the madness is her job. 603 00:29:21,135 --> 00:29:23,678 Somebody's got to be Cuddy's Cuddy. 604 00:29:32,688 --> 00:29:33,521 Nurse! 605 00:29:39,611 --> 00:29:42,405 - Pulmonary edema? - Who tattled? It doesn't matter. 606 00:29:42,656 --> 00:29:45,533 There's a reason we don't give multiple courses of corticosteroids. 607 00:29:45,659 --> 00:29:46,993 Gee, thanks. 608 00:29:47,119 --> 00:29:48,411 It's time to terminate. 609 00:29:48,871 --> 00:29:49,704 That's not what she wants. 610 00:29:49,913 --> 00:29:50,913 Look at her. 611 00:29:51,290 --> 00:29:55,668 She didn't want to be an incubator for a dead baby, but that's what you've done. 612 00:29:55,794 --> 00:29:58,463 Either get me a laryngoscope or get out! 613 00:30:42,466 --> 00:30:43,966 You were right. 614 00:30:44,092 --> 00:30:45,760 You were all right. 615 00:30:45,886 --> 00:30:48,221 Now the mom's lungs are shutting down. 616 00:30:49,097 --> 00:30:52,266 She's dying faster than the baby's lungs are developing. 617 00:30:52,559 --> 00:30:54,393 I had to stop the corticosteroids. 618 00:30:54,603 --> 00:30:56,229 Have you spoken to the family? 619 00:30:56,355 --> 00:30:58,773 The only family she's got is that baby. 620 00:30:58,899 --> 00:31:00,274 Well, he's biased. 621 00:31:01,485 --> 00:31:03,486 What do you think House would do? 622 00:31:03,612 --> 00:31:05,029 House wants to terminate. 623 00:31:05,781 --> 00:31:07,156 I mean if he didn't. 624 00:31:07,282 --> 00:31:09,742 If he shared my position, what do you think he would do? 625 00:31:10,118 --> 00:31:11,786 He wouldn't share your pain. 626 00:31:12,496 --> 00:31:14,372 He'd be objective. 627 00:31:14,998 --> 00:31:16,123 Right. 628 00:31:17,709 --> 00:31:20,461 - He would prioritize his problems. - He'd terminate. 629 00:31:20,712 --> 00:31:23,381 He wouldn't be afraid of screwing with her lungs if there was a bigger issue. 630 00:31:23,674 --> 00:31:24,674 There is no bigger issue. 631 00:31:24,800 --> 00:31:26,717 - She needs her lungs. - Not right now. 632 00:31:26,843 --> 00:31:28,678 She's already on a respirator. 633 00:31:28,804 --> 00:31:30,012 The machine is breathing for her. 634 00:31:30,138 --> 00:31:31,847 I can do whatever I want to her lungs. 635 00:31:31,974 --> 00:31:34,892 If you're playing catch in the living room and you break your mother's vase, 636 00:31:35,018 --> 00:31:37,311 you may as well keep playing catch. The vase is already broken. 637 00:31:37,437 --> 00:31:41,148 Yeah, except that room can't breathe without that vase. 638 00:31:41,358 --> 00:31:44,026 I'm putting her back on corticosteroids. 639 00:31:50,033 --> 00:31:52,326 - It worked. - What worked? 640 00:31:52,452 --> 00:31:54,120 I got the baby's lungs to expand. 641 00:31:54,246 --> 00:31:55,997 - We should be able to figure... - Cab's on its way. 642 00:31:56,123 --> 00:31:58,082 I have to finish packing. 643 00:31:59,710 --> 00:32:02,044 I have a whole new appreciation for what you do. 644 00:32:02,170 --> 00:32:04,463 How hard it is to believe when everyone around you 645 00:32:04,590 --> 00:32:05,423 is telling you that you're wrong. 646 00:32:05,674 --> 00:32:07,508 Helps to know they're idiots. 647 00:32:07,801 --> 00:32:10,052 Do you think I'm an idiot? 648 00:32:10,178 --> 00:32:12,013 You're not objective. 649 00:32:13,807 --> 00:32:15,683 But you're not an idiot. 650 00:32:18,520 --> 00:32:20,855 These lungs are still two weeks away from being viable. 651 00:32:20,981 --> 00:32:22,440 But big enough for a diagnosis. 652 00:32:22,774 --> 00:32:24,233 These tissue buds are new. 653 00:32:24,359 --> 00:32:26,902 Could indicate bronchopulmonary sequestration 654 00:32:27,029 --> 00:32:28,821 or diaphragmatic eventration. 655 00:32:28,947 --> 00:32:31,782 I was thinking bronchogenic cyst or bronchial atresia. 656 00:32:31,908 --> 00:32:33,618 Could be lung lesions, CCAM. 657 00:32:33,952 --> 00:32:35,036 What about... 658 00:32:42,794 --> 00:32:43,919 Move. 659 00:32:46,715 --> 00:32:48,215 Thought you started your vacation. 660 00:32:48,342 --> 00:32:51,344 Somebody had to save our boss's rotundus ass. 661 00:32:51,470 --> 00:32:53,763 Latest MRI of the Sloan fetus. 662 00:32:53,889 --> 00:32:55,348 Small buds in the lungs could indicate... 663 00:32:55,474 --> 00:32:57,475 Thanks. Got the multiple choice all worked out. 664 00:32:57,684 --> 00:33:00,936 Question is, how do we pick between A, B, C, D, and none of the above? 665 00:33:01,063 --> 00:33:03,272 Portable MRI is in her room. We could get a current image. 666 00:33:03,398 --> 00:33:06,400 The fetal lungs are so tiny the MRI won't give us the details we need. 667 00:33:06,526 --> 00:33:10,655 What would we do if this patient were not just a tadpole? 668 00:33:10,781 --> 00:33:11,906 Say it was an actual person. 669 00:33:12,199 --> 00:33:13,574 He is a person. 670 00:33:13,700 --> 00:33:14,950 Thanks for playing along. 671 00:33:15,369 --> 00:33:17,036 Pretend it's a one-pound adult. 672 00:33:17,162 --> 00:33:19,789 Forget the mom, forget the womb, the placenta. 673 00:33:20,207 --> 00:33:22,625 How would we get a better look at what's in the lungs? 674 00:33:22,751 --> 00:33:23,751 Transesophageal echo. 675 00:33:23,877 --> 00:33:25,211 Can't access his esophagus. 676 00:33:25,337 --> 00:33:26,879 High resolution CT could give us a clearer... 677 00:33:27,005 --> 00:33:29,674 Too much radiation for a one-pound person. 678 00:33:29,925 --> 00:33:33,052 You can't just shoot everything down, Chase. 679 00:33:33,261 --> 00:33:35,471 You're not me. Collaborate. 680 00:33:36,390 --> 00:33:38,724 A ventilation perfusion scan would be next. 681 00:33:39,142 --> 00:33:42,436 How do we get a fetus to breathe in a radioactive isotope, idiot? 682 00:33:43,188 --> 00:33:45,231 If it were really a person and we had no other options 683 00:33:45,357 --> 00:33:46,899 we'd do an exploratory surgery. 684 00:33:47,025 --> 00:33:49,276 Cut into its chest and have a look around. 685 00:33:49,403 --> 00:33:50,736 Let's do that. 686 00:33:51,780 --> 00:33:54,615 You're the one who insists we treat it like a person. 687 00:33:54,741 --> 00:33:56,575 I'll put it back when I'm done. 688 00:33:59,705 --> 00:34:01,038 Me again. 689 00:34:01,164 --> 00:34:03,833 It's your friendly neighborhood belly squirter. 690 00:34:03,959 --> 00:34:05,960 We're gonna do open fetal surgery. 691 00:34:06,086 --> 00:34:09,004 Open the uterus, cut out the fetus so we can look around. 692 00:34:09,548 --> 00:34:13,342 I know you can't talk so I need you to look petrified if you consent. 693 00:34:13,635 --> 00:34:15,428 The umbilical cord won't be cut. 694 00:34:15,846 --> 00:34:19,223 During surgery, your body will basically serve as the baby's heart/lung machine. 695 00:34:19,725 --> 00:34:21,976 We find what's wrong and we fix it. 696 00:34:22,436 --> 00:34:23,269 If we can. 697 00:34:23,395 --> 00:34:26,564 Don't lower expectations if you want them to do something. 698 00:34:26,940 --> 00:34:29,066 She should know what she's facing. 699 00:34:32,154 --> 00:34:34,280 This is incredibly dangerous. 700 00:34:34,406 --> 00:34:36,323 It risks both your lives. 701 00:34:36,867 --> 00:34:38,325 The only reason why we're suggesting it, 702 00:34:38,452 --> 00:34:41,078 is because there's nothing else we can do. 703 00:35:04,436 --> 00:35:06,645 You all here for the fetal surgery? 704 00:35:06,897 --> 00:35:08,898 'Cause we're way over capacity. 705 00:35:09,024 --> 00:35:10,649 Mind each other's personal space. 706 00:35:11,109 --> 00:35:13,194 There are sharp implements in the room. 707 00:35:13,320 --> 00:35:14,695 Like this one. 708 00:35:22,078 --> 00:35:24,497 Uterus is fully exposed. 709 00:35:33,381 --> 00:35:34,632 And we're in. 710 00:35:34,841 --> 00:35:36,967 Start draining the amniotic fluid. 711 00:35:39,721 --> 00:35:42,139 Have you never sucked beer out of the bottom of a keg? 712 00:35:42,474 --> 00:35:44,391 Where'd you go to college? Give me that. 713 00:36:11,336 --> 00:36:13,295 Affix the pulse ox to the palm. 714 00:36:18,760 --> 00:36:19,760 House? 715 00:36:22,138 --> 00:36:23,138 Sorry. 716 00:36:23,765 --> 00:36:26,016 Just realized I forgot to TiVo Alien. 717 00:36:33,275 --> 00:36:36,193 Fetal heart rate good. Stats are stable. 718 00:36:36,945 --> 00:36:39,280 Position him for the incision. 719 00:36:44,744 --> 00:36:47,079 I see three well-defined lesions. 720 00:36:47,205 --> 00:36:50,124 It's definitely CCAM. I should be able to resect them. 721 00:36:53,128 --> 00:36:55,546 It's the mom. She's in V-fib. 722 00:36:57,048 --> 00:36:58,591 Charging. 723 00:37:00,302 --> 00:37:02,428 - Clear! - I'm clear. 724 00:37:04,556 --> 00:37:06,557 Looks like asystole. Paddling isn't going to do anything. 725 00:37:06,808 --> 00:37:08,809 It's fine V-fib. I'm going again. Clear! 726 00:37:11,771 --> 00:37:13,814 We're gonna lose them both. Clamp! 727 00:37:15,150 --> 00:37:17,276 The surgery's not doing this to her. The fetus is. 728 00:37:17,402 --> 00:37:18,819 Step away, House. I'm going again. 729 00:37:18,945 --> 00:37:22,489 The only way to save her is to cut away the anchor holding her down. 730 00:37:22,616 --> 00:37:25,117 You keep going, you're gonna get electrocuted. 731 00:37:25,827 --> 00:37:27,828 Clear! 732 00:37:28,663 --> 00:37:31,332 Going again. Clear! 733 00:37:33,793 --> 00:37:36,462 Heart rate's returning to normal. 734 00:37:39,215 --> 00:37:41,383 Continue with the lobectomy. 735 00:37:50,727 --> 00:37:53,979 So my kidneys, liver and lungs are all fine just like that? 736 00:37:55,231 --> 00:37:57,608 - Just like that. - That's amazing. 737 00:37:58,902 --> 00:38:02,404 What's amazing is how blonde your baby's hair is. 738 00:38:05,033 --> 00:38:06,408 My baby? 739 00:38:06,534 --> 00:38:08,494 The thing in your belly that tried to kill you. 740 00:38:08,870 --> 00:38:10,955 You've never called him a baby before. 741 00:38:17,712 --> 00:38:18,712 Any pain? 742 00:38:19,005 --> 00:38:20,506 Nothing I can't deal with. 743 00:38:20,632 --> 00:38:23,050 You can only get out of bed to pee, pooh or shower. 744 00:38:23,176 --> 00:38:26,553 And absolutely no sex. So stop flirting with me. 745 00:38:28,181 --> 00:38:29,306 Sorry. 746 00:38:31,977 --> 00:38:35,270 So this really worked? He'll be normal? 747 00:38:36,690 --> 00:38:39,984 Well, if you call being born twice normal. 748 00:38:45,323 --> 00:38:46,699 Hey, thank you. 749 00:38:49,953 --> 00:38:53,455 Don't thank me. I would've killed the kid. 750 00:39:02,298 --> 00:39:04,842 - Wanna grab a bite? - In a minute. 751 00:39:04,968 --> 00:39:07,052 Emma asked me to bring up her camera. 752 00:39:07,429 --> 00:39:08,971 I'll walk with you. 753 00:39:11,307 --> 00:39:13,559 When'd she take this picture of you? 754 00:39:14,769 --> 00:39:16,687 You look so... 755 00:39:17,063 --> 00:39:18,147 I'm smiling. 756 00:39:19,482 --> 00:39:20,983 I have a nice smile. 757 00:39:21,109 --> 00:39:23,444 No, I've never seen you like this. 758 00:39:23,778 --> 00:39:25,904 She got you to glow. 759 00:39:26,906 --> 00:39:28,741 What were you doing? 760 00:39:29,534 --> 00:39:31,493 What did she say to you? 761 00:39:32,787 --> 00:39:34,371 I always glow. 762 00:39:46,634 --> 00:39:47,760 House. 763 00:39:48,636 --> 00:39:50,304 Need you to take a look at something. 764 00:39:50,430 --> 00:39:52,848 - I'm off the clock. - Just open it. 765 00:39:58,897 --> 00:40:01,148 A first-class ticket to Vancouver Island. 766 00:40:01,274 --> 00:40:04,359 Shoot! The wrong envelope. 767 00:40:08,239 --> 00:40:10,657 - I think it's great. - Yeah. 768 00:40:11,409 --> 00:40:13,952 - Who doesn't like Canadians? - It's big. 769 00:40:14,079 --> 00:40:17,289 You're trying to have a life. You're trying to enjoy yourself. 770 00:40:17,415 --> 00:40:19,041 You didn't need to apologize. 771 00:40:19,334 --> 00:40:20,709 I'm not. I told you why I... 772 00:40:20,835 --> 00:40:22,002 Screwed up. 773 00:40:22,128 --> 00:40:23,587 I saved a life. I saved two lives. 774 00:40:24,089 --> 00:40:25,214 You 775 00:40:25,882 --> 00:40:30,052 let your maternal instinct get the best of you and nearly kill two people. 776 00:40:30,178 --> 00:40:32,721 Case like this, you terminate, mom lives 10 times out of 10. 777 00:40:32,847 --> 00:40:33,889 You do what you did 778 00:40:34,015 --> 00:40:36,642 mom and baby both die 9.9 times out of 10. 779 00:40:37,102 --> 00:40:39,770 Sometimes point one is bigger than 9.9. 780 00:40:39,896 --> 00:40:41,814 No, it's smaller. 781 00:40:42,273 --> 00:40:45,192 Exactly 9.8 smaller. Always is. Always will be. 782 00:40:45,902 --> 00:40:48,737 Well, not for Emma. And not for her son. 783 00:40:50,281 --> 00:40:53,242 Now go away and be happy.