1 00:00:03,003 --> 00:00:05,972 On your right. On your right. On your right. 2 00:00:06,043 --> 00:00:08,136 Back, back, back, back, back. Come on, buddy. 3 00:00:11,756 --> 00:00:14,088 Yeah, Dan! Yeah! 4 00:00:14,161 --> 00:00:15,890 Yea! Yea! 5 00:00:15,966 --> 00:00:19,299 Back, back, back, back, back. Watch the winger! 6 00:00:31,300 --> 00:00:33,461 Yeah! 7 00:00:56,925 --> 00:00:58,916 You okay? 8 00:00:58,997 --> 00:01:01,056 Dan? Dan, talk to me. 9 00:01:01,136 --> 00:01:03,832 Dan. Dan. 10 00:01:03,908 --> 00:01:06,741 Get a doctor! 11 00:01:46,372 --> 00:01:48,670 - Hey. - Close the door. 12 00:01:48,744 --> 00:01:51,304 Close the door. 13 00:01:54,056 --> 00:01:57,150 Is Cuddy down the hall counting to 50? 14 00:01:57,230 --> 00:02:00,063 She knows I'm in here, in the clinic, as she commanded. 15 00:02:00,136 --> 00:02:03,367 - She just doesn't know I'm alone. - Well, you've got a full waiting room. 16 00:02:03,444 --> 00:02:06,174 - How long do you think you can ignore them? - I'm off at 4:00. 17 00:02:07,920 --> 00:02:10,184 You're doing this to avoid five minutes of work? 18 00:02:10,259 --> 00:02:12,887 If I go out there, I get assigned a kid with a runny nose. 19 00:02:12,966 --> 00:02:16,197 That's 30 seconds looking at the nose, 25 minutes talking to a worried mom... 20 00:02:16,273 --> 00:02:19,071 who won't leave until she's sure it's not meningitis or a tumor. 21 00:02:19,147 --> 00:02:21,513 Yes. Concerned parents can be so annoying. 22 00:02:21,585 --> 00:02:25,214 Just tell Cuddy you've got an urgent case. You had to leave early. That would be lying. 23 00:02:25,294 --> 00:02:30,197 And that would be wrong. But luckily the definition of "urgent" is fungible. 24 00:02:30,272 --> 00:02:32,900 Not the definition of "case" though. 25 00:02:36,319 --> 00:02:39,083 You have no cases? 26 00:02:39,159 --> 00:02:41,218 You have no cases? 27 00:02:41,297 --> 00:02:45,028 You've got handpicked doctors-- specialists-- 28 00:02:45,106 --> 00:02:48,007 working for you, and they're sitting on their hands? 29 00:02:48,079 --> 00:02:51,913 - Cameron's answering my mail. - Oh, time well spent, I'm sure. 30 00:02:51,988 --> 00:02:53,979 Foreman and Chase? 31 00:02:54,060 --> 00:02:56,051 Research? 32 00:03:02,746 --> 00:03:05,476 Nine letters. Iodine deficiency in children. 33 00:03:05,553 --> 00:03:07,714 Cretinism. 34 00:03:17,112 --> 00:03:20,013 So, 4:03 p.m., Dr. House checks out. 35 00:03:20,085 --> 00:03:22,019 Please write that down. 36 00:03:22,090 --> 00:03:24,285 Dr. House. Sorry. Done for the day. 37 00:03:24,362 --> 00:03:27,263 Plenty of docs here to take care of you. But we had an appointment. 38 00:03:27,335 --> 00:03:30,668 Nice try, but this is a walk-in clinic, which means there are no appointments. 39 00:03:30,743 --> 00:03:32,973 You walk in, sign the chart, and a doctor will see you. 40 00:03:33,049 --> 00:03:36,541 Just not me. Your letter says that we'd see you. 41 00:03:37,593 --> 00:03:39,993 Not a big letter writer. Here. 42 00:03:42,570 --> 00:03:46,062 When did my signature get so girlie? 43 00:03:46,145 --> 00:03:48,340 - I can explain. - See that "G"? 44 00:03:48,417 --> 00:03:50,851 See how it makes a big loop on top? 45 00:03:50,923 --> 00:03:54,290 Doesn't even look like my handwriting. Think I have something? 46 00:03:54,364 --> 00:03:57,765 What's the differential diagnosis for writing G's like a junior high school girl? 47 00:03:57,839 --> 00:04:01,570 It's impossible to get to you through normal channels. They have called, e-mailed. 48 00:04:01,648 --> 00:04:05,550 Perseverance does not equal worthiness. Next time you want to get my attention, wear something fun. 49 00:04:05,623 --> 00:04:07,591 Low-rider jeans are hot. 50 00:04:07,661 --> 00:04:12,724 Sixteen-year-old male. Sudden onset of double vision and night terrors, with no apparent cause. 51 00:04:12,806 --> 00:04:15,274 The kid's been to two neurologists, and he-- Night terrors? 52 00:04:15,345 --> 00:04:18,143 - As in big scary monsters? - Yes. 53 00:04:20,991 --> 00:04:24,483 - Where are you going? - To see the family. 54 00:04:24,566 --> 00:04:28,627 - You're going to examine a patient? - Nine times out of 10, there's no reason to talk to a patient. 55 00:04:28,709 --> 00:04:32,543 But night terrors in a 16-year-old is a very good reason to talk to this family. 56 00:04:32,618 --> 00:04:34,552 Good work. 57 00:04:37,529 --> 00:04:39,463 Margins are fine. 58 00:04:39,533 --> 00:04:41,467 No lesions. 59 00:04:42,707 --> 00:04:45,005 Color is good. 60 00:04:45,079 --> 00:04:48,412 How long have you been having night terrors? Three weeks. 61 00:04:48,488 --> 00:04:51,685 He's afraid to go to bed. He's exhausted, can barely function. 62 00:04:53,767 --> 00:04:57,259 - What does that tell you? - Nothing. It's just fun watching him blink. 63 00:04:57,341 --> 00:05:00,833 Name as many animals as you can that begin with the letter "B". Go. 64 00:05:07,597 --> 00:05:11,693 - Baby elephant? - Baby elephant is actually a good answer. 65 00:05:11,774 --> 00:05:14,299 - "B" is a bear of a letter. - What does that tell you? 66 00:05:14,380 --> 00:05:18,407 Proves two things: no neurological damage, and your son is never gonna be chief fry cook. 67 00:05:18,489 --> 00:05:22,220 In teens, there are two likely causes of night terrors. 68 00:05:22,298 --> 00:05:25,995 - Posttraumatic stress. Any recent shoot-outs at your high school? - No. 69 00:05:26,073 --> 00:05:27,301 - Then, Dave-- - Dan. 70 00:05:27,376 --> 00:05:31,437 If there's no trauma, the other cause is... sexual abuse. 71 00:05:34,158 --> 00:05:37,594 So who's molesting you? Teacher? 72 00:05:37,666 --> 00:05:40,658 Extra-friendly neighbor? I'd ask if either of you were involved, but you'd deny it. 73 00:05:40,740 --> 00:05:42,469 We would never hurt Dan. 74 00:05:42,544 --> 00:05:44,944 I say it here, it comes out there. 75 00:05:45,016 --> 00:05:47,507 This lack of response is consistent with abuse. 76 00:05:47,589 --> 00:05:50,387 There's no one, okay? I-- I swear. 77 00:05:50,462 --> 00:05:53,556 There was trauma. I got hit in the head during a lacrosse game. 78 00:05:55,407 --> 00:05:58,774 Did you know that he got hit in the head? 79 00:05:58,848 --> 00:06:02,375 - They didn't mention it. No. - Yeah. Why bother? 80 00:06:05,296 --> 00:06:07,821 No, no. We took him to the E.R. after the game. 81 00:06:07,902 --> 00:06:10,427 He was scanned. They tested him. They said he was fine. 82 00:06:10,508 --> 00:06:12,442 No concussion. It's gotta be something else. 83 00:06:12,513 --> 00:06:16,005 You hound me for my opinion, and then you question my diagnosis. 84 00:06:16,087 --> 00:06:19,488 Cool. E.R. obviously screwed up. Kid's got a concussion. 85 00:06:19,562 --> 00:06:22,690 I had double vision before I was hit. Well, that changes everything. 86 00:06:22,769 --> 00:06:25,567 You need glasses. That's why you had double vision, 87 00:06:25,643 --> 00:06:30,342 which is why you got hit, which is why you have a concussion, which is why you have night terrors. 88 00:06:30,420 --> 00:06:33,446 You need to see an ophthalmologist, which I am not. 89 00:06:33,527 --> 00:06:38,897 You enjoyed that. I brought a reasonable case to your attention, and you shoved it in my face just to humiliate me. 90 00:06:38,973 --> 00:06:41,840 You're an only child, aren't you? Why would you say that? 91 00:06:41,913 --> 00:06:43,642 Because everything is about you. 92 00:06:44,786 --> 00:06:49,086 This may seem incredibly controversial, but I think sexual abuse is bad. 93 00:06:49,163 --> 00:06:52,155 I just wanted to make sure he wasn't being diddled by Daddy-- or Mommy. 94 00:06:52,237 --> 00:06:54,262 Anything else is just a bonus. 95 00:07:05,199 --> 00:07:08,532 I'm not an only child. Interesting. 96 00:07:08,607 --> 00:07:10,871 What? Don't move. 97 00:07:11,648 --> 00:07:15,584 - Did I bore you in there? - What? Uh, no. Not-- Not really. 98 00:07:15,657 --> 00:07:18,023 Are you tired? 99 00:07:18,096 --> 00:07:20,155 - Sometimes. - He never sleeps. Ofcourse he's tired. 100 00:07:20,234 --> 00:07:22,702 - Right now. At this moment. Are you tired? - No. No. 101 00:07:22,773 --> 00:07:25,003 That twitch in your leg. Did you feel that? 102 00:07:26,382 --> 00:07:28,612 - Didn't hurt. - His leg twitched. I don't see what-- 103 00:07:28,687 --> 00:07:32,453 It's called a myoclonic jerk. It's very common when you're falling asleep. 104 00:07:32,528 --> 00:07:37,898 Respiration rate falls, and the brain sometimes interprets this as the body dying, so it sends a pulse to wake it up. 105 00:07:37,974 --> 00:07:40,169 - So? - So, he's not asleep. 106 00:07:40,246 --> 00:07:42,976 He's awake. 107 00:07:43,053 --> 00:07:45,044 Admit him. 108 00:07:48,064 --> 00:07:51,465 I recognize that loopy "G". 109 00:07:51,539 --> 00:07:53,530 So, what does the jerk tell us? 110 00:07:53,610 --> 00:07:55,908 Nothing good. The brain's losing control of the body. 111 00:07:55,982 --> 00:07:59,748 Can't order the eyes to focus, regulate sleep patterns or control muscles. 112 00:07:59,825 --> 00:08:01,850 A movement disorder or a degenerative brain disease. 113 00:08:01,929 --> 00:08:05,456 Either way, this kid's gonna be picking up his diploma in diapers and a wheelchair. 114 00:08:05,537 --> 00:08:07,505 Maybe not that bad. Could be an infection. 115 00:08:07,576 --> 00:08:09,601 You wish. No fever, no white count. 116 00:08:09,680 --> 00:08:15,118 Anyone think this differential diagnosis might be compromised because we don't have an accurate family history? 117 00:08:15,192 --> 00:08:18,457 - I took an accurate family history. - You didn't even take an accurate family. 118 00:08:19,402 --> 00:08:21,632 - His father's not his father. - Why would you say that? 119 00:08:21,708 --> 00:08:24,768 Thirty percent of all dads don't realize they're raising someone else's kid. 120 00:08:24,848 --> 00:08:27,976 False paternity's more like 10%. That's what our moms would like us to believe. 121 00:08:28,055 --> 00:08:30,546 Who cares? If he got it from his parents, they'd both be dead. 122 00:08:30,628 --> 00:08:33,495 - Can we get on with the differential diagnosis? - Fifty bucks says I'm right. 123 00:08:33,568 --> 00:08:36,128 - I'll take your money. - Hit a nerve? 124 00:08:36,207 --> 00:08:39,665 - Don't worry. I'm sure the guy who tucked you in was your daddy. - Make it a hundred. 125 00:08:39,749 --> 00:08:43,549 What about leukoencephalopathy in a 16-year-old? 126 00:08:43,624 --> 00:08:45,922 It doesn't necessarily have to be that bad. 127 00:08:45,996 --> 00:08:49,022 If we exclude the night terrors, it could be something systemic. 128 00:08:49,103 --> 00:08:51,628 - His liver, kidneys. Something outside the brain. - Yes. 129 00:08:51,709 --> 00:08:55,440 - Feel free to exclude any symptom if it makes your job easier. - Night terrors were anecdotal. 130 00:08:55,518 --> 00:09:00,251 - He could've had a bad dream. - No. Parents said he was conscious during and didn't remember anything afterwards. 131 00:09:00,329 --> 00:09:02,263 - That's a night terror. - Parents said? 132 00:09:02,334 --> 00:09:04,427 That's a good point. 133 00:09:04,505 --> 00:09:07,770 Before we condemn this kid, maybe we should entertain Dr. Chase's skepticism. 134 00:09:07,846 --> 00:09:12,909 I want a detailed polysomnograph. If he's having night terrors, I want to see them. 135 00:09:35,475 --> 00:09:37,670 I usually don't move during night terrors. 136 00:09:37,747 --> 00:09:39,681 I'm not restraining you for them. 137 00:09:42,559 --> 00:09:45,790 E.E.G. revealed abnormalities in your brain-- 138 00:09:45,866 --> 00:09:48,232 caused nerve damage in your toes. 139 00:09:54,920 --> 00:09:58,048 What are you doing? 140 00:09:58,128 --> 00:10:01,222 - Fixing it. - Can I talk to my parents? 141 00:10:01,302 --> 00:10:03,361 Oh, they know all about this. 142 00:10:03,439 --> 00:10:05,964 I'd really like to see them. 143 00:10:14,499 --> 00:10:17,900 Please. I'd really like them here. 144 00:10:19,676 --> 00:10:21,667 This is gonna hurt, Dan. 145 00:10:21,748 --> 00:10:23,739 Oh. Oh, God. 146 00:10:40,591 --> 00:10:43,116 That's a night terror. 147 00:10:53,286 --> 00:10:57,450 We did a C. T., M.R.I., C.B.C., CHEM-7 and chest X-ray. 148 00:10:57,530 --> 00:11:00,590 All the tests came back normal. There's nothing to explain his symptoms. 149 00:11:00,670 --> 00:11:04,504 Okay, but let's pretend there's something and go from there. Who sees something on this M.R.I.? 150 00:11:06,684 --> 00:11:09,482 No lesions in the white matter. No structural abnormalities. 151 00:11:09,557 --> 00:11:11,525 No space-occupying tumors. 152 00:11:11,595 --> 00:11:16,532 He's 16, so he should have an absolutely pristine brain. The smallest thing is abnormal. 153 00:11:17,843 --> 00:11:20,209 Meningeal enhancement. 154 00:11:20,282 --> 00:11:22,842 - My bet is viral meningitis. - Excellent. 155 00:11:22,921 --> 00:11:24,855 Do you see what he did there? 156 00:11:24,926 --> 00:11:28,692 Took a small clue that there's a neurological problem and wasn't afraid to run with it. 157 00:11:28,768 --> 00:11:31,236 There's no evidence of meningitis on that M.R.I. 158 00:11:31,307 --> 00:11:33,207 No, there's not. He's completely wrong. 159 00:11:33,278 --> 00:11:35,303 Then what clue are you talking about? 160 00:11:35,382 --> 00:11:40,183 He knew that I saw something on the M.R.I., so he figured there must be something there and took a guess. 161 00:11:40,261 --> 00:11:43,753 - Clever, but also pathetic. - So what did you find? 162 00:11:43,835 --> 00:11:46,827 Take a close look at the corpus callosum. 163 00:11:49,482 --> 00:11:52,918 - Looks okay. - Are we all looking at the same thing? 164 00:11:52,990 --> 00:11:55,458 Two hundred million interhemispheric nerve fibers. 165 00:11:55,528 --> 00:11:58,588 The George Washington Bridge between the left and right side of the brain. 166 00:12:00,340 --> 00:12:02,968 It's subtle. 167 00:12:05,051 --> 00:12:07,383 There's some bowing. There. 168 00:12:07,456 --> 00:12:09,447 An upward arch. Are you guessing? 169 00:12:09,527 --> 00:12:11,427 Yes. 170 00:12:11,499 --> 00:12:15,265 - Too bad. You're right. - He probably just moved. 171 00:12:15,341 --> 00:12:17,935 Nobody stays perfectly still for the entire M.R.I. 172 00:12:18,013 --> 00:12:23,508 Yeah. Probably got restless and shifted one hemisphere of his brain to a more comfortable position. 173 00:12:23,592 --> 00:12:26,857 Something is pushing on it. If there was bowing, could be a tumor. 174 00:12:26,934 --> 00:12:30,392 Do you see a tumor on this M.R.I.? No, but I don't see any bowing either. 175 00:12:30,475 --> 00:12:34,002 There's no tumor. Just a blockage causing pressure causing symptoms. 176 00:12:34,084 --> 00:12:37,520 Today, night terrors. Tomorrow, he's bleeding out of his eyes. 177 00:12:37,591 --> 00:12:42,358 Get him a radionucleotide cisternogram. I guarantee you'll see a blockage. 178 00:12:48,282 --> 00:12:50,273 Okay. 179 00:12:53,127 --> 00:12:54,856 Easy. 180 00:12:54,931 --> 00:12:57,195 Okay. Squeeze my hand. 181 00:13:01,011 --> 00:13:03,104 All right. Squeeze hard. 182 00:13:05,688 --> 00:13:07,622 All right. 183 00:13:13,841 --> 00:13:17,106 Now I'm injecting a material that's tagged with a radioisotope. 184 00:13:17,182 --> 00:13:21,016 It's gonna enter your spine and travel up to your brain. 185 00:13:21,090 --> 00:13:24,992 It'll make you able to think deep thoughts, 186 00:13:25,066 --> 00:13:27,000 run a hundred miles an hour. 187 00:13:28,273 --> 00:13:30,537 Easy. 188 00:13:43,408 --> 00:13:46,468 Their eyes aren't the same color, but that fleck in the eyes-- 189 00:13:46,549 --> 00:13:49,575 That's maybe a one-in-10 chance if they're not related? 190 00:13:49,656 --> 00:13:52,056 No. House isn't gonna pay you based on that. 191 00:13:52,128 --> 00:13:55,996 Any excuse we can give the folks to justify a D.N.A. test? 192 00:13:56,070 --> 00:14:00,200 We could tell them he's got Huntington's-- whole family should be tested or they'll all die. 193 00:14:03,755 --> 00:14:05,689 Hey. 194 00:14:05,760 --> 00:14:09,628 There's a lot of blockage. I've scheduled him for surgery. 195 00:14:09,702 --> 00:14:13,536 We're gonna put a shunt into one of the ventricles to give the cerebrospinal fluid an out. 196 00:14:13,611 --> 00:14:16,239 No more pressure, everything goes back to normal. 197 00:14:16,317 --> 00:14:19,252 He's lucky to have you as his doctors. 198 00:14:27,977 --> 00:14:30,969 No formula. Just Mommy's healthy, natural breast milk. 199 00:14:31,050 --> 00:14:32,745 Yummy. 200 00:14:32,821 --> 00:14:35,915 Her whole face just got swollen like this overnight. 201 00:14:35,995 --> 00:14:38,225 Mm-hmm. 202 00:14:39,236 --> 00:14:41,568 No fever. 203 00:14:41,641 --> 00:14:44,474 Glands normal. Missing her vaccination dates. 204 00:14:44,547 --> 00:14:47,209 We're not vaccinating. 205 00:14:48,289 --> 00:14:50,780 Gribbet! Gribbet! 206 00:14:50,863 --> 00:14:52,387 Gribbet! 207 00:14:52,466 --> 00:14:54,161 Think they don't work? 208 00:14:54,237 --> 00:14:57,536 I think some multinational pharmaceutical company wants me to think they work-- 209 00:14:57,611 --> 00:15:00,842 pad their bottom line. Mm-hmm. 210 00:15:00,919 --> 00:15:03,217 - May I? - Sure. 211 00:15:04,226 --> 00:15:06,888 Gribbet. Gribbet. 212 00:15:06,965 --> 00:15:09,263 Gribbet. 213 00:15:09,337 --> 00:15:12,238 Yeah. All-natural, no dyes is a good business. 214 00:15:12,311 --> 00:15:14,438 All-natural children's toys. 215 00:15:14,516 --> 00:15:17,007 Toy companies-- they don't arbitrarily mark up their frogs. 216 00:15:17,089 --> 00:15:20,115 They don't lie about how much they spend on research and development. 217 00:15:20,196 --> 00:15:25,793 The worst that a toy company could be accused of is making a really boring frog. 218 00:15:25,876 --> 00:15:28,709 Gribbet, gribbet, gribbet. 219 00:15:28,782 --> 00:15:31,615 You know another really good business? 220 00:15:31,689 --> 00:15:33,919 Teeny, tiny baby coffins. 221 00:15:35,231 --> 00:15:37,495 You can get 'em in frog green, 222 00:15:37,569 --> 00:15:40,003 fire-engine red-- really. 223 00:15:40,075 --> 00:15:44,307 The antibodies in yummy Mummy only protect the kid for six months, 224 00:15:44,384 --> 00:15:46,978 which is why these companies think they can gouge you. 225 00:15:47,057 --> 00:15:50,788 They think that you'll spend whatever they ask to keep your kid alive. 226 00:15:50,866 --> 00:15:52,891 Want to change things? Prove 'em wrong. 227 00:15:52,970 --> 00:15:57,566 Few hundred parents like you decide they'd rather let their kid die than cough up 40 bucks for a vaccination, 228 00:15:57,648 --> 00:16:00,139 believe me, prices will drop really fast. 229 00:16:00,221 --> 00:16:03,156 Gribbet, gribbet, gribbet, gribbet, gribbet. 230 00:16:03,228 --> 00:16:04,627 Gribbet. 231 00:16:04,697 --> 00:16:06,528 Tell me what she has. 232 00:16:09,676 --> 00:16:12,201 A cold. 233 00:16:12,281 --> 00:16:14,374 There's a problem. 234 00:16:14,453 --> 00:16:17,581 Complications in surgery? Surgery went fine. He's in recovery. 235 00:16:17,660 --> 00:16:19,992 But we took a vial of C.S.F. and tested it. Really? 236 00:16:20,066 --> 00:16:23,035 Turns out the bowing wasn't the cause of his problems. It was a symptom. 237 00:16:23,106 --> 00:16:25,199 Oligoclonal bands and increased intrathecal IgG. 238 00:16:25,278 --> 00:16:29,442 Which means multiple sclerosis. And the reason it takes three of you to tell me this? 239 00:16:29,520 --> 00:16:32,250 Because we're having a disagreement about whether or not it is M.S. 240 00:16:32,327 --> 00:16:35,888 No lesions on the M.R.I. It's early. He's had the disease for maybe two weeks. 241 00:16:35,969 --> 00:16:39,700 - McDonald criteria requires six months to make a definitive diagnosis. - Who cares about MacPhearson? 242 00:16:39,778 --> 00:16:41,712 - I hear he tortured kittens. - McDonald. 243 00:16:41,782 --> 00:16:44,273 Oh, McDonald. Wonderful doctor, loved kittens. 244 00:16:44,354 --> 00:16:46,322 The V.E.P. indicates slowing of the brain. 245 00:16:46,393 --> 00:16:48,361 Without the lesions, we can't be sure. 246 00:16:48,431 --> 00:16:50,865 Well, if it is, it's gone from zero to 60 in three weeks, 247 00:16:50,936 --> 00:16:52,904 which would indicate rapidly progressive M.S. 248 00:16:52,974 --> 00:16:56,307 Not the fun M.S. with the balloons and the bike rides for cripples in wheelchairs. 249 00:16:56,382 --> 00:16:59,510 - We should wait until-- - Start treating him now, 250 00:16:59,589 --> 00:17:03,855 maybe he can walk for another couple of years, maybe live for another five. 251 00:17:03,933 --> 00:17:06,458 Break it to the family. I'm going home. 252 00:17:06,539 --> 00:17:10,600 It'll take months for a definitive diagnosis. What'll happen to me? 253 00:17:12,285 --> 00:17:14,549 M.S. is an incredibly variable disease. 254 00:17:14,623 --> 00:17:18,024 If it is M.S., and we're not a hundred percent sure. 255 00:17:18,099 --> 00:17:20,567 What do you think is gonna happen? 256 00:17:23,911 --> 00:17:26,209 There are some medications to manage the symptoms, 257 00:17:26,283 --> 00:17:29,411 but as the disease progresses, the problems will become more severe. 258 00:17:29,491 --> 00:17:31,823 Bowel and bladder dysfunction, 259 00:17:31,896 --> 00:17:34,490 loss of cognitive function, pain-- 260 00:17:34,569 --> 00:17:37,060 So it's gonna hurt? 261 00:17:38,278 --> 00:17:40,712 The brain's like a big jumble of wires. 262 00:17:40,784 --> 00:17:43,344 M.S. strips them of the insulation, and the nerves die. 263 00:17:43,423 --> 00:17:46,051 Brain interprets it as pain. 264 00:17:46,129 --> 00:17:49,394 But by starting treatment, we're gonna prevent that for as long as possible. 265 00:17:50,405 --> 00:17:52,339 We're looking into a couple of specialists, 266 00:17:52,410 --> 00:17:55,937 and until we get you squared away, you'll stay here, okay? 267 00:18:16,665 --> 00:18:19,156 Security checked the videotapes from all perimeter cameras. 268 00:18:19,238 --> 00:18:21,468 He's still gotta be in the hospital. Where's Chase? 269 00:18:21,543 --> 00:18:24,103 Main floor. Okay. You take the cafeteria and administration. 270 00:18:24,183 --> 00:18:26,777 I'll hit the research annex and work my way back to you. 271 00:19:04,174 --> 00:19:06,165 Dan? 272 00:19:10,421 --> 00:19:13,288 I'm not here. Leave a message. 273 00:19:19,643 --> 00:19:22,441 Dr. Cuddy. Great outfit. 274 00:19:22,516 --> 00:19:24,780 What are you doing back here? Patient? 275 00:19:24,855 --> 00:19:28,347 No. Hooker. Went to my office instead of my home. 276 00:19:38,752 --> 00:19:41,186 Dr. House. 277 00:19:41,259 --> 00:19:44,057 Dan's missing. Yeah. I got that part from the message. 278 00:19:44,131 --> 00:19:47,362 You said I was needed immediately. He shouldn't move after a lumbar puncture. 279 00:19:47,440 --> 00:19:50,136 I agree. He's gonna have a very nasty headache. 280 00:19:50,212 --> 00:19:53,340 That would also be my opinion if consulted tomorrow morning. 281 00:19:53,419 --> 00:19:56,582 We wanted to keep you informed. He heard some pretty heavy news. 282 00:19:58,431 --> 00:20:01,127 This is not a toddler wandering around a department store. 283 00:20:01,204 --> 00:20:04,401 He's 16. You'll find him. 284 00:20:04,478 --> 00:20:06,412 I'm going home. 285 00:20:06,483 --> 00:20:09,452 So when you say, "Call me if you need anything", you mean don't call? 286 00:20:09,523 --> 00:20:11,753 No, I mean call me if I could do something. 287 00:20:11,828 --> 00:20:15,958 I'm bad at search parties, and I'm bad at sitting around looking nervous, doing nothing. 288 00:20:16,037 --> 00:20:18,062 What about his parents? Should we call them? 289 00:20:18,143 --> 00:20:20,543 Why? Do you think they're hiding him? 290 00:20:20,615 --> 00:20:22,583 Make sure someone checks the roof. 291 00:20:23,655 --> 00:20:27,455 Some of the orderlies keep the door propped open so they can grab a smoke. 292 00:21:02,042 --> 00:21:04,909 Dan. You okay? 293 00:21:11,665 --> 00:21:15,396 There are experimental treatments. Ongoing research. 294 00:21:15,474 --> 00:21:17,874 Who knows what they'll discover in a year or two. 295 00:21:17,946 --> 00:21:19,914 This is where I dropped the ball. 296 00:21:19,983 --> 00:21:22,508 Dan, we're standing on the roof of the hospital. 297 00:21:25,195 --> 00:21:27,186 Dan. 298 00:21:27,267 --> 00:21:29,292 Dan, you're not on the field. 299 00:21:29,372 --> 00:21:31,533 He doesn't know where he is. Dan. 300 00:21:31,610 --> 00:21:32,975 Foreman. 301 00:21:34,183 --> 00:21:35,946 Dan. 302 00:21:37,190 --> 00:21:39,124 - Dan? - Dan, no! 303 00:21:49,819 --> 00:21:52,310 Dr. Foreman. 304 00:21:53,961 --> 00:21:55,952 I assume you found the kid. 305 00:21:56,033 --> 00:21:58,627 He almost walked off the roof. Suicidal? 306 00:21:58,705 --> 00:22:02,573 No, he thought he was on his lacrosse field. Look, I was gonna run home, shower, change-- 307 00:22:02,647 --> 00:22:04,581 Conscious? Yeah. 308 00:22:05,654 --> 00:22:08,248 How'd you talk him down? Actually, Chase tackled him. 309 00:22:08,328 --> 00:22:10,262 How come you didn't do it? 310 00:22:10,332 --> 00:22:12,766 Right. Well, I am black, but he was closer. 311 00:22:15,344 --> 00:22:17,335 Come on. You can ride up with me. 312 00:22:24,030 --> 00:22:27,761 Anybody tell the family that their boy almost stepped off a roof? They must be thrilled. 313 00:22:27,839 --> 00:22:30,034 They're not suing, but I think only because Chase asked-- 314 00:22:30,111 --> 00:22:32,636 Why does everybody always think I'm being sarcastic? 315 00:22:32,716 --> 00:22:34,911 This is great news. He doesn't have M.S. 316 00:22:34,988 --> 00:22:38,685 Parents should be thrilled. The mom anyway. Ofcourse, the dad probably doesn't know-- 317 00:22:38,764 --> 00:22:43,064 - Why doesn't he have M.S.? - He was on the roof, thinking he was on a lacrosse field. 318 00:22:43,140 --> 00:22:47,008 - Conscious, and therefore not a night terror. You want some of this? - Yeah, sure. 319 00:22:47,082 --> 00:22:49,175 He was in an acute confusional state, 320 00:22:49,254 --> 00:22:52,052 which doesn't fit with a demyelinating disease like M.S. 321 00:22:52,128 --> 00:22:54,187 Oligoclonal bands-- Were real. 322 00:22:54,266 --> 00:22:57,793 They just mean something other than M.S. So, what are they telling us? 323 00:22:57,874 --> 00:22:59,865 That the immune system is working? Right. 324 00:22:59,945 --> 00:23:02,072 He has an infection in his brain. 325 00:23:02,151 --> 00:23:04,142 What about sex? 326 00:23:04,221 --> 00:23:07,452 Well, it might get complicated. I mean, we work together. 327 00:23:07,530 --> 00:23:10,590 - I'm older, certainly, but maybe you like that. - I meant maybe he has neurosyphilis. 328 00:23:10,670 --> 00:23:14,436 - Huh. Nice cover. - Sorry. R.P.R. was negative. 329 00:23:14,512 --> 00:23:17,970 We don't need a definitive test to confirm. Sure. Didn't need one to confirm M.S. 330 00:23:18,053 --> 00:23:22,547 Okay. Let's wait for you to run titers on 1,400 viruses while this kid's brain turns to mush. 331 00:23:22,630 --> 00:23:26,225 So the fact that he doesn't have M.S., it's-- it's really not good news after all. 332 00:23:26,306 --> 00:23:28,433 Well, it is if it's neurosyphilis. 333 00:23:28,511 --> 00:23:31,571 The likelihood of a false negative on an R.P.R. test: 30%. 334 00:23:31,651 --> 00:23:35,143 Likelihood of a 16-year-old having sex: roughly 120%. 335 00:23:35,226 --> 00:23:37,660 I'll start him on I.V. penicillin. We're not gonna wait for that. 336 00:23:37,731 --> 00:23:41,258 The most effective way to deliver the drug is right into his brain via the spine. 337 00:23:41,340 --> 00:23:43,274 We can't. In a cramped space like the brain, 338 00:23:43,345 --> 00:23:47,111 increased intracranial pressure from a high-volume drug like penicillin could herniate his brain stem. 339 00:23:47,187 --> 00:23:50,213 It'd kill him. No neurologist in his right mind would recommend that. 340 00:23:50,294 --> 00:23:53,127 Show of hands. Who thinks I'm not in my right mind? 341 00:23:53,200 --> 00:23:57,068 And who thinks I forget this fairly basic neurological fact? 342 00:23:57,142 --> 00:23:59,372 Who thinks there's a third option? 343 00:24:01,452 --> 00:24:05,388 - Very good. What's the third choice? - No idea. You just asked if I thought there was one. 344 00:24:09,203 --> 00:24:12,297 The patient has a shunt in his brain. There'll be no increased pressure. 345 00:24:12,377 --> 00:24:14,902 We can put as much penicillin into his body as we want. 346 00:24:14,983 --> 00:24:17,918 Excellent. Inject him through a lumbar puncture. 347 00:24:20,830 --> 00:24:23,958 One of us is gonna do this to you twice a day for the next two weeks. 348 00:24:26,776 --> 00:24:29,540 - I'm ready. Go. - He could get syphilis... 349 00:24:29,616 --> 00:24:32,210 even if he's not sexually active? 350 00:24:33,292 --> 00:24:36,693 Well, it's-- it's unusual, but it's possible. 351 00:24:37,701 --> 00:24:39,692 Okay. Relax. 352 00:24:52,503 --> 00:24:55,666 It's infected, with a really big hole, 353 00:24:55,743 --> 00:24:58,109 like you stuck a nail in it to relieve the pressure. 354 00:24:58,182 --> 00:25:01,174 I wouldn't do that. Although the wound is irregular. 355 00:25:01,256 --> 00:25:04,521 It's not cylindrical. It's shaped like a triangle. So, not a nail. 356 00:25:04,596 --> 00:25:06,655 - Steak knife? - Wife's nail file. 357 00:25:06,735 --> 00:25:09,226 Nail file. 358 00:25:09,307 --> 00:25:11,366 Yeah. Pain will make you do stupid things. 359 00:25:12,448 --> 00:25:15,474 - Something to take the edge off? - Yeah. 360 00:25:17,626 --> 00:25:19,617 Cheers. 361 00:25:23,439 --> 00:25:26,465 So, you have family here in Princeton? 362 00:25:26,546 --> 00:25:29,276 No. Here on work? 363 00:25:29,353 --> 00:25:31,548 - No. Why are you-- - Does your penis hurt? 364 00:25:31,625 --> 00:25:33,786 No. What? Should it? 365 00:25:33,864 --> 00:25:37,391 No. Just thought I'd toss you a really inappropriate question. 366 00:25:37,471 --> 00:25:41,601 - Your lawyer's gonna love it. - Why would I want to sue you? I want you to treat me. 367 00:25:41,681 --> 00:25:44,149 - You're from Maplewood, New Jersey, right? - Yeah. 368 00:25:44,220 --> 00:25:46,484 Now, why would you drive 70 miles... 369 00:25:46,559 --> 00:25:49,494 to get treatment for a condition that a nine-year-old could diagnose? 370 00:25:51,036 --> 00:25:53,971 It's the free-flowing pus that's the tip-off. 371 00:25:54,043 --> 00:25:56,944 I was in town. Not for family. Not for work. 372 00:25:57,016 --> 00:26:00,349 You drove 70 miles to a walk-in clinic. You passed two hospitals on the road. 373 00:26:00,424 --> 00:26:03,916 Either you've got a problem with those hospitals, or they have a problem with you. 374 00:26:03,998 --> 00:26:06,523 My guess is you've sued half the doctors in Maplewood, 375 00:26:06,605 --> 00:26:08,664 and the rest are now refusing to help you. 376 00:26:08,742 --> 00:26:12,473 It's ironic, isn't it? Sort of like the boy who sued wolf. 377 00:26:12,551 --> 00:26:15,782 You know, I bet we have a doctor here named Wolf. 378 00:26:15,859 --> 00:26:18,293 How perfect would that be? 379 00:26:18,365 --> 00:26:20,663 - I'm gonna page him. - Okay. You know what? Thank you. 380 00:26:20,737 --> 00:26:23,001 I'm gonna find a doctor to take care of this. 381 00:26:23,076 --> 00:26:25,010 I didn't say I wouldn't treat you. 382 00:26:25,080 --> 00:26:28,413 - We'll drain your knee, run some lab work. Fix you up. - Why would you do that? 383 00:26:28,488 --> 00:26:30,422 I'm a people person. 384 00:26:30,492 --> 00:26:33,017 You actually treated him? 385 00:26:33,099 --> 00:26:35,067 All I know is he sued some doctors. 386 00:26:35,136 --> 00:26:37,468 Who am I to assume they didn't have it coming to them? 387 00:26:37,541 --> 00:26:40,874 The cutest little tennis outfit. My God, I thought I was gonna have a heart attack. 388 00:26:40,950 --> 00:26:44,181 Oh, my. Didn't see you there. That is so embarrassing. How's your hooker doing? 389 00:26:44,257 --> 00:26:46,191 Sweet of you to ask. Funny story. 390 00:26:46,262 --> 00:26:50,062 She was gonna be hospital administrator, but just hated having to screw people like that. 391 00:26:50,138 --> 00:26:52,936 - Heard you found her on the roof. - You have very acute hearing. 392 00:26:53,010 --> 00:26:54,705 You notify the parents? 393 00:26:54,782 --> 00:26:56,716 In due course, ofcourse. 394 00:26:56,786 --> 00:27:00,278 And is there a paternity bet on the father of the patient? 395 00:27:00,361 --> 00:27:03,660 Doesn't sound like me. Well, it does, actually, but doesn't mean you're guilty. 396 00:27:03,735 --> 00:27:05,726 You think? I saw the parents in the lobby. 397 00:27:05,807 --> 00:27:10,835 - Smart money's obviously on the father. - My guy knows a guy who can get you in for 50 bucks. 398 00:27:10,918 --> 00:27:14,820 Fine. Tell your guy, if I win, you attend the faculty symposium, and you wear a tie. 399 00:27:14,893 --> 00:27:17,361 And if I win, no clinic hours for a week. 400 00:27:17,433 --> 00:27:19,765 My guy will call your guy. 401 00:27:22,277 --> 00:27:24,472 She's very good at her job. 402 00:27:27,857 --> 00:27:31,224 The treatments should start helping soon. 403 00:27:31,297 --> 00:27:34,664 Let us know if it gets easier to focus on things, remember stuff. 404 00:27:36,676 --> 00:27:40,134 Hey, Dan. Isn't Dr. Cameron's necklace a beauty? 405 00:27:40,218 --> 00:27:42,277 Something South American, I think. 406 00:27:42,357 --> 00:27:44,325 Yeah. Guatemalan. 407 00:27:45,397 --> 00:27:47,422 It's a cool necklace. 408 00:27:49,172 --> 00:27:51,834 - Thank you so much. - The kid's in pain. 409 00:27:53,448 --> 00:27:56,008 Don't fight it. Just let it happen. No. 410 00:27:56,087 --> 00:27:58,112 You'll be dead in two days. No what? 411 00:27:58,193 --> 00:28:00,457 I give it a day. Dan? You okay? 412 00:28:00,531 --> 00:28:01,691 Dan? 413 00:28:01,768 --> 00:28:04,236 Night terrors. - Decomposition once he's in the grave. 414 00:28:04,307 --> 00:28:07,208 - Say good-bye to your mother and father. - He's hearing voices. 415 00:28:07,280 --> 00:28:09,748 You're dying. It's all over, Dan. 416 00:28:10,988 --> 00:28:14,219 You're dying. Dying. Dead! 417 00:28:15,232 --> 00:28:18,292 Push two milligrams I.V. Ativan, stat. 418 00:28:18,372 --> 00:28:21,000 It's all over. - Come on, Dan. 419 00:28:21,078 --> 00:28:22,909 Get out of my head! 420 00:28:24,720 --> 00:28:27,712 Auditory hallucination shows further brain degeneration. 421 00:28:27,793 --> 00:28:31,820 Penicillin's not working. So either it's a bad batch of penicillin, 422 00:28:31,903 --> 00:28:33,894 or our diagnosis is wrong. 423 00:28:35,745 --> 00:28:37,736 Square one. 424 00:28:37,816 --> 00:28:41,752 Midnite. L.F. T.'s, B.U.N. and creatinine are all normal. 425 00:28:41,825 --> 00:28:44,293 - Diabetes is out, and no gap. - There goes metabolic. 426 00:28:44,364 --> 00:28:47,026 - M.R.A. rules out vasculitis. - "I" for inflammation. 427 00:28:47,104 --> 00:28:49,732 - Too young for anything degenerative. - "D", see ya. 428 00:28:49,810 --> 00:28:52,074 "N" for neoplastic. M.R.I. was clean. 429 00:28:53,152 --> 00:28:55,780 - "I" for inflammation. - We already did that. 430 00:28:55,857 --> 00:28:59,122 - Stupid to have two I's in one mnemonic. What's the other one? - Infection. 431 00:28:59,198 --> 00:29:03,294 - Oligoclonal bands still have to mean something. - But no fevers. White count's elevated, but within range. 432 00:29:03,375 --> 00:29:06,003 We've tested for anything remotely possible. Everything's negative. 433 00:29:06,081 --> 00:29:09,778 - C.T. scan rules out subdural. - Trauma. Later much. 434 00:29:15,068 --> 00:29:19,198 You know the problem? "Midnight" is actually spelled with a "G" and an "H". 435 00:29:20,213 --> 00:29:23,080 If we could just figure out what those letters stand for. 436 00:29:27,262 --> 00:29:30,789 It's a sick brain, having fun, 437 00:29:32,374 --> 00:29:34,535 torturing him, talking to him. 438 00:29:40,092 --> 00:29:42,083 Scaring the hell out of him. 439 00:29:44,569 --> 00:29:49,336 Get him an E.E.G., left and right E.O.G., esophageal microphones. 440 00:29:49,413 --> 00:29:53,281 If this thing wants to talk, let's listen. 441 00:29:54,992 --> 00:29:58,928 We're missing something. This is screwed-up. 442 00:29:59,001 --> 00:30:02,528 That's why you came up with the brain talking to the virus thing? 443 00:30:02,610 --> 00:30:04,407 I panicked, okay? 444 00:30:04,481 --> 00:30:08,281 Sounded cool though. They bought it. 445 00:30:10,862 --> 00:30:13,592 Oh, crap. 446 00:30:13,668 --> 00:30:18,196 Another reason I don't like meeting patients. If they don't know what you look like, they can't yell at you. 447 00:30:18,279 --> 00:30:20,270 Here we go. 448 00:30:23,491 --> 00:30:25,925 How can you just sit there? 449 00:30:27,367 --> 00:30:29,335 If I eat standing up, I spill. 450 00:30:29,404 --> 00:30:32,464 Our son is dying, and you could care less. 451 00:30:33,648 --> 00:30:36,674 We're going through hell. You're doing nothing? 452 00:30:37,690 --> 00:30:41,490 - I'm sorry. You need to vent. I understand. - Don't be condescending. 453 00:30:42,568 --> 00:30:44,968 You haven't checked in on him once. 454 00:30:45,040 --> 00:30:47,702 Blood pressure is 110 over 70. 455 00:30:47,780 --> 00:30:50,578 His shunt is patent, well-placed in the right lateral ventricle. 456 00:30:50,653 --> 00:30:55,181 The E.K.G. shows a normal Q.R.S. with deep-wave inversions throughout both limb and precordial leads. 457 00:30:55,264 --> 00:30:58,165 L.F. T.'s are elevated, but only twice the normal range. 458 00:30:58,237 --> 00:31:00,705 Oh, yeah. And he's hearing voices. 459 00:31:04,952 --> 00:31:06,943 Go hold his hand. 460 00:31:08,861 --> 00:31:11,455 Go on. I'll bus your tray. 461 00:31:25,432 --> 00:31:28,333 - Got any sample bags on you? - I don't believe you. 462 00:31:28,406 --> 00:31:32,069 You're gonna run D.N.A. tests? Their son is deathly ill. 463 00:31:32,148 --> 00:31:36,278 I know. It's terrible. But the fact is, if I don't keep busy with trivial things like this, 464 00:31:36,357 --> 00:31:38,484 I'm afraid I might start to cry. You're an ass. 465 00:31:38,562 --> 00:31:41,463 Yeah? You want to double the bet? 466 00:31:52,194 --> 00:31:54,856 General Hospital is on channel 6. 467 00:31:54,933 --> 00:31:58,494 Dan's brain's not showing channel 6 right now. Only mush. 468 00:31:58,575 --> 00:32:00,770 No epileptiform activity. 469 00:32:02,450 --> 00:32:05,214 What are you doing? Waiting for C.B.C. and CHEM-7. 470 00:32:05,289 --> 00:32:08,190 Good. Run D.N.A. on these. 471 00:32:09,767 --> 00:32:12,634 What's this? Parents' coffee cups. 472 00:32:14,344 --> 00:32:16,744 I can't believe you. I've had this conversation once already. 473 00:32:16,816 --> 00:32:19,410 If you've got something else to do, do it. Otherwise, do this. 474 00:32:27,674 --> 00:32:30,734 Dr. House. Hey. Mr. Funsten. 475 00:32:30,815 --> 00:32:33,875 I was wondering when you'd be back. You got some papers for me? 476 00:32:33,955 --> 00:32:37,391 You've caused me considerable mental distress. I certainly hope so. 477 00:32:38,432 --> 00:32:42,493 What? Too cheap to get your lawyer to serve it for you, or is it just more fun this way? 478 00:32:42,575 --> 00:32:44,770 I'm obviously prepared to consider a settlement. 479 00:32:44,847 --> 00:32:46,940 You have gonorrhea. 480 00:32:48,755 --> 00:32:52,589 No, I don't. Well, maybe you're right, but I have the lab result says you do. 481 00:32:52,664 --> 00:32:55,258 Could be a false positive, and normally I'd run a second test, 482 00:32:55,338 --> 00:32:58,739 but since you're here, I'll just go with the first. You're just trying to scare me. 483 00:32:58,812 --> 00:33:02,145 It's reportable, you know. Public health issue. I'll be sure to let my wife know. 484 00:33:02,220 --> 00:33:04,848 Don't bother yourself. The state will call for you. 485 00:33:04,926 --> 00:33:07,486 If you're clean, I'm sure it'll all blow over. No big deal. 486 00:33:07,565 --> 00:33:10,898 There's an easy way to find out. Get one of your doctors to run a test. 487 00:33:12,877 --> 00:33:14,811 Uh-uh. 488 00:33:14,882 --> 00:33:17,646 These are mine now. I'll see you in court. 489 00:33:22,098 --> 00:33:25,966 West Nile negative. Not surprising since not too many mosquitoes passing through Jersey in December. 490 00:33:26,041 --> 00:33:28,532 No eastern equine encephalitis. You guys aren't gonna believe this. 491 00:33:28,614 --> 00:33:32,550 What's that? House is right. The father's not the father. 492 00:33:32,623 --> 00:33:36,525 Dude doubled up on me. 493 00:33:36,599 --> 00:33:38,658 You're not gonna believe this. 494 00:33:38,737 --> 00:33:41,228 The mother's not the mother either. 495 00:33:42,511 --> 00:33:45,537 It's not a good idea to move your son in his condition. 496 00:33:45,619 --> 00:33:48,213 - We just want a second opinion. We need an answer. 497 00:33:49,027 --> 00:33:52,485 You idiots. You lied to me. 498 00:33:52,568 --> 00:33:54,502 We didn't lie about anything. 499 00:33:54,573 --> 00:33:57,770 - You, on the other hand, accused us of molesting our son. - Perfect. 500 00:33:57,847 --> 00:34:00,611 Can we get off my screwups and focus on theirs? 501 00:34:00,687 --> 00:34:02,780 Theirs is bigger. You're not Dan's parents. 502 00:34:02,859 --> 00:34:05,692 We're his parents. He was adopted. He doesn't need to know. 503 00:34:05,765 --> 00:34:07,756 - I do. - Adoption makes us just as much-- 504 00:34:07,836 --> 00:34:12,170 Listen. When we were taking his medical history, were you confused? 505 00:34:12,247 --> 00:34:15,045 Did you think we were looking for a genetic clue to his condition, 506 00:34:15,119 --> 00:34:19,180 or did you think we were trying to ascertain who loves him the most in the whole wide world? 507 00:34:19,263 --> 00:34:21,424 How did you find out about this? 508 00:34:21,500 --> 00:34:24,901 - I sampled their D.N.A. - We didn't give you any D.N.A. 509 00:34:24,975 --> 00:34:27,409 Your coffee cups from the cafeteria. 510 00:34:27,481 --> 00:34:31,417 - You can't do that. - Again, why are we getting hung up on what I did? 511 00:34:31,490 --> 00:34:37,326 - Your medical history is useless. - No. We gave you a detailed history of his biological mother. 512 00:34:37,404 --> 00:34:40,567 Her history. Nonsmoker, good health, 513 00:34:40,644 --> 00:34:43,169 low cholesterol, no blood pressure problems. 514 00:34:43,250 --> 00:34:45,377 Dan was adopted two weeks after he was born. 515 00:34:45,455 --> 00:34:49,789 - You have his history. There's nothing you need to know that we didn't tell you. - Sounds reasonable. 516 00:34:49,866 --> 00:34:52,926 Well, if you want to transfer your boy, that is your choice. 517 00:34:53,006 --> 00:34:55,702 I still think it's the wrong-- Was she vaccinated? 518 00:34:57,817 --> 00:35:00,786 The biological mother. When she was a baby, did she get her vaccinations? 519 00:35:00,857 --> 00:35:03,849 Dan was vaccinated. At six months. 520 00:35:03,931 --> 00:35:07,628 Mm-hmm. Do you know why kids get vaccinated at six months? 521 00:35:07,706 --> 00:35:10,334 Because before that they are protected... 522 00:35:10,412 --> 00:35:13,006 by their biological mother's immune system. 523 00:35:13,085 --> 00:35:15,849 So, was she vaccinated? 524 00:35:19,633 --> 00:35:22,397 An infant picks up a regular old measles virus. 525 00:35:22,473 --> 00:35:24,407 Gets a rash. 526 00:35:24,477 --> 00:35:28,106 He's extremely uncomfortable, has a wicked fever, but he lives. 527 00:35:28,186 --> 00:35:32,054 Here's the kicker. Once every million or so times, 528 00:35:32,128 --> 00:35:34,426 the virus mutates. 529 00:35:34,500 --> 00:35:37,025 Instead of Dan having a fever and a rash, 530 00:35:37,107 --> 00:35:39,769 the virus travels to his brain and hides, 531 00:35:39,846 --> 00:35:41,780 like a time bomb. 532 00:35:41,851 --> 00:35:44,217 In this case, for 16 years. 533 00:35:44,290 --> 00:35:46,850 Subacute sclerosing panencephalitis. 534 00:35:48,266 --> 00:35:51,724 I know. There's only been 20 cases in the United States in the last 30 years. 535 00:35:51,806 --> 00:35:55,139 I suppose you could make an argument the kid's still in stage I. 536 00:35:55,215 --> 00:35:57,342 Once S.S.P.E. moves to stage II, it's-- 537 00:35:57,420 --> 00:36:00,548 Boom. Stage II is universally fatal. 538 00:36:00,627 --> 00:36:03,596 I assume its impossible to know when he might move into stage II. 539 00:36:03,668 --> 00:36:07,866 He's already started showing symptoms. Could be a month. Could be tonight. 540 00:36:07,944 --> 00:36:10,174 Can we treat it? Ask the neurologist. 541 00:36:10,249 --> 00:36:12,342 Intraventricular interferon. 542 00:36:12,421 --> 00:36:16,289 Not gonna shove a spike into his brain and drip interferon without confirming this diagnosis. 543 00:36:16,363 --> 00:36:20,129 - Tap him. - We won't get a reliable result for measles antibodies in his C.S.F. 544 00:36:20,205 --> 00:36:22,139 Not after everything we've given him. 545 00:36:22,210 --> 00:36:25,008 So the wrong treatment kills any hope of the right diagnosis. 546 00:36:25,083 --> 00:36:27,847 Why do people lie to me? 547 00:36:27,923 --> 00:36:29,857 Could also kill him. 548 00:36:29,927 --> 00:36:34,364 Your ball, Foreman. Tell me I don't have to biopsy his brain. 549 00:36:35,941 --> 00:36:38,034 Well, there is one other way. 550 00:36:39,616 --> 00:36:41,607 You sure this isn't gonna hurt? 551 00:36:41,688 --> 00:36:43,679 Yeah. It's just scary as hell. 552 00:36:43,759 --> 00:36:45,886 See, we go through the pupil. 553 00:36:45,964 --> 00:36:48,194 But you won't feel it. The eye's been paralyzed. 554 00:36:48,269 --> 00:36:50,601 The needle travels to the back of the eye, 555 00:36:50,674 --> 00:36:53,541 which is where we'll perform the biopsy on your retina. 556 00:36:58,894 --> 00:37:01,920 So we've confirmed that the problem is this mutated virus. 557 00:37:02,001 --> 00:37:05,801 The treatment for S.S.P.E. is intraventricular interferon. 558 00:37:05,876 --> 00:37:08,606 We implant an ommaya reservoir under the scalp, 559 00:37:08,682 --> 00:37:10,912 which is connected to a ventricular catheter... 560 00:37:10,987 --> 00:37:13,547 that delivers the antiviral directly to the left hemisphere. 561 00:37:13,627 --> 00:37:17,461 You want us to consent to this? I don't even understand what you're talking about. 562 00:37:17,536 --> 00:37:19,595 Well, the antiviral-- 563 00:37:22,380 --> 00:37:24,314 Look. I'm sorry. 564 00:37:24,384 --> 00:37:28,753 I can explain this as best I can, but the notion that you're gonna fully understand your son's treatment... 565 00:37:28,828 --> 00:37:32,958 and make an informed decision is-- is kind of insane. 566 00:37:34,709 --> 00:37:36,973 Here's what you need to know. 567 00:37:37,983 --> 00:37:39,951 It's dangerous. 568 00:37:40,021 --> 00:37:42,251 It could kill him. 569 00:37:42,325 --> 00:37:44,316 You should do it. 570 00:37:55,422 --> 00:37:57,652 Did you need something else? 571 00:38:16,303 --> 00:38:19,431 You can't order a $3,200 D.N.A. test to win a bet. 572 00:38:19,510 --> 00:38:21,671 It's not an actual cost. 573 00:38:21,749 --> 00:38:25,617 I don't know if you know this, but the hospital actually owns the sequencing machine. 574 00:38:25,691 --> 00:38:28,285 - I'm serious. - Tell the parents to submit the bill to insurance. 575 00:38:28,365 --> 00:38:30,196 Insurance is not gonna pay for a bet. 576 00:38:30,269 --> 00:38:34,638 Should. We don't make that bet, the kid dies. 577 00:38:34,712 --> 00:38:37,579 If not for the paternity bet, I never would have taken their D.N.A. 578 00:38:37,653 --> 00:38:42,454 Without their D.N.A., we never would have discovered that Dan was adopted, which was the key to this case. 579 00:38:42,530 --> 00:38:44,498 You just don't want to pay your end. 580 00:38:44,567 --> 00:38:47,468 Big mistake. My guy knows a guy. 581 00:38:47,541 --> 00:38:51,238 Fine. I will let you out of clinic duty for one week, 582 00:38:51,317 --> 00:38:54,309 after you pay the 3,200 for the P.C.R. test. 583 00:39:02,108 --> 00:39:03,632 Ooh. 584 00:39:03,712 --> 00:39:07,170 Well, now, there's the hundred you owe me. 585 00:39:08,255 --> 00:39:10,189 Here's a hundred I won from Cameron. 586 00:39:10,259 --> 00:39:12,819 200 I took off of Foreman. 587 00:39:14,202 --> 00:39:16,670 And 600... 588 00:39:16,742 --> 00:39:19,233 I got from Wilson. 589 00:39:20,450 --> 00:39:22,008 Very bitter. 590 00:39:25,963 --> 00:39:27,988 Hey. Good morning. 591 00:39:28,067 --> 00:39:30,831 Good news on your E.E.G. Treatment is working. 592 00:39:30,907 --> 00:39:33,000 And your immune system is responding. 593 00:39:33,079 --> 00:39:36,480 I know it's early, but I just want to take a look. 594 00:39:37,823 --> 00:39:41,725 All right. Let's see what that brain of yours can do. 595 00:39:41,799 --> 00:39:45,257 Name as many animals as you can that start with the letter "O". 596 00:39:45,339 --> 00:39:47,398 Ostrich. 597 00:39:48,180 --> 00:39:50,944 Ox. Old elephant. 598 00:39:51,020 --> 00:39:53,853 Well, that's two better than last time. 599 00:39:54,929 --> 00:39:57,454 How you doing with the whole adoption thing? 600 00:39:57,534 --> 00:40:00,332 - I knew since fifth grade. - How's that? 601 00:40:00,408 --> 00:40:03,343 Cleft chin. 602 00:40:03,415 --> 00:40:06,009 I have one. My dad doesn't. 603 00:40:06,087 --> 00:40:10,717 Looked it up on the Internet. It's one of those trait things. 604 00:40:10,798 --> 00:40:13,289 That's right. It's autosomal dominant. 605 00:40:14,306 --> 00:40:18,743 Since neither of your parents have cleft chins, it's highly unlikely you're biologically related. 606 00:40:20,086 --> 00:40:24,785 - Are you sure you're okay? - I've got no problems with being adopted. 607 00:40:25,798 --> 00:40:27,789 I love my parents. 608 00:40:31,111 --> 00:40:33,545 How's he doing? He's doing pretty well. 609 00:40:33,617 --> 00:40:35,175 He's a smart kid. 610 00:40:35,254 --> 00:40:37,222 I think he's gonna be fine. 611 00:40:41,000 --> 00:40:43,332 - Hey. - Thanks.