1 00:00:05,208 --> 00:00:08,252 On your right. On your right. On your right. 2 00:00:08,253 --> 00:00:13,966 Back, back, back, back, back. Come on, buddy. 3 00:00:13,967 --> 00:00:16,344 Yeah, Dan! Yeah! 4 00:00:16,345 --> 00:00:17,905 Yea! Yea! 5 00:00:18,138 --> 00:00:24,978 Back, back, back, back, back. Watch the winger! 6 00:00:33,488 --> 00:00:34,328 Yeah! 7 00:00:59,057 --> 00:01:00,497 You okay? 8 00:01:01,143 --> 00:01:03,269 Dan? Dan, talk to me. 9 00:01:03,270 --> 00:01:04,710 Dan. Dan. 10 00:01:06,023 --> 00:01:08,063 Get a doctor! 11 00:01:48,443 --> 00:01:50,820 - Hey. - Close the door. 12 00:01:50,821 --> 00:01:53,101 Close the door. 13 00:01:56,118 --> 00:01:59,287 Is Cuddy down the hall counting to 50? 14 00:01:59,288 --> 00:02:02,207 She knows I'm in here, in the clinic, as she commanded. 15 00:02:02,208 --> 00:02:05,502 - She just doesn't know I'm alone. - Well, you've got a full waiting room. 16 00:02:05,503 --> 00:02:09,965 - How long do you think you can ignore them? - I'm off at 4:00. 17 00:02:09,966 --> 00:02:12,301 You're doing this to avoid five minutes of work? 18 00:02:12,302 --> 00:02:15,012 If I go out there, I get assigned a kid with a runny nose. 19 00:02:15,013 --> 00:02:18,308 That's 30 seconds looking at the nose, 25 minutes talking to a worried mom... 20 00:02:18,309 --> 00:02:21,186 who won't leave until she's sure it's not meningitis or a tumor. 21 00:02:21,187 --> 00:02:23,605 Yes. Concerned parents can be so annoying. 22 00:02:23,606 --> 00:02:27,317 Just tell Cuddy you've got an urgent case. You had to leave early. That would be lying. 23 00:02:27,318 --> 00:02:32,281 And that would be wrong. But luckily the definition of "urgent" is fungible. 24 00:02:32,282 --> 00:02:37,562 Not the definition of "case" though. 25 00:02:38,330 --> 00:02:43,293 You have no cases? 26 00:02:43,294 --> 00:02:47,130 You've got handpicked doctors- specialists- 27 00:02:47,131 --> 00:02:50,092 working for you, and they're sitting on their hands? 28 00:02:50,093 --> 00:02:53,971 - Cameron's answering my mail. - Oh, time well spent, I'm sure. 29 00:02:53,972 --> 00:02:56,056 Foreman and Chase? 30 00:02:56,057 --> 00:02:57,377 Research? 31 00:03:04,733 --> 00:03:07,527 Nine letters. lodine deficiency in children. 32 00:03:07,528 --> 00:03:08,968 Cretinism. 33 00:03:19,082 --> 00:03:22,043 So, 4:03 p. m., Dr. House checks out. 34 00:03:22,044 --> 00:03:24,045 Please write that down. 35 00:03:24,046 --> 00:03:26,339 Dr. House. Sorry. Done for the day. 36 00:03:26,340 --> 00:03:29,300 Plenty of docs here to take care of you. But we had an appointment. 37 00:03:29,301 --> 00:03:32,679 Nice try, but this is a walk-in clinic, which means there are no appointments. 38 00:03:32,680 --> 00:03:35,015 You walk in, sign the chart, and a doctor will see you. 39 00:03:35,016 --> 00:03:39,520 Just not me. Your letter says that we'd see you. 40 00:03:39,521 --> 00:03:44,081 Not a big letter writer. Here. 41 00:03:44,526 --> 00:03:48,070 When did my signature get so girlie? 42 00:03:48,071 --> 00:03:50,365 - I can explain. - See that "G"? 43 00:03:50,366 --> 00:03:52,867 See how it makes a big loop on top? 44 00:03:52,868 --> 00:03:56,288 Doesn't even look like my handwriting. Think I have something? 45 00:03:56,289 --> 00:03:59,750 What's the differential diagnosis for writing G's like a junior high school girl? 46 00:03:59,751 --> 00:04:03,545 It's impossible to get to you through normal channels. They have called, e-mailed. 47 00:04:03,546 --> 00:04:07,550 Perseverance does not equal worthiness. Next time you want to get my attention, wear something fun. 48 00:04:07,551 --> 00:04:09,552 Low-rider jeans are hot. 49 00:04:09,553 --> 00:04:14,724 Sixteen-year-old male. Sudden onset of double vision and night terrors, with no apparent cause. 50 00:04:14,725 --> 00:04:17,227 The kid's been to two neurologists, and he- Night terrors? 51 00:04:17,228 --> 00:04:22,268 - As in big scary monsters? - Yes. 52 00:04:22,900 --> 00:04:26,445 - Where are you going? - To see the family. 53 00:04:26,446 --> 00:04:30,574 - You're going to examine a patient? - Nine times out of 10, there's no reason to talk to a patient. 54 00:04:30,575 --> 00:04:34,495 But night terrors in a 16-year-old is a very good reason to talk to this family. 55 00:04:34,496 --> 00:04:36,056 Good work. 56 00:04:39,418 --> 00:04:41,419 Margins are fine. 57 00:04:41,420 --> 00:04:43,100 No lesions. 58 00:04:44,590 --> 00:04:46,750 Color is good. 59 00:04:46,926 --> 00:04:50,345 How long have you been having night terrors? Three weeks. 60 00:04:50,346 --> 00:04:55,601 He's afraid to go to bed. He's exhausted, can barely function. 61 00:04:55,602 --> 00:04:59,188 - What does that tell you? - Nothing. It's just fun watching him blink. 62 00:04:59,189 --> 00:05:09,149 Name as many animals as you can that begin with the letter "B". Go. 63 00:05:09,450 --> 00:05:13,620 - Baby elephant? - Baby elephant is actually a good answer. 64 00:05:13,621 --> 00:05:16,206 - "B" is a bear of a letter. - What does that tell you? 65 00:05:16,207 --> 00:05:20,294 Proves two things: no neurological damage, and your son is never gonna be chief fry cook. 66 00:05:20,295 --> 00:05:24,132 In teens, there are two likely causes of night terrors. 67 00:05:24,133 --> 00:05:27,886 - Posttraumatic stress. Any recent shoot-outs at your high school? - No. 68 00:05:27,887 --> 00:05:29,179 - Then, Dave- - Dan. 69 00:05:29,180 --> 00:05:35,978 If there's no trauma, the other cause is... sexual abuse. 70 00:05:35,979 --> 00:05:39,481 So who's molesting you? Teacher? 71 00:05:39,482 --> 00:05:42,526 Extra-friendly neighbor? I'd ask if either of you were involved, but you'd deny it. 72 00:05:42,527 --> 00:05:44,320 We would never hurt Dan. 73 00:05:44,321 --> 00:05:46,823 I say it here, it comes out there. 74 00:05:46,824 --> 00:05:49,367 This lack of response is consistent with abuse. 75 00:05:49,368 --> 00:05:52,245 There's no one, okay? I- I swear. 76 00:05:52,246 --> 00:05:57,167 There was trauma. I got hit in the head during a lacrosse game. 77 00:05:57,168 --> 00:06:00,629 Did you know that he got hit in the head? 78 00:06:00,630 --> 00:06:07,053 - They didn't mention it. No. - Yeah. Why bother? 79 00:06:07,054 --> 00:06:09,680 No, no. We took him to the E.R. after the game. 80 00:06:09,681 --> 00:06:12,267 He was scanned. They tested him. They said he was fine. 81 00:06:12,268 --> 00:06:14,269 No concussion. It's gotta be something else. 82 00:06:14,270 --> 00:06:17,856 You hound me for my opinion, and then you question my diagnosis. 83 00:06:17,857 --> 00:06:21,318 Cool. E.R. obviously screwed up. Kid's got a concussion. 84 00:06:21,319 --> 00:06:24,530 I had double vision before I was hit. Well, that changes everything. 85 00:06:24,531 --> 00:06:27,366 You need glasses. That's why you had double vision, 86 00:06:27,367 --> 00:06:32,163 which is why you got hit, which is why you have a concussion, which is why you have night terrors. 87 00:06:32,164 --> 00:06:35,249 You need to see an ophthalmologist, which I am not. 88 00:06:35,250 --> 00:06:40,714 You enjoyed that. I brought a reasonable case to your attention, and you shoved it in my face just to humiliate me. 89 00:06:40,715 --> 00:06:43,633 You're an only child, aren't you? Why would you say that? 90 00:06:43,634 --> 00:06:46,512 Because everything is about you. 91 00:06:46,513 --> 00:06:50,891 This may seem incredibly controversial, but I think sexual abuse is bad. 92 00:06:50,892 --> 00:06:53,936 I just wanted to make sure he wasn't being diddled by Daddy- or Mommy. 93 00:06:53,937 --> 00:06:58,377 Anything else is just a bonus. 94 00:07:06,909 --> 00:07:10,287 I'm not an only child. Interesting. 95 00:07:10,288 --> 00:07:13,048 What? Don't move. 96 00:07:13,333 --> 00:07:17,336 - Did I bore you in there? - What? Uh, no. Not- Not really. 97 00:07:17,337 --> 00:07:19,497 Are you tired? 98 00:07:19,757 --> 00:07:21,924 - Sometimes. - He never sleeps. Of course he's tired. 99 00:07:21,925 --> 00:07:24,427 - Right now. At this moment. Are you tired? - No. No. 100 00:07:24,428 --> 00:07:28,056 That twitch in your leg. Did you feel that? 101 00:07:28,057 --> 00:07:30,350 - Didn't hurt. - His leg twitched. I don't see what- 102 00:07:30,351 --> 00:07:34,188 It's called a myoclonic jerk. It's very common when you're falling asleep. 103 00:07:34,189 --> 00:07:39,610 Respiration rate falls, and the brain sometimes interprets this as the body dying, so it sends a pulse to wake it up. 104 00:07:39,611 --> 00:07:41,904 - So? - So, he's not asleep. 105 00:07:41,905 --> 00:07:43,705 He's awake. 106 00:07:44,700 --> 00:07:46,260 Admit him. 107 00:07:49,705 --> 00:07:53,166 I recognize that loopy "G". 108 00:07:53,167 --> 00:07:55,252 So, what does the jerk tell us? 109 00:07:55,253 --> 00:07:57,629 Nothing good. The brain's losing control of the body. 110 00:07:57,630 --> 00:08:01,467 Can't order the eyes to focus, regulate sleep patterns or control muscles. 111 00:08:01,468 --> 00:08:03,552 A movement disorder or a degenerative brain disease. 112 00:08:03,553 --> 00:08:07,140 Either way, this kid's gonna be picking up his diploma in diapers and a wheelchair. 113 00:08:07,141 --> 00:08:09,183 Maybe not that bad. Could be an infection. 114 00:08:09,184 --> 00:08:11,311 You wish. No fever, no white count. 115 00:08:11,312 --> 00:08:16,817 Anyone think this differential diagnosis might be compromised because we don't have an accurate family history? 116 00:08:16,818 --> 00:08:20,988 - I took an accurate family history. - You didn't even take an accurate family. 117 00:08:20,989 --> 00:08:23,324 - His father's not his father. - Why would you say that? 118 00:08:23,325 --> 00:08:26,452 Thirty percent of all dads don't realize they're raising someone else's kid. 119 00:08:26,453 --> 00:08:29,664 False paternity's more like 10%. That's what our moms would like us to believe. 120 00:08:29,665 --> 00:08:32,208 Who cares? If he got it from his parents, they'd both be dead. 121 00:08:32,209 --> 00:08:35,170 - Can we get on with the differential diagnosis? - Fifty bucks says I'm right. 122 00:08:35,171 --> 00:08:37,797 - I'll take your money. - Hit a nerve? 123 00:08:37,798 --> 00:08:41,343 - Don't worry. I'm sure the guy who tucked you in was your daddy. - Make it a hundred. 124 00:08:41,344 --> 00:08:45,180 What about leukoencephalopathy in a 16-year-old? 125 00:08:45,181 --> 00:08:47,558 It doesn't necessarily have to be that bad. 126 00:08:47,559 --> 00:08:50,686 If we exclude the night terrors, it could be something systemic. 127 00:08:50,687 --> 00:08:53,272 - His liver, kidneys. Something outside the brain. - Yes. 128 00:08:53,273 --> 00:08:57,068 - Feel free to exclude any symptom if it makes your job easier. - Night terrors were anecdotal. 129 00:08:57,069 --> 00:09:01,865 - He could've had a bad dream. - No. Parents said he was conscious during and didn't remember anything afterwards. 130 00:09:01,866 --> 00:09:03,867 - That's a night terror. - Parents said? 131 00:09:03,868 --> 00:09:06,036 That's a good point. 132 00:09:06,037 --> 00:09:09,373 Before we condemn this kid, maybe we should entertain Dr. Chase's skepticism. 133 00:09:09,374 --> 00:09:19,374 I want a detailed polysomnograph. If he's having night terrors, I want to see them. 134 00:09:36,987 --> 00:09:39,238 I usually don't move during night terrors. 135 00:09:39,239 --> 00:09:44,077 I'm not restraining you for them. 136 00:09:44,078 --> 00:09:47,372 E.E.G. revealed abnormalities in your brain- 137 00:09:47,373 --> 00:09:52,173 caused nerve damage in your toes. 138 00:09:56,424 --> 00:09:59,304 What are you doing? 139 00:09:59,594 --> 00:10:02,763 - Fixing it. - Can I talk to my parents? 140 00:10:02,764 --> 00:10:04,932 Oh, they know all about this. 141 00:10:04,933 --> 00:10:09,253 I'd really like to see them. 142 00:10:15,945 --> 00:10:20,985 Please. I'd really like them here. 143 00:10:21,117 --> 00:10:23,202 This is gonna hurt, Dan. 144 00:10:23,203 --> 00:10:25,123 Oh. Oh, God. 145 00:10:42,015 --> 00:10:45,375 That's a night terror. 146 00:10:54,695 --> 00:10:58,949 We did a C. T., M.R.I., C.B.C., CHEM-7 and chest X-ray. 147 00:10:58,950 --> 00:11:02,077 All the tests came back normal. There's nothing to explain his symptoms. 148 00:11:02,078 --> 00:11:08,083 Okay, but let's pretend there's something and go from there. Who sees something on this M.R.I.? 149 00:11:08,084 --> 00:11:10,962 No lesions in the white matter. No structural abnormalities. 150 00:11:10,963 --> 00:11:13,005 No space-occupying tumors. 151 00:11:13,006 --> 00:11:19,220 He's 16, so he should have an absolutely pristine brain. The smallest thing is abnormal. 152 00:11:19,221 --> 00:11:21,681 Meningeal enhancement. 153 00:11:21,682 --> 00:11:24,309 - My bet is viral meningitis. - Excellent. 154 00:11:24,310 --> 00:11:26,311 Do you see what he did there? 155 00:11:26,312 --> 00:11:30,149 Took a small clue that there's a neurological problem and wasn't afraid to run with it. 156 00:11:30,150 --> 00:11:32,693 There's no evidence of meningitis on that M.R.I. 157 00:11:32,694 --> 00:11:34,654 No, there's not. He's completely wrong. 158 00:11:34,655 --> 00:11:36,739 Then what clue are you talking about? 159 00:11:36,740 --> 00:11:41,619 He knew that I saw something on the M.R.I., so he figured there must be something there and took a guess. 160 00:11:41,620 --> 00:11:45,207 - Clever, but also pathetic. - So what did you find? 161 00:11:45,208 --> 00:11:50,838 Take a close look at the corpus callosum. 162 00:11:50,839 --> 00:11:54,341 - Looks okay. - Are we all looking at the same thing? 163 00:11:54,342 --> 00:11:56,886 Two hundred million interhemispheric nerve fibers. 164 00:11:56,887 --> 00:12:01,683 The George Washington Bridge between the left and right side of the brain. 165 00:12:01,684 --> 00:12:03,604 It's subtle. 166 00:12:06,397 --> 00:12:08,773 There's some bowing. There. 167 00:12:08,774 --> 00:12:10,859 An upward arch. Are you guessing? 168 00:12:10,860 --> 00:12:11,580 Yes. 169 00:12:12,820 --> 00:12:16,657 - Too bad. You're right. - He probably just moved. 170 00:12:16,658 --> 00:12:19,326 Nobody stays perfectly still for the entire M.R.I. 171 00:12:19,327 --> 00:12:24,916 Yeah. Probably got restless and shifted one hemisphere of his brain to a more comfortable position. 172 00:12:24,917 --> 00:12:28,253 Something is pushing on it. If there was bowing, could be a tumor. 173 00:12:28,254 --> 00:12:31,756 Do you see a tumor on this M.R.I.? No, but I don't see any bowing either. 174 00:12:31,757 --> 00:12:35,385 There's no tumor. Just a blockage causing pressure causing symptoms. 175 00:12:35,386 --> 00:12:38,889 Today, night terrors. Tomorrow, he's bleeding out of his eyes. 176 00:12:38,890 --> 00:12:48,890 Get him a radionucleotide cisternogram. I guarantee you'll see a blockage. 177 00:12:49,568 --> 00:12:50,408 Okay. 178 00:12:54,407 --> 00:12:55,247 Easy. 179 00:12:56,200 --> 00:12:59,440 Okay. Squeeze my hand. 180 00:13:02,290 --> 00:13:05,770 All right. Squeeze hard. 181 00:13:06,962 --> 00:13:08,522 All right. 182 00:13:15,096 --> 00:13:18,431 Now I'm injecting a material that's tagged with a radioisotope. 183 00:13:18,432 --> 00:13:22,311 It's gonna enter your spine and travel up to your brain. 184 00:13:22,312 --> 00:13:26,315 It'll make you able to think deep thoughts, 185 00:13:26,316 --> 00:13:29,485 run a hundred miles an hour. 186 00:13:29,486 --> 00:13:30,326 Easy. 187 00:13:44,627 --> 00:13:47,755 Their eyes aren't the same color, but that fleck in the eyes- 188 00:13:47,756 --> 00:13:50,841 That's maybe a one-in-10 chance if they're not related? 189 00:13:50,842 --> 00:13:53,344 No. House isn't gonna pay you based on that. 190 00:13:53,345 --> 00:13:57,265 Any excuse we can give the folks to justify a D.N.A. test? 191 00:13:57,266 --> 00:14:04,940 We could tell them he's got Huntington's- whole family should be tested or they'll all die. 192 00:14:04,941 --> 00:14:05,661 Hey. 193 00:14:06,943 --> 00:14:10,863 There's a lot of blockage. I've scheduled him for surgery. 194 00:14:10,864 --> 00:14:14,783 We're gonna put a shunt into one of the ventricles to give the cerebrospinal fluid an out. 195 00:14:14,784 --> 00:14:17,495 No more pressure, everything goes back to normal. 196 00:14:17,496 --> 00:14:23,376 He's lucky to have you as his doctors. 197 00:14:29,133 --> 00:14:32,219 No formula. Just Mommy's healthy, natural breast milk. 198 00:14:32,220 --> 00:14:33,180 Yummy. 199 00:14:33,972 --> 00:14:37,141 Her whole face just got swollen like this overnight. 200 00:14:37,142 --> 00:14:38,342 Mm-hmm. 201 00:14:40,395 --> 00:14:41,835 No fever. 202 00:14:42,773 --> 00:14:45,692 Glands normal. Missing her vaccination dates. 203 00:14:45,693 --> 00:14:48,933 We're not vaccinating. 204 00:14:49,405 --> 00:14:51,805 Gribbet! Gribbet! 205 00:14:51,991 --> 00:14:53,191 Gribbet! 206 00:14:53,576 --> 00:14:55,369 Think they don't work? 207 00:14:55,370 --> 00:14:58,747 I think some multinational pharmaceutical company wants me to think they work- 208 00:14:58,748 --> 00:15:02,042 pad their bottom line. Mm-hmm. 209 00:15:02,043 --> 00:15:04,563 - May I? - Sure. 210 00:15:05,339 --> 00:15:07,739 Gribbet. Gribbet. 211 00:15:08,092 --> 00:15:09,292 Gribbet. 212 00:15:10,427 --> 00:15:13,430 Yeah. All-natural, no dyes is a good business. 213 00:15:13,431 --> 00:15:15,599 All-natural children's toys. 214 00:15:15,600 --> 00:15:18,185 Toy companies- they don't arbitrarily mark up their frogs. 215 00:15:18,186 --> 00:15:21,271 They don't lie about how much they spend on research and development. 216 00:15:21,272 --> 00:15:26,944 The worst that a toy company could be accused of is making a really boring frog. 217 00:15:26,945 --> 00:15:29,864 Gribbet, gribbet, gribbet. 218 00:15:29,865 --> 00:15:32,784 You know another really good business? 219 00:15:32,785 --> 00:15:36,287 Teeny, tiny baby coffins. 220 00:15:36,288 --> 00:15:38,623 You can get 'em in frog green, 221 00:15:38,624 --> 00:15:41,126 fire-engine red- really. 222 00:15:41,127 --> 00:15:45,464 The antibodies in yummy Mummy only protect the kid for six months, 223 00:15:45,465 --> 00:15:48,133 which is why these companies think they can gouge you. 224 00:15:48,134 --> 00:15:51,929 They think that you'll spend whatever they ask to keep your kid alive. 225 00:15:51,930 --> 00:15:54,015 Want to change things? Prove 'em wrong. 226 00:15:54,016 --> 00:15:58,686 Few hundred parents like you decide they'd rather let their kid die than cough up 40 bucks for a vaccination, 227 00:15:58,687 --> 00:16:01,273 believe me, prices will drop really fast. 228 00:16:01,274 --> 00:16:04,276 Gribbet, gribbet, gribbet, gribbet, gribbet. 229 00:16:04,277 --> 00:16:05,477 Gribbet. 230 00:16:05,737 --> 00:16:08,977 Tell me what she has. 231 00:16:10,700 --> 00:16:11,900 A cold. 232 00:16:13,328 --> 00:16:15,496 There's a problem. 233 00:16:15,497 --> 00:16:18,666 Complications in surgery? Surgery went fine. He's in recovery. 234 00:16:18,667 --> 00:16:21,085 But we took a vial of C.S.F. and tested it. Really? 235 00:16:21,086 --> 00:16:24,130 Turns out the bowing wasn't the cause of his problems. It was a symptom. 236 00:16:24,131 --> 00:16:26,299 Oligoclonal bands and increased intrathecal IgG. 237 00:16:26,300 --> 00:16:30,512 Which means multiple sclerosis. And the reason it takes three of you to tell me this? 238 00:16:30,513 --> 00:16:33,349 Because we're having a disagreement about whether or not it is M.S. 239 00:16:33,350 --> 00:16:36,977 No lesions on the M.R.I. It's early. He's had the disease for maybe two weeks. 240 00:16:36,978 --> 00:16:40,773 - McDonald criteria requires six months to make a definitive diagnosis. - Who cares about MacPhearson? 241 00:16:40,774 --> 00:16:42,775 - I hear he tortured kittens. - McDonald. 242 00:16:42,776 --> 00:16:45,361 Oh, McDonald. Wonderful doctor, loved kittens. 243 00:16:45,362 --> 00:16:47,364 The V.E.P. indicates slowing of the brain. 244 00:16:47,365 --> 00:16:49,407 Without the lesions, we can't be sure. 245 00:16:49,408 --> 00:16:51,910 Well, if it is, it's gone from zero to 60 in three weeks, 246 00:16:51,911 --> 00:16:53,954 which would indicate rapidly progressive M.S. 247 00:16:53,955 --> 00:16:57,374 Not the fun M.S. with the balloons and the bike rides for cripples in wheelchairs. 248 00:16:57,375 --> 00:17:00,544 - We should wait until- - Start treating him now, 249 00:17:00,545 --> 00:17:04,882 maybe he can walk for another couple of years, maybe live for another five. 250 00:17:04,883 --> 00:17:07,510 Break it to the family. I'm going home. 251 00:17:07,511 --> 00:17:13,225 It'll take months for a definitive diagnosis. What'll happen to me? 252 00:17:13,226 --> 00:17:15,560 M.S. is an incredibly variable disease. 253 00:17:15,561 --> 00:17:19,064 If it is M.S., and we're not a hundred percent sure. 254 00:17:19,065 --> 00:17:24,105 What do you think is gonna happen? 255 00:17:24,863 --> 00:17:27,240 There are some medications to manage the symptoms, 256 00:17:27,241 --> 00:17:30,410 but as the disease progresses, the problems will become more severe. 257 00:17:30,411 --> 00:17:32,829 Bowel and bladder dysfunction, 258 00:17:32,830 --> 00:17:35,498 loss of cognitive function, pain- 259 00:17:35,499 --> 00:17:38,499 So it's gonna hurt? 260 00:17:39,212 --> 00:17:41,713 The brain's like a big jumble of wires. 261 00:17:41,714 --> 00:17:44,341 M.S. strips them of the insulation, and the nerves die. 262 00:17:44,342 --> 00:17:47,053 Brain interprets it as pain. 263 00:17:47,054 --> 00:17:51,307 But by starting treatment, we're gonna prevent that for as long as possible. 264 00:17:51,308 --> 00:17:53,309 We're looking into a couple of specialists, 265 00:17:53,310 --> 00:18:01,950 and until we get you squared away, you'll stay here, okay? 266 00:18:17,545 --> 00:18:20,130 Security checked the videotapes from all perimeter cameras. 267 00:18:20,131 --> 00:18:22,424 He's still gotta be in the hospital. Where's Chase? 268 00:18:22,425 --> 00:18:25,052 Main floor. Okay. You take the cafeteria and administration. 269 00:18:25,053 --> 00:18:33,573 I'll hit the research annex and work my way back to you. 270 00:19:05,012 --> 00:19:05,732 Dan? 271 00:19:11,227 --> 00:19:15,787 I'm not here. Leave a message. 272 00:19:20,445 --> 00:19:23,322 Dr. Cuddy. Great outfit. 273 00:19:23,323 --> 00:19:25,658 What are you doing back here? Patient? 274 00:19:25,659 --> 00:19:32,979 No. Hooker. Went to my office instead of my home. 275 00:19:39,549 --> 00:19:41,109 Dr. House. 276 00:19:42,052 --> 00:19:44,887 Dan's missing. Yeah. I got that part from the message. 277 00:19:44,888 --> 00:19:48,224 You said I was needed immediately. He shouldn't move after a lumbar puncture. 278 00:19:48,225 --> 00:19:50,977 I agree. He's gonna have a very nasty headache. 279 00:19:50,978 --> 00:19:54,189 That would also be my opinion if consulted tomorrow morning. 280 00:19:54,190 --> 00:19:59,194 We wanted to keep you informed. He heard some pretty heavy news. 281 00:19:59,195 --> 00:20:01,947 This is not a toddler wandering around a department store. 282 00:20:01,948 --> 00:20:05,242 He's 16. You'll find him. 283 00:20:05,243 --> 00:20:07,244 I'm going home. 284 00:20:07,245 --> 00:20:10,248 So when you say, "Call me if you need anything", you mean don't call? 285 00:20:10,249 --> 00:20:12,583 No, I mean call me if I could do something. 286 00:20:12,584 --> 00:20:16,755 I'm bad at search parties, and I'm bad at sitting around looking nervous, doing nothing. 287 00:20:16,756 --> 00:20:18,882 What about his parents? Should we call them? 288 00:20:18,883 --> 00:20:21,343 Why? Do you think they're hiding him? 289 00:20:21,344 --> 00:20:24,388 Make sure someone checks the roof. 290 00:20:24,389 --> 00:20:34,389 Some of the orderlies keep the door propped open so they can grab a smoke. 291 00:21:02,721 --> 00:21:04,881 Dan. You okay? 292 00:21:12,315 --> 00:21:16,152 There are experimental treatments. Ongoing research. 293 00:21:16,153 --> 00:21:18,613 Who knows what they'll discover in a year or two. 294 00:21:18,614 --> 00:21:20,656 This is where I dropped the ball. 295 00:21:20,657 --> 00:21:25,829 Dan, we're standing on the roof of the hospital. 296 00:21:25,830 --> 00:21:26,550 Dan. 297 00:21:27,915 --> 00:21:30,000 Dan, you're not on the field. 298 00:21:30,001 --> 00:21:32,252 He doesn't know where he is. Dan. 299 00:21:32,253 --> 00:21:33,453 Foreman. 300 00:21:34,839 --> 00:21:35,559 Dan. 301 00:21:37,842 --> 00:21:40,482 - Dan? - Dan, no! 302 00:21:50,439 --> 00:21:52,239 Dr. Foreman. 303 00:21:54,569 --> 00:21:56,653 I assume you found the kid. 304 00:21:56,654 --> 00:21:59,323 He almost walked off the roof. Suicidal? 305 00:21:59,324 --> 00:22:03,244 No, he thought he was on his lacrosse field. Look, I was gonna run home, shower, change- 306 00:22:03,245 --> 00:22:05,645 Conscious? Yeah. 307 00:22:06,248 --> 00:22:08,916 How'd you talk him down? Actually, Chase tackled him. 308 00:22:08,917 --> 00:22:10,919 How come you didn't do it? 309 00:22:10,920 --> 00:22:15,924 Right. Well, I am black, but he was closer. 310 00:22:15,925 --> 00:22:21,085 Come on. You can ride up with me. 311 00:22:24,601 --> 00:22:28,396 Anybody tell the family that their boy almost stepped off a roof? They must be thrilled. 312 00:22:28,397 --> 00:22:30,690 They're not suing, but I think only because Chase asked- 313 00:22:30,691 --> 00:22:33,276 Why does everybody always think I'm being sarcastic? 314 00:22:33,277 --> 00:22:35,570 This is great news. He doesn't have M.S. 315 00:22:35,571 --> 00:22:39,324 Parents should be thrilled. The mom anyway. Of course, the dad probably doesn't know- 316 00:22:39,325 --> 00:22:43,704 - Why doesn't he have M.S.? - He was on the roof, thinking he was on a lacrosse field. 317 00:22:43,705 --> 00:22:47,625 - Conscious, and therefore not a night terror. You want some of this? - Yeah, sure. 318 00:22:47,626 --> 00:22:49,794 He was in an acute confusional state, 319 00:22:49,795 --> 00:22:52,672 which doesn't fit with a demyelinating disease like M.S. 320 00:22:52,673 --> 00:22:54,799 Oligoclonal bands- Were real. 321 00:22:54,800 --> 00:22:58,428 They just mean something other than M.S. So, what are they telling us? 322 00:22:58,429 --> 00:23:00,472 That the immune system is working? Right. 323 00:23:00,473 --> 00:23:02,682 He has an infection in his brain. 324 00:23:02,683 --> 00:23:04,768 What about sex? 325 00:23:04,769 --> 00:23:08,063 Well, it might get complicated. I mean, we work together. 326 00:23:08,064 --> 00:23:11,191 - I'm older, certainly, but maybe you like that. - I meant maybe he has neurosyphilis. 327 00:23:11,192 --> 00:23:15,029 - Huh. Nice cover. - Sorry. R.P.R. was negative. 328 00:23:15,030 --> 00:23:18,574 We don't need a definitive test to confirm. Sure. Didn't need one to confirm M.S. 329 00:23:18,575 --> 00:23:23,121 Okay. Let's wait for you to run titers on 1,400 viruses while this kid's brain turns to mush. 330 00:23:23,122 --> 00:23:26,791 So the fact that he doesn't have M.S., it's- it's really not good news after all. 331 00:23:26,792 --> 00:23:29,002 Well, it is if it's neurosyphilis. 332 00:23:29,003 --> 00:23:32,131 The likelihood of a false negative on an R.P.R. 30%. 333 00:23:32,132 --> 00:23:35,718 Likelihood of a 16-year-old having sex: roughly 120%. 334 00:23:35,719 --> 00:23:38,220 I'll start him on I.V. penicillin. We're not gonna wait for that. 335 00:23:38,221 --> 00:23:41,808 The most effective way to deliver the drug is right into his brain via the spine. 336 00:23:41,809 --> 00:23:43,810 We can't. In a cramped space like the brain, 337 00:23:43,811 --> 00:23:47,647 increased intracranial pressure from a high-volume drug like penicillin could herniate his brain stem. 338 00:23:47,648 --> 00:23:50,776 It'd kill him. No neurologist in his right mind would recommend that. 339 00:23:50,777 --> 00:23:53,654 Show of hands. Who thinks I'm not in my right mind? 340 00:23:53,655 --> 00:23:57,616 And who thinks I forget this fairly basic neurological fact? 341 00:23:57,617 --> 00:24:01,912 Who thinks there's a third option? 342 00:24:01,913 --> 00:24:09,671 - Very good. What's the third choice? - No idea. You just asked if I thought there was one. 343 00:24:09,672 --> 00:24:12,841 The patient has a shunt in his brain. There'll be no increased pressure. 344 00:24:12,842 --> 00:24:15,427 We can put as much penicillin into his body as we want. 345 00:24:15,428 --> 00:24:21,267 Excellent. Inject him through a lumbar puncture. 346 00:24:21,268 --> 00:24:27,190 One of us is gonna do this to you twice a day for the next two weeks. 347 00:24:27,191 --> 00:24:30,026 - I'm ready. Go. - He could get syphilis... 348 00:24:30,027 --> 00:24:33,696 even if he's not sexually active? 349 00:24:33,697 --> 00:24:38,118 Well, it's- it's unusual, but it's possible. 350 00:24:38,119 --> 00:24:39,919 Okay. Relax. 351 00:24:52,885 --> 00:24:56,137 It's infected, with a really big hole, 352 00:24:56,138 --> 00:24:58,556 like you stuck a nail in it to relieve the pressure. 353 00:24:58,557 --> 00:25:01,643 I wouldn't do that. Although the wound is irregular. 354 00:25:01,644 --> 00:25:04,980 It's not cylindrical. It's shaped like a triangle. So, not a nail. 355 00:25:04,981 --> 00:25:07,107 - Steak knife? - Wife's nail file. 356 00:25:07,108 --> 00:25:08,668 Nail file. 357 00:25:09,694 --> 00:25:12,822 Yeah. Pain will make you do stupid things. 358 00:25:12,823 --> 00:25:17,994 - Something to take the edge off? - Yeah. 359 00:25:17,995 --> 00:25:19,075 Cheers. 360 00:25:23,793 --> 00:25:26,920 So, you have family here in Princeton? 361 00:25:26,921 --> 00:25:29,681 No. Here on work? 362 00:25:29,716 --> 00:25:31,967 - No. Why are you- - Does your penis hurt? 363 00:25:31,968 --> 00:25:34,220 No. What? Should it? 364 00:25:34,221 --> 00:25:37,807 No. Just thought I'd toss you a really inappropriate question. 365 00:25:37,808 --> 00:25:42,020 - Your lawyer's gonna love it. - Why would I want to sue you? I want you to treat me. 366 00:25:42,021 --> 00:25:44,564 - You're from Maplewood, New Jersey, right? - Yeah. 367 00:25:44,565 --> 00:25:46,900 Now, why would you drive 70 miles... 368 00:25:46,901 --> 00:25:51,363 to get treatment for a condition that a nine-year-old could diagnose? 369 00:25:51,364 --> 00:25:54,366 It's the free-flowing pus that's the tip-off. 370 00:25:54,367 --> 00:25:57,328 I was in town. Not for family. Not for work. 371 00:25:57,329 --> 00:26:00,748 You drove 70 miles to a walk-in clinic. You passed two hospitals on the road. 372 00:26:00,749 --> 00:26:04,294 Either you've got a problem with those hospitals, or they have a problem with you. 373 00:26:04,295 --> 00:26:06,921 My guess is you've sued half the doctors in Maplewood, 374 00:26:06,922 --> 00:26:09,049 and the rest are now refusing to help you. 375 00:26:09,050 --> 00:26:12,844 It's ironic, isn't it? Sort of like the boy who sued wolf. 376 00:26:12,845 --> 00:26:16,140 You know, I bet we have a doctor here named Wolf. 377 00:26:16,141 --> 00:26:18,642 How perfect would that be? 378 00:26:18,643 --> 00:26:21,020 - I'm gonna page him. - Okay. You know what? Thank you. 379 00:26:21,021 --> 00:26:23,356 I'm gonna find a doctor to take care of this. 380 00:26:23,357 --> 00:26:25,358 I didn't say I wouldn't treat you. 381 00:26:25,359 --> 00:26:28,778 - We'll drain your knee, run some lab work. Fix you up. - Why would you do that? 382 00:26:28,779 --> 00:26:30,780 I'm a people person. 383 00:26:30,781 --> 00:26:33,366 You actually treated him? 384 00:26:33,367 --> 00:26:35,410 All I know is he sued some doctors. 385 00:26:35,411 --> 00:26:37,829 Who am I to assume they didn't have it coming to them? 386 00:26:37,830 --> 00:26:41,208 The cutest little tennis outfit. My God, I thought I was gonna have a heart attack. 387 00:26:41,209 --> 00:26:44,503 Oh, my. Didn't see you there. That is so embarrassing. How's your hooker doing? 388 00:26:44,504 --> 00:26:46,505 Sweet of you to ask. Funny story. 389 00:26:46,506 --> 00:26:50,385 She was gonna be hospital administrator, but just hated having to screw people like that. 390 00:26:50,386 --> 00:26:53,263 - Heard you found her on the roof. - You have very acute hearing. 391 00:26:53,264 --> 00:26:55,015 You notify the parents? 392 00:26:55,016 --> 00:26:57,017 In due course, of course. 393 00:26:57,018 --> 00:27:00,604 And is there a paternity bet on the father of the patient? 394 00:27:00,605 --> 00:27:03,982 Doesn't sound like me. Well, it does, actually, but doesn't mean you're guilty. 395 00:27:03,983 --> 00:27:06,026 You think? I saw the parents in the lobby. 396 00:27:06,027 --> 00:27:11,157 - Smart money's obviously on the father. - My guy knows a guy who can get you in for 50 bucks. 397 00:27:11,158 --> 00:27:15,119 Fine. Tell your guy, if I win, you attend the faculty symposium, and you wear a tie. 398 00:27:15,120 --> 00:27:17,664 And if I win, no clinic hours for a week. 399 00:27:17,665 --> 00:27:21,625 My guy will call your guy. 400 00:27:22,503 --> 00:27:26,703 She's very good at her job. 401 00:27:28,051 --> 00:27:31,512 The treatments should start helping soon. 402 00:27:31,513 --> 00:27:36,893 Let us know if it gets easier to focus on things, remember stuff. 403 00:27:36,894 --> 00:27:40,397 Hey, Dan. Isn't Dr. Cameron's necklace a beauty? 404 00:27:40,398 --> 00:27:42,565 Something South American, I think. 405 00:27:42,566 --> 00:27:44,966 Yeah. Guatemalan. 406 00:27:45,570 --> 00:27:48,810 It's a cool necklace. 407 00:27:49,365 --> 00:27:53,619 - Thank you so much. - The kid's in pain. 408 00:27:53,620 --> 00:27:56,247 Don't fight it. Just let it happen. No. 409 00:27:56,248 --> 00:27:58,374 You'll be dead in two days. No what? 410 00:27:58,375 --> 00:28:00,710 I give it a day. Dan? You okay? 411 00:28:00,711 --> 00:28:01,431 Dan? 412 00:28:01,921 --> 00:28:04,464 Night terrors. - Decomposition once he's in the grave. 413 00:28:04,465 --> 00:28:07,425 - Say good-bye to your mother and father. - He's hearing voices. 414 00:28:07,426 --> 00:28:11,138 You're dying. It's all over, Dan. 415 00:28:11,139 --> 00:28:15,099 You're dying. Dying. Dead! 416 00:28:15,393 --> 00:28:18,521 Push two milligrams I.V. Ativan, stat. 417 00:28:18,522 --> 00:28:21,232 It's all over. - Come on, Dan. 418 00:28:21,233 --> 00:28:24,233 Get out of my head! 419 00:28:24,862 --> 00:28:27,947 Auditory hallucination shows further brain degeneration. 420 00:28:27,948 --> 00:28:32,035 Penicillin's not working. So either it's a bad batch of penicillin, 421 00:28:32,036 --> 00:28:35,873 or our diagnosis is wrong. 422 00:28:35,874 --> 00:28:37,554 Square one. 423 00:28:37,959 --> 00:28:41,962 Midnite. L.F. T.'s, B.U.N. and creatinine are all normal. 424 00:28:41,963 --> 00:28:44,465 - Diabetes is out, and no gap. - There goes metabolic. 425 00:28:44,466 --> 00:28:47,218 - M.R.A. rules out vasculitis. - "I" for inflammation. 426 00:28:47,219 --> 00:28:49,929 - Too young for anything degenerative. - "D", see ya. 427 00:28:49,930 --> 00:28:53,266 "N" for neoplastic. M.R.I. was clean. 428 00:28:53,267 --> 00:28:55,977 - "I" for inflammation. - We already did that. 429 00:28:55,978 --> 00:28:59,314 - Stupid to have two I's in one mnemonic. What's the other one? - Infection. 430 00:28:59,315 --> 00:29:03,486 - Oligoclonal bands still have to mean something. - But no fevers. White count's elevated, but within range. 431 00:29:03,487 --> 00:29:06,155 We've tested for anything remotely possible. Everything's negative. 432 00:29:06,156 --> 00:29:13,836 - C.T. scan rules out subdural. - Trauma. Later much. 433 00:29:15,166 --> 00:29:20,295 You know the problem? "Midnight" is actually spelled with a "G" and an "H". 434 00:29:20,296 --> 00:29:27,344 If we could just figure out what those letters stand for. 435 00:29:27,345 --> 00:29:32,025 It's a sick brain, having fun, 436 00:29:32,434 --> 00:29:36,754 torturing him, talking to him. 437 00:29:40,151 --> 00:29:44,351 Scaring the hell out of him. 438 00:29:44,614 --> 00:29:49,451 Get him an E.E.G., left and right E.O.G., esophageal microphones. 439 00:29:49,452 --> 00:29:55,041 If this thing wants to talk, let's listen. 440 00:29:55,042 --> 00:29:59,045 We're missing something. This is screwed-up. 441 00:29:59,046 --> 00:30:02,632 That's why you came up with the brain talking to the virus thing? 442 00:30:02,633 --> 00:30:04,509 I panicked, okay? 443 00:30:04,510 --> 00:30:09,790 Sounded cool though. They bought it. 444 00:30:10,892 --> 00:30:12,332 Oh, crap. 445 00:30:13,687 --> 00:30:18,274 Another reason I don't like meeting patients. If they don't know what you look like, they can't yell at you. 446 00:30:18,275 --> 00:30:20,075 Here we go. 447 00:30:23,489 --> 00:30:27,367 How can you just sit there? 448 00:30:27,368 --> 00:30:29,411 If I eat standing up, I spill. 449 00:30:29,412 --> 00:30:33,624 Our son is dying, and you could care less. 450 00:30:33,625 --> 00:30:37,670 We're going through hell. You're doing nothing? 451 00:30:37,671 --> 00:30:42,550 - I'm sorry. You need to vent. I understand. - Don't be condescending. 452 00:30:42,551 --> 00:30:45,011 You haven't checked in on him once. 453 00:30:45,012 --> 00:30:47,764 Blood pressure is 110 over 70. 454 00:30:47,765 --> 00:30:50,600 His shunt is patent, well-placed in the right lateral ventricle. 455 00:30:50,601 --> 00:30:55,230 The E.K.G. shows a normal Q.R.S. with deep-wave inversions throughout both limb and precordial leads. 456 00:30:55,231 --> 00:30:58,192 L.F. T.'s are elevated, but only twice the normal range. 457 00:30:58,193 --> 00:31:03,233 Oh, yeah. And he's hearing voices. 458 00:31:04,908 --> 00:31:07,548 Go hold his hand. 459 00:31:08,787 --> 00:31:12,867 Go on. I'll bus your tray. 460 00:31:25,347 --> 00:31:28,307 - Got any sample bags on you? - I don't believe you. 461 00:31:28,308 --> 00:31:32,061 You're gonna run D.N.A. tests? Their son is deathly ill. 462 00:31:32,062 --> 00:31:36,274 I know. It's terrible. But the fact is, if I don't keep busy with trivial things like this, 463 00:31:36,275 --> 00:31:38,485 I'm afraid I might start to cry. You're an ass. 464 00:31:38,486 --> 00:31:43,406 Yeah? You want to double the bet? 465 00:31:52,084 --> 00:31:54,836 General Hospital is on channel 6. 466 00:31:54,837 --> 00:31:58,465 Dan's brain's not showing channel 6 right now. Only mush. 467 00:31:58,466 --> 00:32:01,946 No epileptiform activity. 468 00:32:02,345 --> 00:32:05,180 What are you doing? Waiting for C.B.C. and CHEM-7. 469 00:32:05,181 --> 00:32:09,261 Good. Run D.N.A. on these. 470 00:32:09,644 --> 00:32:14,190 What's this? Parents' coffee cups. 471 00:32:14,191 --> 00:32:16,692 I can't believe you. I've had this conversation once already. 472 00:32:16,693 --> 00:32:26,053 If you've got something else to do, do it. Otherwise, do this. 473 00:32:27,538 --> 00:32:30,666 Dr. House. Hey. Mr. Funsten. 474 00:32:30,667 --> 00:32:33,794 I was wondering when you'd be back. You got some papers for me? 475 00:32:33,795 --> 00:32:38,257 You've caused me considerable mental distress. I certainly hope so. 476 00:32:38,258 --> 00:32:42,387 What? Too cheap to get your lawyer to serve it for you, or is it just more fun this way? 477 00:32:42,388 --> 00:32:44,681 I'm obviously prepared to consider a settlement. 478 00:32:44,682 --> 00:32:47,442 You have gonorrhea. 479 00:32:48,561 --> 00:32:52,481 No, I don't. Well, maybe you're right, but I have the lab result says you do. 480 00:32:52,482 --> 00:32:55,150 Could be a false positive, and normally I'd run a second test, 481 00:32:55,151 --> 00:32:58,612 but since you're here, I'll just go with the first. You're just trying to scare me. 482 00:32:58,613 --> 00:33:02,033 It's reportable, you know. Public health issue. I'll be sure to let my wife know. 483 00:33:02,034 --> 00:33:04,744 Don't bother yourself. The state will call for you. 484 00:33:04,745 --> 00:33:07,372 If you're clean, I'm sure it'll all blow over. No big deal. 485 00:33:07,373 --> 00:33:12,669 There's an easy way to find out. Get one of your doctors to run a test. 486 00:33:12,670 --> 00:33:13,750 Uh-uh. 487 00:33:14,672 --> 00:33:21,152 These are mine now. I'll see you in court. 488 00:33:21,888 --> 00:33:25,808 West Nile negative. Not surprising since not too many mosquitoes passing through Jersey in December. 489 00:33:25,809 --> 00:33:28,394 No eastern equine encephalitis. You guys aren't gonna believe this. 490 00:33:28,395 --> 00:33:32,399 What's that? House is right. The father's not the father. 491 00:33:32,400 --> 00:33:35,760 Dude doubled up on me. 492 00:33:36,362 --> 00:33:38,488 You're not gonna believe this. 493 00:33:38,489 --> 00:33:42,284 The mother's not the mother either. 494 00:33:42,285 --> 00:33:45,371 It's not a good idea to move your son in his condition. 495 00:33:45,372 --> 00:33:48,791 - We just want a second opinion. We need an answer. 496 00:33:48,792 --> 00:33:52,295 You idiots. You lied to me. 497 00:33:52,296 --> 00:33:54,297 We didn't lie about anything. 498 00:33:54,298 --> 00:33:57,592 - You, on the other hand, accused us of molesting our son. - Perfect. 499 00:33:57,593 --> 00:34:00,429 Can we get off my screwups and focus on theirs? 500 00:34:00,430 --> 00:34:02,598 Theirs is bigger. You're not Dan's parents. 501 00:34:02,599 --> 00:34:05,476 We're his parents. He was adopted. He doesn't need to know. 502 00:34:05,477 --> 00:34:07,561 - I do. - Adoption makes us just as much- 503 00:34:07,562 --> 00:34:11,983 Listen. When we were taking his medical history, were you confused? 504 00:34:11,984 --> 00:34:14,819 Did you think we were looking for a genetic clue to his condition, 505 00:34:14,820 --> 00:34:18,990 or did you think we were trying to ascertain who loves him the most in the whole wide world? 506 00:34:18,991 --> 00:34:21,201 How did you find out about this? 507 00:34:21,202 --> 00:34:24,663 - I sampled their D.N.A. - We didn't give you any D.N.A. 508 00:34:24,664 --> 00:34:27,166 Your coffee cups from the cafeteria. 509 00:34:27,167 --> 00:34:31,170 - You can't do that. - Again, why are we getting hung up on what I did? 510 00:34:31,171 --> 00:34:37,093 - Your medical history is useless. - No. We gave you a detailed history of his biological mother. 511 00:34:37,094 --> 00:34:40,346 Her history. Nonsmoker, good health, 512 00:34:40,347 --> 00:34:42,932 low cholesterol, no blood pressure problems. 513 00:34:42,933 --> 00:34:45,143 Dan was adopted two weeks after he was born. 514 00:34:45,144 --> 00:34:49,523 - You have his history. There's nothing you need to know that we didn't tell you. - Sounds reasonable. 515 00:34:49,524 --> 00:34:52,693 Well, if you want to transfer your boy, that is your choice. 516 00:34:52,694 --> 00:34:57,490 I still think it's the wrong- Was she vaccinated? 517 00:34:57,491 --> 00:35:00,535 The biological mother. When she was a baby, did she get her vaccinations? 518 00:35:00,536 --> 00:35:03,580 Dan was vaccinated. At six months. 519 00:35:03,581 --> 00:35:07,375 Mm-hmm. Do you know why kids get vaccinated at six months? 520 00:35:07,376 --> 00:35:10,045 Because before that they are protected... 521 00:35:10,046 --> 00:35:12,714 by their biological mother's immune system. 522 00:35:12,715 --> 00:35:16,075 So, was she vaccinated? 523 00:35:19,264 --> 00:35:22,099 An infant picks up a regular old measles virus. 524 00:35:22,100 --> 00:35:24,020 Gets a rash. 525 00:35:24,103 --> 00:35:27,814 He's extremely uncomfortable, has a wicked fever, but he lives. 526 00:35:27,815 --> 00:35:31,735 Here's the kicker. Once every million or so times, 527 00:35:31,736 --> 00:35:34,112 the virus mutates. 528 00:35:34,113 --> 00:35:36,740 Instead of Dan having a fever and a rash, 529 00:35:36,741 --> 00:35:39,451 the virus travels to his brain and hides, 530 00:35:39,452 --> 00:35:41,454 like a time bomb. 531 00:35:41,455 --> 00:35:43,914 In this case, for 16 years. 532 00:35:43,915 --> 00:35:47,877 Subacute sclerosing panencephalitis. 533 00:35:47,878 --> 00:35:51,423 I know. There's only been 20 cases in the United States in the last 30 years. 534 00:35:51,424 --> 00:35:54,801 I suppose you could make an argument the kid's still in stage I. 535 00:35:54,802 --> 00:35:57,012 Once S.S.P.E. moves to stage II, it's- 536 00:35:57,013 --> 00:36:00,224 Boom. Stage II is universally fatal. 537 00:36:00,225 --> 00:36:03,269 I assume its impossible to know when he might move into stage II. 538 00:36:03,270 --> 00:36:07,523 He's already started showing symptoms. Could be a month. Could be tonight. 539 00:36:07,524 --> 00:36:09,817 Can we treat it? Ask the neurologist. 540 00:36:09,818 --> 00:36:11,986 Intraventricular interferon. 541 00:36:11,987 --> 00:36:15,949 Not gonna shove a spike into his brain and drip interferon without confirming this diagnosis. 542 00:36:15,950 --> 00:36:19,786 - Tap him. - We won't get a reliable result for measles antibodies in his C.S.F. 543 00:36:19,787 --> 00:36:21,788 Not after everything we've given him. 544 00:36:21,789 --> 00:36:24,625 So the wrong treatment kills any hope of the right diagnosis. 545 00:36:24,626 --> 00:36:27,461 Why do people lie to me? 546 00:36:27,462 --> 00:36:29,463 Could also kill him. 547 00:36:29,464 --> 00:36:35,470 Your ball, Foreman. Tell me I don't have to biopsy his brain. 548 00:36:35,471 --> 00:36:39,140 Well, there is one other way. 549 00:36:39,141 --> 00:36:41,226 You sure this isn't gonna hurt? 550 00:36:41,227 --> 00:36:43,311 Yeah. It's just scary as hell. 551 00:36:43,312 --> 00:36:45,480 See, we go through the pupil. 552 00:36:45,481 --> 00:36:47,816 But you won't feel it. The eye's been paralyzed. 553 00:36:47,817 --> 00:36:50,194 The needle travels to the back of the eye, 554 00:36:50,195 --> 00:36:58,355 which is where we'll perform the biopsy on your retina. 555 00:36:58,412 --> 00:37:01,498 So we've confirmed that the problem is this mutated virus. 556 00:37:01,499 --> 00:37:05,377 The treatment for S.S.P.E. is intraventricular interferon. 557 00:37:05,378 --> 00:37:08,171 We implant an ommaya reservoir under the scalp, 558 00:37:08,172 --> 00:37:10,507 which is connected to a ventricular catheter... 559 00:37:10,508 --> 00:37:13,135 that delivers the antiviral directly to the left hemisphere. 560 00:37:13,136 --> 00:37:17,014 You want us to consent to this? I don't even understand what you're talking about. 561 00:37:17,015 --> 00:37:20,015 Well, the antiviral- 562 00:37:21,854 --> 00:37:23,855 Look. I'm sorry. 563 00:37:23,856 --> 00:37:28,318 I can explain this as best I can, but the notion that you're gonna fully understand your son's treatment... 564 00:37:28,319 --> 00:37:34,199 and make an informed decision is- is kind of insane. 565 00:37:34,200 --> 00:37:37,453 Here's what you need to know. 566 00:37:37,454 --> 00:37:39,497 It's dangerous. 567 00:37:39,498 --> 00:37:41,791 It could kill him. 568 00:37:41,792 --> 00:37:44,432 You should do it. 569 00:37:54,889 --> 00:37:58,969 Did you need something else? 570 00:38:15,745 --> 00:38:18,914 You can't order a $3,200 D.N.A. test to win a bet. 571 00:38:18,915 --> 00:38:21,166 It's not an actual cost. 572 00:38:21,167 --> 00:38:25,087 I don't know if you know this, but the hospital actually owns the sequencing machine. 573 00:38:25,088 --> 00:38:27,757 - I'm serious. - Tell the parents to submit the bill to insurance. 574 00:38:27,758 --> 00:38:29,675 Insurance is not gonna pay for a bet. 575 00:38:29,676 --> 00:38:34,097 Should. We don't make that bet, the kid dies. 576 00:38:34,098 --> 00:38:37,058 If not for the paternity bet, I never would have taken their D.N.A. 577 00:38:37,059 --> 00:38:41,939 Without their D.N.A., we never would have discovered that Dan was adopted, which was the key to this case. 578 00:38:41,940 --> 00:38:43,941 You just don't want to pay your end. 579 00:38:43,942 --> 00:38:46,944 Big mistake. My guy knows a guy. 580 00:38:46,945 --> 00:38:50,698 Fine. I will let you out of clinic duty for one week, 581 00:38:50,699 --> 00:38:57,659 after you pay the 3,200 for the P.C.R. test. 582 00:39:01,460 --> 00:39:02,180 Ooh. 583 00:39:03,087 --> 00:39:07,633 Well, now, there's the hundred you owe me. 584 00:39:07,634 --> 00:39:09,635 Here's a hundred I won from Cameron. 585 00:39:09,636 --> 00:39:13,556 200 I took off of Foreman. 586 00:39:13,557 --> 00:39:15,117 And 600... 587 00:39:16,101 --> 00:39:18,861 I got from Wilson. 588 00:39:19,813 --> 00:39:21,613 Very bitter. 589 00:39:25,319 --> 00:39:27,404 Hey. Good morning. 590 00:39:27,405 --> 00:39:30,240 Good news on your E.E.G. Treatment is working. 591 00:39:30,241 --> 00:39:32,409 And your immune system is responding. 592 00:39:32,410 --> 00:39:37,164 I know it's early, but I just want to take a look. 593 00:39:37,165 --> 00:39:41,127 All right. Let's see what that brain of yours can do. 594 00:39:41,128 --> 00:39:44,672 Name as many animals as you can that start with the letter "O". 595 00:39:44,673 --> 00:39:45,873 Ostrich. 596 00:39:47,510 --> 00:39:50,030 Ox. Old elephant. 597 00:39:50,346 --> 00:39:54,224 Well, that's two better than last time. 598 00:39:54,225 --> 00:39:56,852 How you doing with the whole adoption thing? 599 00:39:56,853 --> 00:39:59,689 - I knew since fifth grade. - How's that? 600 00:39:59,690 --> 00:40:01,370 Cleft chin. 601 00:40:02,693 --> 00:40:05,361 I have one. My dad doesn't. 602 00:40:05,362 --> 00:40:10,075 Looked it up on the Internet. It's one of those trait things. 603 00:40:10,076 --> 00:40:13,578 That's right. It's autosomal dominant. 604 00:40:13,579 --> 00:40:19,376 Since neither of your parents have cleft chins, it's highly unlikely you're biologically related. 605 00:40:19,377 --> 00:40:25,049 - Are you sure you're okay? - I've got no problems with being adopted. 606 00:40:25,050 --> 00:40:27,810 I love my parents. 607 00:40:30,389 --> 00:40:32,891 How's he doing? He's doing pretty well. 608 00:40:32,892 --> 00:40:34,517 He's a smart kid. 609 00:40:34,518 --> 00:40:38,718 I think he's gonna be fine. 610 00:40:40,233 --> 00:40:42,633 - Hey. - Thanks. 611 00:41:17,940 --> 00:41:20,700 Wheels, 18. Wheels.