1 00:00:02,409 --> 00:00:05,703 squeezing or contracting over 60 times each minute. 2 00:00:05,829 --> 00:00:07,413 That's 3,600... 3 00:00:07,539 --> 00:00:10,667 At this point, your blood is a deep purple 4 00:00:10,793 --> 00:00:13,670 because it's just finished dropping off oxygen 5 00:00:13,796 --> 00:00:15,296 for all the parts of your body. 6 00:00:17,675 --> 00:00:19,384 Come on, follow me. 7 00:00:22,012 --> 00:00:23,179 Come on. 8 00:00:26,767 --> 00:00:27,892 Ian. 9 00:00:28,018 --> 00:00:30,269 I have a question and I need to go to the bathroom. 10 00:00:30,396 --> 00:00:31,979 Which would you like to do first? 11 00:00:32,815 --> 00:00:33,648 The question. 12 00:00:33,774 --> 00:00:36,067 - Okay. - Where's the bathroom? 13 00:00:37,236 --> 00:00:38,820 Who knows where the bathroom is? 14 00:00:38,946 --> 00:00:39,946 I do. 15 00:00:40,072 --> 00:00:41,614 Go with Ian to the bathroom. 16 00:00:41,740 --> 00:00:42,740 I don't have to go. 17 00:00:42,866 --> 00:00:45,368 We're not at school, nobody goes anywhere by themselves. 18 00:00:45,494 --> 00:00:47,286 - Why? - In case you get lost. 19 00:00:47,413 --> 00:00:48,996 Or in case somebody kidnaps us. 20 00:00:49,123 --> 00:00:51,499 If somebody kidnaps Ian, they'll kidnap me, too. 21 00:00:51,625 --> 00:00:52,825 I want to stay with the class. 22 00:00:52,918 --> 00:00:54,252 Michael, go with Ian... 23 00:00:55,504 --> 00:00:56,546 Do you need help? 24 00:00:56,672 --> 00:00:57,872 I need you to find a grown-up. 25 00:00:57,965 --> 00:00:58,923 Is the baby coming? 26 00:01:00,134 --> 00:01:02,218 - Who should I take with me? - You're fine. 27 00:01:02,344 --> 00:01:05,054 Go to the front desk or find a security guard. 28 00:01:05,180 --> 00:01:06,931 I really have to pee. 29 00:01:08,934 --> 00:01:10,309 Oh, God. 30 00:01:10,686 --> 00:01:13,813 Is the baby coming? I don't know how to do this. 31 00:01:14,106 --> 00:01:15,773 Are you okay, Ian? 32 00:01:15,899 --> 00:01:17,150 Yeah. Sure. 33 00:01:19,987 --> 00:01:21,779 I don't think you are. 34 00:01:24,825 --> 00:01:26,325 You're bleeding. 35 00:01:29,329 --> 00:01:30,538 Help! 36 00:01:31,039 --> 00:01:32,206 Help! 37 00:02:29,264 --> 00:02:30,932 - $20. - Call. 38 00:02:31,809 --> 00:02:33,267 You'll call anything. 39 00:02:33,393 --> 00:02:35,561 My stack is bigger than your stack. 40 00:02:36,814 --> 00:02:37,814 You in or out? 41 00:02:37,940 --> 00:02:39,774 You know that relative to their size, 42 00:02:39,900 --> 00:02:42,819 gorillas have smaller testicles than humans. 43 00:02:43,529 --> 00:02:46,906 Well, then you'd probably have an edge over a gorilla, but not over me. 44 00:02:47,032 --> 00:02:49,784 Reason is, primate testes' size 45 00:02:49,910 --> 00:02:52,995 inversely corresponds to the fidelity of our females. 46 00:02:54,540 --> 00:02:57,291 You think there might be a better time to annoy me about my wife? 47 00:02:57,417 --> 00:02:58,778 - I'm talking about poker. - Right. 48 00:02:58,877 --> 00:03:00,962 Women are evil, you're right to drive them away. 49 00:03:01,088 --> 00:03:03,297 Call, fold or raise. Story time can wait. 50 00:03:03,423 --> 00:03:05,967 We're smaller and better than chimps, 51 00:03:06,677 --> 00:03:08,553 bigger and worse than gorillas. 52 00:03:08,679 --> 00:03:10,012 For all our rationality, 53 00:03:10,138 --> 00:03:13,391 our supposed trust and fealty to a higher power, 54 00:03:13,517 --> 00:03:17,270 our ability to create a system of rules and laws, 55 00:03:17,563 --> 00:03:20,731 our baser drives are more powerful than any of that. 56 00:03:20,858 --> 00:03:23,860 We want to control our emotions, but we can't. 57 00:03:24,570 --> 00:03:27,113 If we're happy, things don't annoy us. 58 00:03:27,698 --> 00:03:30,908 If, on the other hand, we're sitting on crappy hole cards, 59 00:03:31,034 --> 00:03:34,036 little tiny things annoy us a whole lot more. 60 00:03:38,876 --> 00:03:39,750 I raise. 61 00:03:39,877 --> 00:03:42,357 So, are you gonna tell me an annoying story every time I raise? 62 00:03:42,421 --> 00:03:44,589 God, that would be annoying. 63 00:03:45,215 --> 00:03:46,465 I call. 64 00:03:46,884 --> 00:03:49,135 Dr. Cuddy, I got one of your patients in the ER. 65 00:03:49,261 --> 00:03:50,928 Ian Alston, six-years-old. 66 00:03:51,388 --> 00:03:53,806 Oh, I know him. What's the problem? I'm all in. 67 00:03:53,932 --> 00:03:55,725 Bloody diarrhea. Hemodynamically stable, 68 00:03:55,851 --> 00:03:57,935 but he's been developing some coordination problems. 69 00:03:58,061 --> 00:04:00,021 It sounds like gastroenteritis and dehydration. 70 00:04:00,147 --> 00:04:02,273 Order fluids and I'll take it on my service. 71 00:04:02,399 --> 00:04:03,524 Bet's to you, House. 72 00:04:03,650 --> 00:04:05,610 - They scan his head? - No, why would they scan... 73 00:04:05,652 --> 00:04:07,445 Don't play games. You gonna call? 74 00:04:07,571 --> 00:04:09,614 - How's the heart rate? - Stable. 75 00:04:09,740 --> 00:04:14,160 I'm sorry. House, it's gastroenteritis. I'm not going anywhere. 76 00:04:14,286 --> 00:04:15,369 Put the order in, 77 00:04:15,495 --> 00:04:18,998 and have someone tell Alan and Sarah that I'll be up when I'm done. 78 00:04:19,875 --> 00:04:21,250 You in or out? 79 00:04:25,255 --> 00:04:26,547 I'm out. 80 00:04:30,969 --> 00:04:32,345 Stone cold bluff. 81 00:04:32,471 --> 00:04:36,223 You might want to spend a little more time paying attention to your cards 82 00:04:36,350 --> 00:04:39,101 and a little less time staring at my breasts. 83 00:04:39,227 --> 00:04:40,853 They don't match either. 84 00:04:40,979 --> 00:04:42,939 I'm gonna take some air. 85 00:05:02,918 --> 00:05:04,919 Follow my finger with your eyes. 86 00:05:11,385 --> 00:05:13,386 How much longer will Dr. Cuddy be? 87 00:05:13,512 --> 00:05:16,430 Well, given the number of Mojitos she's knocking back at the party, 88 00:05:16,556 --> 00:05:20,559 I'd say it's gonna be at least three hours before she's even conscious. 89 00:05:20,686 --> 00:05:22,353 Weren't you at the same party? 90 00:05:22,479 --> 00:05:23,813 I don't drink. 91 00:05:26,149 --> 00:05:29,110 I want you to reach out and grab my cane. 92 00:05:34,616 --> 00:05:35,700 What's wrong? 93 00:05:35,826 --> 00:05:39,036 Your son's brain is losing control of his muscles. 94 00:05:39,162 --> 00:05:42,540 Dr. Cuddy's message said it was just dehydration from diarrhea. 95 00:05:42,666 --> 00:05:44,166 She's wrong. 96 00:05:45,794 --> 00:05:47,670 Is he gonna be all right? 97 00:05:50,757 --> 00:05:52,091 I don't know. 98 00:06:21,038 --> 00:06:23,414 So, were you in one of those cages? 99 00:06:23,999 --> 00:06:28,210 No. No, no, no, no. No, those are for tourists. 100 00:06:28,879 --> 00:06:30,838 You were in the water with the great white? 101 00:06:30,964 --> 00:06:34,925 Sure, it's no big deal. You just have to keep an eye on them. 102 00:06:35,052 --> 00:06:38,054 If they get too close, punch them in the nose. 103 00:06:38,305 --> 00:06:40,181 Send them on their way. 104 00:06:41,808 --> 00:06:43,017 I had you going. 105 00:06:43,143 --> 00:06:44,185 You are mean. 106 00:06:44,895 --> 00:06:47,146 Hey. How's that anal fissure? 107 00:06:47,981 --> 00:06:50,107 Did it heal yet? Or is it still draining? 108 00:06:50,233 --> 00:06:51,567 Oh, I'm sorry. 109 00:06:51,693 --> 00:06:53,453 I didn't realize you'd come back for seconds. 110 00:06:53,487 --> 00:06:56,487 I figured that after that girl in the stairwell you'd be done for the night. 111 00:06:56,531 --> 00:06:57,531 He's joking. 112 00:06:57,657 --> 00:06:59,450 No Adam's apple, small hands. 113 00:06:59,576 --> 00:07:01,452 It's no surprises this time. 114 00:07:02,454 --> 00:07:04,163 I'll see you later. 115 00:07:07,042 --> 00:07:08,000 Got a case. 116 00:07:08,126 --> 00:07:09,487 Well, you could've just said that. 117 00:07:09,586 --> 00:07:10,907 You didn't have to screw with me. 118 00:07:10,962 --> 00:07:12,043 If I didn't screw with you, 119 00:07:12,089 --> 00:07:14,290 you'd spent the whole night thinking you might get laid, 120 00:07:14,341 --> 00:07:16,884 which means you'd be useless. Better to extinguish all hope. 121 00:07:17,010 --> 00:07:20,137 Get Foreman and Cameron and meet me upstairs. Stat. 122 00:07:25,310 --> 00:07:26,644 What's so urgent? 123 00:07:26,770 --> 00:07:29,897 Two cases, same symptoms. 124 00:07:30,232 --> 00:07:33,275 What do six-year-olds and 70-year-olds have in common? 125 00:07:33,401 --> 00:07:34,985 Their immune systems don't work as well. 126 00:07:35,112 --> 00:07:37,113 - Could be listeria. - I already checked for that. 127 00:07:37,239 --> 00:07:39,949 Leukemia has a higher prevalence in both young and old. 128 00:07:40,075 --> 00:07:42,451 - So does asthma. - No, no, no. 129 00:07:42,577 --> 00:07:43,994 They can both get diabetes. 130 00:07:44,121 --> 00:07:45,287 No! 131 00:07:47,999 --> 00:07:49,917 The nearly dead and the newly bred 132 00:07:50,043 --> 00:07:53,212 have more in common with each other than with people in the middle. 133 00:07:53,338 --> 00:07:56,590 It's weird. It's kind of a circle of life thing. 134 00:07:56,716 --> 00:07:59,260 - This kid doesn't have kidney failure. - He will. 135 00:07:59,386 --> 00:08:02,138 Based on this file, the kid just ate some bad food. 136 00:08:02,264 --> 00:08:03,305 Was the old man... 137 00:08:03,431 --> 00:08:07,393 They were nowhere near each other in any of the four dimensions. 138 00:08:07,769 --> 00:08:09,562 - This case is 12 years old. - Yep. 139 00:08:09,688 --> 00:08:11,647 And this case is Cuddy's. 140 00:08:11,773 --> 00:08:13,023 She assigned it to me. 141 00:08:13,150 --> 00:08:16,861 She agrees with you that this is something more than gastroenteritis? 142 00:08:16,987 --> 00:08:19,697 She wouldn't have assigned it to me if she didn't, would she? 143 00:08:27,497 --> 00:08:29,248 What were we talking about? 144 00:08:29,374 --> 00:08:31,625 Two patients with two symptoms in common. 145 00:08:31,751 --> 00:08:34,086 And five symptoms not in common. 146 00:08:34,212 --> 00:08:37,006 While you were all wearing your "Frankie Says Relax" t-shirts, 147 00:08:37,132 --> 00:08:39,175 I was treating a 73-year-old woman 148 00:08:39,301 --> 00:08:41,385 who went through this progression of symptoms. 149 00:08:41,511 --> 00:08:43,512 The last of which was... 150 00:08:46,808 --> 00:08:49,101 And in case any of you missed that class in med school, 151 00:08:49,227 --> 00:08:50,936 that one's untreatable. 152 00:08:51,062 --> 00:08:52,479 Kid's got the first two. 153 00:08:52,606 --> 00:08:56,192 It took Ester an hour and 20 minutes to go from two to three. 154 00:08:56,318 --> 00:08:58,485 And less than a day to make it all the way to the rear exit. 155 00:08:58,612 --> 00:09:02,323 This is all because a child has some blood in his diarrhea? 156 00:09:02,532 --> 00:09:03,449 He's got a tummy ache. 157 00:09:03,575 --> 00:09:05,736 If there was any reason to think it was anything worse, 158 00:09:05,785 --> 00:09:07,036 Cuddy would be all over it. 159 00:09:07,162 --> 00:09:08,537 Great. Do a colonoscopy. 160 00:09:08,663 --> 00:09:11,743 On a six-year-old kid who probably has nothing worse than some food poisoning? 161 00:09:11,833 --> 00:09:13,959 And if you happen to find any purple papules, 162 00:09:14,085 --> 00:09:15,628 do me a favor and grab a slice. 163 00:09:15,754 --> 00:09:17,755 I wanna check for Erdheim-Chester. 164 00:09:17,881 --> 00:09:22,301 A disease that there have been, what, maybe 200 reported cases of ever? 165 00:09:22,427 --> 00:09:26,805 If Ester's family had let me do an autopsy, there'd be 201. 166 00:09:39,736 --> 00:09:41,237 See anything? 167 00:09:41,363 --> 00:09:43,405 No, and I don't expect to. 168 00:09:44,741 --> 00:09:46,575 House usually avoids cases. 169 00:09:46,701 --> 00:09:49,995 If he's actually stealing a case from Cuddy, there's gotta be a reason. 170 00:09:50,121 --> 00:09:53,040 It's not the first time I've seen this file. 171 00:09:53,500 --> 00:09:55,417 About a month before Cameron was hired, 172 00:09:55,543 --> 00:09:57,544 some trucker came in here with these symptoms. 173 00:09:57,671 --> 00:09:59,421 House decided he was dying. 174 00:09:59,547 --> 00:10:01,257 Two days and a spinal tap, 175 00:10:01,383 --> 00:10:03,592 bone marrow extraction, and three colonoscopies later, 176 00:10:03,718 --> 00:10:05,928 we send the guy home with a bunch of painkillers 177 00:10:06,054 --> 00:10:08,806 and a diagnosis of a bad cheese sandwich. 178 00:10:09,599 --> 00:10:11,200 One of the guys who worked here before me 179 00:10:11,226 --> 00:10:14,853 said House tried to cure Ester at least three other times. 180 00:10:15,605 --> 00:10:19,400 You know how people see the Virgin Mary in danishes and stuff? 181 00:10:20,277 --> 00:10:23,320 Someone died 12 years ago and House doesn't know why. 182 00:10:23,446 --> 00:10:26,699 House sees that case now in paint peeling, 183 00:10:27,784 --> 00:10:30,202 in clouds, and now in this poor kid. 184 00:10:30,495 --> 00:10:33,831 Erdheim-Chester is an abnormal growth of some of the cells that fight infection. 185 00:10:33,957 --> 00:10:36,250 Is that cancer? Cos he seems okay now. 186 00:10:36,376 --> 00:10:38,669 The other doctor kind of scared us about that. 187 00:10:38,795 --> 00:10:41,547 He shouldn't have. We're just testing. It'll probably be negative. 188 00:10:41,673 --> 00:10:42,548 I don't understand. 189 00:10:42,674 --> 00:10:45,754 You don't think that's what it is but you want to do this thing to him anyway? 190 00:10:45,802 --> 00:10:48,137 - We need to be sure. - Isn't there any other way? 191 00:10:48,263 --> 00:10:50,139 It shouldn't take long. 192 00:10:50,807 --> 00:10:52,016 All right. 193 00:10:52,142 --> 00:10:55,102 Those ridges look a lot like purple papules. 194 00:10:55,228 --> 00:10:58,647 They're not purple. They're red. Probably just blood blisters. 195 00:11:00,775 --> 00:11:02,651 Give me the biopsy needle. 196 00:11:13,038 --> 00:11:15,205 - How long is this gonna take? - Forget it, Chase. 197 00:11:15,332 --> 00:11:19,418 Your punching out the shark story's good, but she's not waiting for you. 198 00:11:19,544 --> 00:11:20,586 So? 199 00:11:20,712 --> 00:11:22,553 We couldn't confirm the source of the bleeding, 200 00:11:22,672 --> 00:11:23,881 but we did biopsy some... 201 00:11:24,007 --> 00:11:26,633 - Blood blisters. - You mean papules. 202 00:11:26,760 --> 00:11:28,635 Come on, Cameron. Who's right? 203 00:11:30,555 --> 00:11:33,182 Chase is. Negative for Erdheim-Chester. 204 00:11:33,308 --> 00:11:34,767 Let me see. 205 00:11:42,484 --> 00:11:44,109 If it's not Erdheim-Chester... 206 00:11:44,235 --> 00:11:47,863 It's exactly what we said before, a garden-variety viral gastroenteritis. 207 00:11:47,989 --> 00:11:49,198 Can we go back to the party? 208 00:11:49,324 --> 00:11:51,241 Do a kidney biopsy. 209 00:11:52,077 --> 00:11:53,952 Ester's shut down in exactly... 210 00:11:54,079 --> 00:11:55,371 This kid is not Ester. 211 00:11:55,497 --> 00:11:57,206 You screwed up. She died. I'm sorry. 212 00:11:57,332 --> 00:11:59,458 But that does not mean this kid is dying as well. 213 00:11:59,584 --> 00:12:03,754 Jeez, you're testy when you don't get any fuzz. Come on. 214 00:12:18,478 --> 00:12:19,520 What'd the test say? 215 00:12:19,646 --> 00:12:21,021 Colonoscopy was clean. 216 00:12:21,147 --> 00:12:23,690 And the biopsy was negative for Erdheim-Chester. 217 00:12:23,817 --> 00:12:27,194 So Ian's going to be all right? It was just some sort of virus. 218 00:12:27,570 --> 00:12:28,779 What's that? 219 00:12:29,489 --> 00:12:30,614 Urine. 220 00:12:30,740 --> 00:12:32,449 Yeah, but it's brown. 221 00:12:33,660 --> 00:12:35,494 Ian's kidneys are shutting down. 222 00:12:35,620 --> 00:12:38,038 Still think it's not the same case? 223 00:12:54,180 --> 00:12:56,974 So, what can cause bloody diarrhea, 224 00:12:57,100 --> 00:12:59,852 ataxia and kidney failure? 225 00:12:59,978 --> 00:13:02,104 - I'll go do a biopsy. - Forget it! 226 00:13:02,230 --> 00:13:03,689 That battle's over. 227 00:13:03,815 --> 00:13:06,066 His rising creatinine is his kidneys' way of saying, 228 00:13:06,192 --> 00:13:07,901 "Go on without me." 229 00:13:08,695 --> 00:13:10,904 What explains everything? 230 00:13:12,615 --> 00:13:15,909 E. Coli HO-157 causes bloody diarrhea 231 00:13:16,035 --> 00:13:17,953 and leads to Hemolytic-uremic Syndrome. 232 00:13:18,079 --> 00:13:20,747 Toxins from the bacteria cause his kidneys to shut down. 233 00:13:20,874 --> 00:13:22,416 We should start him on plasmapheresis. 234 00:13:22,542 --> 00:13:25,794 Clear, concise and completely plausible. 235 00:13:25,920 --> 00:13:29,089 And exactly what I did last time. Didn't work. 236 00:13:29,340 --> 00:13:31,467 - What else? - Goodpasture's Syndrome. 237 00:13:31,593 --> 00:13:33,886 Circulating antibodies cause kidney failure and bleeding. 238 00:13:34,012 --> 00:13:35,846 But not the purple papules. 239 00:13:35,972 --> 00:13:37,681 If you throw in Ester's next symptom, 240 00:13:37,807 --> 00:13:39,600 brain, makes me think heavy metal toxicity. 241 00:13:39,726 --> 00:13:42,144 His hematocrit would have to be low. It's at 44, 242 00:13:42,270 --> 00:13:43,687 and Ester's never dropped below... 243 00:13:43,813 --> 00:13:45,731 - 42. - You have the file memorized? 244 00:13:45,857 --> 00:13:47,524 It's my lucky number. 245 00:13:47,650 --> 00:13:48,734 What about lymphoma? 246 00:13:48,860 --> 00:13:53,489 Causes kidney failure, GI bleed, and can infiltrate the base of the brain. 247 00:13:54,866 --> 00:13:55,991 You check Ester for that? 248 00:13:56,117 --> 00:13:58,535 She never showed any signs of... 249 00:13:59,954 --> 00:14:01,788 If he has lymphoma this far advanced, 250 00:14:01,915 --> 00:14:04,041 we should be able to see it in his blood and brain. 251 00:14:04,167 --> 00:14:06,793 Chase, run a blood smear and immunochemistries. 252 00:14:06,920 --> 00:14:08,879 Foreman, get an MRI. 253 00:14:09,297 --> 00:14:11,673 - I'll page Cuddy. - No, you won't. 254 00:14:11,799 --> 00:14:13,279 She thinks the kid has a stomachache. 255 00:14:13,343 --> 00:14:15,385 Then she'll come right up here and do one of two things. 256 00:14:15,512 --> 00:14:18,305 If she agrees with me, I don't need her. If she disagrees, I don't want her. 257 00:14:18,431 --> 00:14:20,098 Can't handle people disagreeing with you? 258 00:14:20,225 --> 00:14:21,826 She might have a different take on this. 259 00:14:21,851 --> 00:14:25,187 Subordinates can disagree with me all they want. It's healthy. 260 00:14:25,313 --> 00:14:27,940 People who can shut me down on the other hand... 261 00:14:28,066 --> 00:14:30,734 Forget Cuddy. I'll have Wilson keep her busy. 262 00:14:38,576 --> 00:14:41,870 Keep your answers short and discreet. Is Cuddy still playing? 263 00:14:42,956 --> 00:14:45,874 The chicken is still in Piccadilly Square. 264 00:14:46,000 --> 00:14:48,877 Brilliant. She'll never suspect that Normandy is our target. 265 00:14:49,003 --> 00:14:50,379 Is that House? 266 00:14:50,547 --> 00:14:53,799 Tell him that the blinds just went to 20-40 and he's running out of chips. 267 00:14:53,925 --> 00:14:56,176 - How's she doing? - What's going on? 268 00:14:56,302 --> 00:14:58,103 The way you took off, something's obviously... 269 00:14:58,221 --> 00:15:01,181 Love to chat but got a game to play. How's she doing? 270 00:15:01,599 --> 00:15:03,999 The patient is on life support. We're about to pull the plug. 271 00:15:04,018 --> 00:15:05,018 Are you talking about me? 272 00:15:05,144 --> 00:15:06,603 What've you got? 273 00:15:06,896 --> 00:15:09,690 Those sounds like high-dose cardio meds. 274 00:15:09,816 --> 00:15:11,567 Two hearts. 275 00:15:11,693 --> 00:15:12,651 You got the flush? 276 00:15:12,777 --> 00:15:14,152 Still waiting on the final labs. 277 00:15:14,279 --> 00:15:16,071 Is she drinking her seltzer? 278 00:15:16,573 --> 00:15:19,116 No, hydration is not a problem. 279 00:15:19,242 --> 00:15:21,702 She's bluffing. Push her all in. 280 00:15:24,289 --> 00:15:25,455 Call. 281 00:15:25,915 --> 00:15:28,875 Two pair. Show me your hearts. 282 00:15:33,923 --> 00:15:35,299 Seven of clubs. 283 00:15:36,009 --> 00:15:38,176 Oh, dear. Sounds like I messed up. 284 00:15:38,303 --> 00:15:40,804 You're gonna be stuck with her for a while. 285 00:15:40,930 --> 00:15:42,139 Talk to you soon. 286 00:15:43,433 --> 00:15:45,350 Oh, yes! 287 00:16:00,074 --> 00:16:02,034 Why are you taking a picture of his head? 288 00:16:02,160 --> 00:16:04,036 We're looking for lymphoma, but... 289 00:16:04,162 --> 00:16:07,789 So, it's not Erdheim-something and it's not his kidneys, 290 00:16:07,915 --> 00:16:09,541 but his kidneys are failing. 291 00:16:09,667 --> 00:16:10,834 Where's Dr. Cuddy? 292 00:16:10,960 --> 00:16:12,294 Dr. House mentioned another case. 293 00:16:12,420 --> 00:16:14,963 Is there another patient with the same thing that Ian has? 294 00:16:15,089 --> 00:16:17,299 - Not exactly. - What does that mean? 295 00:16:17,425 --> 00:16:19,551 Dr. House had a patient a while back 296 00:16:19,677 --> 00:16:21,845 who exhibited the same symptoms as your son. 297 00:16:21,971 --> 00:16:25,057 - Then you know what's wrong? - No. 298 00:16:25,183 --> 00:16:26,600 So what do you know? 299 00:16:26,726 --> 00:16:29,436 We know the likely course the disease will take. 300 00:16:29,562 --> 00:16:30,562 Which is? 301 00:16:30,688 --> 00:16:32,564 She had multiple system failures affecting... 302 00:16:32,690 --> 00:16:34,149 What happened to her? 303 00:16:38,071 --> 00:16:41,073 She died 24 hours after her admission. 304 00:16:48,206 --> 00:16:51,333 Mr. Or Mrs. Alston, would you mind giving me a hand? 305 00:16:53,461 --> 00:16:55,712 He's having trouble sitting still. 306 00:16:55,838 --> 00:16:57,923 It's impossible to get the detail we need. 307 00:16:58,049 --> 00:17:02,135 So I figured he might feel more comfortable hearing your voices. 308 00:17:07,100 --> 00:17:08,308 Ian, honey. 309 00:17:09,977 --> 00:17:14,189 Just sit still. They'll be done in a moment. We're here with you. 310 00:17:14,315 --> 00:17:15,774 I'm scared. 311 00:17:17,276 --> 00:17:19,027 It's okay, honey. It's... 312 00:17:19,153 --> 00:17:23,073 It's only a big camera. It's gonna take a picture of your head. 313 00:17:24,158 --> 00:17:26,827 You love it when I take your picture at home, don't you? 314 00:17:26,953 --> 00:17:28,078 Yeah. 315 00:17:29,080 --> 00:17:32,165 And you have to hold still for that, too, right? 316 00:17:32,458 --> 00:17:34,459 But this isn't like that. 317 00:17:36,713 --> 00:17:40,173 I know it's scary, Ian, but you can do it. 318 00:17:41,551 --> 00:17:43,969 You're getting to be so grown-up. 319 00:17:46,264 --> 00:17:51,184 So just hold perfectly still, just for a little bit. 320 00:17:51,853 --> 00:17:54,187 Mommy, are you crying? 321 00:17:55,189 --> 00:17:58,984 No. No, honey, I'm just tired. 322 00:18:00,486 --> 00:18:02,654 Okay. I'll try. 323 00:18:31,893 --> 00:18:34,978 The base of his brain's been infiltrated by a small mass. We think... 324 00:18:35,104 --> 00:18:36,897 - Pituitary? - Looks that way. 325 00:18:37,023 --> 00:18:39,191 Explains the low blood pressure. 326 00:18:41,110 --> 00:18:43,653 And pretty much confirms the lymphoma. 327 00:18:48,409 --> 00:18:50,619 If we'd started Ester on prednisone... 328 00:18:50,745 --> 00:18:53,163 Did anyone see the lymphoma? 329 00:18:53,289 --> 00:18:55,957 No, we saw a mass. The location is consistent with... 330 00:18:56,083 --> 00:18:58,001 Didn't see any in the blood either. 331 00:18:58,127 --> 00:19:01,213 White blood cells show no spindling or abnormal nuclei. 332 00:19:01,339 --> 00:19:04,758 Nothing on immunochemistries either. It's not lymphoma. 333 00:19:37,166 --> 00:19:38,542 House! 334 00:19:40,294 --> 00:19:41,628 It's a train. 335 00:19:42,630 --> 00:19:44,965 - We don't know what kind of train... - Whoa. Whoa. Whoa. 336 00:19:45,091 --> 00:19:47,133 - I'm thirsty. - It's closed. 337 00:19:51,264 --> 00:19:52,639 It's not now. 338 00:19:59,313 --> 00:20:02,315 We got one advantage. We know where the tracks are going. 339 00:20:02,441 --> 00:20:06,152 The fact that the end of the line is death is an advantage? 340 00:20:06,279 --> 00:20:08,613 The fact that we know is an advantage. 341 00:20:08,739 --> 00:20:11,074 It means maybe we can get ahead of it. 342 00:20:11,701 --> 00:20:13,118 Next station is the liver. 343 00:20:13,244 --> 00:20:15,745 We got about 90 minutes before it gets there. 344 00:20:15,872 --> 00:20:19,165 Maybe we can cut down a tree across the line just outside of town. 345 00:20:19,292 --> 00:20:20,292 I'll do an ultrasound. 346 00:20:20,418 --> 00:20:22,210 No, treatment will tell us more, faster. 347 00:20:22,336 --> 00:20:25,171 How can we start treatment if we have no idea what we're treating for? 348 00:20:25,298 --> 00:20:27,173 Treat him for everything. 349 00:20:27,300 --> 00:20:30,176 Give him acetylcysteine, and interferon, and silymarin, 350 00:20:30,303 --> 00:20:33,555 and whatever else you can think of to protect the liver. 351 00:20:47,445 --> 00:20:48,278 What's going on? 352 00:20:48,404 --> 00:20:51,907 Oh, just catching up on some TV. How're you doing? 353 00:20:52,033 --> 00:20:55,243 Well, thanks to your last consult, the patient has improved dramatically. 354 00:20:55,369 --> 00:20:57,913 Tell House the patient is about to kill the doctor. 355 00:20:58,039 --> 00:20:59,539 - She says the patient... - I heard. 356 00:20:59,665 --> 00:21:02,459 - What've you got? - Well, Cuddy just raised and... 357 00:21:02,585 --> 00:21:03,710 - You're paired. - What? 358 00:21:03,836 --> 00:21:05,045 Nines. 359 00:21:07,423 --> 00:21:08,506 How do you know? 360 00:21:08,633 --> 00:21:11,176 Anything lower, you wouldn't sound so excited. 361 00:21:11,302 --> 00:21:12,802 Jacks or higher, 362 00:21:12,929 --> 00:21:16,181 your voice sounds like Debbie from accounting is sitting in your lap. 363 00:21:16,307 --> 00:21:18,433 Ask Cuddy if she can beat a pair of threes. 364 00:21:18,559 --> 00:21:20,360 What's going on? If you're gonna mess with me, 365 00:21:20,436 --> 00:21:21,978 wouldn't it be more fun to do it in person? 366 00:21:22,104 --> 00:21:23,688 Yes, it would. 367 00:21:25,858 --> 00:21:27,567 Can you beat a pair of threes? 368 00:21:27,693 --> 00:21:28,735 What'd she do? 369 00:21:28,861 --> 00:21:30,987 I left orders for PO fluids, Doctor. 370 00:21:31,113 --> 00:21:33,365 Enough with the codes. She obviously knows it's me. 371 00:21:33,491 --> 00:21:35,617 She's drinking her seltzer. 372 00:21:36,160 --> 00:21:37,452 Did she stop? 373 00:21:37,662 --> 00:21:39,162 - Yes. - Go all in. 374 00:21:40,247 --> 00:21:41,957 - But... - Just do it. 375 00:21:42,375 --> 00:21:44,292 You couldn't care less about this charity event. 376 00:21:44,418 --> 00:21:46,378 You claim not to be messing with me. 377 00:21:46,504 --> 00:21:47,865 You're either trying to keep me... 378 00:21:47,964 --> 00:21:49,214 Shut up. 379 00:21:49,340 --> 00:21:52,801 Look, last time I wanted the game to go on. I still do. 380 00:21:52,927 --> 00:21:55,136 It means that this time you get to win. 381 00:21:55,262 --> 00:21:56,304 Hold on. 382 00:22:03,145 --> 00:22:04,396 I fold. 383 00:22:12,947 --> 00:22:15,365 House, are you sure you're okay? 384 00:22:46,939 --> 00:22:50,150 Meds seem to be working. Liver's holding its own. 385 00:22:50,818 --> 00:22:51,818 Good. 386 00:22:51,944 --> 00:22:54,362 - But the platelets are dropping. - Even better. 387 00:22:54,488 --> 00:22:55,947 Why? It means he's getting sicker. 388 00:22:56,073 --> 00:22:58,408 It's new. New is good. 389 00:22:59,535 --> 00:23:01,494 Because old ended in death. 390 00:23:04,665 --> 00:23:06,207 I can't breathe. 391 00:23:07,585 --> 00:23:08,543 Chase! 392 00:23:11,047 --> 00:23:12,672 What's happening? 393 00:23:17,303 --> 00:23:18,678 Ian, come on. 394 00:23:19,305 --> 00:23:21,222 Honey, just relax. 395 00:23:21,682 --> 00:23:24,517 Ian, breathe. Come on, honey. Please. 396 00:23:25,102 --> 00:23:26,436 Please, honey. 397 00:24:19,615 --> 00:24:21,324 We had to put him on a ventilator. 398 00:24:21,450 --> 00:24:23,493 He's back on Ester's path 399 00:24:24,203 --> 00:24:26,746 and we managed to make the train skip a few stations. 400 00:24:26,872 --> 00:24:30,834 Which means that instead of 12 hours, he's probably got less than two. 401 00:24:30,960 --> 00:24:33,670 Which begs the question, why? What did we do? 402 00:24:33,796 --> 00:24:35,463 Acetylcysteine could mess with the lungs. 403 00:24:35,589 --> 00:24:38,299 Mess with them, not shut them down in 20 minutes. 404 00:24:38,425 --> 00:24:40,468 Interferon modulates the immune system. 405 00:24:40,594 --> 00:24:43,513 It could affect a cancer of the blood, like one of the leukemias. 406 00:24:43,639 --> 00:24:45,515 It doesn't speed them up. It slows them down. 407 00:24:45,641 --> 00:24:47,267 It slows down all 500 of them? 408 00:24:47,393 --> 00:24:50,937 Anybody know where we can find an oncologist at this hour? 409 00:24:55,484 --> 00:24:58,820 What effects would interferon have on leukemia? 410 00:24:59,113 --> 00:25:01,781 Depends on what type. Could make it better. Could make it worse. 411 00:25:01,907 --> 00:25:03,783 A four-year fellowship to learn that. 412 00:25:03,909 --> 00:25:05,535 Tell House if he wants to play cards, 413 00:25:05,661 --> 00:25:07,537 he can get his ass back down here and play. 414 00:25:07,663 --> 00:25:10,582 You hear that. She wants me off the phone. 415 00:25:10,708 --> 00:25:12,250 Means she's vulnerable. Go all in. 416 00:25:12,376 --> 00:25:16,129 But the party's over in less than three hours. 417 00:25:16,589 --> 00:25:18,590 It's over in less than two hours, 418 00:25:18,716 --> 00:25:20,884 which means you either have 419 00:25:21,635 --> 00:25:24,012 three of a kind or just threes. 420 00:25:24,722 --> 00:25:26,681 I'm guessing threes. 421 00:25:27,600 --> 00:25:29,851 I bet $500. 422 00:25:31,604 --> 00:25:34,105 - Go all in. - You obviously want to bust me. 423 00:25:34,231 --> 00:25:35,231 Why would you... 424 00:25:35,357 --> 00:25:36,399 Either you go all in, 425 00:25:36,525 --> 00:25:39,944 or I tell everybody in the building that you wear toenail polish. 426 00:25:41,113 --> 00:25:42,572 I'm all in. 427 00:25:44,200 --> 00:25:45,825 I'll call. 428 00:25:46,452 --> 00:25:48,995 I'm betting you have a pair of threes, 429 00:25:49,121 --> 00:25:51,789 but even if you have three, 430 00:25:52,958 --> 00:25:55,710 it's not gonna beat trip nines. 431 00:25:57,796 --> 00:25:59,547 Oh! Oh! Oh, no! 432 00:26:00,299 --> 00:26:03,676 Oh, no! Oh! Oh, that's gotta hurt. 433 00:26:03,802 --> 00:26:04,761 What happened? 434 00:26:04,887 --> 00:26:06,527 I just killed two birds with one straight. 435 00:26:06,639 --> 00:26:07,722 Goodbye. 436 00:26:08,599 --> 00:26:11,226 Fine, keep playing. But I need you to recommend a good oncologist 437 00:26:11,352 --> 00:26:13,478 because if I don't get one up here in the next few minutes, 438 00:26:13,604 --> 00:26:15,647 I got a dead six-year-old. 439 00:26:18,400 --> 00:26:21,653 If you need help, ask. These games are insane. 440 00:26:22,238 --> 00:26:24,197 The games have a higher success rate. 441 00:26:24,323 --> 00:26:26,616 Well, I don't see anything that looks like leukemia. 442 00:26:26,742 --> 00:26:29,035 - You do a bone marrow biopsy? - No time. 443 00:26:29,161 --> 00:26:31,329 Even if there is an occult blood cancer, 444 00:26:31,455 --> 00:26:33,498 you wouldn't expect interferon to make it worse. 445 00:26:33,624 --> 00:26:35,124 Certainly not this fast. 446 00:26:35,251 --> 00:26:37,835 - What would move this fast? - Autoimmune diseases. 447 00:26:37,962 --> 00:26:39,722 If his body's own defenses are attacking him, 448 00:26:39,838 --> 00:26:41,838 beefing them up is just gonna put fuel on the fire. 449 00:26:41,840 --> 00:26:43,967 Sarcoidosis could be in his brain and lungs. 450 00:26:44,093 --> 00:26:46,636 No. No enlarged hilar lymph nodes on his chest x-ray. 451 00:26:46,762 --> 00:26:49,764 The systemic nature suggests Juvenile Rheumatoid Arthritis. 452 00:26:49,890 --> 00:26:51,140 Or Kawasaki's Disease. 453 00:26:51,267 --> 00:26:52,600 Can't be Kawasaki's. 454 00:26:52,726 --> 00:26:54,644 That doesn't affect the elderly. 455 00:26:55,980 --> 00:26:57,563 This is a kid's x-ray? 456 00:26:57,690 --> 00:26:59,732 House had another patient. 457 00:27:01,777 --> 00:27:03,569 Who may or may not have had Kawasaki's. 458 00:27:03,696 --> 00:27:04,862 This kid on the other hand, 459 00:27:04,989 --> 00:27:08,533 he makes antibodies that are eating the inside of his arteries, 460 00:27:08,659 --> 00:27:11,619 choking off blood to his major organs, one by one. 461 00:27:11,745 --> 00:27:15,623 First the GI tract, then the kidneys, then the brain, now the lungs. 462 00:27:16,959 --> 00:27:21,254 Can anyone think of a reason why Kawasaki's can't affect the elderly, 463 00:27:21,630 --> 00:27:26,426 other than that it doesn't? Nice. 464 00:27:26,552 --> 00:27:28,511 We can confirm with blood work. 465 00:27:28,637 --> 00:27:30,471 We need an ANA, sed rate... 466 00:27:30,597 --> 00:27:32,223 Labs will take two hours. 467 00:27:32,850 --> 00:27:34,267 What was the old lady's sed rate? 468 00:27:34,393 --> 00:27:35,768 Elevated, 98. 469 00:27:35,894 --> 00:27:39,689 You can't use another patient's labs to diagnosis Kawasaki's disease. 470 00:27:39,815 --> 00:27:41,136 Is that like a dare or something? 471 00:27:41,191 --> 00:27:42,650 You don't have time to be wrong. 472 00:27:42,776 --> 00:27:45,778 Fine. We'll look for Kawasaki where he lives, 473 00:27:45,904 --> 00:27:47,864 Ian's coronary arteries. 474 00:27:53,954 --> 00:27:55,872 This other patient, 475 00:27:58,125 --> 00:28:00,793 the old lady, Ester? 476 00:28:04,465 --> 00:28:06,007 Have you read Moby Dick? 477 00:28:06,133 --> 00:28:07,425 It was a book? 478 00:28:07,676 --> 00:28:10,094 - It was ten years ago. - Twelve. 479 00:28:10,429 --> 00:28:11,971 Obsession is dangerous. 480 00:28:12,097 --> 00:28:14,766 Only if you're on a wooden ship, and your obsession is a whale. 481 00:28:14,892 --> 00:28:16,184 I think I'm in the clear. 482 00:28:16,310 --> 00:28:17,560 You do realize it's a metaphor. 483 00:28:17,686 --> 00:28:20,855 You realize the point of metaphors is to scare people from doing things 484 00:28:20,981 --> 00:28:23,358 by telling them that something much scarier is gonna happen 485 00:28:23,484 --> 00:28:25,777 than what will really happen. 486 00:28:25,986 --> 00:28:29,155 God, I wish I had a metaphor to explain that better. 487 00:28:29,281 --> 00:28:33,117 Go back to the game. Don't worry, I'm not gonna get eaten by witches. 488 00:28:37,915 --> 00:28:40,792 Coronary arteries clear. No aneurysms. 489 00:28:40,959 --> 00:28:43,503 Flip the mode. Let's see the flow. 490 00:28:46,924 --> 00:28:49,175 How did that other woman die? 491 00:28:49,718 --> 00:28:52,762 She went into respiratory distress. 492 00:28:53,222 --> 00:28:55,932 - Her heart and liver were already... - No. 493 00:28:57,142 --> 00:28:58,559 Did she suffer? 494 00:29:00,062 --> 00:29:01,646 Was she in pain? 495 00:29:01,772 --> 00:29:03,189 I don't know. 496 00:29:06,568 --> 00:29:10,363 Laminar flow. No blood clots, no ragged edges. 497 00:29:10,781 --> 00:29:13,658 Damn. Shut it down. We're just wasting time. 498 00:29:19,957 --> 00:29:21,374 Look at the right atrium. 499 00:29:21,500 --> 00:29:23,626 - That's not Kawasaki's. - No. 500 00:29:24,545 --> 00:29:26,254 It's small, but it's there. 501 00:29:26,380 --> 00:29:28,798 Ester didn't have a mass in her heart. 502 00:29:28,924 --> 00:29:31,259 Ian's younger. He can take more of a pounding. 503 00:29:31,385 --> 00:29:33,428 Ester died before the disease reached her heart. 504 00:29:33,554 --> 00:29:35,555 The disease made a mass and made it fast. 505 00:29:35,681 --> 00:29:37,265 - Could be bacteria. - Muscle. 506 00:29:37,391 --> 00:29:38,307 Connective tissue. 507 00:29:38,434 --> 00:29:40,393 The kid can't take any more theories. 508 00:29:40,519 --> 00:29:42,439 Only thing we know is that whatever that mass is, 509 00:29:42,521 --> 00:29:43,938 that's what he's got. 510 00:29:44,064 --> 00:29:47,400 We need a piece of it. I'm doing a biopsy. 511 00:30:01,957 --> 00:30:03,374 I'll shut the blinds. 512 00:30:03,500 --> 00:30:04,750 No, let them watch. 513 00:30:04,877 --> 00:30:07,503 I do my best work on the big stage. 514 00:30:09,047 --> 00:30:11,799 Passing through the superior vena cava. 515 00:30:11,925 --> 00:30:14,010 You're in the atrium. Pull back. 516 00:30:16,054 --> 00:30:18,473 You've hit the wall of the heart. 517 00:30:18,599 --> 00:30:20,266 These procedures would be so much simpler 518 00:30:20,392 --> 00:30:22,935 if you could do them on healthy people. 519 00:30:23,770 --> 00:30:25,396 And out again. 520 00:30:28,400 --> 00:30:29,692 - V-fib. - Cardiac arrest. 521 00:30:29,818 --> 00:30:31,402 Call a code. 522 00:30:32,154 --> 00:30:33,738 Come on, paddles! 523 00:30:35,866 --> 00:30:37,241 - Come on. - Charge. 524 00:30:37,367 --> 00:30:38,576 Clear! 525 00:30:39,953 --> 00:30:41,746 Code blue, ISO room. 526 00:30:41,872 --> 00:30:43,998 Code blue, ISO room. 527 00:30:45,584 --> 00:30:47,001 And again. 528 00:30:50,547 --> 00:30:52,256 - Nothing. - Again. 529 00:31:07,689 --> 00:31:08,940 You got a clock on this? 530 00:31:09,066 --> 00:31:11,567 How much longer you gonna keep doing this? 531 00:31:11,693 --> 00:31:12,902 Clear. 532 00:31:16,490 --> 00:31:18,699 Wait. I've got something. 533 00:31:21,870 --> 00:31:23,287 He's back. 534 00:31:30,712 --> 00:31:33,589 - What are you doing? - I'm doing what we came here to do. 535 00:31:33,715 --> 00:31:35,925 - It almost killed him. - I know. I was right here. 536 00:31:36,051 --> 00:31:37,176 I need a Vacutainer. 537 00:31:37,302 --> 00:31:40,304 His brain's been oxygen deprived for over eight minutes. 538 00:31:40,430 --> 00:31:42,031 There might be nothing left. He might... 539 00:31:42,099 --> 00:31:45,476 Tell the parents. Where the hell is that Vacutainer? 540 00:31:57,573 --> 00:32:00,533 - So, what's he got? - Brain damage. 541 00:32:00,659 --> 00:32:02,952 Good chance. I was talking about before that. 542 00:32:03,078 --> 00:32:05,638 - You're not worried about... - Things I can't do anything about? 543 00:32:05,706 --> 00:32:07,415 - I try not to. - Yeah. 544 00:32:07,541 --> 00:32:09,792 Things just roll off you like water off a duck. 545 00:32:09,918 --> 00:32:11,002 Histiocytosis. 546 00:32:11,128 --> 00:32:13,296 Very unlikely in a 73-year-old. 547 00:32:13,422 --> 00:32:15,923 Whatever this is, it's very unlikely. 548 00:32:16,174 --> 00:32:17,925 Come on. More ideas. Let's go, people. 549 00:32:18,051 --> 00:32:21,470 Genetic disorders could cause masses everywhere. Tuberous sclerosis. 550 00:32:21,597 --> 00:32:23,556 If it's genetic, he's had it all his life. 551 00:32:23,682 --> 00:32:25,016 - Why now? - I don't know. 552 00:32:25,142 --> 00:32:26,601 It sure fits nice enough. 553 00:32:26,727 --> 00:32:28,519 We haven't ruled out leukemia yet. 554 00:32:28,645 --> 00:32:31,397 Or sarcoma. He could have multiple soft tissue tumors. 555 00:32:31,523 --> 00:32:32,523 Or sarcoidosis. 556 00:32:32,649 --> 00:32:34,191 Multiple neurofibromatosis. 557 00:32:34,318 --> 00:32:35,943 Chondrocytomas. 558 00:32:37,946 --> 00:32:39,655 How's it going? You win? 559 00:32:39,781 --> 00:32:42,825 I got called away by the angry parents of a patient. 560 00:32:42,951 --> 00:32:44,327 There are three of you here. 561 00:32:44,453 --> 00:32:46,912 None of you had the sense to stop him, to pick up a phone and call me. 562 00:32:47,039 --> 00:32:48,414 I told them you'd signed off. 563 00:32:48,540 --> 00:32:50,750 The parents are mad because their kid is dying. 564 00:32:50,876 --> 00:32:52,084 It's understandable. 565 00:32:52,210 --> 00:32:54,170 But if he doesn't die, they won't be mad anymore. 566 00:32:54,296 --> 00:32:56,631 If he's brain damaged, they might still be a little ticked. 567 00:32:56,757 --> 00:32:57,798 Had to do it to save him. 568 00:32:57,924 --> 00:33:00,509 You had to do it to diagnose Ester. 569 00:33:00,636 --> 00:33:02,511 You may have killed a six-year-old 570 00:33:02,638 --> 00:33:06,015 because you're obsessed with a woman who's been dead for 12 years. 571 00:33:06,141 --> 00:33:08,351 Sometimes you lose, House! You're not God! 572 00:33:08,477 --> 00:33:09,435 He's not dead yet. 573 00:33:09,561 --> 00:33:10,721 No, but you're done with him. 574 00:33:10,729 --> 00:33:12,980 It's my case now. Go home. Go ride your motorcycle. 575 00:33:13,106 --> 00:33:16,651 Go brood in a dark room. Just don't go near Ian again. 576 00:33:23,909 --> 00:33:27,036 So, anything else or is it just these seven? 577 00:33:27,162 --> 00:33:28,496 Drop it, House. She's right. 578 00:33:28,622 --> 00:33:30,122 No, she's not! 579 00:33:31,249 --> 00:33:33,376 - You know she's not. - We should have called her. 580 00:33:33,502 --> 00:33:34,835 I'm surprised you didn't. 581 00:33:34,961 --> 00:33:36,671 You're gonna have to find a way to let this go. 582 00:33:36,797 --> 00:33:38,297 We can't go near Ian. 583 00:33:38,423 --> 00:33:40,257 We don't need to go near him. 584 00:33:40,676 --> 00:33:42,259 We have his tumor. 585 00:33:42,886 --> 00:33:45,262 Well, Cuddy may be right that we screwed up the protocol. 586 00:33:45,389 --> 00:33:48,015 She may be right about my screwed up obsession. 587 00:33:48,141 --> 00:33:50,643 But I'm right about the medicine. 588 00:33:50,811 --> 00:33:53,104 How many tests can we do with that? 589 00:33:53,230 --> 00:33:55,648 Look, we cure the kid, we solve everybody's problems. 590 00:33:55,774 --> 00:33:57,108 How many? 591 00:34:00,070 --> 00:34:01,445 Maybe two good pieces. 592 00:34:01,571 --> 00:34:03,322 How many okay pieces? 593 00:34:04,116 --> 00:34:06,158 Three would be pushing it. 594 00:34:07,828 --> 00:34:10,121 Three tests, seven choices. 595 00:34:11,665 --> 00:34:13,332 Okay, what's first? 596 00:34:13,792 --> 00:34:15,960 Sarcoidosis seems most likely. 597 00:34:16,086 --> 00:34:19,547 Yeah. So likely that Cuddy's gonna think of that all on her own. 598 00:34:19,673 --> 00:34:22,967 She's got the kid's whole body to play with. Let her do that test. 599 00:34:23,093 --> 00:34:24,468 What's next? 600 00:34:24,594 --> 00:34:26,074 It's moving too fast to be spreading. 601 00:34:26,179 --> 00:34:28,420 It has to be growing from something that's already there. 602 00:34:28,515 --> 00:34:30,391 Genetic disorder. Tuberous sclerosis. 603 00:34:30,517 --> 00:34:33,519 Or it's his immune system. Histiocytosis. 604 00:34:34,229 --> 00:34:37,398 Well, there are more documented cases of Histio amongst older people 605 00:34:37,524 --> 00:34:40,151 than tuberous sclerosis. Let's start with that. 606 00:34:45,741 --> 00:34:47,742 Wing or drumstick? 607 00:34:50,078 --> 00:34:51,620 Gonna need a little more than that. 608 00:34:51,747 --> 00:34:52,997 A little more is more than a third. 609 00:34:53,123 --> 00:34:57,209 If we have to repeat this test because you didn't cut us enough... 610 00:35:02,716 --> 00:35:05,676 I'm adding one micro liter of the immunoperoxidase. 611 00:35:05,802 --> 00:35:07,928 Make it two. I don't want House biting off our heads 612 00:35:08,054 --> 00:35:11,182 because we weren't sure if it turned red or not. 613 00:35:16,813 --> 00:35:18,731 That's definitely not red. 614 00:35:24,321 --> 00:35:26,572 The problem could still be an abnormal cell growth 615 00:35:26,698 --> 00:35:27,782 but a different cell line. 616 00:35:27,908 --> 00:35:30,075 Sarcoma? Muscle cells are throughout his body. 617 00:35:30,202 --> 00:35:31,452 It would explain the geography. 618 00:35:31,578 --> 00:35:34,789 Genetic disorder is far more likely in a six-year-old. Tuberous sclerosis. 619 00:35:34,915 --> 00:35:36,791 Pretty unlikely to cause a GI bleed. 620 00:35:36,917 --> 00:35:38,000 The time course fits. 621 00:35:38,126 --> 00:35:40,628 Mr. Foreman, you agree with both of them? Thanks for playing. 622 00:35:40,754 --> 00:35:43,339 If we have enough tissue for two tests, why not do both? 623 00:35:43,465 --> 00:35:44,905 Then we don't have to think as hard. 624 00:35:44,966 --> 00:35:47,966 Taking the pressure off the choice makes us less likely to think critically. 625 00:35:48,053 --> 00:35:50,888 Sarcoma is more likely to hit a six and 70-year-old. 626 00:35:51,014 --> 00:35:52,681 Tuberous sclerosis, it is. 627 00:35:52,808 --> 00:35:54,141 You think sarcoma is less likely? 628 00:35:54,267 --> 00:35:55,392 It's more likely. 629 00:35:55,519 --> 00:35:58,854 The test for it, on the other hand, is less reliable. 630 00:36:10,992 --> 00:36:13,285 Test is negative. Well, that's okay. 631 00:36:13,411 --> 00:36:17,957 If the tumor cells hadn't matured, the Ki-67 protein wouldn't have turned off. 632 00:36:19,751 --> 00:36:22,211 - What happens if we don't solve this? - Kid dies. 633 00:36:22,337 --> 00:36:24,588 I mean for the next 12 years. 634 00:36:25,966 --> 00:36:28,008 Ki-67's negative. 635 00:36:31,596 --> 00:36:33,806 And PCH antigen is negative. 636 00:36:45,235 --> 00:36:47,862 Mighty Casey's down to his last strike. 637 00:36:47,988 --> 00:36:49,947 Mighty Casey struck out. 638 00:36:50,156 --> 00:36:52,533 Thanks a lot. I was gonna read that this weekend. 639 00:36:52,659 --> 00:36:56,036 Chondrocytoma. Connective tissue's been in all the places we've been looking. 640 00:36:56,162 --> 00:36:58,803 The kid is too sick for that. We're better off testing for sarcoma. 641 00:36:58,832 --> 00:37:01,584 We would've seen signs of that when we tested for tuberous sclerosis. 642 00:37:01,710 --> 00:37:03,919 The tumor cells looked like muscle under the microscope. 643 00:37:04,045 --> 00:37:06,881 No, they didn't. They looked like fat. 644 00:37:07,924 --> 00:37:10,009 I vote for neurofibromatosis. 645 00:37:11,094 --> 00:37:13,971 - Why? - Because the other choices suck worse. 646 00:37:22,564 --> 00:37:24,106 Give me a minute. 647 00:37:53,720 --> 00:37:55,679 You want me out of here? 648 00:37:57,933 --> 00:37:59,975 You come up with anything? 649 00:38:02,103 --> 00:38:03,228 No. 650 00:38:30,090 --> 00:38:32,967 Hey. We can talk about it tomorrow. 651 00:38:40,976 --> 00:38:42,059 I... 652 00:38:43,895 --> 00:38:46,021 I won the poker tournament. 653 00:38:47,983 --> 00:38:50,901 I totally played this guy, Berman, from business affairs. 654 00:38:51,027 --> 00:38:54,989 I got great cards. But I don't bet. Just call, no raises. 655 00:38:55,115 --> 00:38:57,366 Berman pairs his king on the flop. 656 00:38:57,492 --> 00:38:59,910 I keep calling, the river turns, 657 00:39:00,954 --> 00:39:02,746 I check. He can't stand it. 658 00:39:02,872 --> 00:39:06,000 He goes all in. He's sure he's won. 659 00:39:07,752 --> 00:39:09,878 I call, I flip them. 660 00:39:11,464 --> 00:39:12,756 Pocket aces. 661 00:39:13,049 --> 00:39:14,675 I nailed his ass. 662 00:39:23,643 --> 00:39:26,020 The aces were hiding all along. 663 00:39:34,487 --> 00:39:36,947 Test him for Erdheim-Chester disease. 664 00:39:37,073 --> 00:39:39,450 Erdheim-Chester? That's not even on the list. 665 00:39:39,576 --> 00:39:42,244 Because we already did it. He tested negative. 666 00:39:42,370 --> 00:39:44,538 - So did Ester. - The disease lied. 667 00:39:44,664 --> 00:39:47,666 Yeah, the tumor's got it in for you. Diseases don't lie. 668 00:39:47,792 --> 00:39:49,960 Fine, it didn't lie. It slow played us. 669 00:39:50,086 --> 00:39:53,672 We biopsied the colon, it hadn't reached the GI tract yet. 670 00:39:53,840 --> 00:39:56,633 It's there now. It's in his liver, his lungs. 671 00:39:56,760 --> 00:39:58,677 You want it to be there. 672 00:39:58,803 --> 00:40:00,846 Because then you didn't screw up 12 years ago. 673 00:40:00,972 --> 00:40:04,808 We can't waste our one test on the one disease we know it's not. 674 00:40:07,687 --> 00:40:09,313 Run the test. 675 00:40:20,909 --> 00:40:22,576 You sure about this? 676 00:40:22,702 --> 00:40:25,496 Wait. Let me think about that. Don't pressure me. 677 00:40:25,622 --> 00:40:27,498 Just run the damn test. 678 00:40:30,418 --> 00:40:32,461 Cells look like macrophages. 679 00:40:32,587 --> 00:40:34,296 That's a good start. 680 00:40:40,303 --> 00:40:42,721 Take your time, and say it loud. 681 00:40:52,482 --> 00:40:54,191 CD 68 positive. 682 00:41:06,746 --> 00:41:08,455 Start the treatment. 683 00:42:07,849 --> 00:42:10,350 So, Ester can rest peaceful now, huh? 684 00:42:10,977 --> 00:42:12,144 Yeah. 685 00:42:18,860 --> 00:42:19,860 $40. 686 00:42:25,241 --> 00:42:26,867 You got lucky. 687 00:42:27,785 --> 00:42:29,286 You gonna call? 688 00:42:29,454 --> 00:42:30,871 What I do 689 00:42:31,956 --> 00:42:34,625 is not just based on the flip of a card. 690 00:42:34,959 --> 00:42:37,336 You guessed. You got lucky. 691 00:42:37,462 --> 00:42:38,462 It fit. 692 00:42:38,588 --> 00:42:41,673 It could just as easily have been sarcoma or tuberous sclerosis. 693 00:42:41,799 --> 00:42:44,051 No, not just as easily. 694 00:42:44,177 --> 00:42:46,845 Maybe not. But it wasn't impossible. 695 00:42:50,308 --> 00:42:51,975 Are you gonna call? 696 00:42:53,645 --> 00:42:55,979 You know, relative to its size, 697 00:42:56,648 --> 00:42:59,733 the barnacle has the largest penis of any animal.