WEBVTT 00:00:03.003 --> 00:00:05.971 On your right. On your right. On your right. 00:00:06.039 --> 00:00:08.132 Back, back, back, back, back. Come on, buddy. 00:00:11.745 --> 00:00:14.077 Yeah, Dan! Yeah! 00:00:14.147 --> 00:00:15.876 Yea! Yea! 00:00:15.949 --> 00:00:19.282 Back, back, back, back, back. Watch the winger! 00:00:31.264 --> 00:00:33.425 Yeah! 00:00:56.856 --> 00:00:58.847 You okay? 00:00:58.925 --> 00:01:00.984 Dan? Dan, talk to me. 00:01:01.061 --> 00:01:03.757 Dan. Dan. 00:01:03.830 --> 00:01:06.663 Get a doctor! 00:01:46.239 --> 00:01:48.537 - Hey. - Close the door. 00:01:48.608 --> 00:01:51.168 Close the door. 00:01:53.913 --> 00:01:57.007 Is Cuddy down the hall counting to 50? 00:01:57.083 --> 00:01:59.916 She knows I'm in here, in the clinic, as she commanded. 00:01:59.986 --> 00:02:03.217 - She just doesn't know I'm alone. - Well, you've got a full waiting room. 00:02:03.289 --> 00:02:06.019 - How long do you think you can ignore them? - I'm off at 4:00. 00:02:07.760 --> 00:02:10.024 You're doing this to avoid five minutes of work? 00:02:10.096 --> 00:02:12.724 If I go out there, I get assigned a kid with a runny nose. 00:02:12.799 --> 00:02:16.030 That's 30 seconds looking at the nose, 25 minutes talking to a worried mom... 00:02:16.102 --> 00:02:18.900 who won't leave until she's sure it's not meningitis or a tumor. 00:02:18.972 --> 00:02:21.338 Yes. Concerned parents can be so annoying. 00:02:21.407 --> 00:02:25.036 Just tell Cuddy you've got an urgent case. You had to leave early. That would be lying. 00:02:25.111 --> 00:02:30.014 And that would be wrong. But luckily the definition of "urgent" is fungible. 00:02:30.083 --> 00:02:32.711 Not the definition of "case" though. 00:02:36.122 --> 00:02:38.886 You have no cases? 00:02:38.958 --> 00:02:41.017 You have no cases? 00:02:41.094 --> 00:02:44.825 You've got handpicked doctors-- specialists-- 00:02:44.898 --> 00:02:47.799 working for you, and they're sitting on their hands? 00:02:47.867 --> 00:02:51.701 - Cameron's answering my mail. - Oh, time well spent, I'm sure. 00:02:51.771 --> 00:02:53.762 Foreman and Chase? 00:02:53.840 --> 00:02:55.831 Research? 00:03:02.515 --> 00:03:05.245 Nine letters. Iodine deficiency in children. 00:03:05.318 --> 00:03:07.479 Cretinism. 00:03:16.863 --> 00:03:19.764 So, 4:03 p.m., Dr. House checks out. 00:03:19.832 --> 00:03:21.766 Please write that down. 00:03:21.834 --> 00:03:24.029 Dr. House. Sorry. Done for the day. 00:03:24.103 --> 00:03:27.004 Plenty of docs here to take care of you. But we had an appointment. 00:03:27.073 --> 00:03:30.406 Nice try, but this is a walk-in clinic, which means there are no appointments. 00:03:30.476 --> 00:03:32.706 You walk in, sign the chart, and a doctor will see you. 00:03:32.779 --> 00:03:36.271 Just not me. Your letter says that we'd see you. 00:03:37.317 --> 00:03:39.717 Not a big letter writer. Here. 00:03:42.288 --> 00:03:45.780 When did my signature get so girlie? 00:03:45.858 --> 00:03:48.053 - I can explain. - See that "G"? 00:03:48.127 --> 00:03:50.561 See how it makes a big loop on top? 00:03:50.630 --> 00:03:53.997 Doesn't even look like my handwriting. Think I have something? 00:03:54.067 --> 00:03:57.468 What's the differential diagnosis for writing G's like a junior high school girl? 00:03:57.537 --> 00:04:01.268 It's impossible to get to you through normal channels. They have called, e-mailed. 00:04:01.341 --> 00:04:03.292 Perseverance does not equal worthiness. Next time 00:04:03.293 --> 00:04:05.243 you want to get my attention, wear something fun. 00:04:05.311 --> 00:04:07.279 Low-rider jeans are hot. 00:04:07.347 --> 00:04:09.878 Sixteen-year-old male. Sudden onset of double 00:04:09.879 --> 00:04:12.410 vision and night terrors, with no apparent cause. 00:04:12.485 --> 00:04:14.953 The kid's been to two neurologists, and he-- Night terrors? 00:04:15.021 --> 00:04:17.819 - As in big scary monsters? - Yes. 00:04:20.660 --> 00:04:24.152 - Where are you going? - To see the family. 00:04:24.230 --> 00:04:26.260 - You're going to examine a patient? - Nine times 00:04:26.261 --> 00:04:28.291 out of 10, there's no reason to talk to a patient. 00:04:28.368 --> 00:04:32.202 But night terrors in a 16-year-old is a very good reason to talk to this family. 00:04:32.272 --> 00:04:34.206 Good work. 00:04:37.176 --> 00:04:39.110 Margins are fine. 00:04:39.178 --> 00:04:41.112 No lesions. 00:04:42.348 --> 00:04:44.646 Color is good. 00:04:44.717 --> 00:04:48.050 How long have you been having night terrors? Three weeks. 00:04:48.121 --> 00:04:51.318 He's afraid to go to bed. He's exhausted, can barely function. 00:04:53.393 --> 00:04:56.885 - What does that tell you? - Nothing. It's just fun watching him blink. 00:04:56.963 --> 00:05:00.455 Name as many animals as you can that begin with the letter "B". Go. 00:05:07.206 --> 00:05:11.302 - Baby elephant? - Baby elephant is actually a good answer. 00:05:11.377 --> 00:05:13.902 - "B" is a bear of a letter. - What does that tell you? 00:05:13.980 --> 00:05:18.007 Proves two things: no neurological damage, and your son is never gonna be chief fry cook. 00:05:18.084 --> 00:05:21.815 In teens, there are two likely causes of night terrors. 00:05:21.888 --> 00:05:25.585 - Posttraumatic stress. Any recent shoot-outs at your high school? - No. 00:05:25.658 --> 00:05:26.886 - Then, Dave-- - Dan. 00:05:26.959 --> 00:05:31.020 If there's no trauma, the other cause is... sexual abuse. 00:05:33.733 --> 00:05:37.169 So who's molesting you? Teacher? 00:05:37.236 --> 00:05:40.228 Extra-friendly neighbor? I'd ask if either of you were involved, but you'd deny it. 00:05:40.306 --> 00:05:42.035 We would never hurt Dan. 00:05:42.108 --> 00:05:44.508 I say it here, it comes out there. 00:05:44.577 --> 00:05:47.068 This lack of response is consistent with abuse. 00:05:47.146 --> 00:05:49.944 There's no one, okay? I-- I swear. 00:05:50.016 --> 00:05:53.110 There was trauma. I got hit in the head during a lacrosse game. 00:05:54.954 --> 00:05:58.321 Did you know that he got hit in the head? 00:05:58.391 --> 00:06:01.918 - They didn't mention it. No. - Yeah. Why bother? 00:06:04.831 --> 00:06:07.356 No, no. We took him to the E.R. after the game. 00:06:07.433 --> 00:06:09.958 He was scanned. They tested him. They said he was fine. 00:06:10.036 --> 00:06:11.970 No concussion. It's gotta be something else. 00:06:12.038 --> 00:06:15.530 You hound me for my opinion, and then you question my diagnosis. 00:06:15.608 --> 00:06:19.009 Cool. E.R. obviously screwed up. Kid's got a concussion. 00:06:19.078 --> 00:06:22.206 I had double vision before I was hit. Well, that changes everything. 00:06:22.281 --> 00:06:25.079 You need glasses. That's why you had double vision, 00:06:25.151 --> 00:06:27.500 which is why you got hit, which is why you have a 00:06:27.501 --> 00:06:29.850 concussion, which is why you have night terrors. 00:06:29.922 --> 00:06:32.948 You need to see an ophthalmologist, which I am not. 00:06:33.025 --> 00:06:35.710 You enjoyed that. I brought a reasonable case to your 00:06:35.711 --> 00:06:38.395 attention, and you shoved it in my face just to humiliate me. 00:06:38.464 --> 00:06:41.331 You're an only child, aren't you? Why would you say that? 00:06:41.401 --> 00:06:43.130 Because everything is about you. 00:06:44.270 --> 00:06:48.570 This may seem incredibly controversial, but I think sexual abuse is bad. 00:06:48.641 --> 00:06:51.633 I just wanted to make sure he wasn't being diddled by Daddy-- or Mommy. 00:06:51.711 --> 00:06:53.736 Anything else is just a bonus. 00:07:04.657 --> 00:07:07.990 I'm not an only child. Interesting. 00:07:08.060 --> 00:07:10.324 What? Don't move. 00:07:11.097 --> 00:07:15.033 - Did I bore you in there? - What? Uh, no. Not-- Not really. 00:07:15.101 --> 00:07:17.467 Are you tired? 00:07:17.537 --> 00:07:19.596 - Sometimes. - He never sleeps. Ofcourse he's tired. 00:07:19.672 --> 00:07:22.140 - Right now. At this moment. Are you tired? - No. No. 00:07:22.208 --> 00:07:24.438 That twitch in your leg. Did you feel that? 00:07:25.812 --> 00:07:28.042 - Didn't hurt. - His leg twitched. I don't see what-- 00:07:28.114 --> 00:07:31.880 It's called a myoclonic jerk. It's very common when you're falling asleep. 00:07:31.951 --> 00:07:34.636 Respiration rate falls, and the brain sometimes interprets 00:07:34.637 --> 00:07:37.321 this as the body dying, so it sends a pulse to wake it up. 00:07:37.390 --> 00:07:39.585 - So? - So, he's not asleep. 00:07:39.659 --> 00:07:42.389 He's awake. 00:07:42.462 --> 00:07:44.453 Admit him. 00:07:47.467 --> 00:07:50.868 I recognize that loopy "G". 00:07:50.937 --> 00:07:52.928 So, what does the jerk tell us? 00:07:53.005 --> 00:07:55.303 Nothing good. The brain's losing control of the body. 00:07:55.374 --> 00:07:59.140 Can't order the eyes to focus, regulate sleep patterns or control muscles. 00:07:59.212 --> 00:08:01.237 A movement disorder or a degenerative brain disease. 00:08:01.314 --> 00:08:04.841 Either way, this kid's gonna be picking up his diploma in diapers and a wheelchair. 00:08:04.917 --> 00:08:06.885 Maybe not that bad. Could be an infection. 00:08:06.953 --> 00:08:08.978 You wish. No fever, no white count. 00:08:09.055 --> 00:08:11.774 Anyone think this differential diagnosis might be compromised 00:08:11.775 --> 00:08:14.493 because we don't have an accurate family history? 00:08:14.560 --> 00:08:17.825 - I took an accurate family history. - You didn't even take an accurate family. 00:08:18.764 --> 00:08:20.994 - His father's not his father. - Why would you say that? 00:08:21.067 --> 00:08:24.127 Thirty percent of all dads don't realize they're raising someone else's kid. 00:08:24.203 --> 00:08:27.331 False paternity's more like 10%. That's what our moms would like us to believe. 00:08:27.406 --> 00:08:29.897 Who cares? If he got it from his parents, they'd both be dead. 00:08:29.976 --> 00:08:32.842 - Can we get on with the differential diagnosis? - Fifty bucks says I'm right. 00:08:32.912 --> 00:08:35.472 - I'll take your money. - Hit a nerve? 00:08:35.548 --> 00:08:39.006 - Don't worry. I'm sure the guy who tucked you in was your daddy. - Make it a hundred. 00:08:39.085 --> 00:08:42.885 What about leukoencephalopathy in a 16-year-old? 00:08:42.955 --> 00:08:45.253 It doesn't necessarily have to be that bad. 00:08:45.324 --> 00:08:48.350 If we exclude the night terrors, it could be something systemic. 00:08:48.427 --> 00:08:50.952 - His liver, kidneys. Something outside the brain. - Yes. 00:08:51.030 --> 00:08:52.895 - Feel free to exclude any symptom if it makes 00:08:52.896 --> 00:08:54.761 your job easier. - Night terrors were anecdotal. 00:08:54.834 --> 00:08:57.200 - He could've had a bad dream. - No. Parents said he was 00:08:57.201 --> 00:08:59.567 conscious during and didn't remember anything afterwards. 00:08:59.639 --> 00:09:01.573 - That's a night terror. - Parents said? 00:09:01.641 --> 00:09:03.734 That's a good point. 00:09:03.809 --> 00:09:07.074 Before we condemn this kid, maybe we should entertain Dr. Chase's skepticism. 00:09:07.146 --> 00:09:12.209 I want a detailed polysomnograph. If he's having night terrors, I want to see them. 00:09:34.740 --> 00:09:36.935 I usually don't move during night terrors. 00:09:37.009 --> 00:09:38.943 I'm not restraining you for them. 00:09:41.814 --> 00:09:45.045 E.E.G. revealed abnormalities in your brain-- 00:09:45.117 --> 00:09:47.483 caused nerve damage in your toes. 00:09:54.160 --> 00:09:57.288 What are you doing? 00:09:57.363 --> 00:10:00.457 - Fixing it. - Can I talk to my parents? 00:10:00.533 --> 00:10:02.592 Oh, they know all about this. 00:10:02.668 --> 00:10:05.193 I'd really like to see them. 00:10:13.713 --> 00:10:17.114 Please. I'd really like them here. 00:10:18.884 --> 00:10:20.875 This is gonna hurt, Dan. 00:10:20.953 --> 00:10:22.944 Oh. Oh, God. 00:10:39.772 --> 00:10:42.297 That's a night terror. 00:10:52.451 --> 00:10:56.615 We did a C. T., M.R.I., C.B.C., CHEM-7 and chest X-ray. 00:10:56.689 --> 00:10:59.749 All the tests came back normal. There's nothing to explain his symptoms. 00:10:59.825 --> 00:11:01.742 Okay, but let's pretend there's something and go 00:11:01.743 --> 00:11:03.659 from there. Who sees something on this M.R.I.? 00:11:05.831 --> 00:11:08.629 No lesions in the white matter. No structural abnormalities. 00:11:08.701 --> 00:11:10.669 No space-occupying tumors. 00:11:10.736 --> 00:11:15.673 He's 16, so he should have an absolutely pristine brain. The smallest thing is abnormal. 00:11:16.976 --> 00:11:19.342 Meningeal enhancement. 00:11:19.412 --> 00:11:21.972 - My bet is viral meningitis. - Excellent. 00:11:22.048 --> 00:11:23.982 Do you see what he did there? 00:11:24.050 --> 00:11:27.816 Took a small clue that there's a neurological problem and wasn't afraid to run with it. 00:11:27.887 --> 00:11:30.355 There's no evidence of meningitis on that M.R.I. 00:11:30.423 --> 00:11:32.323 No, there's not. He's completely wrong. 00:11:32.391 --> 00:11:34.416 Then what clue are you talking about? 00:11:34.493 --> 00:11:36.893 He knew that I saw something on the M.R.I., so he 00:11:36.894 --> 00:11:39.294 figured there must be something there and took a guess. 00:11:39.365 --> 00:11:42.857 - Clever, but also pathetic. - So what did you find? 00:11:42.935 --> 00:11:45.927 Take a close look at the corpus callosum. 00:11:48.574 --> 00:11:52.010 - Looks okay. - Are we all looking at the same thing? 00:11:52.078 --> 00:11:54.546 Two hundred million interhemispheric nerve fibers. 00:11:54.613 --> 00:11:57.673 The George Washington Bridge between the left and right side of the brain. 00:11:59.418 --> 00:12:02.046 It's subtle. 00:12:04.123 --> 00:12:06.455 There's some bowing. There. 00:12:06.525 --> 00:12:08.516 An upward arch. Are you guessing? 00:12:08.594 --> 00:12:10.494 Yes. 00:12:10.563 --> 00:12:14.329 - Too bad. You're right. - He probably just moved. 00:12:14.400 --> 00:12:16.994 Nobody stays perfectly still for the entire M.R.I. 00:12:17.069 --> 00:12:19.816 Yeah. Probably got restless and shifted one hemisphere 00:12:19.817 --> 00:12:22.564 of his brain to a more comfortable position. 00:12:22.641 --> 00:12:25.906 Something is pushing on it. If there was bowing, could be a tumor. 00:12:25.978 --> 00:12:29.436 Do you see a tumor on this M.R.I.? No, but I don't see any bowing either. 00:12:29.515 --> 00:12:33.042 There's no tumor. Just a blockage causing pressure causing symptoms. 00:12:33.119 --> 00:12:36.555 Today, night terrors. Tomorrow, he's bleeding out of his eyes. 00:12:36.622 --> 00:12:41.389 Get him a radionucleotide cisternogram. I guarantee you'll see a blockage. 00:12:47.299 --> 00:12:49.290 Okay. 00:12:52.138 --> 00:12:53.867 Easy. 00:12:53.939 --> 00:12:56.203 Okay. Squeeze my hand. 00:13:00.012 --> 00:13:02.105 All right. Squeeze hard. 00:13:04.683 --> 00:13:06.617 All right. 00:13:12.825 --> 00:13:16.090 Now I'm injecting a material that's tagged with a radioisotope. 00:13:16.162 --> 00:13:19.996 It's gonna enter your spine and travel up to your brain. 00:13:20.065 --> 00:13:23.967 It'll make you able to think deep thoughts, 00:13:24.036 --> 00:13:25.970 run a hundred miles an hour. 00:13:27.239 --> 00:13:29.503 Easy. 00:13:42.354 --> 00:13:45.414 Their eyes aren't the same color, but that fleck in the eyes-- 00:13:45.491 --> 00:13:48.517 That's maybe a one-in-10 chance if they're not related? 00:13:48.594 --> 00:13:50.994 No. House isn't gonna pay you based on that. 00:13:51.063 --> 00:13:54.931 Any excuse we can give the folks to justify a D.N.A. test? 00:13:55.000 --> 00:13:59.130 We could tell them he's got Huntington's-- whole family should be tested or they'll all die. 00:14:02.675 --> 00:14:04.609 Hey. 00:14:04.677 --> 00:14:08.545 There's a lot of blockage. I've scheduled him for surgery. 00:14:08.614 --> 00:14:10.531 We're gonna put a shunt into one of the ventricles 00:14:10.532 --> 00:14:12.448 to give the cerebrospinal fluid an out. 00:14:12.518 --> 00:14:15.146 No more pressure, everything goes back to normal. 00:14:15.221 --> 00:14:18.156 He's lucky to have you as his doctors. 00:14:26.866 --> 00:14:29.858 No formula. Just Mommy's healthy, natural breast milk. 00:14:29.935 --> 00:14:31.630 Yummy. 00:14:31.704 --> 00:14:34.798 Her whole face just got swollen like this overnight. 00:14:34.874 --> 00:14:37.104 Mm-hmm. 00:14:38.110 --> 00:14:40.442 No fever. 00:14:40.512 --> 00:14:43.345 Glands normal. Missing her vaccination dates. 00:14:43.415 --> 00:14:46.077 We're not vaccinating. 00:14:47.152 --> 00:14:49.643 Gribbet! Gribbet! 00:14:49.722 --> 00:14:51.246 Gribbet! 00:14:51.323 --> 00:14:53.018 Think they don't work? 00:14:53.092 --> 00:14:56.391 I think some multinational pharmaceutical company wants me to think they work-- 00:14:56.462 --> 00:14:59.693 pad their bottom line. Mm-hmm. 00:14:59.765 --> 00:15:02.063 - May I? - Sure. 00:15:03.068 --> 00:15:05.730 Gribbet. Gribbet. 00:15:05.804 --> 00:15:08.102 Gribbet. 00:15:08.173 --> 00:15:11.074 Yeah. All-natural, no dyes is a good business. 00:15:11.143 --> 00:15:13.270 All-natural children's toys. 00:15:13.345 --> 00:15:15.836 Toy companies-- they don't arbitrarily mark up their frogs. 00:15:15.915 --> 00:15:18.941 They don't lie about how much they spend on research and development. 00:15:19.018 --> 00:15:24.615 The worst that a toy company could be accused of is making a really boring frog. 00:15:24.690 --> 00:15:27.523 Gribbet, gribbet, gribbet. 00:15:27.593 --> 00:15:30.426 You know another really good business? 00:15:30.496 --> 00:15:32.726 Teeny, tiny baby coffins. 00:15:34.033 --> 00:15:36.297 You can get 'em in frog green, 00:15:36.368 --> 00:15:38.802 fire-engine red-- really. 00:15:38.871 --> 00:15:43.103 The antibodies in yummy Mummy only protect the kid for six months, 00:15:43.175 --> 00:15:45.769 which is why these companies think they can gouge you. 00:15:45.844 --> 00:15:49.575 They think that you'll spend whatever they ask to keep your kid alive. 00:15:49.648 --> 00:15:51.673 Want to change things? Prove 'em wrong. 00:15:51.750 --> 00:15:54.048 Few hundred parents like you decide they'd rather let 00:15:54.049 --> 00:15:56.346 their kid die than cough up 40 bucks for a vaccination, 00:15:56.422 --> 00:15:58.913 believe me, prices will drop really fast. 00:15:58.991 --> 00:16:01.926 Gribbet, gribbet, gribbet, gribbet, gribbet. 00:16:01.994 --> 00:16:03.393 Gribbet. 00:16:03.462 --> 00:16:05.293 Tell me what she has. 00:16:08.434 --> 00:16:10.959 A cold. 00:16:11.036 --> 00:16:13.129 There's a problem. 00:16:13.205 --> 00:16:16.333 Complications in surgery? Surgery went fine. He's in recovery. 00:16:16.408 --> 00:16:18.740 But we took a vial of C.S.F. and tested it. Really? 00:16:18.811 --> 00:16:21.780 Turns out the bowing wasn't the cause of his problems. It was a symptom. 00:16:21.847 --> 00:16:23.940 Oligoclonal bands and increased intrathecal IgG. 00:16:24.016 --> 00:16:28.180 Which means multiple sclerosis. And the reason it takes three of you to tell me this? 00:16:28.253 --> 00:16:30.983 Because we're having a disagreement about whether or not it is M.S. 00:16:31.056 --> 00:16:34.617 No lesions on the M.R.I. It's early. He's had the disease for maybe two weeks. 00:16:34.693 --> 00:16:36.558 - McDonald criteria requires six months to make a 00:16:36.559 --> 00:16:38.424 definitive diagnosis. - Who cares about MacPhearson? 00:16:38.497 --> 00:16:40.431 - I hear he tortured kittens. - McDonald. 00:16:40.499 --> 00:16:42.990 Oh, McDonald. Wonderful doctor, loved kittens. 00:16:43.068 --> 00:16:45.036 The V.E.P. indicates slowing of the brain. 00:16:45.104 --> 00:16:47.072 Without the lesions, we can't be sure. 00:16:47.139 --> 00:16:49.573 Well, if it is, it's gone from zero to 60 in three weeks, 00:16:49.641 --> 00:16:51.609 which would indicate rapidly progressive M.S. 00:16:51.677 --> 00:16:55.010 Not the fun M.S. with the balloons and the bike rides for cripples in wheelchairs. 00:16:55.080 --> 00:16:58.208 - We should wait until-- - Start treating him now, 00:16:58.283 --> 00:17:02.549 maybe he can walk for another couple of years, maybe live for another five. 00:17:02.621 --> 00:17:05.146 Break it to the family. I'm going home. 00:17:05.223 --> 00:17:09.285 It'll take months for a definitive diagnosis. What'll happen to me? 00:17:10.963 --> 00:17:13.227 M.S. is an incredibly variable disease. 00:17:13.298 --> 00:17:16.699 If it is M.S., and we're not a hundred percent sure. 00:17:16.769 --> 00:17:19.237 What do you think is gonna happen? 00:17:22.574 --> 00:17:24.872 There are some medications to manage the symptoms, 00:17:24.943 --> 00:17:28.069 but as the disease progresses, the problems will become more severe. 00:17:28.146 --> 00:17:30.479 Bowel and bladder dysfunction, 00:17:30.549 --> 00:17:33.143 loss of cognitive function, pain-- 00:17:33.218 --> 00:17:35.709 So it's gonna hurt? 00:17:36.922 --> 00:17:39.356 The brain's like a big jumble of wires. 00:17:39.425 --> 00:17:41.985 M.S. strips them of the insulation, and the nerves die. 00:17:42.061 --> 00:17:44.689 Brain interprets it as pain. 00:17:44.763 --> 00:17:48.028 But by starting treatment, we're gonna prevent that for as long as possible. 00:17:49.034 --> 00:17:50.968 We're looking into a couple of specialists, 00:17:51.036 --> 00:17:54.563 and until we get you squared away, you'll stay here, okay? 00:18:15.260 --> 00:18:17.751 Security checked the videotapes from all perimeter cameras. 00:18:17.830 --> 00:18:20.060 He's still gotta be in the hospital. Where's Chase? 00:18:20.132 --> 00:18:22.692 Main floor. Okay. You take the cafeteria and administration. 00:18:22.768 --> 00:18:25.362 I'll hit the research annex and work my way back to you. 00:19:02.708 --> 00:19:04.699 Dan? 00:19:08.947 --> 00:19:11.814 I'm not here. Leave a message. 00:19:18.157 --> 00:19:20.955 Dr. Cuddy. Great outfit. 00:19:21.026 --> 00:19:23.290 What are you doing back here? Patient? 00:19:23.362 --> 00:19:26.854 No. Hooker. Went to my office instead of my home. 00:19:37.242 --> 00:19:39.676 Dr. House. 00:19:39.745 --> 00:19:42.543 Dan's missing. Yeah. I got that part from the message. 00:19:42.614 --> 00:19:45.845 You said I was needed immediately. He shouldn't move after a lumbar puncture. 00:19:45.918 --> 00:19:48.614 I agree. He's gonna have a very nasty headache. 00:19:48.687 --> 00:19:51.815 That would also be my opinion if consulted tomorrow morning. 00:19:51.890 --> 00:19:55.053 We wanted to keep you informed. He heard some pretty heavy news. 00:19:56.895 --> 00:19:59.591 This is not a toddler wandering around a department store. 00:19:59.665 --> 00:20:02.862 He's 16. You'll find him. 00:20:02.935 --> 00:20:04.869 I'm going home. 00:20:04.937 --> 00:20:07.906 So when you say, "Call me if you need anything", you mean don't call? 00:20:07.973 --> 00:20:10.203 No, I mean call me if I could do something. 00:20:10.275 --> 00:20:14.405 I'm bad at search parties, and I'm bad at sitting around looking nervous, doing nothing. 00:20:14.479 --> 00:20:16.504 What about his parents? Should we call them? 00:20:16.582 --> 00:20:18.982 Why? Do you think they're hiding him? 00:20:19.051 --> 00:20:21.019 Make sure someone checks the roof. 00:20:22.087 --> 00:20:25.887 Some of the orderlies keep the door propped open so they can grab a smoke. 00:21:00.425 --> 00:21:03.292 Dan. You okay? 00:21:10.035 --> 00:21:13.766 There are experimental treatments. Ongoing research. 00:21:13.839 --> 00:21:16.239 Who knows what they'll discover in a year or two. 00:21:16.308 --> 00:21:18.276 This is where I dropped the ball. 00:21:18.343 --> 00:21:20.868 Dan, we're standing on the roof of the hospital. 00:21:23.548 --> 00:21:25.539 Dan. 00:21:25.617 --> 00:21:27.642 Dan, you're not on the field. 00:21:27.719 --> 00:21:29.880 He doesn't know where he is. Dan. 00:21:29.955 --> 00:21:31.320 Foreman. 00:21:32.524 --> 00:21:34.287 Dan. 00:21:35.527 --> 00:21:37.461 - Dan? - Dan, no! 00:21:48.140 --> 00:21:50.631 Dr. Foreman. 00:21:52.277 --> 00:21:54.268 I assume you found the kid. 00:21:54.346 --> 00:21:56.940 He almost walked off the roof. Suicidal? 00:21:57.015 --> 00:22:00.883 No, he thought he was on his lacrosse field. Look, I was gonna run home, shower, change-- 00:22:00.952 --> 00:22:02.886 Conscious? Yeah. 00:22:03.955 --> 00:22:06.549 How'd you talk him down? Actually, Chase tackled him. 00:22:06.625 --> 00:22:08.559 How come you didn't do it? 00:22:08.627 --> 00:22:11.061 Right. Well, I am black, but he was closer. 00:22:13.632 --> 00:22:15.623 Come on. You can ride up with me. 00:22:22.307 --> 00:22:26.038 Anybody tell the family that their boy almost stepped off a roof? They must be thrilled. 00:22:26.111 --> 00:22:28.306 They're not suing, but I think only because Chase asked-- 00:22:28.380 --> 00:22:30.905 Why does everybody always think I'm being sarcastic? 00:22:30.982 --> 00:22:33.177 This is great news. He doesn't have M.S. 00:22:33.251 --> 00:22:36.948 Parents should be thrilled. The mom anyway. Ofcourse, the dad probably doesn't know-- 00:22:37.022 --> 00:22:41.322 - Why doesn't he have M.S.? - He was on the roof, thinking he was on a lacrosse field. 00:22:41.393 --> 00:22:45.261 - Conscious, and therefore not a night terror. You want some of this? - Yeah, sure. 00:22:45.330 --> 00:22:47.423 He was in an acute confusional state, 00:22:47.499 --> 00:22:50.297 which doesn't fit with a demyelinating disease like M.S. 00:22:50.369 --> 00:22:52.428 Oligoclonal bands-- Were real. 00:22:52.504 --> 00:22:56.031 They just mean something other than M.S. So, what are they telling us? 00:22:56.108 --> 00:22:58.099 That the immune system is working? Right. 00:22:58.176 --> 00:23:00.303 He has an infection in his brain. 00:23:00.379 --> 00:23:02.370 What about sex? 00:23:02.447 --> 00:23:05.678 Well, it might get complicated. I mean, we work together. 00:23:05.751 --> 00:23:08.811 - I'm older, certainly, but maybe you like that. - I meant maybe he has neurosyphilis. 00:23:08.887 --> 00:23:12.653 - Huh. Nice cover. - Sorry. R.P.R. was negative. 00:23:12.724 --> 00:23:16.182 We don't need a definitive test to confirm. Sure. Didn't need one to confirm M.S. 00:23:16.261 --> 00:23:20.755 Okay. Let's wait for you to run titers on 1,400 viruses while this kid's brain turns to mush. 00:23:20.832 --> 00:23:24.427 So the fact that he doesn't have M.S., it's-- it's really not good news after all. 00:23:24.503 --> 00:23:26.630 Well, it is if it's neurosyphilis. 00:23:26.705 --> 00:23:29.765 The likelihood of a false negative on an R.P.R. test: 30%. 00:23:29.841 --> 00:23:33.333 Likelihood of a 16-year-old having sex: roughly 120%. 00:23:33.412 --> 00:23:35.846 I'll start him on I.V. penicillin. We're not gonna wait for that. 00:23:35.914 --> 00:23:39.441 The most effective way to deliver the drug is right into his brain via the spine. 00:23:39.518 --> 00:23:41.452 We can't. In a cramped space like the brain, 00:23:41.520 --> 00:23:43.403 increased intracranial pressure from a high-volume 00:23:43.404 --> 00:23:45.286 drug like penicillin could herniate his brain stem. 00:23:45.357 --> 00:23:48.383 It'd kill him. No neurologist in his right mind would recommend that. 00:23:48.460 --> 00:23:51.293 Show of hands. Who thinks I'm not in my right mind? 00:23:51.363 --> 00:23:55.231 And who thinks I forget this fairly basic neurological fact? 00:23:55.300 --> 00:23:57.530 Who thinks there's a third option? 00:23:59.604 --> 00:24:03.540 - Very good. What's the third choice? - No idea. You just asked if I thought there was one. 00:24:07.345 --> 00:24:10.439 The patient has a shunt in his brain. There'll be no increased pressure. 00:24:10.515 --> 00:24:13.040 We can put as much penicillin into his body as we want. 00:24:13.118 --> 00:24:16.053 Excellent. Inject him through a lumbar puncture. 00:24:18.957 --> 00:24:22.085 One of us is gonna do this to you twice a day for the next two weeks. 00:24:24.896 --> 00:24:27.660 - I'm ready. Go. - He could get syphilis... 00:24:27.732 --> 00:24:30.326 even if he's not sexually active? 00:24:31.403 --> 00:24:34.804 Well, it's-- it's unusual, but it's possible. 00:24:35.807 --> 00:24:37.798 Okay. Relax. 00:24:50.589 --> 00:24:53.752 It's infected, with a really big hole, 00:24:53.825 --> 00:24:56.191 like you stuck a nail in it to relieve the pressure. 00:24:56.261 --> 00:24:59.253 I wouldn't do that. Although the wound is irregular. 00:24:59.331 --> 00:25:02.596 It's not cylindrical. It's shaped like a triangle. So, not a nail. 00:25:02.667 --> 00:25:04.726 - Steak knife? - Wife's nail file. 00:25:04.803 --> 00:25:07.294 Nail file. 00:25:07.372 --> 00:25:09.431 Yeah. Pain will make you do stupid things. 00:25:10.509 --> 00:25:13.535 - Something to take the edge off? - Yeah. 00:25:15.680 --> 00:25:17.671 Cheers. 00:25:21.486 --> 00:25:24.512 So, you have family here in Princeton? 00:25:24.589 --> 00:25:27.319 No. Here on work? 00:25:27.392 --> 00:25:29.587 - No. Why are you-- - Does your penis hurt? 00:25:29.661 --> 00:25:31.822 No. What? Should it? 00:25:31.897 --> 00:25:35.424 No. Just thought I'd toss you a really inappropriate question. 00:25:35.500 --> 00:25:39.630 - Your lawyer's gonna love it. - Why would I want to sue you? I want you to treat me. 00:25:39.704 --> 00:25:42.172 - You're from Maplewood, New Jersey, right? - Yeah. 00:25:42.240 --> 00:25:44.504 Now, why would you drive 70 miles... 00:25:44.576 --> 00:25:47.511 to get treatment for a condition that a nine-year-old could diagnose? 00:25:49.047 --> 00:25:51.982 It's the free-flowing pus that's the tip-off. 00:25:52.050 --> 00:25:54.951 I was in town. Not for family. Not for work. 00:25:55.020 --> 00:25:58.353 You drove 70 miles to a walk-in clinic. You passed two hospitals on the road. 00:25:58.423 --> 00:26:01.915 Either you've got a problem with those hospitals, or they have a problem with you. 00:26:01.993 --> 00:26:04.518 My guess is you've sued half the doctors in Maplewood, 00:26:04.596 --> 00:26:06.655 and the rest are now refusing to help you. 00:26:06.731 --> 00:26:10.462 It's ironic, isn't it? Sort of like the boy who sued wolf. 00:26:10.535 --> 00:26:13.766 You know, I bet we have a doctor here named Wolf. 00:26:13.838 --> 00:26:16.272 How perfect would that be? 00:26:16.341 --> 00:26:18.639 - I'm gonna page him. - Okay. You know what? Thank you. 00:26:18.710 --> 00:26:20.974 I'm gonna find a doctor to take care of this. 00:26:21.046 --> 00:26:22.980 I didn't say I wouldn't treat you. 00:26:23.048 --> 00:26:26.381 - We'll drain your knee, run some lab work. Fix you up. - Why would you do that? 00:26:26.451 --> 00:26:28.385 I'm a people person. 00:26:28.453 --> 00:26:30.978 You actually treated him? 00:26:31.056 --> 00:26:33.024 All I know is he sued some doctors. 00:26:33.091 --> 00:26:35.423 Who am I to assume they didn't have it coming to them? 00:26:35.493 --> 00:26:38.826 The cutest little tennis outfit. My God, I thought I was gonna have a heart attack. 00:26:38.897 --> 00:26:42.128 Oh, my. Didn't see you there. That is so embarrassing. How's your hooker doing? 00:26:42.200 --> 00:26:44.134 Sweet of you to ask. Funny story. 00:26:44.202 --> 00:26:48.002 She was gonna be hospital administrator, but just hated having to screw people like that. 00:26:48.073 --> 00:26:50.871 - Heard you found her on the roof. - You have very acute hearing. 00:26:50.942 --> 00:26:52.637 You notify the parents? 00:26:52.711 --> 00:26:54.645 In due course, ofcourse. 00:26:54.713 --> 00:26:58.205 And is there a paternity bet on the father of the patient? 00:26:58.283 --> 00:27:01.582 Doesn't sound like me. Well, it does, actually, but doesn't mean you're guilty. 00:27:01.653 --> 00:27:03.644 You think? I saw the parents in the lobby. 00:27:03.722 --> 00:27:06.236 - Smart money's obviously on the father. - My guy 00:27:06.237 --> 00:27:08.750 knows a guy who can get you in for 50 bucks. 00:27:08.827 --> 00:27:12.729 Fine. Tell your guy, if I win, you attend the faculty symposium, and you wear a tie. 00:27:12.797 --> 00:27:15.265 And if I win, no clinic hours for a week. 00:27:15.333 --> 00:27:17.665 My guy will call your guy. 00:27:20.171 --> 00:27:22.366 She's very good at her job. 00:27:25.744 --> 00:27:29.111 The treatments should start helping soon. 00:27:29.180 --> 00:27:32.547 Let us know if it gets easier to focus on things, remember stuff. 00:27:34.552 --> 00:27:38.010 Hey, Dan. Isn't Dr. Cameron's necklace a beauty? 00:27:38.089 --> 00:27:40.148 Something South American, I think. 00:27:40.225 --> 00:27:42.193 Yeah. Guatemalan. 00:27:43.261 --> 00:27:45.286 It's a cool necklace. 00:27:47.032 --> 00:27:49.694 - Thank you so much. - The kid's in pain. 00:27:51.302 --> 00:27:53.862 Don't fight it. Just let it happen. No. 00:27:53.938 --> 00:27:55.963 You'll be dead in two days. No what? 00:27:56.041 --> 00:27:58.305 I give it a day. Dan? You okay? 00:27:58.376 --> 00:27:59.536 Dan? 00:27:59.611 --> 00:28:02.079 Night terrors. - Decomposition once he's in the grave. 00:28:02.147 --> 00:28:05.048 - Say good-bye to your mother and father. - He's hearing voices. 00:28:05.116 --> 00:28:07.584 You're dying. It's all over, Dan. 00:28:08.820 --> 00:28:12.051 You're dying. Dying. Dead! 00:28:13.058 --> 00:28:16.118 Push two milligrams I.V. Ativan, stat. 00:28:16.194 --> 00:28:18.822 It's all over. - Come on, Dan. 00:28:18.897 --> 00:28:20.728 Get out of my head! 00:28:22.534 --> 00:28:25.526 Auditory hallucination shows further brain degeneration. 00:28:25.603 --> 00:28:29.630 Penicillin's not working. So either it's a bad batch of penicillin, 00:28:29.708 --> 00:28:31.699 or our diagnosis is wrong. 00:28:33.545 --> 00:28:35.536 Square one. 00:28:35.613 --> 00:28:39.549 Midnite. L.F. T.'s, B.U.N. and creatinine are all normal. 00:28:39.617 --> 00:28:42.085 - Diabetes is out, and no gap. - There goes metabolic. 00:28:42.153 --> 00:28:44.815 - M.R.A. rules out vasculitis. - "I" for inflammation. 00:28:44.889 --> 00:28:47.517 - Too young for anything degenerative. - "D", see ya. 00:28:47.592 --> 00:28:49.856 "N" for neoplastic. M.R.I. was clean. 00:28:50.929 --> 00:28:53.557 - "I" for inflammation. - We already did that. 00:28:53.631 --> 00:28:56.896 - Stupid to have two I's in one mnemonic. What's the other one? - Infection. 00:28:56.968 --> 00:28:59.016 - Oligoclonal bands still have to mean something. - But 00:28:59.017 --> 00:29:01.064 no fevers. White count's elevated, but within range. 00:29:01.139 --> 00:29:03.767 We've tested for anything remotely possible. Everything's negative. 00:29:03.842 --> 00:29:07.539 - C.T. scan rules out subdural. - Trauma. Later much. 00:29:12.817 --> 00:29:16.947 You know the problem? "Midnight" is actually spelled with a "G" and an "H". 00:29:17.956 --> 00:29:20.823 If we could just figure out what those letters stand for. 00:29:24.996 --> 00:29:28.523 It's a sick brain, having fun, 00:29:30.101 --> 00:29:32.262 torturing him, talking to him. 00:29:37.809 --> 00:29:39.800 Scaring the hell out of him. 00:29:42.280 --> 00:29:47.047 Get him an E.E.G., left and right E.O.G., esophageal microphones. 00:29:47.118 --> 00:29:50.986 If this thing wants to talk, let's listen. 00:29:52.690 --> 00:29:56.626 We're missing something. This is screwed-up. 00:29:56.694 --> 00:30:00.221 That's why you came up with the brain talking to the virus thing? 00:30:00.298 --> 00:30:02.095 I panicked, okay? 00:30:02.167 --> 00:30:05.967 Sounded cool though. They bought it. 00:30:08.540 --> 00:30:11.270 Oh, crap. 00:30:11.342 --> 00:30:13.606 Another reason I don't like meeting patients. If they 00:30:13.607 --> 00:30:15.870 don't know what you look like, they can't yell at you. 00:30:15.947 --> 00:30:17.938 Here we go. 00:30:21.152 --> 00:30:23.586 How can you just sit there? 00:30:25.023 --> 00:30:26.991 If I eat standing up, I spill. 00:30:27.058 --> 00:30:30.118 Our son is dying, and you could care less. 00:30:31.296 --> 00:30:34.322 We're going through hell. You're doing nothing? 00:30:35.333 --> 00:30:39.133 - I'm sorry. You need to vent. I understand. - Don't be condescending. 00:30:40.205 --> 00:30:42.605 You haven't checked in on him once. 00:30:42.674 --> 00:30:45.336 Blood pressure is 110 over 70. 00:30:45.410 --> 00:30:48.208 His shunt is patent, well-placed in the right lateral ventricle. 00:30:48.279 --> 00:30:50.543 The E.K.G. shows a normal Q.R.S. with deep-wave 00:30:50.544 --> 00:30:52.807 inversions throughout both limb and precordial leads. 00:30:52.884 --> 00:30:55.785 L.F. T.'s are elevated, but only twice the normal range. 00:30:55.854 --> 00:30:58.322 Oh, yeah. And he's hearing voices. 00:31:02.560 --> 00:31:04.551 Go hold his hand. 00:31:06.464 --> 00:31:09.058 Go on. I'll bus your tray. 00:31:23.014 --> 00:31:25.915 - Got any sample bags on you? - I don't believe you. 00:31:25.984 --> 00:31:29.647 You're gonna run D.N.A. tests? Their son is deathly ill. 00:31:29.721 --> 00:31:33.851 I know. It's terrible. But the fact is, if I don't keep busy with trivial things like this, 00:31:33.925 --> 00:31:36.052 I'm afraid I might start to cry. You're an ass. 00:31:36.127 --> 00:31:39.028 Yeah? You want to double the bet? 00:31:49.741 --> 00:31:52.403 General Hospital is on channel 6. 00:31:52.477 --> 00:31:56.038 Dan's brain's not showing channel 6 right now. Only mush. 00:31:56.114 --> 00:31:58.309 No epileptiform activity. 00:31:59.984 --> 00:32:02.748 What are you doing? Waiting for C.B.C. and CHEM-7. 00:32:02.820 --> 00:32:05.721 Good. Run D.N.A. on these. 00:32:07.292 --> 00:32:10.159 What's this? Parents' coffee cups. 00:32:11.863 --> 00:32:14.263 I can't believe you. I've had this conversation once already. 00:32:14.332 --> 00:32:16.926 If you've got something else to do, do it. Otherwise, do this. 00:32:25.176 --> 00:32:28.236 Dr. House. Hey. Mr. Funsten. 00:32:28.313 --> 00:32:31.373 I was wondering when you'd be back. You got some papers for me? 00:32:31.449 --> 00:32:34.885 You've caused me considerable mental distress. I certainly hope so. 00:32:35.920 --> 00:32:39.981 What? Too cheap to get your lawyer to serve it for you, or is it just more fun this way? 00:32:40.058 --> 00:32:42.253 I'm obviously prepared to consider a settlement. 00:32:42.327 --> 00:32:44.420 You have gonorrhea. 00:32:46.230 --> 00:32:50.064 No, I don't. Well, maybe you're right, but I have the lab result says you do. 00:32:50.134 --> 00:32:52.728 Could be a false positive, and normally I'd run a second test, 00:32:52.804 --> 00:32:56.205 but since you're here, I'll just go with the first. You're just trying to scare me. 00:32:56.274 --> 00:32:59.607 It's reportable, you know. Public health issue. I'll be sure to let my wife know. 00:32:59.677 --> 00:33:02.305 Don't bother yourself. The state will call for you. 00:33:02.380 --> 00:33:04.940 If you're clean, I'm sure it'll all blow over. No big deal. 00:33:05.016 --> 00:33:08.349 There's an easy way to find out. Get one of your doctors to run a test. 00:33:10.321 --> 00:33:12.255 Uh-uh. 00:33:12.323 --> 00:33:15.087 These are mine now. I'll see you in court. 00:33:19.530 --> 00:33:21.464 West Nile negative. Not surprising since not too 00:33:21.465 --> 00:33:23.398 many mosquitoes passing through Jersey in December. 00:33:23.468 --> 00:33:25.959 No eastern equine encephalitis. You guys aren't gonna believe this. 00:33:26.037 --> 00:33:29.973 What's that? House is right. The father's not the father. 00:33:30.041 --> 00:33:33.943 Dude doubled up on me. 00:33:34.012 --> 00:33:36.071 You're not gonna believe this. 00:33:36.147 --> 00:33:38.638 The mother's not the mother either. 00:33:39.917 --> 00:33:42.943 It's not a good idea to move your son in his condition. 00:33:43.021 --> 00:33:45.615 - We just want a second opinion. We need an answer. 00:33:46.424 --> 00:33:49.882 You idiots. You lied to me. 00:33:49.961 --> 00:33:51.895 We didn't lie about anything. 00:33:51.963 --> 00:33:55.160 - You, on the other hand, accused us of molesting our son. - Perfect. 00:33:55.233 --> 00:33:57.997 Can we get off my screwups and focus on theirs? 00:33:58.069 --> 00:34:00.162 Theirs is bigger. You're not Dan's parents. 00:34:00.238 --> 00:34:03.071 We're his parents. He was adopted. He doesn't need to know. 00:34:03.141 --> 00:34:05.132 - I do. - Adoption makes us just as much-- 00:34:05.209 --> 00:34:09.543 Listen. When we were taking his medical history, were you confused? 00:34:09.614 --> 00:34:12.411 Did you think we were looking for a genetic clue to his condition, 00:34:12.483 --> 00:34:16.543 or did you think we were trying to ascertain who loves him the most in the whole wide world? 00:34:16.621 --> 00:34:18.782 How did you find out about this? 00:34:18.856 --> 00:34:22.257 - I sampled their D.N.A. - We didn't give you any D.N.A. 00:34:22.326 --> 00:34:24.760 Your coffee cups from the cafeteria. 00:34:24.829 --> 00:34:28.764 - You can't do that. - Again, why are we getting hung up on what I did? 00:34:28.833 --> 00:34:31.751 - Your medical history is useless. - No. We gave 00:34:31.752 --> 00:34:34.668 you a detailed history of his biological mother. 00:34:34.739 --> 00:34:37.902 Her history. Nonsmoker, good health, 00:34:37.975 --> 00:34:40.500 low cholesterol, no blood pressure problems. 00:34:40.578 --> 00:34:42.705 Dan was adopted two weeks after he was born. 00:34:42.780 --> 00:34:44.947 - You have his history. There's nothing you need to 00:34:44.947 --> 00:34:47.114 know that we didn't tell you. - Sounds reasonable. 00:34:47.185 --> 00:34:50.245 Well, if you want to transfer your boy, that is your choice. 00:34:50.321 --> 00:34:53.016 I still think it's the wrong-- Was she vaccinated? 00:34:55.126 --> 00:34:58.095 The biological mother. When she was a baby, did she get her vaccinations? 00:34:58.162 --> 00:35:01.154 Dan was vaccinated. At six months. 00:35:01.232 --> 00:35:04.929 Mm-hmm. Do you know why kids get vaccinated at six months? 00:35:05.002 --> 00:35:07.630 Because before that they are protected... 00:35:07.705 --> 00:35:10.299 by their biological mother's immune system. 00:35:10.374 --> 00:35:13.138 So, was she vaccinated? 00:35:16.914 --> 00:35:19.678 An infant picks up a regular old measles virus. 00:35:19.750 --> 00:35:21.684 Gets a rash. 00:35:21.752 --> 00:35:25.381 He's extremely uncomfortable, has a wicked fever, but he lives. 00:35:25.456 --> 00:35:29.324 Here's the kicker. Once every million or so times, 00:35:29.393 --> 00:35:31.691 the virus mutates. 00:35:31.762 --> 00:35:34.287 Instead of Dan having a fever and a rash, 00:35:34.365 --> 00:35:37.027 the virus travels to his brain and hides, 00:35:37.101 --> 00:35:39.035 like a time bomb. 00:35:39.103 --> 00:35:41.469 In this case, for 16 years. 00:35:41.539 --> 00:35:44.099 Subacute sclerosing panencephalitis. 00:35:45.510 --> 00:35:48.968 I know. There's only been 20 cases in the United States in the last 30 years. 00:35:49.046 --> 00:35:52.379 I suppose you could make an argument the kid's still in stage I. 00:35:52.450 --> 00:35:54.577 Once S.S.P.E. moves to stage II, it's-- 00:35:54.652 --> 00:35:57.780 Boom. Stage II is universally fatal. 00:35:57.855 --> 00:36:00.824 I assume its impossible to know when he might move into stage II. 00:36:00.892 --> 00:36:05.090 He's already started showing symptoms. Could be a month. Could be tonight. 00:36:05.163 --> 00:36:07.393 Can we treat it? Ask the neurologist. 00:36:07.465 --> 00:36:09.558 Intraventricular interferon. 00:36:09.634 --> 00:36:13.502 Not gonna shove a spike into his brain and drip interferon without confirming this diagnosis. 00:36:13.571 --> 00:36:17.337 - Tap him. - We won't get a reliable result for measles antibodies in his C.S.F. 00:36:17.408 --> 00:36:19.342 Not after everything we've given him. 00:36:19.410 --> 00:36:22.208 So the wrong treatment kills any hope of the right diagnosis. 00:36:22.280 --> 00:36:25.044 Why do people lie to me? 00:36:25.116 --> 00:36:27.050 Could also kill him. 00:36:27.118 --> 00:36:31.555 Your ball, Foreman. Tell me I don't have to biopsy his brain. 00:36:33.124 --> 00:36:35.217 Well, there is one other way. 00:36:36.794 --> 00:36:38.785 You sure this isn't gonna hurt? 00:36:38.863 --> 00:36:40.854 Yeah. It's just scary as hell. 00:36:40.932 --> 00:36:43.059 See, we go through the pupil. 00:36:43.134 --> 00:36:45.364 But you won't feel it. The eye's been paralyzed. 00:36:45.436 --> 00:36:47.768 The needle travels to the back of the eye, 00:36:47.838 --> 00:36:50.705 which is where we'll perform the biopsy on your retina. 00:36:56.047 --> 00:36:59.073 So we've confirmed that the problem is this mutated virus. 00:36:59.150 --> 00:37:02.950 The treatment for S.S.P.E. is intraventricular interferon. 00:37:03.020 --> 00:37:05.750 We implant an ommaya reservoir under the scalp, 00:37:05.823 --> 00:37:08.053 which is connected to a ventricular catheter... 00:37:08.125 --> 00:37:10.685 that delivers the antiviral directly to the left hemisphere. 00:37:10.761 --> 00:37:14.595 You want us to consent to this? I don't even understand what you're talking about. 00:37:14.665 --> 00:37:16.724 Well, the antiviral-- 00:37:19.503 --> 00:37:21.437 Look. I'm sorry. 00:37:21.505 --> 00:37:23.689 I can explain this as best I can, but the notion that 00:37:23.690 --> 00:37:25.874 you're gonna fully understand your son's treatment... 00:37:25.943 --> 00:37:30.073 and make an informed decision is-- is kind of insane. 00:37:31.816 --> 00:37:34.080 Here's what you need to know. 00:37:35.086 --> 00:37:37.054 It's dangerous. 00:37:37.121 --> 00:37:39.351 It could kill him. 00:37:39.423 --> 00:37:41.414 You should do it. 00:37:52.503 --> 00:37:54.733 Did you need something else? 00:38:13.357 --> 00:38:16.485 You can't order a $3,200 D.N.A. test to win a bet. 00:38:16.560 --> 00:38:18.721 It's not an actual cost. 00:38:18.796 --> 00:38:22.664 I don't know if you know this, but the hospital actually owns the sequencing machine. 00:38:22.733 --> 00:38:25.327 - I'm serious. - Tell the parents to submit the bill to insurance. 00:38:25.403 --> 00:38:27.234 Insurance is not gonna pay for a bet. 00:38:27.305 --> 00:38:31.674 Should. We don't make that bet, the kid dies. 00:38:31.742 --> 00:38:34.609 If not for the paternity bet, I never would have taken their D.N.A. 00:38:34.679 --> 00:38:37.079 Without their D.N.A., we never would have discovered 00:38:37.080 --> 00:38:39.480 that Dan was adopted, which was the key to this case. 00:38:39.550 --> 00:38:41.518 You just don't want to pay your end. 00:38:41.585 --> 00:38:44.486 Big mistake. My guy knows a guy. 00:38:44.555 --> 00:38:48.252 Fine. I will let you out of clinic duty for one week, 00:38:48.326 --> 00:38:51.318 after you pay the 3,200 for the P.C.R. test. 00:38:59.103 --> 00:39:00.627 Ooh. 00:39:00.705 --> 00:39:04.163 Well, now, there's the hundred you owe me. 00:39:05.242 --> 00:39:07.176 Here's a hundred I won from Cameron. 00:39:07.244 --> 00:39:09.804 200 I took off of Foreman. 00:39:11.182 --> 00:39:13.650 And 600... 00:39:13.718 --> 00:39:16.209 I got from Wilson. 00:39:17.421 --> 00:39:18.979 Very bitter. 00:39:22.927 --> 00:39:24.952 Hey. Good morning. 00:39:25.029 --> 00:39:27.793 Good news on your E.E.G. Treatment is working. 00:39:27.865 --> 00:39:29.958 And your immune system is responding. 00:39:30.034 --> 00:39:33.435 I know it's early, but I just want to take a look. 00:39:34.772 --> 00:39:38.674 All right. Let's see what that brain of yours can do. 00:39:38.743 --> 00:39:42.201 Name as many animals as you can that start with the letter "O". 00:39:42.279 --> 00:39:44.338 Ostrich. 00:39:45.116 --> 00:39:47.880 Ox. Old elephant. 00:39:47.952 --> 00:39:50.785 Well, that's two better than last time. 00:39:51.856 --> 00:39:54.381 How you doing with the whole adoption thing? 00:39:54.458 --> 00:39:57.256 - I knew since fifth grade. - How's that? 00:39:57.328 --> 00:40:00.263 Cleft chin. 00:40:00.331 --> 00:40:02.925 I have one. My dad doesn't. 00:40:03.000 --> 00:40:07.630 Looked it up on the Internet. It's one of those trait things. 00:40:07.705 --> 00:40:10.196 That's right. It's autosomal dominant. 00:40:11.208 --> 00:40:13.426 Since neither of your parents have cleft chins, 00:40:13.427 --> 00:40:15.645 it's highly unlikely you're biologically related. 00:40:16.981 --> 00:40:21.680 - Are you sure you're okay? - I've got no problems with being adopted. 00:40:22.686 --> 00:40:24.677 I love my parents. 00:40:27.992 --> 00:40:30.426 How's he doing? He's doing pretty well. 00:40:30.494 --> 00:40:32.052 He's a smart kid. 00:40:32.129 --> 00:40:34.097 I think he's gonna be fine. 00:40:37.868 --> 00:40:40.200 - Hey. - Thanks. 00:41:15.573 --> 00:41:17.837 Wheels, 18. Wheels. 00:43:06.917 --> 00:43:08.179 Ripped by phaelox for divxstation.com