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name,line
Melanie, Why are you late?
Rebecca, You're not going to like the answer.
Melanie, I already know the answer.
Rebecca, I missed the bus.
Melanie," I don't doubt it, no bus stops near Brad's. You spent the night, the alarm didn't work. Or maybe it did."
Rebecca, I didn't sleep with him.
Melanie," Girl, there's...[Interrupted]"
Rebecca, I missed the bus!
Melanie," There's something either very wrong with you, or there's something very wrong with him."
Rebecca, There's nothing wrong with him.
Melanie, Please tell me you know that for a fact.
Rebecca," Melanie, I gotta go."
Melanie, You're lying aren't you?
Rebecca, I wouldn't lie to you. [Turns to class of 5 year olds] Good morning guys!
Class, Good morning Miss Rebecca!
Rebecca, Everybody's in their seats?
Class, Yes!
Rebecca," Ok, Sidney, why don't you tell us what you did this weekend. Come on, Sidney, we know you're not shy."
Sidney," How come we always have to tell you what we did, and you nEver tell us what you did?"
Class, [giggles]
Rebecca," Ok, I had a really great weekend, but you can't tell Miss Melanie, ok?"
Sidney, What did you do?
Rebecca," I made a new friend. It's so much fun to make new friends, isn't it?"
Class," Yeah, Yes, etc."
Rebecca, Absolutely! You should nEver keep anything from your parents. And I told them [gibberish]
Class, [giggles]
Rebecca, Wh..
Rebecca, [gibberish]
Class, [Laughs and giggles]
Class," C, A, T, H"
Sidney," ""the""ù"
Boy," We know that word, ""the""ù"
Wilson," 29 year old female, first seizure one month ago, lost the ability to speak. Babbled like a baby. Present deterioration of mental status."
House, See that? They all assume I'm a Patient because of this cane.
Wilson, So put on a white coat like the rest of us.
House, I don't want them to think I'm a doctor.
Wilson, You see where the administration might have a pRoblem with that attitude.
House, People don't want a sick doctor.
Wilson, Fair enough. I don't like healthy Patients. The 29 year old female!
House," The one who can't talk, I liked that part."
Wilson, She's my cousin.
House," And your cousin doesn't like the diagnosis. I wouldn't either. Brain tumor, she's gonna die, boring."
Wilson, No wonder you're such a renowned diagnostician. You don't need to actually know anything to figure out what's wrong.
House, You're the oncologist; I'm just a lowly infectious disease guy.
Wilson," Hah, yes, just a simple country doctor. Brain tumors at her age are highly unlikely."
House, She's 29. WhatEver she's got is highly unlikely.
Wilson, Protein markers for the three most prevalent brain cancers came up negative.
House, That's an HMO lab; you might as well have sent it to a high school kid with a chemistry set.
Wilson, No family history.
House, I thought your uncle died of cancer.
Wilson, Other side. No environmental factors.
House, That you know of.
Wilson, And she's not responding to radiation treatment.
House, None of which is Even close to dispositive. All it does is raise one question. Your cousin goes to an HMO?
Wilson, Come on! Why leave all the fun for the coroner? What's the point of putting together a team if you're not going to use them? You've got three overqualified doctors working for you. Getting bored.
Foreman, It's a lesion.
House, And the big green thing in the middle of the bigger blue thing on a map is an island. I was hoping for something a bit more creative.
Foreman, Shouldn't we be speaking to the Patient before we start diagnosing?
House, Is she a doctor?
Foreman," No, but!"
House, Everybody lies.
Cameron, Dr. House doesn't like dealing with Patients.
Foreman, Isn't treating Patients why we became doctors?
House," No, treating illnesses is why we became doctors, treating Patients is what makes most doctors miserable."
Foreman, So you're trying to eliminate the huManity from the practice of medicine.
House," If we don't talk to them they can't lie to us, and we can't lie to them. HuManity is overrated. I don't think it's a tumor."
Foreman," First year of medical school if you hear hoof beats you think ""horses""ù not ""zebras""ù."
House," Are you in first year of medical school? No. First of all, there's nothing on the CAT scan. Second of all, if this is a horse then the kindly family doctor in Trenton makes the obvious diagnosis and it nEver gets near this office. Differential diagnosis, people: if it's not a tumor what are the suspects? Why couldn't she talk?"
Chase," Aneurysm, stroke, or some other ischemic syndrome."
House, Get her a contrast MRI.
Cameron, Creutzfeld-Jakob disease.
Chase, Mad cow?
House, Mad zebra.
Foreman, Wernickie's encephalopathy?
House," No, blood thiamine lEvel was normal."
Foreman," Lab in Trenton could have screwed up the blood test. I assume it's a corollary if people lie, that people screw up."
House, Re-draw the blood tests. And get her scheduled for that contrast MRI ASAP. Let's find out what kind of zebra we're dealing with here.
Cuddy, I was expecting you in my office 20 minutes ago.
House," Really? Well, that's odd, because I had no intention of being in your office 20 minutes ago."
Cuddy, You think we have nothing to talk about?
House," No, just that I can't think of anything that I'd be interested in."
Cuddy, I sign your paychecks.
House," I have tenure. Are you going to grab my cane now, stop me from leaving?"
Cuddy, That would be juvenile.
Cuddy, I can still fire you if you're not doing your job.
House, I'm here from 9 to 5.
Cuddy, Your billings are practically nonexistent.
House, Rough year.
Cuddy, You ignore requests for consults.
House, I call back. Sometimes I misdial.
Cuddy, You're 6 years behind on your obligation to this clinic.
House," See, I was right, this doesn't interest me."
Cuddy," 6 years, times 3 weeks; you owe me better than 4 months."
House, It's 5:00. I'm going home.
Cuddy, To what?
House, Nice.
Cuddy," Look, Dr. House, the only reason that I don't fire you is because your reputation still worth something to this hospital."
House," Excellent, we have a point of agreement. You aren't going to fire me."
Cuddy, Your reputation won't last up if you don't do your job. The clinic is part of your job. I want you to do your job.
House," Well, like the philosopher Jagger once said, ""You can't always get what you want.""ù"
Rebecca, You're not my doctor. Are you Dr. House?
Chase, Thankfully no. I'm Dr. Chase.
Cameron," Dr. House is the head of diagnostic medicine. He's very busy, but he has taken a keen interest in your case."
Foreman, We inject gadolinium into a vein. It distributes itself throughout your brain and acts as a contrast material for the magnetic resonance imagery.
Cameron," Basically, whatEver's in your head, lights up like a Christmas tree."
Foreman, It might make you feel a little light-headed.
Nurse," Dr. Cameron. I'm sorry I have to stop you, there's a pRoblem."
House, You pulled my authorization.
Cuddy," Yes, why are you yelling?"
House," No MRIs, no imaging studies, no labs."
Cuddy, You also can't make long distance phone calls.
House, If you're gonna fire me at least have the guts to face me.
Cuddy, Or photocopies; you're still yelling.
House, I'm ANGRY! You're risking a Patient's life.
Cuddy, I assume those are two separate points.
House," You showed me disrespect, you embarrassed me and as long as I'm still work here you have![interrupted]"
Cuddy," Is your yelling designed to scare me because I'm not sure what I'm supposed to be scared of. More yelling? That's not scary. That you're gonna hurt me? That's scary, but I'm pretty sure I can outrun ya."
Cuddy," Oh, I looked into that philosopher you quoted, Jagger, and you're right, ""You can't always get what you want,""ù but as it turns out ""if you try sometimes you get what you need.""ù"
House," So, because you want me to treat Patients, you aren't letting me treat Patients."
Cuddy, I need you to do your job.
House," Do the MRI, she folded. [Ducklings leave, House turns to Wilson] I've gotta do four hours a week in this clinic until I make up the time I've missed. 2054. I'll be caught up in 2054. [He walks into the clinic] You better love this cousin a whole lot."
Cameron," All right Rebecca, [over intercom] we know you may feel a little claustrophobic in there, but we need you to remain still."
Chase," [over intercom] Ok, we're gonna begin."
Rebecca, I don't feel so good.
Chase, It's all right. Just try to relax.
Cameron, Rebecca? [over intercom] Rebecca? [back in booth] Rebecca! Get her out of there.
Chase, Ah she pRobably fell asleep; she's exhausted.
Cameron," She was claustrophobic 30 seconds ago, she's not sleeping. We gotta get her out of there!"
Chase, It'll just be another minute.
Cameron, She's having an allergic reaction to gadolinium. She'll be dead in two minutes.
Foreman, Hold her neck.
Cameron," Oh, she's ashen."
Foreman, She's not breathing. Epi point five.
Cameron," Come on, I can't ventilate."
Foreman," Too much edema, where's the surgical airway kit?"
Chase," Yep, coming."
Chase, Good call.
Chase, We'll get that tube out of your throat later today.
Cameron, Just get some rest for now.
House," Told you, can't trust people."
Cameron," She pRobably knew she was allergic to gadolinium, figured it was an easy way to get someone to cut a hole in her throat."
House," Can't get a picture, gonna have to get a thousand words."
Foreman, You actually want me to talk to the Patient? Get a history?
House, We need to know if there's some genetic or environmental causes triggering an inflammatory response.
Foreman, I thought Everybody lied?
House, Truth begins in lies. Think about it.
Foreman," That doesn't mean anything,does it?"
House," 12:52 PM Dr. House checks in, please write that down. Do you have cable TV here somewhere? General Hospital starts in 8 minutes."
Cuddy," No TV, but we've got Patients."
House, Can't you give out the aspirin yourself? I'll do paperwork.
Cuddy, I made sure your first case was an interesting one.
House," Cough just won't go away, runny nose looks a funny color."
Cuddy, Patient admitted complaining of back spasms.
House, I think I read about something like that in the New England Journal of Medicine.
Cuddy, Patient is orange.
House, The color?
Cuddy," No, the fruit."
House, You mean yellow; it's jaundice.
Cuddy, I mean orange.
House," Well, how orange?"
Cuddy, Exam room 1.
Orange Guy," I was playing golf and my cleat got stuck. I mean, it hurt a little but I kept playing. The next morning I could barely stand up. Well, you're smiling so I take it that means this isn't serious."
Orange Guy, What's that? What are you doing?
House, Painkillers.
Orange Guy," Oh, for you, for your leg."
House," No, 'cause they're yummy. You want one? It'll make your back feel better."
House," Unfortunately, you have a deeper pRoblem. Your wife is having an affair."
Orange Guy, What?!
House," You're orange, you moron! It's one thing for you not to notice, but if your wife hasn't picked up on the fact that her husband has changed color, she's just not paying attention. By the way, do you consume just a ridiculous amount of carrots and mega-dose vitamins?"
House," The carrots turn you yellow, the niacin turns you red. Get some finger-paints and do the math. And get a good Lawyer."
House, Deep breath.
Little boy, It's cold.
House, Has he been using his inhaler?
Mother," Not in the past few days. He's, um, only ten. I worry about Parkldren taking such strong medicine so frequently."
Little boy, What happened to your leg?
House," Your doctor pRobably was concerned about the strength of the medicine, too. She pRobably weighed that danger against the danger of not breathing. Oxygen is so important during those prepubescent years, don't you think? Ok, I'm gonna assume that no body's Ever told you what asthma is, or if they have, you had other things on your mind. A stimulant triggers cells in your Parkld's airways to release substances that inflame the air passages and cause them to contract. Mucus production increases, cell-lining starts to shed. But the steroids, the steroids!stop the inflammation. The more often this happens![trails off and starts to leave the room]"
Mother," What? ""The more often this happens!""ùwhat?""ù"
House," Forget it. If you don't trust steroids, you shouldn't trust doctors."
Rebecca," My mother passed away three years ago. She had a heart attack, and my father broke his back doing construction."
Cameron," It's House, it's urgent. I'm sorry."
Cameron, You couldn't have knocked?
House," Steroids. Give her steroids, high doses of prednisone."
Foreman, You're looking for support for a diagnosis of cerebral vasculitus.
Cameron, Inflammation of the blood vessels in the brain is awfully rare. Especially for someone her age.
House, So is a tumor. Her SED rate was elevated.
Foreman, Mildly.
Cameron," That could mean anything, or nothing."
House," Yeah, I know. I have no reason to think that it's vasculitus except that it could be."
Cameron, You can't diagnose that without a biopsy.
House," Yes, we can, we treat it. If she gets better we know that we're right."
Cameron, And if we're wrong?
House, We learn something else.
Rebecca, Why steroids?
Chase, Just part of your treatment. You haven't had Many visitors. No boyfriend?
Rebecca, Three dates. I wouldn't have stood by him if her were vomiting all day.
Chase," Well, what abut work? You must have friends from work."
Rebecca, Pretty much Everybody I like is 5 years old. A nurse said you're stopping my radiation.
Chase," We're just trying some alternative medications. So, where's your family from then?"
Rebecca, Steroids aren't an alternative to radiation.
Chase, The tests weren't really conclusive.
Cameron," We're treating you for vasculitus, it's the inflammation of blood vessels in the brain."
Rebecca, It's not a tumor? I don't have a tumor?
Chase, You should have told her the truth. It's a long shot guess.
Cameron," [to nurse] Thank you. [To Chase] If House is right, no harm, if he's wrong we've given a dying Woman a couple days hope."
Chase, False hope.
Cameron, If there was any other type available I would have given her that.
Sidney, Why are you smelling Billy's pants?
Foreman, I'm not.
Sidney, Looked like you were.
Foreman, I was smelling the floor.
Sidney, Oh.
Foreman, Do you have any pets in this class?
Sidney," No, but we used to have a gerbil, but Carly L. dropped a book on it."
Foreman, Careless.
Sidney, Do you need to smell it?
Foreman," No, I'm smelling for mold. I don't need to smell it."
Sidney, You can smell our parrot.
Foreman, You said you didn't have any pets in this class.
Sidney, A parrot is a bird.
Foreman, Parrots are the primary source of psitticosis.
House, It's not the parrot.
Foreman, Psitticosis can lead to nerve pRoblems and neurological complications.
House, How Many kids were there in the class?
Foreman,20
House, How Many are home sick?
Foreman," None, but!"
House," None, but you think that 5 year olds are more serious about bird hygiene than their teacher. You've been through her home?"
Foreman, She lives in Trenton. I can go up to her room tomorrow morning and ask her for the key.
House, Would the police call for permission before dropping by to check out a crime scene?
Foreman, It's not a crime scene.
House, Far as I know she's running a Meth Lab out of her basement.
Foreman, She's a kindergarten teacher!
House," And if I was a Kindergarten student I would trust her implicitly. [Sigh] Ok, I'll give you a for instance. The lady back there, who made your egg-salad sandwich. Her eyes look glassy, did you notice that? Now hospital policy is to stay home if you're sick, but if you're making $8.00 an hour, then ya kinda need the $8.00 an hour right? The sign in the bathroom says that employees must wash after using the facilities, but I figure that somebody who wipes snot on a sleEve isn't hyper concerned about sanitary conditions. So what do ya think? Should I trust her? I want you to check the Patient's home for contaminants, garbage, medication![interrupted]"
Foreman," Whoa, oh, I can't just break into someone's House."
House," Isn't that how you got into the Felker's home? [pause] Yeah, I know, court records are sealed, you were 16, it was a stupid mistake, but your old gym teacher has a big mouth. You should write a thank you note."
Foreman, I should thank him?
House," Well, I needed somebody around here with street smarts. Ok? Knows when you're being conned, knows how to con."
Foreman, I should sue you!
House, I'm pretty sure you can't sue somebody for wrongful hiring.
Foreman, But I'm pretty sure I can sue if you fire me for not breaking into some lady's House.
House, I'm doing research. People are fascinating aren't they?
Cuddy, Why are you giving Adler steroids?
House," Well, she's my Patient that's what you do with Patients. You give them medicine."
Cuddy, You don't prescribe medicine based on guesses. At least we don't since Tuskeegee and Mengele.
House, You're comparing me to a Nazi? Nice.
Cuddy, I'm stopping the treatment.
House, She's my Patient.
Cuddy, It's my hospital.
House," I did not get her sick, she is not an experiment, I have a legitimate theory about what's wrong with her."
Cuddy, With no proof.
House, There's nEver any proof. 5 different doctors come up with 5 different diagnoses based on the same evidence.
Cuddy, You don't have any evidence. And nobody knows anything huh? Then how is it that you always assume you're right?
House," I don't, I just find it hard to operate on the opposite assumption. And why are you so afraid of making a mistake?"
Cuddy, Because I'm a doctor. Because when we make mistakes people die.
House, Come on.
House, People used to have more respect for cripples you know! [Turns to a guy in a wheelchair] They didn't really.
Rebecca," Much better, thanks. Are you Dr. House? I thought he was a he, but!?"
Cuddy, No. Don't eat too much too fast.
Rebecca, Thank him for me.
Cuddy, Right.
House," Should I discontinue the treatment, boss?"
Cuddy, You got lucky.
House," Cool, huh?"
Wilson," Ok, once again."
Wilson, Good.
Rebecca, Am I Ever gonna meet Dr. House?
Wilson," [scoffs] Well, you might run into him at the movies or on the bus."
Rebecca, Is he a good Man?
Wilson, He's a good doctor.
Rebecca, Can you be one without the other? Don't you have to care about people?
Wilson, Caring's a good motivator. He's found something else. [Has Rebecca grab his hands] Feel this?
Rebecca, umhmm
Wilson, How about this?
Rebecca, umhmm
Wilson, Ok squeeze. [Pause] Harder. All right.
Rebecca," He's your friend, huh?"
Wilson, Yeah.
Rebecca, Does he care about you?
Wilson, I think so.
Rebecca, You don't know?
Wilson," As Dr. House likes to say, ""Everybody lies.""ù"
Rebecca," It's not what people say, it's what they do."
Wilson," [Pause] Yes, he cares about me."
Rebecca, I can't see. [Pause] I can't see.
Wilson, A little help in here!
Foreman, Your chest will be sore for a while. We needed to shock you to get your heart going. Ok. [He lays a bunch of cards with pictures on them in front of Rebecca] Can you arrange these to tell a story?
Foreman, She couldn't put them in order.
Chase, Could the damage have been caused by a lack of oxygen during her seizure?
Foreman," No, I gave her the same test 5 minutes later and she did just fine. The altered mental status is intermittent, just like the verbal skills."
Cameron," So, what now?"
Foreman," Given the latest symptoms it's clearly growing deeper into the brain stem. Soon she won't be able to walk, she'll go blind perManently, and then the respiratory center will fail."
House, How long do we have?
Foreman," If it's a tumor we're talking a month, maybe two, if it's infectious a few weeks, if it's vascular that'll pRobably be fastest of all, maybe a week."
House, We're gonna stop all treatment.
Foreman, I still think it's a tumor. I think we should go back to the radiation.
Chase, She didn't respond to the radiation.
Foreman," Well, maybe we didn't see the effects until we started steroids."
House," No, it's not a tumor. The steroids did something, I just don't know what."
Foreman, So we're just gonna do nothing? We're just gonna watch her die?
House," Yeah, we're gonna watch her die. Specifically we're gonna watch how fast she's dying. You just told us, each diagnosis has its own timeframe. When we see how fast it's killing her we'll know what it is."
Cameron, And by then maybe there's nothing we can do about it.
Foreman," There's go to be something we can do, something better than watParkng her die."
House," Well, I got nothing. How 'bout you?"
Foreman," Bastard. [Turns to Cameron] Oh, Cameron, I need you for a couple of hours."
Cameron, What's up?
Foreman, When you break into someone's House; it's always better to have a white Parkck with you.
Cameron, Adler's House? Why don't we just ask her for a key?
Foreman, For all we know she could be running a meth lab out of her basement.
Guy, I'm tired a lot.
House, Any other reason you think you may have Chronic Fatigue Syndrome?
Guy, It's kinda the definition isn't it?
House, It's kinda the definition of getting older.
Guy," I had a couple headaches last month, mild fEver, sometimes I can't sleep, and I have trouble concentrating."
House, Apparently not while researParkng this stuff on the internet.
Guy, I was thinking it also might be fibromyalgia.
House," [Looks contemplative, and then serious] Excellent diagnosis [sarcastic]!"
Guy, Is there anything for that?
House," [heavy sigh] Ya know, I think there just might be."
House," I need 36 Vicodin, and change for a dollar."
Nurse," (jumbled, I can't tell)"
House, Exam room 2. [Places the bottle back on the counter.]
Cameron, House doesn't beliEve in pretense. Figures life's too short and too painful. So he just says what he thinks.
Foreman," Nothing interesting in the garbage. ""I say what I think""ù is just another way of saying ""I'm an ass.""ù"
Cameron," Well, if you wanted to be Judged on your medical prowess only, maybe you shouldn't have broken into someone's home."
Foreman," I was 16! Don't know about ticks, but her dog's definitely got fleas."
Cameron, I Managed to make it to 17 without a criminal record.
Foreman, Yeah? Well you obviously didn't grow up in my neighborhood.
Cameron, That's right. You stole a loaf of bread to feed your starving family right? You always eat during break-ins?
Foreman, Am I supposed to respect their food more than I respect their DVD players? You want some?
Cameron, No.
Foreman, You gonna go hungry until she dies?
Cameron, No.
Foreman," You know what, after centuries of oppression, decades of civil rights marches, and more significantly living like a monk, nEver getting less than a 4.0 GPA, you don't think it's kind of disgusting I get one of the top jobs in the country because I'm a delinquent? We'll eat, then we'll tear up the carpet."
Cameron, You went to Hopkins right?
Foreman, Yep.
Cameron," So, you went to a better school than I did, got better grades than I did."
Foreman, So how'd you get the job? Did you stab a guy in a bar fight?
Foreman, Nothing.
House, It's not a tumor; she's getting worse too fast. She can't stand up.
Wilson," No toxins, no medication?"
Foreman, Nothing that would explain these symptoms.
Wilson, Family history of neurological pRoblems?
Foreman, Not that I could tell from her underwear drawer.
House, You said nothing that would explain these symptoms. What did you find that doesn't explain these symptoms?
Foreman, Dr. Wilson convinced you to treat this Patient under false pretenses. Adler's not his cousin.
Wilson, That's ridiculous. You can ask her yourself. Can we get back to! [interrupted]
Foreman, She's not Jewish!
Wilson, Rachel Adler's not Jewish?
Foreman, I had ham at her apartment!
Wilson," [chuckles] Dr. Foreman, a lot of Jews have non-Jewish relatives, and most of us don't keep kosher. I can see getting through high school without learning a thing about Jews, but medical school!"
Foreman," Ok, maybe she's Jewish, but she's definitely not your cousin."
Wilson, Really? This guy's!he!
Foreman, You don't Even know her name! You called her Rachel; her name is Rebecca!
Wilson," Yes, yes, her name is Rebecca. I call her Rachel."
House, You idiot!
Wilson, Hey!listen!
House," Not you, him! You said you didn't find anything."
Foreman, Everything I found was in [interrupted]
House, You found ham.
Foreman, So?
House," Where there's ham there's pork, where there's pork there's neurocysticercosis."
Chase, Tapeworm?! You think she's got a worm in her brain?
House," It fits. Could have been living there for years, it nEver occurred to me [interrupted]"
Cameron, Millions of people eat ham Every day. It's quite a leap to think that she's got a tapeworm.
House," OK, Mr. Neurologist. What happens when you give steroids to a person who has a tapeworm?"
Foreman," They, they get a little better and then they get worse."
Wilson, Just like Rebecca Adler did.
House," In a typical case if you don't cook pork well enough you ingest live tapeworm larvae. They got these little hooks they grab onto your bowel, they live, they grow up, they reproduce."
Chase," Reproduce? There's only got one lesion, and it's nowhere near her bowel."
House," That's because this is not a typical case. Tapeworm can produce 20 to 30,000 eggs a day. Guess where they go."
Foreman, Out.
House," Not all of them. Unlike the larvae, the egg can pass right through the walls of the intestines and into the blood stream. And where does the blood stream go?"
Cameron, Everywhere.
House," As long as it's healthy the immune system doesn't Even know it's there. The worm builds a wall, uses secretions to shut down the body's immune response and control fluid flow. It's really kinda beautiful."
Foreman," As long as it's healthy, so what do we do? Call a vet and nurse the little guy back to health?"
House," It's too late for that. It's dying, and as it dies this parasite loses the ability to control of the host's defenses. The immune system wakes up and attacks the worm and Everything starts to swell, and that is very bad for the brain."
Wilson, It could still be a hundred other things. The eosinophil count was normal.
Chase, It's only abnormal in 30% of cases.
Wilson, Proving nothing.
House," No, no, no, no, you see, it fits, it's perfect! It explains Everything."
Wilson, But it proves nothing.
House, I can prove it by treating it.
Wilson," No, you can't. I was just with her, she doesn't want any more treatments, she doesn't want any more experiments, she wants to go home and die."
House," [To nurse] Will you excuse us, please?"
House, I'm Dr. House.
Rebecca, It's good to meet you.
House," You're being an idiot. Ahem. [Pause] You have a tapeworm in your brain, it's not pleasant, but if we don't do anything you'll be dead by the weekend."
Rebecca, Have you actually seen the worm?
House, When you're all better I'll show you my diplomas.
Rebecca, You were sure I had vasculitus too. Now I can't walk and I'm wearing a
House," I'm not talking about a treatment; I'm talking about a cure. But because I might be wrong, you want to die."
Rebecca, What made you a cripple?
House, I had an infarction.
Rebecca, A heart attack?
House, It's what happens when the blood flow is obstructed. If it's in the heart it's a heart attack. If it's in the lungs it's a pulmonary embolism. If it's in the brain it's a stroke. I had it in my thigh muscles.
Rebecca, Wasn't there something they could do?
House," There was plenty they could do, if they made the right diagnosis, but the only symptom was pain. Not may people get to experience muscle death."
Rebecca, Did you think you were dying?
House, I hoped I was dying.
Rebecca," So you hide in your office, refuse to see Patients because you don't like the way people look at you. You feel cheated by life so now you're gonna get Even with the world. You want me to fight this. Why? What makes you think I'm so much better than you?"
House," When you're scared, you'll turn into me."
Rebecca, I just want to die with a little dignity.
House," There's no such thing! Our bodies break down, sometimes when we're 90, sometimes before we're Even born, but it always happens and there's nEver any dignity in it. I don't care if you can walk, see, wipe your own ass. It's always ugly, always. [Pause] You can live with dignity, we can't die with it."
House, No treatment.
Foreman," Maybe we can get a court order, override her wishes. Claim she doesn't have the capacity to make this decision."
House, But she does.
Cameron, But we could claim that the illness made her mentally incompetent.
Foreman, Pretty common result.
House, That didn't happen here.
Wilson, He's not gonna do it. She's not just a file to him anymore. He respects her.
Cameron," So because you respect her, you're going to let her die?"
House," I solved the case, my work is done."
House," Patients always want proof, we're not making cars here, we don't give guarantees."
Chase," I think we can prove it's a worm. It's noninvasive, it's safe. I'm not completely sure but![interrupted]"
House," Yeah, yeah, yeah what's the damn idea?"
Chase," Have you Ever seen a worm under an x-ray, a regular old no contrast 100-year-old technology x-ray? They light up like shotgun pellets. Just like on a contrast MRI."
Foreman," Which is the same thing as a CT scan, which we did, which proved nothing."
House," Worm cysts is the same density as the cerebrospinal fluid, we're not going to see anything in her head, but Chase is right, he's right, we should x-ray her, but we don't x-ray her brain, we x-ray her leg, worms love thigh muscle. If she's got one in her head I guarantee you there's one in her leg."
Chase," Hold still, Rebecca."
Chase, This here is a worm larva. [Chase pointing to x-ray of her leg]
Rebecca," So, if it's in my leg, it's in my brain?"
Chase," Are you looking for a guarantee? It's there, pRobably been there 6 to 10 years."
Rebecca, Could I have more?
Chase, PRobably. It's good news.
Rebecca, What do we do now?
Chase, Now we get you better. Albendazole.
Rebecca, Two pills?
Chase," Yeah, Every day for at least a month with a meal."
Rebecca, Two pills?
Chase," Yeah, possible side effects include abdominal pain, nausea, headache, dizziness, fEver, and hair loss. We'll pRobably make you keep taking the pills Even if you get Every one of those."
Cameron, Why did you hire me?
House, Does it matter?
Cameron, Kinda hard to work for a guy who doesn't respect you.
House, Why?
Cameron, Is that rhetorical?
House," No, it just seems that way because you can't think of an answer. Does it make a difference why I think I'm a jerk? The only thing that matters is what you think. Can you do the job?"
Cameron, You hired a black guy because he had a juvenile record.
House," No, it wasn't a racial thing, I didn't see a black guy. I just saw a doctor!with a juvenile record. I hired Chase 'cause his dad made a phone call. I hired you because you are extremely pretty."
Cameron, You hired me to get into my pants?!
House," I can't beliEve that that would shock you. It's also not what I said. No, I hired you because you look good; it's like having a nice piece of art in the lobby."
Cameron, I was in the top of my class.
House, But not THE top.
Cameron, I did an internship at the Mayo Clinic.
House," Yes, you were a very good applicant."
Cameron, But not the best?
House," Would that upset you, really, to think that you were hired because of some genetic gift of beauty not some genetic gift of intelligence?"
Cameron, I worked very hard to get where I am.
House," But you didn't have to. People choose the paths that gain them the greatest rewards for the least amount of effort. That's a law of nature, and you defied it. That's why I hired you. You could have married rich, could have been a model, you could have just shown up and people would have given you stuff. Lots of stuff, but you didn't, you worked your stunning little ass off."
Cameron, Am I supposed to be flattered?
House, Gorgeous women do not go to medical school. Unless they're as damaged as they are beautiful. Were you abused by a family member?
Cameron, No!
House, Sexually assaulted?
Cameron, No.
House," But you are damaged, aren't you?"
Cameron, I have to go.
Orange guy, I followed her. I couldn't stop thinking about what that doctor said.
Cuddy," I told you not to listen to him, he's an idiot."
Orange guy, I was ORANGE.
Cuddy, I don't want to know what you found out.
Orange guy, You don't care?
Cuddy," I'm your doctor, you've been good to me and good to this hospital, of course I care, but I don't see how this conversation can end well for me. Either your wife is having an affair, or she's not having an affair and you have come here because you rightly think I should fire him, but I can't Even if it cost me your money, the son of a bitch is the best doctor we have."
Chase, Feeling any better?
Rebecca, I can't complain.
Chase," As you know the hospital has certain rules, and as you also know we tend to ignore them, but I think this one's gonna be a little obvious unless we get your help."
Cameron," If anyone asks, you have 11 daughters and 5 sons."
Rebecca," Hi, you guys!"
Class, Hi!
Rebecca, Come here!
Rebecca, It's so good to see you guys! I missed you! Is this for me?
Rebecca," Oh, I love you guys. [To Chase and Cameron] I wanted to thank Dr. House, but he nEver visited again."
Cameron," He cured you, you didn't cure him."
Rebecca," [Talking to class] Ok, I want a hug and a kiss from Every single one of you. Get up here right now!"
Class," [Giggles, and laughs]"
on mini TV, There.
Male Dr on mini TV, Hold on.
on mini TV, She's converted.
House, You said she was your cousin. Why would you lie?
Wilson, It got you to take the case.
House," You lied to a friend to save a stranger, you don't think that's screwed up?"
Wilson, You've nEver lied to me?
House, I NEveR lie.
Wilson," Oh, really."
Male Dr on mini TV, Why do we do this?
on mini TV," Because we're doctors, when we make mistakes people die."
re, Cuddy using the same line earlier]
Nurse, Dr. House? You have a Patient.
Nurse, He says he needs a refill.
House, Got change for a dollar?
Singing," ""No, you can't always get what you want.""ù ""You can't always get what you want.""ù"
Crowd, [Cheering and Shouting]
s Dad," Yeah, Dan!"
Crowd, [Continues cheering and shouting]
Crowd, [More cheering and whistling]
Dan, [grunts with the impact]
Coach," [muffled] You ok? Dan, Dan, talk to me. Dan, Dan, get a doctor!"
Wilson, Hey!
House, Close the door. Close the door!
Wilson, Is Cuddy down the hall counting to 50?
House," She's knows I'm in here, the clinic, as she comManded; she just doesn't know I'm alone."
Wilson," Well, you've got a full waiting room, how long do you think you can ignore them?"
House, I'm off at 4:00.
Wilson, You're doing this to avoid 5 minutes of work?
House," I go out there, I get assigned a kid with a runny nose. That's 30 seconds looking at the nose; 25 minutes talking to a worried mom who won't leave until she sure it's not meningitis or a tumor."
Wilson," Yes, concerned parents can be so annoying. Just tell Cuddy you've got an urgent case, you had to leave early."
House, That would be lying.
Wilson," And that would be wrong. But luckily, the definition of urgent is fungible."
House, Not the definition of case though.
Wilson," You have no cases. You have NO cases. You've got handpicked doctors, specialists, working for you, and they're sitting on their hands?"
House, Cameron is answering my mail.
Wilson, Time well spent I'm sure. Foreman and Chase?
House, Research?
Chase," 9 letters, iodine deficiency in Parkldren."
Foreman, Cretinism.
Chase, Huh [Fills in the space]
House," So, 4:03 PM. Dr. House checks out. Please write that down."
s Dad, Dr. House. (from now on he'll just be called Dad)
House," Sorry, done for the day. There's plenty of docs here to take care of you."
Dad, But we had an appointment.
House," Hah, nice try, but this is a walk-in clinic, which means there are no appointments. It means you walk in, sign the chart and a doctor will see you, just not me."
Dad, But your letter says that we would see you.
House, Not a big letter writer.
Dad, Here.
House, When did my signature get so girly?
Cameron, I can explain.
House," See that ""G""ù, see how it makes a big loop on top? It doesn't Even look like my handwriting. Think I have something? What's the differential diagnosis for writing ""G's""ù like a junior high school girl?"
Cameron," It's impossible to get to you through normal channels, they have called![interrupted]"
House, PersEverance does not equal worthiness. Next time you want to get my attention wear something fun. Low-rider jeans are hot.
Cameron," 16 year old male, sudden onset of double vision and night terrors, with no apparent cause. The kid's been to 2 neurologists![interrupted]"
House," Night terrors, yeah? As in big scary monsters?"
Cameron, Yeah.
Cameron, Where are you going?
House, To see the family.
Cameron, You're going to examine a Patient?
House," 9 times out of 10 there's no reason to talk to a Patient, but night terrors in a 16 year old is a VERY good reason to talk to this family. Good work."
House," Margins look fine. No lesions, color is good. How long have you been having night terrors?"
Dan, Three weeks.
Dad," He's afraid to go to bed, he's exhausted, he can barely function."
Mom, What does that tell you?
House," Nothing, it's just fun watParkng him blink. [To Dan] Name as Many animals as you can that begin with the letter ""B""ù go."
Dan, Baby elephant.
House," Baby elephant is actually a good answer; ""B""ù is a bear of a letter."
Dad, What does that tell you?
House," Proves two things, no neurological damage, and your son is nEver going to be Parkef fry cook. In teens there are two likely causes of night terrors: post traumatic stress, any recent shootouts at your high school?"
Dan, No.
House," Well, then, Dave!"
Cameron, Dan
House,"!if there's no trauma the other cause is sexual abuse. So, who's molesting you? Teacher, extra friendly neighbor? I'd ask if either one of you were involved, but you'd deny it."
Dad, We would nEver do anything to hurt Dan.
House," I say it here, it comes out there. This lack of response is consistent with abuse."
Dan," There's no one, ok? I swear. There was trauma; I got hit in the head during a lacrosse game."
House, [To Cameron] Did you know that he got hit in the head?
Cameron," They didn't mention it, no."
House," Yeah, why bother."
Dad," No, no, we took him to the ER after the game. He was scanned, they tested him, they said he was fine. No concussion, it's gotta be something else."
House," You hound me for my opinion and then question my diagnosis. Cool. ER obviously screwed up, kid's got a concussion."
Dan, I had double vision before I got hit.
House," Well, that changes Everything, you need glasses. That's why you had double vision, which is why you got hit, which is why you have a concussion, which is why you have night terrors. You need to see an ophthalmologist, which I am not."
Cameron," You enjoyed that. I brought a reasonable case to your attention, and you shoved it in my face just to humiliate me."
House," You're an only Parkld, aren't you?"
Cameron, Why would you say that?
House," Everything is about you. This may seem incredibly controversial, but I think sexual abuse is bad. I just wanted to make sure he wasn't being diddled by daddy, or mommy, anything else is just a bonus."
Cameron, I'm not an only Parkld.
House, [attention on Dan] Interesting.
Cameron, What?
House, Don't move. Did I bore you in there?
Dan," What? Ah, no, not, not really."
House, Are you tired?
Dan, Sometimes.
Dad, He nEver sleeps! Of course he's tired.
House," Right now, at this moment, are you tired?"
Dan," No, no."
House, That twitch in your leg. Did you feel that?
Dan, Didn't hurt.
Dad, His leg twitched. I don't see what![interrupted]
House," It's called a myoclonic jerk, it's very common when you're falling asleep. Respiration rate falls, and the brain interprets this as the body dying, so it sends a pulse to wake it up."
Dad, So?
House," So, he's not asleep, he's awake. [Turns to Cameron] Admit him."
House," I recognize that loopy ""G""ù. So, what does the jerk tell us?"
Foreman," Nothing good, the brain's losing control of the body. Can't order the eyes to focus, regulate sleep patterns or control muscle movements."
House," A movement disorder, or degenerative brain disease. Either way this kid's gonna be picking up his diploma in diapers and a wheelchair."
Chase," Maybe not that bad, could be an infection."
House," You wish. No fEver, no white count. Anyone think this differential diagnosis might be compromised because we don't have an accurate family history?"
Cameron, I took an accurate family history.
House, You didn't Even take an accurate family. His father's not his father.
Chase, Why would you say that?
House, 30% of all dads out there don't realize they're raising someone else's kid.
Foreman, From what I've read false paternity is more like 10%.
House, That's what our moms would like us to beliEve.
Cameron," Who cares? If he got it from his parents they'd both be dead by now, can we get on with the differential diagnosis?"
House, Fifty bucks says I'm right.
Foreman, I'll take your money.
House," Hit a nerve? Don't worry, Foreman. I'm sure the guy who tucked you in at night was your daddy."
Foreman, Make it $100.
Cameron, What about leukoencephalopathy? In a 16 year old.
Chase," It doesn't necessarily have to be that bad. If we exclude the night terrors it could be something systemic: his liver, kidneys, something outside the brain."
House," Yes, feel free to exclude any symptom if it makes your job easier."
Chase, The night terrors were anecdotal. He could have had a bad dream.
Cameron," No, parents said he was conscious during the Event and didn't remember anything afterwards. That's a night terror."
Chase, Parents said?
House," That's a good point. Before we condemn this kid, maybe we should entertain Dr. Chase's skepticism. I want a detailed polysomnograph. If he's having night terrors I want to see them."
Dan, I usually don't move during night terrors.
House, I'm not restraining you for them. EEG rEvealed abnormalities in your brain caused by nerve damage in your toes.
Dan, [Whimpering] What are you doing?
House, Fixing it.
Dan, [Still whimpering] Can I talk to my parents?
House," Oh, they know all about this."
Dan, I'd really like to see them. [Whimpering after pause] Please! I'd really like them here.
House," This is gonna hurt, Dan."
Dan," [Whimpers and then screams] Oh, God!"
Chase, That's a night terror.
Foreman," We did a CT, MRI, CBC, Chem-7 and chest x-ray. All the tests came back normal. There's nothing to explain his symptoms."
House," Ok, but let's pretend there's something and go from there. Who sees something on this MRI?"
Cameron," No lesions, no white matter."
Foreman, No structural abnormalities.
Cameron, No space-occupying tumors.
House," He's 16, so he should have an absolutely pristine brain. The smallest thing is abnormal."
Chase, Meningeal enhancement. My bet is viral meningitis.
House," Excellent, you see what he did there? He took a small clue that there's a neurological pRoblem and wasn't afraid to run with it."
Foreman, There's no evidence of meningitis on that MRI.
House," No, there's not, he's completely wrong."
Cameron, Then what clue are you talking about?
House," He knew that I saw something on the MRI so he figured there must be something there and took a guess. ClEver, but also pathetic."
Chase," So, what did you find?"
House, Take a close look at the corpus callosum.
Chase, It looks ok.
House," Are we all looking at the same thing? 200 million interhemispheric nerve fibers, the George Washington Bridge between the left and right side of the brain. It's subtle."
Chase," There's some bowing, there. An upward arch."
House, Are you guessing?
Chase, Yes.
House," Too bad, you're right."
Foreman," He pRobably just moved, nobody stays perfectly still for their entire MRI."
House," Yeah, he pRobably got restless and shifted one hemisphere of his brain to a more comfortable position. Something is pushing on it."
Foreman, If there's bowing it could be a tumor.
House, Do you see a tumor on this MRI?
Foreman," No, but I don't see any bowing, either."
House," There's no tumor, just a blockage causing pressure, causing symptoms. Today"
Dad," Ok!all right easy![Pause and then mumbles to Dan, I can't make it out]"
Foreman," Now, I'm injecting a material that's tagged with a radioactive isotope. It's gonna enter your spine and travel up to your brain. It'll make you able to think deep thoughts, at about 100 miles per hour."
Dad, [Whispers] Easy.
Foreman," Their eyes aren't the same color, but that fleck in the eyes! that's maybe a one in ten chance if they're not related?"
Chase," Nah, House isn't gonna pay you based on that."
Foreman, [chuckles] Any excuse we can give the folks to justify a DNA test?
Chase, We could tell them he's got Huntington's. The whole family should be tested or they'll all die.
Foreman, [Chuckles again]
Foreman," Hey, there's a lot of blockage."
Chase, I've scheduled him for surgery. They're gonna put a shunt into one of the ventricles to give the cerebrospinal fluid an out.
Foreman," No more pressure, Everything goes back to normal."
House, He's lucky to have you as his doctors.
Young Mother," No formula, just mommy's healthy natural breast milk."
House, Yummy.
Young Mother, Her whole face just got swollen like this overnight.
House," Mmhmm. No fEver, glands normal, missing her vaccination dates."
Young Mother, We're not vaccinating.
Young Mother," [Takes a toy frog and starts to make frog sounds] Gribbit, gribbit, gribbit. [Giggles]"
House, Think they don't work?
Young Mother, I think some multinational pharmaceutical company wants me to think they work. Pad their bottom line.
House, Mmmm. May I? [He takes the frog and starts to do the gribbit noise with the baby]
Young Mother, [Whispered] Sure.
House," Gribbit, gribbit, gribbit. [The baby laughs] All natural, no dyes. That's a good business: all-natural Parkldren's toys. Those toy companies, they don't arbitrarily mark up their frogs. They don't lie about how much they spend on research and dEvelopment. The worst a toy company can be accused of is making a really boring frog."
House," Gribbit, gribbit, gribbit. You know another really good business? Teeny tiny baby coffins. You can get them in frog green or fire engine red. Really. The antibodies in yummy mummy only protect the kid for 6 months, which is why these companies think they can gouge you. They think that you'll spend whatEver they ask to keep your kid alive. Want to change things? Prove them wrong. A few hundred parents like you decide they'd rather let their kid die then cough up 40 bucks for a vaccination, beliEve me, prices will drop REALLY fast. Gribbit, gribbit, gribbit, gribbit, gribbit."
Young Mother, Tell me what she has.
House, A cold.
Cameron, There's a pRoblem.
House, Complications in surgery?
Foreman," Surgery went fine, he's in recovery, but we took a vial of CSF and tested it."
House, Really?
Foreman," Turns out the bowing wasn't the cause of his pRoblems, it was a symptom."
Chase," Oligoclonal bands, and an increase of intrathecal IGG."
House, Which means multiple sclerosis. And the reason it takes three of you to tell me this?
Cameron, Because we're having a disagreement about whether or not it is MS.
Chase, No lesions on the MRI.
Foreman, It's early; he's had the disease for maybe two weeks.
Cameron, McDonald criteria requires six months to make a definitive diagnosis.
House," Oh, who cares about McPherson? I hear he tortured kittens."
Foreman, McDonald.
House," Oh, McDonald. Wonderful doctor, loved kittens."
Foreman, The VEP indiCates slowing of the brain.
Cameron, Without the lesions we can't be sure.
House," Well if it is, it's gone from 0 to 60 in three weeks, which would indiCate rapidly progressive MS. Not the fun MS with the balloons and the bike rides for cripples in wheelchairs."
Cameron, We should wait until we [interrupted]
House," Start treating him now, he can walk for another couple of years, maybe live for another 5. Break it to the family. I'm going home."
Chase, It'll take months for a definitive diagnosis.
Dan, What'll happen to me?
Chase," MS is an incredibly variable disease, if it is MS, and we're not 100% sure."
Dad, What do you think is gonna happen?
Chase," There are some medications to Manage the symptoms, but as the disease progresses the pRoblems will become more sEvere: bowel and bladder dysfunction, loss of cognitive function, pain."
Dan, It's gonna hurt?
Chase," The brain's like a big jumble of wires. MS strips them of the insulation, and the nerves die. The brain interprets it as pain, but by starting treatment we're gonna avoid that for as long as possible. We're looking into a couple specialists, and until we get you squared away you'll stay here. Ok?"
Cameron, Security checked the videotapes for all the perimeter cameras; he's still gotta be in the hospital.
Foreman, Where's Chase?
Cameron, Main floor.
Foreman," Ok, you take the cafeteria and administration. I'll hit the research annex and work my way back to you."
Chase, Dan?
s answering maParkne, I'm not here. Leave a message.
House," Dr. Cuddy, great outfit."
Cuddy, What are you doing back here? Patient?
House," No, hooker. Went to my office instead of my home."
Foreman," Dr. House, Dan's missing."
House," Yeah, I got that part from the message. You said I was needed immediately."
Foreman, He shouldn't move after a lumbar puncture.
House," I agree, he's gonna have a very nasty headache. That would also be my opinion if consulted tomorrow morning."
Foreman, We wanted to keep you informed. He heard some pretty heavy news.
House, [Sighs] This is not a toddler wandering around a department store. He's 16. You'll find him. I'm going home.
Foreman," So, when you say ""Call me if you need anything,""ù You mean, ""Don't call me.""ù"
House," No, I mean ""Call me if I can do something.""ù I'm bad at search parties and I'm bad at sitting around looking nervous doing nothing."
Foreman, What about his parents? Should we call them?
House, Why? You think they're hiding him? Make sure someone checks the roof; some of the orderlies keep the door propped open so they can grab a smoke.
Chase," Dan? You ok? [Pause] There are experimental treatments, ongoing research! Who knows what they'll discover in a year or two?"
Dan, This is where I dropped the ball.
Chase," Dan, we're standing on the roof of the hospital! Dan! Dan, you're not on the field!"
Cameron, He doesn't know where he is.
Foreman, Dan!
Chase, Foreman!
Chase, Dan.
Cameron, Dan!
Foreman, Dan! No!
House, Dr. Foreman. I assume you found the kid.
Foreman, He almost walked off the roof.
House, Suicidal?
Foreman," No, he thought he was on his lacrosse field. Look, look, I was just gonna run home, shower, change![interrupted]"
House, Conscious?
Foreman, Yeah.
House, How'd you talk him down?
Foreman," Actually, Chase tackled him."
House, How come you didn't do it?
Foreman," Right, well, I am black, but he was closer."
House," Come on, you can ride up with me."
House, Anybody tell the family that their boy almost stepped off a roof? They must be thrilled.
Cameron," They're not suing, but I think only because Chase asked them."
House," Why does Everyone always think I'm being sarcastic? This is great news! He doesn't have MS. The parents should be thrilled, well, the mom anyway. Of course, the dad pRobably doesn't know![interrupted]"
Foreman, Why doesn't he have MS?
House," He was on the roof thinking he was on the lacrosse field, conscious, and therefore not a night terror. You want some of this? [Asking Foreman about the coffee]"
Foreman," Yeah, sure."
House," He was in an acute confusional state, which doesn't fit with a demyelinating disease like MS."
Foreman, The oligoclonal bands.
Chase, That the immune system is working.
House," Right, he has an infection in his brain."
Cameron, What about sex?
House," Well, it might get compliCated. We work together. I am older, certainly, but maybe you like that."
Cameron, I meant maybe he has neurosyphilis.
House," Heh, nice cover."
Chase," Sorry, RPR was negative."
House, We don't need a definitive test to confirm this.
Cameron," Sure, didn't need one to confirm MS."
House," Ok, let's wait for you to run titers on 4000 viruses while this kid's brain turns to mush."
Foreman," So the fact that he doesn't have MS is, it's really not good news after all?"
House," Well, it is if it's neurosyphilis, the likelihood of a false negative on an RPR test, 30%, the likelihood of a 16 year old having sex, roughly 120%."
Cameron, I'll start him on IV penicillin.
House, We're not going to wait for that. The most effective way to deliver the drug is right into his brain via the spine.
Foreman," We can't. In a cramped space like the brain, increased intracranial pressure from a high-volume drug like penicillin could herniate his brain stem and kill him. No neurologist in his right mind would recommend that."
House, Show of hands. Who thinks I'm not in my right mind?
House, And who thinks I forget this fairly basic neurological fact?
House, Who thinks there's a third option?
House," Very good, what's the third choice?"
Chase," No idea, you just asked if I thought there was one."
Foreman," [Sighs] The Patient has a shunt in his brain. There'll be no increased pressure, we can put as much penicillin into his body as we want."
House," Excellent, inject him through a lumbar puncture."
FoeMan, One of us is going to do this to you twice a day for the next two weeks.
Dan,[Sighs]
Dad, He could get syphilis Even if he's not sexually active?
Foreman," Well, it's unusual, but it's possible. Relax."
Dan," [Sighs again, and then grunts in pain]"
House," Geesh. It's infected, with a really big hole like you stuck a nail in it to reliEve the pressure."
Funsten, I wouldn't do that.
House," Although the wound is irregular, not cylindrical, it's shaped like a triangle, so not a nail. Steak knife?"
Funsten, Wife's nail file.
House," [Whispered] Nail File. Yeah, pain'll make you do stupid things. Something to take the edge off? [Takes out his pills and puts one in his hand]"
Funsten, Yeah.
House, Cheers. [Dry swallows the pill and Funsten eats his (ewwwww)] [Limps back
Funsten, No.
House, Here on work?
Funsten," No, why are you [interrupted]"
House, Does your penis hurt?
Funsten, No. What? Should it?
House," No, just thought I'd toss you a really inappropriate question. Your Lawyer's gonna love it."
Funsten, Why would I want to sue you? I want you to treat me.
House," You're from Maplewood, New Jersey. Right?"
Funsten, Yeah.
House," Now, why would you drive 70 miles to get treatment for a condition that a 9 year old could diagnose? It's the free-flowing pus that's the tip-off."
Funsten, I was in town.
House," Not for family, not for work. You drove 70 miles to a walk-in-clinic. You passed two hospitals on the road. Now, either you have a pRoblem with those hospitals, or they have a pRoblem with you. My guess is that you've sued half the doctors in Maplewood, and the rest are now refusing to treat you. It's ironic, isn't it? It's like the boy who sued wolf. You know what? I bet we have a doctor here named Wolfe. How perfect would that be? I'm gonna page him."
Funsten," Ok, you know what? Thank you, I'm gonna find a doctor to take care of this."
House," I didn't say I wouldn't treat you. We'll drain your knee, run some lab work, fix you right up."
Funsten, Why would you do that?
House, I'm a people person.
Wilson, You actually treated him?
House," All I know is that he sued some doctors, who am I to assume that they didn't have it coming to them. [Stops when he sees Cuddy coming] The cutest little tennis outfit, my God I thought I was going to have a heart attack.[Acts like he just realized that Cuddy was there.] Oh my, I didn't see you there, that is so embarrassing."
Cuddy, How's your hooker doing?
House," Oh, sweet of you to ask, funny story, she was going to be a hospital administrator, but hated having to screw people like that."
Cuddy, I heard you found her on the roof.
House, You have very acute hearing.
Cuddy, You notify the parents?
House," In due course, of course."
Cuddy, And is there a paternity bet on the father of the Patient?
House, Doesn't sound like me.
Wilson," Well, it does actually, but that doesn't mean you're guilty."
House, You think?
Cuddy," I saw the parents in the lobby, smart money is obviously on the father."
House, [Stage whisper] My guy knows a guy who can get you in for $50 bucks.
Cuddy," Fine. You tell your guy if I win, you attend the faculty symposium and you wear a tie."
House," And if I win, no clinic hours for a week."
Cuddy, My guy will call your guy.
Wilson, She's very good at her job.
Chase," The treatments should start helping soon. Let us know if it gets easier to focus on things, remember stuff."
Chase," Hey Dan, isn't Dr. Cameron's necklace a beauty? Something South American, I think."
Cameron," Yeah, Guatemalan."
Dan, It's a cool necklace.
Cameron, Thank you so much.
Chase, The kid's in pain.
Cameron, [Scoffs]
Dan, No.
Chase," No, what?"
Chase, Dan? You ok?
Cameron, Dan?
Cameron, He's hearing voices.
Chase," [muffled] Dan? [Regular] Push three milligrams IV, stat!"
Cameron, Come on Dan!
Dan, [screaming] GET OUT OF MY HEAD!
Cameron, Auditory hallucination shows further brain degeneration.
Chase, Penicillin's not working.
House," So, either it's a bad batch of penicillin, or our diagnosis is wrong. Square one. ""Mignight.""ù"
Foreman," LFTs, BUN, and creatinine, are all normal, diabetes is out. No gap."
House," There goes metabolic. [Crosses off ""M""ù]"
Cameron, MRI rules out vasculitis.
House," ""I""ù for inflammation. [Crosses out the ""I""ù]"
Chase, Too young for anything degenerative.
House," ""D""ù, see ya. [Crosses out the ""D""ù] ""N""ù for neoplastic?"
Chase, MRI was clean.
House," ""I""ù for inflammation."
Cameron, We already did that.
House, Stupid to have two I's in one mneumonic. What's the other one?
Foreman, Infection.
Cameron, Oligoclonal bands still have to mean something.
Foreman, But no fEvers; white count's elevated but within range.
Chase, And we've tested for anything remotely possible. Everything is negative.
Cameron, CT scan rules out subdural.
House," Trauma, later much. [Looks at the board which is now all crossed out.] You know the pRoblem? Midnight is actually spelled with a ""G""ù and an ""H,""ù If we could just figure out what those two letters stand for. [Sighs and walks away for the board. His back is now facing the ducklings] It's a sick brain, having fun, torturing him, talking to him. [pause] Scaring the hell out of him. Get him an EEG, left and right EOG esophageal microphones. If this thing wants to talk, let's listen."
House, We're missing something. This is screwed up.
Wilson, That's why you came up with the brain talking to the virus thing?
House," I panicked, ok? Sounded cool though, they bought it."
House," Oh, crap. Another reason I don't like meeting Patients. If they don't know what you look like they can't yell at you. [Aside to Wilson] Here we go."
Mom, How can you just sit there?
House," If I eat standing up, I spill."
Dad," Our son is dying, and you could care less? We're going through hell; you're doing nothing?"
House," I'm sorry, you need to vent, I understand."
Dad, Don't be condescending. You haven't checked in on him once.
House," Blood pressure's 110/70, the shunt is patent well placed in the right lateral ventricle, the EKG shows a normal QRS with deep wave inversions throughout both limb and pericardial leads. LFTs are elevated but only twice the normal range. Oh yeah, and he's hearing voices. [Pause] Go hold his hand. Go on; I'll bus your tray."
House, Got any sample bags on you?
Wilson, I don't beliEve you. You're gonna run DNA tests?
House," Their son is deathly ill, I know it's terrible, but the fact is if I don't keep busy with trivial things like this I'm afraid I might start to cry."
Wilson, You're an ass.
House, Yeah? You want to double the bet?
House, General Hospital is on channel 6.
Foreman," Dan's brain's not showing channel 6 right now, only mush."
House, No epileptiform activity. [Turns to Cameron] What are you doing?
Cameron, Waiting for CBC and Chem-7.
House," Good, run DNA on these. [He puts down two cups that are labeled ""Mommy""ù and ""Daddy???""ù]"
Cameron, What's this?
House, Parents' coffee cups.
Cameron, I can't beliEve you [interrupted]
House," I've had this conversation once already. If you've got something else to do, do it. Otherwise, do this."
Funsten, Dr. House?
House," Hey, Mr. Funsten! I was wondering when you'd be back. Got some papers for me?"
Funsten, You've caused me considerable mental distress.
House," I certainly hope so. [Funsten hands him an envelope] What? Too cheap to have your Lawyer serve it for you, or is it more fun this way?"
Funsten, I'm obviously prepared to consider a settlement.
House, You have gonorrhea.
Funsten," No, I don't!"
House," Well, maybe you're right, but I have a lab result that says you do. It could be a false positive; normally I'd run a second test, but since you're here I'll just go with the first."
Funsten, You're just trying to scare me.
House," It's reportable you know, public health issue."
Funsten, I'll be sure to let my wife know.
House," Oh, don't bother yourself, the state will call for you. Look, if you're clean I'm sure this will all blow over, no big deal. There's an easy way to find out, get one of your doctors to run a test."
House, Uh-uh. These are mine now. I'll see you in court. [House enters the elevator.]
Foreman," West Nile negative, not surprising, since not too Many mosquitoes passing through Jersey in December."
Chase, No Eastern Equine Encephalitis.
Cameron, You guys aren't going to beliEve this.
Chase, What's that?
Cameron," House was right, the father's not the father."
Foreman, [Sighs] Dude doubled up on me.
Chase," You're not gonna beliEve this, the mother's not the mother either."
Cuddy, It's not a good idea to move your son in his condition.
Mom, We just want a second opinion.
Dad, We need an answer.
House, You idiots! You lied to me!
Dad," We didn't lie about anything. You, on the other hand, accused us of molesting our son."
Cuddy, Perfect.
House, Can we get off my screw-ups and focus on theirs? Theirs is bigger. You're not Dan's parents.
Mom, We're his parents.
Dad, He was adopted. He doesn't need to know.
House, I do.
Dad, Adoption makes him just as much his [interrupted]
House," Listen, when we were taking his medical history, were you confused? Did you think we were looking for a genetic clue to his condition, or did you think we were trying to ascertain who loves him the most in the whole wide world?"
Cuddy, How did you find out about this?
House, I sampled their DNA.
Dad, We didn't give you any DNA.
House, Your coffee cups from the cafeteria.
Cuddy, You can't do that!
House," Again, why are we getting hung up on what I did? [Turns to Dan's parents] Your medical history is useless."
Dad," No, we gave you a detailed history of his biological mother."
Mom," Her history; non-smoker, good health, low cholesterol, no blood pressure pRoblems."
Dad, Dan was adopted two weeks after he was born. You have his history. There's nothing you need to know that we didn't tell you.
Cuddy," Sounds reasonable. Well, if you want to transfer your boy that is your choice, but I still think it's the wrong [interrupted]"
House," Was she vaccinated? [Pause] The biological mother, when she was a baby, did she get her vaccinations?"
Dad, Dan was vaccinated at 6 months.
House," Mm hmm, and do you know why kids get vaccinated at 6 months? Because before that, they are protected by their biological mother's immune system. So, was she vaccinated?"
House," An infant picks up a regular old measles virus. He gets a rash, he's extremely uncomfortable, has a wicked fEver, but he lives. Here's the kicker, once Every million or so times, the virus mutates. [Cut to House's office. House and the ducklings are there] Instead of Dan having a fEver and a rash the virus travels to his brain and hides like a time bomb. In this case for 16 years."
Foreman, Sub-acute Sclerosing Pan-encephalitis.
House, I know. There's only been 20 cases in the United States in the past 30 years.
Foreman, I suppose you could make an argument that the kid's still in stage one. Once SSPE moves to stage two [Interrupted]
House," Boom, stage two is universally fatal."
Cameron, I assume it's impossible to tell when he might move into stage two.
House," He's already started showing symptoms. It could be a month, it could be tonight."
Cameron, Can we treat it?
House, Ask the neurologist.
Foreman, Intraventricular interferon.
Chase, We're not gonna shove a spike into his brain and drip interferon without confirming this diagnosis.
House, Tap him.
Foreman," We won't get a reliable result for measles antibodies in his CSF, not after Everything we've given him."
House," So the wrong treatment kills any hope of the right diagnosis. Why do people lie to me? [Pauses and sighs] It could also kill him. Your ball, Foreman, tell me I don't have to biopsy his brain."
Foreman," [Sighs] Well, there is one other way."
Dan, You sure this isn't gonna hurt?
Foreman," Yeah, it's just scary as hell. See, we go through the pupil. You won't feel it; the eye's been paralyzed. The needle travels to the back of the eye which is where we perform the biopsy on your retina."
Foreman," So we've confirmed that the pRoblem is this mutated virus. The treatment for SSPE is intra-ventricular interferon. We implant an Ommaya reservoir under the scalp, which is connected to a ventricular catheter that delivers the antiviral directly to the left hemisphere [interrupted]"
Dad," Look, you want us to consent to this? I don't Even understand what you're talking about."
Foreman," Well, the antiviral![pauses] Look, I'm sorry, I can explain this as best I can, but the notion that you're gonna fully understand your son's treatment and make an informed decision, is, it's kinda insane. Now, here's what you need to know, it's dangerous, it could kill him, you should do it."
Cuddy," You can't order a $3,200 DNA test to win a bet."
House," It's not an actual cost. I don't know if you know this, but the hospital actually owns the sequencing maParkne."
Cuddy, I'm serious.
House," Well, tell the parents to submit the bill to insurance."
Cuddy, Insurance is not going to pay for a bet.
House," It should. If we don't make that bet, the kid dies. If not for the paternity bet, I nEver would have taken their DNA, without their DNA we nEver would have discovered that Dan was adopted, which was the key to this case. You just don't want to pay your end. Big mistake. My guy knows a guy."
Cuddy," Fine. I will let you out of clinic duty for one week, after you pay the $3,200 for the PCR test."
Cuddy, Whoo.
House," Well now, there's the $100 you owe me, there's the $100 I won from Cameron, $200 I took off of Foreman, and $600 I got from Wilson. Very bitter."
Cameron," Hey, good morning."
Foreman," Good news on your EEG, treatment is working."
Cameron, And your immune system is responding.
Foreman," I know it's early, but let me take a look. Let's see what that brain of yours can do. Name as Many animals as you can that start with the letter ""O""ù."
Dan," Ostrich, ox, old elephant."
Cameron," Well, that's 2 better than last time. How you doing with the whole adoption thing?"
Dan, I knew since 5th grade.
Foreman, How's that?
Dan," Cleft Parkn. I have one, my dad doesn't. I looked it up on the Internet; it's one of those trait things."
ForMan," That's right, it's autosomal dominant. Since neither of your parents have cleft Parkns, it's highly unlikely that you're biologically related."
Cameron, You sure you're ok?
Dan, I've got no pRoblems with being adopted. I love my parents.
Dad, How's he doing?
Cameron, He's doing pretty well. He's a smart kid. I think he's gonna be fine.
Dad, Thanks.
House," Wheels, one-eight! Wheels!"
Brandon," I didn't sleep well last night, and I woke up with a scratchy throat. I just don't feel so good. [Pause] Uh, cough, [clears his throat] Yeah, I'm, I'm, a bit of an upset stomach too, and I think I'm running a fEver, I'm just worried I might be contagious. [Coughs] Inventory, tomorrow, yeah I'm sure I'll be feeling better by then. [Pause] Thanks, Mr. Nobby."
Mindy, I cannot beliEve you just did that.
Brandon, I really do have a cough.
Mindy," Oh, so you weren't lying, you'd be curled up in bed with a bowl of Parkcken soup Even if you didn't have a horny girl in your bed?"
Brandon," Yes, [laughs] Because I really do, hey, I really do have a cough."
Mindy, You also have a little rash. [giggles]
Brandon," Um, umm, I'm uh not sure that we should be kissing."
Mindy," Oh, that's ok, because I have almost no interest in kissing you."
Both, [Laugh]
Mindy," [Panting and giggling] Oh, Brandon. (singsongy) Brandon, I know I'm good but come on. Brandon, Brandon, Brandon! [Brandon is unconscious.]"
House, Why do you want me to treat this guy?
Wilson, Blood pressure's not responding to IV fluids.
House," No, no I didn't ask how you plan to con me into treating him, I asked you why YOU want me to treat him."
Wilson," He's sick, I care, I'm pathetic."
House," There are about a billion sick people on the planet, why this one?"
Wilson, Because this one's is in our emergency room.
House," Ah, so it's a proximity issue. If somebody was sick in the third floor stairwell that's who we would be talking about."
Wilson," Yes, I checked the stairwell, it's clear."
House," Ok then, emergency room guy it is."
Wilson," Wait, how was that so easy?"
House, You know why.
Wilson, Blood pressure's not responding to IV fluids?
House," Yeah, that's just weird."
House," CBC was unremarkable, abdominal CT scan didn't show anything. So, people, differential diagnosis. What's wrong with her?"
Cameron, Him.
House," Him, her, does it matter? Does anyone think it is a testicular pRoblem? No, so Chase!"
Chase, Absidia infection?
Foreman," No, you wouldn't get the rash or cough. What about arthritis? Accompanying vasculitis causes nerve damage ""ì"
Cameron," No, it wouldn't cause the blood pressure pRoblems. Allergy?"
Chase, The kid's got abdominal pain. Maybe carcinoid?
Foreman," Nah, but then you wouldn't get the ""ì [House slams a giant book in front of Foreman.]"
House," Foreman, if you're going to list all the things it's not, it might be quicker to do it alphabetically. Let's see. Absidia? Excellent. Doesn't account for any of the symptoms."
Cameron, No condition accounts for all these symptoms.
House," Well, good! Because I thought maybe he was sick, but apparently he's not. Who wants to do up the discharge papers? [pause] Okay, unless we control the blood pressure, he's going to start circling the drain before we can figure out what's wrong with him. Treat him for sepsis, broad-spectrum antibiotics and I want a cort-stim test and an echocardiogram."
Chase, You all right?
Brandon, Yeah.
Foreman, Cort-stim tests will tell us if your pituitary and adrenal glands are working properly.
Mindy, His glands? What does that mean?
Chase, We have a few theories we're working on.
Mindy, You mean you don't know.
Brandon, Mindy!
Mindy," I'm just saying if they knew they wouldn't be testing you, they'd be treating you."
Foreman," Yeah, well, that's the way it works. First you find out what it is, then we get you better."
Cuddy, You're half an hour late.
House, Busy case load.
Cuddy," One case is not a ""load""ù."
House," So, how are we doing on cotton swabs today? If there's an acute shortage I could run home ""ì"
Cuddy," [looks at his leg] No, you couldn't."