House 1x2

1. On your right. On your right. On your right.

2. Back, back, back, back, back.

3. Come on, buddy.

4. Yeah, Dan! Yeah!

5. Yeah! Yeah!

6. Back, back, back, back, back.

7. Come on! Watch the winger!

8. Yeah!

9. You okay?

10. Dan? Dan, talk to me. Dan. Dan.

11. Get a doctor!

12. - Hey. - Close the door.

13. Close the door.

14. Is Cuddy down the hall counting to 50?

15. She knows I'm in here, in the clinic, as she commanded.

16. She just doesn't know I'm alone.

17. Well, you've got a full waiting room.

18. How long do you think you can ignore them?

19. I'm off at 4:00.

20. You're doing this to avoid five minutes of work?

21. If I go out there, I get assigned a kid with a runny nose.

22. That's 30 seconds looking at the nose,

23. 25 minutes talking to a worried mom

24. who won't leave until she's sure it's not meningitis or a tumor.

25. Yes. Concerned parents can be so annoying.

26. Just tell Cuddy you've got an urgent case. You had to leave early.

27. - That would be lying. - And that would be wrong.

28. But luckily the definition of "urgent" is fungible.

29. Not the definition of "case", though.

30. You have no cases?

31. You've got handpicked doctors, specialists

32. working for you, and they're sitting on their hands?

33. - Cameron's answering my mail. - Oh, time well spent, I'm sure.

34. Foreman and Chase?

35. Research?

36. Nine letters. Iodine deficiency in children.

37. Cretinism.

38. So, 4:03 p.m., Dr. House checks out.

39. - Please write that down. - Dr. House.

40. Sorry. Done for the day. Plenty of docs here to take care of you.

41. But we had an appointment.

42. Nice try, but this is a walk-in clinic,

43. which means there are no appointments.

44. You walk in, sign the chart and a doctor will see you.

45. Just not me.

46. Your letter says that we'd see you.

47. - Not a big letter writer. - Here.

48. When did my signature get so girlie?

49. I can explain.

50. See that "G"?

51. See how it makes a big loop on top?

52. Doesn't even look like my handwriting.

53. Think I have something? What's the differential diagnosis

54. for writing G's like a junior high school girl?

55. It's impossible to get to you through normal channels.

56. They have called, e-mailed.

57. Perseverance does not equal worthiness.

58. Next time you want to get my attention, wear something fun.

59. - Low-rider jeans are hot. - Sixteen-year-old male.

60. Sudden onset of double vision and night terrors,

61. with no apparent cause.

62. - The kid's been to two neurologists... - Night terrors?

63. - As in big scary monsters? - Yes.

64. - Where are you going? - To see the family.

65. You're going to examine a patient?

66. Nine times out of 10, there's no reason to talk to a patient.

67. But night terrors in a 16-year-old

68. is a very good reason to talk to this family. Good work.

69. Margins are fine.

70. No lesions.

71. Color is good.

72. How long have you been having night terrors?

73. - Three weeks. - He's afraid to go to bed.

74. He's exhausted, can barely function.

75. What does that tell you?

76. Nothing. It's just fun watching him blink.

77. Name as many animals as you can

78. that begin with the letter "B". Go.

79. Baby elephant?

80. Baby elephant is actually a good answer.

81. - "B" is a bear of a letter. - What does that tell you?

82. Proves two things, no neurological damage,

83. and your son is never gonna be chief fry cook.

84. In teens, there are two likely causes of night terrors.

85. Post-traumatic stress.

86. Any recent shoot-outs at your high school?

87. - No. - Well, then, Dave...

88. - Dan. - If there's no trauma,

89. the other cause is sexual abuse.

90. So who's molesting you?

91. Teacher? Extra-friendly neighbor?

92. I'd ask if either of you were involved, but you'd deny it.

93. No. We would never do anything to hurt Dan.

94. I say it here, it comes out there.

95. This lack of response is consistent with abuse.

96. There's no one, okay? I swear.

97. There was trauma.

98. I got hit in the head during a lacrosse game.

99. Did you know that he got hit in the head?

100. They didn't mention it. No.

101. Yeah. Why bother?

102. No, no. We took him to the ER after the game.

103. He was scanned. They tested him. They said he was fine.

104. No concussion. It's gotta be...

105. You hound me for my opinion, and then you question my diagnosis.

106. Cool.

107. ER obviously screwed up. Kid's got a concussion.

108. I had double vision before I was hit.

109. Well, that changes everything.

110. You need glasses. That's why you had double vision,

111. which is why you got hit, which is why you have a concussion,

112. which is why you have night terrors.

113. You need to see an ophthalmologist, which I am not.

114. You enjoyed that.

115. I brought a reasonable case to your attention,

116. and you shoved it in my face just to humiliate me.

117. - You're an only child, aren't you? - Why would you say that?

118. Because everything is about you.

119. This may seem incredibly controversial,

120. but I think sexual abuse is bad.

121. I just wanted to make sure he wasn't being diddled by daddy or mommy.

122. Anything else is just a bonus.

123. - I'm not an only child. - Interesting.

124. - What? - Don't move.

125. - Did I bore you in there? - What? No. Not really.

126. Are you tired?

127. - Sometimes. - He never sleeps. Of course he's tired.

128. - Right now. Are you tired? - No. No.

129. That twitch in your leg. Did you feel that?

130. - Didn't hurt. - His leg twitched. I don't see what...

131. It's called a myoclonic jerk.

132. It's very common when you're falling asleep.

133. Respiration rate falls,

134. and the brain sometimes interprets this as the body dying,

135. so it sends a pulse to wake it up.

136. - So? - So, he's not asleep. He's awake.

137. Admit him.

138. I recognize that loopy "G...

139. So, what does the jerk tell us?

140. Nothing good. The brain's losing control of the body.

141. Can't order the eyes to focus,

142. regulate sleep patterns or control muscles.

143. A movement disorder or a degenerative brain disease.

144. Either way, this kid's gonna be picking up his diploma

145. in diapers and a wheelchair.

146. Maybe not that bad. Could be an infection.

147. You wish. No fever, no white count.

148. Anyone think this differential diagnosis might be compromised

149. because we don't have an accurate family history?

150. I took an accurate family history.

151. You didn't even take an accurate family.

152. - His father's not his father. - Why would you say that?

153. Thirty percent of all dads out there

154. don't realize they're raising someone else's kid.

155. From what I've read, false paternity's more like 10%.

156. That's what our moms would like us to believe.

157. Who cares? If he got it from his parents, they'd both be dead by now.

158. Can we get on with the differential diagnosis?

159. Fifty bucks says I'm right.

160. - I'll take your money. - Hit a nerve?

161. Don't worry, Foreman.

162. I'm sure the guy who tucked you in at night was your daddy.

163. Make it $100.

164. What about leukoencephalopathy in a 16-year-old?

165. It doesn't necessarily have to be that bad.

166. If we exclude the night terrors,

167. it could be something systemic.

168. His liver, kidneys. Something outside the brain.

169. Yes. Feel free to exclude any symptom if it makes your job easier.

170. The night terrors were anecdotal. He could've had a bad dream.

171. No. parents said he was conscious during the event

172. and didn't remember anything afterwards.

173. - That's a night terror. - Parents said?

174. That's a good point.

175. Before we condemn this kid, maybe we should entertain Dr. Chase's skepticism.

176. I want a detailed polysomnograph.

177. If he's having night terrors, I want to see them.

178. I usually don't move during night terrors.

179. I'm not restraining you for them.

180. EEG revealed abnormalities in your brain,

181. caused nerve damage in your toes.

182. - What are you doing? - Fixing it.

183. Can I talk to my parents?

184. - Oh, they know all about this. - I'd really like to see them.

185. Please. I'd really like them here.

186. This is gonna hurt, Dan.

187. Oh. Oh, God.

188. That's a night terror.

189. We did a CT, MRI, CBC, CHEM-7 and chest X-ray.

190. All the tests came back normal.

191. There's nothing to explain his symptoms.

192. Okay, but let's pretend there's something and go from there.

193. Who sees something on this MRI?

194. - No lesions in the white matter. - No structural abnormalities.

195. No space-occupying tumors.

196. He's 16, so he should have an absolutely pristine brain.

197. The smallest thing is abnormal.

198. Meningeal enhancement.

199. - My bet is viral meningitis. - Excellent.

200. Do you see what he did there?

201. Took a small clue that there's a neurological problem

202. and wasn't afraid to run with it.

203. There's no evidence of meningitis on that MRI.

204. No, there's not. He's completely wrong.

205. Then what clue are you talking about?

206. He knew that I saw something on the MRI,

207. so he figured there must be something there and took a guess.

208. - Clever, but also pathetic. - So what did you find?

209. Take a close look at the corpus callosum.

210. Looks okay.

211. Are we all looking at the same thing?

212. Two hundred million interhemispheric nerve fibers.

213. The George Washington Bridge between the left and right side of the brain.

214. It's subtle.

215. There's some bowing. There. An upward arch.

216. - Are you guessing? - Yes.

217. - Too bad. You're right. - He probably just moved.

218. Nobody stays perfectly still for the entire MRI.

219. Yeah. Probably got restless

220. and shifted one hemisphere of his brain

221. to a more comfortable position. Something is pushing on it.

222. If there was bowing, could be a tumor.

223. Do you see a tumor on this MRI?

224. No, but I don't see any bowing either.

225. There's no tumor. Just a blockage causing pressure causing symptoms.

226. Today, night terrors. Tomorrow, he's bleeding out of his eyes.

227. Get him a radionucleotide cisternogram.

228. I guarantee you'll see a blockage.

229. Okay.

230. Easy.

231. Okay. Squeeze my hand.

232. All right. Squeeze hard.

233. All right.

234. Now I'm injecting a material that's tagged with a radioisotope.

235. It's gonna enter your spine and travel up to your brain.

236. It'll make you able to think deep thoughts,

237. run 100 miles an hour.

238. Easy.

239. Their eyes aren't the same color, but that fleck in the eyes,

240. that's maybe a 1-in-10 chance if they're not related?

241. No. House isn't gonna pay you based on that.

242. Any excuse we can give the folks to justify a DNA test?

243. We could tell them he's got Huntington's,

244. whole family should be tested or they'll all die.

245. Hey.

246. There's a lot of blockage.

247. I've scheduled him for surgery.

248. We're gonna put a shunt into one of the ventricles

249. to give the cerebrospinal fluid an out.

250. No more pressure, everything goes back to normal.

251. He's lucky to have you as his doctors.

252. No formula. Just Mommy's healthy, natural breast milk.

253. Yummy.

254. Her whole face just got swollen like this overnight.

255. No fever.

256. Glands normal. Missing her vaccination dates.

257. We're not vaccinating.

258. Think they don't work?

259. I think some multinational pharmaceutical company

260. wants me to think they work, pad their bottom line.

261. - May I? - Sure.

262. Yeah. All-natural, no dyes is a good business.

263. All-natural children's toys.

264. Toy companies, they don't arbitrarily mark up their frogs.

265. They don't lie about how much they spend on research and development.

266. The worst that a toy company could be accused of

267. is making a really boring frog.

268. You know another really good business?

269. Teeny, tiny baby coffins.

270. You can get them in frog green, fire-engine red. Really.

271. The antibodies in yummy mummy only protect the kid for six months,

272. which is why these companies think they can gouge you.

273. They think that you'll spend whatever they ask to keep your kid alive.

274. Want to change things? Prove them wrong.

275. Few hundred parents like you decide they'd rather let their kid die

276. than cough up 40 bucks for a vaccination,

277. believe me, prices will drop really fast.

278. Tell me what she has.

279. A cold.

280. There's a problem.

281. Complications in surgery?

282. Surgery went fine. He's in recovery.

283. But we took a vial of CSF and tested it.

284. Really?

285. Turns out the bowing wasn't the cause of his problems.

286. It was a symptom.

287. Oligoclonal bands and increased intrathecal IgG.

288. Which means multiple sclerosis.

289. And the reason it takes three of you to tell me this?

290. Because we're having a disagreement about whether or not it is MS.

291. No lesions on the MRI.

292. It's early. He's had the disease for maybe two weeks.

293. McDonald criteria requires six months to make a definitive diagnosis.

294. Who cares about MacPhearson?

295. - I hear he tortured kittens. - McDonald.

296. Oh, McDonald. Wonderful doctor, loved kittens.

297. The VEP indicates slowing of the brain.

298. Without the lesions, we can't be sure.

299. Well, if it is, it's gone from 0 to 60 in three weeks,

300. which would indicate rapidly progressive MS.

301. Not the fun MS with the balloons

302. and the bike rides for cripples in wheelchairs.

303. - We should wait until... - Start treating him now,

304. maybe he can walk for another couple of years,

305. maybe live for another five.

306. Break it to the family. I'm going home.

307. It'll take months for a definitive diagnosis.

308. What'll happen to me?

309. MS is an incredibly variable disease.

310. If it is MS, and we're not 100% sure.

311. What do you think is gonna happen?

312. There are some medications to manage the symptoms,

313. but as the disease progresses, the problems will become more severe.

314. Bowel and bladder dysfunction,

315. loss of cognitive function, pain...

316. So it's gonna hurt?

317. The brain's like a big jumble of wires.

318. MS strips them of the insulation, and the nerves die.

319. Brain interprets it as pain.

320. But by starting treatment, we're gonna prevent that for as long as possible.

321. We're looking into a couple of specialists,

322. and until we get you squared away, you'll stay here, okay?

323. Security checked the videotapes from all perimeter cameras.

324. He's still gotta be in the hospital.

325. Where's Chase?

326. - Main floor. - Okay.

327. You take the cafeteria and administration.

328. I'll hit the research annex and work my way back to you.

329. Dan?

330. I'm not here. Leave a message.

331. Dr. Cuddy. Great outfit.

332. What are you doing back here? Patient?

333. No. Hooker.

334. Went to my office instead of my home.

335. Dr. House.

336. Dan's missing.

337. Yeah. I got that part from the message.

338. You said I was needed immediately.

339. He shouldn't move after a lumbar puncture.

340. I agree. He's gonna have a very nasty headache.

341. That would also be my opinion if consulted tomorrow morning.

342. We wanted to keep you informed.

343. He heard some pretty heavy news.

344. This is not a toddler wandering around a department store.

345. He's 16. You'll find him.

346. I'm going home.

347. When you say, "Call me if you need anything", you mean, "Don't call"?

348. No, I mean call me if I could do something.

349. I'm bad at search parties,

350. and I'm bad at sitting around looking nervous, doing nothing.

351. What about his parents? Should we call them?

352. Why? Do you think they're hiding him?

353. Make sure someone checks the roof.

354. Some of the orderlies keep the door propped open so they can grab a smoke.

355. Dan. You okay?

356. There are experimental treatments.

357. Ongoing research.

358. Who knows what they'll discover in a year or two.

359. This is where I dropped the ball.

360. Dan, we're standing on the roof of the hospital.

361. Dan.

362. Dan, you're not on the field.

363. - He doesn't know where he is. - Dan!

364. Foreman.

365. Dan.

366. - Dan? - Dan, no!

367. Dr. Foreman.

368. I assume you found the kid.

369. - He almost walked off the roof. - Suicidal?

370. No, he thought he was on his lacrosse field.

371. Look, I was just gonna run home, shower, change...

372. - Conscious? - Yeah.

373. How'd you talk him down?

374. - Actually, Chase tackled him. - How come you didn't do it?

375. Right. Well, I am black, but he was closer.

376. Come on. You can ride up with me.

377. Anybody tell the family that their boy almost stepped off a roof?

378. They must be thrilled.

379. They're not suing, but I think only because Chase asked...

380. Why does everybody always think I'm being sarcastic?

381. This is great news. He doesn't have MS.

382. Parents should be thrilled. Well, the mom anyway.

383. Of course, the dad probably doesn't know...

384. Why doesn't he have MS?

385. He was on the roof, thinking he was on a lacrosse field.

386. Conscious, and therefore not a night terror.

387. - You want some of this? - Yeah, sure.

388. He was in an acute confusional state,

389. which doesn't fit with a demyelinating disease like MS.

390. Oligoclonal bands...

391. Were real.

392. They just mean something other than MS.

393. So, what are they telling us?

394. That the immune system is working?

395. Right.

396. He has an infection in his brain.

397. - What about sex? - Well, it might get complicated.

398. I mean, we work together.

399. I'm older, certainly, but maybe you like that.

400. I meant maybe he has neurosyphilis.

401. Nice cover.

402. Sorry. RPR was negative.

403. We don't need a definitive test to confirm this.

404. Sure. Didn't need one to confirm MS.

405. Okay. Let's wait for you to run titers on 1,400 viruses

406. while this kid's brain turns to mush.

407. So the fact that he doesn't have MS,

408. it's really not good news after all.

409. Well, it is if it's neurosyphilis.

410. The likelihood of a false negative on an RPR test, 30%.

411. Likelihood of a 16-year-old having sex, roughly 120%.

412. I'll start him on IV penicillin.

413. No. We're not gonna wait for that.

414. The most effective way to deliver the drug

415. is right into his brain via the spine.

416. We can't. In a cramped space like the brain,

417. increased intracranial pressure from a high-volume drug like penicillin

418. could herniate his brain stem. It'd kill him.

419. No neurologist in his right mind would recommend that.

420. Show of hands. Who thinks I'm not in my right mind?

421. And who thinks I forget this fairly basic neurological fact?

422. Who thinks there's a third option?

423. Very good. What's the third choice?

424. No idea. You just asked if I thought there was one.

425. The patient has a shunt in his brain.

426. There'll be no increased pressure.

427. We can put as much penicillin into his body as we want.

428. Excellent. Inject him through a lumbar puncture.

429. One of us is gonna do this to you twice a day for the next two weeks.

430. I'm ready. Go.

431. He could get syphilis even if he's not sexually active?

432. Well, it's unusual, but it's possible.

433. Okay. Relax.

434. It's infected, with a really big hole,

435. like you stuck a nail in it to relieve the pressure.

436. I wouldn't do that.

437. Although the wound is irregular.

438. It's not cylindrical. It's shaped like a triangle.

439. So, not a nail.

440. - Steak knife? - Wife's nail file.

441. Nail file.

442. Yeah. Pain will make you do stupid things.

443. Something to take the edge off?

444. Yeah.

445. Cheers.

446. So, you have family here in Princeton?

447. No.

448. Here on work?

449. - No. Why are you... - Does your penis hurt?

450. No. What? Should it?

451. No. Just thought I'd toss you a really inappropriate question.

452. Your lawyer's gonna love it.

453. Why would I want to sue you?

454. I want you to treat me.

455. You're from Maplewood, New Jersey, right?

456. Yeah.

457. Now, why would you drive 70 miles

458. to get treatment for a condition

459. that a nine-year-old could diagnose?

460. It's the free-flowing pus that's the tip-off.

461. I was in town.

462. Not for family. Not for work.

463. You drove 70 miles to a walk-in clinic.

464. You passed two hospitals on the road.

465. Now, either you've got a problem with those hospitals,

466. or they have a problem with you.

467. My guess is you've sued half the doctors in Maplewood,

468. and the rest are now refusing to help you.

469. It's ironic, isn't it?

470. Sort of like the boy who sued wolf.

471. You know, I bet we have a doctor here named Wolf.

472. How perfect would that be?

473. I'm gonna page him.

474. Okay. You know what? Thank you.

475. I'm gonna find a doctor to take care of this.

476. I didn't say I wouldn't treat you.

477. We'll drain your knee, run some lab work. Fix you right up.

478. - Why would you do that? - I'm a people person.

479. You actually treated him?

480. All I know is he sued some doctors.

481. Who am I to assume they didn't have it coming to them?

482. The cutest little tennis outfit.

483. My God, I thought I was gonna have a heart attack.

484. Oh, my. I didn't see you there. That is so embarrassing.

485. How's your hooker doing?

486. Sweet of you to ask. Funny story.

487. She was gonna be hospital administrator,

488. but just hated having to screw people like that.

489. I heard you found her on the roof.

490. - You have very acute hearing. - You notify the parents?

491. In due course, of course.

492. And is there a paternity bet on the father of the patient?

493. Doesn't sound like me.

494. Well, it does, actually, but doesn't mean you're guilty.

495. - You think? - I saw the parents in the lobby.

496. Smart money's obviously on the father.

497. My guy knows a guy who can get you in for 50 bucks.

498. Fine. Tell your guy, if I win,

499. you attend the faculty symposium, and you wear a tie.

500. And if I win, no clinic hours for a week.

501. My guy will call your guy.

502. She's very good at her job.

503. The treatments should start helping soon.

504. Let us know if it gets easier to focus on things, remember stuff.

505. Hey, Dan.

506. Isn't Dr. Cameron's necklace a beauty?

507. Something South American, I think.

508. Yeah. Guatemalan.

509. It's a cool necklace.

510. - Thank you so much. - The kid's in pain.

511. Don't fight it. Just let it happen.

512. No.

513. - You'll be dead in two days. - "No" what?

514. I give it a day.

515. Dan? You okay?

516. - Dan? - Night terrors.

517. Body decomposition once he's in the grave.

518. Say goodbye to your mother and father.

519. He's hearing voices.

520. You're dying. It's all over, Dan.

521. You're dying. Dying. Dead!

522. You're a dead man!

523. Push 2 milligrams IV Ativan, stat.

524. It's all over.

525. Come on, Dan.

526. Get out of my head!

527. Auditory hallucination shows further brain degeneration.

528. Penicillin's not working.

529. So either it's a bad batch of penicillin,

530. or our diagnosis is wrong.

531. Square one. MIDNIT.

532. LFTs, BUN and creatinine are all normal.

533. Diabetes is out, and no gap.

534. - There goes metabolic. - MRA rules out vasculitis.

535. "I" for inflammation.

536. Too young for anything degenerative.

537. "D", see ya.

538. - "N" for neoplastic. - MRI was clean.

539. - "I" for inflammation. - We already did that.

540. Stupid to have two I's in one mnemonic. What's the other one?

541. Infection.

542. Oligoclonal bands still have to mean something.

543. But no fevers.

544. White count's elevated, but within range.

545. We've tested for anything remotely possible. Everything's negative.

546. CT scan rules out subdural.

547. Trauma. Later much.

548. You know the problem?

549. "Midnight" is actually spelled with a "G" and an "H".

550. If we could just figure out what those letters stand for.

551. It's a sick brain, having fun,

552. torturing him, talking to him.

553. Scaring the hell out of him.

554. Get him an EEG, left and right EOG, esophageal microphones.

555. If this thing wants to talk, let's listen.

556. We're missing something. This is screwed up.

557. That's why you came up with the brain talking to the virus thing?

558. I panicked, okay?

559. Sounded cool, though. They bought it.

560. Crap.

561. Another reason I don't like meeting patients.

562. If they don't know what you look like, they can't yell at you.

563. Here we go.

564. How can you just sit there?

565. If I eat standing up, I spill.

566. Our son is dying, and you could care less?

567. We're going through hell. You're doing nothing?

568. I'm sorry. You need to vent. I understand.

569. Don't be condescending.

570. You haven't checked in on him once.

571. Blood pressure is 110 over 70.

572. His shunt is patent, well-placed in the right lateral ventricle.

573. The EKG shows a normal QRS

574. with deep-wave inversions throughout both limb and precordial leads.

575. LFTs are elevated, but only twice the normal range.

576. Oh, yeah. And he's hearing voices.

577. Go hold his hand.

578. Go on. I'll bus your tray.

579. Got any sample bags on you?

580. I don't believe you. You're gonna run DNA tests?

581. Their son is deathly ill. I know. It's terrible.

582. But the fact is, if I don't keep busy

583. with trivial things like this, I'm afraid I might start to cry.

584. You're an ass.

585. Yeah? You want to double the bet?

586. General Hospital is on Channel 6.

587. Dan's brain's not showing Channel 6 right now. Only mush.

588. No epileptiform activity.

589. What are you doing?

590. - Waiting for CBC and CHEM-7. - Good. Run DNA on these.

591. - What's this? - Parents' coffee cups.

592. I can't believe you.

593. I've had this conversation once already.

594. If you've got something else to do, do it. Otherwise, do this.

595. Dr. House?

596. Hey. Mr. Funsten.

597. I was wondering when you'd be back.

598. You got some papers for me?

599. You've caused me considerable mental distress.

600. I certainly hope so.

601. What? Too cheap to get your lawyer to serve it for you,

602. or is it just more fun this way?

603. I'm obviously prepared to consider a settlement.

604. You have gonorrhea.

605. No, I don't.

606. Well, maybe you're right, but I have a lab result says you do.

607. Could be a false positive, and normally I'd run a second test,

608. but since you're here, I'll just go with the first.

609. You're just trying to scare me.

610. It's reportable, you know. Public health issue.

611. I'll be sure to let my wife know.

612. Don't bother yourself. The state will call for you.

613. Look, if you're clean, I'm sure it'll all blow over. No big deal.

614. There's an easy way to find out.

615. Get one of your doctors to run a test.

616. Uh-uh.

617. These are mine now. I'll see you in court.

618. West Nile, negative. Not surprising since not too many mosquitoes

619. passing through Jersey in December.

620. No eastern equine encephalitis.

621. You guys aren't gonna believe this.

622. What's that?

623. House is right. The father's not the father.

624. Dude doubled up on me.

625. You're not gonna believe this.

626. The mother's not the mother either.

627. It's not a good idea to move your son in his condition.

628. - We just want a second opinion. - We need an answer.

629. You idiots. You lied to me.

630. We didn't lie about anything.

631. You, on the other hand, accused us of molesting our son.

632. - Perfect. - Can we get off my screw-ups

633. and focus on theirs? Theirs is bigger.

634. - You're not Dan's parents. - We're his parents.

635. He was adopted. He doesn't need to know.

636. I do.

637. Adoption makes us just as much...

638. Listen. When we were taking his medical history, were you confused?

639. Did you think we were looking for a genetic clue to his condition,

640. or did you think we were trying to ascertain

641. who loves him the most in the whole wide world?

642. How did you find out about this?

643. - I sampled their DNA. - We didn't give you any DNA.

644. Your coffee cups from the cafeteria.

645. You can't do that.

646. Again, why are we getting hung up on what I did?

647. Your medical history is useless.

648. No. We gave you a detailed history of his biological mother.

649. Her history. Non-smoker, good health,

650. low cholesterol, no blood pressure problems.

651. Dan was adopted two weeks after he was born.

652. You have his history. There's nothing you need to know

653. - that we didn't tell you. - Sounds reasonable.

654. Well, if you want to transfer your boy, that is your choice.

655. I still think it's the wrong...

656. Was she vaccinated?

657. The biological mother.

658. When she was a baby, did she get her vaccinations?

659. Dan was vaccinated at six months.

660. Do you know why kids get vaccinated at six months?

661. Because before that they are protected

662. by their biological mother's immune system.

663. So, was she vaccinated?

664. An infant picks up a regular old measles virus.

665. Gets a rash. He's extremely uncomfortable,

666. has a wicked fever, but he lives.

667. Here's the kicker.

668. Once every million or so times, the virus mutates.

669. Instead of Dan having a fever and a rash,

670. the virus travels to his brain and hides, like a time bomb.

671. In this case, for 16 years.

672. Subacute sclerosing panencephalitis.

673. I know. There's only been 20 cases

674. in the United States in the last 30 years.

675. I suppose you could make an argument the kid's still in Stage 1.

676. Once SSPE moves to Stage 2, it's...

677. Boom. Stage 2 is universally fatal.

678. I assume it's impossible to know

679. when he might move into Stage 2.

680. He's already started showing symptoms.

681. Could be a month. Could be tonight.

682. - Can we treat it? - Ask the neurologist.

683. Intraventricular interferon.

684. Not gonna shove a spike into his brain

685. and drip interferon without confirming this diagnosis.

686. - Tap him. - We won't get a reliable result

687. for measles antibodies in his CSF.

688. Not after everything we've given him.

689. So the wrong treatment kills any hope of the right diagnosis.

690. Why do people lie to me?

691. Could also kill him. Your ball, Foreman.

692. Tell me I don't have to biopsy his brain.

693. Well, there is one other way.

694. You sure this isn't gonna hurt?

695. Yeah. It's just scary as hell.

696. See, we go through the pupil.

697. But you won't feel it. The eye's been paralyzed.

698. The needle travels to the back of the eye,

699. which is where we'll perform the biopsy on your retina.

700. So we've confirmed that the problem is this mutated virus.

701. The treatment for SSPE is intraventricular interferon.

702. We implant an Ommaya reservoir under the scalp,

703. which is connected to a ventricular catheter

704. that delivers the antiviral directly to the left hemisphere.

705. You want us to consent to this?

706. I don't even understand what you're talking about.

707. Well, the antiviral...

708. Look. I'm sorry.

709. I can explain this as best I can,

710. but the notion that you're gonna fully understand your son's treatment

711. and make an informed decision is kind of insane.

712. Here's what you need to know.

713. It's dangerous. It could kill him.

714. You should do it.

715. Did you need something else?

716. You can't order a $3,200 DNA test to win a bet.

717. It's not an actual cost.

718. I don't know if you know this,

719. but the hospital actually owns the sequencing machine.

720. - I'm serious. - Tell the parents

721. to submit the bill to insurance.

722. Insurance is not gonna pay for a bet.

723. It should.

724. We don't make that bet, the kid dies.

725. If not for the paternity bet, I never would have taken their DNA.

726. Without their DNA, we never would have discovered

727. that Dan was adopted, which was the key to this case.

728. You just don't want to pay your end.

729. Big mistake. My guy knows a guy.

730. Fine. I will let you out of clinic duty for one week,

731. after you pay the $3,200 for the PCR test.

732. Well, now, there's the $100 you owe me.

733. Here's the $100 I won from Cameron.

734. $200 I took off of Foreman.

735. And $600 I got from Wilson.

736. Very bitter.

737. Hey. Good morning.

738. Good news on your EEG.

739. Treatment is working.

740. And your immune system is responding.

741. I know it's early, but I just want to take a look.

742. All right.

743. Let's see what that brain of yours can do.

744. Name as many animals as you can

745. that start with the letter "O".

746. Ostrich.

747. Ox. Old elephant.

748. Well, that's two better than last time.

749. How you doing with the whole adoption thing?

750. I knew since fifth grade.

751. How's that?

752. Cleft chin.

753. I have one. My dad doesn't.

754. Looked it up on the Internet.

755. It's one of those trait things.

756. That's right. It's autosomal dominant.

757. Since neither of your parents have cleft chins,

758. it's highly unlikely you're biologically related.

759. Are you sure you're okay?

760. I've got no problems with being adopted.

761. I love my parents.

762. How's he doing?

763. He's doing pretty well. He's a smart kid.

764. I think he's gonna be fine.

765. - Hey. - Thanks.

766. Wheels, 18. Wheels.