1. So now the plan is either find ourselves a new counselor,Copy !req
2. stick it out with the old one but go more often,Copy !req
3. or resign ourselves to the fact that she's never gonna be happyCopy !req
4. no matter what I do, so let's just take the money we're wastingCopy !req
5. and put it towards a membership at Lakeview, you know?Copy !req
6. I'm guessing the last option obviously formally present her.Copy !req
7. Yeah... Jeez what's with you?Copy !req
8. It usually takes about half speed to stay with me.Copy !req
9. I didn't get a lot of sleep last night.Copy !req
10. How are things with Elise?Copy !req
11. Great.Copy !req
12. Great?Copy !req
13. Yeah.Copy !req
14. Simple answers. You're either out of breath or you're lying to me.Copy !req
15. Yeah... we have our moments,
but they usually work out.Copy !req
16. Can I get some water?Copy !req
17. Yeah...Copy !req
18. So how do you work things out?Copy !req
19. Talk, someone apologizes.Copy !req
20. Man I shouldn't have drank last night.Copy !req
21. Hey, you mean you apologize.Copy !req
22. Yeah, I guess.Copy !req
23. How often do you guys have sex?Copy !req
24. Enough...Copy !req
25. You do it this morning?Copy !req
26. You did, you did it this morning,Copy !req
27. maybe that's why you can't stand up. Come on!Copy !req
28. Elise!Copy !req
29. Honey, I'm dehydrated.Copy !req
30. We have anything with electrolytes?Copy !req
31. Sleeping beauty, wake up,
this is an emergency.Copy !req
32. The fridge is empty.Copy !req
33. Come on, it's almost four!Copy !req
34. Elise, sweetie...Copy !req
35. Call Jacques, tell him I'm not feeling well.Copy !req
36. It's Saturday.Copy !req
37. You haven't been to work in three days, remember?Copy !req
38. Just let me sleep.Copy !req
39. Come on. You haven't been out of bed since Wednesday.Copy !req
40. Leave me alone...Copy !req
41. Come on, lets go.Copy !req
42. I SAID LEVE ME ALONE!Copy !req
43. I think there's something wrong with me.Copy !req
44. 1X07: FIDELITYCopy !req
45. Original Airdate on FOX: December 28, 2004Copy !req
46. She's been averaging 18 hours of sleep a day since her admission.Copy !req
47. Clinical depression.
Incredibly contagious.Copy !req
48. Every time I'm around one of them I get blue.Copy !req
49. It's not clinical depression.Copy !req
50. Great, you got it all figured out.
You don't need me.Copy !req
51. Three ER doctors, two neurologists
and a radiologist have all figured out what its not,Copy !req
52. we need to figure out what it IS.Copy !req
53. Well, maybe if above mentioned doctors
were interested in my opinion
they would have asked for it.Copy !req
54. None of them are willing to subject themselves to you.Copy !req
55. No pain no gain.Copy !req
56. The blood work showed no signs of inflammation,Copy !req
57. and no one can figure out what's actually the cause of—Copy !req
58. Huh.Copy !req
59. What?Copy !req
60. Husband described her
as being unusually irritable recently.Copy !req
61. And?Copy !req
62. I didn't know it was possible for a woman
to be "unusually" irritable.Copy !req
63. Nice try, but you're a misanthrope, not a masochist.Copy !req
64. What's the first thing you ask a doctor who's referring a patient?Copy !req
65. Are you questioning my ability to take a history?Copy !req
66. "What's the primary"--Copy !req
67. Not "what?". "Why?"Copy !req
68. Diseases don't have motives.Copy !req
69. No, but doctors do.Copy !req
70. Why this patient, what interests you?Copy !req
71. Give me the chart.Copy !req
72. Why?Copy !req
73. I find your interest interesting.Copy !req
74. She's irritable, sleeping 18 hours a day.Copy !req
75. What's interesting about that?Copy !req
76. Hypersomnia is usually accompanied
by irritability in depressed patients.Copy !req
77. True, but not relevant.
She's not depressed.Copy !req
78. Hello! She's sleeping 18 hours a day!Copy !req
79. Fever.Copy !req
80. Clinical depression does not cause fever.Copy !req
81. She could be sick and depressed?Copy !req
82. She's sick! Dammit,
why didn't I think of that?Copy !req
83. Yeah, that's what I mean...Copy !req
84. Elevated SED rate indicates inflammation.Copy !req
85. Hypersomnia and personality changes point toward the brain.Copy !req
86. Not the spleen.Copy !req
87. Thank goodness we hired a neurologist!Copy !req
88. Brain symptoms... hmm, could this be a brain problem?Copy !req
89. No other systemic signs of inflammation, probably not vasculitis.Copy !req
90. What about parasites? Malaria, chagas?Copy !req
91. Patient's never been outside the United States, especially the tropics.Copy !req
92. You mean she claims she's never been outside the U.S.Copy !req
93. Very good.Copy !req
94. Doesn't matter, blood and c-sub smears show no sign of parasites.Copy !req
95. Has to be a tumor then.Copy !req
96. A tumor sitting directly on top of the brain stem.Copy !req
97. That three ER doctors, two neurologists, and a radiologist missed?Copy !req
98. Partridge in a pear tree missed it too.Copy !req
99. Redo the blood work and get a new MRI with 2 millimeter cuts through the mesodiencephalic.Copy !req
100. And check for evil stepmothers.Copy !req
101. This much sleep usually indicates poisoned apples.Copy !req
102. Anything else beside the shortness of breath?Copy !req
103. Not really, its actually just kind of a tightness.Copy !req
104. You smoke?Copy !req
105. No, never.Copy !req
106. Exercise?Copy !req
107. Eight hours a day.Copy !req
108. I teach preschool.Copy !req
109. Sounds fun.Copy !req
110. Any history of heart disease in your family?Copy !req
111. Not that I know of.Copy !req
112. Take a deep breath.Copy !req
113. Been under a lot of stress lately?Copy !req
114. None more than usual.Copy !req
115. You're probably just a little anemic,Copy !req
116. but I'm going to do an EKG just to make sure.Copy !req
117. Do I need to take this off?Copy !req
118. No, you can just pull that down in front.Copy !req
119. Good. Lord. Are those real?Copy !req
120. Do they look real?Copy !req
121. They look... pretty damn good.Copy !req
122. They were a present for my husband's 40th.Copy !req
123. I figured he'd enjoy them more than a sweater.Copy !req
124. That's so sweet.Copy !req
125. I'm afraid the cause of your problem could be staring us right in the face.Copy !req
126. Actually I guess I'm the one doing the staring.Copy !req
127. Of course I can't be sure,
I'd like to consult a colleague.Copy !req
128. He's actually somewhat of an expert in these matters.Copy !req
129. Can I get a page on Dr. Wilson?Copy !req
130. A tumor?Copy !req
131. We don't know, we're checking just to be safe.Copy !req
132. They already checked for that.Copy !req
133. The previous MRI had a broader view.Copy !req
134. Some tumors are almost impossible to see unless we know exactly where to look.Copy !req
135. That means it would be small, right?Copy !req
136. Yes.Copy !req
137. So you'd be able to operate? Take it out?Copy !req
138. If it is a tumor, there are a variety of treatment options,Copy !req
139. but there are variables other than just size.Copy !req
140. Don't worry...Copy !req
141. Too late.Copy !req
142. Try to remain as still as possible.Copy !req
143. The less distortion there is,
the more we'll be able to see.Copy !req
144. Ok.Copy !req
145. Well. That's what breasts look like.Copy !req
146. Is a lie a lie if everybody knows it's a lie?Copy !req
147. Well, if a tree pretends to fall in a forest...Copy !req
148. House, come on, they're breasts.Copy !req
149. They're a birthday present,
not a philosophical treatise.Copy !req
150. Lie number one,Copy !req
151. she did not do that for her husband,
she did that for herself.Copy !req
152. She thinks if she looks different, she'll be different.Copy !req
153. No, she thinks if she looks different,
she'll be more attractive, which, I have to say...Copy !req
154. Not to her husband.Copy !req
155. Cosmetic surgery is so that everyone else will look at us differently.Copy !req
156. Same reason you're wearing that tie.Copy !req
157. Well exactly, that was going to be my next point.Copy !req
158. Last three months, same five ties.Copy !req
159. Thursday should be that paisley thing.Copy !req
160. It's a gift from my wife.Copy !req
161. No its not. Julie hates green.
You bought that yourself.Copy !req
162. You want to look pretty. At work.Copy !req
163. Wilson's got a girlfriend...Copy !req
164. Stop! Stop. I don't.Copy !req
165. It takes TWO department heads to treat shortness of breath?Copy !req
166. What, do the complications increase exponentially with cup size?Copy !req
167. I want an EKG and blood tests including tox screen on Mrs...Copy !req
168. Exam Room 1.Copy !req
169. You're ordering tests to cover your lechery.Copy !req
170. Interesting.Copy !req
171. Very tricky case.Copy !req
172. You love everybody.
That's your pathology.Copy !req
173. There were no lesions and no mass effect that we could see.Copy !req
174. What does that mean?Copy !req
175. It means we're still not sure what's causing your neurological problems.Copy !req
176. I know some thing are hard to cure,Copy !req
177. but what I just don't get is
why it's taking so long to figure out
what's wrong with her.Copy !req
178. I know you're scared, I would be too.Copy !req
179. I don't feel good...Copy !req
180. You feeling nauseous?Copy !req
181. Honey? You all right?Copy !req
182. She's seizing!Copy !req
183. Get her on her side.
I need some Ativan!Copy !req
184. I'll get it!Copy !req
185. What's happening?Copy !req
186. She's having a seizure.Copy !req
187. She's aspirating, suction!Copy !req
188. Elise!Copy !req
189. Come on Elise!Copy !req
190. The MRI reveals nothing.Copy !req
191. That we were able to detect.Copy !req
192. It's not a tumor.Copy !req
193. A small glioma could hide from contrast.
We could do a PET scan.Copy !req
194. Yes, that's how a responsible doctor would waste his time in the situation.Copy !req
195. Suddenly tests and radiologists aren't capable of error?Copy !req
196. A glioma not presenting on a contrast MRI would have to be smaller than a grain of sand,Copy !req
197. which does not a gravely ill person make.Copy !req
198. It could be just postictal disorientation.Copy !req
199. We would have seen improvement by now.Copy !req
200. Late stage Lyme Disease can cause seizures.Copy !req
201. Does the husband care about her?Copy !req
202. He hasn't left her bedside.Copy !req
203. No way... it also means she doesn't have Lyme Disease.Copy !req
204. What? Love conquers all?Copy !req
205. Lyme Disease initially presents with a rash.Copy !req
206. Mr. Clingy would have noticed.Copy !req
207. We've looked at everything else.Copy !req
208. Did you look at her breasts?Copy !req
209. Pff. Men.Copy !req
210. Could be paraneoplastic.Copy !req
211. She have any family history of breast cancer?Copy !req
212. Her mother died of it.Copy !req
213. The brain, but not the brain. Clever, huh?Copy !req
214. How can breast cancer cause problems in her brain?Copy !req
215. There are molecular similarities between brain cells and tumor cells.Copy !req
216. Paraneoplastic Syndrome causes the body's own antibodies to get thrown off track.Copy !req
217. They end up attacking the brain instead of the tumor.Copy !req
218. So if you do find the tumor, what do you do?Copy !req
219. We treat the underlying malignancy.Copy !req
220. Once there's no tumor to attack,
there's nothing for the antibodies
to get confused about.Copy !req
221. If the tumor's treatable.Copy !req
222. Exactly.Copy !req
223. OW!Copy !req
224. I'm sorry, I know it's uncomfortable.Copy !req
225. The tighter we go,
the better the image will be.Copy !req
226. Least it'll keep me awake.Copy !req
227. Don't worry, it's almost over.Copy !req
228. I wish people would stop telling me not to worry.Copy !req
229. I'm sorry.Copy !req
230. My mom was the same age.Copy !req
231. We've been trying to get pregnant for over a year.Copy !req
232. I guess we're lucky we didn't.Copy !req
233. A lot has changed since your mom died.Copy !req
234. Don't worr...Copy !req
235. Don't give up.Copy !req
236. No tumor?Copy !req
237. The MRI and mammogram only showed a few benign calcifications.Copy !req
238. It's most likely a small cell tumor,Copy !req
239. its no surprise we're having trouble finding it.Copy !req
240. We should do a PET scan.Copy !req
241. Start with her lungs, and maybe her bones...Copy !req
242. Sometimes it presents with no tumor at all.Copy !req
243. How can a disease caused by a tumor present if there's no tumor?Copy !req
244. It happens. Twelve percent of cases.Copy !req
245. And how do you treat it if there's no tumor?Copy !req
246. You don't. Those twelve percent have no treatment.Copy !req
247. They were too busy looking for the tumor,Copy !req
248. right till they put the patient in the ground.Copy !req
249. What choice do we have?Copy !req
250. Treat the symptoms.
IV Immunoglobulin.Copy !req
251. So we're just going to ignore the tumor?Copy !req
252. Eventually it'll get bigger.
Then it'll be really easy to find.Copy !req
253. One of you needs to check out where she works.Copy !req
254. Why?Copy !req
255. Cause the husband's not sick.Copy !req
256. Meaning?Copy !req
257. If it's not paraneoplastic and
it is a reaction to some kind of toxic,
it's obviously not coming from their home.Copy !req
258. Foreman, you do it.Copy !req
259. Why are you riding me?Copy !req
260. It's what I do... has it gotten worse lately?Copy !req
261. Yeah. Seems to me.Copy !req
262. Really. Well that rules out the race thing.Copy !req
263. Cause you were just as black last week.Copy !req
264. How long has Elise worked here?Copy !req
265. Three years, she's my best rotisseur.Copy !req
266. What's that?Copy !req
267. The rotisseur prepares the roasted meats and gravies.Copy !req
268. How do you clean your grill?Copy !req
269. They say elbow grease.Copy !req
270. Do you use chemical cleaners?Copy !req
271. Ah, no. Absolutely no, our chefs don't do the cleaning, anyway.Copy !req
272. What about pesticides?Copy !req
273. You must spray for roaches and that sort of thing?Copy !req
274. Nope, my kitchen is clean. No roaches.Copy !req
275. I need to get back to work.Copy !req
276. And the fact that I'm here asking you these questions, it doesn't worry you?Copy !req
277. Look at me. I'm here 18 hours a day.Copy !req
278. That guy practically lives here,
he does live here...Copy !req
279. I use the same detergents for 15 years
and everyone is healthy as a horse.Copy !req
280. Whatever Elise has she didn't get here.Copy !req
281. Tell her I hope she feels better,
and I had to get a new rotisseur.Copy !req
282. Where's Ed?Copy !req
283. He went down to the gift shop to buy a shirt.Copy !req
284. I told him I'd stay up here in case you woke up.Copy !req
285. You must have better things to do.Copy !req
286. I send my laundry out.Copy !req
287. You're not married?Copy !req
288. No.Copy !req
289. Waiting for the perfect guy?Copy !req
290. Let me guess.Copy !req
291. You've already found him.Copy !req
292. He threw my towels out the window.Copy !req
293. What?Copy !req
294. It's how we met.Copy !req
295. Freshman year, he came to a party my roommate and I threw.Copy !req
296. He spent most of the night on the bathroom floor.Copy !req
297. He figured I wouldn't notice vomit on the towels if I didn't have any towels.Copy !req
298. I'm assuming he came back the next day to apologize?Copy !req
299. No way. We had to track him down.Copy !req
300. Conflict resolution has never been one of Ed's strong points.Copy !req
301. Nobody's perfect, right?Copy !req
302. I guess.Copy !req
303. Oh my neck hurts.Copy !req
304. You've been in this bed for a really long time.Copy !req
305. We're gonna do the same test we did last night, ok?Copy !req
306. Do you know what day it is?Copy !req
307. My arm itches.Copy !req
308. It's probably just a mild skin irritation,Copy !req
309. I'll get you some hydrocortisone in a minute.Copy !req
310. Do you know what day it is?Copy !req
311. Tuesday. It really itches.Copy !req
312. How about get you that cream right now.Copy !req
313. Oh my God! Get them off! Someone! Get them off of me!Copy !req
314. Elise calm down.Copy !req
315. Elise calm down.Copy !req
316. I need some Haldol, 5 milligrams.Copy !req
317. Elise, what's wrong?Copy !req
318. Get them off! Get them off! Get them off!Copy !req
319. There's nothing there, Elise.
There's nothing there!Copy !req
320. We had to sedate her.Copy !req
321. You gave sedatives to a patient who's already sleeping 18 hours a day?Copy !req
322. It was better than letting her scratch all the skin off her arms.Copy !req
323. Or supposed to be.Copy !req
324. Creepy-crawlies are consistent with paraneoplastic syndrome.Copy !req
325. Onset immediately after IVIG isn't.Copy !req
326. There is a simple explanation. Maybe she really has bugs under her skin.Copy !req
327. Infection?Copy !req
328. That's what the worsening of symptoms after immunotherapy would suggest.Copy !req
329. Blood cultures and the timeline rule out most bacteria.Copy !req
330. If a patient throws up on your shoes do you clean up "most" of it?Copy !req
331. The symptoms rule out the rest.Copy !req
332. Serology rules out viruses,
CSS smears rule out parasites.Copy !req
333. In the final stage of African Trypanosomiasis almost all the parasites are inside the brain.Copy !req
334. It's possible they wouldn't show on smears.Copy !req
335. But it's not possible for a patient who's never been to Africa to have African Sleeping Sickness.Copy !req
336. I'm just saying it fits the symptoms.Copy !req
337. She could have got it from a transfusion.Copy !req
338. Or I'm just saying she could have got it from a transfusion.Copy !req
339. Which she never had.Copy !req
340. Okay...Copy !req
341. What about toxins?Copy !req
342. No, the kitchen she works in is cleaner than some hospitals.Copy !req
343. But they do serve rabbit.
Rabbit Fever fits her symptoms.Copy !req
344. Tularemia initially presents with a rash or ulcer near the infection site.Copy !req
345. Not if she inhaled it.Copy !req
346. Chopping the meat with a cleaver could easily aerosolize the bacteria.Copy !req
347. No, then she'd have respiratory symptoms.Copy !req
348. Maybe she ignored it,
figured she had a cold.Copy !req
349. We rejected Lyme Disease because the couple would have noticed a rash,Copy !req
350. but a wet hacking cough is just going to slip right by.Copy !req
351. Hey, it's either that or she missed her exit on the turnpike and wound up in Africa.Copy !req
352. Ok. Two lousy ideas.Copy !req
353. Unfortunately they're better than all the other ideas.Copy !req
354. Tularemia. Bizarre.Copy !req
355. Very nice.Copy !req
356. That's why I ride you.Copy !req
357. Did he just turn on the TV?Copy !req
358. He needs to think.Copy !req
359. So this should tell us whether or not she's got rabbit fever?Copy !req
360. For a diagnosis of Tularemia you need a four-fold increase in serum antibody levels.Copy !req
361. To measure an increase you need a before, all we have is an after.Copy !req
362. A single titer over 160 would be a big clue.Copy !req
363. "That's why I ride you."
What does that mean?Copy !req
364. Even when I have a good idea it's because of him?Copy !req
365. Actually I think he said your idea was a lousy idea.Copy !req
366. It has to be one of these two conditions.Copy !req
367. I say we take our best guess and just start treatment. Or treat both.Copy !req
368. The treatment for Tularemia can cause aplastic anemia.Copy !req
369. How come he doesn't ride you guys?Copy !req
370. He's got a crush on you.
He just doesn't know how to show it.Copy !req
371. Get over it, he rides everybody.Copy !req
372. And the treatment for sleeping sickness kills one in ten patients.Copy !req
373. So we start with the safer treatment.Copy !req
374. By "safer" you mean the one that's slightly less likely to kill her?Copy !req
375. Foreman got the gang testing for Tularemia?Copy !req
376. Yep.Copy !req
377. Probably inconclusive, but worth doing.Copy !req
378. So what's her name?
When do I get to meet her?Copy !req
379. There's nobody.
Give it up.Copy !req
380. Your lips say no,
your shoes say yes.Copy !req
381. Well they're French.
You can't trust a word they say.Copy !req
382. Solid, yet stylish.Copy !req
383. A professional woman would be impressed.Copy !req
384. I'm thinking accountant, actuary, maybe.Copy !req
385. It's somebody in the hospital.Copy !req
386. Patient?Copy !req
387. No, chemo's not sexy.
Daughter of the patient?Copy !req
388. She would certainly have the neediness you need.Copy !req
389. I'm not gonna date a patient's daughter.Copy !req
390. Very ethical.Copy !req
391. Of course, most married men would say they don't date at all.Copy !req
392. There was no date!Copy !req
393. I had lunch with one of the nurses.Copy !req
394. It's her first time in an oncology unit
and she's having a tough time,Copy !req
395. emotionally.Copy !req
396. Perfect.Copy !req
397. I wanted to be nice.
That's all. I mean it.Copy !req
398. You always do.
It's part of your charm.Copy !req
399. Hi boys.Copy !req
400. Mrs. Campbell's test results.Copy !req
401. Oh, you remember her, the preschool teacher with the heart of silicon.Copy !req
402. Nope, doesn't ring a bell.Copy !req
403. They came in yesterday, I figured
you guys would have been all over them.Copy !req
404. I know how concerned you are.Copy !req
405. She's all upset because we paid more attention to the other girl.Copy !req
406. You check out her ass,
I've got the chest.Copy !req
407. The tests were normal.Copy !req
408. 'Cause that's just my opinion,
you may want to call a couple of guys
from maintenance in for a consult.Copy !req
409. You check her EKG results before she left the other day?Copy !req
410. You ordered it.Copy !req
411. You're the responsible one.Copy !req
412. What's wrong? They look normal to me.Copy !req
413. Where is she?Copy !req
414. Waiting downstairs, why?Copy !req
415. I was right.Copy !req
416. Do I have to get rid of the implants?Copy !req
417. Surprisingly, no.Copy !req
418. But your EKG shows a slightly decreased heart rate.Copy !req
419. Is that a problem?Copy !req
420. You told me you hadn't changed your diet or exercise, were you lying?Copy !req
421. Lying?Copy !req
422. Does your husband have high blood pressure?Copy !req
423. My husband?Copy !req
424. Yeah.. see, if you're gonna repeat everything I say this conversation is gonna take twice as long.Copy !req
425. Yes, he was diagnosed six moths ago...Copy !req
426. He do a lot of cooking at home?Copy !req
427. Not really, other than oatmeal in the morning.Copy !req
428. Did you happen to notice a slightly odd taste to the oatmeal lately?Copy !req
429. Wait, are you saying that...Copy !req
430. That it looks like your husband stirred in some of his blood pressure medication along with brown sugar.Copy !req
431. You think my husbands trying to poison me?Copy !req
432. No, nothing like that.Copy !req
433. He just doesn't want to have sex with you.Copy !req
434. Decreased sex drive is one of the most common side effects of the beta blockers he's been taking.Copy !req
435. I'm guessing he figured if you're both frigid, no harm no foul.Copy !req
436. You should have gotten him the sweater.Copy !req
437. That's ridiculous.Copy !req
438. Fine.Copy !req
439. But if you're still concerned about the shortness of breath, I'd start making your own breakfast.Copy !req
440. Wait!Copy !req
441. What should I do?Copy !req
442. If you care about your husband at all,Copy !req
443. I'd do the responsible thing:Copy !req
444. buy yourself some condoms,
go to a bar, find...Copy !req
445. Lab tests inconclusive?Copy !req
446. Not surprisingly.Copy !req
447. No. Too bad.
Luckily, I have the answer.Copy !req
448. To what?Copy !req
449. Thanks for asking.
The life itself. Sex.Copy !req
450. Anything that can be transmitted via the blood can be transmitted through sex.Copy !req
451. Sleeping sickness from sex?Copy !req
452. It's not without precedent.Copy !req
453. I'm pretty sure it is.Copy !req
454. Unless you're talking about going to Africa and having sex with the tse tse fly.Copy !req
455. A Portuguese man was diagnosed three years ago with CNS affected sleeping sickness.Copy !req
456. His only connection with Africa was through a girlfriend who served under the military in Angola.Copy !req
457. Oi, where'd you find that?Copy !req
458. The journal de Instituto de Higina y Medicina Tropical.Copy !req
459. You don't read Portuguese?Copy !req
460. You do?Copy !req
461. I'm pretty sure that's what it said.Copy !req
462. Either that or it was an ad for sunglasses.Copy !req
463. Her husband has never been to Africa either.Copy !req
464. Ooh, stymied again.
Your logic is bulletproof.Copy !req
465. I think ignoring respiratory symptoms is more likely than cheating.Copy !req
466. Because?Copy !req
467. They're completely devoted to each other.Copy !req
468. Because?Copy !req
469. They love each other.Copy !req
470. Or?Copy !req
471. They're overcompensating for guilt.Copy !req
472. Find out which it is.Copy !req
473. You want me to ask a man whose wife is about to die if he cheated on her?Copy !req
474. No, I want you to be polite and let her die.Copy !req
475. Actually, I don't want you to ask her anything.Copy !req
476. Foreman take the husband,
Chase take the wife.Copy !req
477. You don't trust me to do my job?Copy !req
478. We all formulate questions based on the answers we want to hear.Copy !req
479. And how exactly do you re-formulate
"Have you screwed around?"Copy !req
480. Did you know she's been trying to get pregnant?Copy !req
481. Yes.Copy !req
482. After you got so freaked about the sick babies a while ago I figured that was your thing.Copy !req
483. But you've never been prescribed folic acid,Copy !req
484. and you can't lose a baby if you've never been pregnant.Copy !req
485. You pulled my medical records?Copy !req
486. You coughed the other day,
I was concerned.Copy !req
487. You were curious.Copy !req
488. Like an eight-year old boy with a puzzle that's just a little to grown-up for him to figure out.Copy !req
489. To-MAY-to, to-MAH-to...Copy !req
490. So... it's either sleeping sickness or this rabbit thing.Copy !req
491. They're both fatal without treatment.Copy !req
492. And unfortunately the treatment for both is extremely dangerous.Copy !req
493. Are there test you can do?Copy !req
494. Not at this stage.Copy !req
495. But each condition has a unique history.Copy !req
496. We're hoping your answers to a few questions will help us.Copy !req
497. Sure. Whatever you need to know.Copy !req
498. Before the sleeping problems,
did you have any trouble breathing,Copy !req
499. a cough that wouldn't go away,
anything like that?Copy !req
500. No.Copy !req
501. Are you certain?Copy !req
502. Absolutely.Copy !req
503. I've never been away from her
for more than a night,Copy !req
504. if she had breathing troubles,
I would have noticed.Copy !req
505. The other condition is significantly more likely if...Copy !req
506. if you've had an affair.Copy !req
507. Have you ever had an affair?Copy !req
508. Of course not.Copy !req
509. You sure?Copy !req
510. I think I'd remember cheating on my wife.Copy !req
511. You might be reluctant to admit it...Copy !req
512. No.Copy !req
513. I just want to be perfectly clear.Copy !req
514. If your wife has sleeping sickness
and we don't treat her, she'll die.Copy !req
515. I would never do that to Ed.Copy !req
516. I love him.Copy !req
517. Absolutely not.Copy !req
518. I love her.Copy !req
519. Alright then.Copy !req
520. They say no cheating,
we cross of sleeping sickness.Copy !req
521. Any new ideas?Copy !req
522. Ok, we go with Foreman's Tularemia.Copy !req
523. Start her on IV-Chloramphenicol 25 milligrams per kilogram four times a day.Copy !req
524. Good night.Copy !req
525. Where's Ed?Copy !req
526. Right next to you.
Two down, two to go.Copy !req
527. Two days?Copy !req
528. No, doses.Copy !req
529. You have about twenty more days of this fun.Copy !req
530. What time is it?Copy !req
531. About four a.m.
I pulled the short straw.Copy !req
532. Flow rate looks good.Copy !req
533. No rash or flushing...Copy !req
534. What time is it?Copy !req
535. 4 a.m.Copy !req
536. Do you not remember just asking?Copy !req
537. I don't know...Copy !req
538. Elise...?Copy !req
539. Elise? Elise? Elise!Copy !req
540. What are you doing?Copy !req
541. Trying to wake her.Copy !req
542. She fall asleep again?Copy !req
543. In the middle of a sentence.Copy !req
544. Elise!Copy !req
545. Elise!Copy !req
546. What's happening?Copy !req
547. Patient's not responding.Copy !req
548. Pulse is fine, airways open.Copy !req
549. Check her blood pressure.Copy !req
550. Pupils are reactive.Copy !req
551. Elise wake up.
You gotta wake up.Copy !req
552. What does that mean?
What are you doing?Copy !req
553. She's not responsive to pain.Copy !req
554. Come on Elise!Copy !req
555. Is she dying?Copy !req
556. I don't know.Copy !req
557. She's in a coma.Copy !req
558. There's only one way a Tularemia patient goes into a coma while on IV-Chloramphenicol.Copy !req
559. The patient doesn't have Tularemia.Copy !req
560. And then there was one.Copy !req
561. Patient comes in because she's sleeping too much.Copy !req
562. It takes ten doctors and a coma to diagnose sleeping sickness.Copy !req
563. And then there was none.Copy !req
564. We still have the problem of explaining
how a white chick from Jersey
who's never traveled south of D.C.Copy !req
565. Well, the obvious explanation?Copy !req
566. I made it clear.Copy !req
567. If this guy's lying about sleeping around,
he knows he's murdering his wife.Copy !req
568. Does seem unlikely...Copy !req
569. Go away.Copy !req
570. What are you doing?Copy !req
571. Checking for lymphadenopothy.
And waiting for you.Copy !req
572. Who are you?Copy !req
573. I'm Dr. House.Copy !req
574. Your wife has human African Trypanosomiasis.Copy !req
575. Sleeping sickness.Copy !req
576. You mean its not Tularemia.
A virus, tumor or- or cancer.Copy !req
577. Nope.Copy !req
578. I've never had an affair.Copy !req
579. I believe you.Copy !req
580. And I trust Elise.Copy !req
581. The treatment for this disease is a drug that's... fatal on its own ten percent of the time.Copy !req
582. Which is why I need your written consent before I can legally prescribe it.Copy !req
583. Why would she lie if she knew it could kill her?Copy !req
584. I don't ask why patients lie,
I just assume they all do.Copy !req
585. But why?Copy !req
586. To protect you, because she didn't think it mattered.Copy !req
587. It just seemed easier because...Copy !req
588. that's what people do.Copy !req
589. Now, If you're absolutely certain that your wife has never had sex with anyone but youCopy !req
590. since you've been married,
then I'm wrong.Copy !req
591. But if you think there's a possibility that just one time she wasn't perfect...Copy !req
592. one weekend you're out of town...Copy !req
593. one fight when she ran to a friend,
one stupid Christmas party...Copy !req
594. then you need to allow me to start treatment.Copy !req
595. Because if we don't...Copy !req
596. she's gonna be dead by tomorrow morning.Copy !req
597. Do you trust your wife that much?Copy !req
598. I don't know...Copy !req
599. I'll start the treatment.Copy !req
600. Glass syringes?Copy !req
601. And special IV tubing.Copy !req
602. Why do we need this stuff?Copy !req
603. Because Melarsoprol melts plastic.Copy !req
604. This stuff's supposedly arsenic mixed with antifreeze.Copy !req
605. What doesn't kill us makes us stronger, huh?Copy !req
606. At least you wouldn't have been so glib if you'd been prescribed Melarsoprol.Copy !req
607. Can cause vomiting, abdominal pain, blood toxicity, neural damage, cardiac arrhythmia...Copy !req
608. Forgot to say it's gonna hurt like all hell.Copy !req
609. She's lucky she's in a coma.Copy !req
610. How long before we know its working?Copy !req
611. It's tough to say.Copy !req
612. It's a good sign that she hasn't gotten any worse.Copy !req
613. Does she even know I'm here?Copy !req
614. She knows you're always there for her.Copy !req
615. Yeah...Copy !req
616. If she gets better it means she wasn't always there for me.Copy !req
617. It means she made a mistake.Copy !req
618. I can't help it.Copy !req
619. Part of me, a big part of me...
can't handle that.Copy !req
620. Doesn't want her to get better.Copy !req
621. Does that make me a terrible person?Copy !req
622. Yes.Copy !req
623. So we're treating her for African sleeping sicknessCopy !req
624. because you don't think it's possible for someone to be faithful in a relationship?Copy !req
625. And you do?Copy !req
626. Yes.Copy !req
627. And you need to tell me that?Copy !req
628. Look, I'm not having an affair.Copy !req
629. I had lunch, with someone I work with, at work. Once.Copy !req
630. I believe you.Copy !req
631. What I don't believe is that it'll be just once.Copy !req
632. I love my wife.Copy !req
633. You certainly love saying it.Copy !req
634. I'm sorry. I know you love your wife.Copy !req
635. You loved all your wives.
Probably still do.Copy !req
636. In fact, you probably still love all the women you ever loved who weren't your wives.Copy !req
637. You can be a real jerk sometimes, you know that?Copy !req
638. Yeah. And you're the good guy.Copy !req
639. At least I try.Copy !req
640. As long as you're trying to be good,
you can do whatever you want.Copy !req
641. And as long as you're not trying,
you can say whatever you want.Copy !req
642. So between us, we can do anything.
We can rule the world!Copy !req
643. Mixing up some margaritas?Copy !req
644. Mines a double, Senorita.Copy !req
645. That's Portuguese, you know.Copy !req
646. Spanish.Copy !req
647. Uh-oh.Copy !req
648. What's going on?Copy !req
649. I'm re-calibrating the centrifuge.Copy !req
650. Turn around.Copy !req
651. It's a very sad thing,Copy !req
652. an un-calibrated centrifuge.
It makes me cry too.Copy !req
653. I'm not crying.Copy !req
654. Ok.Copy !req
655. I told the husband he was a jerk.Copy !req
656. Why?Copy !req
657. When I was in college, I...Copy !req
658. I fell in love, and I got married. And...Copy !req
659. At that age the chances of a marriage lasting...Copy !req
660. It lasted six months.Copy !req
661. Thyroid cancer metastasized to his brain.Copy !req
662. There was nothing they could do.Copy !req
663. I was 21, and... I watched my husband die.Copy !req
664. I'm sorry...Copy !req
665. But that's not the whole story.Copy !req
666. It's a symptom, not your illness.Copy !req
667. Thyroid cancer would have been diagnosed at least a year before his death,Copy !req
668. you knew he was dying when you married him.Copy !req
669. Must have been when you first met him.Copy !req
670. And you married him anyway.Copy !req
671. You can't be that good a person and well adjusted.Copy !req
672. Why?Copy !req
673. Because you wind up crying over centrifuges.Copy !req
674. Or hating people.Copy !req
675. Fever spiked at 104.
Echo shows global hyperkinesis.Copy !req
676. Blood pressure?Copy !req
677. Barely 90 over 40.Copy !req
678. You give her gilpamine?Copy !req
679. Started 270 micrograms per minute ten minutes ago, still no change.Copy !req
680. Killing her parasites isn't gonna do much good
if we kill her heart at the same time.Copy !req
681. A heart can be replaced, a brain can't.Copy !req
682. Right now were killing both.Copy !req
683. If she's gonna die, we should at least let her do it without that acid flowing through her veins.Copy !req
684. What's happening?Copy !req
685. We would have expected your wife's condition to show some improvement by now,Copy !req
686. but it hasn't. It's going the other way.Copy !req
687. Please don't die...Copy !req
688. please don't die...Copy !req
689. She's awake!Copy !req
690. Hey. She's gonna be ok.Copy !req
691. Yeah, sure.Copy !req
692. What are you gonna do?Copy !req
693. Were you always honest with her?Copy !req
694. Do you know how lucky you are?
Your wife is alive, she loves you!Copy !req
695. What she did...Copy !req
696. you can't love a person and do that to them.Copy !req
697. She LOVES you.Copy !req
698. I need to know who you had the affair with.Copy !req
699. He has to be notified so he can get treatment as well.Copy !req
700. Why did you lie to us?Copy !req
701. You knew your life was at stake.Copy !req
702. He's not coming back, is he?Copy !req
703. We all make mistakes,
and we all pay a price.Copy !req
704. I need that name.Copy !req
705. Hi, there...Copy !req
706. How you doing?Copy !req
707. Fine.Copy !req
708. Do you know where your dad is?Copy !req
709. Can I help you?Copy !req