1. The human heart is a giant muscle
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2. squeezing our contracting
over 60 times each minute.
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3. That's 3,600...
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4. At this point,
your blood is a deep purple.
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5. Because it's just finished
dropping off oxygen for
all the parts of your body.
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6. Come on, follow me.
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7. Come on.
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8. Ian.
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9. I have a question, and
I need to go to the bathroom.
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10. Which would you like to do first?
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11. - The question.
- Okay.
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12. Where's the bathroom?
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13. Who knows where
the bathroom is?
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14. I do.
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15. Go with Ian to the bathroom.
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16. I don't have to go.
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17. We're not at school.
Nobody goes anywhere
by themselves.
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18. Why?
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19. In case you get lost.
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20. Or in case
somebody kidnaps us.
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21. If somebody kidnaps Ian,
they'll kidnap me too.
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22. I want to stay
with the class.
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23. Michael, go with Ian—
Aah!
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24. Do you need help?
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25. I need you
to find a grown-up.
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26. Is the baby coming?
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27. Aah! Aah!
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28. Who should I take with me?
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29. You're fine.
Go to the front desk, or—
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30. Or find a security guard.
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31. I really have to pee.
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32. God.
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33. Is—is the baby coming?
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34. I don't know
how to do this.
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35. Are you okay, Ian?
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36. Yeah, sure.
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37. I don't think you are.
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38. You're bleeding.
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39. Help!
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40. Help!
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41. 2X17 - All In
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42. - 20.
- Call.
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43. You'll call anything.
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44. My stack is bigger than your stack.
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45. You in or out?
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46. You know that relative to their size,
gorillas have smaller testicles than humans.
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47. Well, then you'd probably
have an edge over a gorilla.
But not over me.
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48. The reason is,
primate teste size inversely corresponds
to the fidelity of our females.
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49. Do you think
there might be a better time
to annoy me about my wife?
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50. - I'm talking about poker.
- Right.
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51. Women are evil.
You're right to drive them away.
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52. Call, fold, or raise.
Story time can wait.
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53. We're smaller and
better than chimps,
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54. bigger and worse than gorillas.
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55. For all our rationality, supposed trust
and fealty to a higher power,
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56. our ability to create
a system of rules and laws,
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57. our baser drives are
more powerful than any of that.
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58. We want to control
our emotions, but we can't.
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59. If we're happy,
things don't annoy us.
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60. If, on the other hand, we're
sitting on crappy hole cards,
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61. little tiny things annoy us
a whole lot more.
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62. I raise.
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63. So are you going to
tell me an annoying story
every time I raise?
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64. God, that would be annoying.
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65. I call.
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66. Dr. Cuddy?
Got one of your patients in the E.R.
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67. Ian Alston.
Six years old.
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68. Ah... Oh, I know him.
What's the problem?
I'm all in.
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69. Bloody diarrhea, hemodynamically stable,
but he's been developing
some coordination problems.
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70. It sounds like gastroenteritis
and dehydration.
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71. Order fluids, and
I'll take it on my service.
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72. Bet's to you, House.
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73. They scan his head?
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74. - No, why would they scan—
- Don't play games.
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75. - You gonna call?
- How's the heart rate?
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76. Stable.
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77. I'm sorry. House?
It's gastroenteritis.
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78. I'm not going anywhere.
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79. Put the order in, and
have someone tell Alan and Sarah
that I'll be up when I'm done.
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80. You in or out?
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81. I'm out.
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82. Stone cold bluff.
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83. You might want to
spend a little more time
paying attention to your cards,
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84. and a little less time
staring at my breasts.
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85. They don't match, either.
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86. I'm going to take some air.
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87. Follow my finger with your eyes.
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88. How much longer
will Dr. Cuddy be?
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89. Well, given the number of Mojitos
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90. she's knocking back at the party,
I'd say it's gonna be at least three hours
before she's even conscious.
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91. Weren't you at the same party?
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92. I don't drink.
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93. I want you to reach out
and grab my cane.
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94. What's wrong?
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95. Your son's brain is
losing control of his muscles.
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96. Dr. Cuddy's message said it was
just dehydration from the diarrhea.
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97. She's wrong.
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98. Is he going to be all right?
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99. I don't know.
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100. So were you in one of those cages?
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101. No.
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102. No, no, no.
Those are for tourists.
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103. You were in the water
with a great white.
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104. Sure.
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105. It's no big deal.
You just have to keep an eye on them.
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106. If they get too close,
punch 'em in the nose.
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107. Send them on their way.
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108. - I had you going.
- You are mean.
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109. Hey, how's that anal fissure?
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110. Did it heal yet,
or is it still draining?
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111. Oh, I'm sorry. I didn't realize
you came back for seconds.
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112. I figured that
after that girl in the stairwell,
you'd be done for the night.
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113. He's joking.
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114. No Adam's apple, small hands.
It's no surprises this time.
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115. I'll, uh, see you later.
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116. Got a case.
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117. Well, you could've just said that.
You didn't have to screw with me.
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118. Yeah, but if I didn't screw with you,
you'd spend the whole night
thinking you might get laid.
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119. Which means you'd be useless.
Better to extinguish all hope.
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120. Get Foreman and Cameron
and meet me upstairs, stat.
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121. What's so urgent?
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122. Two cases, same symptoms.
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123. What do 6-year-olds and
70-year-olds have in common?
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124. Their immune systems
don't work as well.
Could be listeria.
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125. I already checked for that.
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126. Leukemia has a higher prevalence
in both the young and old.
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127. So does asthma.
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128. No, no, no.
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129. They can both get diabetes.
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130. No.
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131. The nearly dead and the newly bred
have more in common with each other
than with people in the middle.
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132. It's weird.
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133. Some kind of circle of life thing.
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134. This kid doesn't have
kidney failure.
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135. He will.
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136. Based on this file,
the kid just ate some bad food.
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137. Was the old man—
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138. They were nowhere near each other
in any of the four dimensions.
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139. - This case is 12 years old.
- Yep.
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140. - And this case is Cuddy's.
- She assigned it to me.
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141. She agrees with you that
this is something more
than gastroenteritis?
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142. She wouldn't have assigned it to me
if she did, now would she?
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143. Gohhh.
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144. What were we talking about?
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145. Two patients with
two symptoms in common.
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146. And five symptoms
not in common.
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147. While you were all wearing your
"Frankie says relax" t-shirts,
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148. I was treating
a 73-year-old woman
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149. who went through this
progression of symptoms.
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150. The last of which was...
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151. In case any of you missed
that class in med school,
that one's untreatable.
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152. Kid's got the first two.
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153. Took Esther
an hour and 20 minutes
to go from two to three.
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154. And less than a day to make it
all the way to the rear exit.
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155. This is all because a child has
some blood in his diarrhea.
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156. He's got a tummy ache.
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157. If there was any reason to think
it was anything worse,
Cuddy would be all over it.
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158. Great.
Do a colonoscopy.
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159. On a six-year-old kid who
probably has nothing worse
than some food poisoning?
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160. If you happen to
find any purple papules,
do me a favor and grab a slice.
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161. I want to check
for Erdheim Chester.
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162. A disease that there have been what,
maybe 200 reported cases of? Ever?
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163. If Esther's family had
let me do an autopsy,
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164. there'd be 201.
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165. See anything?
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166. No, and I don't expect to.
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167. House usually avoids cases.
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168. If he's actually
stealing a case from Cuddy,
there's got to be a reason.
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169. It's not the first time
I've seen this file.
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170. About a month before
Cameron was hired,
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171. some trucker came in here
with these symptoms.
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172. House decided he was dying.
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173. Two days and a spinal tap,
bone marrow extraction, and
three colonoscopies later,
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174. we sent the guy home
with a bunch of pain killers and
a diagnosis of a bad cheese sandwich.
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175. One of the guys who
worked here before me said House tried
to cure Esther at least three other times.
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176. You know how people see
the Virgin Mary in Danishes and stuff?
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177. Someone died 12 years ago,
and House doesn't know why.
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178. House sees that case now
in paint peeling, in clouds,
and now in this poor kid.
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179. Erdheim Chester is
an abnormal growth of some
of the cells that fight infection.
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180. Is that cancer?
'Cause he seems okay now.
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181. Yeah, the other doctor
kind of scared us about that.
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182. He shouldn't have.
We're just testing.
It'll probably be negative.
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183. I don't understand.
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184. You don't think that's what it is,
but you want to—
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185. you want to do
this thing to him anyway?
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186. We need to be sure.
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187. Isn't there any other way?
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188. It shouldn't take long.
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189. All right.
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190. Those ridges look a lot
like purple papules.
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191. They're not purple, they're red.
They're probably just blood blisters.
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192. Give me the biopsy needle.
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193. How long is this going to take?
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194. Forget it, Chase. Your
punching-out-the-shark story's good,
but she's not waiting for you.
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195. So?
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196. We couldn't confirm
the source of the bleeding.
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197. - But we did biopsy some—
- Blood blisters.
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198. You mean papules.
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199. Come on, Cameron.
Who's right?
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200. Chase is.
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201. Negative for Erdheim Chester.
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202. Let me see.
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203. - If it's not Erdheim Chester—
- It's exactly what we said before.
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204. Garden variety viral gastroenteritis.
Can we go back to the party?
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205. Do a kidney biopsy.
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206. Esther's shut down
in exactly—
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207. This kid is not Esther.
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208. You screwed up,
she died. I'm sorry.
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209. But that does not mean
this kid is dying as well.
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210. Jeez.
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211. You get testy when
you don't get any fuzz.
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212. Come on.
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213. What did the test say?
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214. Colonoscopy was clean.
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215. And the biopsy was negative
for Erdheim Chester.
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216. So Ian's going to be all right.
It was just some sort of virus.
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217. What's that?
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218. Urine.
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219. But it's brown.
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220. Ian's kidneys
are shutting down.
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221. Still think it's
not the same case?
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222. So, what can cause bloody diarrhea,
ataxia, and kidney failure?
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223. - I'll go do a biopsy.
- House: Forget it.
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224. That battle's over.
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225. His rising creatinine is
his kidneys' way of saying,
"Go on without me."
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226. What explains everything?
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227. E. Coli HO:157 causes
bloody diarrhea and leads to
hemolytic uremic syndrome.
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228. Toxins from the bacteria
cause his kidneys to shut down.
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229. We should start him
on plasmaphoresis.
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230. Clear, concise,
and completely plausible.
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231. And exactly what I did
last time. Didn't work.
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232. - What else?
- Good Pasture's syndrome.
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233. Circulating antibodies cause
kidney failure and bleeding.
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234. But not the purple papules.
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235. If you throw in
Esther's next symptom—
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236. brain—makes me think
heavy metal toxicity.
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237. His hematocrit would
have to be low. It's at 44, and
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238. - Esther's never dropped below...
- 42.
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239. You have the file memorized?
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240. It's my lucky number.
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241. What about lymphoma?
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242. Causes kidney failure, GI bleed,
and can infiltrate the base of the brain.
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243. You check Esther for that?
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244. She never showed
any signs of...
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245. If he has lymphoma
this far advanced, we should be
able to see it in his blood and brain.
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246. Chase, run a blood smear
and immunochemistries.
Foreman, get an MRI.
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247. - I'll page Cuddy.
- No, you won't.
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248. She thinks the kid
has a stomach ache.
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249. She'll come right up here
and do one of two things.
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250. If she agrees with me,
I don't need her.
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251. If she disagrees,
I don't want her.
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252. Can't handle people
disagreeing with you?
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253. She might have
a different take on this.
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254. Subordinates can disagree
with me all they want. It's healthy.
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255. People who can shut me down,
on the other hand...
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256. Forget Cuddy.
I'll have Wilson keep her busy.
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257. Keep your answers
short and discreet.
Is Cuddy still playing?
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258. The chicken...
is still in Piccadilly Square.
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259. Brilliant.
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260. She'll never suspect that
Normandy is our target.
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261. Is that House?
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262. Tell him that the blinds
just went to 20/40, and
he's running out of chips.
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263. H ouse:
How's she doing?
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264. Well, what's going on?
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265. The way you took off,
something's obviously—
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266. Love to chat.
But got a game to play.
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267. How's she doing?
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268. The patient is on life support.
We're about to pull the plug.
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269. Are you talking about me?
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270. What have you got?
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271. Mmm... Those sound like
high-dose cardio meds.
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272. Two hearts.
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273. You got the flush?
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274. Still waiting on the final labs.
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275. She drinking her seltzer?
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276. No. Hydration
is not a problem.
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277. Means she's bluffing.
Push her all in.
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278. Call.
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279. Two pair.
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280. Show me your hearts.
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281. Seven of clubs.
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282. Oh, dear.
Sounds like I messed up.
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283. You're gonna be stuck
with her for a while.
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284. Talk to you soon.
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285. Oh... Yes.
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286. Why are you taking
a picture of his head?
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287. We're looking
for lymphoma, but—
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288. So it's not
Erdheim something.
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289. And it's not his kidneys.
But his kidneys are failing.
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290. What—
Where's Dr. Cuddy?
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291. Dr. House
mentioned another case.
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292. Is there another patient with
the same— same thing that Ian has?
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293. - Not... exactly.
- What does that mean?
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294. Dr. House had a patient
a while back who exhibited
the same symptoms as your son.
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295. Then you know
what's wrong?
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296. No.
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297. So what do you know?
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298. We know the likely course
the disease will take.
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299. Which is?
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300. - She had multiple system failures—
- What happened to her?
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301. She died 24 hours
after her admission.
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302. Mr. or Mrs. Alston,
would you mind giving me a hand?
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303. He's having trouble sitting still.
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304. It's impossible to get
the detail we need.
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305. So I figured he might feel more
comfortable hearing your voices.
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306. Ian, honey?
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307. Just sit still.
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308. You'll be done in a moment.
We're here with you.
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309. I'm scared.
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310. It's okay, honey. It's...
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311. It's only a big camera.
It's going to take
a picture of your head.
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312. You love it when I take your
picture at home, don't you?
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313. Yeah.
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314. And you have to hold still
for that too, right?
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315. But this isn't like that.
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316. I know it's scary, Ian.
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317. But you can do it.
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318. You're getting
to be so grown up.
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319. So just...
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320. hold perfectly still.
Just for a little bit.
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321. Mommy, are you crying?
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322. No. No, honey.
I'm just tired.
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323. Okay. I'll try.
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324. The base of his brain has been
infiltrated by a small mass.
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325. - We think—
- Pituitary?
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326. Looks that way.
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327. Explains
the low blood pressure.
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328. Pretty much confirms
the lymphoma.
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329. If we'd started Esther
on prednisone...
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330. Uh, did anyone see
the lymphoma?
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331. No, we saw a mass.
The location was consistent with—
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332. Didn't see any
in the blood, either.
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333. White blood cells show
no spindling or abnormal nuclei.
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334. Nothing on
immunochemistries, either.
It's not lymphoma.
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335. House.
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336. It's a train.
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337. We don't know
what kind of train.
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338. - Whoa, whoa, whoa.
- I'm thirsty.
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339. It's closed.
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340. It's not now.
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341. We got one advantage.
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342. We know where
the tracks are going.
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343. The fact that the end
of the line is death...
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344. is an advantage?
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345. The fact that we know
is an advantage.
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346. Means maybe we can
get ahead of it.
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347. Next station is the liver. We've got...
About 90 minutes before it gets there.
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348. Maybe we can cut down a tree
across the line just outside of town.
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349. I'll do an ultrasound.
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350. No, treatment will
tell us more, faster.
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351. How can we start treatment if we have no idea what we'retreating for?
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352. Treat him for everything.
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353. Give him acetylcysteine.
And interferon. And silymarin.
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354. And whatever else you can
think of to protect the liver.
Copy !req
355. What's going on?
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356. Oh, just catching up
on some TV.
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357. How are you doing?
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358. Well, thanks to
your last consult,
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359. the patient has
improved dramatically.
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360. Tell House the patient is
about to kill the doctor.
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361. - She says the pa—
- I heard. What d'ya got?
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362. Well, Cuddy just
raised, and, uh...
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363. - You're paired.
- What?
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364. Nines?
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365. How do you know?
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366. Anything lower,
you wouldn't sound so excited.
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367. Jacks or higher,
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368. your voice sounds like
Debbie from accounting
is sitting in your lap.
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369. Ask Cuddy if she can
beat a pair of threes.
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370. Wait, what's—What's going on?
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371. If you're going to mess with me,
wouldn't it be more fun to do it in person?
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372. Yes, it would.
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373. Um, can you beat
a pair of threes?
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374. What did she do?
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375. I left orders
for PO fluids, doctor.
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376. Enough with the codes.
She obviously knows it's me.
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377. She's drinking her seltzer.
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378. Did she stop?
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379. - Yes.
- Go all in.
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380. - Um... but...
- Just do it.
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381. You couldn't care less
about this charity event.
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382. You claim not to be
messing with me.
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383. Obviously, you're either
trying to keep me—
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384. Shut up.
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385. Look, last time,
I wanted the game to go on.
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386. I still do.
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387. That means that this time,
you get to win.
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388. Hold on.
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389. I fold.
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390. Ho, ho, ho.
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391. House,
are you sure you're okay?
Copy !req
392. Meds seem to be working.
Liver's holding its own.
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393. Good.
Copy !req
394. But the platelets are dropping.
Copy !req
395. Even better.
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396. Why? It means
he's getting sicker.
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397. It's new.
New is good.
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398. Because old ended in death.
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399. I can't breathe.
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400. Chase!
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401. What?
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402. What's happening?
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403. Ian. Come on.
Copy !req
404. Honey, just relax.
Copy !req
405. Ian, breathe.
Come on, honey.
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406. Breathe,
please, honey.
Copy !req
407. We had to put him
on a ventilator.
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408. He's back
on Esther's path.
Copy !req
409. And we managed to
make the train skip a few stations.
Copy !req
410. Which means
that instead of 12 hours,
he's probably got less than two.
Copy !req
411. Which begs the question, why?
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412. What did we do?
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413. Acetylcysteine could
mess with the lungs.
Copy !req
414. Mess with them.
Not shut them down
in 20 minutes.
Copy !req
415. Interferon modulates
the immune system.
Copy !req
416. It could affect
cancer of the blood,
like one of the leukemias.
Copy !req
417. It doesn't speed them up,
it slows them down.
Copy !req
418. It slows down
all 500 of them?
Copy !req
419. Anybody know
where we can find
an oncologist at this hour?
Copy !req
420. What effects would
interferon have on leukemia?
Copy !req
421. Depends on what type.
Could make it better,
could make it worse.
Copy !req
422. Four-year fellowship
to learn that.
Copy !req
423. Tell House if he wants to play cards,
he should get his ass
back down here and play.
Copy !req
424. You hear that?
Copy !req
425. She wants me off the phone.
Means she's vulnerable.
Copy !req
426. Go all in.
Copy !req
427. But, um, the party's over
in less than three hours.
Copy !req
428. It's over in less than two hours.
Copy !req
429. Which means you either have
three of a kind, or just 3s.
Copy !req
430. I'm guessing 3s.
Copy !req
431. I bet 500.
Copy !req
432. Go all in.
Copy !req
433. You obviously want to bust me.
Why would you—
Copy !req
434. Either you go all in, or
Copy !req
435. I tell everybody in the building
that you wear toenail polish.
Copy !req
436. I'm all in.
Copy !req
437. I'll call.
Copy !req
438. I'm betting you have a pair of threes,
but even if you have three...
Copy !req
439. it's not going to beat trip nines.
Copy !req
440. Oh. Oh, oh no.
Copy !req
441. Oh, no.
Copy !req
442. Oh, oh.
That's gotta hurt.
Copy !req
443. What happened?
Copy !req
444. I just killed two birds
with one straight.
Copy !req
445. Good-bye.
Copy !req
446. Fine. Keep playing.
Copy !req
447. But I need you to
recommend a good oncologist.
Copy !req
448. Because if I don't get one
up here in the next few minutes,
I got a dead six-year-old.
Copy !req
449. If you need help, ask.
Copy !req
450. These games are insane.
Copy !req
451. Games have
a higher success rate.
Copy !req
452. Well, I don't see anything
that looks like leukemia.
Copy !req
453. You do a bone marrow biopsy?
Copy !req
454. No time.
Copy !req
455. Even if there is
an occult blood cancer,
Copy !req
456. you wouldn't expect
interferon to make it worse.
Copy !req
457. Certainly not this fast.
Copy !req
458. What would move this fast?
Copy !req
459. Autoimmune diseases.
Copy !req
460. If his body's own defenses are
attacking him, then beefing them up
is just going to put fuel on the fire.
Copy !req
461. Sarcoidosis could be
in his brain and lungs.
Copy !req
462. No, no enlarged hilar lymph nodes
on his chest x-ray.
Copy !req
463. The systemic nature suggests
Juvenile Rheumatoid Arthritis.
Copy !req
464. Or Kawasaki's disease.
Copy !req
465. Can't be Kawasaki's.
Copy !req
466. Doesn't affect the elderly.
Copy !req
467. Uh, these...
This is a kid's x-ray.
Copy !req
468. House had another patient...
Copy !req
469. Who may or may not
have had Kawasaki's.
Copy !req
470. This kid,
on the other hand...
Copy !req
471. He makes antibodies that are
eating the inside of his arteries.
Copy !req
472. Choking off blood to
his major organs one by one.
Copy !req
473. First the GI tract, then the kidneys,
then the brain, now the lungs.
Copy !req
474. Can anyone think of a reason why
Kawasaki's can't affect the elderly?
Copy !req
475. Other than that it doesn't?
Copy !req
476. Nice.
Copy !req
477. We can confirm with blood work.
Copy !req
478. We need an ANA, sed rate—
Copy !req
479. Labs will take two hours.
Copy !req
480. What was the old lady's sed rate?
Copy !req
481. Elevated. 98.
Copy !req
482. You can't use another patient's labs
to diagnose Kawasaki's disease.
Copy !req
483. Is that like a dare
or something?
Copy !req
484. You don't have time
to be wrong.
Copy !req
485. Fine.
Copy !req
486. We'll look for Kawasaki
where he lives.
Copy !req
487. Ian's coronary arteries.
Copy !req
488. This other patient.
Copy !req
489. The old lady. Esther?
Copy !req
490. Have you read Moby Dick?
Copy !req
491. It was a book?
Copy !req
492. It was 10 years ago.
12.
Copy !req
493. Obsessionis dangerous.
Copy !req
494. Only if you're on a wooden ship
and your obsession is a whale.
Copy !req
495. I think I'm in the clear.
Copy !req
496. You do realize
it's a metaphor?
Copy !req
497. You do realize that
the point of metaphors is to scare people
from doing things by telling them that
Copy !req
498. something much scarier
is going to happen than
what will really happen.
Copy !req
499. God, I wish I had a metaphor
to explain that better.
Copy !req
500. Go back to the game.
Copy !req
501. Don't worry.
I'm not going to
get eaten by witches.
Copy !req
502. Coronary arteries clear.
No aneurysms.
Copy !req
503. Flip the mode.
Let's see the flow.
Copy !req
504. How did that other woman die?
Copy !req
505. She went into
respiratory distress.
Copy !req
506. Her heart and liver
were already com—
Copy !req
507. No.
Copy !req
508. Did she suffer?
Copy !req
509. Was she in pain?
Copy !req
510. I don't know.
Copy !req
511. Laminar flow.
Copy !req
512. No blood clots,
no ragged edges.
Copy !req
513. Damn. Shut it down.
Copy !req
514. We're just wasting time.
Copy !req
515. Look at the right atrium.
Copy !req
516. That's not Kawasaki's.
Copy !req
517. No.
Copy !req
518. It's small. But it's there.
Copy !req
519. Esther didn't have
a mass in her heart.
Copy !req
520. Ian's younger.
Copy !req
521. He can take
more of a pounding.
Copy !req
522. Esther died before
the disease reached her heart.
Copy !req
523. The disease made a mass
and made it fast.
Copy !req
524. Could be bacteria.
Copy !req
525. - Muscle.
- Connective tissue.
Copy !req
526. The kid can't take
any more theories.
Copy !req
527. Only thing we know is
that whatever that mass is,
that's what he's got.
Copy !req
528. We need a piece of it.
Copy !req
529. I'm doing a biopsy.
Copy !req
530. I'll shut the blinds.
Copy !req
531. No, let them watch.
Copy !req
532. I do my best work
on the big stage.
Copy !req
533. Passing through
the superior vena cava.
Copy !req
534. You're in the atrium.
Pull back.
Copy !req
535. You hit the wall of the heart.
Copy !req
536. These procedures would be so much simpler
if we could do them on healthy people.
Copy !req
537. And out again.
Copy !req
538. - V. Fib.
- Cardiac arrest. Call it.
Copy !req
539. Come on. Paddles.
Copy !req
540. - Come on.
- Charging.
Copy !req
541. Clear.
Copy !req
542. "Code blue. ISO room."
Copy !req
543. And again.
Copy !req
544. - Nothing.
- Again.
Copy !req
545. Have you got
a clock on this?
Copy !req
546. How much longer
you going to be doing this?
Copy !req
547. Clear.
Copy !req
548. Wait. Got something.
Copy !req
549. He's back.
Copy !req
550. What are you doing?
Copy !req
551. I'm doing what
we came here to do.
Copy !req
552. - It almost killed him.
- I know. I was right here.
Copy !req
553. Give me a vacutainer.
Copy !req
554. His brain's been oxygen-deprived
for over eight minutes.
Copy !req
555. There might benothing left.
You might be—
Copy !req
556. Tell the parents.
Where the hell is that vacutainer?
Copy !req
557. So. What's he got?
Copy !req
558. Brain damage.
Copy !req
559. Good chance.
I was talking about before that.
Copy !req
560. You're not worried about—
Copy !req
561. Things I can't do anything about?
I try not to.
Copy !req
562. Things just roll off you
like water off a duck.
Copy !req
563. Histiocytosis.
Copy !req
564. Very unlikely
in a 73-year-old.
Copy !req
565. Whatever this is,
is very unlikely.
Copy !req
566. Come on, more ideas.
Let's go, people.
Copy !req
567. Genetic disorders could
cause masses everywhere.
Copy !req
568. Tuberous sclerosis.
Copy !req
569. If it's genetic,
he's had it all his life.
Why now?
Copy !req
570. I don't know.
It sure fits nice enough.
Copy !req
571. We haven't ruled out leukemia yet.
Copy !req
572. Or sarcoma. He could have
multiple soft tissue tumors.
Copy !req
573. Or sarcoidosis.
Copy !req
574. - Multiple neurofibromatosis.
Chondrocytomas.
Copy !req
575. How's it going?
You win?
Copy !req
576. I got called away
by the angry parents of a patient.
Copy !req
577. There are three of you here.
None of you had the sense to stop him.
Copy !req
578. - To pick up a phoneand call me.
- House: I told them you'd signed off.
Copy !req
579. The parents are mad
because their kid is dying.
Copy !req
580. It's understandable.
Copy !req
581. But if he doesn't die,
they won't be mad anymore.
Copy !req
582. If he's brain-damaged,
they might still be a little ticked.
Copy !req
583. - I had to do it to save him.
- You had to do it to diagnose Esther.
Copy !req
584. You may have killed
a six-year-old
Copy !req
585. because you're obsessed with
a woman who's been dead for 12 years.
Copy !req
586. Sometimes you lose, House.
You're not God.
Copy !req
587. He's not dead yet.
Copy !req
588. No, but you're done with him.
It's my case now. Go home.
Copy !req
589. Go ride your motorcycle.
Go brood in a dark room.
Copy !req
590. Just don't go near Ian again.
Copy !req
591. So, anything else?
Or is it just these seven?
Copy !req
592. Drop it, House. She's right.
Copy !req
593. No, she's not.
Copy !req
594. - You know she's not.
- We should have called her.
Copy !req
595. I'm surprised you didn't.
Copy !req
596. You're going to have to find a way
to let this go—we can't go near Ian.
Copy !req
597. We don't need to go near him.
Copy !req
598. We have his tumor.
Copy !req
599. Cuddy may be right that
we screwed up the protocol.
Copy !req
600. She may be right about
my screwed-up obsession.
Copy !req
601. But I am right
about the medicine.
Copy !req
602. How many tests
can we do with that?
Copy !req
603. Look, we cure the kid,
we solve everybody's problems.
Copy !req
604. How many?
Copy !req
605. - Maybe two good pieces.
- How many okay pieces?
Copy !req
606. Three would be pushing it.
Copy !req
607. Three tests, seven choices.
Copy !req
608. Okay, what's first?
Copy !req
609. Uh... sarcoidosis
seems most likely.
Copy !req
610. Yeah, so likely that
Cuddy's going to think of
that all on her own.
Copy !req
611. She's got the kid's
whole body to play with.
Copy !req
612. Let her do that test.
What's next?
Copy !req
613. It's moving too fast
to be spreading.
Copy !req
614. It has to be growing from
something that's already—
Copy !req
615. Genetic disorder—
Tuberous sclerosis.
Copy !req
616. Or it's his immune system.
Histiocytosis.
Copy !req
617. There are more documented cases
of histio amongst older people
than tuberous sclerosis.
Copy !req
618. Let's start with that.
Copy !req
619. Wing or drumstick?
Copy !req
620. Gonna need a little
more than that.
Copy !req
621. A little more is
more than a third.
Copy !req
622. If we have to repeat this test
because you didn't cut us enough...
Copy !req
623. I'm adding one microliter
of the immunoperoxidase.
Copy !req
624. Make it two.
Copy !req
625. I don't want House biting off our heads
because we weren't sure if it turned red or not.
Copy !req
626. That's definitely not red.
Copy !req
627. The problem could still be
an abnormal cell growth,
but a different cell line.
Copy !req
628. Sarcoma? Muscle cells are
throughout his body.
Copy !req
629. Would explain the geography.
Copy !req
630. Genetic disorder is
far more likely in a six-year-old.
Copy !req
631. Tuberous sclerosis.
Copy !req
632. Pretty unlikely
to cause a GI bleed.
Copy !req
633. The time course fits.
Copy !req
634. So, Foreman,
you agree with both of them.
Thanks for playing.
Copy !req
635. If we have enough tissue
for two tests, why not do both?
Copy !req
636. Then we don't have to
think as hard.
Copy !req
637. Taking the pressure off the choice
makes us less likely to think critically.
Copy !req
638. Sarcoma is more likely to hita 6- and a 70-year-old.
Copy !req
639. Tuberous sclerosis it is.
Copy !req
640. You think
sarcoma is less likely?
Copy !req
641. It's more likely.
Copy !req
642. The test for it,
on the other hand, is less reliable.
Copy !req
643. Nestin's negative.
Copy !req
644. Well, that's okay.
Copy !req
645. If the tumor cells haven't matured,
the Ki-67 protein wouldn't have turned off.
Copy !req
646. What happens
if we don't solve this?
Copy !req
647. - The kid dies.
- I mean for the next 12 years.
Copy !req
648. Ki-67's negative.
Copy !req
649. And PCH antigen is negative.
Copy !req
650. Mighty Casey's
down to his last strike.
Copy !req
651. Mighty Casey struck out.
Copy !req
652. Thanks a lot. I was going to
read that this weekend.
Copy !req
653. Chondrocytoma.
Copy !req
654. Connective tissue has been
in all the places we've been looking.
Copy !req
655. The kid is too sick for that.
We're better off testing for sarcoma.
Copy !req
656. We would have seen signs of that
when we tested for tuberous sclerosis.
Copy !req
657. Tumor cells look like muscle
under the microscope.
Copy !req
658. No, they didn't.
They looked like fat.
Copy !req
659. I vote for
neurofibromatosis.
Copy !req
660. Why?
Copy !req
661. Because the other choices
suck worse.
Copy !req
662. Give me a minute.
Copy !req
663. You want me out of here?
Copy !req
664. You come up with anything?
Copy !req
665. No.
Copy !req
666. Hey.
Copy !req
667. We can talk about it tomorrow.
Copy !req
668. I, um...
Copy !req
669. I won the poker tournament.
Copy !req
670. I totally played this guy Berman
from business affairs.
Copy !req
671. I got great cards.
But I don't bet. Just call, no raises.
Copy !req
672. Berman pairs his King on the flop.
Copy !req
673. I keep calling,
the river turns, I check.
Copy !req
674. He can't stand it. He goes all in.
He's sure he's won.
Copy !req
675. I call, I flip 'em. Pow!
Copy !req
676. Pocket aces.
Copy !req
677. I nailed his ass.
Copy !req
678. The aces were hiding all along.
Copy !req
679. Test him for
Erdheim Chester disease.
Copy !req
680. Erdheim Chester?
That's not even on the list.
Copy !req
681. Because we already did it.
Copy !req
682. He tested negative.
Copy !req
683. So did Esther.
Copy !req
684. The disease lied.
Copy !req
685. Yeah,
the tumor's got it in for you.
Diseases don't lie.
Copy !req
686. Fine, it didn't lie.
It slow played us.
Copy !req
687. We biopsied the colon, but
it hadn't reached the GI tract yet.
Copy !req
688. It's there now.
Copy !req
689. It's in his liver, his lungs...
Copy !req
690. You want it to be there.
Copy !req
691. Because then you didn't
screw up 12 years ago.
Copy !req
692. We can't waste our one test
on the one disease we know it's not.
Copy !req
693. Run the test.
Copy !req
694. You sure about this?
Copy !req
695. Wait, let me think about that.
Copy !req
696. Don't pressure me.
Copy !req
697. Just run the damn test.
Copy !req
698. Cells look like macrophages.
Copy !req
699. That's a good start.
Copy !req
700. Take your time
and say it loud.
Copy !req
701. CD 68 positive.
Copy !req
702. Start the treatment.
Copy !req
703. So Esther can
rest peaceful now, huh?
Copy !req
704. Yeah.
Copy !req
705. 40.
Copy !req
706. You got lucky.
Copy !req
707. You gonna call?
Copy !req
708. What I do...
Copy !req
709. is not just based
on the flip of a card.
Copy !req
710. You guessed.
You got lucky.
Copy !req
711. It fit.
Copy !req
712. It could just as easily have been
sarcoma or tuberous sclerosis.
Copy !req
713. No, not just as easily.
Copy !req
714. Maybe not.
But it wasn't impossible.
Copy !req
715. Are you going to call?
Copy !req
716. You know,
Copy !req
717. relative to its size,
Copy !req
718. the barnacle has
the largest penis of any animal.
Copy !req
719. Transcript : Raceman
Synchro : Vaccine
Copy !req