House 2x18

1. Hannah, are you okay?

2. Still can't sleep?

3. I'm fine.

4. Can I do anything to help you?

5. Just go back to sleep. I wanna go get a glass of wine.

6. - I can keep you company. - You have work in the morning.

7. Are you sure? You don't want me to...

8. I'll be right back. Just sleep.

9. Hannah?

10. Hannah?

11. What'd you do?

12. I just wanted to sleep.

13. I'm calling an ambulance.

14. 2X18 - Sleeping Dogs Lie

15. Original Airdate (FOX): 18 APR-2006

16. You've seen one patient in the last two hours.

17. Complicated case.

18. I'm a night owl.

19. Wilson's an early bird.

20. We are different species.

21. Then move him into his own cage.

22. Who'll clean the droppings for mine?

23. 25 year old female, with sleep issues.

24. I guess she's...

25. Oh, what's the medical term?

26. Upset.

27. 25-year-old females are usually completely rational, they rocks, really.

28. Aghhh...

29. My theory seems to be supported by the fact she swallowed a bottle of sleepng pills.

30. She hasn't slept in 10 days.

31. She's lying.

32. Without REM sleep your neurons stop regenerating.

33. Your brain shuts down lobe by lobe.

34. She'd be insane after 5 days, dead by 10.

35. Give me a little credit. I know what gets you off.

36. She took the pills to sleep, not to kill herself.

37. Clever alibi.

38. They didn't work.

39. She stayed awake even though she downed the whole bottle.

40. And the longest anyone's ever survived without sleep is 11 days.

41. Which gives you 22 hours.

42. You stole my article.

43. I wouldn't do that.

44. I wrote up the case where we induced hyperthermic cardiac arrest in the terminal cancer girl.

45. I wrote my own. I didn't steel yours.

46. You knew I was writing one. You gave me notes.

47. Got a case.

48. It can wait. You two finish.

49. 5 bucks says someone loses an eye.

50. Fine. You're only putting off the inevitable.

51. 25-year-old female, hasn't slept for 10 days.

52. I assume the ER tried giving her some sedatives. We should up the dosage.

53. Sedation isn't the same as sleep.

54. Thanks for your insight.

55. For someone who hasn't slept in 10 days, sedation is a great start.

56. Sleep is an active process.

57. Reboots the system, restores the brain. Sedatives don't—

58. The brain is being stressed; we need to relieve that.

59. You've had my article on your desk for the last 4 months.

60. I'm a very slow reader.

61. No fever, no white count means no infection.

62. Schizophrenia?

63. No delusions.

64. You read his.

65. Signed it, didn't read it.

66. Aside from the sleeping pills, tox screen was clean.

67. No cocaine, methamphetamines or diet pills.

68. Only medicatiosn she's had recently are Steroids for poison ivy and ibuprofen for a knee she hurt skiing.

69. Nothing that would cause sleep disturbances.

70. - When did you get his article - Uh... about 3 weeks ago.

71. Let's go back to the beginning.

72. How far back?

73. Genesis.

74. God said, "Let there be light".

75. Sleep is initially contrlled by external light cues.

76. And if her brain can't interpret those cues...

77. Optic nerve disease.

78. I'm sensing another article.

79. I'll go run the test.

80. I'm injecting a dye which will allow us to take a look at your retina and your optic nerve.

81. Everything's kinda blurry.

82. Normal, because of the dye, it's gonna be that way next few hours.

83. Need a hand?

84. No.

85. We're never gonna work together again?

86. Just don't see the need to make you feel better by forgiving you.

87. I wasn't asking for forgiveness. I was asking if you needed help.

88. It's unprofessional to be talking about this in front of the patient. Myabe that doesn't matter to you, but...

89. Doesn't matter. She's not listening..

90. She's asleep.

91. Normal stage one brain waves.

92. Maybe she's... better?

93. Still blurry.

94. You fell asleep.

95. No, I didn't.

96. Negative for optic nerve desease.

97. But she sleeps.

98. For like 10 seconds, maximum 1 minute.

99. We also checked the ocular pressure. It's normal.

100. And she doesn't know she sleeps.

101. Brain is often aware of stage one sleep.

102. CT showed no tumers, no clots, no seizure disorder.

103. So she sleeps. She just can't stay asleep.

104. You going somewhere with this.

105. You know what keeps me awake at night?

106. "Monsters in the closet".

107. There's no monster in the closet. We looked.

108. Well, it's certainly not showing up on the scans.

109. Where's Cameron?

110. She felt I could deliver the news on my own.

111. Oh, this is going to work out great.

112. Come on.

113. If you two guys can't play nice together, I'll take away your toys.

114. I don't care whose fault this is.

115. - If you hadn't... - Especially, I don't care if it was my fault.

116. Whatever this woman has, it's not showing upon our tests,

117. which means she's sick.

118. Just not sick enough for us to see it.

119. You want us make her sicker?

120. Yes.

121. I wanna stress her body. Specifically her brain.

122. Keep her awake.

123. Depriving her of even the 5 minutes of sleep she does have— it's torture.

124. So is cutting people with knives,

125. but you can totally get away with that if you havea doctor coat on.

126. House, those few seconds of sleep maybe the only reason she's still alive.

127. More symptom we can force out her, the more tests we can do

128. The more tests we do, the more information we get, the quicker we make a diagnosis.

129. See how much more fun it is when you guys get along?

130. You two take the first 4 hours.

131. Hannah?

132. Hannah!

133. You fell asleep.

134. No, I didn't.

135. Your brain doesn't remember. It was just a few seconds.

136. Is this really necessary?

137. The sooner we find out what's wrong, the sooner she can get a real night's rest.

138. Hannah?

139. Hannah?

140. Hannah?

141. Ow.

142. What did you do that for?

143. - You fell asleep again. - No, I didn't.

144. - We are sorry. - We have to do this.

145. We don't have to be cruel.

146. You know what happens when you're nice. Nothing.

147. That's how you define "nice"? Not "stealing"?

148. Doctors!

149. She fall asleep again?

150. We got rectal bleeding.

151. What, all of you?

152. So monster is peeking out from under the bed.

153. Which either means she has a clotting disorder or she has a tumer in her colon.

154. I'll do a colonoscopy.

155. Who's keeping her awake now?

156. We figured once we found another symptom, it really didn't matter.

157. Yeah, he's got all the ideas.

158. Who is with her?

159. Her partner's donating blood, so she's with a nurse.

160. Probably singing her lullabies. I want her awake.

161. You have to sedate a patient to do a colonoscopy.

162. Why? Just because of the pain?

163. If you find a tumar in her colon, you can knock her out. If you don't, she stays awake.

164. Aghhh! God! It hurts.

165. - Can't you hurry? - Trust me. You don't want me to hurry.

166. God, you're killing me.

167. Hold my hand.

168. Keep breathing, nice and steady.

169. How am I supposed to work with him?

170. Um, maybe we shouldn't be talking about this right now?

171. You think I'm overreacting?

172. Um, I need you to relax your anus.

173. We are not here. We are skiing.

174. It's Thanksgiving, at Vail.

175. You want me to think about nearly killing myself on a snowboard?

176. Come on, you never fell.

177. You were awesome.

178. Is that what you told him? I'm hysterical, and I need to relax my anus?

179. I told him— how many cases do we work up in the year?

180. They're all weird; he could've written up any one of them.

181. She's bleeding.

182. I can't breathe. I can't breathe!

183. Hold on.

184. We packed her nose to control the bleed and started transfusing 2 units of whole blood.

185. The pathologyfrom the rectal bleed showed traces of nasal epithelium.

186. So, the butt bleed's just a nose bleed.

187. That much blood is not a "just a" anything.

188. When two people fight this much,

189. You know what it means?

190. It's gotta be a massive sinus hemorrhage that was draining down her throat and out the back.

191. The question isn't what, it's why.

192. Oh, get a room.

193. Rat poison mixed with some sort of neurogenic toxin could cause bleeding and sleep disturbances.

194. Do you have a specific type of neurogenic toxin in mind,

195. or should we just start running a thousand different tox screens?

196. Just pretend I'm not here. I'll be reading.

197. It could also be some type of coagulopathy.

198. Or could be us. Do you have any idea what it feels like to have a 6-foot-long hose shoved into your large intestine?

199. No, but I now havea much greater respect for whichever basketball player you dated in college.

200. We've basically been torturing this girl for the last eight hours.

201. We've been poking her foot, not punching her face.

202. Extreme stress can cause high blood pressure which can cause bleeding.

203. Wouldn't keep her awake for 10 days.

204. What if the poison ivy... wasn't poison ivy.

205. She got the rash that was diagnosed as poison ivy around the same time the insomnia started.

206. Rash + nose bleed + sleep distuvance equals Wegener's Granulomatosis.

207. Start corticosteroid treatment.

208. The poison ivy treatment was steroids.

209. Much lower dosage.

210. Get her back on the juice, triple the dose.

211. Get a c-ANCA and upper airway biopsy to confirm Wegener's.

212. She has, uh, menstrual problems.

213. They are really bad. The pain keeps her in bed all day.

214. Plus she's super depressed.

215. She said super depressed?

216. She heard that birth control pills can make her feel better.

217. She wants birth control pills

218. - for her PMS (premenstrual syndrome). - I guess.

219. Judging by the redness around your mom's nostrils and the tissue,

220. she's got conveniently stashed inside her wrist and I'd say her problem is more likely a URI.

221. Not a PMS.

222. - URI? - Upper Respiratory Infection.

223. A cold.

224. I don't think so.

225. I also think she's got a problem with SAC.

226. SAC?

227. Thanks for palying. Stupid American Child.

228. If you want the pill,

229. all you have to do is to walk into any health clinic in Jersey alone and ask for it.

230. What exactly was your plan?

231. Were you going to exchange the birth control pills for some

232. over-the-counter-decongestants and hope that your mom's cold lasts another 6 years?

233. No.

234. - Is that for her cold? - No, that's for your ovaries.

235. I assume you haven't had a stroke. Have you had a blood clot?

236. No.

237. Super.

238. Each 3 months when you need a refill, take a bus to a free clinic.

239. Don't wait around hoping for Mom to get another sniffle.

240. Not the sharpest chopstick in the drower, is she?

241. Was this just one of your experiments?

242. You just wanted to see how I'd react being screwed over by Foreman?

243. Nice idea, but no.

244. It was just good old-fashioned laziness.

245. Gotta hand it to Foreman, though.

246. He knew that you're a suck-up and I don't give a crap.

247. He successfully exploited us both.

248. Right. We're both victims.

249. A simple heads up, that's all I needed.

250. Maybe between your incredibly witty remarks about anal sex and Cuddy's breasts You could have tip me off.

251. Then I'd have Foreman pissed at me,

252. and as annoying as you could be,

253. at least, you're not gonna pop a cap in my ass.

254. Witty, huh?

255. You, on the other hand,

256. continue to be flabbergasted every time someone actually acts like a human being.

257. Foreman did what he did 'cause it worked out best that way for him.

258. That's what everyone does.

259. That is not the definition of being human.

260. That's the definition of being an ass.

261. This will numb you up.

262. And this will keep your tongue out of the way.

263. Don't worry, you shouldn't feel anything except for slight pulling.

264. So you think I was out of line?

265. That article would set on House's desk for the next 6 years.

266. I could have told her.

267. You could've written it for too.

268. She knows House as well as any of us.

269. You should've known she was waiting for to do something she was never gonna do.

270. Chase.

271. Hannah, sill with us?

272. What's wrong with her eyes?

273. It looks like REM.

274. - What's that? - Rapid Eye Movements.

275. That's what your eyes do when you're sleeping.

276. But she's awake.

277. Hannah.

278. Hannah, can you hear me?

279. Yeah, off course.

280. Was she sitting up or lying down?

281. - Sitting up. - Then It wasn't REM.

282. Chase says her eyes are moving the exact way.

283. Did you start her on Steroids?

284. - Not yet. We were still doing the— - But she wasn't sleeping.

285. How do you know?

286. 'Cause we haven't done anything yet.

287. She may be able to sleep with her eyes open but unless you also discovered she's got two extra tits and her hooves for feet.

288. There's no way she'd be able to maintain enough muscle tensity during REM sleep to sit upright.

289. It's a movement disdorder,

290. which rules out Wegener's.

291. Where's Foreman?

292. - Keeping her awake. - Good.

293. Rabies could cause muscle spasms, malaise, anxiety and wakefulness.

294. Pretty unlikely she forget being bitten by a crazed animal.

295. She could've been exposed through an open wound.

296. She have a dog?

297. For less than a week. She had an allergic reaction, so they had to give it away.

298. Allergies?

299. Animal allergies seemed unlikely but it's possible that—

300. - When? - When what?

301. When did she get rid of the dog?

302. About a month ago. Her girlfriend gave it to her for her birthday.

303. Well, then it's not allergies.

304. She's just leaving her girlfrined.

305. You... spoke to the dog?

306. If her birthday was a month ago, she would've still been on steroids for the poison ivy.

307. Those meds would've suppressed any reaction she might've had to the dog.

308. Which means she lied about being allergic.

309. Dog's a commitment.

310. You pretend to be allergic because you don't wanna tell your girlfriend

311. that you're not planning on being around that long.

312. So I think we can move onto options other than allergies.

313. We should still do a scratch test. If she's allergic to one thing—

314. She is not allergic.

315. Okay. Well, we could either base our diagnosis on your admittedly keen understanding of lesbian relationships,

316. or we could do a scratch test.

317. Do a scratch test.

318. You still feeling a lot of blood in your throat?

319. No, it's actually getting a little better.

320. Good. Maybe things are just starting to improve on their own.

321. Just a few more.

322. You want some water to wash out your mouth?

323. No, I'm okay.

324. Come on, that can't taste good. I'm gonna get you a soda.

325. - It's okay, isn't it? - Mm-hmm.

326. You and Max seem to have a really nice relationship.

327. - Yeah. - She's very supportive.

328. Uh-huh.

329. When Max got you the dog, did you lie about having an allergic reaction?

330. No.

331. Why?

332. If you have pre-existing conditions, it's important we know.

333. But if you don't, it's just as important.

334. - If I'm wasting my time doing this allergy test— - You're not gonna tell her, are you?

335. It's none of my business.

336. She's a good person and then...

337. We've just been together so long, I...

338. I'm tired of her.

339. Sounds terrible, doesn't it?

340. I guess it happens sometimes.

341. Oh, my back hurts.

342. Hannah, can you turn over?

343. What's wrong?

344. I'm not sure.

345. Oh, my God.

346. She has massive internal bleeding.

347. Did she have access to aspirin?

348. She'd have to take a hell of a lot.

349. Why not, considering her current mental state.

350. What about her mental state?

351. You were right about her wanting to break up.

352. That just means I was right, doesn't mean she's suicidal.

353. A bottle of pills is what landed her here in the first place.

354. Sleeping pills.

355. God knows why she'd want them.

356. What else can cause sleep disorder and internal bleeding?

357. Drugs or alcohol can mess with the sleeping and compromise the liver.

358. What are you doing here? Who's keeping her awake?

359. Doesn't matter.

360. Liver function tests are through the sky.

361. Liver's not compromised, it's dead.

362. She doesn't need a diagnosis, she needs a new liver.

363. She's not getting a new liver unless we can figure out what's wrong with her.

364. Test for cirrhosis: 12 hours. Test for hepatitis: 8.

365. Her liver's not gonna last another 6.

366. So your advice is we just give up?

367. My advice is that we narrow our focus to conditions that we can diagnose treat, and cure in less than 6 hours.

368. And there's nothing on that list.

369. The girlfriend donated blood, right?

370. Yeah, so?

371. It means that they're the same type.

372. You can't ask the person she's about to dump to donate half her liver.

373. It does seem tacky, doesn't it?

374. I'm Dr. Hosue.

375. I'm in charge of your case.

376. What's going on?

377. How come no one is keeping her awake anymore?

378. You're in acute liver failure.

379. We can continue the transfusions and the lactulose,

380. But it's only a stop-gap.

381. There's really nothing we can do to stop the toxins from building up in your bloodstream.

382. Which means that in a few hours

383. you will lapse into a coma...

384. and you won't wake up.

385. I'm sorry.

386. That's it? You are giving up? You're...

387. not gonna figure out what's doing this to her?

388. Even with the right diagnosis, any treatment's gonna take longer than the time she has left.

389. If it's her liver, can't she get a transplant?

390. Wouldn't work without a diagnosis.

391. Whatever killed the first liver would do the same to the second.

392. But it would— it would give you more time to make the diagnosis, to get her better.

393. Well, it might give us an extra day or two, but...

394. no procurement agency is gonna let a liver go to a patient with an undiagnosed, pre-existing—

395. Hannah and I have the same blood type.

396. Couldn't I be the donor.

397. It is medically possible for us to take a part of your—

398. Please, I don't care about the risks.

399. You're very lucky to have such a devoted partner.

400. I just bought us 36 hours.

401. Differential diagnosis.

402. Which monster eats your liver, screws up your sleep, and causes bleeding?

403. Does Max know Hannah plans to leave her?

404. Didn't come up. So I guess no.

405. If she knew, there's no way she'd go through with this.

406. And if you didn't have a pathological need to create a close, personal relationship

407. with every dying person you meet, we would be blissfully ignorant of any ethical dilemmas

408. and might actually be able to concentrate on the differential.

409. Scratch test was negative.

410. It's rare, bet any of the hepatitis viruses could cause sleep disturbances and liver failure.

411. No, PCRs were normal.

412. - We have an ethical dilemma. - No, we don't.

413. Continue.

414. What about splenic cancer or Non-Hodgkin's lymphoma? She's the right age.

415. Could explain the bleeding. Maybe the liver failure.

416. We're withholding information relevant to her decision to risk her life.

417. How is that not an ethical dilemma?

418. It's not medical information.

419. - Who cares? - The AMA.

420. Wilson's disease could explain liver and neurological symptoms.

421. It also causes bleeding disorders.

422. No Kayser-Fleischer rings in her eyes.

423. Rings don't have to be there if there's neurological symptoms.

424. - This is immoral. - Look, let's say you're right.

425. We tell, she changes her mind, our patient dies.

426. How is that moral?

427. What else?

428. Poison mushrooms can cause liver failure, sleep disturbances, and internal bleeding.

429. She's not 'shrooming; she's a sport's nut.

430. Right. Skiers never party.

431. She's doing this out of love and Max doesn't know—

432. It's only moral to save a person if they love you?

433. It's kind of a selfish way of looking at life.

434. I like Wilson's disease, like cancer, love mushrooms.

435. Yeah, but we don't have the time to test for any of it.

436. Before she can get the transplant, we need to do about 80 procedures.

437. So do those tests and my tests at the same time.

438. Use the PET to look for cancer and Wilson's while you endoscope her bile ducts, scrape her stomach for mushroom spores.

439. One of you CT her liver, while the other two check proteins CA-125 and CA-19.5.

440. Oh yeah, anyone says anything to Max,

441. they're fired.

442. - We have to. - We have to not.

443. Because she's not our patient.

444. She's getting surgery, she's someone's patient.

445. Calvin and Sam. Great, thank you.

446. Need a little help.

447. Inexplicable rash on a patient's scrotum you need me to look at?

448. 27-year-old female wants to donate half her liver to her dying girlfriend.

449. That's very generous.

450. This is sleepless girl? What's she got?

451. Liver failure.

452. Sort of figured that out when you said she needed a new liver.

453. You don't have a diagnosis.

454. Transplant buys me time.

455. Let's just skip the part where I say this is insane.

456. It was her idea.

457. If she wants to be an idiot, it's her call.

458. You don't need me.

459. Just have one of your team walk her through the process.

460. The donor and the donee sort of have opposing interests, right?

461. You can't really advise them both.

462. You're concerned about the ethics of this?

463. What's going on? What do you know?

464. Nothing medically relevant.

465. But you know something, and it is relevant.

466. If I can't tell her, I can't really tell you, can I?

467. Not if you're advising her.

468. I assume this information is in the medical file.

469. - My patient's confidential file. - This hospital's file.

470. You can either satisfy your curiosity,

471. or you can remain ignorant, do nothing ethically wrong,

472. and my patient doesn't die in three hours.

473. These tests and the counseling normally happen over weeks.

474. Sometimes months.

475. It's okay.

476. Well, the most important part we're skipping is time—

477. time for you to change your mind.

478. I don't want to change my mind.

479. Not now, but with time and perspective, maybe we learn things—

480. If we had the time, we'd take the time, but we don't.

481. So can you get this over with?

482. Either I sign off on this, or it doesn't happen.

483. So I need you to listen to me.

484. Because there's a chance that you will die on that table.

485. I just want me and Hannah to be able to lie in bed together,

486. as old ladies. Compare scars.

487. I need you to lie on your side, and hold your knees.

488. I'm gonna check for vascular abnormalities that might prevent us from doing the transplant.

489. At the same time I'm also checking for mushroom spores to see if that's the underlying—

490. I don't do mushrooms.

491. You lie about your love life, maybe you lie about drugs. Open.

492. Aren't you at all concerned about what Max is going through right now?

493. They're shoving a tube up her rectum.

494. They're gonna swab her stomach, just like I'm doing.

495. It's going to hurt, just like this hurts.

496. Which is nothing at all like the risk she's taking on the table.

497. You really don't love her, do you?

498. I'm not leaving her because I don't—

499. I'm not talking about the leaving. I'm talking about this.

500. If you care for her at all, you won't let her do this blind.

501. - You'd really tell. - Yeah.

502. You'd die.

503. Take it you've seen that.

504. Seen it, digested it, watched it blow up my entire department.

505. - You read Cameron's version? - Didn't read either.

506. It was good.

507. Better than Foreman's?

508. Maybe. He was more analytical about the diagnostic procedures.

509. She concentrated more on the ethical dilemmas of informed consent.

510. How any patient can really be informed without a medical degree.

511. Same old party lines.

512. Foreman should've told her.

513. Oh, shoulda woulda coulda.

514. If you allow this sort of thing in your department, you're basically saying it's okay.

515. No, I'm saying that I don't care what they do as long as my life isn't interrupted by pointless conversations like this one.

516. They won't trust each other, and they won't trust you.

517. They shouldn't.

518. Deception like this is just one step removed from actively sabotaging one another.

519. Then what would you do?

520. I could be the kindest, gentlest boss in the world

521. and Foreman would've still done what he did because that's who he is.

522. We can only hope that Cameron has learned something.

523. Right, because you're all about the teaching.

524. Our children are the future.

525. Hey.

526. Cuddy cleared Max for surgery. She's okay to go.

527. - How's our patient? - She's also cleared.

528. I don't care about the prep. I care about the diagnostic tests.

529. Well, it looks negative for Wilson's disease, we'll know for surein an hour.

530. - Blood proteins are normal, it's not— - Where's Cameron?

531. Taking a sample of the bile duct.

532. Surgeries are supposed to start in about 15 minutes.

533. She had a chance to get one last—

534. Hannah and Max will be in the same room.

535. You wanted us to do as much as we can before—

536. They're both awake. With Cameron.

537. Maybe we should give these two a minute together before the surgery.

538. You ready, honey?

539. Max.

540. It's okay. I'm right here.

541. - I need you to know something. - I know. I love you, too.

542. I don't know how to say this.

543. Good lord.

544. You can tell me anything.

545. She hasn't slept in eleven days, you people trying to torture her?

546. Ding, ding, let's go.

547. - I told you not— - I didn't say a word to Max.

548. This is exactly why you got screwed with Foreman.

549. You're looking for people to do the right thing.

550. She hasn't slept, her judgment's compromised due to inactivity in her prefrontal cortex.

551. Oh, she could have the best prefrontal cortex in the history of mankind.

552. But given the choice of life versus death, those bad, bad people are going to choose life.

553. Then why'd you sedate her?

554. If she wasn't gonna tell, if she was never gonna do the right thing, why bother knocking her out?

555. This isn't about them. If she talks, if she does the decent thing,

556. then you don't get to solve your puzzle, your game's over, you lose.

557. Yeah, I want to save her; I'm morally bankrupt.

558. How's it going?

559. They're about to remove Hannah's liver.

560. All right, I'm good to go.

561. You can start removing Max's liver.

562. You want to let me in on what the big secret is between these two?

563. You read Foreman's article?

564. It was good.

565. He basically stole it from me.

566. So?

567. You're on his side?

568. Sides? No, this isn't dodgeball.

569. What am I supposedto do? Just sit backand take it?

570. No, write another article.

571. Kick ass, until you're sitting behind some big expensive desk, and someone from Johns Hopkins calls and says,

572. "We're thinking about hiring Eric Foreman as our Head of Neurology,"

573. and you can say whatever you want.

574. Lovely. Revenge as motive for success.

575. Well, it doesn't have to be the motive.

576. But it sure tastes good.

577. She's in VF. I've got no pulse!

578. She's arresting.

579. Paddles.

580. Ugh! I am so relieved you two are here.

581. Without you looking out, they'd be playing foosball down there.

582. Max's heart stopped.

583. Your patient is on the other side.

584. Get yourself upstairs and figure out what Hannah has, or Max has risked her life for nothing.

585. Charging.

586. Clear.

587. We're okay.

588. Max's cardiac arrest was caused by hypoxia from hypoventilation.

589. They restarted her heart and the right lobe of her liver was successfully transplanted into Hannah.

590. Now, where were we before we were so rudely interrupted by the liver transplant?

591. DOPA decarboxylase was processed normally and the cerolo-plasmaand copper levels were normal.

592. So no Wilson's disease.

593. Gastric content was negative for spores, so no mushroom toxicity.

594. And the initial tests were negative for cancer.

595. - Which cancer were you looking for? - Any of them.

596. We ran blood tests for ovarian, lung, and lymphomas.

597. It's not gonna tell you much.

598. Her blood was taken after she was given immunosuppressants.

599. They fight rejection. They also mess up our ability to get any clear readings.

600. Great battles kick up a lot of dirt.

601. Obscure the battlefield so generals can't see what's going on.

602. So what are your orders, General House?

603. Sound the retreat.

604. How ya feeling?

605. Is Max okay?

606. She's still unconscious, but her vitals look good.

607. We need to stop all the immunosuppressant drugs which are protecting your new liver.

608. But if you stop the drugs, I'll die.

609. You're dead anyway if we don't figure out what caused all this.

610. By removing any outside influences, it'll help us see what's really going on with your body.

611. So you did all this to buy me a couple of days, and now you're taking 'em back?

612. Will it hurt?

613. As your body goes into acute organ rejection,

614. your liver will begin to swell, it'll put pressure on—

615. Yeah. It'll hurt. We can knock you out.

616. Mm, no. If Max wakes up, I want to talk to her.

617. She's been taking the decongestants, but she's not getting better. She also says...

618. What?

619. Her boobs are bigger.

620. Ugh. How could you get them mixed up?

621. They come in a little wheel, they don't look anything like decongestants.

622. Oh, God! The cashier put them both in the same bag. I thought I gave her the right ones.

623. No, you gave her the wrong pills.

624. You speak Mandarin?

625. I can count to ten, ask to goto the bathroom, and...

626. I'm not pregnant! We—we haven't even done it yet.

627. Okay, I'm going to leave you two alone now.

628. I'm sure you got a lot to talk about.

629. Fever's 106, she's in full rejection mode.

630. Is that supposed to surprise me?

631. Her white count is normal.

632. Normal is not normal.

633. She's been on steroids,

634. transplant team gave her a cocktail of immunosuppressants,

635. she hasn't slept in over a week.

636. Her white count should be in the tank.

637. Looks like the problem is some sort of infection.

638. Probably caused a hypotension, shocked the liver.

639. We should start broad spectrum antibiotics.

640. Yeah, you might want to add some chicken soup.

641. It'd be just as useless, but it's got chicken.

642. We need to know exactly what kind of infection we're dealing with.

643. What infection causes sleep disturbance, bleeding,

644. movement disorder, organ failure, and an abnormally normal white count.

645. - What about tularemia? - Chest was clear.

646. Tularemia doesn't cause movement disorders.

647. It would if she developed meningitis.

648. There was no ulcerations on the skin.

649. With the bleeding, it looks more like leptospirosis.

650. Without conjunctivitis and elevated creatinine?

651. What about typhoid or some kind of relapsing fever?

652. Makes sense, if we were in the Sudan.

653. We sure she hasn't been out of the country?

654. She hasn't even been out of the state in at least a year. Neither has Max.

655. Maybe she lied.

656. You talk to her friends, neighbors?

657. You don't know?

658. Come on, if you don't stay up to date on my notes, where's your next article gonna come from?

659. You talk to the dog?

660. We're not as upon foreign languages as you are.

661. Ha! Has the dog been traveling?

662. - It came from a breeder. - Where?

663. I don't know.

664. A place called Blue Barrel Kennels.

665. They only had the thing for like two days.

666. Blue Barrel is a kind of cactus.

667. You see many cacti in Jersey?

668. Want to seea magic trick?

669. Oh, no! Where'd it go? Where'd it go?

670. Is it here?

671. No. What about here?

672. There it is.

673. Aw, that doesn't look anything like a nose.

674. That wasn't there this morning.

675. Get that to the lab and call CDC.

676. And tell them what?

677. That we have a patient with the plague.

678. The black plague?

679. Looks that way.

680. Plague is carried by rodents, not dogs.

681. Where there's dogs, there's fleas.

682. And if they hail from the Southwest,

683. and those fleas can't tell the difference between prairie dogs and puppy dogs.

684. A small percentage of plague cases present with sleep disturbance.

685. Imagine an idyllic river of bacteria.

686. Okay, it's not idyllic for her, but it serves my purposes.

687. The steroids and immunosuppressants acted like a big, honkin' dam across the river—

688. Physics 101. Put a dam up in front of a raging river, the river rises.

689. By stopping the immunosuppressants,

690. we blew up the dam and a 100-foot wall of bacteria flooded her lymph nodes.

691. We better find out where that dog is now.

692. After we start the immunosuppressants

693. and fill her up to the eyeballs with streptomycin sulfate gentamicin and tetracycline.

694. Use a garden hose if you've got one.

695. Get yourselves some prophylactic treatments as well.

696. I've got the plague?

697. Don't worry, it's treatable.

698. Being a bitch, though, nothing we can do about that.

699. You weren't in your room.

700. The surgeon said I'd heal faster if I walk.

701. Got this far, needed a rest.

702. What you did was crazy, but it was pretty amazing too.

703. Yeah, I'm a hero.

704. She's been planning to leave me.

705. Really?

706. She told a friend; the friend let it slip.

707. You knew and you gave up half your liver anyway?

708. She can't leave me now.

709. You really want her to stay out of guilt? That's not gonna make either of you happy.

710. You don't know that.

711. I love her.

712. I just want her to stay.

713. I don't own House's cases.

714. You had just as much right as I did to write it up.

715. You shoulda told me, but I shoulda handled it better too.

716. If we want this not to get in the way of our friendship,

717. I think we both have to apologize, and

718. put it behind us.

719. I like you, really.

720. We have a good time working together.

721. But ten years from now,

722. we're not gonna be hanging out, having dinners.

723. Maybe we'll exchange Christmas cards,

724. say hi, give a hug if we're at the same conference.

725. We're not friends.

726. We're colleagues.

727. And I don't have anything to apologize for.

728. Transcript : Raceman Synchro : Vaccine