House 2x4

1. Hey!

2. Dr. Sebastian.

3. Two pallets of antibiotics for tuberculosis.

4. We've got six pallets worth of patients.

5. Stoia Tucker needs a math lesson. I'm headed back tomorrow.

6. Hey! Hey!

7. Come on, come on. Come on, kids, let the truck through.

8. Move those boxes quick, quick. Let's move! Hurry, hurry, hurry!

9. Let's go! Let's go, man! Hurry!

10. I've got some very special medicine here. It's from Hershey, Pennsylvania.

11. One per person. One per person.

12. Let's calm down, kids. Wait, wait.

13. Help! Help! Dr. Sebastian! Come quickly!

14. My son, he fell. He fell on this log. We were just waiting for his friends.

15. I got no breath sounds on the left. Give me that.

16. Yeah, he's gonna be okay.

17. The fall didn't cause him to drop a lung.

18. The lung caused him to fall. TB chewed it up.

19. He'll be lucky to live another year.

20. This is Sarni. I picked up the tab for the back brace myself.

21. The funny thing is,

22. is that the brace cost more than the medicine

23. that would have prevented her from needing it.

24. It's your medicine.

25. All of the antibiotics that we need are right here

26. in your warehouses, in your factories.

27. We provide over 10,000 doses a year. Which is not enough.

28. You know we'd love to do more, but our hands are tied.

29. New car, Jerry?

30. I saw it on the way in, looks beautiful. Don't make this personal.

31. All the way from Germany, too. I know that's a lot of red tape.

32. I'm not like you. I'm not ashamed of making a living.

33. And I know you didn't become a chem major for the money.

34. Now, you want the same things that I want. You just...

35. You have to... You just have to push a little...

36. You have to push a little bit harder...

37. Harder for it. Sebastian?

38. Call 911.

39. Okay. Is he okay?

40. Isn't someone here a doctor?

41. Selling subscriptions? I heard 20 and you get a new bike.

42. Dr. Sebastian Charles collapsed during a presentation at Stoia Tucker.

43. Really? Crushed under the weight of his own ego?

44. Wow! Is there nobody you admire?

45. Well, there is this gal I met in Nam who could blow out a candle without using...

46. He thinks it's TB.

47. Good thing he's not the syphilis expert. He wants a second opinion.

48. Second to his own. Okay.

49. It's not TB. What is it?

50. Oh, you want specifics?

51. Lemma, big Knicks fan.

52. You've never had an episode like this before?

53. No. He died last month.

54. Stupidly tried to share his meds with his cousin,

55. and they only had enough for one.

56. Dr. House, I'm Sebastian Charles.

57. Patients aren't usually part of the diagnostic process.

58. Well, I'm a doctor.

59. Listen, I know you guys don't make a lot of money...

60. I wrote your people a check last month. Oh, well. Write us another one.

61. Talk to Chase. He's rich. My dad, not me.

62. Every minute four people die of TB.

63. Wow! How can you sleep at night?

64. There's people dying in Africa of a disease that we cured over...

65. Yeah, I know. I saw the concert.

66. Seriously. Let's see, you sleep six hours. That means every night you kill

67. 1,440 people.

68. I guess you got to get some sleep, but come on.

69. If you'd stayed up another 10 minutes, you could have saved 40 lives.

70. Do you send notes to the families in the morning?

71. That's gonna take at least 10 minutes. So that's another 40 dead, another 40 notes.

72. Why don't you go wrack yourself with guilt in your own room?

73. No, thanks. I'll stay. I'd like to hear the differential.

74. Dr. Cameron, tell the doctor why it's not a good idea for the patient to be here.

75. He's an immunologist and a TB expert.

76. That'll be very useful if we need somebody to say the words,

77. "l think it's TB."

78. What is that?

79. Oh, that. I'm sorry, that's my body powder.

80. It's the only thing I've found that works in the Sahara.

81. I'm kind of used to it. I don't even notice it.

82. Who thinks it smells like an elephant-dung smoothie?

83. It smells okay to me.

84. That is exactly why the patient shouldn't be in the room.

85. If you can't tell a man that his cologne makes you want to puke,

86. how are you gonna tell him that he's an idiot?

87. He's not an idiot.

88. Sure, you say that now, while he's in the room.

89. Look, I don't have time for this. It's TB. Nope.

90. The symptoms are too varied.

91. Well, if you haven't seen 10,000 cases, I agree that's what you'd think.

92. I told you he's an idiot.

93. You said you wanted a second opinion. No, actually,

94. my backers wanted a second opinion.

95. Yeah, doesn't look good if you drop dead while wearing your shoe sponsor's logo.

96. It's TB and I'm not dying. I'm gonna want you to plant a PPD

97. and induce a sputum to confirm the TB. Imaging studies will determine the progress,

98. and I think we should probably take a CT scan of my lungs

99. just so that nobody second guesses us. Wouldn't want that.

100. Hello? No, I'm feeling much better.

101. Well, what you can do is, you can get your board to approve

102. the increased med shipments that... Sorry.

103. No, don't, don't, don't try. No, don't do your best.

104. Just get it done, okay?

105. That's Stoia Tucker, and they're the nice pharmaceutical company.

106. I'm sorry, but it's against hospital regs. Oh, I need the phone.

107. (PAGER BEEPlNG) Why don't we focus on getting you better right now?

108. What'll you do, throw me out? No, just the phone.

109. Sorry. We've got an emergency.

110. Got to go.

111. There's a phone in your room. Yeah, I figured that there would be.

112. Right. I just thought...

113. It's not like the hospitals you may be used to in Africa.

114. I don't know what the facilities were like, so...

115. Thank you.

116. You're welcome.

117. And thanks for that check.

118. (PAGER BEEPlNG) I should go.

119. The nameless poor have a face, and it's a pompous white man.

120. Yeah, what a jerk, saving all those lives like that.

121. What's the emergency?

122. I can't remember how to do "walk the dog."

123. The guy's sick, maybe dying.

124. And you've forgotten all about doing a differential diagnosis.

125. You just sent us off to test him for... Well, I had to get him out of there.

126. Now we can all sit around and call him an idiot.

127. Who wants to go first? He's right.

128. Tuberculosis could present hundreds of different ways.

129. Well, by that logic, everyone in the hospital should be treated.

130. Not everybody in the hospital has been exposed to it for the last 20 years.

131. TB takes years to kill you.

132. Two weeks ago, he was perfectly healthy.

133. Now he's got a whiteboard full of symptoms.

134. What about something metabolic? Welcome aboard the Good Ship Ass-Kisser.

135. Nice day for a sail. Pucker up, me hearties.

136. It's not metabolic. Kidney, liver and thyroid are all normal. No diabetes.

137. What about his heart? Obviously big as all outdoors.

138. Abnormal heart rhythm. Wave forms show PR variability.

139. It's subtle, but it's there.

140. You think it's his heart? Sick sinus syndrome?

141. Loose throttle. Sometimes beats too fast, sometimes too slow.

142. Causing him to pass out. It would account for the episode.

143. I'll put him on telemetry, do a stress test and an echocardiogram.

144. Treat him like every other hospital patient.

145. I want to see that pious, body-powdered tush hanging out of his gown.

146. Could you give me a hand with this thing?

147. I don't recall asking for a stress test or an echocardiogram.

148. What are you gonna do, walk out?

149. Corporate sponsors aren't gonna like that.

150. I need your forearm.

151. What's House thinking?

152. Sick sinus syndrome. Well, that's a lot more serious than TB.

153. Is that a PPD?

154. If it changes color in the next 48 hours...

155. Yeah, if House doesn't think it's TB, why would he have you test for that?

156. Just covering all his bases, I guess.

157. Uh-huh.

158. He doesn't seem like a guy who does that.

159. We have you scheduled for a 10:30 echo. Good for you.

160. Every minute that we refuse to love one another,

161. another puppy cries another tear.

162. You're just mad because he's closer to a Nobel Prize than you are.

163. And yet I've nailed more Swedish babes. Crazy, crazy world.

164. It's not just a trip to Stockholm, you know.

165. It comes with a cash prize.

166. Seriously?

167. No wonder everybody's going after that peace thing.

168. He cures thousands of people every year.

169. You cure what, 30?

170. McDonald's makes a better hamburger than your mother because they make more?

171. Oh, I see.

172. So you hate him because the lives he saves aren't as good as the lives you save?

173. Yeah, that's the reason.

174. Nobel invented dynamite. I won't accept his blood money.

175. The top of my head's killing me.

176. We spent a week doing "top of head" in anatomy.

177. I know just where it is.

178. That is not the top of my head. Close enough for clinic.

179. Your sinuses are clogged.

180. Judging by the scratches on your hands, I'm guessing a new cat.

181. It was my mother's. She's dead.

182. You keep a dead cat?

183. No. My mother's dead.

184. Poor cat. You're allergic.

185. We can control it with antihistamine.

186. One pill a day. Pills?

187. You don't like to swallow. Not surprised.

188. Forget the pills. We'll give you a nasal spray.

189. Steroids?

190. Is there something else you can give me?

191. Well, if you live by the river, I've got a bag.

192. Hey. Stress test was normal.

193. But his EKG was not normal. Echo's normal.

194. Two for you, one for me. We need a tiebreaker.

195. Echo and stress tests are more reliable. Tilt table tests.

196. That never works.

197. I'll bet you a week's clinic duty it does.

198. You're on.

199. You like this guy?

200. You always tell us our opinion of the patient's irrelevant.

201. Medically, it's irrelevant. It says something about you.

202. You figure anybody who gives a crap about people in Africa must be full of it?

203. Yes.

204. There's an evolutionary imperative why we give a crap about our family and friends.

205. And there's an evolutionary imperative why we don't give a crap about anybody else.

206. If we loved all people indiscriminately, we couldn't function.

207. So the great humanitarian's as selfish as the rest of us?

208. Just not as honest about it.

209. Well, you also always tell us motives are irrelevant.

210. Dr. Charles, your heart's handljng the changes jn orjentatjon just fjne.

211. No pauses on your EKG.

212. And House drives in for the lay-up and no, rejected!

213. What does this knobby thing do? I'm within protocol range.

214. You're not gonna get a different result.

215. The way I figure it is, this could show you problems at six,

216. imagine what it'll tell you if you crank it to 10.

217. House, is that you? Does it go to 11?

218. Would you stop? You lost. I'm scheduled for clinic duty Thursday and Friday.

219. All right, I'm beginning to feel nauseous.

220. Would you turn the damn thing off before you break it?

221. Okay, I'm getting dizzy.

222. I can't see and I'm gonna pass out.

223. I win. At those speeds, astronauts throw up.

224. I'm not talking about the nausea.

225. The test revealed the problem. Yeah? House is insane?

226. What he just did... Abusive and unprofessional.

227. If he hadn't done it, we wouldn't have seen the problem.

228. You've got an abnormal PR interval.

229. It could be dangerous, possibly fatal, particularly if you're in Africa

230. away from advanced medicine.

231. I'm gonna need a pacemaker?

232. You're scheduled for surgery this afternoon.

233. We'll be able to maintain your pacemaker from anywhere.

234. You just need to get yourself to a phone line every few months.

235. Better yet, you could join me at one of my clinics.

236. I'm kind of spoiled. Well, we'll get you a hut with a view.

237. Do you like sand? I meant medically.

238. No PET scans, no MRls... This is ridiculous.

239. Dr. Charles... I know. I know. Hospital regulations.

240. Darling, have a seat. Come on.

241. You're smart. You'll adapt.

242. We're going up or down? Basement.

243. All right.

244. You might even find that without the technological crutches,

245. you become a better diagnostician.

246. My heart can handle this, right?

247. So far, just carnival rides have set you off.

248. When you meet these people, it changes you.

249. We should talk about it over dinner.

250. Are you asking me to Africa or on a date?

251. I can ask you halfway around the world, I can't ask you to a restaurant a block away?

252. Well, one's a job, and the other's... Yeah, hospital regs.

253. You can't date patients, right? I wouldn't wanna risk your precious objectivity.

254. You haven't answered either question, by the way.

255. You don't think objectivity's important?

256. I think doctors like House cling to objectivity

257. like a three-year-old to a blanket. Don't get too worked up.

258. Stay calm. Stay cool and maintain the correct perspective.

259. The only flaw in their argument is that when you have millions of people dying,

260. the correct perspective is to be yelling at the top of your lungs.

261. Sorry. My head is killing me. Here, sit on the step.

262. So, are you gonna go out with me or not?

263. Your heart rate's normal.

264. Yeah, of course it is. It's one flight of stairs. I'm gonna be fine.

265. Hand's a little...

266. Call a code, second floor stairwell!

267. You were wrong. Hey, I have feelings.

268. I'm trying my best. Isn't that enough for you?

269. The abnormal EKG was real. It's not sick sinus syndrome.

270. Thank God we found out before we put the pacemaker in.

271. And thank God you dragged him into a stairwell to get his heart racing.

272. We were taking the stairs. They keep them in the stairwell.

273. The guy's a selfish jerk. Why would you...

274. Why would you say he's selfish?

275. Because he's been talking to Foreman. No, I haven't. I'm just giving my opinion.

276. (PHONE RlNGlNG) This kind of altruism doesn't just naturally...

277. Excellent briefing.

278. Hey, the guy's still sick. Can we talk about that?

279. Now, headaches point to a neurological problem. Acoustic neuroma.

280. A brain tumor causes dizziness, loss of consciousness,

281. messes with breathing patterns, heart rhythms...

282. Get an MRl.

283. Hello?

284. Oh, I'm sorry. I'll be right down. No problem.

285. I'll do an extra hour to make up.

286. I'm late for my clinic duty.

287. Here, go be me for a couple of hours.

288. Explosive diarrhea, fever, it's probably the flu.

289. Wow. You're good. You a Harvard boy?

290. You're not Hill, Oliver. No.

291. Carter, Cecelia.

292. They put you in the wrong room, Cecelia. Mrs. Carter.

293. Sorry.

294. I'll just be a few more minutes.

295. Don't take these in order, everything falls apart.

296. I have cancer.

297. I felt a lump.

298. I'll go get a nurse. Yeah, see you in an hour or two.

299. Lie flat.

300. Lift your left arm up and under your head.

301. Right there? Yeah.

302. I felt it this morning.

303. Oh, my cousin had the same thing.

304. It's nothing.

305. We should check it again on your next cycle,

306. but you really don't have anything to worry about.

307. That's what they told Donna.

308. She was dead in six months. Listen, the edges are smooth.

309. It has mobility. It has all the earmarks of a benign...

310. Why should I believe you?

311. Because you're trying to rush me out of here?

312. The risks of a false positive on a biopsy outweigh...

313. Either you do the biopsy, or I talk to your superior.

314. Which is it, Dr. House?

315. I'll arrange the biopsy. Thanks.

316. He asked me out. I'm shocked.

317. I'm shocked when patients don't ask you out.

318. He also asked me to come to Africa.

319. Boy, he moves fast.

320. I think the two questions had two different objectives.

321. Do you like him? Good-looking single guy, genius doctor,

322. cares about the world. I take it you said no.

323. You think I'm that hung up on rules? He's not House.

324. There's nothing there.

325. Yeah, there is.

326. Did I ask you to plant a PPD?

327. It was positive. He's got TB!

328. Well, of course he's got TB. The guy's been in the jungle for 20 years.

329. If he tested positive for pinkeye, would you think that was his big problem?

330. I did a test. It was positive. Why is that a problem?

331. Because now he's got the big red target on his arm,

332. the stubborn jerk thinks he's right. He won't let us do any more tests.

333. Well, maybe he's not the only stubborn jerk.

334. I did an LP, too. Low glucose, and he has an increased sed rate.

335. Everything screams tuberculosis! Not everything!

336. If any of the symptoms are caused by the TB, it would throw off our diagnosis.

337. You're right. We gotta treat the TB.

338. Who knows? Maybe he'll just get better.

339. You'd like that, wouldn't you?

340. So, it's TB, but not TB?

341. I'm complicated. The guy does know tuberculosis.

342. If he says it can manifest... The guy's not even a real doctor.

343. He's a human telethon. Is that your problem with him?

344. You see hypocrites every day. Why is this guy so special?

345. You think I have a hypocritical attitude to hypocrisy?

346. The problem is, there are 26 letters in the alphabet and he only uses two of them.

347. He treats thousands of patients with one diagnosis.

348. He knows the answer going in. It's cheating.

349. So it's all because he's one of them useless specialists?

350. Oh, did I hurt the big-time oncologist's itty-bitty feelings?

351. You're a big help to patients who actually have cancer.

352. Other times you're just annoying. You've outdone yourself.

353. I'll say. My salad's covering a free T-bone steak.

354. Cecelia Carter, remember her?

355. Last week they said it was mystery stew. They owe me.

356. She was just in my office crying because of the way you treated her.

357. That doesn't sound like you.

358. Then it probably wasn't.

359. I get that you like to shock people,

360. stun them out of complacency, out of stupidity.

361. But this woman thought she had cancer.

362. She had a lump in her breast. What were you trying to accomplish?

363. Let me ask you something. If this were another doctor,

364. if the patient were complaining about, let's say, I don't know, Foreman,

365. you'd just dismiss this as the paranoid bitching of another paranoid bitch.

366. And file it under "P" for... Paranoid?

367. Am not.

368. You're right. Good.

369. Apologize to her before the end of business today.

370. What did you do to Ceci? I have no idea.

371. Just the salad today. Big breakfast.

372. Hey.

373. Levofloxacin?

374. You have a resistant strain of TB.

375. Wow, you just walk right in with these. That's what we doctors do.

376. We write down the name of some medicine, and someone gives it to us.

377. You know, there's parts of the world where you get knifed walking around with this.

378. I mean, the regular stuff is bad enough,

379. but the treatment for the resistant strain?

380. They get $6 a tablet for that.

381. And I take it for two years.

382. Streptomycin. Now, that's two grand.

383. Ten grand, cure one person.

384. I had a patient in Djani once.

385. It was a mother, had three little boys.

386. She had resistant TB.

387. She couldn't afford these.

388. She couldn't afford bread.

389. We gave her the regular stuff, but

390. no surprise, she died. Sorry.

391. I'm not taking these pills.

392. Because she couldn't get them, you're not gonna take them?

393. That's insane. Why?

394. 'Cause I'm better than her? Because letting her die was wrong,

395. but letting you die is just as wrong.

396. Maybe I won't die.

397. Maybe somebody will pay a little more attention to my story.

398. He figures the pharmaceutical companies

399. (PHONE RlNGlNG) need something big to force them into action.

400. This'll get a lot more media play than 1,000 African villagers dying.

401. So, he won't take the pills.

402. Newsweek's calling you. And he won't agree to any more tests.

403. He has his diagnosis.

404. See what happens when you don't listen to me?

405. Maybe millions of lives get saved.

406. Yeah. That's my point.

407. Increased heart rate, night sweats,

408. loss of consciousness. Besides rough sex, what do they all have in common?

409. T... It's not TB!

410. His autonomic nervous system?

411. We know that it's not a brain tumor. So what else could be eating his nerves?

412. Fabry's. Autonomic dysregulation syndrome.

413. Shy-Drager syndrome. It doesn't matter. He won't let us test him.

414. In my opinion, Dr. Sebastian Charles is an idiot.

415. Yeah, you can quote me. C-U-D-D-Y.

416. Sebastian is refusing life-saving treatment.

417. He's refusing TB treatment. You don't think he has TB.

418. Ergo, you should care less. He won't let me test him.

419. And what do you want me to do about it? Hold him down.

420. Have you apologized to Cecelia Carter yet?

421. Trust me, she doesn't wanna hear from me.

422. Look, the guy is killing himself!

423. Am I the only one who realizes this is a bad thing?

424. If he was a Christian Scientist refusing meds, we'd have 18 attorneys...

425. You're putting on makeup.

426. That's not a good sign for my side, is it?

427. Sebastian has called a press conference for 3:00.

428. He's asked me to be there to confirm the diagnosis and the prognosis.

429. You are as big a media whore as he is.

430. Of course I am. It couldn't possibly be that I think he's right,

431. and that I'd like to be a small part of what he's doing.

432. Oh, whores can like the sex. Doesn't mean they're not whores.

433. And with that eye shadow, I am totally screwed, aren't l?

434. Totally.

435. How you feeling? A little weak.

436. You're having a good day.

437. The symptoms will quickly focus more and more on your lungs.

438. You'll find it difficult to talk and eventually breathe at all.

439. I think I know what I'll have to look forward to.

440. I know.

441. I just came to ask if you'd be willing to accept any treatment.

442. No, if you're trying to scare me into... No. Palliative treatment.

443. Narcotics.

444. Fentanyl patch, morphine drip, whatever it takes.

445. We can make your last days fairly comfortable.

446. And if you have another good day, maybe dinner.

447. Thank you.

448. You want Third World treatment? You got it.

449. Boy, is it hot here in Djani. What are you doing?

450. What am I doing?

451. Putting everything on the floor of the hut.

452. What's the magic box with the moving pictures?

453. You think he's a hypocrite? Hypocrite? No.

454. Everybody in Africa's got cell phones and running water.

455. This thing just will not flush.

456. Do you really think that if you come in here and make it a little hot,

457. make it smell a little,

458. that I'm just gonna fold and abandon everything that matters to me?

459. Lousy sanitation over there, too.

460. You are not the same as them. Your life is not the same.

461. And you're cheapening everything they're going through by pretending you are.

462. I am the same. I'm not special.

463. You can't demand to be treated like any Third World sick person

464. and call a press conference! They treat me special!

465. That doesn't mean I am.

466. And what kind of selfish jerk wouldn't take advantage of that fact?

467. It's all preventable.

468. Stoia Tucker makes medications right here in New Jersey.

469. They have warehouses full of the stuff. There's more than enough to go around.

470. So if I can get them, why can't Lemma?

471. Why can't Quesmo? And why can't Sarni?

472. Another person just died. Where is your outrage?

473. No, I have no jntentjon of martyrjng myself.

474. I'm just puttjng myself...

475. Sure, they're dying, but it's got a great beat.

476. Must be hot as hell under those lights. Yep.

477. Hey, why the page?

478. He okay? He's in a coma.

479. I need you to apologize to Ceci, Cecily.

480. Mrs. Carter? For what? For whatever I did.

481. You didn't do anything. That has been my position all along.

482. Hjs chest x-rays are negatjve, so he's not contagjous at thjs pojnt.

483. Hjs condjtjon js currently stable.

484. Do you ever notice how all the self-sacrificing women in history,

485. Joan of Arc, Mother Teresa,

486. can't think of any others, they all die alone.

487. The men, on the other hand, get so much fuzz it's crazy.

488. It's an unfair world.

489. House, she was scared and unreasonable. Insulting a woman with breast cancer,

490. that's a move best left to the pros. Frankly, you don't have the chops.

491. I didn't insult her! I did the unnecessary biopsy like she wanted.

492. It was negative like I knew it would be.

493. What'd you do, call them perky?

494. You are years away from mad skills like that.

495. I need you to apologize.

496. Cuddy's only doing this because she thinks it's you.

497. Welcome to the world.

498. Everyone's different, everyone gets treated different.

499. And you try fighting that, you wind up dying of TB.

500. What are you doing?

501. Testing the patient's autonomic nervous system.

502. Of course. His internal heating and ventilation should be off.

503. He shouldn't be able to sweat.

504. That's why he's got that awful body powder.

505. Take it away, crank up the heat, stick him under the lights,

506. he can't cool himself. He should be turning bright red.

507. The picture's fine.

508. Yeah.

509. I'm askjng Stoja Tucker

510. to save these lives, millions of lives,

511. including my own.

512. Dr. House, I would appreciate it if you left us...

513. Get that out of my face. What are you tryjng to prove, House?

514. Dr. House, I would apprecjate jt jf you left the room whjle...

515. He's sweating like a pig.

516. It's 100 degrees in here, House, because you turned up the thermostat.

517. Did they hear me? The media, did they listen?

518. He's disoriented. They have to hear me.

519. His arteries are clamping down. I want everybody out of here now!

520. Get the crash cart. He's having a cardiac arrest.

521. Get it set up. All right.

522. Get them out!

523. Everyone. I want everyone out of here now!

524. Clear.

525. Come on, Sebastian.

526. Clear.

527. I've got sinus rhythm.

528. That js not TB. Compelling television.

529. Do whatever tests you want. I want to treat you for TB.

530. Dr. Cameron found low sugar in your cerebrospinal fluid.

531. It's a classic finding of TB. Oh, now you think TB's the problem?

532. No.

533. If TB caused cardiac arrest on a hot day,

534. your work in Africa would be even more futile than it already is.

535. Can you get to your point, please?

536. That whiteboard in my office, we're up to about a dozen symptoms now.

537. Cardiac arrest, clearly not TB.

538. CSF sugar clearly is TB.

539. The rest of them could go either way.

540. Unless we know which ones are which, I can't diagnose you.

541. I'll take any other tests or treatments you might want to prescribe.

542. So you're not special, but TB is.

543. People die of TB because we let them. It's our choice.

544. People die of malaria because we let them. They die of dysentery. They...

545. No, TB's my disease. You own a disease?

546. Well, I'm sorry I missed the lPO on dengue fever.

547. Look, I know I have a way about me, and I know I piss a lot of people off.

548. And a whole lot more I just annoy.

549. But you're the first person that I've ever met

550. who I think is actually annoyed by what I do.

551. Do you think I'm not saving any lives, or is that a bad thing?

552. Right now, I'm just trying to save your life.

553. Or do you just have a problem with hope?

554. You know, the difference between our jobs is not numbers or styles.

555. It's that I know I'm gonna fail. Even if I save a million people,

556. there's gonna be another million. You couldn't handle that.

557. I think you resent anyone who can.

558. Can't we just agree that you're incredibly annoying?

559. Take the pills, or I'll let you die,

560. do an autopsy, call my own press conference

561. and make sure the world knows that you didn't die of TB.

562. Corporate sponsors will be disappointed, but they'll find another disease.

563. Why would you do that?

564. Because I'm just a mean son of a bitch.

565. So, we still have to explain PR variability, syncope, headaches

566. and

567. low sugar?

568. That was classic TB. Apparently not.

569. You rerun the test? Yeah.

570. This is good. Good? This is bizarre.

571. "Bizarre" is good.

572. "Common" has hundreds of explanations. "Bizarre" has hardly any.

573. What else could cause low CSF sugar?

574. I get to ask the questions.

575. I've found you look a lot smarter asking questions than dumbly not answering them.

576. High insulin levels in his blood. They'd have to be very high.

577. Okay, very high insulin levels in his blood.

578. How could he get high insulin levels?

579. We've checked daily blood sugars, all normal.

580. See how smart she looks? 'Cause she asked the question.

581. And it's not glucagonoma because he has no rash.

582. It's not self-induced because he's not an idiot.

583. And it's not a tumor because the CT and the MRl were both negative.

584. Which just leaves tumor.

585. Why do you do this? Why do you ignore what I say like I'm not even...

586. Small tumor. Really, really tiny.

587. So small we can't see it.

588. Nesidioblastoma.

589. An abnormal growth of the insulin-secreting cells in his pancreas?

590. That only intermittently secrets insulin... In response to stress,

591. like if, I don't know, if someone accidentally puts the mechanical bull on 11.

592. Easily removed by surgery.

593. Except if it's so small we can't see it,

594. how are we even gonna prove it's there?

595. She asked, looking clever.

596. Just start hacking away at his pancreas until he gets better?

597. How do you prove something exists when you can't see it?

598. Does God exist? Does the wind blow?

599. We know because the leaves move. Look for effects.

600. You should look the other way.

601. There's Cuddy with your patient. Dr. House!

602. Dr. House has an emergency.

603. We can't avoid her forever. Eventually she'll die.

604. You sure she doesn't have breast cancer?

605. We think you have a tumor.

606. Easily removed surgically. We're gonna poke it with a stick.

607. And if there's no tumor? Nothing happens.

608. Splenic artery, it's a hard left off the celiac.

609. If there is a tumor?

610. What usually happens when you poke something with a stick?

611. Pokes back.

612. He's stuck in the superior mesenteric.

613. I knew we should have stopped for directions. Men!

614. I'm there.

615. We're gonna inject calcium into your pancreas.

616. The beta cells will release insulin.

617. If there are too many beta cells because of a tumor,

618. your blood sugar will drop precipitously.

619. How do we know it won't go too low?

620. Fingers and toes crossed.

621. Go ahead.

622. Glucose is holding steady at 75.

623. No leaves rustling. Blow harder. I already gave him one amp.

624. Well, I guess now would be the time to give him more than one amp.

625. Fifty. It's starting to drop.

626. Forty-five. I think my arm's shaking.

627. I'm gonna start him on a glucose drip. He's gonna seize.

628. Not yet.

629. It's continuing to drop. Not fast enough.

630. He's seizing. We've got to reverse this.

631. He's at 40, 38, 35.

632. Push an amp of D50. You want to kill the guy?

633. We're back to 40.

634. Congratulations. You have a tumor.

635. Are you gonna go out with him?

636. Is that any of your business? Nope.

637. I don't think so.

638. Two days ago, you were holding his hand. What's changed?

639. He practically lives in Africa. There's no future.

640. On the other hand, maybe there's too much of a future now.

641. You weren't attracted to him because he was prepared to die for a cause.

642. You were attracted to him because he was actually doing it.

643. Right. It's that simple. That was simple?

644. I put a label on him and go from there. Everybody does it.

645. We are who people think we are.

646. People think he's a great doctor, so they give him stuff.

647. He is a great doctor. The reality is irrelevant.

648. I'll prove it.

649. People who know me see me as an ass, treat me as an ass.

650. People who don't know me see a cripple, treat me like a cripple.

651. What sort of selfish jerk wouldn't take advantage of that fact?

652. Oh, my goodness. Are you okay?

653. Yeah. I am so sorry.

654. It was completely my fault.

655. It's nothing. I'm fine.

656. Well, I'm very relieved. I feel terrible.

657. Please don't worry about it. I'm fine. You sure?

658. Okay.

659. How's everything?

660. I'm gonna go. My foot's killing me.

661. What did you do to... It was nothing. It was all my fault.

662. Yeah, listen. Bogale, relax, okay?

663. I'm gonna be back on Tuesday.

664. Tell Sarni I'm gonna bring her a new brace. All right.

665. Just in case. You get them?

666. Six-months' supply. Should fix you right up.

667. I'll see you when you come back for a refill?

668. Yeah, I'll see you in two months.

669. You gonna give them away?

670. Well, you know how these things happen. You leave a bag on the airplane,

671. you drop some pills down the drain.

672. I have an idea. You could bring me the refill in Africa.

673. I don't think so.

674. You actually like working for House? You find this satisfying?

675. There he is.

676. It's good to see you. Dr. Sebastian. Thank you.

677. Thank you. I appreciate that. I appreciate the support.

678. It's not about the kids dying every eight seconds.

679. It's about the media stroking, adulation, the pats on the head.

680. That's your problem with him, isn't it?

681. Look at him. Loves it, eats it up.

682. Yeah, the man actually enjoys what he does.

683. Listen, I saved his life.

684. That means I get credit for every life he saves from here on out.

685. I'll make sure Stockholm knows.