1
00:00:45,780 --> 00:00:48,230
Hannah, you okay?

2
00:00:48,680 --> 00:00:51,030
Still can't sleep?

3
00:00:51,030 --> 00:00:53,090
I'm fine.

4
00:00:55,360 --> 00:00:57,170
Can I do anything to help you?

5
00:00:57,170 --> 00:00:59,560
Just go back to sleep. I wanna go get a glass of wine.

6
00:00:59,560 --> 00:01:00,820
I can keep you company.

7
00:01:00,820 --> 00:01:02,080
You have work in the morning.

8
00:01:02,080 --> 00:01:03,710
Are you sure, you don't want me to...

9
00:01:03,710 --> 00:01:06,750
I'll be right back. Just sleep.

10
00:01:16,970 --> 00:01:18,230
Hannah?

11
00:01:22,030 --> 00:01:23,500
Hannah?

12
00:01:35,240 --> 00:01:36,990
What'd you do?

13
00:01:37,380 --> 00:01:39,910
I just wanted to sleep.

14
00:01:40,220 --> 00:01:42,600
I'm calling an ambulance.

15
00:02:33,950 --> 00:02:37,460
You've seen one patient in the last two hours.

16
00:02:37,460 --> 00:02:39,440
Complicated case.

17
00:02:39,740 --> 00:02:41,030
I'm a night owl.

18
00:02:41,030 --> 00:02:44,580
Wilson's an early bird. We're different species.

19
00:02:44,580 --> 00:02:45,920
Then move him into his own cage.

20
00:02:45,920 --> 00:02:48,460
Who'll clean the droppings from mine?

21
00:02:49,620 --> 00:02:52,880
25-year-old female with sleep issues.

22
00:02:52,880 --> 00:02:56,700
I'm guessing she's... oh, what's the medical term...

23
00:02:56,700 --> 00:02:57,420
upset.

24
00:02:58,750 --> 00:03:04,040
25-year-old females, they're usually completely rational, they're rocks, really.

25
00:03:05,160 --> 00:03:09,110
my theory seems to be supported by the fact that she swallowed a bottle of sleeping pills.

26
00:03:09,110 --> 00:03:11,970
Get her a shrink. I need some shut-eye.

27
00:03:12,200 --> 00:03:14,730
She's a little bit more than upset.

28
00:03:14,730 --> 00:03:17,120
She hasn't slept in ten days.

29
00:03:17,120 --> 00:03:18,250
She's lying.

30
00:03:18,250 --> 00:03:22,130
Without rem sleep your neurons stop regenerating.

31
00:03:22,130 --> 00:03:24,310
Your brain shuts down, lobe by lobe.

32
00:03:24,310 --> 00:03:27,810
She'd be insane after five days, dead by ten.

33
00:03:27,810 --> 00:03:31,200
Give me a little credit. I know what gets you off.

34
00:03:31,200 --> 00:03:34,090
She took the pills to sleep, not to kill herself.

35
00:03:34,090 --> 00:03:35,460
Clever alibi.

36
00:03:35,460 --> 00:03:36,360
They didn't work.

37
00:03:36,360 --> 00:03:40,280
She stayed awake even though she downed the whole bottle.

38
00:03:43,010 --> 00:03:47,470
And the longest anyone's ever survived without sleep is 11 days.

39
00:03:47,470 --> 00:03:50,730
Which gives you about 22 hours.

40
00:03:54,580 --> 00:03:56,130
You stole my article.

41
00:03:56,130 --> 00:03:57,390
I wouldn't do that.

42
00:03:57,390 --> 00:04:00,920
I wrote up the case where we induced hypothermic cardiac arrest in the terminal cancer girl.

43
00:04:00,920 --> 00:04:02,860
I wrote my own. I didn't steal yours.

44
00:04:02,860 --> 00:04:05,500
You knew I was writing one. You gave me notes.

45
00:04:06,260 --> 00:04:08,210
Got a case.

46
00:04:08,780 --> 00:04:11,170
It can wait. You two finish.

47
00:04:11,170 --> 00:04:14,280
Five bucks says someone loses an eye.

48
00:04:15,220 --> 00:04:18,080
Fine. You're only putting off the inevitable.

49
00:04:18,080 --> 00:04:21,640
25-year-old female, hasn't slept for ten days.

50
00:04:21,640 --> 00:04:24,770
I assume the er tried giving her some sedatives. We should up the dosage.

51
00:04:24,770 --> 00:04:26,410
Sedation isn't the same as sleep.

52
00:04:26,410 --> 00:04:27,390
Thanks for your insight.

53
00:04:27,390 --> 00:04:30,590
For someone who hasn't slept in ten days, sedation is a great start.

54
00:04:30,590 --> 00:04:31,790
Sleep is an active process--

55
00:04:31,790 --> 00:04:34,080
Reboots the system, restores the brain. Sedatives don't--

56
00:04:34,080 --> 00:04:36,230
The brain is being stressed; we need to relieve that.

57
00:04:36,230 --> 00:04:38,560
You've had my article on your desk for the last four months.

58
00:04:38,560 --> 00:04:43,150
I'm a very slow reader. No fever, no white count means no infection.

59
00:04:43,150 --> 00:04:44,480
Schizophrenia?

60
00:04:44,480 --> 00:04:47,470
- No delusions.
- You read his.

61
00:04:47,470 --> 00:04:49,500
Signed it, didn't read it.

62
00:04:49,500 --> 00:04:52,960
Aside from the sleeping pills, tox screen was clean.

63
00:04:52,960 --> 00:04:55,960
No cocaine, methamphetamines, or diet pills.

64
00:04:55,960 --> 00:04:59,690
Only medications she's had recently are steroids for poison ivy

65
00:04:59,690 --> 00:05:02,150
and ibuofen for a knee she hurt skiing.

66
00:05:02,150 --> 00:05:05,430
Nothing that would cause sleep disturbances. When did you get his article?

67
00:05:05,430 --> 00:05:07,510
About three weeks ago.

68
00:05:07,510 --> 00:05:09,590
Let's go back to the beginning.

69
00:05:09,590 --> 00:05:10,950
How far back?

70
00:05:10,950 --> 00:05:12,570
Genesis.

71
00:05:12,570 --> 00:05:16,790
God said let there be light.

72
00:05:16,790 --> 00:05:19,530
Sleep is initially controlled by external light cues.

73
00:05:19,530 --> 00:05:24,170
- And if her brain can't interpret those cues...
- Optic nerve disease.

74
00:05:24,390 --> 00:05:27,140
I'm sensing another article.

75
00:05:27,140 --> 00:05:29,670
I'll go run the tests.

76
00:05:31,260 --> 00:05:36,780
I'm injecting a dye which will allow us to take a look at your retina and your optic nerve.

77
00:05:36,780 --> 00:05:38,600
Everything's kinda blurry.

78
00:05:38,600 --> 00:05:42,280
Normal, because of the dye. It's gonna be that way the next few hours.

79
00:05:48,200 --> 00:05:49,610
Need a hand?

80
00:05:49,610 --> 00:05:50,940
No.

81
00:05:50,940 --> 00:05:53,540
We're never going to work together again?

82
00:05:53,540 --> 00:05:56,840
Just don't see the need to make you feel better by forgiving you.

83
00:05:57,100 --> 00:06:00,390
I wasn't asking for forgiveness. I was asking if you needed help.

84
00:06:00,390 --> 00:06:02,820
It's unprofessional to be talking about this in front of the patient.

85
00:06:02,820 --> 00:06:05,030
Maybe that doesn't matter to you, but...

86
00:06:05,030 --> 00:06:08,860
Doesn't matter. She's not listening.

87
00:06:09,280 --> 00:06:10,810
She's asleep.

88
00:06:10,810 --> 00:06:13,610
Normal stage one brain waves.

89
00:06:14,520 --> 00:06:17,170
Maybe she's... better?

90
00:06:18,390 --> 00:06:20,930
Still blurry.

91
00:06:20,930 --> 00:06:22,810
You fell asleep.

92
00:06:22,810 --> 00:06:25,170
No, I didn't.

93
00:06:26,270 --> 00:06:28,490
Negative for optic nerve disease.

94
00:06:28,490 --> 00:06:29,810
But she sleeps.

95
00:06:29,810 --> 00:06:32,560
For like ten seconds, Maximum one minute.

96
00:06:32,560 --> 00:06:35,880
We also checked the ocular pressure. It's normal.

97
00:06:36,240 --> 00:06:38,110
And she doesn't know she sleeps.

98
00:06:38,110 --> 00:06:40,690
Brain is often unaware of stage one sleep.

99
00:06:40,690 --> 00:06:44,830
Ct showed no tumors, no clots, no seizure disorder.

100
00:06:44,830 --> 00:06:49,410
So she sleeps, she just can't stay asleep.

101
00:06:49,790 --> 00:06:51,650
You going somewhere with this?

102
00:06:51,650 --> 00:06:53,410
You know what keeps me awake at night?

103
00:06:53,640 --> 00:06:55,550
Monsters in the closet.

104
00:06:55,550 --> 00:06:57,930
There's no monster in the closet. We looked.

105
00:06:57,930 --> 00:07:00,680
Well, it's certainly not showing up on the scans.

106
00:07:00,680 --> 00:07:02,870
Where's Cameron?

107
00:07:03,510 --> 00:07:07,370
She felt I could deliver the news on my own.

108
00:07:08,750 --> 00:07:11,310
Oh, this is going to work out great.

109
00:07:13,040 --> 00:07:14,670
Come on.

110
00:07:17,820 --> 00:07:21,070
If you two guys can't play nice together, I'm taking away your toys.

111
00:07:21,070 --> 00:07:22,970
I don't care whose fault this is.

112
00:07:22,970 --> 00:07:25,850
- If you hadn't...
- Specially don't care if it was my fault.

113
00:07:25,850 --> 00:07:31,060
Whatever this woman has it's not showing up on our tests, which means she's sick.

114
00:07:31,060 --> 00:07:33,810
Just not sick enough for us to see it.

115
00:07:33,810 --> 00:07:35,590
You want us to make her sicker?

116
00:07:35,590 --> 00:07:40,060
Yes. I want to stress her body. Specifically her brain.

117
00:07:40,060 --> 00:07:41,750
Keep her awake.

118
00:07:41,750 --> 00:07:45,340
Depriving her of even the few minutes of sleep she does have... it's torture.

119
00:07:45,340 --> 00:07:47,500
So is cutting people with knives,

120
00:07:47,500 --> 00:07:49,950
but you can totally get away with that if you have a doctor coat on.

121
00:07:49,950 --> 00:07:53,190
House, those few seconds of sleep are maybe the only reason she's still alive.

122
00:07:53,190 --> 00:07:55,500
The more symptoms we can force out of her, the more tests we can do.

123
00:07:55,500 --> 00:07:59,700
The more tests we do, the more information we get, the quicker we make a diagnosis.

124
00:07:59,700 --> 00:08:02,420
See how much more fun it is when you guys get along?

125
00:08:02,420 --> 00:08:06,320
You two take the first four hours.

126
00:08:11,480 --> 00:08:13,150
Hannah.

127
00:08:14,950 --> 00:08:16,580
Hannah!

128
00:08:17,940 --> 00:08:19,560
You fell asleep.

129
00:08:19,560 --> 00:08:21,810
No, I didn't.

130
00:08:21,810 --> 00:08:24,850
Your brain doesn't remember, it was just a few seconds.

131
00:08:24,850 --> 00:08:26,110
Is this really necessary?

132
00:08:26,110 --> 00:08:29,870
The sooner we find out what's wrong, the sooner she can get a real night's rest.

133
00:08:29,870 --> 00:08:32,000
Hannah?

134
00:08:32,000 --> 00:08:33,490
Hannah?

135
00:08:33,490 --> 00:08:35,370
Hannah?

136
00:08:39,690 --> 00:08:41,370
What did you do that for?

137
00:08:41,370 --> 00:08:42,640
You fell asleep again.

138
00:08:42,640 --> 00:08:43,740
No, I didn't.

139
00:08:43,740 --> 00:08:46,330
We're sorry. We have to do this.

140
00:08:46,330 --> 00:08:48,650
We don't have to be cruel.

141
00:08:48,650 --> 00:08:51,440
You know what happens when you're nice. Nothing.

142
00:08:51,440 --> 00:08:54,100
That's how you define nice? Not stealing?

143
00:08:54,100 --> 00:08:55,170
Doctors?

144
00:08:55,170 --> 00:08:58,270
She fall asleep again?

145
00:09:14,020 --> 00:09:16,070
We've got rectal bleeding.

146
00:09:16,070 --> 00:09:17,630
What, all of you?

147
00:09:18,840 --> 00:09:22,380
So the monster is peeking out from under the bed.

148
00:09:22,380 --> 00:09:26,760
Which either means she has a clotting disorder or she has a tumor in her colon.

149
00:09:26,760 --> 00:09:28,430
We'll do a colonoscopy.

150
00:09:28,430 --> 00:09:30,490
Who's keeping her awake now?

151
00:09:30,490 --> 00:09:33,680
We figured once we found another symptom, it really didn't matter.

152
00:09:33,680 --> 00:09:35,280
Yeah, he's got all the ideas.

153
00:09:35,280 --> 00:09:36,390
Who is with her?

154
00:09:36,390 --> 00:09:39,050
Her partner's donating blood, so she's with a nurse.

155
00:09:39,050 --> 00:09:42,550
Probably singing her lullabies. I want her awake.

156
00:09:42,550 --> 00:09:44,910
You have to sedate a patient to do a colonoscopy.

157
00:09:44,910 --> 00:09:47,240
Why? Just because of the pain?

158
00:09:47,580 --> 00:09:51,380
You find a tumor in her colon, you can knock her out. If you don't,

159
00:09:51,380 --> 00:09:53,560
she stays awake.

160
00:09:56,000 --> 00:09:58,790
Oh, god! It hurts!

161
00:09:58,790 --> 00:09:59,760
Can't you hurry?

162
00:09:59,760 --> 00:10:02,100
Trust me, you don't want me to hurry.

163
00:10:02,330 --> 00:10:04,940
God, you're killing me.

164
00:10:04,940 --> 00:10:06,960
Hold my hand.

165
00:10:07,490 --> 00:10:10,510
Keep breathing, nice and steady.

166
00:10:11,480 --> 00:10:14,300
How am I supposed to work with him?

167
00:10:15,340 --> 00:10:18,550
Maybe we shouldn't be talking about this right now?

168
00:10:18,550 --> 00:10:20,810
You think I'm overreacting?

169
00:10:21,770 --> 00:10:25,200
I need you to relax your anus.

170
00:10:26,220 --> 00:10:29,410
We're not here. We're skiing.

171
00:10:29,410 --> 00:10:31,960
It's Thanksgiving, at Vail.

172
00:10:31,960 --> 00:10:34,840
You want me to think about nearly killing myself on a snowboard?

173
00:10:34,840 --> 00:10:37,770
Come on, you never fell.

174
00:10:38,720 --> 00:10:40,890
You were awesome.

175
00:10:42,230 --> 00:10:46,410
Is that what you told him? I'm hysterical, and I need to relax my anus?

176
00:10:47,170 --> 00:10:51,090
I told him, how many cases do we work up in a year?

177
00:10:51,090 --> 00:10:53,770
They're all weird; he could've written up any one of them.

178
00:10:54,360 --> 00:10:55,850
She's bleeding.

179
00:10:57,270 --> 00:10:58,450
I can't breathe. I can't breathe!

180
00:10:58,450 --> 00:11:00,270
Hold on.

181
00:11:06,520 --> 00:11:10,010
To control the bleed and started transfusing two units of whole blood.

182
00:11:10,010 --> 00:11:13,580
The pathology from the rectal bleed showed traces of nasal epithelium.

183
00:11:13,580 --> 00:11:15,680
So, the butt bleed's just a nose bleed.

184
00:11:15,680 --> 00:11:18,090
That much blood is not a "just a" anything.

185
00:11:18,090 --> 00:11:22,080
When two people fight this much, you know what it means.

186
00:11:22,080 --> 00:11:26,020
It's gotta be a massive sinus hemorrhage that was draining down her throat and out the back.

187
00:11:26,020 --> 00:11:27,770
The question isn't what, it's why.

188
00:11:27,770 --> 00:11:29,110
Oh, get a room.

189
00:11:29,110 --> 00:11:33,390
Rat poison mixed with some sort of neurogenic toxin could cause bleeding and sleep disturbances.

190
00:11:33,390 --> 00:11:35,220
Do you have a specific type of neurogenic toxin in mind,

191
00:11:35,220 --> 00:11:37,810
or should we just start running a thousand different tox screens?

192
00:11:37,810 --> 00:11:39,750
Just pretend I'm not here. I'll be reading.

193
00:11:39,750 --> 00:11:41,730
It could also be some type of coagulopathy.

194
00:11:41,730 --> 00:11:44,210
Or it could be us. Do you have any idea what it feels like

195
00:11:44,210 --> 00:11:46,840
to have a six-foot-long hose shoved into your large intestine?

196
00:11:46,840 --> 00:11:49,580
No, but I now have a much greater respect for

197
00:11:49,580 --> 00:11:52,570
whichever basketball player you dated in college.

198
00:11:52,840 --> 00:11:55,810
We've basically been torturing this girl for the last eight hours.

199
00:11:55,810 --> 00:11:58,130
We've been poking her foot, not punching her face.

200
00:11:58,130 --> 00:12:01,440
Extreme stress can cause high blood pressure, which can cause bleeding.

201
00:12:01,440 --> 00:12:03,000
Wouldn't keep her awake for ten days.

202
00:12:03,000 --> 00:12:06,930
What if the poison ivy wasn't poison ivy?

203
00:12:06,930 --> 00:12:09,230
She got the rash

204
00:12:09,230 --> 00:12:13,160
that was diagnosed as poison ivy around the same time the insomnia started.

205
00:12:13,160 --> 00:12:18,210
Rash, plus nose bleed, plus sleep disturbance equals Wegener's granulomatosis.

206
00:12:18,210 --> 00:12:20,550
Start corticosteroid treatment.

207
00:12:20,550 --> 00:12:22,420
The poison ivy treatment was steroids.

208
00:12:22,420 --> 00:12:25,620
Much lower dosage. Get her back on the juice, triple the dose.

209
00:12:25,620 --> 00:12:30,700
Get a c-anca and an upper airway biopsy to confirm the Wegener's.

210
00:12:42,760 --> 00:12:47,750
She has, menstrual problems. They're really bad, the pain keeps her in bed all day.

211
00:12:47,750 --> 00:12:51,170
Plus, she's super depressed.

212
00:12:55,590 --> 00:12:58,030
She said super depressed?

213
00:12:58,030 --> 00:13:02,290
She heard that birth control pills can make her feel better.

214
00:13:02,290 --> 00:13:06,410
She wants birth control pills for her pms?

215
00:13:06,410 --> 00:13:07,900
I guess.

216
00:13:09,000 --> 00:13:12,040
Judging by the redness around your mom's nostrils,

217
00:13:12,040 --> 00:13:14,860
and the tissue she's got conveniently stashed inside her wrist band,

218
00:13:14,860 --> 00:13:18,810
I'd say her problem is more likely a uri than a pms.

219
00:13:18,810 --> 00:13:20,220
Uri?

220
00:13:20,220 --> 00:13:23,020
Upper respiratory infection. A cold.

221
00:13:23,020 --> 00:13:24,880
I don't think so.

222
00:13:24,880 --> 00:13:27,330
I also think she's got a problem with sac.

223
00:13:27,330 --> 00:13:28,400
Sac?

224
00:13:28,400 --> 00:13:32,180
Thanks for playing. Stupid american child.

225
00:13:32,180 --> 00:13:33,870
If you want the pill,

226
00:13:33,870 --> 00:13:38,790
all you have to do is to walk into any health clinic in Jersey alone and ask for it.

227
00:13:39,280 --> 00:13:41,400
What exactly was your plan?

228
00:13:41,400 --> 00:13:43,890
Were you going to exchange the birth control pills for some

229
00:13:43,890 --> 00:13:48,190
over-the-counter decongestants and hope that your mom's cold lasts another six years?

230
00:13:48,190 --> 00:13:49,430
No.

231
00:13:50,880 --> 00:13:52,730
That for her cold?

232
00:13:52,730 --> 00:13:55,260
No, that's for your ovaries.

233
00:13:55,490 --> 00:13:58,830
I assume you haven't had a stroke. Have you ever had a blood clot?

234
00:13:58,830 --> 00:14:00,150
No.

235
00:14:00,150 --> 00:14:01,380
Super.

236
00:14:01,380 --> 00:14:04,600
In three months when you need a refill, take a bus to a free clinic.

237
00:14:04,600 --> 00:14:08,060
Don't wait around hoping for mom to get another sniffle.

238
00:14:08,600 --> 00:14:12,850
Not the sharpest chopstick in the drawer, is she?

239
00:14:14,340 --> 00:14:16,190
Was this just one of your experiments?

240
00:14:16,190 --> 00:14:19,320
You just wanted to see how I'd react to being screwed over by Foreman?

241
00:14:20,310 --> 00:14:22,060
Nice idea, but no.

242
00:14:22,060 --> 00:14:25,270
This was just good old-fashioned laziness.

243
00:14:25,590 --> 00:14:27,440
Gotta hand it to Foreman, though.

244
00:14:27,440 --> 00:14:30,060
He knew that you're a suck-up and I don't give a crap.

245
00:14:30,060 --> 00:14:32,360
He successfully exploited us both.

246
00:14:32,360 --> 00:14:34,270
Right. We're both victims.

247
00:14:34,270 --> 00:14:36,360
A simple heads up, that's all I needed.

248
00:14:36,360 --> 00:14:40,090
Maybe between your incredibly witty remarks about anal sex and Cuddy's breasts,

249
00:14:40,090 --> 00:14:41,490
you could've tipped me off.

250
00:14:41,490 --> 00:14:43,540
Then I'd have Foreman pissed at me,

251
00:14:43,540 --> 00:14:45,450
and as annoying as you could be,

252
00:14:45,450 --> 00:14:48,280
at least I know you're not gonna pop a cap in my ass.

253
00:14:48,280 --> 00:14:50,500
Witty, huh?

254
00:14:53,400 --> 00:14:55,250
You, on the other hand,

255
00:14:55,250 --> 00:15:00,660
continue to be flabbergasted every time someone actually acts like a human being.

256
00:15:00,890 --> 00:15:04,080
Foreman did what he did because it worked out best that way for him.

257
00:15:04,080 --> 00:15:06,080
That's what everyone does.

258
00:15:06,080 --> 00:15:08,170
That is not the definition of being human.

259
00:15:08,170 --> 00:15:11,230
That's the definition of being an ass.

260
00:15:15,650 --> 00:15:17,320
This will numb you up.

261
00:15:20,150 --> 00:15:23,420
And this will keep your tongue out of the way.

262
00:15:24,510 --> 00:15:27,760
Don't worry, you shouldn't feel anything except for a slight pulling.

263
00:15:27,760 --> 00:15:29,570
So you think I was out of line?

264
00:15:29,570 --> 00:15:33,180
That article would've sat on House's desk for the next six years.

265
00:15:33,180 --> 00:15:35,050
I could've told her.

266
00:15:35,430 --> 00:15:37,510
You could've written it for her too.

267
00:15:37,510 --> 00:15:39,570
She knows House as well as any of us.

268
00:15:39,570 --> 00:15:43,500
She should've known she was waiting for him to do something he was never gonna do.

269
00:15:47,060 --> 00:15:48,610
Chase?

270
00:15:50,750 --> 00:15:52,820
Hannah? You still with us?

271
00:15:52,820 --> 00:15:55,140
- What's wrong with her eyes?
- Looks like REM.

272
00:15:55,140 --> 00:15:56,510
What's that?

273
00:15:56,510 --> 00:15:58,960
Rapid eye movements. It's what your eyes do when you're sleeping.

274
00:15:58,960 --> 00:16:00,400
But she's awake.

275
00:16:00,400 --> 00:16:01,260
Hannah.

276
00:16:01,260 --> 00:16:03,280
Hannah, can you hear me?

277
00:16:03,280 --> 00:16:06,680
Yeah, of course.

278
00:16:07,380 --> 00:16:09,440
Was she sitting up or lying down?

279
00:16:09,440 --> 00:16:11,570
- Sitting up.
- Then it wasn't REM.

280
00:16:11,570 --> 00:16:13,780
Chase says her eyes were moving the exact way--

281
00:16:13,780 --> 00:16:15,130
Did you start her on the steroids?

282
00:16:15,130 --> 00:16:16,540
Not yet, we were still doing the--

283
00:16:16,540 --> 00:16:17,980
- Then she wasn't sleeping.
- How do you know?

284
00:16:17,980 --> 00:16:19,780
'Cause we haven't done anything yet.

285
00:16:19,780 --> 00:16:21,830
She may be able to sleep with her eyes open

286
00:16:21,830 --> 00:16:25,320
but unless you also discovered she's got two extra teats and hooves for feet

287
00:16:25,320 --> 00:16:29,250
there's no way she'd be able to maintain enough muscle tensity during rem sleep to sit upright.

288
00:16:29,250 --> 00:16:33,040
It's a movement disorder, which rules out Wegener's.

289
00:16:33,040 --> 00:16:34,900
Where's Foreman?

290
00:16:34,900 --> 00:16:36,430
Keeping her awake.

291
00:16:36,430 --> 00:16:37,170
Good.

292
00:16:37,170 --> 00:16:41,000
Rabies could cause muscle spasms, malaise, anxiety, and wakefulness.

293
00:16:41,000 --> 00:16:43,280
Pretty unlikely she'd forget being bitten by a crazed animal.

294
00:16:43,280 --> 00:16:44,940
She could've been exposed through an open wound.

295
00:16:44,940 --> 00:16:46,080
She have a dog?

296
00:16:46,080 --> 00:16:49,130
For less than a week. She had an allergic reaction, so they had to give it away.

297
00:16:49,130 --> 00:16:49,840
Allergies.

298
00:16:49,840 --> 00:16:52,670
Animal allergies seemed unlikely but it's possible that--

299
00:16:52,670 --> 00:16:54,630
- When?
- When what?

300
00:16:55,000 --> 00:16:56,450
When did she get rid of the dog?

301
00:16:56,450 --> 00:16:59,880
About a month ago. Her girlfriend gave it to her for her birthday.

302
00:16:59,880 --> 00:17:02,390
Well, then it's not allergies.

303
00:17:02,390 --> 00:17:05,100
She's just leaving her girlfriend.

304
00:17:06,470 --> 00:17:09,660
You... spoke to the dog?

305
00:17:09,660 --> 00:17:13,840
If her birthday was a month ago, she would've still been on steroids for the poison ivy.

306
00:17:13,840 --> 00:17:16,880
Those meds would've suppressed any reaction she might've had to the dog.

307
00:17:16,880 --> 00:17:18,990
Which means she lied about being allergic.

308
00:17:18,990 --> 00:17:19,950
Dog's a commitment.

309
00:17:19,950 --> 00:17:22,970
You pretend to be allergic because you don't want to tell your girlfriend

310
00:17:22,970 --> 00:17:25,010
that you're not planning on being around that long.

311
00:17:25,010 --> 00:17:27,630
So I think we can move on to options other than allergies.

312
00:17:27,630 --> 00:17:31,050
We should still do a scratch test. If she's allergic to one thing--

313
00:17:31,050 --> 00:17:33,180
She is not allergic.

314
00:17:33,180 --> 00:17:36,490
Okay, well, we could either base our diagnosis on

315
00:17:36,490 --> 00:17:38,770
your admittedly keen understanding of lesbian relationships,

316
00:17:38,770 --> 00:17:42,010
or we could do a scratch test.

317
00:17:44,100 --> 00:17:46,400
Do a scratch test.

318
00:17:51,340 --> 00:17:53,530
You still feeling a lot of blood in your throat?

319
00:17:53,530 --> 00:17:55,470
No, it's actually getting a little better.

320
00:17:55,470 --> 00:17:58,170
Good, maybe things are just starting to improve on their own.

321
00:17:58,170 --> 00:18:00,300
Just a few more.

322
00:18:00,940 --> 00:18:02,530
You want some water to wash out your mouth?

323
00:18:02,530 --> 00:18:03,360
No, I'm okay.

324
00:18:03,360 --> 00:18:06,050
Come on, that can't taste good. I'm going to get you a soda--

325
00:18:06,050 --> 00:18:07,970
It's okay, isn't it?

326
00:18:12,620 --> 00:18:15,570
You and Max seem to have a really nice relationship.

327
00:18:16,710 --> 00:18:19,000
She's very supportive.

328
00:18:22,040 --> 00:18:27,060
When Max got you the dog, did you lie about having an allergic reaction?

329
00:18:28,480 --> 00:18:29,440
No. Why?

330
00:18:32,730 --> 00:18:35,110
If you have pre-existing conditions, it's important we know.

331
00:18:35,110 --> 00:18:38,240
But if you don't, it's just as important.

332
00:18:38,510 --> 00:18:42,910
- If I'm wasting my time...
- You're not going to tell her, are you?

333
00:18:44,130 --> 00:18:46,060
It's none of my business.

334
00:18:46,060 --> 00:18:47,850
She's a good person.

335
00:18:47,850 --> 00:18:50,820
We've just been together so long, I...

336
00:18:53,440 --> 00:18:55,940
I'm tired of her.

337
00:18:59,600 --> 00:19:02,770
Sounds terrible, doesn't it?

338
00:19:03,580 --> 00:19:06,040
I guess it happens sometimes.

339
00:19:07,140 --> 00:19:09,270
My back hurts.

340
00:19:15,170 --> 00:19:16,920
Hannah, can you turn over?

341
00:19:16,920 --> 00:19:18,290
What's wrong?

342
00:19:18,290 --> 00:19:20,490
I'm not sure.

343
00:19:25,240 --> 00:19:27,180
Oh, my God.

344
00:19:29,040 --> 00:19:30,950
She has massive internal bleeding.

345
00:19:30,950 --> 00:19:32,350
Did she have access to aspirin?

346
00:19:32,350 --> 00:19:33,750
She'd have to take a hell of a lot.

347
00:19:33,750 --> 00:19:36,440
Why not, considering her current mental state.

348
00:19:36,440 --> 00:19:38,960
What about her mental state?

349
00:19:39,270 --> 00:19:41,940
You were right about her wanting to break up.

350
00:19:41,940 --> 00:19:44,510
That just means I was right, doesn't mean she's suicidal.

351
00:19:44,510 --> 00:19:46,940
Bottle of pills is what landed her here in the first place.

352
00:19:46,940 --> 00:19:48,310
Sleeping pills.

353
00:19:48,310 --> 00:19:50,870
God knows why she'd want them.

354
00:19:50,870 --> 00:19:54,760
What else can cause sleep disorder and internal bleeding?

355
00:19:54,760 --> 00:19:57,460
Drugs or alcohol can mess with the sleeping and compromise the liver.

356
00:19:57,460 --> 00:20:00,620
What are you doing here? Who's keeping her awake?

357
00:20:00,620 --> 00:20:01,800
Doesn't matter.

358
00:20:01,800 --> 00:20:04,120
Liver function tests are through the sky.

359
00:20:04,120 --> 00:20:06,730
Liver's not compromised, it's dead.

360
00:20:07,110 --> 00:20:10,420
She doesn't need a diagnosis, she needs a new liver.

361
00:20:10,740 --> 00:20:14,430
She's not getting a new liver unless we can figure out what's wrong with her.

362
00:20:14,430 --> 00:20:18,360
Test for cirrhosis: 12 hours. Test for hepatitis: 8. Her liver's not gonna last another six.

363
00:20:18,360 --> 00:20:20,570
So your advice is we just give up.

364
00:20:20,790 --> 00:20:23,340
My advice is that we narrow our focus to conditions that

365
00:20:23,340 --> 00:20:26,930
we can diagnose, treat, and cure in less than six hours.

366
00:20:27,360 --> 00:20:29,860
And there's nothing on that list.

367
00:20:31,320 --> 00:20:34,240
The girlfriend donated blood, right?

368
00:20:34,240 --> 00:20:35,920
Yeah, so?

369
00:20:35,920 --> 00:20:38,640
It means that they're the same type.

370
00:20:39,170 --> 00:20:43,010
You can't ask the person she's about to dump to donate half her liver.

371
00:20:43,010 --> 00:20:45,680
It does seem tacky, doesn't it?

372
00:20:54,020 --> 00:20:59,080
I'm Dr. House. I'm in charge of your case.

373
00:20:59,360 --> 00:21:00,860
What's going on?

374
00:21:00,860 --> 00:21:03,330
How come no one is keeping her awake anymore?

375
00:21:03,330 --> 00:21:06,480
You're in acute liver failure.

376
00:21:06,790 --> 00:21:10,620
We can continue the transfusions and the lactulose,

377
00:21:10,620 --> 00:21:12,600
but it's only a stopgap.

378
00:21:13,160 --> 00:21:18,110
There's really nothing we can do to stop the toxins from building up in your bloodstream.

379
00:21:18,110 --> 00:21:21,100
Which means that in a few hours

380
00:21:21,490 --> 00:21:24,040
you will lapse into a coma...

381
00:21:25,140 --> 00:21:27,790
and you won't wake up.

382
00:21:32,500 --> 00:21:34,460
I'm sorry.

383
00:21:36,320 --> 00:21:39,060
That's it? You're giving up?

384
00:21:39,060 --> 00:21:42,140
You're not going to try to figure out what's doing this to her?

385
00:21:42,370 --> 00:21:46,520
Even with the right diagnosis, any treatment's gonna take longer than the time she has left.

386
00:21:46,520 --> 00:21:49,290
If it's her liver, can't she get a transplant?

387
00:21:49,290 --> 00:21:51,950
Wouldn't work without a diagnosis.

388
00:21:51,950 --> 00:21:55,260
Whatever killed the first liver would do the same to the second.

389
00:21:55,260 --> 00:22:01,610
But it would give you more time to make the diagnosis, to get her better.

390
00:22:02,960 --> 00:22:06,100
Well, it might give us an extra day or two, but...

391
00:22:06,340 --> 00:22:10,660
no procurement agency is going to let a liver go to a patient with an undiagnosed, pre-existing--

392
00:22:10,660 --> 00:22:13,830
Hannah and I have the same blood type.

393
00:22:13,830 --> 00:22:16,800
Couldn't I be the donor?

394
00:22:23,300 --> 00:22:27,420
It is medically possible for us to take a part of your--

395
00:22:27,420 --> 00:22:30,740
Please, I don't care about the risks.

396
00:22:40,000 --> 00:22:43,480
You're very lucky to have such a devoted partner.

397
00:22:57,560 --> 00:23:01,470
I just bought us 36 hours. Differential diagnosis:

398
00:23:01,470 --> 00:23:05,880
Which monster eats your liver, screws up your sleep, and causes bleeding.

399
00:23:05,880 --> 00:23:07,450
Does Max know Hannah plans to leave her?

400
00:23:07,450 --> 00:23:09,430
Didn't come up. So I guess... no.

401
00:23:09,430 --> 00:23:11,520
If she knew, there's no way she'd go through with this.

402
00:23:11,520 --> 00:23:15,170
And if you didn't have pathological need to create a close personal relationship

403
00:23:15,170 --> 00:23:18,300
with every dying person you meet, we would be blissfully ignorant of

404
00:23:18,300 --> 00:23:21,230
any ethical dilemmas and might be able to actually concentrate on the differential.

405
00:23:21,230 --> 00:23:22,550
Scratch test was negative.

406
00:23:22,550 --> 00:23:26,780
It's rare, but any of the hepatitis viruses could cause sleep disturbances and liver failure.

407
00:23:26,780 --> 00:23:29,450
- No, PCRS were normal.
- We have an ethical dilemma.

408
00:23:29,450 --> 00:23:30,630
No, we don't.

409
00:23:30,630 --> 00:23:32,190
Continue.

410
00:23:32,190 --> 00:23:36,580
What about splenic cancer or Non-Hodgkin's lymphoma? She's the right age.

411
00:23:36,580 --> 00:23:38,220
Could explain the bleeding.

412
00:23:38,220 --> 00:23:39,550
Maybe the liver failure.

413
00:23:39,550 --> 00:23:42,780
We're withholding information relevant to her decision to risk her life.

414
00:23:42,780 --> 00:23:45,040
How is that not an ethical dilemma?

415
00:23:45,040 --> 00:23:46,790
It's not medical information.

416
00:23:46,790 --> 00:23:48,580
- Who cares?
- The ama.

417
00:23:48,580 --> 00:23:52,010
Wilson's disease could explain the liver and neurological symptoms.

418
00:23:52,010 --> 00:23:53,650
It also causes bleeding disorders.

419
00:23:53,650 --> 00:23:55,560
No Kayser-Fleischer rings in her eyes.

420
00:23:55,560 --> 00:23:57,800
Rings don't have to be there if there's neurological symptoms.

421
00:23:57,800 --> 00:23:58,970
This is immoral.

422
00:23:58,970 --> 00:24:00,410
Look, let's say you're right.

423
00:24:00,410 --> 00:24:04,600
We tell, she changes her mind, our patient dies. How is that moral?

424
00:24:05,300 --> 00:24:06,360
What else?

425
00:24:06,360 --> 00:24:10,810
Poison mushrooms can cause liver failure, sleep disturbances, and internal bleeding.

426
00:24:10,810 --> 00:24:13,170
She's not 'shrooming; she's a sport's nut.

427
00:24:13,170 --> 00:24:15,130
Right. Skiers never party.

428
00:24:15,130 --> 00:24:17,610
She's doing this out of love, and Max doesn't know--

429
00:24:17,610 --> 00:24:20,440
It's only moral to save a person if they love you?

430
00:24:20,440 --> 00:24:23,250
It's kind of a selfish way of looking at life.

431
00:24:23,250 --> 00:24:26,860
I like Wilson's disease, like cancer, love mushrooms.

432
00:24:26,860 --> 00:24:28,830
Yeah, but we don't have the time to test for any of it.

433
00:24:28,830 --> 00:24:32,410
Before she can get the transplant, we need to do about 80 procedures.

434
00:24:32,410 --> 00:24:34,830
So do those tests and my tests at the same time.

435
00:24:34,830 --> 00:24:38,710
Use the PET to look for cancer and Wilson's while you endoscope her bile ducts,

436
00:24:38,710 --> 00:24:41,680
scrape her stomach for mushroom spores. One of you CT her liver,

437
00:24:41,680 --> 00:24:46,160
while the other two check proteins CA-125 and CA-19. 5.

438
00:24:46,160 --> 00:24:51,300
Oh yeah, anyone says anything to Max, they're fired.

439
00:24:51,690 --> 00:24:52,890
We have to.

440
00:24:52,890 --> 00:24:54,860
We have to not.

441
00:24:54,860 --> 00:24:56,270
Because she's not our patient.

442
00:24:56,270 --> 00:24:59,800
She's getting surgery, she's someone's patient.

443
00:25:01,930 --> 00:25:04,400
Calvin and Sam. Great, thank you.

444
00:25:04,400 --> 00:25:06,230
Need a little help.

445
00:25:06,230 --> 00:25:09,890
Inexplicable rash on a patient's scrotum you need me to look at?

446
00:25:09,890 --> 00:25:14,230
27-year-old female wants to donate half her liver to her dying girlfriend.

447
00:25:14,230 --> 00:25:15,430
That's very generous.

448
00:25:15,430 --> 00:25:18,210
This is sleepless girl? What's she got?

449
00:25:18,210 --> 00:25:19,630
Liver failure.

450
00:25:19,630 --> 00:25:23,060
Sort of figured that out when you said she needed a new liver.

451
00:25:25,360 --> 00:25:27,230
You don't have a diagnosis.

452
00:25:27,230 --> 00:25:29,250
Transplant buys me time.

453
00:25:29,250 --> 00:25:31,970
Let's just skip the part where I say this is insane.

454
00:25:31,970 --> 00:25:35,570
- It was her idea.
- If she wants to be an idiot, it's her call. You don't need me.

455
00:25:35,570 --> 00:25:38,180
Just have one of your team walk her through the process.

456
00:25:38,180 --> 00:25:41,530
The donor and the donee sort of have opposing interests, right?

457
00:25:41,530 --> 00:25:43,070
You can't really advise them both.

458
00:25:43,070 --> 00:25:46,310
You're concerned about the ethics of this?

459
00:25:46,580 --> 00:25:48,860
What's going on? What do you know?

460
00:25:48,860 --> 00:25:50,620
Nothing medically relevant.

461
00:25:50,620 --> 00:25:53,670
But you know something, and it is relevant.

462
00:25:54,000 --> 00:25:58,980
If I can't tell her, I can't really tell you, can I? Not if you're advising her.

463
00:25:58,980 --> 00:26:02,030
I assume this information is in the medical file.

464
00:26:02,030 --> 00:26:03,920
My patient's confidential file.

465
00:26:03,920 --> 00:26:06,240
This hospital's file.

466
00:26:08,150 --> 00:26:12,060
You can either satisfy your curiosity, or you can remain ignorant,

467
00:26:12,060 --> 00:26:17,200
do nothing ethically wrong, and my patient doesn't die in three hours.

468
00:26:23,290 --> 00:26:29,020
These tests and the counseling normally happen over weeks.

469
00:26:29,020 --> 00:26:31,080
Sometimes months.

470
00:26:31,080 --> 00:26:32,900
It's okay.

471
00:26:33,320 --> 00:26:36,590
The most important part we're skipping is time--

472
00:26:36,590 --> 00:26:38,910
time for you to change your mind.

473
00:26:38,910 --> 00:26:41,110
I don't want to change my mind.

474
00:26:41,110 --> 00:26:47,080
Not now, but with time and perspective, maybe we learn things--

475
00:26:47,080 --> 00:26:49,220
If we had the time, we'd take the time, but we don't.

476
00:26:49,220 --> 00:26:51,770
So can you get this over with?

477
00:26:53,540 --> 00:26:58,100
Either I sign off on this, or it doesn't happen.

478
00:26:58,100 --> 00:27:00,520
So I need you to listen to me.

479
00:27:00,520 --> 00:27:05,120
Because there's a chance that you will die on that table.

480
00:27:12,190 --> 00:27:16,000
I just want me and Hannah to be able to lie in bed together,

481
00:27:16,680 --> 00:27:21,730
as old ladies. Compare scars.

482
00:27:30,000 --> 00:27:33,580
I need you to lie on your side, and hold your knees.

483
00:27:37,660 --> 00:27:42,300
I'm gonna check for vascular abnormalities that might prevent us from doing the transplant.

484
00:27:42,300 --> 00:27:46,700
At the same time I'm also checking for mushroom spores to see if that's the underlying--

485
00:27:46,700 --> 00:27:47,650
I don't do mushrooms.

486
00:27:47,650 --> 00:27:50,900
You lie about your love life, maybe you lie about drugs. Open.

487
00:27:54,320 --> 00:27:57,110
Aren't you at all concerned about what Max is going through right now?

488
00:27:57,110 --> 00:27:59,040
They're shoving a tube up her rectum.

489
00:27:59,040 --> 00:28:01,380
They're gonna swab her stomach, just like I'm doing.

490
00:28:01,380 --> 00:28:03,710
It's going to hurt, just like this hurts.

491
00:28:03,710 --> 00:28:09,200
Which is nothing at all like the risk she's taking on the table.

492
00:28:11,320 --> 00:28:13,830
You really don't love her, do you?

493
00:28:13,830 --> 00:28:16,120
I'm not leaving her because I don't--

494
00:28:16,120 --> 00:28:18,550
I'm not talking about the leaving. I'm talking about this.

495
00:28:18,550 --> 00:28:22,360
If you care for her at all, you won't let her do this blind.

496
00:28:26,130 --> 00:28:28,550
You'd really tell.

497
00:28:30,810 --> 00:28:33,090
You'd die.

498
00:28:41,610 --> 00:28:43,660
Take it you've seen that.

499
00:28:46,230 --> 00:28:50,980
Seen it, digested it, watched it blow up my entire department.

500
00:28:50,980 --> 00:28:52,760
You read Cameron's version?

501
00:28:52,760 --> 00:28:53,860
Didn't read either.

502
00:28:53,860 --> 00:28:55,310
It was good.

503
00:28:55,310 --> 00:28:56,910
Better than Foreman's?

504
00:28:56,910 --> 00:29:01,600
Maybe. He was more analytical about the diagnostic procedures.

505
00:29:01,940 --> 00:29:05,530
She concentrated more on the ethical dilemmas of informed consent.

506
00:29:05,530 --> 00:29:08,270
How any patient can really be informed without a medical degree.

507
00:29:08,270 --> 00:29:10,410
Same old party lines.

508
00:29:10,760 --> 00:29:12,280
Foreman should've told her.

509
00:29:12,280 --> 00:29:14,230
Oh, shoulda woulda coulda.

510
00:29:14,230 --> 00:29:18,470
If you allow this sort of thing in your department, you're basically saying it's okay.

511
00:29:18,470 --> 00:29:20,970
No, I'm saying that I don't care what they do

512
00:29:20,970 --> 00:29:24,560
as long as my life isn't interrupted by pointless conversations like this one.

513
00:29:24,560 --> 00:29:27,040
They won't trust each other, and they won't trust you.

514
00:29:27,040 --> 00:29:28,690
They shouldn't.

515
00:29:28,920 --> 00:29:34,700
Deception like this is just one step removed from actively sabotaging one another.

516
00:29:34,700 --> 00:29:36,360
Then what would you do?

517
00:29:36,360 --> 00:29:39,590
I could be the kindest, gentlest boss in the world

518
00:29:39,590 --> 00:29:42,670
and Foreman would've still done what he did because that's who he is.

519
00:29:42,670 --> 00:29:45,870
We can only hope that Cameron has learned something.

520
00:29:46,670 --> 00:29:50,050
Right, because you're all about the teaching.

521
00:29:50,050 --> 00:29:53,500
Our children are the future.

522
00:30:00,260 --> 00:30:03,140
Cuddy cleared Max for surgery. She's okay to go.

523
00:30:03,140 --> 00:30:04,290
How's our patient?

524
00:30:04,290 --> 00:30:05,380
She's also cleared.

525
00:30:05,380 --> 00:30:08,580
I don't care about the prep. I care about the diagnostic tests.

526
00:30:08,580 --> 00:30:11,160
Well, it looks negative for Wilson's disease, we'll know for sure in an hour.

527
00:30:11,160 --> 00:30:13,350
- Blood proteins are normal, it's not...
- Where's Cameron?

528
00:30:13,350 --> 00:30:15,650
Taking a sample of the bile duct.

529
00:30:16,300 --> 00:30:18,840
Surgeries are supposed to start in about 15 minutes.

530
00:30:18,840 --> 00:30:20,460
She had a chance to get one last--

531
00:30:20,460 --> 00:30:21,960
Hannah and Max will be in the same room.

532
00:30:21,960 --> 00:30:24,020
You wanted us to do as much as we can before--

533
00:30:24,020 --> 00:30:27,500
They're both awake. With Cameron.

534
00:30:31,500 --> 00:30:34,770
Maybe we should give these two a minute together before the surgery.

535
00:30:35,700 --> 00:30:37,410
You ready, honey?

536
00:30:39,650 --> 00:30:42,420
- Max.
- It's okay.

537
00:30:42,420 --> 00:30:44,170
I'm right here.

538
00:30:44,170 --> 00:30:46,430
I need you to know something.

539
00:30:46,430 --> 00:30:49,900
I know. I love you, too.

540
00:30:51,050 --> 00:30:52,990
I don't know how to say this.

541
00:30:52,990 --> 00:30:53,830
Good lord.

542
00:30:53,830 --> 00:30:55,420
You can tell me anything.

543
00:30:55,420 --> 00:30:57,290
She hasn't slept in eleven days,

544
00:30:57,290 --> 00:30:59,760
you people trying to torture her?

545
00:31:04,030 --> 00:31:06,810
Ding, ding, let's go.

546
00:31:11,050 --> 00:31:13,750
- I told you not...
- I didn't say a word to Max.

547
00:31:13,750 --> 00:31:16,330
This is exactly why you got screwed with Foreman.

548
00:31:16,330 --> 00:31:18,490
You're looking for people to do the right thing.

549
00:31:18,490 --> 00:31:22,400
She hasn't slept, her judgment's compromised due to inactivity in her prefrontal cortex.

550
00:31:22,400 --> 00:31:26,420
Oh, she could have the best prefrontal cortex in the history of mankind.

551
00:31:26,420 --> 00:31:31,420
But given the choice of life versus death, those bad, bad people are going to choose life.

552
00:31:31,420 --> 00:31:33,580
Then why'd you sedate her?

553
00:31:33,580 --> 00:31:38,240
If she wasn't gonna tell, if she was never gonna do the right thing, why bother knocking her out?

554
00:31:38,540 --> 00:31:42,440
This isn't about them. If she talks, if she does the decent thing,

555
00:31:42,440 --> 00:31:45,550
then you don't get to solve your puzzle, your game's over, you lose.

556
00:31:45,550 --> 00:31:49,830
Yeah, I want to save her; I'm morally bankrupt.

557
00:32:11,070 --> 00:32:12,080
How's it going?

558
00:32:12,080 --> 00:32:14,740
They're about to remove Hannah's liver.

559
00:32:18,370 --> 00:32:21,370
All right, I'm good to go.

560
00:32:21,370 --> 00:32:24,370
You can start removing Max's liver.

561
00:32:25,350 --> 00:32:28,540
You want to let me in on what the big secret is between these two?

562
00:32:28,540 --> 00:32:31,130
You read Foreman's article?

563
00:32:32,270 --> 00:32:34,790
It was good.

564
00:32:35,330 --> 00:32:38,310
He basically stole it from me.

565
00:32:39,240 --> 00:32:40,590
So?

566
00:32:40,590 --> 00:32:42,300
You're on his side?

567
00:32:42,300 --> 00:32:45,600
Sides? No, this isn't dodgeball.

568
00:32:45,990 --> 00:32:48,910
What am I supposed to do? Just sit back and take it?

569
00:32:48,910 --> 00:32:51,110
No, write another article.

570
00:32:51,110 --> 00:32:53,930
Kick ass, until you're sitting behind some big expensive desk,

571
00:32:53,930 --> 00:32:56,290
and someone from Johns Hopkins calls and says,

572
00:32:56,290 --> 00:33:00,500
"we're thinking about hiring Eric Foreman as our head of neurology,"

573
00:33:00,760 --> 00:33:03,040
and you can say whatever you want.

574
00:33:03,040 --> 00:33:07,150
Lovely. Revenge as motive for success.

575
00:33:07,150 --> 00:33:09,500
Well, it doesn't have to be the motive.

576
00:33:09,500 --> 00:33:12,040
But it sure tastes good.

577
00:33:12,620 --> 00:33:14,490
She's in vf. I've got no pulse!

578
00:33:14,490 --> 00:33:15,750
She's arresting.

579
00:33:16,710 --> 00:33:18,160
Paddles.

580
00:33:18,160 --> 00:33:21,470
I am so relieved you two are here.

581
00:33:21,470 --> 00:33:24,230
Without you looking out, they'd be playing foosball down there.

582
00:33:24,230 --> 00:33:25,270
Max's heart stopped.

583
00:33:25,270 --> 00:33:27,170
Your patient is on the other side.

584
00:33:27,170 --> 00:33:33,000
Get yourself upstairs and figure out what Hannah has, or Max has risked her life for nothing.

585
00:33:35,320 --> 00:33:39,120
Charging. Clear.

586
00:33:44,340 --> 00:33:45,740
We're okay.

587
00:33:50,510 --> 00:33:55,370
Max's cardiac arrest was caused by hypoxia from hypoventilation.

588
00:33:55,370 --> 00:33:56,910
They restarted her heart

589
00:33:56,910 --> 00:34:00,460
and the right lobe of her liver was successfully transplanted into Hannah.

590
00:34:00,460 --> 00:34:05,670
Now, where were we before we were so rudely interrupted by the liver transplant?

591
00:34:05,670 --> 00:34:07,900
Dopa decarboxylase was processed normally

592
00:34:07,900 --> 00:34:11,490
and the cerolo-plasma and copper levels were normal. So no Wilson's disease.

593
00:34:11,490 --> 00:34:14,600
Gastric content was negative for spores, so no mushroom toxicity.

594
00:34:14,600 --> 00:34:16,700
And the initial tests were negative for cancer.

595
00:34:16,700 --> 00:34:18,190
Which cancer were you looking for?

596
00:34:18,190 --> 00:34:18,720
Any of them.

597
00:34:18,720 --> 00:34:21,690
We ran blood tests for ovarian, lung, and lymphomas.

598
00:34:21,690 --> 00:34:22,440
It's not gonna tell you much.

599
00:34:22,440 --> 00:34:24,960
Her blood was taken after she was given immunosuppressants.

600
00:34:24,960 --> 00:34:26,590
They fight rejection.

601
00:34:26,590 --> 00:34:30,190
They also mess up our ability to get any clear readings.

602
00:34:30,870 --> 00:34:34,480
Great battles kick up a lot of dirt.

603
00:34:34,970 --> 00:34:39,630
Obscure the battlefield so generals can't see what's going on.

604
00:34:39,630 --> 00:34:43,500
So what are your orders, general House?

605
00:34:44,450 --> 00:34:47,250
Sound the retreat.

606
00:34:49,010 --> 00:34:50,680
How ya feeling?

607
00:34:50,990 --> 00:34:52,820
Is Max okay?

608
00:34:52,820 --> 00:34:55,440
She's still unconscious, but her vitals look good.

609
00:34:55,440 --> 00:35:02,180
We need to stop all the immunosuppressant drugs which are protecting your new liver.

610
00:35:03,600 --> 00:35:06,140
But if you stop the drugs, I'll die.

611
00:35:06,140 --> 00:35:10,680
You're dead anyway if we don't figure out what caused all this.

612
00:35:11,440 --> 00:35:13,870
By removing any outside influences,

613
00:35:13,870 --> 00:35:16,430
it'll help us see what's really going on with your body.

614
00:35:16,430 --> 00:35:21,090
So you did all this to buy me a couple of days, and now you're taking 'em back?

615
00:35:25,040 --> 00:35:26,860
Will it hurt?

616
00:35:27,320 --> 00:35:31,880
As your body goes into acute organ rejection, your liver will begin to swell,

617
00:35:31,880 --> 00:35:33,930
it'll put pressure on--

618
00:35:35,840 --> 00:35:39,540
It'll hurt. We can knock you out.

619
00:35:40,170 --> 00:35:45,050
Mm, no. If Max wakes up, I want to talk to her.

620
00:35:51,860 --> 00:35:56,840
She's been taking the decongestants, but she' not getting better. She also says...

621
00:35:56,840 --> 00:35:58,460
What?

622
00:35:58,850 --> 00:36:01,350
Her boobs are bigger.

623
00:36:08,940 --> 00:36:11,390
How could you get them mixed up?

624
00:36:11,390 --> 00:36:14,700
They come in a little wheel, they don't look anything like decongestants.

625
00:36:14,700 --> 00:36:18,990
Oh, god! The cashier put them both in the same bag. I thought I gave her the right ones.

626
00:36:26,450 --> 00:36:29,490
No, you gave her the wrong pills.

627
00:36:29,490 --> 00:36:32,170
You speak Mandarin?

628
00:36:32,170 --> 00:36:39,440
I can count to ten, ask to go to the bathroom, and...

629
00:36:39,970 --> 00:36:44,270
I'm not pregnant! We--we haven't even done it yet.

630
00:36:48,110 --> 00:36:50,130
Okay, I'm going to leave you two alone now.

631
00:36:50,130 --> 00:36:52,560
I'm sure you got a lot to talk about.

632
00:36:58,550 --> 00:37:01,290
Fever's 106, she's in full rejection mode.

633
00:37:01,290 --> 00:37:03,470
Is that supposed to surprise me?

634
00:37:03,470 --> 00:37:05,720
Her white count is normal.

635
00:37:05,720 --> 00:37:08,500
Normal is not normal.

636
00:37:08,500 --> 00:37:12,720
She's been on steroids, transplant team gave her a cocktail of immunosuppressants,

637
00:37:12,720 --> 00:37:14,750
she hasn't slept in over a week.

638
00:37:14,750 --> 00:37:16,160
Her white count should be in the tank.

639
00:37:16,160 --> 00:37:18,180
Looks like the problem is some sort of infection.

640
00:37:18,180 --> 00:37:20,380
Probably caused a hypotension, shocked the liver.

641
00:37:20,380 --> 00:37:22,740
We should start broad spectrum antibiotics.

642
00:37:22,740 --> 00:37:25,250
Yeah, you might want to add some chicken soup.

643
00:37:25,250 --> 00:37:28,260
It'd be just as useless, but it's got chicken.

644
00:37:28,260 --> 00:37:30,950
We need to know exactly what kind of infection we're dealing with.

645
00:37:30,950 --> 00:37:33,210
What infection causes sleep disturbance, bleeding,

646
00:37:33,210 --> 00:37:36,790
movement disorder, organ failure, and an abnormally normal white count.

647
00:37:36,790 --> 00:37:38,780
- What about tularemia?
- Chest was clear.

648
00:37:38,780 --> 00:37:40,680
Tularemia doesn't cause movement disorders.

649
00:37:40,680 --> 00:37:41,810
It would if she developed meningitis.

650
00:37:41,810 --> 00:37:44,140
There was no ulcerations on the skin.

651
00:37:44,140 --> 00:37:47,000
With the bleeding, it looks more like leptospirosis.

652
00:37:47,000 --> 00:37:49,270
Without conjunctivitis and elevated creinine?

653
00:37:49,270 --> 00:37:51,930
What about typhoid or some kind of relapsing fever?

654
00:37:51,930 --> 00:37:53,680
Makes sense, if we were in the Sudan.

655
00:37:53,680 --> 00:37:55,250
We sure she hasn't been out of the country?

656
00:37:55,250 --> 00:37:58,100
She hasn't even been out of the state in at least a year. Neither has Max.

657
00:37:58,100 --> 00:37:59,690
Maybe she lied.

658
00:38:00,070 --> 00:38:01,860
You talk to her friends, neighbors?

659
00:38:01,860 --> 00:38:03,260
You don't know?

660
00:38:03,260 --> 00:38:05,090
Come on, if you don't stay up to date on my notes,

661
00:38:05,090 --> 00:38:07,570
where's your next article going to come from?

662
00:38:07,840 --> 00:38:09,270
You talk to the dog?

663
00:38:09,270 --> 00:38:12,430
We're not as up on foreign languages as you are.

664
00:38:12,430 --> 00:38:14,590
Has the dog been traveling?

665
00:38:14,590 --> 00:38:16,240
It came from a breeder.

666
00:38:16,240 --> 00:38:17,400
Where?

667
00:38:17,630 --> 00:38:19,400
I don't know.

668
00:38:20,430 --> 00:38:24,040
A place called Blue Barrel Kennels. They only had the thing for like two days.

669
00:38:24,040 --> 00:38:26,940
Blue barrel is a kind of cactus.

670
00:38:27,170 --> 00:38:30,130
You see many cacti in Jersey?

671
00:38:37,740 --> 00:38:40,420
Want to see a magic trick?

672
00:38:45,520 --> 00:38:48,630
Oh, no! Where'd it go? Where'd it go?

673
00:38:48,630 --> 00:38:50,730
Is it here?

674
00:38:51,460 --> 00:38:52,210
No.

675
00:38:53,370 --> 00:38:54,930
What about here?

676
00:38:55,770 --> 00:38:58,350
There it is.

677
00:38:58,920 --> 00:39:02,790
That doesn't look anything like a nose.

678
00:39:02,790 --> 00:39:05,380
That wasn't there this morning.

679
00:39:19,450 --> 00:39:22,680
Get that to the lab and call cdc.

680
00:39:22,680 --> 00:39:24,050
And tell them what?

681
00:39:24,050 --> 00:39:27,400
That we have a patient with the plague.

682
00:39:27,970 --> 00:39:30,960
The black plague?

683
00:39:31,280 --> 00:39:32,440
Looks that way.

684
00:39:32,440 --> 00:39:34,370
Plague is carried by rodents, not dogs.

685
00:39:34,370 --> 00:39:36,700
Where there's dogs, there's fleas.

686
00:39:36,940 --> 00:39:40,100
And if they hail from the southwest, and those fleas can't tell the difference

687
00:39:40,100 --> 00:39:42,400
between prairie dogs and puppy dogs...

688
00:39:42,400 --> 00:39:47,470
a small percentage of plague cases present with sleep disturbance.

689
00:39:48,270 --> 00:39:52,680
Imagine an idyllic river of bacteria.

690
00:39:53,220 --> 00:39:55,500
Okay, it's not idyllic for her, but it serves my purposes.

691
00:39:55,500 --> 00:40:00,830
The steroids and immunosuppressants acted like a big, honkin' dam across the river. Physics 101.

692
00:40:00,830 --> 00:40:03,280
Put a dam up in front of a raging river, the river rises.

693
00:40:03,280 --> 00:40:06,660
By stopping the immunosuppressants, we blew up the dam

694
00:40:06,660 --> 00:40:10,090
and a 100-foot wall of bacteria flooded her lymph nodes.

695
00:40:10,090 --> 00:40:11,820
We better find out where that dog is now.

696
00:40:11,820 --> 00:40:14,340
After we start the immunosuppressants

697
00:40:14,340 --> 00:40:18,640
and fill her up to the eyeballs with streptomycin sulfate, gentamicin and tetracycline.

698
00:40:18,640 --> 00:40:20,520
Use a garden hose if you've got one.

699
00:40:20,520 --> 00:40:23,830
Get yourselves some prophylactic treatments as well.

700
00:40:25,180 --> 00:40:27,360
I've got the plague?

701
00:40:28,090 --> 00:40:30,220
Don't worry, it's treatable.

702
00:40:30,220 --> 00:40:32,780
Being a bitch, though,

703
00:40:32,780 --> 00:40:35,750
nothing we can do about that.

704
00:40:42,260 --> 00:40:44,350
You weren't in your room.

705
00:40:44,350 --> 00:40:47,480
The surgeon said I'd heal faster if I walk.

706
00:40:47,480 --> 00:40:50,580
Got this far, needed a rest.

707
00:40:50,580 --> 00:40:53,750
What you did was crazy, but it was pretty amazing too.

708
00:40:53,750 --> 00:40:57,300
Yeah, I'm a hero.

709
00:40:59,500 --> 00:41:03,120
She's been planning to leave me.

710
00:41:04,870 --> 00:41:06,160
Really?

711
00:41:06,160 --> 00:41:10,500
She told a friend; the friend let it slip.

712
00:41:12,470 --> 00:41:16,920
You knew and you gave up half your liver anyway?

713
00:41:18,850 --> 00:41:21,070
She can't leave me now.

714
00:41:25,330 --> 00:41:29,340
You really want her to stay out of guilt? That's not gonna make either of you happy.

715
00:41:29,340 --> 00:41:31,620
You don't know that.

716
00:41:31,620 --> 00:41:33,560
I love her.

717
00:41:35,520 --> 00:41:38,400
I just want her to stay.

718
00:41:54,940 --> 00:41:57,780
I don't own House's cases.

719
00:41:58,620 --> 00:42:01,730
You had just as much right as I did to write it up.

720
00:42:01,730 --> 00:42:03,410
You shoulda told me, but

721
00:42:03,700 --> 00:42:06,520
I shoulda handled it better too.

722
00:42:08,880 --> 00:42:14,500
If we want this not to get in the way of our friendship, I think we both have to apologize,

723
00:42:14,500 --> 00:42:17,970
and put it behind us.

724
00:42:19,720 --> 00:42:21,790
I like you, really.

725
00:42:21,790 --> 00:42:24,580
We have a good time working together.

726
00:42:24,580 --> 00:42:29,910
But ten years from now, we're not gonna be hanging out, having dinners.

727
00:42:29,910 --> 00:42:35,610
Maybe we'll exchange Christmas cards, say hi, give a hug if we're at the same conference.

728
00:42:37,390 --> 00:42:41,560
We're not friends. We're colleagues.

729
00:42:43,240 --> 00:42:48,060
And I don't have anything to apologize for.

730
00:50:43,240 --> 00:50:44,340
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