Original Airdate on FOX: November 23, 2004
Written by Lawrence Kaplow
Directed by Peter O'Fallon
Transcript written by Taru
Crowd: [Cheering and Shouting]
Player 1: On your right, on your right.
Player 2: Back, back, back.
Dan’s Dad: Yeah, Dan!
Crowd: [Continues cheering and shouting]
Player 3: Back, back, back, back
Player 4: Watch the winger!
Crowd: [More cheering and whistling]
[Zoom in on one player, wearing #29 jersey. Sound becomes muffled, and scene becomes blurred and wavy]
[Cut to inside his head where a neuron fires and then cut back to the field. Player #29 (Dan) gets hit hard by another player]
Dan: [grunts with the impact]
Coach: [muffled] You ok? Dan, Dan, talk to me. Dan, Dan, get a doctor!
[Cut to credits which are sooo cool!]
(commercial, blah, I know that we couldn’t have TV without them but…yuck!)
Wilson: Hey!
House: Close the door. Close the door!
Wilson: Is Cuddy down the hall counting to 50?
House: She’s knows I’m in here, the clinic, as she commanded; she just doesn’t know I’m alone.
Wilson: Well, you’ve got a full waiting room, how long do you think you can ignore them?
House: I’m off at 4:00.
Wilson: You’re doing this to avoid 5 minutes of work?
House: I go out there, I get assigned a kid with a runny nose. That’s 30 seconds looking at the nose; 25 minutes talking to a worried mom who won’t leave until she sure it’s not meningitis or a tumor.
Wilson: Yes, concerned parents can be so annoying. Just tell Cuddy you’ve got an urgent case, you had to leave early.
House: That would be lying.
Wilson: And that would be wrong. But luckily, the definition of urgent is fungible.
[He goes to leave]
House: Not the definition of case though.
[Wilson stops and looks back at House in shock]
Wilson: You have no cases. You have NO cases. You’ve got hand picked doctors, specialists, working for you, and they’re sitting on their hands?
House: Cameron is answering my mail.
Wilson: Time well spent I’m sure. Foreman and Chase?
House: Research?
[Cut to the DM offices and you can see Cameron on a computer typing, Foreman is tapping his fingers and Chase has a book of crossword puzzles open.]
Chase: 9 letters, iodine deficiency in children.
Foreman: Cretinism.
Chase: Huh [Fills in the space]
[Cut back to House at the clinic. He leaves the exam room]
House: So, 4:03 PM. Dr. House checks out. Please write that down.
Dan’s Dad: Dr. House. (from now on he’ll just be called Dad)
House: Sorry, done for the day. There’s plenty of docs here to take care of you.
Dad: But we had an appointment.
House: Hah, nice try, but this is a walk in clinic, which means there are no appointments. It means you walk in, sign the chart and a doctor will see you, just not me.
Dad: But your letter says that we would see you.
House: Not a big letter writer.
Dad: Here.
[Cut onto the letter, now in House’s office.}
House: When did my signature get so girly?
Cameron: I can explain.
House: See that “G”, see how it makes a big loop on top? It doesn’t even look like my handwriting. Think I have something? What’s the differential diagnosis for writing “G’s” like a junior high school girl?
Cameron: It’s impossible to get to you through normal channels, they have called…[interrupted]
House: Perseverance does not equal worthiness. Next time you want to get my attention wear something fun. Low-rider jeans are hot.
Cameron: 16 year old male, sudden onset of double vision and night terrors, with no apparent cause. The kid’s been to 2 neurologists…[interrupted]
House: Night terrors, yeah? As in big scary monsters?
Cameron: Yeah.
[House gets up and grabs his cane]
Cameron: Where are you going?
House: To see the family.
Cameron: You’re going to examine a patient?
House: 9 times out of 10 there’s no reason to talk to a patient, but night terrors in a 16 year old is a VERY good reason to talk to this family. Good work.
[He exits. Cut to an exam room with Dr. House examining the patient (Dan)]
House: Margins look fine. No lesions, color is good. How long have you been having night terrors?
Dan: Three weeks.
Dad: He’s afraid to go to bed, he’s exhausted, he can barely function.
[House flicks at both of Dan’s eyes]
Mom: What does that tell you?
House: Nothing, it’s just fun watching him blink. [To Dan] Name as many animals that begin with the letter “B” go.
[Long pause]
Dan: Baby elephant.
House: Baby elephant is actually a good answer; “B” is a bear of a letter.
Dad: What does that tell you?
House: Proves two things, no neurological damage, and your son is never going to be chief fry cook. In teens there are two likely causes of night terrors: post traumatic stress, any recent shootouts at your high school?
Dan: No.
House: Well, then, Dave…
Cameron: Dan
House:…if there’s no trauma the other cause is sexual abuse. So, who’s molesting you? Teacher, extra friendly neighbor? I’d ask if either one of you were involved, but you’d deny it.
Dad: We would never do anything to hurt Dan.
House: I say it here, it comes out there. This lack of response is consistent with abuse.
Dan: There’s no one, ok? I swear. There was trauma; I got hit in the head during a lacrosse game.
House: [To Cameron] Did you know that he got hit in the head?
Cameron: They didn’t mention it, no.
House: Yeah, why bother.
[House leaves, and they all follow]
Dad: No, no, we took him to the ER after the game. He was scanned, they tested him, they said he was fine. No concussion, it’s gotta be something else.
House: You hound me for my opinion and then question my diagnosis. Cool. ER obviously screwed up, kid’s got a concussion.
Dan: I had double vision before I got hit.
House: Well, that changes everything, you need glasses. That’s why you had double vision, which is why you got hit, which is why you have a concussion, which is why you have night terrors. You need to see an ophthalmologist, which I am not.
Cameron: You enjoyed that. I brought a reasonable case to your attention, and you shoved it in my face just to humiliate me.
House: You’re an only child, aren’t you?
Cameron: Why would you say that?
House: Everything is about you. This may seem incredibly controversial, but I think sexual abuse is bad. I just wanted to make sure he wasn’t being diddled by daddy, or mommy, anything else is just a bonus.
[Knocking sound comes from the reception area; House looks over and sees that Dan’s leg is spasming.]
Cameron: I’m not an only child.
House: [attention on Dan] Interesting.
[House goes back out to Dan and his parents]
Cameron: What?
House: Don’t move. Did I bore you in there?
Dan: What? Ah, no, not, not really.
House: Are you tired?
Dan: Sometimes.
Dad: He never sleeps! Of course he’s tired.
House: Right now, at this moment, are you tired?
Dan: No, no.
House: That twitch in your leg. Did you feel that?
Dan: Didn’t hurt.
Dad: His leg twitched. I don’t see what…[interrupted]
House: It’s called a myoclonic jerk, it’s very common when you’re falling asleep. Respiration rate falls, and the brain interprets this as the body dying, so it sends a pulse to wake it up.
Dad: So?
House: So, he’s not asleep, he’s awake. [Turns to Cameron] Admit him.
[Cut to House’s office, Cameron is writing on the white board]
House: I recognize that loopy “G”. So, what does the jerk tell us?
Foreman: Nothing good, the brain’s losing control of the body. Can’t order the eyes to focus, regulate sleep patterns or control muscle movements.
House: A movement disorder, or degenerative brain disease. Either way this kid’s gonna be picking up his diploma in diapers and a wheelchair.
Chase: Maybe not that bad, could be an infection.
House: You wish. No fever, no white count. Anyone think this differential diagnosis might be compromised because we don’t have an accurate family history?
Cameron: I took an accurate family history.
House: You didn’t even take an accurate family. His father’s not his father.
Chase: Why would you say that?
House: 30% of all dads out there don’t realize they’re raising someone else’s kid.
Foreman: From what I’ve read false paternity is more like 10%.
House: That’s what our mom’s would like us to believe.
Cameron: Who cares? If he got it from his parents they’d both be dead by now, can we get on with the differential diagnosis?
House: $50 bucks says I’m right.
Foreman: I’ll take your money.
House: Hit a nerve? Don’t worry, Foreman. I’m sure the guy who tucked you in at night was your daddy.
Foreman: Make it $100.
Cameron: What about leucoencephalopathy? In a 16 year old.
Chase: It doesn’t necessarily have to be that bad. If we exclude the night terrors it could be something systemic: his liver, kidneys, something outside the brain.
House: Yes, feel free to exclude any symptom if it makes your job easier.
Chase: The night terrors were anecdotal. He could have had a bad dream.
Cameron: No, parents said he was conscious during the event and didn’t remember anything afterwards. That’s a night terror.
Chase: Parents said?
House: That’s a good point. Before we condemn this kid, maybe we should entertain Dr. Chase’s skepticism. I want a detailed polysomnograph. If he’s having night terrors I want to see them.
[Cut to outside hospital night. Cut into an isolation room, Dan is covered in wires, and other medical stuff.]
[Foreman is typing on a computer and monitoring Dan]
[House comes into the room with a tray on wheels. Dan sits up and is obviously scared. House tightens the restraints that are on Dan’s arms]
Dan: I usually don’t move during night terrors.
House: I’m not restraining you for them. EEG revealed abnormalities in your brain caused by nerve damage in your toes.
[House starts to draw a line around the base of Dan’s big toe]
Dan: [Whimpering] What are you doing?
House: Fixing it.
Dan: [Still whimpering] Can I talk to my parents?
House: Oh, they know all about this.
Dan: I’d really like to see them. [Whimpering after pause] Please! I’d really like them here.
House: This is gonna hurt, Dan.
[House takes up a big tool that looks like monster wire cutters and starts to cut off Dan’s big toe]
Dan: [Whimpers and then screams] Oh, God!
[Neat crunching and tearing sounds come from Dan’s feet]
[Cut to the room, and you see that it was just a night terror, and that Dan’s toes are all still there. He is not in restraints, and he’s sleeping. See a monitor with weird wavy lines on it.]
Chase: That’s a night terror.
(Commercials…blah…a stupid one about batteries on my tape. I don’t care about the bloody batteries! I want more House!)
Foreman: We did a CT, MRI, CBC, Chem-7 and chest x-ray. All the tests came back normal. There’s nothing to explain his symptoms.
House: Ok, but let’s pretend there’s something and go from there. Who sees something on this MRI?
Cameron: No lesions, no white matter.
Foreman: No structural abnormalities.
Cameron: No space-occupying tumors.
House: He’s 16, so he should have an absolutely pristine brain. The smallest thing is abnormal.
Chase: Meningeal enhancement. My bet is viral meningitis.
House: Excellent, you see what he did there? He took a small clue that there’s a neurological problem and wasn’t afraid to run with it.
Foreman: There’s no evidence of meningitis on that MRI.
House: No, there’s not, he completely wrong.
Cameron: Then what clue are you talking about?
House: He knew that I saw something on the MRI so he figured there must be something there and took a guess. Clever, but also pathetic.
Chase: So, what did you find?
House: Take a close look at the corpus collosum.
Chase: It looks ok.
House: Are we all looking at the same thing? 200 million interhemispheric nerve fibers, the George Washington Bridge between the left and right side of the brain. It’s subtle.
[Pause while the ducklings look at the MRI]
Chase: There’s some bowing, there. An upward arch.
House: Are you guessing?
Chase: Yes.
House: Too bad, you’re right.
Foreman: He probably just moved, nobody stays perfectly still for their entire MRI.
House: Yeah, he probably got restless and shifted one hemisphere of his brain to a more comfortable position. Something is pushing on it.
Foreman: If there’s bowing it could be a tumor.
House: Do you see a tumor on this MRI?
Foreman: No, but I don’t see any bowing, either.
House: There’s no tumor, just a blockage causing pressure, causing symptoms. Today
night terrors, tomorrow he’s bleeding out of his eyes. Get him a radionucleotide cisternogram. I guarantee you’ll see a blockage.
[Cut to Dan’s room day, Foreman is placing an extraordinarily large needle in his back. This seems to be causing Dan a lot of pain, and his Dad is holding him while he grunts and groans]
Dad: Ok…all right easy…[Pause and then mumbles to Dan, I can’t make it out]
Foreman: Now, I’m injecting a material that’s tagged with a radioactive isotope. It’s gonna enter your spine and travel up to your brain. It’ll make you able to think deep thoughts, at about 100 miles per hour.
Dad: [Whispers] Easy.
[Foreman is checking out the Dad and Dan, trying to prove that the guy really is Dan’s dad. He sees that they both have a strange fleck in their irises.]
Foreman: Their eyes aren’t the same color, but that fleck in the eyes… that’s maybe a one in ten chance if they’re not related?
Chase: Nah, House isn’t gonna pay you based on that.
Foreman: [chuckles] Any excuse we can give the folks to justify a DNA test?
Chase: We could tell them he’s got Huntington’s. The whole family should be tested or they’ll all die.
Foreman: [Chuckles again]
[Foreman notices House entering the lab where he and Chase are sitting]
Foreman: Hey, there’s a lot of blockage.
Chase: I’ve scheduled him for surgery. They’re gonna put a shunt into one of the ventricles to give the cerebrospinal fluid an out.
Foreman: No more pressure, everything goes back to normal.
House: He’s lucky to have you as his doctors.
[House walks away. Cut to the clinic and House is in an exam room with a young mother and her baby.]
Young Mother: No formula, just mommy’s healthy natural breast milk.
House: Yummy.
Young Mother: Her whole face just got swollen like this overnight.
House: Mmhmm. No fever, glands normal, missing her vaccination dates.
Young Mother: We’re not vaccinating.
[Baby giggles and coos]
Young Mother: [Takes a toy frog and starts to make frog sounds] Gribbit, gribbit, gribbit. [Giggles]
[Baby smiles and giggles too]
House: Think they don’t work?
Young Mother: I think some multinational pharmaceutical company wants me to think they work. Pad their bottom line.
House: Mmmm. May I? [He takes the frog and starts to do the gribbit noise with the baby]
Young Mother: [Whispered] Sure.
House: Gribbit, gribbit, gribbit. [The baby laughs] All natural no dies. That’s a good business: all-natural children’s toys. Those toy companies, they don’t arbitrarily mark up their frogs. They don’t lie about how much they spend in research and development. The worst a toy company can be accused of is making a really boring frog.
[Young Mother laughs and so does House. The baby giggles again]
House: Gribbit, gribbit, gribbit. You know another really good business? Teeny tiny baby coffins. You can get them in frog green or fire engine red. Really. The antibodies in yummy mummy only protect the kid for 6 months, which is why these companies think they can gouge you. They think that you’ll spend whatever they ask to keep your kid alive. Want to change things? Prove them wrong. A few hundred parents like you decide they’d rather let their kid die then cough up 40 bucks for a vaccination, believe me, prices will drop REALLY fast. Gribbit, gribbit, gribbit, gribbit, gribbit.
Young Mother: Tell me what she has.
House: A cold.
[Cut to House leaving the clinic when the ducklings all approach.]
Cameron: There’s a problem.
House: Complications in surgery?
Foreman: Surgery went fine, he’s in recovery, but we took a vial of CSF and tested it.
House: Really?
Foreman: Turns out the bowing wasn’t the cause of his problems, it was a symptom.
Chase: Oligoclonal bands, and an increase of intrathecal IGG.
House: Which means multiple sclerosis. And the reason it takes three of you to tell me this?
Cameron: Because we’re having a disagreement about whether or not it is MS.
Chase: No lesions on the MRI.
Foreman: It’s early; he’s had the disease for maybe two weeks.
Cameron: McDonald criteria requires six months to make a definitive diagnosis.
House: Oh, who cares about McPherson? I hear he tortured kittens.
Foreman: McDonald.
House: Oh, McDonald. Wonderful doctor, loved kittens.
Foreman: The VEP indicates slowing of the brain.
Cameron: Without the lesions we can’t be sure.
House: Well if it is, it’s gone from 0 to 60 in three weeks, which would indicate rapidly progressive MS. Not the fun MS with the balloons and the bike rides for cripples in wheelchairs.
Cameron: We should wait until we [interrupted]
House: Start treating him now, he can walk for another couple of years, maybe live for another 5. Break it to the family. I’m going home.
[Cut to Dan’s room. Chase is there explaining about the whole MS thing]
Chase: It’ll take months for a definitive diagnosis.
Dan: What’ll happen to me?
Chase: MS is an incredibly variable disease, if it is MS, and we’re not 100% sure.
Dad: What do you think is gonna happen?
[Pause]
Chase: There are some medications to manage the symptoms, but as the disease progresses the problems will become more severe: bowel and bladder dysfunction, loss of cognitive function, pain.
Dan: It’s gonna hurt?
Chase: The brain’s like a big jumble of wires. MS strips them of the insulation, and the nerves die. The brain interprets it as pain, but by starting treatment we’re gonna avoid that for as long as possible. We’re looking into a couple specialists, and until we get you squared away you’ll stay here. Ok?
[It’s nighttime. A nurse is walking around with trays. The nurse enters Dan’s room, and he’s missing! Cut to Cameron walking over to Foreman.]
Cameron: Security checked the videotapes for all the perimeter cameras; he’s still gotta be in the hospital.
Foreman: Where’s Chase?
Cameron: Main floor.
Foreman: Ok, you take the cafeteria and administration. I’ll hit the research annex and work my way back to you.
[Chase is wandering around in a dark office. Cut to Cameron opening doors. Cuts back to Chase still looking around the offices. Cut to House’s apartment. He’s sitting in a chair brooding. There’s a TV show on in the background, but I can’t tell what it is. The phone keeps ringing and he pays it no attention except to glance over at the first ring. Cut back to Chase, still wandering around.]
Chase: Dan?
[Cut back to House’s apartment. Phone is still ringing. He gets up just as his machine comes on. He doesn’t make any attempt to answer the phone. He uses both arms to sort of lever himself out of what looks like a very comfortable chair.]
House’s answering machine: I’m not here. Leave a message.
[Cut to outside hospital. House is approaching, and Cuddy is leaving. See Cuddy opening the doors.]
House: Dr. Cuddy, great outfit.
Cuddy: What are you doing back here? Patient?
House: No, hooker. Went to my office instead of my home.
[House walks off and Cuddy leaves a little pissed off.]
[Cut to the elevator. Doors open and House steps out. He heads down a hallway, and is intercepted by Foreman.]
Foreman: Dr. House, Dan’s missing.
House: Yeah, I got that part from the message. You said I was needed immediately.
Foreman: He shouldn’t move after a lumbar puncture.
House: I agree, he’s gonna have a very nasty headache. That would also be my opinion if consulted tomorrow morning.
Foreman: We wanted to keep you informed. He heard some pretty heavy news.
House: [Sighs] This is not a toddler wandering around a department store. He’s 16. You’ll find him. I’m going home.
Foreman: So, when you say “Call me if you need anything,” You mean, “Don’t call me.”
House: No, I mean “Call me if I can do something.” I’m bad at search parties and I’m bad at sitting around looking nervous doing nothing.
Foreman: What about his parents? Should we call them?
House: Why? You think they’re hiding him? Make sure someone checks the roof; some of the orderlies keep the door propped open so they can grab a smoke.
[He gets back into the elevator, and goes home.]
[Cut to Foreman and Cameron running up the stairs. Another Cut puts us on an open field at night. Dan is standing there looking around. Suddenly Chase appears.]
Chase: Dan? You ok? [Pause] There are experimental treatments, ongoing research… Who knows what they’ll discover in a year or two?
Dan: This is where I dropped the ball.
Chase: Dan, we’re standing on the roof of the hospital! Dan! Dan, you’re not on the field!
[Cut to see Foreman and Cameron have arrived.]
Cameron: He doesn’t know where he is.
Foreman: Dan!
Chase: Foreman!
[Chase motions that Foreman shouldn’t move just yet.]
Chase: Dan.
Cameron: Dan!
Foreman: Dan! No!
[Dan goes to step off the roof, and Chase tackles him.]
(La te da. Commercials. Evil.)
[Exterior of the hospital. It’s the next day.]
[House is standing at the elevator when Foreman comes down the steps.]
House: Dr. Foreman. I assume you found the kid.
Foreman: He almost walked off the roof.
House: Suicidal?
Foreman: No, he thought he was on his lacrosse field. Look, look, I was just gonna run home, shower, change…[interrupted]
House: Conscious?
Foreman: Yeah.
House: How’d you talk him down?
Foreman: Actually, Chase tackled him.
House: How come you didn’t do it?
Foreman: Right, well, I am black, but he was closer.
House: Come on, you can ride up with me.
[Foreman sighs and then gets into the elevator.]
[Cut to House’s office. Cameron and Chase are there.]
House: Anybody tell the family that their boy almost stepped off a roof? They must be thrilled.
Cameron: They’re not suing, but I think only because Chase asked them.
House: Why does everyone always think I’m being sarcastic? This is great news! He doesn’t have MS. The parents should be thrilled, well, the mom anyway. Of course, the dad probably doesn’t know…[interrupted]
Foreman: Why doesn’t he have MS?
House: He was on the roof thinking he was on the lacrosse field, conscious, and therefore not a night terror. You want some of this? [Asking Foreman about the coffee]
Foreman: Yeah, sure.
House: He was in an acute confusional state, which doesn’t fit with a demyelinating disease like MS.
Foreman: The Oligoclonal bands.
House. Were real. They just mean something other then MS. So, what are they telling us?
Chase: That the immune system is working.
House: Right, he has an infection in his brain.
Cameron: What about sex?
House: Well, it might get complicated. We work together. I am older, certainly, but maybe you like that.
Cameron: I meant maybe he has neurosyphilis.
House: Heh, nice cover.
Chase: Sorry, RPR was negative.
House: We don’t need a definitive test to confirm this.
Cameron: Sure, didn’t need one to confirm MS.
House: Ok, let’s wait for you to run titers on 4000 viruses while this kid’s brain turns to mush.
Foreman: So the fact that he doesn’t have MS is, it’s really not good news after all?
House: Well, it is if it’s neurosyphilis, the likelihood of a false negative on an RPR test, 30%, the likelihood of a 16 year old having sex, roughly 120%.
Cameron: I’ll start him on IV penicillin.
House: We’re not going to wait for that. The most effective way to deliver the drug is right into his brain via the spine.
Foreman: We can’t. In a cramped space like the brain, increased intracranial pressure from a high volume drug like penicillin could herniate his brain stem and kill him. No neurologist in his right mind would recommend that.
House: Show of hands. Who thinks I’m not in my right mind?
[No one raises their hand]
House: And who thinks I forget this fairly basic neurological fact?
[Again, no one raises their hand]
House: Who thinks there’s a third option?
[Chase raises his hand]
House: Very good, what’s the third choice?
Chase: No idea, you just asked if I thought there was one.
Foreman: [Sighs] The patient has a shunt in his brain. There’ll be no increased pressure, we can put as much penicillin into his body as we want.
House: Excellent, inject him through a lumbar puncture.
[Cut to Dan’s room, Foreman is there and Dan’s dad is there too]
Foeman: One of us is going to do this to you twice a day for the next two weeks.
Dan:[Sighs]
Dad: He could get syphilis even if he’s not sexually active?
[Dan looks at Foreman with sort of a pleading look on his face.]
Foreman: Well, it’s unusual, but it’s possible. Relax.
Dan: [Sighs again, and then grunts in pain]
[Cut to an exam room. There’s a guy with a really nasty pussy abscess on his knee. House backs off after he sees it.]
House: Geesh. It’s infected, with a really big hole like you stuck a nail in it to relieve the pressure.
Mr. Funsten: I wouldn’t do that.
House: Although the wound is irregular, not cylindrical, it’s shaped like a triangle, so not a nail. Steak knife?
Funsten: Wife’s nail file.
House: [Whispered] Nail File. Yeah, pain’ll make you do stupid things. Something to take the edge off? [Takes out his pills and puts one in his hand]
Funsten: Yeah.
House: Cheers. [Dry swallows the pill and Funsten eats his (ewwwww)] [Limps back
over and sits on a rolly stool] So, do you have family here in Princeton?
Funsten: No.
House: Here on work?
Funsten: No, why are you [interrupted]
House: Does your penis hurt?
Funsten: No. What? Should it?
House: No, just thought I’d toss you a really inappropriate question. Your lawyer’s gonna love it.
Funsten: Why would I want to sue you? I want you to treat me.
House: You’re from Maplewood, New Jersey. Right?
Funsten Yeah.
House: Now, why would you drive 70 miles to get treatment for a condition that a 9 year old could diagnose? It’s the free flowing puss that’s the tip off.
Funsten: I was in town.
House: Not for family, not for work. You drove 70 miles to a walk-in-clinic. You passed two hospitals on the road. Now, either you have a problem with those hospitals, or they have a problem with you. My guess is that you’ve sued half the doctors in Maplewood, and the rest are now refusing to treat you. It’s ironic, isn’t it? It’s like the boy who sued wolf. You know what? I bet we have a doctor here named Wolfe. How perfect would that be? I’m gonna page him.
Funsten: Ok, you know what? Thank you, I’m gonna find a doctor to take care of this.
House: I didn’t say I wouldn’t treat you. We’ll drain your knee, run some lab work, fix you right up.
Funsten: Why would you do that?
House: I’m a people person.
[Cut to elevator. See House and Wilson exiting.]
Wilson: You actually treated him?
House: All I know is that he sued some doctors, who am I to assume that they didn’t have it coming to them. [Stops when he sees Cuddy coming] The cutest little tennis outfit, my God I thought I was going to have a heart attack.[Acts like he just realized that Cuddy was there.] Oh my, I didn’t see you there, that is so embarrassing.
Cuddy: How’s your hooker doing?
House: Oh, sweet of you to ask, funny story, she was going to be a hospital administrator, but hated having to screw people like that.
Cuddy: I heard you found her on the roof.
House: You have very acute hearing.
Cuddy: You notify the parents?
House: In due course, of course.
Cuddy: And is there a paternity bet on the father of the patient?
House: Doesn’t sound like me.
Wilson: Well, it does actually, but that doesn’t mean you’re guilty.
House: You think?
Cuddy: I saw the parents in the lobby, smart money is obviously on the father.
House: [Stage whisper] My guy knows a guy who can get you in for $50 bucks.
Cuddy: Fine. You tell your guy if I win, you attend the faculty symposium and you wear a tie.
House: And if I win, no clinic hours for a week.
Cuddy: My guy will call your guy.
[Cuddy walks off]
Wilson: She’s very good at her job.
[Cut back to Dan’s room. Chase is giving him his treatment. Cameron is at his head.]
Chase: The treatments should start helping soon. Let us know if it gets easier to focus on things, remember stuff.
[Dan is obviously in pain.]
Chase: Hey Dan, isn’t Dr. Cameron’s necklace a beauty? Something South American, I think.
Cameron: Yeah, Guatemalan.
Dan: It’s a cool necklace.
[She looks down and sees that it’s in a very revealing spot.]
Cameron: Thank you so much.
Chase: The kid’s in pain.
Cameron: [Scoffs]
Male Voice 1: Don’t fight it.
Male Voice 2: Just let it happen.
Dan: No.
Chase: No, what?
Female Voice 1: You’ll be dead in three days.
Female Voice 2: I give it a day.
Chase: Dan? You ok?
Cameron: Dan?
[Dan starts shaking]
Cameron: He’s hearing voices.
[As this is going on the voices taunt Dan with sayings. They are all telling him that he’s gonna die.]
Chase: [muffled] Dan? [Regular] Push three milligrams IV, stat!
Cameron: Come on Dan!
Dan: [screaming] GET OUT OF MY HEAD!
(Commercials)
Cameron: Auditory hallucination shows further brain degeneration.
Chase: Penicillin’s not working.
House: So, either it’s a bad batch of penicillin, or our diagnosis is wrong. Square one. “Mignight.”
[House writes M,I,D,N,I,T on the white board]
Foreman: LFTs, BUN, and creatinine, are all normal, diabetes is out. No gap.
House: There goes metabolic. [Crosses off “M”]
Cameron: MRI rules out vasculitis.
House: “I” for inflammation. [Crosses out the “I”]
Chase: To young for anything degenerative.
House: “D”, see ya. [Crosses out the “D”] “N” for neoplastic?
Chase: MRI was clean.
[House crosses out the “n”]
House: “I” for inflammation.
Cameron: We already did that.
House: Stupid to have two I’s in one mneumonic. What’s the other one?
Foreman: Infection.
Cameron: Oligoclonal bands still have to mean something.
Foreman: But no fevers; white count’s elevated but within range.
Chase: And we’ve tested for anything remotely possible. Everything is negative.
[House crosses out the other “I”]
Cameron: CT scan rules out subdural.
House: Trauma, later much. [Looks at the board which is now all crossed out.] You know the problem? Midnight is actually spelled with a “G” and an “H,” If we could just figure out what those two letters stand for. [Sighs and walks away for the board. His back is now facing the ducklings] It’s a sick brain, having fun, torturing him, talking to him. [pause] Scaring the hell out of him. Get him an EEG, left and right EOG esophageal microphones. If this thing wants to talk, let’s listen.
[Cut to outside day. Almost continued from the last scene. House is sitting with Wilson.]
House: We’re missing something. This is screwed up.
Wilson: That’s why you came up with the brain talking to the virus thing?
House: I panicked, ok? Sounded cool though, they bought it.
[House sees Dan’s parents walking his way.]
House: Oh, crap. Another reason I don’t like meeting patients. If they don’t know that you look like they can’t yell at you. [Aside to Wilson] Here we go.
Mom: How can you just sit there?
House: If I eat standing up, I spill.
Dad: Our son is dying, and you could care less? We’re going through hell; you’re doing nothing?
House: I’m sorry, you need to vent, I understand.
Dad: Don’t be condescending. You haven’t checked in on him once.
House: Blood pressure’s 110/70, the shunt is patent well placed in the right lateral ventricle, the EKG shows a normal QRS with deep wave inversions throughout both limb and pericardial leads. LFTs are elevated but only twice the normal range. Oh yeah, and he’s hearing voices. [Pause] Go hold his hand. Go on; I’ll bus your tray.
[They walk off holding hands]
House: Got any sample bags on you?
Wilson: I don’t believe you. You’re gonna run DNA tests?
House: Their son is deathly ill, I know it’s terrible, but the fact is if I don’t keep busy with trivial things like this I’m afraid I might start to cry.
Wilson: You’re an ass.
House: Yeah? You want to double the bet?
[Cut to Cameron and Foreman in a lab. House enters.]
House: General Hospital is on channel 6.
Foreman: Dan’s brain’s not showing channel 6 right now, only mush.
House: No epileptiform activity. [Turns to Cameron] What are you doing?
Cameron: Waiting for CBC and Chem-7.
House: Good, run DNA on these. [He puts down two cups that are labeled “Mommy” and “Daddy???”]
Cameron: What’s this?
House: Parents’ coffee cups.
Cameron: I can’t believe you [interrupted]
House: I’ve had this conversation once already. If you’ve got something else to do, do it. Otherwise, do this.
[Cut to House in hallway.]
Funsten: Dr. House?
House: Hey, Mr. Funsten! I was wondering when you’d be back. Got some papers for me?
Funsten: You’ve caused me considerable mental distress.
House: I certainly hope so. [Funsten hands him an envelope] What? Too cheep to have your lawyer serve it for you, or is it more fun this way?
Funsten: I’m obviously prepared to consider a settlement.
House: You have gonorrhea.
Funsten: No, I don’t!
House: Well, maybe you’re right, but I have a lab result that says you do. It could be a false positive; normally I’d run a second test, but since you’re here I’ll just go with the first.
Funsten: You’re just trying to scare me.
House: It’s reportable you know, public health issue.
Funsten: I’ll be sure to let my wife know.
House: Oh, don’t bother yourself, the state will call for you. Look, if you’re clean I’m sure this will all blow over, no big deal. There’s an easy way to find out, get one of your doctors run a test.
[Funsten grabs for the papers, but House snatches them away.]
House: Uh-uh. These are mine now. I’ll see you in court. [House enters the elevator.]
[Cut to Chase, Foreman, and Cameron in a lab.]
Foreman: West Nile negative, not surprising, since not too many mosquitoes passing through Jersey in December.
Chase: No Eastern Equine Encephalitis.
Cameron: You guys aren’t going to believe this.
Chase: What’s that?
Cameron: House was right, the father’s not the father.
Foreman: [Sighs] Dude doubled up on me.
Chase: You’re not gonna believe this, the mother’s not the mother either.
[Cut to Cuddy’s office. Dan’s parents are there.]
Cuddy: It’s not a good idea to move your son in his condition.
Mom: We just want a second opinion.
Dad: We need an answer.
[House comes into the office.]
House: You idiots! You lied to me!
Dad: We didn’t lie about anything. You, on the other hand, accused us of molesting our son.
Cuddy: Perfect.
House: Can we get off my screw-ups and focus on theirs? Theirs is bigger. You’re not Dan’s parents.
Mom: We’re his parents.
Dad: He was adopted. He doesn’t need to know.
House: I do.
Dad: Adoption makes him just as much his [interrupted]
House: Listen, when we were taking his medical history, were you confused? Did you think we were looking for a genetic clue to his condition, or did you think we were trying to ascertain who loves him the most in the whole wide world?
Cuddy: How did you find out about this?
House: I sampled their DNA.
Dad: We didn’t give you any DNA.
House: Your coffee cups from the cafeteria.
Cuddy: You can’t do that!
House: Again, why are we getting hung up on what I did? [Turns to Dan’s parents] Your medical history is useless.
Dad: No, we gave you a detailed history of his biological mother.
Mom: Her history; non-smoker, good health, low cholesterol, no blood pressure problems.
Dad: Dan was adopted two weeks after he was born. You have his history. There’s nothing you need to know that we didn’t tell you.
Cuddy: Sounds reasonable. Well, if you want to transfer your boy that is your choice, but I still think it’s the wrong [interrupted]
House: Was she vaccinated? [Pause] The biological mother, when she was a baby, did she get her vaccinations?
Dad: Dan was vaccinated at 6 months.
House: Mm hmm, and do you know why kids get vaccinated at 6 months? Because before that, they are protected by their biological mother’s immune system. So, was she vaccinated?
[Cut to a scene with a cool looking round thing with green prongs (it’s the measles virus) and it overlaps the speech that House makes. It travels around and then there is a cut inside of it and you can see a double helix of DNA breaking or “unzipping”.]
House: An infant picks up a regular old measles virus. He gets a rash, he’s extremely uncomfortable, has a wicked fever, but he lives. Here’s the kicker, once every million or so times, the virus mutates. [Cut to House’s office. House and the ducklings are there] Instead of Dan having a fever and a rash the virus travels to his brain and hides like a time bomb. In this case for 16 years.
Foreman: Sub-acute Sclerosing Pan-encephalitis.
House: I know. There’s only been 20 cases in the United States in the past 30 years.
Foreman: I suppose you could make an argument that the kid’s still in stage one. Once SSPE moves to stage two [Interrupted]
House: Boom, stage two is universally fatal.
Cameron: I assume it’s impossible to tell when he might move into stage two.
House: He’s already started showing symptoms. It could be a month, it could be tonight.
Cameron: Can we treat it?
House: Ask the neurologist.
Foreman: Intraventricular interferon.
Chase: We’re not gonna shove a spike into his brain and drip interferon without confirming this diagnosis.
House: Tap him.
Foreman: We won’t get a reliable result for measles antibodies in his CSF, not after everything we’ve given him.
House: So the wrong treatment kills any hope of the right diagnosis. Why do people lie to me? [Pauses and sighs] It could also kill him. Your ball, Foreman, tell me I don’t have to biopsy his brain.
Foreman: [Sighs] Well, there is one other way.
[Cut to a room and there is Dan with a HUGE needle pointing at his right eye.]
Dan: You sure this isn’t gonna hurt?
Foreman: Yeah, it’s just scary as hell. See, we go through the pupil. You won’t feel it; the eye’s been paralyzed. The needle travels to the back of the eye which is where we perform the biopsy on your retina.
[Cut to the needle entering Dan’s eye with a really cool sound. You can see the measles
virus from the previous cut scene sitting there and then getting sucked up.]
Foreman: So we’ve confirmed that the problem is this mutated virus. The treatment for SSPE is intra-ventricular interferon. We implant an Ommaya reservoir under the scalp, which is connected to a ventricular catheter that delivers the antiviral directly to the left hemisphere [interrupted]
Dad: Look, you want us to consent to this? I don’t even understand what you’re talking about.
Foreman: Well, the antiviral…[pauses] Look, I’m sorry, I can explain this as best I can, but the notion that you’re gonna fully understand your son’s treatment and make an informed decision, is, it’s kinda insane. Now, here’s what you need to know, it’s dangerous, it could kill him, you should do it.
[Cut to operating room. Dan is awake on the table, we can see a doctor with a drill standing behind him. Cameron and Foreman is there, I’m not sure about Chase. Cut to a screen next to the operating table and you can see the drill make a hole in Dan’s skull.]
[Cut to Cuddy’s office]
Cuddy: You can’t order a $3,200 DNA test to win a bet.
House: It’s not an actual cost. I don’t know if you know this, but the hospital actually owns the sequencing machine.
Cuddy: I’m serious.
House: Well, tell the parents to submit the bill to insurance.
Cuddy: Insurance is not going to pay for a bet.
House: It should. If we don’t make that bet, the kid dies. If not for the paternity bet, I never would have taken their DNA, without their DNA we never would have discovered that Dan was adopted, which was the key to this case. You just don’t want to pay your end. Big mistake. My guy knows a guy.
Cuddy: Fine. I will let you out of clinic duty for one week, after you pay the $3,200 for the PCR test.
[House sighs and picks up his cane. He limps over to her desk, and slams his cane down.]
Cuddy: Whoo.
House: Well now, there’s the $100 you owe me, there’s the $100 I won from Cameron, $200 I took off of Foreman, and $600 I got from Wilson. Very bitter.
[Cut to Dan’s room. Foreman is there and so is Cameron. I’m guessing it’s the next day. Dan wakes up.]
Cameron: Hey, good morning.
Foreman: Good news on your EEG, treatment is working.
Cameron: And your immune system is responding.
Foreman: I know it’s early, but let me take a look. Let’s see what that brain of yours can do. Name as many animals as you can that start with the letter “O”.
Dan: Ostrich, ox, old elephant.
Cameron: Well, that’s 2 better then last time. How you doing with the whole adoption thing?
Dan: I knew since 5th grade.
Foreman: How’s that?
Dan: Cleft chin. I have one, my dad doesn’t. I looked it up on the Internet; it’s one of those trait things.
Forman: That’s right, it’s autosomal dominant. Since neither of your parents have cleft chins, it’s highly unlikely that you’re biologically related.
Cameron: You sure you’re ok?
Dan: I’ve got no problems with being adopted. I love my parents.
[Dan’s parents enter.]
Dad: How’s he doing?
Cameron: He’s doing pretty well. He’s a smart kid. I think he’s gonna be fine.
[A song starts playing in the background. I’m not going to include the lyrics unless I get some requests for them. Sorry.]
Dad: Thanks.
[Cut to a lacrosse game on a field. House is standing on the sidelines.]
House: Wheels, one-eight! Wheels!
[18 makes a goal. House’s hand moves with the player’s movement, and House gives a small smile. The team all gathers around and cheers together. House picks up his cane and holds it like a lacrosse stick. Cut around House and see that there’s no one there. He limps out onto the field. ]
THE END!
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