Original Airdate on FOX: December 7, 2004
Written by Peter Blake (IV)
Directed by Newton Thomas Sigel
Transcript written by Mari
[Open on face of a newborn baby. Overhead speaker is calling for Radiology.]
Ethan Hartig: Amber.
Karen Hartig: [scoffs] No.
Ethan: Why not?
Karen: Amber’s a stripper name.
Ethan: Find me one stripper named Amber Hartig. [small pause] Or not, okay. Non-stripper names, okay. [baby makes a few noises] Desiree? Bambi? Candy cane?
[We see Karen in the hospital bed, holding Baby Hartig. Ethan is next to them.]
Karen: Max. Maxine. Max Hartig is a cute name, isn’t it?
Ethan: If you’re a professional boxer, maybe.
Karen: Can you believe we made this little creature?
Ethan: I know, it’s incredible.
Karen: It’s the most amazing thing we’ve ever done.
Ethan: I almost ran the marathon last year.
Karen: [to Baby Hartig] If we’re lucky you won’t inherit your daddy’s sense of humor.
Ethan: [waving a teddy bear] Hello! Say hi to Bear!
[Baby starts to spit up. The parents are taken aback a little.]
Karen: She hasn’t even eaten anything; what is she spitting up?
Ethan: Well, honey, we can’t bug them –
Karen: Just –
Ethan: Okay, okay.
[Cut to Ethan walking in with Dr. Lim]
Ethan: Sorry, it’s our first kid, we’re both a little panicky I guess.
Dr. Lim: Well, you gotta ask the pediatrician next time. I just deliver ‘em. [to Karen] She spitting up?
Karen: Yeah. Second time in an hour?
Lim: [takes Baby Hartig] You lived underwater for nine months, you’d have a lot to spit up, too. [He touches Baby’s cheek, who doesn’t respond.]
Karen: Is something wrong?
Lim: Eh, a little lethargic.
Ethan: We didn’t think –
Lim: She’s hot. [Baby starts seizing.]
Ethan: Is she, uh –
Karen: What’s happening?
Lim: [simultaneously] Baby’s seizing! Get the crash cart!
Ethan: What’s, what’s, what’s, what’s wrong?
Lim: Can I get some help in here?!
Karen: Oh, oh God! Is she all right?
A nurse: IV access?
Lim: No, ativan.[Dr. Lim puts Baby Hartig on the table, and starts to try to clear her airway.]
Karen: What’s going on?
[Credits and such.]
[Soap opera, presumably General Hospital.]
Soap doctor: MRI results are back.
Soap patient: And?
Soap doctor: It’s what we expected. The accident caused serious damage.
[House starts to talk over the soap as he walks to a chair, opening a cup of jello or something similar. Mmm, hospital jello.]
House: It’s amnesia.
Soap doctor: I’m sorry.
Soap patient: I just can’t believe it.
[Lim and Dr. Kubisak walk into the lounge, talking.]
Lim: Enjoying our lounge, House?
House: I just came in to get milk for my coffee, which you’re out of.
Dr. Kubisak: Flat or sparkling?
House: Flat.
Lim: [simultaneously] Sparkling.
[Kubisak throws a bottle to Lim.]
Kubisak: So, the Hartigs?
Lim: Their baby gets a fever.
Kubisak: Wait, don’t tell me. Their kid had a seizure.
Lim: Yep. The parents, of course, start freaking and I have to deal with that for an hour.
Kubisak: Like it was your fault.
Lim: She was perfect when I delivered her. If you want to blame someone, blame the pediatrician.
Kubisak: So, how’s the kid now?
Lim: Bowel obstruction, she’s under observation, she’ll be fine. [While all this is going on, House is “watching” the soap intently.]
Kubisak: Pediatrician’ll take all the credit.
[House exits suddenly, leaving most of his jello behind.]
[Cut to Baby Hartig.]
House: [to Wilson] Exhibit A: Baby girl Hartig. Term baby, 42 hours old. Went into seizures 6 hours ago, brought into the intensive care, diagnosed with obstruction of the small bowel. [looks at Wilson]
Wilson: I’m still amazed you’re in the same room with a patient.
House: People don’t bug me until they get teeth. [small pause] Exhibit B: Baby boy Hausen. Another term baby, 48 hours old. Brought into the NICU before the Hartig baby: fever of unknown origin, 101 degrees, trending upwards.
Wilson: Wow, that is amazing. You hung out in the OB/GYN lounge and heard about two sick babies. It’s eerie. [goes to touch something, I’m presuming a baby]
House: Don’t touch that.
Wilson: [confused] All right…
House: We have an infection spreading in the hospital.
Wilson: [unbelieving] These kids have totally unrelated illnesses.
House: They fell sick within four hours of each other. They had the same delivery rooms, maternity rooms are neighboring, so transmission’s possible. They have the same symptoms.
Wilson: The Hartig girl has a bowel obstruction. No matter how close their beds are, I’m pretty sure kids can’t share a blockage.
House: What does bowel obstruction on a chart indicate?
Wilson: Well, normally, I’d say it indicates a patient’s bowel is obstructed, but I’m pretty sure you have some deeper truth to impart –
House: It means that some random doctor of indeterminate skill thinks that the patient’s bowel is obstructed.
Wilson: [trying not to laugh] Okay, you’re upset because they threw you out of their lounge.
House: Look at the x-ray. It’s a normal gas pattern.
Wilson: You want, I can get you a key to the oncology lounge.
House: [simultaneously] Air. Air in the column.
Wilson: We’re getting TiVo.
House: If it’s air, no bowel obstruction.
Wilson: Even if it is air, it could have been there before the obstruction.
House: No. Something’s infected both these infants.
[Cut to Cuddy’s office.]
Cuddy: And you’re the only one who put this together because…?
House: Because I’m the only one who looked at both kids. I want them isolated; I want the maternity ward shut down.
Cuddy: Because you’re better at reading an x-ray than a radiologist.
House: Radiologists always over-read babies’ x-rays, especially if they’re asked to rule out a pathology. He read into it what he wanted.
Cuddy: Which is exactly what you’re doing. You’re finding a cluster because you think it’s interesting to find a cluster. Two… plain old sick babies would bore you.
House: See, this is why I don’t waste money on shrinks, ‘cause you give me all these really great insights for free.
Cuddy: [smiling] Shrink. If you would consider going to a shrink, I would pay for it myself. The hospital would hold a bake sale, for God’s sake.
House: We have an epidemic! [Cuddy stops from going out the door and turns to House.]
Cuddy: [slowly] Two sick babies is very sad, but it doesn’t prove an epidemic. [She leaves. House is left alone in her office.]
House: How many do?
[Cut to diagnostic lounge. Chase is sleeping in a chair, until House throws a big red book in his lap.]
House: Get up! We’re going hunting.
Foreman: For what?
House: Wabbits.
[Cut to some maternity room. Mother and father are resting, their baby at the foot of the bed. House and Foreman enter the room; House picks up the baby, who starts to cry, waking the father and mother.]
House: Hi. [pause] Bye. [passes the baby to Foreman, saying quietly] He’s screaming, he’s fine.
Foreman: [puts the baby down, smiling and fully aware of the awkward situation] Good looking baby.
[Cut to a delivery room, where a birth is in process. Expectant dad is filming. Chase and Cameron stride in.]
Cameron: Oh, sorry, wrong room.
Chase: [half-wave] We’ll see you later.
Cameron: [out in the hall] 12 rooms, that’s it?
Chase: [closing the door to the room] Yep. We’ve definitely checked the whole floor. [They meet up with House and Foreman by the elevator.] Good news, no epidemic.
Foreman: Tragic, huh?
House: [looks at elevator] Overflow rooms, third floor. [goes into elevator]
Foreman: [to Cameron and Chase] This imaginary infection has spread to the next floor?
[Cut to mothers Kim Chen and Judy Lupino. They look worried. House enters the room.]
Judy: We were just going to call.
House: Did he get hot all of a sudden?
Judy: Yeah.
[Cut to hallway outside NICU. Cuddy is watching babies being brought in, but turns toward voices near the elevator.]
Man’s voice: Don’t worry, we’re almost there.
Cuddy: Excuse me! Hi. Intake sent you up here?
Man: Yeah, my wife’s contractions are less than –
Cuddy: Yeah, Intake messed up. I’m very, very sorry. Nurse Alpret will arrange for an ambulance to take you to Princeton General. [starts to wheel the pregnant woman back to the elevator]
Man: Wha –
Cuddy: The maternity ward is temporarily closed.
Woman: We have to leave?!
Cuddy: Yes, I am very sorry. [elevator opens, House comes out]
Man: Why are you doing this? [woman groans]
Cuddy: You’ll be there very, very soon. [elevator door closes, next line to House] Happy now?
House: No. But I am interested.
[Cut to a shot of more babies being brought into NICU. Commerical.]
[House’s office. He’s got his whiteboard out.]
House: Three sick babies, and a fourth showing early symptoms.
Cuddy: How bad?
Chase: Spiking fevers.
Foreman: BP’s plummeting. They’re barely able to keep systolic up; at this rate, they’ll be dead in a day.
Cuddy: Where did this come from?
Cameron: Two delivery rooms, four different maternity rooms, no common personnel and no common equipment.
Cuddy: Well, there’s gotta be something in common.
House: Yeah. That would be the difference between an epidemic and a coincidence.
Cuddy: I’m putting a team together. We’re going to start swabbing. [She leaves.]
Foreman: What’s she gonna swab? Every respirator, sink, vent, drain in the entire hospital? That’ll take months.
Cameron: A needle in a haystack.
House: It’s worse than that. We don’t even know what’s the needle we’re looking for. [He starts to erase the whiteboard.]
Cameron: Then why’d you let her go do it?
House: Because the hospital’s her baby, and her baby’s sick. If she doesn’t solve this soon, her head’s going to explode, and I don’t want to get any on me. [Chase and Cameron snicker softly] So let’s figure out what’s in the haystack. Differential diagnosis, people.
Foreman: Parasite.
Cameron: Spreading too quickly. [House writes “parasite” on the board and crosses it off.]
House: Next?
Chase: Virus? [House writes “virus”.]
Cameron: Kids are too sick, and the blood tests show no lymphocytosis.
Foreman: And they’re not responding to a cycle of avirarapovirin. If it’s some other virus, we’ll never find it in time, anyway. [House writes a question mark next to “virus”.]
House: Which leads us to bacterial infection. [which he writes on the board] It’s not responding to broad-spectrum antibiotics, so we’ve got something resistant. The usual suspects.
Foreman: MRSA. It’s always MRSA in hospitals.
Cameron: Maybe a contaminated food or water source? Psuedomonas.
Chase: VRE?
Foreman: H-Flu. [House writes these all down.]
House: Okay, those are the big ones. Cultures will take 48 hours, might as well be post-mortem. We’ll start them on Vancomycin for the MRSA and Aztreonam for the rest. Let’s get MRIs, check for abcesses or some occult infection. I’ll be in the clinic. Grab me if you find something important. Or unimportant.
[Cut to a hallway, where a nurse is wheeling a sick baby. The Hartigs look on.
Close up on Karen’s face as the nurse rounds the corner.]
[Cut to Chase and Cameron putting a baby (presumably Baby Hartig) into the MRI machine. Machine starts to make noise.]
[Cut to Chase looking at the MRI results.]
Cameron: [talking to Kim and Judy] We did a MRI on all the babies, and unfortunately, we didn’t find anything, so we’re starting him on the strongest antibiotics we’ve got, and we’re hoping that that’ll take care of it.
Judy: But he’s so tiny.
Kim: How sick is he?
Cameron: [pause] His fever’s up to 103.5 and his blood pressures 80 over 40.
Judy: Um, how bad is that?
Cameron: [freezes up] Ah, it…
Foreman: [behind Cameron] It, it’s low. The heart needs to circulate the blood. If it’s weak, oxygen isn’t getting to the liver, the kidneys, the brain. [Kim nods sadly.]
Judy: Um, I have to ask you something.
Kim: Judy –
Judy: No, no, Kim. Let me. Um, I had a cold last month, and I told the doctors about it, and –
Kim: Honey, this has nothing to do with you.
Cameron: Kim’s right. Your son was born healthy. He caught the infection after his birth. There’s no reason to think he got it from you.
Judy: But you don’t know, I mean – You don’t know how he got sick. [Cameron sighs and looks at Foreman.]
[Cut to Cameron and Foreman walking in a hallway.]
Foreman: Pretty standard question: how sick is my child? You couldn’t answer it.
Cameron: I answered.
Foreman: You rattled off numbers! BP, O2 stats.… That’s not what they need to know.
Cameron: What they need to know is the future. Got a magic 8-ball? [She starts to work on charts.]
Foreman: No, just eight years of medical training. Look, I realize it’s tough to break bad news to family –
Cameron: Not as tough as hearing it.
Foreman: And I guess being the poor guy dying is toughest of all?
Cameron: [pause] No. It’s easier to die than to watch someone die. [She leaves Foreman standing at the front clinic desk.]
[Cut to Cuddy and her team, swabbing.]
Cuddy: Well, we’re checking the vents, it could be airborne. Somebody get the sinks, too, and underneath them.
Med Student with the Tie: I’ll get it.
Wilson: How many med students have you got swabbing the decks?
Cuddy: Oh, what else are they going to do? It’s not like they’re delivering babies.
Wilson: Find anything yet?
Cuddy: Ah, yeah. About half the antibacterial gel dispensers are empty or broken.
Wilson: That’s bad. And diagnostically, completely insignificant.
Cuddy: Well, if the staff can’t wash their hands, it’s no wonder an infection has spread. [While they’re talking, we see Med Student’s tie has been hanging in the sink and generally being a nuisance.] Hey, tie clip!
Med Student with the Tie: Sorry?
Cuddy: We have an epidemic in this hospital and your tie is becoming a Petri dish. Put on a tie clip or take the damn thing off.
[Cut to the clinic.]
Patient (Jill): My joints have been feeling all loose, and lately I’ve been feeling sick a lot. Maybe I’m overtraining; I’m doin’ the marathon, like, ten miles a day, [House looks tired] but I can’t seem to lose any weight.
House: Lift up your arms. [She does so.] You have a parasite.
Jill: Like a tapeworm or something?
House: Lie back and lift up your sweater. [She lies back, and still has her hands up.] You can put your arms down.
Jill: Can you do anything about it?
House: Only for about a month or so. After that it becomes illegal to remove, except in a couple of states. [He starts to ultrasound her abdomen.]
Jill: Illegal?
House: Don’t worry. Many women learn to embrace this parasite. They name it, dress it up in tiny clothes, arrange playdates with other parasites –
Jill: Playdates…
House: [shows her the ultrasound] It has your eyes. [It’s a baby!]
Jill: But… that’s impossible.
House: Well, I assume you weren’t getting your period. Maybe that should have give you an inkling.
Jill: But I’m on this birth control implant…
House: Yeah, I know. I saw the scar on your arm.
Jill: …and my doctor said I might not get any periods at all if it was working.
House: Mm hmm. Interestingly enough, you also don’t get any periods if it isn’t working, which is why you were supposed to get regular pregnancy tests. [Jill makes a pained face.] I’m going to send a nurse in here to schedule your prenatal care. You’re due in about five months, so start planning the shower.
Jill: Um, Doctor? Please. Me and my husband wanted to have a kid soon, but… oh, God. Like four months ago we had this really big fight. [House looks like he knows where this is going] He moved out. I did something stupid.
House: One-night stand?
Jill: Ex-boyfriend.
House: I’ll schedule you a paternity test, too.
Jill: I can’t let my husband know.
House: Does the old boyfriend look like your husband?
Jill: [thinks a little] Yeah…
House: Then just have the kid. He’ll never know. The most successful marriages are based on lies. You’re off to a great start. [He leaves, Jill looks like she’s going to cry.]
[Cut to House’s office.]
House: Well, you look cheery. What’s going on?
Cameron: The Hartig and Chen-Lupino babies. Their kidneys are shutting down.
Chase: And the urine tests show no casts.
House: Which means the antibiotics are causing the kidney failure.
Foreman: You’re the nephrologist. Which one did it? We’ll take ‘em off that one. [pause] Don’t tell me both Vancomycin and Aztreonam can –
Chase: They both can cause this. There’s no way to know which one it is. No test. [House looks at Chase.]
Foreman: We can’t take them off the antibiotics. They’ll die of the infection.
Cameron: If we leave them on both the antibiotics they’ll die of kidney failure.
Chase: So, we take our best guess, then. Which drug’s causing the kidney failure?
Foreman: It’s like I said: it’s always MRSA in hospitals. Take ‘em off Aztreonam.
Cameron: I still think it’s the pseudomonas. I vote to take them off the Vancomycin. [long pause]
House: There’s no point in guessing. Take one kid off Vancomycin and the other off Aztreonam.
Chase: They have the same disease, you want to give them different treatment?
Foreman: What the hell are you doing?
House: Theraputic trial to find the cause of the infection.
Foreman: That’s wrong.
House: We have four sick kids, at least. Who knows how many more haven’t started showing symptoms yet?
Foreman: We have a duty to these two!
House: If these two have different reactions we know how to save the rest.
Foreman: So you’re condemning one of these kids to die based on random chance. [pregnant pause]
House: I guess I am.
[Commercial]
[NICU. Some baby is crying. Cut to Cuddy’s office.]
Cuddy: So, you’re going to flip a coin? That’s how you decide which baby lives?
House: Can I borrow a quarter?
Hospital Attorney: Do you want to get sued, lose your license, House? Well, generally I’d applaud that, but my job is to protect this hospital, so I strongly advice you to come up with a medical rationale why Baby A should get Medicine X and vice-versa.
House: Whoa, whoa, whoa, hold on there, Slick. We didn’t all go to law school. Your advice is that I should use medical reasons to make medical decisions? Hmm, that’s not going to be as easy…
Attorney: Any medical justification. Doesn’t need to be a good one.
House: Well, Hartig sounds Jewish, so does Aztreonam, so we’ll take the Hartig kid off Vancomycin, how’s that? [pause]
Cuddy: You can’t experiment on babies.
House: Doctors experiment all the time.
Cuddy: On adults. With their consent.
House: Fine. I’ll get the parents’ consent.
Attorney: Their informed consent. They have to know the other kid is getting a different treatment.
House: Sorry, can’t do that. It’d be unethical for one patient to know about another patient’s treatment.
Attorney: They have a right to know.
House: If they know, they won’t consent; that defeats the whole purpose.
Attorney: That’s their right.
House: [getting up from the couch] Two more babies have just become symptomatic. I defer to your legal wisdom: which takes precedence? Six dying babies or a missing consent form?
Attorney: You can’t do it.
Cuddy: [sighing; to House] Do what you think is best. [House leaves; Cuddy looks very unhappy about the whole situation.]
[Cut to House sitting in his office. He’s twirling a coin between his fingers. He spins it and watches how it lands.]
[Cut to Foreman talking to the Hartigs, Cameron is talking to the Chen-Lupinos simultaneously.]
Foreman: Your daughter’s kidneys are shutting down…
Cameron: Your son’s kidneys are failing.
Foreman: …so we’re going to take her of the Aztreonam.
Cameron: We’re taking him off Vancomycin.
Ethan: But, uh, but what made her sick in the first place?
Kim: What do you think is causing it?
Cameron: It seems to be a germ called pseudomonas.
Foreman: We think it’s MRSA. Methicillin-Resistant Staph Aureus. It’s a very resistant form of a very common bacteria.
Cameron: We’re hoping the Aztreonam will clear it up.
Foreman: Vancomycin is the best treatment for MRSA, so we’re gonna keep giving it to her.
Ethan: Right. Is it gonna cure her?
Foreman: Your child is very sick. You need to know that. This is a ‘hail Mary’ pass. It might cure her, it might not. [Ethan sits back on the couch, defeated.]
Judy: So, so that’ll cure him?
Cameron: We’ll know in 24 hours if it’s working. [Judy and Kim look very happy. Cameron walks away from them; Wilson is at the reception desk.]
Wilson: What did you tell them?
Cameron: I told them the truth.
Wilson: They seemed relieved. You tell them how sick their son is?
Cameron: I explained what was going on.
Wilson: Alison, their baby’s dying. If the parents weren’t in tears when you left, you didn’t tell them the truth.
Cameron: That’s not how I see it.
Wilson: Do you want them blindsided? Want them coming up and saying “My God, my baby died, why didn’t you warn me?”
Cameron: So now it’s about worrying about them yelling at us?
Wilson: No, it’s about getting them prepared for the likely death of their child.
Cameron: If their son dies tomorrow, do you think they’ll give a damn of what I said them today? It’s not going to matter; they’re not going to care; it’s not going to be the same ever again. Just give those poor women a few hours of hope. [She walks away from him.]
[Cut to House leaving his office. Jill runs up, towing her husband.]
Jill: Dr. House! Dr. House, this is my husband, Charlie.
House: Who told you where my office was?
Charlie: Jill, come on, he obviously doesn’t want us bothering him.
House: Ooh, I was trying to hide it.
Jill: Look, Doctor, this is about the mono you said you thought I had…
House: The mono?
Jill: Yes. You know, shouldn’t Charlie be tested? You know, [House looks at Jill like she’s insane] the test. The blood test.
House: [catches on] Right. Yeah, I’m sorry, I sometimes forget patients, I thought you were this idiot who doesn’t know how to use birth control. [pointed look]
Charlie: I can’t have mono. I don’t even feel sick or anything.
House: That’s very often the first sign. [He gets into the elevator.] Call my office in the morning, I’ll schedule him for bloodtests. [The elevator doors close.]
Jill: Thank you!
Charlie: I’m not even tired.
[Cut to Cuddy swabbing medical equipment. Wilson walks up.]
Wilson: Find anything yet?
Cuddy: No, just some baby formula being stored under a sink with a dripping faucet.
Wilson: Tap water contamination. You thinking pseudomonas infection?
Cuddy: I was. I wasted a couple of hours chasing it down, but of course the formula hasn’t been anywhere near the babies.
Wilson: Huh.
Cuddy: Whatever idiot stored them there –
Wilson: All right, we’ll figure it out! Just… just calm down.
Cuddy: I am calm. [She walks over to Med Student with Tie, and takes scissors to him, leaving him Med Student without Tie.]
Med Student without Tie: Aw, could –
Cuddy: I warned you. [to Wilson] I did that calmly. [She and Wilson walk into NICU as Chase walks out. Karen is looking in the windows.]
Karen: [to Chase] Hey.
Chase: Hi.
Karen: Is she any better?
Chase: Her fever’s been stable the last hour.
Karen: We’re not going to make it, are we?
Chase: Sorry?
Karen: Me and Ethan. Our next-door neighbor, their little boy died in a car crash and she and her husband split up, like, four months after the funeral. It’s just, uh, what always happens, right? [pause]
Chase: Um, what happens to patients after they leave the hospital, I don’t know, but… try not to get ahead of yourself. [Beeping is heard inside the NICU. Chase goes back in.]
Nurse’s voice: Dr. Chase? Activity on the monitor.
Chase: How long?
Nurse: I don’t know, it just started.
Chase: Pulse? [Nurse mutters something.] Fluid wide open. Do we have an arterial line?
Nurse: Not yet.
Chase: Let’s get a BP. [Karen walks into the NICU.] You can’t come in here.
Karen: Is my baby dying?
Chase: Mrs. Hartig –
Karen: Is she dying?!
Nurse: [half-pushing Karen out the door] Ma’am, you’ll have to leave.
Chase: It’s not your baby!
Chase: Fenlay, BP 60 over 20. [House walks into the NICU and stands next to Wilson.]
Cameron: Heart rate’s 180.
House They start the levofed?
Wilson: They’ve got it.
Kim and Judy come to the window.]
Chase: Still dropping. 50 over 10.
Cameron: Can’t hold BP with three pressers? We’re losing pulse.
Chase: V-fib.
Wilson: Shut the blinds. [A nurse does so. Judy starts to cry. Wilson and Chase prep the defibrillator.]
Chase: Charging. Clear. [CGI of inside the baby’s chest. We see that the shock does nothing to jumpstart the heart.]
Foreman: Still v-fib.
Chase: Charging. Clear. [another shock] Charging. Clear. [CGI shot shows no movement.]
Foreman: Still v-fib.
Chase: Charging. Clear. [shock] Charging.
House: Chase. [pause] Time of death: 6:57 PM. [long pause] The Aztreonam doesn’t work. Double-cover all the other babies with Vancomycin.
Chase: I’ll do it.
House: Cameron, you tell the parents. Tell them their child probably saved five lives.
Cameron: But Chase should –
House: Chase is busy.
Cameron: You’re the attending.
House: [to Wilson] Make sure she does her job.
[Cut to Kim and Judy. Cameron and Wilson walk out to them. We see Cameron freeze up, and Wilson starts to talk. Judy and Kim sob. As Wilson and Cameron leave, she looks back at the two women.]
[Cut to House and Wilson leaving the elevator.]
House: I asked you to make sure she does her job, not do it for her.
Wilson: She froze up.
House: She felt sorry for the parents so she shut up. You felt sorry for her so you opened your mouth.
Wilson: She has a problem.
House: Yeah, she needs to deal with it. If you hadn’t bailed her out, she would have done it.
Wilson: Great, then she wouldn’t have slept for two weeks. Maybe she should be thinking about a different specialty. Lab work, research? [Chase walks up.]
House: Yeah, what is it?
Chase: The Hartig baby. She’s getting sicker, too. The Vancomycin isn’t working, either.
[Cut to a late night in House’s office.]
House: Vancomycin doesn’t kill it. Aztreonam doesn’t kill it. What the hell is this?
Foreman: It’s a super bug.
Chase: It could be VRSA.
Cuddy: There’s only been two reported cases of it ever in the United States.
Chase: One of the kids, the Hausen baby, had a skin rash. It could be scalded-skin syndrome which would be a sign of VRSA.
Foreman: Then these kids are dead.
House: This is our fault. Doctors over-prescribing antibiotics. Got a cold? Take some penicillin. Sniffles? No problem. Have some azithromycin. Is that not working anymore? Well, got your Levaquin. Antibacterial soaps in every bathroom. We’ll be adding Vancomycin to the water supply soon. We bred these super bugs. They’re our babies. Now they’re all grown up and they’ve got body piercings and a lot of anger. [sigh] On the other hand, maybe antibiotics had nothing to do with it. Did you notice how low his BP was at the end? Even with three pressers?
Wilson: Heart damage?
House: Go home. There’s nothing more you can do tonight.
[Cut to House, preparing to do an autopsy on the dead baby. He speaks into a little microphone.]
House: Baby boy Chen-Lupino. Time of death 6:57 PM Thursday, December 2nd, 2004. [He takes the covers off of the tools and starts to remove the baby’s diaper.]
[Cut to the next morning in House’s office.]
House: This is a cross-section of the Chen-Lupino boy’s myocardium. Fibrosis, lymphocydic infiltrates.
Cameron: There was no sign of lymphcytosis in the blood tests.
House: Yes, well, we all had plenty of good reasons to think bacterial. Nobody is scolding you. [He hands Cameron his cane.] Unfortunately, all of those clever reasons were wrong. It is a virus infecting their hearts.
Foreman: We’re screwed. We can’t chase down a virus; there’s a thousand possibilities.
Cameron: We could run gels, antibody tests.
Foreman: A thousand of them? The kids don’t have enough blood.
House: Chase, you’re the intensivist. How many could we do before we risk exsanguinating the kids?
Chase: You’re talking vials, not stick tests? I wouldn’t take more than five or six.
House: [writes “Virus” on the white board’] Okay, so we have to narrow the thousand viruses down to six. Now, the autopsy’s shown us what the virus does. So, let’s go. What do we know?
Wilson: Ribavirin and encyclovir don’t knock it out.
Cuddy: Cross out the herpes viruses.
House: Also adenovirus. [House starts to make a T-chart on the board.] What else, what else? Keep talking.
Chase: Well, it, it only seems to hit children. The mothers aren’t sick, so…
Foreman: No toxoplasmosis, no rubella. Cross out the entire Torgh syndrome.
Wilson: You didn’t find any lung damage?
House: No.
Wilson: None of the paramyxoviridae.
House: Cardiac scarring, people.
Chase: CMV?
Foreman: Enteroviruses, too, I think.
House: [muttering] Echo 11.
Cuddy: Influenza A.
House: [mutters] Influ A. Yes. And? [We see more ideas being written on the board.] I’m putting RSV down as a yes. That makes eight.
Chase: Eight vials of blood is pushing it.
House: Pushing it, but we love that! Get the antibody kits, start testing the sick kids.
Wilson: All right, I’ll start looking into whether there are any antivirals for these eight.
House: Wait a second. The, the kids on the floor who didn’t get sick. Are any of them still in the hospital?
Wilson: They got moved to the fifth floor. But they’re probably all checked out by now.
Cuddy: No, the Lindpert boy had a bit of jaundice. He should be checking out today.
House: I want to test his blood, too.
Cuddy: Why?
House: ‘Cause we need all the information we can get. The healthy kid can be our control group.
Cuddy: I’ll just tell his parents he can’t check out because he has the smallpox.
[Cut to Cameron drawing blood from sick babies. Chase is taking some from the healthy one on floor five. The baby is crying.]
Chase: All done, all done.
[Cut to House’s office.]
House: What did we get?
Foreman: Well, the sick babies all tested positive for Echovirus 11.
House: Great.
Foreman: And CMV, and parvovirus B19.
House: Three viruses?
Foreman: What’s weirder, the healthy kid we tested: he’s positive for Echovirus 11 and CMV antibodies as well.
House: [sighs] They’re infants. They have their mother’s blood, their mother’s antibodies.
Foreman: So we just learned nothing?
House: Uh-uh. We have half the picture. The healthy kids survived because their mothers’ antibodies saved them.
Foreman: The mom had CMV in the past she’d have the antibodies for them, the kid would be immune from it. So we test the sick kids’ moms for Echovirus, CMV, and parvovirus.
House: And whichever they don’t have the antibodies for, that’s what’s killing their kids.
Foreman: I’ll test the mothers.
[Cut to Foreman drawing blood from Karen. The overhead speaker is asking for an inhalation specialist to go to pediatrics.]
[Cut to House’s white board. House crosses off Parvovirus B19 and CMV and circles Echo-11.]
[Cut to Foreman and Cameron, who are talking to Karen and Ethan.]
Foreman: Echovirus 11. It’s an enterovirus. It lodges in the intestinal tract.
Cameron: Enteroviruses cause diarrhea and flu-like symptoms in adults, maybe a rash, but for newborns it can be deadly. It’s damaging her heart.
Karen: Well, is there anything you can do?
Foreman: Viruses are more difficult to treat than bacterial infections. We still haven’t found a cure for the common cold.
Ethan: So, there’s no vaccine, or…
Foreman: There’s a company in Pennsylvania developing an antiviral. It got positive results in a lab setting and we managed to get our hands on it.
[Cut to Cameron, helping with Baby Hartig.]
Cameron: Imagine not being able to touch your own baby. [She goes out to Karen and Ethan.] Can I get your guys’ help with something?
Ethan: Sure.
Cameron: Your daughter, her –
Ethan: Maxine.
Karen: That’s her name.
Cameron: We need someone to hold Maxine off of the bed while the nurse changes her sheet.
Ethan: Sure. {They enter the room, now in scrubs, and hold Maxine.]
[Cut to House, getting into of the elevator.]
House: Hey, Foreman? Got a minute? [Foreman gets into the elevator.]
Foreman: So, pulmonary resistance is stabilized for the two kids, but BP’s still –
House: No news, then. How’s Cameron?
Foreman: Dr. Cameron?
House: Sure. Let’s start with her, and move on to all the other Camerons we know.
Foreman: Sorry, I’m just not used to you asking about someone’s well-being.
House: I can understand how the question would surprise you. I don’t quite get how it would confuse you.
Foreman: Why do you want to know? [They get out of the elevator.]
House: Why do you want to know why I want to know?
Foreman: Just curious.
House: Me, too.
Foreman: You don’t get curious.
House: I’m the most curious man in the world.
Foreman: Not about trivialities.
House: Well, then, this must not be trivial. How is Cameron handling everything? [They’re at the doors of the clinic.]
Foreman: Just fine.
House: Great, glad we talked.
[Cut to House, who’s meeting with Jill.]
House: Your husband is definitely the source of your “mono”.
Jill: Oh, wow. Oh, thank God. Wow, I’m going to be a mom. Whoa, heh heh. Thank you so much; I gotta get you a gift or something.
House: Sometimes the best gift is the gift of never seeing you again.
Jill: Okay, all right! But, Dr. House, you’ve been so awesome. I mean, I really, totally trust you. Do you think you –
House: No.
Jill: -- could do the prenatal?
House: No.
Jill: Or deliver the baby?
House: That would be no.
Jill: Okay!
[Cut to Ethan and Karen sitting on a couch in the waiting room.]
[Cut to NICU.]
Foreman: Chase, take a look at this. [Chase comes over, and starts to check out Baby Hartig with the stethoscope.]
[Cut to Chase and Foreman coming to talk to the Hartigs.]
Ethan: Oh, God. It’s good news.
Chase: No, it’s great. [Ethan and Karen start to laugh and cry.]
[Cut to Karen in a room. Cameron and Chase wheel in Baby Hartig, who Karen is ecstatic to see and hold.]
[Cut to Cameron, working in House’s office. House walks in, and Cameron starts to pack up.]
House: They all gone?
Cameron: Hartigs are checking out right now.
House: You look tired.
Cameron: Thanks.
House: It’s no wonder. You’ve had a hard time the last couple of days.
Cameron: And you haven’t?
House: Not like you. [pause] Anyone who’s that awkward either has no experience around death or too much, and I’m pretty sure it’s not the former. [Cameron starts to put on her coat.] Chase told me about that ID you had: the parents holding the baby. Where’d you get that? Did you lose someone? Did you lose a baby?
Cameron: You can be a real bastard. [She leaves.]
[As Cameron leaves, she sees the Hartigs exiting via the elevator. They all look very happy, which makes Cameron smile.]
[Let’s look at the outside of the hospital for a rather lengthy stretch of time! Okay!]
[Cut to House sitting on a couch in the waiting room. Wilson walks by.]
Wilson: Unfinished business?
House: I’m in the haystack.
Wilson: Ah, because now you know you’re looking for a needle.
House: Right.
Wilson: If I tell you to “let it go,” it won’t make any difference, will it?
House: Enteroviruses are spread by humans. Fecal, oral… could be respiratory secretions, though.
Wilson: So, Cuddy got stool samples from the whole staff. Just wait until they come back.
House: That won’t do it.
Wilson: Why not?
House: The shedder, whoever he is, is so virulent, Cuddy must have noticed him.
Wilson: Hmmm.
House: And the babies didn’t share any common personnel. That’s what’s weird.
Wilson: Yeah, yeah. That’s what’s weird. [Wilson leaves. We hear coughing in the distance. A old woman is pushing a cart around with teddy bears to give to the newborns. CGI shot of inside the woman’s nose, which shows the offending virus traveling from her nose, to her hand, to the fur of the teddy bear, to the face of a baby.]
Old woman: [to House] Can I help you?
[Cut to the soap opera.]
Soap patient: You saved my life.
Soap doctor: I just ran some tests. Your will and determination are what saved your life.
Soap patient: I know who I am now.
Soap doctor: Yes, you do. And I know who I am as well. [House is watching this in the OB/GYN lounge again. The door opens.]
Lim: Hey, seriously, man, you’re not supposed to be here.
House: I’m performing a delivery.
Kubisak: You are.
House: Patient who’s prenatal care I’ve been handling. Just checking her out a couple of minutes ago. Of course, I’ll need one of you two guys to supervise.
Lim: When’s she due?
House: Late March.
Kubisak: That’s five months from now.
House: Thank God these chairs are comfortable.
[End!]
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