1 00:00:02,274 --> 00:00:03,775 He is not sick. 2 00:00:03,900 --> 00:00:06,778 Dr. Riley is throwing up. He obviously can't lecture. 3 00:00:06,903 --> 00:00:09,531 You witnessed the spew or do you just have his word for it? 4 00:00:09,656 --> 00:00:11,450 I think I'm coming down with a little bit of the clap. 5 00:00:11,575 --> 00:00:12,993 I may have to go home for a few days. 6 00:00:13,118 --> 00:00:15,621 Dr. Riley doesn't have a history of lying to me. 7 00:00:15,746 --> 00:00:18,415 You said this is the fifth time he's missed a class this year. 8 00:00:18,540 --> 00:00:19,875 Either he's dying or he's lying. 9 00:00:20,000 --> 00:00:21,960 I'll give you two hours off clinic duty. 10 00:00:22,085 --> 00:00:25,005 Fine. I'll have Cameron do it. She loves inspiring the inspired. 11 00:00:25,130 --> 00:00:26,465 You'll do it. 12 00:00:26,632 --> 00:00:27,966 Why is it always me? 13 00:00:28,091 --> 00:00:29,384 Because the world hates you. 14 00:00:29,509 --> 00:00:31,595 Or because it's a class on diagnostics. 15 00:00:31,720 --> 00:00:35,015 Pick whichever reason feeds your narcissism better. 16 00:00:35,140 --> 00:00:37,184 I'm not doing it. 17 00:00:38,393 --> 00:00:40,103 (DOOR OPENS) 18 00:00:49,029 --> 00:00:51,990 You're supposed to stop me. Renegotiate. 19 00:00:52,115 --> 00:00:53,700 And you were supposed to keep on walking. 20 00:00:53,825 --> 00:00:56,787 Sorry. I guess we both screwed up. Go on. Do it again. 21 00:00:57,954 --> 00:00:59,956 I'll do the lecture for four hours off clinic. 22 00:01:00,082 --> 00:01:03,418 Two. I know you'd rather spend a couple of hours 23 00:01:03,543 --> 00:01:05,962 listening to yourself than listening to patients. 24 00:01:06,088 --> 00:01:07,339 (SIGHS) 25 00:01:07,964 --> 00:01:10,092 Class starts in 20 minutes. 26 00:01:12,552 --> 00:01:13,720 Dr. House, there's a patient. 27 00:01:13,845 --> 00:01:15,722 I'm outta here. Take it up with Cuddy. 28 00:01:15,847 --> 00:01:17,766 STACY: Greg. 29 00:01:23,563 --> 00:01:25,524 Hi, Stacy. 30 00:01:26,441 --> 00:01:28,026 How you doing? 31 00:01:29,152 --> 00:01:31,613 How am I doing? 32 00:01:32,072 --> 00:01:34,950 Well, the last five years have been like... 33 00:01:35,075 --> 00:01:37,869 You ever see those "Girls Gone Wild" videos? 34 00:01:37,994 --> 00:01:41,998 Your life's been like that, or your life's been spent watching them? 35 00:01:46,128 --> 00:01:47,963 I have missed you. 36 00:01:49,339 --> 00:01:51,508 Is that why you're here? 37 00:01:56,263 --> 00:01:58,098 I need your help. 38 00:02:08,483 --> 00:02:10,360 Who am I looking at? 39 00:02:10,485 --> 00:02:12,154 My husband. 40 00:02:15,574 --> 00:02:19,286 Who is suffering abdominal pain and fainting spells. 41 00:02:20,328 --> 00:02:23,582 No sign of tumors, no vasculitis. 42 00:02:23,707 --> 00:02:26,209 Could be indigestion. 43 00:02:26,334 --> 00:02:28,295 Or maybe a kidney stone. 44 00:02:28,462 --> 00:02:30,422 Little one can pack a lot of wallop. 45 00:02:30,547 --> 00:02:33,467 Did you think I wasn't going to get married? 46 00:02:33,592 --> 00:02:34,676 (SIGHS) 47 00:02:34,801 --> 00:02:37,012 Not to someone so poorly endowed. 48 00:02:37,137 --> 00:02:39,473 This guy's pancreas is pathetic. 49 00:02:43,852 --> 00:02:46,021 There is no kidney stone, no indigestion. 50 00:02:46,146 --> 00:02:49,649 Three hospitals, five doctors. Not one of them found anything. 51 00:02:49,775 --> 00:02:51,276 Maybe there's nothing to be found. 52 00:02:51,401 --> 00:02:52,819 Right. You suddenly trust doctors, 53 00:02:52,944 --> 00:02:54,613 love puppies and long walks in the rain. 54 00:02:54,738 --> 00:02:56,740 Walks are out. 55 00:02:57,282 --> 00:03:00,660 I was around you long enough to know when something's not right. 56 00:03:00,786 --> 00:03:02,037 Mark's had personality changes. 57 00:03:02,162 --> 00:03:04,790 He's acting strange, disconnected. 58 00:03:04,915 --> 00:03:06,500 Interesting. 59 00:03:06,625 --> 00:03:08,543 Means there's either a neurological component, 60 00:03:08,668 --> 00:03:10,295 or he's having an affair. 61 00:03:10,420 --> 00:03:12,964 No affair. No nothing. He's sick. 62 00:03:14,257 --> 00:03:17,344 I know you're not too busy. You avoid work like the plague. 63 00:03:17,469 --> 00:03:19,846 Unless it actually is the plague. 64 00:03:19,971 --> 00:03:21,973 I'm asking you a favor. 65 00:03:22,933 --> 00:03:24,935 I'm not too busy. 66 00:03:26,686 --> 00:03:29,731 But I'm not sure I want him to live. 67 00:03:31,858 --> 00:03:33,985 It's good seeing you again. 68 00:04:24,911 --> 00:04:28,623 Three guys walk into a clinic. 69 00:04:28,915 --> 00:04:32,544 Their legs hurt. What's wrong with them? 70 00:04:35,046 --> 00:04:36,756 I'm not gonna like you, am I? 71 00:04:36,882 --> 00:04:39,509 The most likely cause of leg pain is muscle strain. 72 00:04:39,634 --> 00:04:42,220 Apply heat and rest affected areas. 73 00:04:42,345 --> 00:04:44,890 Statistically, you're right. Very good. 74 00:04:45,015 --> 00:04:48,059 My experience, over half of leg pain is musculoskeletal, 75 00:04:48,184 --> 00:04:50,353 generally from excessive exercise, 76 00:04:50,478 --> 00:04:54,024 12 percent is varicose veins brought on by pregnancy, 77 00:04:54,149 --> 00:04:57,527 and most of the rest is the result of vehicular accidents. 78 00:04:57,652 --> 00:05:00,071 I said three people. That's six legs. 79 00:05:00,196 --> 00:05:02,657 So you've got three hurl: jogging, 80 00:05:02,782 --> 00:05:05,452 two in collisions, and one of the legs is pregnant. 81 00:05:05,785 --> 00:05:06,786 (STUDENTS CHUCKLE) 82 00:05:06,912 --> 00:05:08,330 What were they doing when pain presented? 83 00:05:08,455 --> 00:05:09,456 I have no idea. 84 00:05:09,581 --> 00:05:11,499 You didn't ask? You didn't take a history? 85 00:05:11,625 --> 00:05:16,004 Of course. But all that told us is what they said happened. 86 00:05:16,129 --> 00:05:20,008 Person A, farmer, says he was fixing a fence. 87 00:05:23,011 --> 00:05:25,555 HOUSE: Tightness in the ankle, loss of muscle control. 88 00:05:25,680 --> 00:05:27,432 (GROANING) 89 00:05:27,557 --> 00:05:30,977 Person B, volleyball practice. 90 00:05:35,815 --> 00:05:38,401 Coach figured it was a pulled muscle. 91 00:05:38,526 --> 00:05:42,489 And C, we've got Carmen Electra golfing. 92 00:05:43,323 --> 00:05:44,532 Yes! 93 00:05:44,658 --> 00:05:47,452 Whoa. You treated the "Baywatch" chick? 94 00:05:47,577 --> 00:05:50,497 The "Baywatch" thespian. And no. 95 00:05:51,164 --> 00:05:53,833 I gotta disguise the identity of each of the patients, 96 00:05:53,959 --> 00:05:55,919 and I got tired of using the middle-aged man. 97 00:05:56,044 --> 00:05:59,255 Carmen seemed like a pleasant alternative. 98 00:05:59,381 --> 00:06:01,800 Also, she's apparently quite the golfer. 99 00:06:01,925 --> 00:06:05,011 In less than two hours, one of these three 100 00:06:05,136 --> 00:06:06,888 will be tossed out of the hospital because 101 00:06:07,013 --> 00:06:08,848 they were faking it to score narcotics, 102 00:06:08,974 --> 00:06:12,978 and one will be very close to death. 103 00:06:13,937 --> 00:06:16,731 Any guesses on which is which? 104 00:06:18,066 --> 00:06:20,735 Okay, I say we start with the farmer. 105 00:06:22,362 --> 00:06:25,740 Did you hike to the fence, and how far? 106 00:06:25,865 --> 00:06:29,285 Yes. It's about a half a mile from my farmhouse. 107 00:06:29,411 --> 00:06:31,121 And where is the pain localized? 108 00:06:31,246 --> 00:06:35,000 It started just above my ankle, and it's radiating up. 109 00:06:35,125 --> 00:06:37,002 So, what should we do first? 110 00:06:37,127 --> 00:06:38,461 Family history? 111 00:06:38,586 --> 00:06:41,006 Indicative of leg pain? That's a very short list. 112 00:06:41,131 --> 00:06:44,134 Any history of bone cancer, osteogenesis imperfecta 113 00:06:44,259 --> 00:06:46,344 or multiple myeloma? 114 00:06:46,469 --> 00:06:47,804 Could be a blood issue. 115 00:06:47,929 --> 00:06:50,015 We should run a CBC and a D-Dimer. 116 00:06:50,140 --> 00:06:51,307 And get an MRI. 117 00:06:51,433 --> 00:06:52,767 MRI or a PET scan? 118 00:06:52,892 --> 00:06:53,852 If the problem's vascular, he's better off... 119 00:06:53,977 --> 00:06:56,938 (BUZZING) Sorry. Thanks for playing. 120 00:06:57,063 --> 00:06:59,691 Patient's dead. You killed him. 121 00:07:01,276 --> 00:07:03,903 We had no time to run any tests. There was nothing we could do. 122 00:07:04,029 --> 00:07:06,489 You had time to look at the leg. 123 00:07:11,327 --> 00:07:13,872 I thought we were starting with the farmer's case first. 124 00:07:13,997 --> 00:07:17,125 We are. But if we're gonna look at a leg... 125 00:07:17,250 --> 00:07:20,086 I need you to take off your pants. 126 00:07:48,156 --> 00:07:49,365 Puncture. 127 00:07:49,491 --> 00:07:50,492 FEMALE STUDENT: Snake bite. 128 00:07:50,617 --> 00:07:51,826 That would be my guess. 129 00:07:51,951 --> 00:07:53,244 Farmer didn't know he'd been bitten by a snake? 130 00:07:53,369 --> 00:07:54,370 HOUSE: That's what he said. 131 00:07:54,496 --> 00:07:56,748 Sudden shooting pain, tall grass. 132 00:07:56,873 --> 00:07:58,333 Never saw a thing. 133 00:07:58,458 --> 00:07:59,501 What kind of snake? 134 00:07:59,626 --> 00:08:01,002 You want me to tell you what kind of snake it was 135 00:08:01,127 --> 00:08:02,712 from the shape of the hole in the leg? 136 00:08:02,837 --> 00:08:04,756 Well, how are we supposed to know what kind of antivenom to use 137 00:08:04,881 --> 00:08:06,049 if we don't know what kind of snake it is? 138 00:08:06,174 --> 00:08:09,219 Oh, there are people to find those things out. 139 00:08:09,344 --> 00:08:11,554 Shouldn't we wait for the Humane Society or something? 140 00:08:11,679 --> 00:08:14,182 Guy might only have a couple of hours. 141 00:08:14,307 --> 00:08:16,392 (DOGS BARKING) 142 00:08:21,231 --> 00:08:24,859 And while we wait for the Humane Society to show up, 143 00:08:24,984 --> 00:08:27,821 let's say we check in on the volleyball player. 144 00:08:28,613 --> 00:08:31,032 You have tendinitis. 145 00:08:31,449 --> 00:08:33,409 FEMALE STUDENT: How old is this person? 146 00:08:33,535 --> 00:08:35,829 I mean, it's not really a 40-year-old man 147 00:08:35,954 --> 00:08:36,996 on a girls' volleyball team, right? 148 00:08:37,122 --> 00:08:39,124 It's a leg. A leg is a leg is a leg. 149 00:08:39,249 --> 00:08:40,750 Well, I was just worried that... 150 00:08:40,875 --> 00:08:44,129 Would you worry about her more if she was younger? 151 00:08:44,712 --> 00:08:47,841 Well, obviously, we should care about all our patients, no matter what age... 152 00:08:47,966 --> 00:08:49,384 Yeah, right. 153 00:08:49,509 --> 00:08:51,386 I saw the way you were looking at Carmen. 154 00:08:51,511 --> 00:08:53,012 She's mine. Stay away. 155 00:08:53,138 --> 00:08:54,222 (STUDENTS LAUGHING) 156 00:08:54,347 --> 00:08:55,974 Would you operate on your mother? 157 00:08:56,766 --> 00:08:58,351 Of course not. 158 00:08:58,476 --> 00:09:01,062 I'd be too nervous. Couldn't be objective. 159 00:09:01,187 --> 00:09:05,108 Then why are you so anxious to treat every patient like they're family? 160 00:09:05,358 --> 00:09:07,610 The actual patient is 16. 161 00:09:07,735 --> 00:09:11,114 Here's what happens when doctors care too much. 162 00:09:11,239 --> 00:09:14,117 I need to know everything about you. 163 00:09:15,994 --> 00:09:17,412 CAMERON: I went back three generations. 164 00:09:17,537 --> 00:09:21,040 No history of cancer, Parkinson's or any other degenerative condition, 165 00:09:21,166 --> 00:09:23,209 but there's this boy at school, and he's on the boys' volleyball team 166 00:09:23,334 --> 00:09:25,336 and they made out at a party, and now he won't call her back. 167 00:09:25,461 --> 00:09:26,546 And this friend of hers at school 168 00:09:26,671 --> 00:09:29,299 said this boy didn't like her and never did. 169 00:09:29,424 --> 00:09:31,092 You got all this from an examination of the knee? 170 00:09:31,217 --> 00:09:32,260 I think she's depressed. 171 00:09:32,385 --> 00:09:33,469 She doesn't have tendinitis? 172 00:09:33,595 --> 00:09:34,679 She has tendinitis. 173 00:09:34,804 --> 00:09:35,805 She's depressed about having tendinitis? 174 00:09:35,930 --> 00:09:37,348 She's depressed for the same reason that she has tendinitis. 175 00:09:37,473 --> 00:09:39,559 - Not the boy? - No, the boy's a jerk. 176 00:09:39,684 --> 00:09:41,853 She knows that, and yet she's depressed. 177 00:09:41,978 --> 00:09:43,688 I found a nodule. 178 00:09:43,813 --> 00:09:44,814 Ah. 179 00:09:45,190 --> 00:09:48,151 Problems with the thyroid gland causes depressed mental state, 180 00:09:48,276 --> 00:09:50,904 can cause inflammation of the tendons. 181 00:09:51,029 --> 00:09:52,947 I'll run the tests. 182 00:09:53,072 --> 00:09:55,825 So because she took such an extreme interest, 183 00:09:55,950 --> 00:09:58,286 she found out that the person had a thyroid condition. 184 00:09:58,411 --> 00:10:03,416 No. Because she took such an interest, she discovered a tiny nodule, 185 00:10:03,541 --> 00:10:06,836 which in reality signified nothing, but gave us no choice 186 00:10:06,961 --> 00:10:11,424 but to put a person with tendinitis through an expensive and painful test. 187 00:10:16,721 --> 00:10:17,889 (GASPING) 188 00:10:18,014 --> 00:10:21,017 Here's how a well-adjusted doctor handles a case. 189 00:10:25,772 --> 00:10:27,232 (SIGHS) 190 00:10:27,357 --> 00:10:28,983 Can I put my pants back on now? 191 00:10:29,150 --> 00:10:31,027 I'd rather you didn't. 192 00:10:31,152 --> 00:10:33,238 Which Carmen Electra is this? 193 00:10:33,363 --> 00:10:35,615 The first one, the golfer. 194 00:10:35,740 --> 00:10:38,868 Then why isn't she wearing pants? 195 00:10:39,994 --> 00:10:43,289 You have decreased reflexes in your patellar tendon. 196 00:10:43,414 --> 00:10:44,499 Anyone? 197 00:10:44,624 --> 00:10:45,833 Slipped disc. 198 00:10:45,959 --> 00:10:48,378 Could be. How bad does it hurt? 199 00:10:48,503 --> 00:10:50,088 It hurts really, really bad. 200 00:10:50,213 --> 00:10:51,422 Yeah? 201 00:10:51,547 --> 00:10:54,926 It doesn't seem real. Is she the one faking? 202 00:10:55,051 --> 00:10:57,512 Oh, for God's sake. She's here to play into my fantasy, 203 00:10:57,637 --> 00:10:59,305 not 'cause she's Meryl Streep. 204 00:11:02,517 --> 00:11:03,601 Fine. 205 00:11:03,726 --> 00:11:06,062 What the hell is wrong with me! 206 00:11:06,562 --> 00:11:07,897 Do something! 207 00:11:08,022 --> 00:11:09,816 (GROANING) 208 00:11:09,941 --> 00:11:11,693 Too much pain to be a slipped disc. 209 00:11:11,818 --> 00:11:13,444 Could be herniated and impinging the nerve root. 210 00:11:13,569 --> 00:11:15,905 Or it could be referred pain from his groin. 211 00:11:16,030 --> 00:11:17,782 Sir, are you getting pain anywhere else? 212 00:11:17,907 --> 00:11:19,325 (SCREAMING) 213 00:11:19,450 --> 00:11:21,035 He's curling. It's not the back. 214 00:11:21,160 --> 00:11:23,871 - Sir, where are you getting pain? - Help me! 215 00:11:23,997 --> 00:11:26,666 He's not gonna tell us anything if we don't get him out of pain. 216 00:11:26,791 --> 00:11:27,959 Give him 50 milligrams of Demerol. 217 00:11:28,084 --> 00:11:30,128 We have no history. He could be allergic. 218 00:11:30,253 --> 00:11:31,296 What do I do? 219 00:11:31,421 --> 00:11:32,880 We can't diagnose him while he screams. 220 00:11:33,006 --> 00:11:35,091 Better than killing him with painkillers. 221 00:11:35,341 --> 00:11:37,969 (GRUNTING) 222 00:11:39,053 --> 00:11:40,972 (GROANING) 223 00:11:42,098 --> 00:11:43,433 (SIGHS) 224 00:11:44,642 --> 00:11:47,186 Apparently, he's not allergic. 225 00:11:48,313 --> 00:11:52,150 Thank you. I feel a lot better now. 226 00:11:53,151 --> 00:11:54,569 (SIGHS) 227 00:11:55,611 --> 00:11:57,447 We screwed up. 228 00:11:57,572 --> 00:12:00,325 No. You did exactly what his attending did. 229 00:12:00,450 --> 00:12:02,035 MALE STUDENT: And that was the proper way to handle the case? 230 00:12:02,160 --> 00:12:03,119 Yeah. 231 00:12:03,244 --> 00:12:04,662 The guy used him as a dealer. 232 00:12:04,787 --> 00:12:07,957 You're gonna see a lot of drug-seeking behavior in your practice. 233 00:12:08,082 --> 00:12:11,002 And there's a reason. It works. 234 00:12:11,127 --> 00:12:13,880 Meanwhile, back on the farm... 235 00:12:14,005 --> 00:12:16,090 (RATTLING) 236 00:12:18,718 --> 00:12:21,387 Yeah, timber rattlesnake. 237 00:12:21,888 --> 00:12:25,391 Four vials of the CroFab antivenom. 238 00:12:25,516 --> 00:12:26,601 He)!' how you doing? 239 00:12:26,726 --> 00:12:29,103 - All right. - Thank you. 240 00:12:29,228 --> 00:12:32,190 CAMERON: This will start making you feel better really fast. 241 00:12:35,651 --> 00:12:37,403 (GASPING) 242 00:12:37,528 --> 00:12:39,447 (wmzeznqe) 243 00:12:39,572 --> 00:12:42,950 CAMERON: He's having an allergic reaction. Bag. 244 00:12:43,076 --> 00:12:44,952 (WHEEZING CONTINUES) 245 00:12:45,078 --> 00:12:46,496 Paddles and epi. 246 00:12:46,621 --> 00:12:48,956 His heart's fine. It's not gonna stay that way. 247 00:12:50,333 --> 00:12:52,085 Paddles! 248 00:12:59,175 --> 00:13:04,263 What say we take five, get some coffee, go pee. 249 00:13:12,188 --> 00:13:15,108 You didn't think she was gonna get married? 250 00:13:16,109 --> 00:13:18,277 She asked me the same question. 251 00:13:20,822 --> 00:13:24,075 And what? You're not gonna treat him? 252 00:13:26,244 --> 00:13:28,496 There's probably nothing wrong with him. 253 00:13:28,621 --> 00:13:29,872 Oh, sure, that makes sense. 254 00:13:29,997 --> 00:13:32,333 She's just using the old sick-husband routine 255 00:13:32,458 --> 00:13:35,211 as an excuse to get back in touch with you. 256 00:13:35,336 --> 00:13:37,338 You think this is easy for her? 257 00:13:37,463 --> 00:13:40,091 The only reason she'd be anywhere near you is if she was desperate. 258 00:13:40,216 --> 00:13:42,760 So I should help her because she hates me? 259 00:13:42,885 --> 00:13:45,930 She doesn't hate you. She loves you. 260 00:13:46,055 --> 00:13:51,978 She just can't stand to be around you. 261 00:13:55,606 --> 00:13:59,485 Dr. House, it's been almost six minutes. 262 00:14:01,654 --> 00:14:03,072 (SIGHS) 263 00:14:07,994 --> 00:14:10,163 Found him. 264 00:14:11,205 --> 00:14:13,416 The volleyball player 265 00:14:14,417 --> 00:14:16,669 was responding to the anti-inflammatories 266 00:14:16,836 --> 00:14:19,088 as you'd expect in a case of tendinitis. 267 00:14:19,213 --> 00:14:20,882 Whoa, whoa, whoa. 268 00:14:21,048 --> 00:14:22,216 What about the snake-bite guy? 269 00:14:22,341 --> 00:14:24,927 I don't really care about the volleyball player. 270 00:14:25,052 --> 00:14:28,264 What if I told you the volleyball player had a sudden massive stroke? 271 00:14:28,389 --> 00:14:30,725 - Really? - No. 272 00:14:30,850 --> 00:14:33,060 But that would make you interested, right? 273 00:14:33,186 --> 00:14:35,146 What if her T4 came back low? 274 00:14:35,271 --> 00:14:36,481 It's not quite as interesting, 275 00:14:36,606 --> 00:14:37,982 but it has the benefit of being true. 276 00:14:38,107 --> 00:14:40,860 You said the thyroid biopsy was a wasted test. 277 00:14:40,985 --> 00:14:44,197 No, I didn't. I said she put a person with tendinitis 278 00:14:44,322 --> 00:14:46,282 through an expensive and painful test. 279 00:14:46,407 --> 00:14:49,869 Apparently, the patient had tendinitis and a thyroid condition. 280 00:14:49,994 --> 00:14:51,329 We're gonna start you on thyroxine. 281 00:14:51,454 --> 00:14:54,165 It'll make you feel better and level your moods. 282 00:14:56,125 --> 00:14:57,668 Thank you. 283 00:15:08,137 --> 00:15:10,097 So that's it? 284 00:15:10,515 --> 00:15:12,016 You were right the first time. 285 00:15:12,141 --> 00:15:14,519 Snake-bite guy's way more interesting. 286 00:15:14,644 --> 00:15:16,437 Gross, actually. 287 00:15:18,981 --> 00:15:20,650 FOREMAN: The patient responded to epinephrine, 288 00:15:20,775 --> 00:15:23,069 and the allergic reaction was arrested. 289 00:15:23,194 --> 00:15:25,738 Unfortunately, the patient continues to deteriorate. 290 00:15:25,863 --> 00:15:27,907 Maybe the snake wrangler was wrong about the type we caught. 291 00:15:28,032 --> 00:15:29,700 He faxed us a venom test. 292 00:15:29,825 --> 00:15:32,161 Confirmed. It's a timber rattlesnake. 293 00:15:33,829 --> 00:15:36,415 No, it's not. Notice the volume? 294 00:15:36,541 --> 00:15:39,043 I skimmed over that and the gender and the coloring. 295 00:15:39,168 --> 00:15:40,878 Jumped right to the name of the snake. 296 00:15:41,003 --> 00:15:43,089 Two hundred milligrams. 297 00:15:43,214 --> 00:15:45,424 Our guy got bit less than four hours ago. 298 00:15:45,675 --> 00:15:48,970 There's no way a snake regenerates that much venom that quickly. 299 00:15:49,095 --> 00:15:51,055 We're supposed to know how fast snakes make their venom? 300 00:15:51,180 --> 00:15:52,306 No. 301 00:15:52,431 --> 00:15:55,893 Unless you've got a patient bit by one. Then it might be helpful. 302 00:15:56,060 --> 00:15:57,103 So what do we do now? 303 00:15:57,228 --> 00:15:59,564 He must have been bitten by a different snake. 304 00:15:59,689 --> 00:16:01,107 We go back and find it. 305 00:16:01,232 --> 00:16:02,692 Or you go online, and you find 306 00:16:02,817 --> 00:16:04,819 there's only three poisonous snakes common in New Jersey, 307 00:16:04,944 --> 00:16:07,905 the copperhead, timber rattler and the coral. 308 00:16:08,030 --> 00:16:09,907 Copperhead and timber rattler both respond 309 00:16:10,032 --> 00:16:11,784 to the antivenoms we gave the guy. 310 00:16:11,909 --> 00:16:14,078 So we give him the antivenom for the other one. 311 00:16:14,245 --> 00:16:15,204 Is that a question? 312 00:16:15,329 --> 00:16:17,456 Well, we can't just blindly give him another antivenom, 313 00:16:17,582 --> 00:16:19,542 especially after the first one almost killed him. 314 00:16:19,667 --> 00:16:20,918 You said only three types of 315 00:16:21,043 --> 00:16:23,421 poisonous snakes commonly found in New Jersey. 316 00:16:23,546 --> 00:16:25,506 Well, what if this is an uncommon one? 317 00:16:25,631 --> 00:16:26,632 Very good. 318 00:16:26,757 --> 00:16:27,758 We gotta find the right snake. 319 00:16:27,883 --> 00:16:30,428 No need. Odds are by the time you get back, 320 00:16:30,553 --> 00:16:32,972 the autopsy results will tell you what kind of snake it was. 321 00:16:33,097 --> 00:16:33,931 But you said... 322 00:16:34,056 --> 00:16:37,393 So we do give him the antivenom for the other one? 323 00:16:37,518 --> 00:16:40,396 Again, was that a question? I asked what you would do. 324 00:16:40,521 --> 00:16:43,899 It seems unfair for you to ask me what you would do. 325 00:16:44,025 --> 00:16:47,278 Who gives the guy the other antivenom? 326 00:16:48,613 --> 00:16:51,532 And who goes looking for the snake? 327 00:16:52,116 --> 00:16:54,910 I assume that one choice kills him, the other one saves him. 328 00:16:55,036 --> 00:16:58,914 That's usually the way it works at the leg-turning-black stage. 329 00:16:59,040 --> 00:17:03,044 So half of us killed him, and half of us saved his life. 330 00:17:03,169 --> 00:17:06,005 - Yeah. - We can't be blamed... 331 00:17:06,130 --> 00:17:08,507 I'm sure this goes against everything you've been taught, 332 00:17:08,633 --> 00:17:11,177 but right and wrong do exist. 333 00:17:11,844 --> 00:17:14,096 Just because you don't know what the right answer is, 334 00:17:14,221 --> 00:17:16,057 maybe there's even no way you could know what the right answer is, 335 00:17:16,182 --> 00:17:18,893 doesn't make your answer right or even okay. 336 00:17:19,018 --> 00:17:20,936 It's much simpler than that. 337 00:17:21,062 --> 00:17:23,230 It's just plain wrong. 338 00:17:26,233 --> 00:17:27,818 We gave the guy the antivenom. 339 00:17:27,943 --> 00:17:29,528 What if I'm allergic again? 340 00:17:30,237 --> 00:17:32,073 That's why these people are here. 341 00:17:32,198 --> 00:17:35,201 If you have a reaction, we're ready to do whatever's necessary 342 00:17:35,326 --> 00:17:38,371 to ensure your airways stay open and your heart keeps beating. 343 00:17:38,496 --> 00:17:41,207 My wife's on her way in. Can't this wait? 344 00:17:41,332 --> 00:17:43,959 I'm sorry. It can't. 345 00:18:01,227 --> 00:18:03,145 (EXHALES) 346 00:18:14,240 --> 00:18:15,950 It hurts again. 347 00:18:16,075 --> 00:18:17,702 FEMALE STUDENT: He came back? 348 00:18:18,953 --> 00:18:22,039 On average, drug addicts are stupid. 349 00:18:22,707 --> 00:18:23,999 I'd call the cops. 350 00:18:24,125 --> 00:18:25,584 Good for you. 351 00:18:25,710 --> 00:18:28,254 A lot of doctors wouldn't risk their careers on a hunch. 352 00:18:28,379 --> 00:18:30,798 It's not a hunch. I mean, I know he wants drugs. 353 00:18:30,923 --> 00:18:33,092 Well, even drug addicts get sick. 354 00:18:33,217 --> 00:18:35,386 Actually, for some reason, 355 00:18:35,511 --> 00:18:38,639 they tend to get sick more often than non-drug addicts. 356 00:18:40,057 --> 00:18:43,060 Luckily, you don't have to play your hunch. 357 00:18:43,185 --> 00:18:44,437 There's a faster way. 358 00:18:44,562 --> 00:18:45,730 Actually, there are several. 359 00:18:45,855 --> 00:18:47,732 My preference is urine testing. 360 00:18:47,857 --> 00:18:50,067 But you already know he has drugs in his system. 361 00:18:50,192 --> 00:18:51,986 That's not what I'm testing for. 362 00:18:52,111 --> 00:18:53,988 We're gonna put this hard rubber tube 363 00:18:54,113 --> 00:18:56,449 up your urethra and into your bladder. 364 00:18:56,782 --> 00:18:57,950 It may be a little uncomfortable. 365 00:18:58,075 --> 00:19:00,035 Shouldn't I be getting some sort of anesthetic? 366 00:19:00,161 --> 00:19:01,120 (GROANING) 367 00:19:01,245 --> 00:19:03,956 We're concerned about allergic reactions today. 368 00:19:04,081 --> 00:19:05,875 (GROANING) 369 00:19:12,006 --> 00:19:13,924 If the guy can handle a rod in his penis 370 00:19:14,049 --> 00:19:16,469 for half an hour, he's really sick. 371 00:19:16,594 --> 00:19:18,554 Or he's really jonesing. 372 00:19:18,679 --> 00:19:20,598 There's easier ways to get a hold of drugs. 373 00:19:20,723 --> 00:19:21,974 Other hospitals, for example. 374 00:19:22,099 --> 00:19:23,100 (SNIFFING) 375 00:19:25,269 --> 00:19:28,397 The volleyball player is not responding to treatment. 376 00:19:31,108 --> 00:19:32,693 At least we think it's not working 377 00:19:32,818 --> 00:19:35,613 on account of the fact that she's getting worse. 378 00:19:35,738 --> 00:19:37,156 Can you still hear me? 379 00:19:37,281 --> 00:19:38,616 No. 380 00:19:38,741 --> 00:19:39,742 A little! 381 00:19:39,867 --> 00:19:41,035 Not really! 382 00:19:42,870 --> 00:19:45,206 Well, if you can't hear me, how do you know what I asked? 383 00:19:45,331 --> 00:19:46,332 (GROANING) 384 00:19:46,457 --> 00:19:47,666 I'm sorry. What did I do? 385 00:19:47,792 --> 00:19:49,293 I don't know. It really hurts. 386 00:19:49,418 --> 00:19:51,504 I promise to be very careful. 387 00:19:52,254 --> 00:19:53,172 Susan... 388 00:19:53,297 --> 00:19:54,965 Not her real name! 389 00:19:55,090 --> 00:19:56,967 Susan, I barely touched you. 390 00:19:57,092 --> 00:19:58,135 (CRYING) 391 00:19:58,260 --> 00:20:00,387 - It hurts so much! - I'm sorry. 392 00:20:00,513 --> 00:20:03,057 I have to get this blood. Just hold on. 393 00:20:03,182 --> 00:20:05,100 Hypersensitivity to touch. 394 00:20:05,226 --> 00:20:06,185 CHASE: Her calcium up? 395 00:20:06,310 --> 00:20:07,478 Lab over 16. 396 00:20:07,603 --> 00:20:09,897 Question is why. Likely suspects? 397 00:20:10,022 --> 00:20:11,065 Parathyroid adenoma. 398 00:20:11,190 --> 00:20:12,525 - Kidney problems. - Vit D intoxication. 399 00:20:12,650 --> 00:20:14,068 - Hyperthyroid. - Caused by our treatment? 400 00:20:14,193 --> 00:20:16,987 Whoa, whoa, whoa. Can you please slow down? 401 00:20:21,992 --> 00:20:24,912 The adenoma is most likely. 402 00:20:25,037 --> 00:20:30,376 Check her PTH, phosphorus and ionized calcium. 403 00:20:30,501 --> 00:20:33,254 And do a technetium sestamibi. 404 00:20:33,379 --> 00:20:36,298 Okay, that's enough about the volleyball player. 405 00:20:36,423 --> 00:20:38,133 What's up with the farmer? 406 00:20:39,134 --> 00:20:40,469 What farmer? 407 00:20:40,594 --> 00:20:42,763 Snake-bite guy. 408 00:20:42,888 --> 00:20:44,849 Oh, right, you guys don't know about him. 409 00:20:44,974 --> 00:20:46,141 He doesn't get bitten until three months 410 00:20:46,267 --> 00:20:48,394 after we treat the volleyball player. 411 00:20:48,519 --> 00:20:52,648 Luckily, it's been well-established that time is not a fixed construct. 412 00:20:52,773 --> 00:20:55,401 His condition's not improving. Double the dosage. 413 00:20:55,526 --> 00:20:56,485 Already did. 414 00:20:56,610 --> 00:20:58,571 There's another antivenom. It's not as effective... 415 00:20:58,696 --> 00:20:59,697 Already tried it. 416 00:20:59,822 --> 00:21:01,282 The first stuff, the stuff he was allergic to. 417 00:21:01,407 --> 00:21:03,158 Gave it to him with high-dose steroids. 418 00:21:03,284 --> 00:21:04,910 Nothing's working. 419 00:21:05,119 --> 00:21:06,412 What does it all mean? 420 00:21:06,537 --> 00:21:08,080 Wrong snake? 421 00:21:08,205 --> 00:21:10,124 We tried every other antivenom we had. 422 00:21:10,249 --> 00:21:11,083 We're too late? 423 00:21:11,208 --> 00:21:14,920 Yep. He's dying. His wife's here. 424 00:21:15,045 --> 00:21:16,797 Finally found a babysitter. 425 00:21:16,964 --> 00:21:18,716 Who wants to let them know? 426 00:21:19,717 --> 00:21:21,010 Actually, I'm kidding. 427 00:21:21,135 --> 00:21:22,469 He's not dying? 428 00:21:22,845 --> 00:21:25,764 Oh, yeah, he's dying, but there's no wife and kid, 429 00:21:25,890 --> 00:21:27,433 which is great. 430 00:21:27,558 --> 00:21:31,520 Makes the breaking-the-news thing way easier. 431 00:21:31,896 --> 00:21:34,106 Oh, yeah. One more piece of news. 432 00:21:37,151 --> 00:21:38,652 (GROANING) 433 00:21:39,570 --> 00:21:42,781 The drug addict is peeing blood. 434 00:21:48,162 --> 00:21:52,166 How do they teach you how to tell someone that they're dying? 435 00:21:55,002 --> 00:21:56,795 It's kind of like teaching architects 436 00:21:56,921 --> 00:21:59,757 how to explain why their building fell down. 437 00:22:00,758 --> 00:22:02,968 Do you role-play and stuff? 438 00:22:03,093 --> 00:22:06,347 Yeah. One of us gives the bad news, and one of us gets the bad news. 439 00:22:06,472 --> 00:22:10,809 What do you have to do to get an A in You're-Dying 101? 440 00:22:10,935 --> 00:22:14,563 They grade you on gentleness and supportiveness? 441 00:22:14,688 --> 00:22:18,233 Is there a scale for measuring compassion? 442 00:22:20,152 --> 00:22:22,029 This buddy of mine, 443 00:22:22,154 --> 00:22:26,075 I gotta give him 10 bucks every time someone says thank you. 444 00:22:26,784 --> 00:22:30,245 Imagine that. This guy's so good, 445 00:22:30,371 --> 00:22:34,083 people thank him for telling them hat they're dying. 446 00:22:37,878 --> 00:22:39,546 Needs brown. 447 00:22:40,464 --> 00:22:42,758 I don't get thanked that often. 448 00:22:43,634 --> 00:22:45,094 You're dying. 449 00:22:46,929 --> 00:22:48,430 In a few hours. 450 00:22:50,599 --> 00:22:53,978 There's nothing we can do except deal with the pain. 451 00:22:55,270 --> 00:22:57,022 Well, I need to go home. 452 00:22:57,147 --> 00:22:59,066 You're not going home. 453 00:23:00,442 --> 00:23:04,613 But my dog. What will happen to my dog? 454 00:23:10,828 --> 00:23:12,705 Her neck looks clean. No adenoma. 455 00:23:12,830 --> 00:23:15,082 Wait, wait, wait. The guy's dying, 456 00:23:15,207 --> 00:23:17,334 and all he cares about is his dog? 457 00:23:19,920 --> 00:23:24,258 Any of you guys go the dog route in your improv sessions? 458 00:23:24,800 --> 00:23:29,638 It's a basic truth of the human condition that everybody lies. 459 00:23:31,181 --> 00:23:33,600 The only variable is about what. 460 00:23:34,268 --> 00:23:36,145 The great thing about telling someone they're dying 461 00:23:36,270 --> 00:23:39,857 is that it tends to focus their priorities. 462 00:23:40,482 --> 00:23:43,444 You find out what matters to them, 463 00:23:43,610 --> 00:23:46,780 what they're willing to die for. 464 00:23:48,240 --> 00:23:50,451 What they're willing to lie for. 465 00:23:50,576 --> 00:23:52,077 You must have a neighbor who can... 466 00:23:52,202 --> 00:23:54,163 Neighbors don't like him. 467 00:23:55,122 --> 00:23:57,249 So the Humane Society will take him in and find him a home. 468 00:23:57,374 --> 00:23:59,043 No, they won't. 469 00:24:00,044 --> 00:24:01,295 (SIGHS) 470 00:24:03,297 --> 00:24:05,049 Yeah, but maybe, maybe my aunt... 471 00:24:05,174 --> 00:24:07,426 It wasn't a snakebite, was it? 472 00:24:09,720 --> 00:24:11,388 I said I don't remember being bit. 473 00:24:11,513 --> 00:24:14,099 Sure you do. Just not by a snake. 474 00:24:15,142 --> 00:24:19,188 I assume that Cujo bit one of your neighbors a while back. 475 00:24:19,313 --> 00:24:21,982 You tell me that he bit you, and I gotta report it. 476 00:24:22,107 --> 00:24:25,152 Cujo's got a record. He gets the chair. 477 00:24:27,654 --> 00:24:30,991 (SIGHS) The good news is you might just live. 478 00:24:31,116 --> 00:24:33,202 The bad news is your dog's gonna die. 479 00:24:33,327 --> 00:24:34,495 (BARKING) 480 00:24:34,620 --> 00:24:37,164 Guy risked his life to save this thing? 481 00:24:40,209 --> 00:24:42,920 I'll hold him. You swab the mouth. 482 00:24:43,045 --> 00:24:44,505 I think I've got a better grip here. 483 00:24:44,630 --> 00:24:46,465 You go for the mouth. 484 00:24:46,965 --> 00:24:48,550 All right. I'm odds. 485 00:24:48,675 --> 00:24:49,927 Are you serious? 486 00:24:50,052 --> 00:24:51,386 Come on, one, two, three! 487 00:24:51,512 --> 00:24:52,679 Damn. 488 00:24:54,098 --> 00:24:56,058 I don't care if he's scratching your nads off, you don't let go. 489 00:24:56,183 --> 00:24:57,726 Just do it! 490 00:24:57,851 --> 00:25:00,145 (GROWLING) 491 00:25:01,772 --> 00:25:03,023 I say we let the guy die. 492 00:25:03,148 --> 00:25:04,441 I got his head. Just do it. 493 00:25:04,608 --> 00:25:06,151 Got it. 494 00:25:10,948 --> 00:25:12,908 What would you call that? 495 00:25:13,992 --> 00:25:15,911 It's tea-colored, right? 496 00:25:17,121 --> 00:25:20,249 The guy who we thought was just after the drugs... 497 00:25:21,416 --> 00:25:25,879 What's the differential diagnosis for urine that's tea-colored? 498 00:25:26,004 --> 00:25:27,840 FEMALE STUDENT: Kidney stone. 499 00:25:27,965 --> 00:25:30,050 Kidney stones would cause what? 500 00:25:30,175 --> 00:25:31,468 Blood in urine. 501 00:25:31,593 --> 00:25:34,388 - What color is your pee? - Yellow. 502 00:25:34,513 --> 00:25:36,557 - What color is your blood? - Red. 503 00:25:36,682 --> 00:25:39,810 - What colors did I use? - Red, yellow and brown. 504 00:25:39,935 --> 00:25:41,854 And brown. What causes brown? 505 00:25:41,979 --> 00:25:43,021 Waste. 506 00:25:43,147 --> 00:25:45,440 Which means the kidneys are shutting down. Why? 507 00:25:45,566 --> 00:25:47,234 - Trauma. - None that his history would indicate. 508 00:25:47,359 --> 00:25:49,945 Could be damage done by the self-injection of the Demerol. 509 00:25:50,070 --> 00:25:51,572 - Treatment? - Heat and rest... 510 00:25:51,697 --> 00:25:52,656 Other possible causes? 511 00:25:52,781 --> 00:25:53,699 Infection. 512 00:25:53,824 --> 00:25:56,118 Start him on antibiotics. What else? 513 00:25:56,994 --> 00:25:58,370 Come on! Come on! 514 00:25:58,537 --> 00:25:59,872 (STUTTERING) I don't know. 515 00:25:59,997 --> 00:26:03,834 You're useless, but at least you know it. 516 00:26:03,959 --> 00:26:06,670 Blood tests show elevated creatine kinase. What does that tell you? 517 00:26:06,795 --> 00:26:08,255 The trauma diagnosis was right. 518 00:26:08,380 --> 00:26:09,882 He takes it easy for a few days, he'll be fine. 519 00:26:10,007 --> 00:26:11,091 You sure? 520 00:26:11,216 --> 00:26:12,509 The elevated CK rules out infection. 521 00:26:12,634 --> 00:26:14,511 You know what's worse than useless? 522 00:26:14,636 --> 00:26:16,805 Useless and oblivious. 523 00:26:17,931 --> 00:26:20,017 What are they missing? 524 00:26:20,142 --> 00:26:22,811 You know, it's kind of hard to think when you're in our face like... 525 00:26:22,936 --> 00:26:24,021 Yeah? You think it's gonna be easier 526 00:26:24,146 --> 00:26:26,857 when you got a real patient really dying? 527 00:26:26,982 --> 00:26:28,150 What are you missing? 528 00:26:28,692 --> 00:26:29,902 CAMERON: Muscle death. 529 00:26:34,615 --> 00:26:36,283 Not your case. 530 00:26:36,575 --> 00:26:38,243 Nothing wrong with a consult. 531 00:26:40,329 --> 00:26:44,583 Dying muscle leaks myoglobin. It's toxic to the kidneys. 532 00:26:45,250 --> 00:26:47,044 Brilliant. 533 00:26:47,961 --> 00:26:51,131 HOUSE: MRI his leg. See what's killing it. 534 00:26:57,137 --> 00:26:58,472 Why is the girl getting the MRI? 535 00:26:58,597 --> 00:27:00,140 Because the neck scan revealed nothing, 536 00:27:00,265 --> 00:27:03,852 and her doctor's way more obsessive than she thinks she is. 537 00:27:03,977 --> 00:27:05,354 But you said the guy needed the MRI. 538 00:27:05,479 --> 00:27:07,689 Because Dr. Cameron back there said muscle death. 539 00:27:07,814 --> 00:27:09,441 Not one of you said it. 540 00:27:09,775 --> 00:27:11,485 Not one of this guy's doctors said it. 541 00:27:12,236 --> 00:27:15,739 They gave him bed rest and antibiotics, just like you guys would have. 542 00:27:15,948 --> 00:27:17,491 Did he get better? 543 00:27:17,616 --> 00:27:18,617 No. 544 00:27:18,867 --> 00:27:21,286 - How long... - Three days. 545 00:27:22,412 --> 00:27:26,333 It is in the nature of medicine that you are gonna screw up. 546 00:27:26,458 --> 00:27:28,210 You are gonna kill someone. 547 00:27:29,127 --> 00:27:32,464 If you can't handle that reality, pick another profession. 548 00:27:32,589 --> 00:27:35,384 Or finish medical school and teach. 549 00:27:35,509 --> 00:27:36,635 Three days 550 00:27:36,760 --> 00:27:38,512 before they thought it might have been muscle death? 551 00:27:38,637 --> 00:27:40,764 No, three days before the patient 552 00:27:40,889 --> 00:27:43,058 suggested it might have been muscle death. 553 00:27:47,020 --> 00:27:50,899 The MRI revealed an osteosarcoma. 554 00:27:51,024 --> 00:27:53,318 A cancerous tumor on your femur. 555 00:27:53,860 --> 00:27:56,029 It needs to be removed surgically. 556 00:27:56,154 --> 00:27:59,908 With chemo, she has an excellent chance of survival. 557 00:28:00,033 --> 00:28:01,952 But I have to warn you, depending on 558 00:28:02,077 --> 00:28:05,372 how large the tumor is and how ingrained it is, 559 00:28:07,374 --> 00:28:10,252 the surgeon may need to amputate your leg. 560 00:28:11,670 --> 00:28:13,672 I'm sorry. 561 00:28:15,090 --> 00:28:16,258 It's okay. 562 00:28:16,383 --> 00:28:18,176 (sesame) 563 00:28:22,597 --> 00:28:25,809 Dogs' mouths are pretty filthy, but they have natural antibodies 564 00:28:25,934 --> 00:28:28,020 to fight off most of the stuff. We don't. 565 00:28:28,145 --> 00:28:30,272 That's why dog bites can be so nasty. 566 00:28:30,397 --> 00:28:34,192 The lab tests of your dog's saliva revealed a type of strep bacteria. 567 00:28:34,318 --> 00:28:37,779 It's commonly known as the flesh-eating disease. 568 00:28:37,904 --> 00:28:40,824 We'll need to operate immediately to remove the damaged tissue. 569 00:28:40,949 --> 00:28:43,243 We may need to remove the leg. 570 00:28:51,960 --> 00:28:54,087 The MRI revealed a problem. 571 00:28:54,212 --> 00:28:55,297 No kidding. 572 00:28:55,422 --> 00:28:57,466 I'm sorry none of your doctors found it earlier. 573 00:28:57,591 --> 00:28:59,926 I am personally gonna oversee your treatment from now on. 574 00:29:00,052 --> 00:29:02,679 You're gonna cut me open, aren't you? 575 00:29:04,973 --> 00:29:07,267 We may need to remove the leg. 576 00:29:17,778 --> 00:29:22,908 His MRI showed that the leg pain wasn't caused by the self-injection. 577 00:29:23,033 --> 00:29:25,660 It wasn't caused by an infection. 578 00:29:27,788 --> 00:29:33,460 It was an aneurysm that clotted, leading to an infarction. 579 00:29:34,211 --> 00:29:37,214 My God, you were right. It's House. 580 00:29:38,799 --> 00:29:40,926 CUDDY: We have to do the surgery. 581 00:29:41,051 --> 00:29:43,387 The necrotic tissue has to be removed. 582 00:29:43,512 --> 00:29:44,596 If there's too much... 583 00:29:44,721 --> 00:29:46,556 I don't care what you find. 584 00:29:46,681 --> 00:29:48,975 It may become necessary in order to save your life. 585 00:29:49,101 --> 00:29:51,645 I like my leg. 586 00:29:52,062 --> 00:29:54,022 I've had it for as long as I can remember. 587 00:29:54,147 --> 00:29:56,066 Honey, I love your leg as much as you do. 588 00:29:56,191 --> 00:29:58,318 They're not cutting it off. 589 00:30:02,572 --> 00:30:05,450 The patient made the right choice. 590 00:30:05,575 --> 00:30:08,328 Tell a surgeon that it's okay to cut a leg off, 591 00:30:08,453 --> 00:30:11,164 and he's gonna spend the night polishing his good hacksaw. 592 00:30:11,289 --> 00:30:14,376 Right. Surgeons could care less about saving limbs. 593 00:30:14,501 --> 00:30:16,211 Of course they care about their patients, 594 00:30:16,336 --> 00:30:18,380 they just care about themselves more, 595 00:30:18,839 --> 00:30:21,341 which is not an unreasonable position. 596 00:30:21,466 --> 00:30:23,593 Trying to maximize the tissue you save 597 00:30:23,718 --> 00:30:26,513 also maximizes the chances of something going wrong, 598 00:30:26,638 --> 00:30:28,932 which means you've gotta be extra careful, 599 00:30:29,099 --> 00:30:31,184 which is such a pain in the ass. 600 00:30:32,644 --> 00:30:34,855 Amazing advances have been made. 601 00:30:34,980 --> 00:30:38,483 Kids with prosthetic legs are running the 100-meter dash in 12 seconds. 602 00:30:38,608 --> 00:30:41,111 Yeah, they're just not as pretty. 603 00:30:42,737 --> 00:30:44,948 Do a bypass. Restore the circulation. 604 00:30:45,073 --> 00:30:46,450 Amputation is safer. 605 00:30:46,575 --> 00:30:47,909 For you or me? 606 00:30:48,034 --> 00:30:49,161 The blockage of blood flow... 607 00:30:49,286 --> 00:30:50,954 Four-day blockage. 608 00:30:51,079 --> 00:30:53,915 Yes. It caused muscle cell death. 609 00:30:54,040 --> 00:30:56,710 When those cells die, they release cytokines and potassium. 610 00:30:56,835 --> 00:30:59,629 And if you restore the blood flow instead of just lopping it all off, 611 00:30:59,754 --> 00:31:01,756 then all that crap gets washed back into my system. 612 00:31:01,882 --> 00:31:04,092 The cytokines could cause organ failure. 613 00:31:04,217 --> 00:31:06,052 The potassium could cause cardiac arrest. 614 00:31:06,178 --> 00:31:09,806 On the other hand, I may just get the use of my leg back. 615 00:31:10,474 --> 00:31:12,058 The postoperative pain alone... 616 00:31:12,184 --> 00:31:13,018 I'll get through it. 617 00:31:13,143 --> 00:31:14,978 HOUSE: I understand the risks. You're in the clear. 618 00:31:15,145 --> 00:31:17,022 Go schedule an OR. 619 00:31:23,778 --> 00:31:25,864 God, you're an idiot. 620 00:31:25,989 --> 00:31:28,241 I think I'm more of a jerk. 621 00:31:28,366 --> 00:31:31,036 I'm not being glib, and I'm not being cute. 622 00:31:31,161 --> 00:31:33,371 I don't want you to kill yourself. 623 00:31:34,873 --> 00:31:35,999 I'm not gonna die. 624 00:31:36,124 --> 00:31:37,334 Oh. 625 00:31:37,792 --> 00:31:39,753 I feel completely reassured. 626 00:32:08,281 --> 00:32:09,866 WOMAN: More suction. 627 00:32:20,919 --> 00:32:23,880 (WHIRRING) 628 00:32:55,120 --> 00:32:57,038 MAN: Inserting now. 629 00:33:14,806 --> 00:33:16,016 (HOUSE SCREAMING) 630 00:33:21,187 --> 00:33:24,274 They gotta up the morphine. 631 00:33:24,399 --> 00:33:25,942 Doctors say they can't. 632 00:33:26,067 --> 00:33:29,321 Doctors who recommended bed rest and antibiotics. 633 00:33:29,446 --> 00:33:31,448 They screwed up. It doesn't mean they're wrong this time. 634 00:33:31,573 --> 00:33:32,949 Sure doesn't mean they're right. 635 00:33:33,074 --> 00:33:34,034 Morphine will kill you. 636 00:33:34,159 --> 00:33:35,201 I can handle it. 637 00:33:35,327 --> 00:33:36,703 You're in pain. You're not thinking right. 638 00:33:36,828 --> 00:33:38,788 That's why I need the damn morphine! 639 00:33:38,913 --> 00:33:41,333 Okay. I'll talk to them. 640 00:33:44,961 --> 00:33:47,922 Oh, my God. How much longer is the pain gonna last? 641 00:33:48,048 --> 00:33:50,050 It depends on how much muscle cell death there was. 642 00:33:50,175 --> 00:33:51,885 He could be right. He could come out of this 643 00:33:52,010 --> 00:33:53,720 with almost full use of his leg. 644 00:33:53,845 --> 00:33:55,096 Or? 645 00:33:56,139 --> 00:33:59,059 He could be in pain for the rest of his life. 646 00:34:01,686 --> 00:34:04,648 There's a third option, surgically. 647 00:34:04,773 --> 00:34:08,193 A middle ground between what we did and amputation. 648 00:34:11,488 --> 00:34:13,782 He's not big on middle ground. 649 00:34:14,866 --> 00:34:15,992 Yeah. 650 00:34:40,517 --> 00:34:41,935 Nurse. 651 00:34:42,977 --> 00:34:44,229 Nurse. 652 00:34:44,604 --> 00:34:45,980 I need more calcium gluconate. 653 00:34:46,106 --> 00:34:47,732 You just had five mls. 654 00:34:47,857 --> 00:34:50,276 The QRS is getting wider. My potassium is rising. 655 00:34:50,402 --> 00:34:51,486 I'll talk to your doctor. 656 00:34:51,611 --> 00:34:52,612 Well, you better make it fast, 657 00:34:52,737 --> 00:34:54,864 'cause I'm about to go into cardiac arrest. 658 00:34:54,989 --> 00:34:59,035 You give me the dose, or I go into wide complex tachycardia. 659 00:34:59,160 --> 00:35:00,203 I could get in trouble. 660 00:35:00,328 --> 00:35:01,329 Listen, it's not a narcotic! 661 00:35:01,454 --> 00:35:03,665 I'm not looking for a buzz. 662 00:35:03,790 --> 00:35:05,417 You got about 20 seconds. 663 00:35:05,542 --> 00:35:07,752 (GASPING) 664 00:35:08,128 --> 00:35:10,380 (MACHINE BEEPING RAPIDLY) 665 00:35:11,548 --> 00:35:14,134 I was wrong. 666 00:35:20,056 --> 00:35:21,015 What do you got? 667 00:35:21,141 --> 00:35:22,308 Wide complex tachycardia. 668 00:35:22,434 --> 00:35:24,018 - Who diagnosed... - He did. 669 00:35:24,144 --> 00:35:26,312 - Defibrillator. - Paddles. 670 00:35:26,438 --> 00:35:27,981 Charge. Clear. 671 00:35:33,570 --> 00:35:36,865 The patient was technically dead for over a minute. 672 00:35:38,032 --> 00:35:39,617 (BARKING) 673 00:35:55,216 --> 00:35:58,511 (CROWD APPLAUDING, WHISTLING) 674 00:36:07,228 --> 00:36:08,980 (LONG BEEP) 675 00:36:09,564 --> 00:36:11,107 (STEADY BEEPING) 676 00:36:11,900 --> 00:36:13,067 He's back. 677 00:36:19,365 --> 00:36:21,367 WILSON: Do you think he was dead? 678 00:36:22,160 --> 00:36:24,913 Do you think those experiences were real? 679 00:36:26,164 --> 00:36:28,082 Define "real." 680 00:36:28,792 --> 00:36:31,252 They were real experiences. 681 00:36:31,377 --> 00:36:33,880 What they meant... 682 00:36:34,005 --> 00:36:35,131 Personally, I choose to believe 683 00:36:35,256 --> 00:36:37,675 that the white light people sometimes see, 684 00:36:37,801 --> 00:36:40,720 the visions this patient saw, 685 00:36:40,845 --> 00:36:42,222 they're all just chemical reactions 686 00:36:42,347 --> 00:36:44,766 that take place while the brain shuts down. 687 00:36:45,850 --> 00:36:47,852 You choose to believe that? 688 00:36:48,144 --> 00:36:50,188 There's no conclusive science. 689 00:36:50,855 --> 00:36:53,274 My choice has no practical relevance to my life. 690 00:36:53,399 --> 00:36:56,277 I choose the outcome I find more comforting. 691 00:36:56,402 --> 00:37:00,073 You find it more comforting to believe that this is it? 692 00:37:00,198 --> 00:37:06,120 I find it more comforting to believe that this isn't simply a test. 693 00:37:10,041 --> 00:37:12,210 (PANTING) 694 00:37:12,335 --> 00:37:14,462 How bad is the pain right now? 695 00:37:15,255 --> 00:37:16,714 It's bad. 696 00:37:16,840 --> 00:37:17,966 It's not getting any better. 697 00:37:18,091 --> 00:37:20,134 If you were right, the pain would be subsiding. 698 00:37:20,260 --> 00:37:21,511 You'd be getting better. 699 00:37:21,636 --> 00:37:23,263 It's just taking longer. 700 00:37:23,388 --> 00:37:25,348 No, it's not. 701 00:37:26,140 --> 00:37:29,227 We've gotta let them cut the leg off. 702 00:37:31,396 --> 00:37:35,108 It's my leg. It's my life. 703 00:37:36,484 --> 00:37:38,152 Would you give up your leg to save my life? 704 00:37:38,278 --> 00:37:40,113 Of course I would. 705 00:37:40,238 --> 00:37:43,783 Then why do you think your life is worth less than mine? 706 00:37:45,034 --> 00:37:46,452 If this were any other patient, 707 00:37:46,578 --> 00:37:48,538 what would you tell them to do? 708 00:37:53,251 --> 00:37:54,836 I would say it's their choice. 709 00:37:54,961 --> 00:37:56,504 For... Not a chance. 710 00:37:56,629 --> 00:37:58,756 You'd browbeat them until they made the choice 711 00:37:58,882 --> 00:38:00,967 you knew was right. 712 00:38:01,092 --> 00:38:05,138 You'd shove it in their face that it's just a damn leg. 713 00:38:06,306 --> 00:38:08,933 You don't think you deserve to live? 714 00:38:09,767 --> 00:38:12,437 You don't think you deserve to be happy? 715 00:38:13,855 --> 00:38:16,232 Now let them cut off your leg. 716 00:38:19,277 --> 00:38:21,571 I can't. I can't. 717 00:38:23,364 --> 00:38:24,991 I'm sorry. 718 00:38:32,749 --> 00:38:34,918 The pain alone is gonna kill you. 719 00:38:35,627 --> 00:38:37,837 I know. I know. 720 00:38:42,759 --> 00:38:45,720 I need you to talk to the doctor. 721 00:38:54,270 --> 00:38:56,064 He change his mind? 722 00:38:56,189 --> 00:38:57,565 No. 723 00:38:58,942 --> 00:39:02,070 He's asked to be put in a chemically-induced coma 724 00:39:02,195 --> 00:39:05,365 so that he can sleep through the worst part of the pain. 725 00:39:07,033 --> 00:39:08,743 We can do that. 726 00:39:11,162 --> 00:39:14,123 What happens after he's in the coma? 727 00:39:14,248 --> 00:39:16,584 We'll obviously monitor his condition closely, 728 00:39:16,709 --> 00:39:18,795 and if he can get through the next 48 hours 729 00:39:18,920 --> 00:39:20,046 without another cardiac incident... 730 00:39:20,171 --> 00:39:21,673 I meant, I'm his health-care proxy. 731 00:39:21,798 --> 00:39:26,177 I get to make medical decisions for him if he's not able to. 732 00:39:28,304 --> 00:39:30,723 You should talk to him about what he wants to do. 733 00:39:30,848 --> 00:39:34,602 I know what he wants, but if he's out, it's my call, right? 734 00:39:51,619 --> 00:39:53,871 You'll be out in less than a minute. 735 00:39:58,626 --> 00:40:00,545 Thank you. 736 00:40:04,716 --> 00:40:05,800 Hey. 737 00:40:05,925 --> 00:40:06,968 Hey. 738 00:40:08,094 --> 00:40:10,346 I'll see you when I wake up. 739 00:40:12,515 --> 00:40:14,225 We'll go golfing. 740 00:40:18,187 --> 00:40:20,231 I love you. 741 00:40:22,692 --> 00:40:24,610 I love you, too. 742 00:40:27,488 --> 00:40:28,906 I'm sorry. 743 00:40:32,952 --> 00:40:35,747 You've got nothing to be sorry about. 744 00:40:53,848 --> 00:40:56,350 The middle ground you were talking about... 745 00:40:56,476 --> 00:40:59,187 We go in, take out the dead muscle. 746 00:40:59,312 --> 00:41:01,856 There's still some risk of reperfusion injury, but... 747 00:41:01,981 --> 00:41:04,400 Give me the forms you need signed. 748 00:41:08,154 --> 00:41:10,281 You're saving his life. 749 00:41:11,532 --> 00:41:13,534 He won't see it that way. 750 00:41:19,123 --> 00:41:21,292 (DOOR OPENS) 751 00:41:23,669 --> 00:41:25,129 (DOOR CLOSES) 752 00:41:32,053 --> 00:41:36,224 Because of the extent of the muscle removed, 753 00:41:37,016 --> 00:41:40,853 the utility of the patient's leg was severely compromised. 754 00:41:40,978 --> 00:41:44,065 Because of the time delay in making the diagnosis, 755 00:41:44,190 --> 00:41:47,485 the patient continues to experience chronic pain. 756 00:41:54,075 --> 00:41:55,993 FEMALE STUDENT: She had no right to do that. 757 00:41:56,119 --> 00:41:57,036 She had the proxy. 758 00:41:57,161 --> 00:41:58,246 She knew he didn't want the surgery. 759 00:41:58,371 --> 00:41:59,330 She saved his life. 760 00:41:59,455 --> 00:42:01,082 Well, we don't know that. Maybe he would've been fine. 761 00:42:01,207 --> 00:42:03,543 It doesn't matter. It's the patient's call. 762 00:42:03,668 --> 00:42:05,461 The patient's an idiot. 763 00:42:06,754 --> 00:42:08,297 They usually are. 764 00:42:10,091 --> 00:42:11,342 Do you have a buzzer or something? 765 00:42:11,467 --> 00:42:12,844 What time does this class end? 766 00:42:12,969 --> 00:42:15,304 20 minutes ago. 767 00:42:20,852 --> 00:42:23,062 I'm not doing this again. 768 00:42:23,187 --> 00:42:25,898 And this guy is not the world's greatest dad. 769 00:42:26,023 --> 00:42:27,900 Not even ranked. 770 00:42:28,025 --> 00:42:30,361 Who the hell lets their kids play with lead-based paint? 771 00:42:30,486 --> 00:42:31,988 That's why he's always sick. 772 00:42:32,113 --> 00:42:35,825 Find him some plastic cups, and the class is all his again. 773 00:42:55,887 --> 00:42:58,306 (CELL PHONE DIALING) 774 00:43:03,895 --> 00:43:06,063 Stacy, it's Greg. 775 00:43:06,189 --> 00:43:10,234 I've got an opening in my calendar for 10:00 tomorrow morning. 776 00:43:10,359 --> 00:43:13,446 Make sure your husband isn't late.