Friday, 17 March 2017

Breast Cancer Symptoms Skin Rash

♪ rudolph the red-nosedreindeer... ♪ ♪ (house)we are condemnedto useless labor. fourth circle of hell. charting goes a lot faster when you eliminate all classic poetry. writing down what we already knowto be read by nobody. i'm sure dante would agreethat qualifies as useless. you're over two weeks behind

in your charting. oops.i missed. what are you, eight? could an eight-year-olddo this? better stop or it'll stick that way. you have a patient in exam one. yeah, see i'm--i'm off at 12:00,and it's already five of. she's been waiting for you since 11:00.

melancholy without hope. which circle is that? hi. i'm dr. house. what seems to be the problem? show him your hands,augustine. it looks like stigmata. pius. you must be all the talk

around the holy water cooler. been washing a lot of dishes recently? i help out in the kitchen. anything new in the kitchen? we just got a donationof saucepans and pots this week. i unpacked and washed them. should've spent your timesaving souls. it's easier on the hands. this is contact dermatitis.

you're allergic to dish soap. nonsense. we've always used that soap. why is there a problem now? i've been a doctor for years. why do i have tokeep assuring people that i know what i'm doing? a person can become allergic to substances that they've hadrepeated and prolonged

exposure to. the good news is, free samples. diphenhydramine. it's an antihistamine. it'll stopthe allergic reaction. take one every eight hours. it might make you feela little sleepy. and get some of that over-the-counter

cortisone cream. thank you, doctor. you want some water? i have some tea. well, you just relaxfor a few minutes. that stuff works pretty fast. still out by 12:00. how do you solve a problemlike dermatitis? what?

(nun) doctor? i want to thank youfor your patience. is she talkin' to you? i don't know.she's certainly looking at me. oh, it's good to geta secular diagnosis. the sisters tend to interpret their illnessesas divine intervention. and you don't? i mean, you're wearingan awfully funny hat.

(wilson) ooh, boy. excuse me. if i break my leg, i believe it happenedfor a reason. i believe god wanted meto break my leg. i also believe he wants me to put a cast on it. (nun)doctor? something's wrong. [monitor beeping]

lift up your chin. sister, you're havingan asthma attack. i need you to relax. roll up her sleeve, please. gonna give you epinephrine. open your lungsto help you breathe. what happened? she take the pill? yes.

it was probably an allergic reaction. she's allergicto an anti-allergy medicine? you figure somebody'sout to get her? how are you feeling? better. i'll put you onsome steroids instead. is my heart supposedto be feeling so funny? it's called adrenaline. makes your heart beat fast.

[pulse beating rapidly] but not this fast. get a nurse, please. lay down, come on. help! somebody help us! somebody get in here! call a codeand charge up the defibrillator. she's got no pulse.

(cuddy) you diagnosed the patient with allergies and prescribed antihistamines. she went into respiratorydistress. and you injected herwith epinephrine. presumable one cc. point-one cc. that is the standard dose,that is what i gave her. people don't gointo cardiac arrest from point-one cc epinephrine.

she must have a pre-existingheart condition that got exacerbatedby the epinephrine. it's too bad you didn't makea notation in the chart. i can make it up right now. the drawer has syringes is with both dosages, you could've easily reachedfor the wrong-- but i didn't. everyone makes mistakes.

this is why doctorspay through the nose for malpractice insurance. relax, they're not gonna sue. worst they'd do is whack my handwith a ruler. and the discipline board, arethey gonna whack your hand too? you're gonna report me? what choice do i have? uh... how about not report me?

i can justify keeping her herefor a 24-hour observation. if you haven't foundan underlying cause for the cardiac arrest by then, i will have to notifyour attorneys. (cameron)her hands were red and swollen. maybe she has a skin infection,cellulitis? that could manifestwith hypo-cardio. there's no history of fever. results from the cvcdidn't indicate an infection.

the centifills were mildly elevated. rates up a bit. could we be lookingat a systemic allergic response? it's no allergic, and allergies don't cause cardiac arrestlike this. could be inflammationof the blood vessels. vasculitis? that wouldn't give you anelevated eosinophil count. churg strauss vasculitis would.

blood vessels of the heart,lungs, and skin become inflamed, causing the asthma, rash,and heart problems. covers all her symptoms. need a biopsy to diagnose. chest ct would be quicker. the lady just came inwith a rash. what the hell are those? candy canes. candy canes?

are you mocking me? no, i-it's christmas, and i-- i--i thought-- relax.it was a joke. (foreman) isn't the prognosis for churg strauss a bit grim? yeah. untreated, only 33% of patientssurvive past a year, treated, five years. then i definitelysuggest treatment.

i it was any otherattending doctor, i'd say that he made a mistake andgave her too much epinephrine. saying you wouldn't sayit was my mistake. saying it was my mistake. everyone screws up.your rule. i think you fitwithin the subset of everyone. i didn't screw up. order a chest ct and startthe sister on prednisone.

40 milligrams, tid. the sister? oh, didn't i mention? patient's a nun.sister augustine. oh. i hate nuns. who doesn't? [steel drum music] ♪ ♪

(cameron) sister augustine? we weren't watching. we were trying to seeif this is the bed control. oh, um, this one'sthe bed control. and that's the tv control. i'm dr. cameron. this is dr. chaseand dr. forman. i haven't seen televisionin over 20 years. do you consider itthe work of the devil,

or do you just not get cable where you live? (foreman) um... how are you feeling, sister? i seem to be a little better. they gave me some medication. prednisone. it's a steroid to help with the inflammation.

has dr. house figured outwhat i have? will i be okay? we're not sure what's wrong yet. you'll have a chest ct scanthis afternoon that'll help the diagnosis. (nun) dr. house was giving her medication, and he doesn't knowwhat she has yet? (augustine) trust, sister pious. it all happens for a reason.

(foreman) he doesn't know what he's doing. the only problemthat woman has is that house grabbedthe wrong syringe. you don't trust him? i don't trust a man who won'tadmit he might be wrong. i notice you weren't so quick totell her she's got churg strauss and only has a coupleof years to live. i don't tell patients bad newsunless it's conclusive. because you knowhe might be wrong.

about churg strauss, not aboutwhat happened in the clinic. what about you, chase?you think he's infallible too? all i know is, if housedidn't make a mistake, and sister augustinehas churg strauss, he'll be self-satisfied, and our lives will be goodfor a few weeks. if house did make a mistake, he'll be upset and our liveswill be miserable for months. there is that.

if cuddy thinks i madea mistake, the least she could dois suspend me from clinic duty. she doesn't confusemaking a mistake with being incompetent. oh, here we go.lesson time. i recognize that confidenceis not my short suit. i also recognize that i am humanand capable of error. so you might've screwed this up? no.

so it's merely a theoreticalcapacity for error. good point. maybe there isn't one.maybe that's my error. you know, most people who thinkas much of themselves as you do like to talk about themselves. most people don't liketo listen. so what's wrong with you? lemme guess.inflammatory bowel. wow, yeah.is it that bad?

yes. it's also written on your chart. bloody diarrhea, gas, pain. took sulfasalazine,but it didn't work. no, then--then i, uh-- next tried steroid enemas, oral corticosteroids, 5asa, 6-mercaptopuine. i'm impressed.

by my medical history? by how wellyour last doctor charted. it's one thing to have to goto the bathroom every hour, but when the kids siton my lap, it's-- the store sent me home. they're gonna fire me. can't you put me backon 5asa? maybe it'll work this time. not likely. i'm giving you a prescription.

it's cheap, which is good, 'cause your insurance company won't pay for it. cogaritis? cigarettes. one twice a day.no more, no less. studies have shown that cigarette smoking is one of the mosteffective ways to control inflammatory bowel. plus it's been well-established

that you'll look 30% cooler. are you kidding me? about the looking cooler?yeah. the rest is true. isn't it addictiveand dangerous? pretty much all the drugsi prescribe are addictive and dangerous. the only differencewith this one is it's completely legal.

merry christmas. (augustine)i was talking to the nurse. arsenio. do you know him? not really. he can take pictureswith his phone. cool. that woman from the labwas interesting too. she studied astrophysicsbefore becoming a nurse. you know this stuffbetter than i do.

well, i love to hearall about people. you live in a monastery. it's where i serve our lordand the world best. our lord, maybe. the rest of the world,on the other hand, would probably get more out offeeding the homeless or-- healing the sick? as an example, yeah. did you always want to be a doctor?

always.you always want to be a nun? my parents died when i was six. i was raised in a foster homerun by the church. when i was 18,i went to the monastery, where they let me take my vows. i've known no other life, and i haven't wanted to. (foreman)okay, sister, we need youto lie as still as possible. if you get scared, just let us know. as jonah said

from inside the whale, "when i lost all hope, i turned my thoughts to the lord." she's got god on her side. (cameron) i don't believe it god. you're not evena little agnostic? (augustine) is it supposed to smell funny? someone ralphed in therethis morning. we cleaned it up, but--

it's normal, sister. i-it's just a few more minutes. i believe in a higher order, that can control what happens, but not one anthropomorphic entity called "god" that's concerned with theeveryday workings of you and me. what else is there to control but the everyday workingsof you and me? it's always about you, foreman.

what are you talking about?the trees, the fish? should they be the onesthat think it's all about them? what about you, chase? you believe in god? i believe sister augustinehas no vascular pathology. which means no churg strauss. which means housemade a mistake. no, not necessarily.it could be something else. thyrotoxicosis, or carcinoid--

i don't get you. you don't believe in god, but you're willing to putcomplete faith in one man? (augustine) please...the smell. let's get her out of there. i'm coming, sister. i got ya. coming. please...

oh, the smell. i'm gonna be sick, sick. there's no smell. oh--oh, god! oh, it's jesus. it's jesus. he's coming for me! he's burning me with his touch! let's get her on some ativan.

smells, religious visions, symptomatictype of lobe swelling. we don't--we don't want her to-- (cameron) she's seizing. jaw block. help me get her on her side. religious visions? and next comes...

patient tested positivefor herpetic encephalitis. so what's that tell us? her immune systemis severely compromised. oh, i know. prednisone compromisesthe immune system. isn't that the medicinethat you gave her for that thing she doesn't have? yeah, the--hey. i'm thinking

that's a trick question. (cameron) her immune system is severely compromised. two doses of prednisonewouldn't do that. are you hanging your diagnosison an adverb? in 10 seconds,i'm going to announce that i gave her the wrong dose in the clinic. you're gonna admit negligence?

unless you leave the room. if you stay,you'll have to testify. five...four... three...two... so there i wasin the clinic, drunk. i open the drawer, close my eyes, take the first syringe i can find-- so, what are the optionsfor compromised immune system?

mixed connective tissue disease. it'd explain why she was feelingbetter on the prednisone. sure she was feeling betterright up to the moment when it almost killed her. on the other hand, it explains the symptoms. swollen hands,pulmonary problems, cardiac problems, it all fits.

except her ana was normal. so redraw the blood. but the treatment is corticosteroids, prednisone. and we can't go therebecause of the encephalitis. well, treat it with something that modulatesthe immune system, but doesn't suppress it. hyperbaric oxygen chamber.

there's no protocol for putting a patientin a high-pressure oxygen room to treat autoimmune problems. oh, you people, alwayswith the protocols. prep the nun.and discontinue the prednisone. i am both amused and annoyed that you think i should beless stubborn than you are. you are awareof the hippocratic oath, right? the one that starts"first, do nor harm,"

and then goes on to tell usno abortions, no seductions, and definitely no cuttingof those who labor beneath the stone? yeah, i took a read once,wasn't impressed. hyperbaric treatmentscould cause oxygen toxicity,lung and eye damage. every treatment has its dangers. which is why we only treat if we're convinced the patient

actually needs the treatment. i'm convinced.you're not. the question is,what are you gonna do about it? hmm? i have an openingthursday at 3:00. do you have a fourth? is he any good? uh, can i call you right back?bye-bye. what's up?

(chase)the pressure will forcethe oxygen into your system, and saturate your blood. it will enhancewhite cell activity, reduce the inflammation. and that will help with thismixed connective tissue disease? we'll be doing about 10 treatments, and then we'll reevaluate. the last treatment withprednisone

caused the seizures, right? how confident is dr. houseabout this? (cameron)that you reacted so strongly tothe prednisone let us know that you had an underlyingproblem with your immune system. then i guess it was a blessing. of sorts. so who's your favoritereindeer, nurse arnold? rudolph.

i would have thoughtit was vixen. what are you implying? nothing. but i saw youat the christmas party with dr. milesand dr. jargons and nurse crandall. (nurse on tv) i was just doing some christmas dancing. this is a chapel. a house of prayer. a house of prayer. huh.

well, that explainsthe good reception. also why nobody's ever here. i need to talk with you,dr. house. sister augustine believesin things that aren't real. i thought that was a jobrequirement for you people. she's been known to lie. to get sympathy.she's a hypochondriac. so you're warning methat i may be treating a non-existent ailment.

sore throats, joint pains. there's always something wrong. and there's nevera reason for it. mother superior playsright into it. lets augustine off work duties. treating her as...fragile.special. that must make you angry. it bothers me. it's not reallyin augustine's best interest.

want some? i shouldn't. i guess you gotta be goodat reading people to be a good infirmarian, huh? mm, mm-hmm. so we got pride, anger, envy, gluttony. that four out of sevendeadly sins

in under two minutes. do you people keep recordsof these things? is there a cath-lympics? they say you have a gift. they like to talk. you hide behindyour intelligence. yeah, that's pretty stupid. and you make jokesbecause you're afraid to take anything seriously.

because if you take thingsseriously, they matter. and if they matter-- then when things go wrong,i get hurt. i'm not tough, i'm vulnerable. i barely know you. and i don't know if i'm right. i just hope i am. because the alternative is, you really are as miserable as you seem to be.

you know, from the wayyou're looking at me right now, i'd say you just hitnumber five. lust. (nurse on tv) dr. brown, i love you too. how you feeling? a little weak. that's from the oxygen. my mouth is dry. okay, well, uh,

i'll get you some of your tea. mixed connective tissue disease? her ana is barely elevated. well, thanks for checking upon her. good to knowyou got my back. o2 sats down to 83. pulmonary problems,breathing problems-- irritation from the oxygenis typical. she comes in with a rash,

and you put herinto cardiac arrest. that well just never runs dry,does it? if there was no underlyingproblem, why is she still havingthe rapid heart rate? maybe from the herpeticencephalitis caused by you giving herprednisone. her reaction is a symptom,not an error. there's always an explanation,isn't there? yes, there is, and if this onedoesn't work,

we'll find another. but never one involving youscrewing up. one that fits all the facts. look, we obviously havea difference of opinion, and that's fine. but unfortunately, i used up all the timei budgeted today for banging my headagainst a wall. i am gonna do youthe biggest favor

one doctor can do for another. i am gonna stop youfrom killing your patient. you're off the case. we're gonna treatthe symptoms. not the underlying condition? there is no underlyingcondition. what's her status? the sister's breathingis labored. pneumonitisfrom the hyperbaric chamber.

put her on 40% oxygen until her o2 sats increase. bun and creatinine's rising. alt and ast twicethe normal range. could be fromthe hypotensive episode. let's follow them with labs. she still has the rashand joint pain she came in with. order a non-steroidalanti-inflammatory. when we were looking at thedifferential diagnosis

with dr. house, we wereconsidering-- i don't need to hearwhat dr. house was considering. all of this woman's symptomscan be traced to dr. house's considerations. okay. let's just get this patienthealthy. i want her going outthe front door and not the back. hey, it's not likei betrayed him.

cuddy would've found out about the hyperbaric treatmentseventually. you did what you feltyou had to. can't get enough of this place, huh? just left my stethoscope. so i shouldn't read too muchinto the fact that you were looking for itin the drawer with the epinephrine syringesin it? okay. yeah.

i'd like to cure my reputation. oh, right, i forgot how much youcare about what people think. prescribing cigarettes for inflammatory bowel? they cause lung cancer,you know. you know why they have ribbons for breast cancer,colorectal cancer, prostate cancer,and not for lung cancer? they...ran out of colors?

it's because people blamelung cancer patients. they smoke, they screwed up,they deserve to die. the reason people diefrom lung cancer is guilt. huh. well, guilt doesa lot of damage. you said thatwith great significance. you're not hereto find your stethoscope. you're not here to clearyour reputation. you're here becauseyou're having doubts.

you might've screwed up. i'm here because if i'm right,cuddy is killing that patient. but if you're wrong? then she's saving her. fine. you're gonna have to go throughevery record of every patient who's been through this clinicin the last two days. and you're gonna haveto hope that those records can be trusted.

which, by the way, yours can't. (foreman) these pills'll help your kidneys function a little better, sister. (chase) get your wrist. what's it at? 104. is that good? it's fine. you're a lousy liar, dr. chase.

[pager beeping] i have to get this.excuse me. my mother's been dead for ten years. but she's always with youin spirit. what do you know about the nun? which one? the cute one.i think she likes me. the sick one, obviously.

her parents diedwhen she was a child. and she's been with the church ever since. what's she lying about? why do you say that? i always say that. and the old nun thinksthe sick nun is a big, fat nun liar. you know nuns. what do you think?

i don't know nuns. you hate nuns. you can't hate someoneif you don't know them. know any nazis?maybe i hate them on principle. i have a theoryabout what makes good boys good. it's not becauseof some moral imperative. good boys have the fear of godput into them. catholic church specializesin that kind of training. to make good boys afraidof divine retribution.

so they'll dowhat their daddies tell 'em. like, for example,going into medical school when it's the last thingthey want to do. what do you think? i think if she didhave a secret, her boss would know. did you paint or put innew carpets recently? any way she could've got access to drugs?

well, we lockall our medications in the infirmary, and we don'tkeep prescription drugs here. why haven't you askedsister augustine about these things directly? i found that when you want to know the truth about someone, that someone is probablythe last person you should ask. ah. and have you been speakingto sister eucharist? she ratted out her fellow sisterpretty quickly.

if i were you, i'd have her repeat a year of nun school. becoming a nundoesn't make you a saint. becoming a doctor doesn't make you a healer. hmm. and just because we livein a monastery and we spend most of our timein prayer doesn't mean we don't find timefor drama. so what is the sick one's drama? sister augustine livedin catholic foster care

until she came to us. tea? sure. do all of you lie? it's a good strategy. it's simplerwhen you tell the same lie. but she does not spend herentire life as a good catholic. when she had a cardiac arrest, i had to open her blouseto do cpr.

and i learned two things. nuns can have nice breasts. and she has a tattooon her shoulder. of a skunk. now, maybe this wasthe sacred skunk of joseph, but as far as i know, catholic foster careand monasteries do not keep tattoo parlors in their refectories.

we consider that our life begins when we put on our habitsand take our vows. what happens before then-- it's irrelevant to you. but it's relevant to me. sister augustinewent into foster care when she was six years old. but she left when she was 12. she lived on the streets,she got into drugs.

when she was 15,she became pregnant. tried to self-abort. she lost the child,she became ill. we took her inwhen she came back. if we had thought thatit was medically relevant, we would have told you. it's not. this tea is delicious. local herbs?

any change with the medication? yeah, she's getting worse. lung functions deteriorating, bun and creatininecontinuing to rise. she's starting to run a fever,and the rash is spreading. at this rate,she's not gonna make christmas. maybe house was right. maybe there isan underlying condition that explains the symptoms.

something we haven't considered. like what? it could be a metabolicdisorder. specifically? might be genetic. i'm just saying that-- you're just sayingyou think house is right. might be right. of course he might be right.

it might be the hand of god at work. don't say it's something else unless you've got something concrete to offer. what's this?hemlock? i'm gonna do youthe biggest favor one doctor can do another. i'm gonna stop youfrom killing your patient. it's figwort tea. great for that little pick-me-up

we're all looking forin the morning. opens the lungs, increases the blood pressure, stimulates the heart. unfortunately,if you then get injected with even point-one cc of epinephrine, instant cardiac arrest. still, what the hell,it tastes great.

sister augustine-- has been drinking it religiously, so to speak. and if you takethe cardiac arrest out of the equation-- all the rest of the symptoms can be explained by a severe long-termallergic reaction. well, that's what cameron saidin the beginning. (house)yes.

she did.well done. but your unwillingnessto stick by your diagnosis almost killed this woman. take a lesson from foreman and stand upfor what you believe. okay. let's go figure outhow to save a nun. damned if you do,damned if you don't. (house) 'cause it's been untreated for so long,

it's gone from a simple wateryeyes, scratchy throat allergy to a whoppingi'm-gonna-kick-your-ass allergy. compromising her immune system,diminishing her ability to heal, and breaking downher organ systems. so what's the source? (chase) the dish soap. no, symptoms persisted daysafter the dishwashing episode. it's gotta be somethingshe's been exposed to here in the hospital,as well as the monastery.

well, what about the tea? it caused her arrhythmia. aah, could be,but it's not definitive. we'll skin test for allergies. not yet,she's too reactive. she'll test positiveto everything. we need to stabilize her, isolate herfrom all possible allergens and give her system a rest.

get her in the clean room. okay, then we'll graduallyintroduce allergens to see how she responds. when she reacts to something, we'll knowthat's what's killing her. there you go.no television, no books. not even my bible? i'm afraid not. this room has filtered air,

filtered water. you even have silk sheets. very decadentand hypoallergenic. you should befeeling better here. we'll be back to check on youin a little while. can the other sisters come in and pray with me? it'd be betterif you don't have any visitors. once we isolatewhat's causing your allergy,

then we can be a little more lax. [whimpers] i-i can pray with you. i don't want to die. why has he left me? i was in seminary school. they asked us oncewhat our favorite passage was. i chose first peter 1:7. "these trialsonly test your faith

"to see whether or notit is strong and pure. "your faith is being tested. as fire tests goldand purifies it." "and your faithis far more precious to the lord "than mere gold. "so if your faithremains strong "after being tested,it will bring you "much praise and glory and honor on the dayof his return."

he hasn't left you. [whimpering and chuckling] the only thing in the wayof you knowing he's there is your fear. you have a choice.faith or fear. that's the test. choosing faith doesn't meani won't die. but it will affect howyou will experience your death. and therefore your life.

it's up to you. why did you leaveseminary school? that test... you passed, i didn't. we'll call youif anything changes. will she be all right? as long as she's not exposedto anything that can aggravate her allergy,she'll be fine. [knocking on glass]

need some help in here. [monitor beeping rapidly] [wheezing] screw the procedure. she's in anaphylactic shock. no way,she's in the damn clean room! get in here! point-one cc of epi. we've got to intubate.

(cameron) i got it. get the ambu bag. i'm in. [deep breathing] breathing stabilized. it's a clean room. (house) how do you get an allergic reaction in a clean room? maybe it was the preservativesin the iv. checked that. latex tubing?

checked that.checked everything. well, it could bemast cell leukemia. it can cause anaphylaxis. we checked the blood levels. and it's not eosinophiliaodiopathic anaphylaxis. maybe it's just divine will. it's not my will. you do realize,if you're wrong-- about the pig picture, that is--

you're going to burn, right? what do you want me to do?just accept it, pack it in? yeah, i want you to accept that sometimes patients dieagainst all reason. and sometimes they get betteragainst all reason. no, they don't.we just don't know the reason. i think the nunswould agree with you on that. i just wanted to say that i know you did everythingyou could.

i don't need verificationfrom you to know thati'm doing my job well. that's your problem,not mine. i was just being nice. yeah, well, you don't needto always do that. sister augustine'sbeen extubated. good. she's requested

to check outagainst medical advice. she wants to go backto the monastery. well, talk her out of it. i think i may havetalked her into it. room's paid upfor the rest of the week. might as well stick around. this illness is a testof my faith. if it's his will to take me,it doesn't matter where i am. i can accept that.

does anybody believeanything you say? you're not accepting. you're running away. just like you always do. you ran away from the monasteryto get laid. you ran away from the real worldwhen getting laid didn't work out so good. now things aren't working outagain, so off you go.

why is it so difficultfor you to believe in god? what i have difficulty with is the whole concept of belief. faith isn't based on logicand experience. i experience god on a daily basis. and the miracle of lifeall around. the miracle of birth. the miracle of love. he is always with me.

where is the miracle in deliveringa crack-addicted baby? and watching her motherabandon her 'cause she needs another score. miracle of love. you are over twice as likelyto be killed by the person you lovethan by a stranger. are you trying to talk meout of my faith? you can haveall the faith you want

in spirits and the afterlife. and heaven and hell. but when it comes to this world,don't be an idiot. 'cause you can tell methat you put your faith in god to get you through the day. but when it comes timeto cross the road, i know you look both ways. i don't believe he is inside me

and is going to save me. i believe he is inside mewhether i live or die. then you might as well live. you got a better shotbetting on me than on him. when i was 15, i was on every kindof birth control known to man. and i still got pregnant. i blamed god.

i hated him for ruining my life. but then i realized something. you can't be angry with god and not believe in himat the same time. no one can. not even you, dr. house. how'd it go? she has god inside her. would've been easierto deal with a tumor.

maybe she's allergic to god. we've looked everywherefor an allergen that could be causingthis reaction except one place. inside her. on her medical history,she didn't mention any surgery. she had one. can we get her records?what hospital was it at? she didn't have itat a hospital. order a full body scan.

what if she refuses? tell her i'm lookingfor a miracle. no piercings.no fillings. no surgical pins in the arm. no implants. it's clean as a whistle. what's house looking for? what is that? don't know.

lock on it.get a 3-d representation. oh, my god. (house) the copper cross. a form of birth control pulledoff the market in the '80s. so she's allergic to copper? rare, but it happens. didn't she knowshe had an iud? she had an abortion. iud must have been left in,

embedded in the endometrial tissue where it couldn't be detected. so all we have to do is remove the iud. then the symptomsshould subside. i got this iud when i was 15. i-it's been more than 20 years. well, prolonged exposureto an allergen with minimal symptoms.

but at some point, all it takesis one last contact to cause a full-blown reaction. it's like a balloonfilled with air. one last breath, it explodes. the first time i got the rash was when i was washingthe copper cookware. and all your subsequent symptoms came from ingesting foodprepared in it.

dr. house found his miracle. i doubt he'll interpret itthat way. you told meyour favorite passage. would you like to hear mine? "celebrate and be glad,because your brother was dead and is alive again." the prodigal son. he'll be waiting for youwhen you're ready. we'll schedule your surgeryfor tomorrow.

the sixth circle of hell. confined in a sweat boxwith a bloody nose, and all the tissues are soggy. i think that's the seventh. no, the seventh is-- god, you must be funat parties. i think we both know the flawin that theory. how's the sister? heart rate is normal,kidney is functioning.

you know how it is with nuns, you take out their iuds,they just bounce right back. great. told you i didn't screw up. you screwed up. i gave her point-one ccof epinephrine. yeah, and if cuddy hadn'ttaken you off the case, you would've killed her. you wanna come overfor christmas dinner?

you're jewish. yeah, hanukkah dinner. wh-what do you care?it's food, it's people. no thanks. maybe i'll come to your place. your wife doesn't mind being alone at christmas? i'm a doctor,she's used to being alone. i don't want to talk about it.

neither do i. you did good.with the nun. congratulations. thank you. merry christmas, dr. house. dr. wilson. good night. that was sweet. [instrumental silent night played on piano]

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