[club music, partygoers] [dogs barking] hi. sounds like a good party. 20 bucks. okay, no problem. i mean, i just--i got it in here somewhere. oh, i'm--i'm sorry. i guess i must have forgottento go to the machine.
yeah, and brush your teeth. lady, you don't havetwo cents. well, i can--i can get itfrom my friend who's inside. he can give it to me and theni'll bring it back out to you. you don't know anybody here. yes, i do. james; he's blondeand he's really friendly and he's a big talker. i need to see him.
go on in. [club music] ♪ ♪ james? james? hi. do you know where james is? oh, yeah, he's-- he's around heresomewhere.
let's go find him. [distorted audio] james? do you know where james is? where's james? james? he's a big talker. james? he's really friendly. james? he's a big talker. oh, yeah, he's around here. where is he?
please, i really needto find him. [spits] what are you doing? bitch! [siren] no! she's trying to help me.get off her! [wails]get off me! aah, aah.
settle down! don't move. jeez, i didn't touch her. great. now we gotta go to the hospital. [new age music] homeless. admitted 24 hours ago witha suspected drug overdose. her tox screen's clean,but she's still delusional.
homeless.usually means crazy. and no money.cuddy's not gonna-- we're a teaching hospital. no i.d., doesn't even seemto know her name. i got called in becauseof some lesions on her arm. homeless always meansno roof. leads to too much sun. the lesions werenon-cancerous. but, i noticed a twitch.her wrist.
you feel that? sure.i'm human. make a fist around my fingersas tight as you can. squeeze. i am. right. raise your armsabove your head for me. [whimpers] she's seizing.
give me some ativan. or she doesn't wantto be discharged. she's manipulating you. smack! it's real. check a finger stick. blood sugar's 38. we need d-50 iv push.stat. fake low blood sugar.now that's acting.
the blood sugar was real. she's probably diabetic. od'd on her own insulin. room 2032, you haveher effects out here? look, a seizure buys hera place to sleep while the nice doctorsrun their tests, maybe a few free meals. 20 bucks says there'sinsulin in there. oh! wow.
put this back please. what about the twitch? her arm moved. why fakea twitch? in case the seizurewas too subtle? a twitch could indicatea tumor. which couldindicate-- a need to seea neurologist. which is whyyou called me.
keep an eye on her'til 2:00 p.m., watch her blood sugar, give her a nice hot lunch,then discharge her. he's wrong. foreman is wrong? the neurologist is wrong abouta neurological problem? he took one look at herand figured it was a scam. so you figure he's notbeing objective? house, the woman had a twitch,she had a seizure--
both of which foreman saw? he just wanted herout the door! whoa, whoa, whoa,back up here, big fella. foreman's the guy you wannatake a swing at. [sighs] i just want her to getsome medical attention. that's not even closeto being true. there's something else,something personal. give me the file.
looks like this'll be fun. the twitch could bea mini-seizure, unrelated to the diabetes. a brain tumor? glad youcould join us, eric. what's the differentialfor a twitch in the wrist? if the patient'sa 30-ish jane doe, i thought i justdischarged her. no, she's my patient.
no harm in a second opinion. a blow to the head, a subdural hematoma? read the file: no evidenceof cranial trauma. a twitch could indicatea brain tumor. or about a dozen other things. come on. there's two things homeless people are good at. getting sickand running scams.
if you're so worried about itbeing a brain tumor, get her an mri. when she's clear on that, then you can bounce herout of here. well, you've got herall figured out. i've known a lot morehomeless people than you have. yes, you've got that going for you. how could i have doubtedyour medical opinion? the big question.
you're missing it.all of you. oh, jeez. who is she? okay, why are we on this case? just because wilson asked? (house)do i need a better reason? well, most people wouldn't. you do. the only thing we know for sureabout jane doe
is that her nameisn't jane doe. which meansno medical history. allergies, medication,previous diagnoses, treatment. we have no baseline, no context formedical treatment. wow, looks just like insulin. vomit.still moist. what do you think,a couple days old? are you trying to make me hurl?
yeah.and here's the big finish. salty. chemical imbalance. low magnesium couldcause a twitch. or high calcium. or it's a coincidence. the point is, we don'tknow anything. so, do the mriand find out-- the mri can wait.hang a banana bag.
give her 24 hours to correctthe electrolyte imbalance. we'll take it from there. great.thanks. okay, even if she's not faking, what's so fascinatingabout this case? at the moment, how muchyou don't want me to take it, that's pretty fascinating. nice likeness of dr. foreman. in fact, he's neverlooked better.
he doesn't like me. i can tell. that's okay.he doesn't like me either. who's james? oh! pain in your head? oh, go-- get away from me! oh, no, no, no!
all right, let's clear it out. one milligram ativan, push. no, no, no, no, no, no! hold on, hold on. [groans] she bit me! [whining]you don't believe me! good news is, she's negativefor hiv and hep c. yeah?
i'm getting a tetanus shot,she's getting an mri. there's a two-day waitfor non-emergency mri. she's getting an mri,and then she's out of here. but dr. terhark specificallysaid i'd have the mri at 10:00. it's almost 11:00, and i haven't even hadthe pre-test yet. sorry, we're a littlebacked up. excuse me?you're dr. terhark's 10:00? i'm angela whitney.
i'm meeting my decoratorat 11:30. she's coming all the wayfrom new york. dr. terhark promisedi'd be home in time. oh, of course. she's just about preppedfor her mri? mrs. whitney? you tried to stealsomeone else's test. dr. terhark isa plastic surgeon. the woman was getting
a six month check-up on her chin implants. i can't believeyou authorized this. really? sounds exactly likesomething i'd do. she can't have an mri. the ct scan shows she hasa surgical pin in her arm. the mri magnet would haveripped it out of her body. do you like the alien movies? you had no medical history.what were you thinking?
we'll surgically remove the pin,then do the mri. does that sound good? she has an electrolyteimbalance. dr, foreman, a neurologist, believes this womanhas a brain tumor. actually, i-- hey, don't ever apologizefor a medical opinion. if he's right, we don'tdo this test, the patient dies. now, i realize that you havea specialty of your own.
but does yours have anythingto do with the brain? his does. fine. but nothing more untilyou find out who she is. how are we supposed-- hey! he knows more homeless peoplethan any of us. go check out the hood, dawg. i don't know.
i've seen a lot of facesaround here, but i don't thinki know her. hey, i, uh, like that jacket. yeah, uh, it's allcoming to me now. i know whereshe keeps her stuff. [distant sirens] ahh.
[bats screech] they're just bats. i thought the liningwould be thicker. no tumor.nothing. her brain is clear. which means that girlhad surgery just so you wouldn'tget reamed out by cuddy. not necessarily. there could still be somethingneurological going on.
sure, she's not conning us,the mri is. not wearing a coatin this weather. that is so wrong. she drew these. they might give us a clue. did she sign them? her name would be a start. well, the mythology,the locations, they'd all dependon her life experience.
philadelphia. look at that skyline. it's very evocative. the chrysler building. that's a cloud. and the chrysler building'sin new york. eh, i'm getting philly. and that cactus... it's a smashed car--
car accident. a cactus inphiladelphia? water? well, water's october,right? obviously. on the page number 22,so that's october 2nd, 2002. ergo, the patient wasin a car accident two years ago last october. my goodness,was she okay?
broke her arm, i think.they fixed it. with this. surgical pin. better than a wallet. serial numbers--in case of recall, tied to a patient's name. that's why you insistedon the mri? so you could removethe surgical pin from her arm? you didn't think i was gonna
do it to save your sorry ass,did you? you might wantto take a look at that. her name isvictoria matsen. or at least that's the oneshe used then. any hospital with a record of treating her should be sending that information. oh, crap! her bloodwork came backan hour ago. magnesium is normal.
did you changeher banana bag? stopped the magnesium, started iron dextranfor severe anemia. she's allergicto iron dextran. grab some epioff the code cart. respiratory arrest.call a code. you're having an allergic reaction. can you speak? [wheezing]
she's not getting any air. got the epi. stats are down in the 80sand dropping. we have aboutanother minute. we've got her sedated and stabilized. and you still think there'snothing wrong with her? well, nothing's changed. you almost killed her. that's different.
and we know who she is. so far we've heardfrom three hospitals with recordsof victoria matsen, seven visits going backtwo years. any home addresses? the pin in her arm went induring an er visit. she wasn't conscious,so they didn't get an address. the other visits,she gave fake addresses. (wilson) any treatment for neurological problems?
anything that mightexplain the twitch? last winter,jefferson hospital in philly, got treated for frostbite. baby, it's cold outside. and depression.they put her on prozac. well, i'd be bummed out too. zero degrees,living in a box. put her back on it. she cheers up, she might stopbiting people.
(chase)there's a billing record fromhantman hospital last year. two appointments, ultrasounds,doesn't say what for. pregnant? only if she was expectingan elephant. the appointments wereten months apart. kept the first,blew off the second. abdominal pain. the chart doesn't say-- wait a minute.
she goes in the first time, then they look,can't find anything, ten months later, why should she subject herself to that again? (foreman) why make a second appointment? she didn't. the nurse madethe appointment. they were looking... they were lookingfor ovarian cancer.
you got all of that from onecancelled appointment? with jerry lauseng, yeah. he's an oncologist. (chase)hang on, her current bloodworkdoesn't show cancer. ca 125 is normal. the cancer wouldn't account for the alleged twitch or anyof her other alleged symptoms. actually, it would. neoplastic syndromeassociated with the cancer
could cause her twitch likea bunny on crystal meth. ultrasound her ovaries. did you find a brain tumoron her mri? no, foreman was wrong. i'm starting to wonderabout the guy's medical chops. shelly diamond. dr. house is readyto see you now. these little ones are lickingeach other again, and harry's got a seeping warton his extra toe.
what room should we go to? [sneezes] oh, you know what? i think i might be coming downwith something. and i'd hate to give itto you guys. sorry. oh, yeah, just walk outlike i'm not gonna do anything. bah-bye. working hard?
this stuff's pretty good. calendraica works forthe council of genius. bad guy is mr. fury, fairly generic,no special skills, but apparentlyvery well organized. you think you work hard, try ruling the universe. you trying toteach me something here? we've got a flowing dress,and a ring.
think the patientwas married. maybe it was a bad breakup. maybe he dumped her'cause she was on drugs. you care abouther personal history? no. the question is,why don't you? i hate to cite a cliche, but...dad on the streets? dad's with mom. they're both livingon the streets?
no, on a pension. so who pissed you off? right now, you. (house) your turn. you gonna tell me why this case? she's my new girlfriend. i'm having a tattoo designed. i was hoping you couldfind out her name. so she's just anothersick person that kindly dr. wilsonhas made sure doesn't get lost
in the big, ugly system. yes, i forgot. i need a reasonto give a crap. you're giving two craps. the metric systemalways confuses me. dr. house. time for girl scout cookiesalready? get me some thin mints. since you're too sickto work in the clinic--
oh, okay. i-- i thought you coulddo some teaching. patient histories. my specialty. when you teach, you learnso much, don't you think? it's all aboutthe giving back. good old cuddy. always thinking.
she assign you a patientto interview? then why are you still here? (chase)why are we on this case? 'cause wilson asked houseto do him a favor. well, i think house just wantsto prove she's sick so foreman will be wrong. oh, you boys. hey, i'm just doing my job. whoa...
foreman's gonna beso embarrassed when he finds outshe's got cancer. ah, i thought you weretoo sick to be down here. i had to get awayfrom those students, so i faked a page. foreman's parents, happily married, 40 years. mazel tov. kanana hora.
so why does he hatethe homeless people? i mean, if it's an uncleor a grandparent, you'd think he'd use it inhis college application essay. family struggles beatsa 4.0 gpa any day. i think he had a 4.0. maybe he's just a snob. you really don't need to knoweverything about everybody. i don't need to watch the oc,but it makes me happy. yeah, delirious.
what's the other file? wilson, james, boy wonder oncologist. you know him? you know, in some cultures, it's considered almost rude forone friend to spy on another. of course, in swedish,the word friend can also be translated as "limping twerp."
[pager beeps] did your pagerreally just go off, or are you ditchingthe conversation? why can't both be true?come on. (wilson)solid non-cystic masson the left ovary. five by three centimeters. central necrosis. the only question is whethershe dies in two months or three. oh, god.
you were right. there's nothing we cando for her here. might as well put her backon the street. unless it's not cancer. you've got to be joking. well, hard not to. nothing funnier than cancer. but what if it's a tuberculoma? she's living out on the streets
breathing all kinds of crap 24/7. the odds are she's got tb. why can't she have a nicebenign growth to go with it? a solid mass on her ovary. ovarian cancer'sway more likely. you're right.it's not even close. start her on inh,rifampin and streptomycin. but that's the treatmentfor a tuberculoma. and what is the treatmentfor advanced ovarian cancer?
pine box. what are you giving me? a second doseof antibiotics. if you've got a tuberculoma,it should help. i don't have a tuberculoma,do i? probably not. hey, listen, i'm sorryi didn't believe you. i'm sorry i lied to you. i took too much insulinon purpose.
i really wanteda place to sleep. were you ever married,victoria? but in the comic, it-- well, it's a comic,comics are just made up. so who's james? is he real or did you make him up? he's real. can i help you find him? oh, the light's bright--
what's--it's getting brighter. oh! ow! oh! ow! take it easy,everything's fine. mr. fury wants to hurt me. please, help me. stop hurt-- wait, wait, wait. please turn it off. all right, hold on,victoria.
hold on, take it easy. everything's fine. it's burning! take it easy. everything's fine,victoria. hold on, take a sip,take a sip. take a sip. it's poison!you gave me poison! hold on.
take it easy. [shrieks] hey, turn offthat damn light! take it easy, take it easy. the bad guyscan't get you here. i've got you covered. mr. fury's not the bad guy. i'm the bad guy. it's me, i'm the bad guy.
[sobbing] it's not a tuberculoma. it can't be. i didn't know the biopsywas back. her temperature's 105. the treatment's not working.it's cancer. she's dying. 105. (chase)good news.
it's a tuberculoma. how do you figure that? her temperature'sthrough the roof. the lab resultsfrom the biopsy. it's definitelya tuberculoma. so, we're rightabout the diagnosis, and the treatment for thatdiagnosis is killing her. perfect. (chase) the lab checked the biopsy again, twice.
well, a tuberculoma doesn'tgive you a temperature of 105. then it's a tuberculomaand something else. the something else is gonnamelt her brain. poach. better metaphor. a fever that highhas to be bacterial. maybe the bowel got nickedin the biopsy. i did the biopsy. no nick.
she could have picked upan infection on the streets. well, she didn't have a feverwhen i admitted her. the prozac we gave hercould have triggered serotonin syndrome,which would explain the fever. no, jefferson put her on prozac,and it wasn't a problem. she probably never took it. most likely,they saw her one time and dumped her out of the erwith a script. oh, just like you weregonna do?
okay, you two. grab some scalpelsand settle this like doctors. send blood and urine culturesand get a chest x-ray. and fine, take her offthe prozac, put her on bromocryptenefor the serotonin syndrome. you might want to get herin an ice bath as well, assuming we want herto live long enough to see those test results. i said i was sorry.
your fever's 105. if we don'tbring it down fast-- foreman, why are youdoing this to me? i'm saving your life. don't make me go in there,please! don't make me do it, please. i don't want to go! come on.you can do this. [whimpering]
[screams] [crying] please. seventeen-year-old femalepresents with abrasions and apparent trauma injuryto her wrist. dr. house? continue. you're readinga comic book. and you're calling attentionto your bosom by wearing a low-cut top.
oh, i'm sorry,i thought we were having a state-the-obvious contest. i'm competitive by nature. i thought you weresupposed to be listening to ourpatient histories. no, i'm supposed to beteaching you. if i can do thatwithout listening, more power to me. seventeen-year-old female--
if this guy'ssupposed to have universal powerover all gravity, how come his hair won't stay down? that's just stupid. she fell off her horse while riding in the county fair. no she didn't. she fell off the steps of her beach house. you must have goneto the wrong room. hard to believe that one patientcould slip past cuddy
and get herself admittedwith a sprained wrist. two seems almost impossible.what room? room 2106. patients lie, but usually onlyone lie at a time. how much does she weigh? it's her wrist,not her weight-- poundage, ladies,and bye-the-bye, what color's her nose? she's thin.
flesh tone? what does thishave to do with her wrist? almost nothing. she's either under 90 poundsor she has a red nose. i've gotta go. what's wrong with her? that would be telling. oh, i am just too nice. it starts with c.
the urine culturesare negative. so is the chest x-ray. i assume there'sa positive coming. lumbar puncturerevealed elevated proteins and white counts. csf cultures? still brewing. nothing on gram stain,it looks like meningitis. (chase)we know it's definitelyan infection.
and we know where it is. well, meningitis isnice and simple. get her in isolationand start her on ceftriaxone. either she gets betteror she dies. let me knowwhich one happens. oh, my god. she was sedated. (chase) it must have worn off. (foreman)i did it myselfa half hour ago.
i'll checkthe nurse's station. calendraica. she's gonnadie out there. you don'twalk out of a room with 10 milligramsof haldol in your system. you don't walk at all. it was 10 milligrams,i gave it to her-- it doesn't matter. bacterial meningitis,highly contagious.
if she is out of the hospital,we are so liable. not to worry. she'll be dead beforeshe can kill anybody. the security tapeconfirms it. she stole some clothesand she's gone. wrong coat. the cape's in the closet,i had it cleaned. funny. you gonna save her?
in her comics, mr. furylives in sloan harbor. the night she came in, she was at a raveat 1408 sloan street. you've been reading. my, how you've changed. (cuddy)you are a doctor. do what doctors do. pick up the phone. dial 911.
and a cop on the other enddoes what cops do and finds the missing person. i assume the rest of you have doctor things to do. i know you do. cacchi-ricci disease. do you even knowwhat that is or are you just guessingeverything that starts with c? the kidney problemscould result in weight loss.
cacchi--c-a-c--oh, jeez,she's going alphabetically. doctor, why are youwearing that bird pin? it sets off my eyes. hi, jodi, i'm dr. house. what brings youto the hospital? my wrist. how did that happen? i was ridingthe ferris wheel, and this huge seagull flew right at me.
how horrifying. i swung my arm at the bird,but i hit the ferris wheel. she's making it all up? no, her wristreally does hurt. i'm not lying. of course you are. you have no ideawhat happened. you have no memory. korsakoff syndrome.
her brain is damagedby excessive drinking or insufficient diet,pretty obviously the latter. she has no new memories,no new ideas, can't even processthat idea. so her brainfills the gaps as best it canusing visual clues. the horse on your shirtled her to a riding accident. and the surf scene on yourclipboard led her to the beach. korsakoff doesn'tstart with a c.
i didn't say c.or did i? a lesson to be learned. treat everybodyas if they have korsakoffs. we all lie anyway. give her thiamine right away. she'll bounce backpretty quickly. and then get her to eatsome cake and ice cream. yes? did you need to beso cruel?
i think she's crying. hi, jodi,i'm dr. house. what happenedto your wrist? there was this weird old guy;he had a cane-- see?it's like it never happened. perfect forgiveness. pulse is rapid. you got a temp? don't know,she's warm, but--
something to look into,she has meningitis-- i'm sorry, i was more worriedabout her heart blowing up. her pulse is 150-- rhythm regular? yeah. ready, one, two, three. where did you find her? battlefield state park. is shenarrow complex?
uh-huh. she wasn't at sloan? she was just passed outon the grass. foreman.i need foreman. all right. superventriculartachycardia. give me adenosine,one milligram, iv push. right away. thank you.
hang in there. [machines beeping] her arrhythmia's stabilized. doesn't make sense. what would push herheart rate over 150? dehydration?fever? unlikely, by themselves,neither one would do it. we must be wrongabout the meningitis. maybe it's structural heart disease.
her heart rate dropped when youadministered the adenosine. two seconds. it's still meningitis. if it is, with the delay in treatment, she's got almost no chance. start the treatment. read the report. i found herlying on the grass. you should readmy reports.
i make up stuffall the time. what really happened? oh, since it's you... wow, that isa great-looking gun. it's not a gun.it's a taser. it's so cool looking.what does it do? fire about60,000 volts? at least, that'swhat it would take to jack someone's heartup to 150.
okay, okay. let's just sayi tell you what happened. it stays between you and me,all right? fine.don't tell me. tell my friend,ben franklin. i watch a lotof cop shows. [cardiogram beeps] the good news is,the heart rate thing is not connectedto her condition.
well, then,she's dying. 'cause the meningitis treatmentisn't helping her. she's getting worse. well, that brings usto the bad news. the coptasered her. jerk. probably couldn't getto his real gun fast enough. the first time,he hit her in the thigh. then she just kept going, like it was nothing. right about here.
she didn'tfeel the taser. localized numbness? yeah, in that one spot. the diabetes? i don't think so. no alcohol. not entrapment syndrome. can't be a vitamin deficiency. we can't chase downevery sensory neuropathy. is that where shebit you?
what the hell? can't get angry if you don'tfeel anything. so first, there'slocalized numbness. then sensitivity to light. disorientation, paranoia, ineffectivenessof sedatives, and hydrophobia. fear of water. rabies.
there have only been, what,ten cases in the last 20 years? yeah, that's becausenon-homeless people, when they get bitten,they get shots. there were bats. [beeping] there's no treatment. how much timedoes she have? a day, maybe two. and if you don'tget your shots
in the next, say,three hours, i'm gonna have to make anotheraffirmative action hire. come on. do it. do you want meto talk to her? and say what? there's someexperimental treatment? that's not gonna work. or, "don't worry,we can make you comfortable"?
doesn't matter. now that she's gonna diein that room. yeah, that's what yousay to her. keep that thereand rest for a minute. whoa, whoa, whoa. tell house i need to go outfor about an hour. she may not have that long. i don't want herto die alone. you're goingto find james?
i'm gonna try. well, i must say,he's done a lot with the place. hello! hey. this is it. [door bangs] no one's been in herefor a long time. it's gotta be james. maybe there'sanother address.
it's not james. paul.paul furia. mr. fury. her husband. then who's james? her kid. aw, i just wanna eat you up. you're so delicious.[smooches] aw, look at me,you're just like your papa.
look at you.just like your dad. foreman. foreman. they're dead. that car crash two years ago-- she broke her arm, and they were killed. she was driving. james.
no, it's paul. paul... you've come to take me. no. i've come to forgive you. [gasps] it wasn't your fault. i'm so sorry.i'm so sorry. i'm so sorry.
i know. [crying] it's okay, victoria. it's okay. [sobs] oh, you followed me? you were wearing rain boots today, but you were parkedin the underground garage. so the only reasonyou'd need boots was if you werehitting the streets.
i followed you. didn't we have a conversationabout friendship? yeah. i had somefollow-up questions. i met your parentsand your brother-- i have two brothers. well, why wouldn't youtell me-- it wasn't relevant. why not? because he's notin my life anymore.
well, that's relevant. this was the last placei saw him. nine years ago. i don't even knowif he's alive. captioning by captionmaxwww.captionmax.com
No comments:
Post a Comment