House, M.D. s01e06 Episode Script
HOU-103 - The Socratic Method
Cat got your tongue? No.
You killed the cat.
Cut off his head.
Need to take a look at this.
Mom? Mom.
Mom, it's okay.
Just a couple of questions before I can authorize extending her disability benefits.
I don't like her.
She's fat.
I could lose a little weight.
You all right? - Actually, before she signs-- - I killed the cat.
Lots of blood.
It's okay.
I have a couple of questions about some of these dates.
- The first diagnosis-- - Schizophrenia.
Dr.
Walters, May 11, last year.
The letter's in the medical file.
And April 6-- that was the last day she worked? But she received unemployment benefits for that week.
We fixed that.
I know we did.
We returned the money.
That's the canceled check.
Not the real one, you know.
It's a copy.
And you're the dependent? No.
That's my little brother.
I'm 18.
Just helping out.
You're all set.
Just need a signature.
Hey! I'm talking to you! The cat's first.
Now it's your turn, Lucy.
Shut up.
Shut up, shut up! It's okay.
She just-- She just needs a little water is all.
I'll go get it.
Just hold on, okay? Just-- When she comes back, sign it and we're gonna be done.
We need this, okay? Please.
Okay.
The voices-- The voices aren't real.
What? Mom? Mom.
Mom? Mom! Mom! Thirty-eight-year-old Caucasian woman.
Status: post-respiratory arrest in the field.
Intubated, oxygenating poorly.
Dr.
Gregory House, please call Dr.
Cuddy at extension 3731.
This is a good hospital? Depends what you mean by "good".
I like these chairs.
How is she? Stable.
Okay.
Your Mom had a small pulmonary embolism-- a blood clot that got stuck in her lungs, blocked the oxygen.
But the pain started in her leg.
Where the clot started-- her calf.
It's called a deep vein thrombosis.
Basically, a bigger clot.
It never hurt there before.
I would have noticed.
A piece of that broke off, went up the vein, through her heart and blocked the blood flow to her lungs.
No blood flow, no oxygen.
Okay.
Is your Dad here? I have some things I need to talk to him about.
Uh, my Dad's running a little late.
He's dead.
Just talk to me.
I take care of her.
All right.
Your mom's blood alcohol was .
12.
I gave it to her.
Two ounces of vodka.
It cools her out.
But that's the first since Monday.
That was three days ago.
I've been real careful.
She hears voices.
She's schizophrenic.
That explains the D.
V.
T.
The alcohol makes her pass out.
She's immobile for long periods of time.
That doesn't happen.
She's not an alcoholic.
She only drinks when you give it to her? We put her on blood thinners.
You can probably take her home tomorrow.
It's not the alcohol.
It's gotta be something else.
Ofcourse it's the alcohol.
Hello! This guy's a professional doctor.
Plays golf and everything, I bet.
He's not gonna tell you your mom's an alcoholic without proof.
I'm sure he scoped for varices, checked her esophagus, ran all kinds of blood tests.
Doctors like this, they don't make assumptions.
They do the work.
I'd be happy to refer you the case, Dr.
House.
You seem so interested.
What case? It's over.
You're sending her home.
- How old is she? - You're a doctor? Own my own stethoscope.
Did I ask you how old she was? I forget.
A 38-year-old woman with no previous symptoms or history presents with deep vein thrombosis.
How did she get it? Oral contraceptives, smoking, diabetes, obesity.
What's the point here? A D.
V.
T.
is a D.
V.
T.
Put her on I.
V.
Heparin to prevent future clots.
- What's the big mystery? - Fine.
You're all sleepy.
You need a clue.
She's 38 years old.
She's 20 years too young to get a deep vein thrombosis.
I treated a 12-year-old girl once, a soccer player.
She got kicked in the leg.
There was no trauma.
None of the risk factors.
You took a history? I have some notes.
They're not mine, but reliable, I think, for the purposes of this discussion.
As for the immobility, well, she's real active right now, ofcourse.
Paranoia keeps her limber.
- Paranoia? - Oh, yeah.
She's schizophrenic.
And her kid wrote this, so it might be a little biased.
You know, having to take care of his nutso mom and all.
You think there's a connection? - Do we include schizophrenia in the differential for D.
V.
T.
? - Well-- The answer is no.
Abnormal dopaminergic pathways in the brain do not cause blood clots.
Schizophrenia is not the cause of D.
V.
T.
On the other hand, we don't really know anything about schizophrenia, so maybe it is connected.
Well, schizophrenia explains one mystery-- why you're so fascinated by a woman with a bump in her leg.
It's like Picasso deciding to whitewash a fence.
Thanks.
I'm more of a Leroy Neiman man.
And it is only about the D.
V.
T.
She's 38 years old.
She shouldn't-- Right, solve this one, and you're on your way to Stockholm.
We don't even know how to treat it.
Come on.
Fumigation of the vagina? A little louder.
I don't think everyone heard you.
Two thousand years ago, that's how Galen treated schizophrenics.
The Marcus Welby of ancient Greece.
Oh, clearly you're not interested.
Oh, I'm interested.
I'm interested in how voices in the head could be caused by malposition of the uterus.
There's a better place for it? Now, what do we got? We've got lobotomies, rubber rooms, electric shocks.
My, Galen was so primitive.
Where are you going? Going to see the patient.
That all-important human connection.
Thought I'd give it a whirl.
You won't talk to patients because they lie, but give you a patient with no concept of reality-- If it wasn't for Socrates, that raving, untreated schizophrenic, we wouldn't have the Socratic method-- the best way of teaching everything, apart from juggling chain saws.
Without Isaac Newton, we'd be floating on the ceiling.
Dodging chain saws, no doubt.
And that guitar player in that English band.
He was great.
You think I'm interested because of the schizophrenia.
Yeah, I'm pretty sure.
Galen was pretty sure about the fumigation thing.
Pink Floyd.
- Mom, this is Dr.
Gr-- - Gregory House.
Nice to meet you.
Would it be all right if we spoke alone for a while? Well, you're gonna need me to-- I've got your case notes, Doctor.
There's a cafeteria downstairs.
Get yourself whatever you want, as long as there's enough left over for a Reuben sandwich, dry, no fries, hold the pickles.
Should run you about 5.
80 with tax.
I'll page you when we're done.
No pickles.
Nice kid.
How much do you really drink? He's really talking to a patient? I don't know who I am anymore.
It's a blood clot.
What's so fascinating about that? He likes crazy people.
He likes the way they think.
They think badly.
That's the definition of crazy.
Why would he like-- They're not boring.
He likes that.
And the meds? Baseball.
I like baseball.
Very nice.
Very sad.
My boy and me, we went to see a game.
Not "Mets".
Meds.
Medicine.
You take what he tells you to take.
No one believes me.
I do.
I thought he liked rationality.
He likes puzzles.
Patients are puzzles? You don't think so? I think they're people.
Yeah.
Well, he hates them, and he's fascinated by them.
Tell me you can't relate to that sentiment.
You told Luke it never hurt before.
Just rough.
They didn't hurt.
Didn't? Don't lie to him, Limpy.
Lively Lucy never lies to Lucas.
Look what I do to him.
Radiation therapist to Oncology.
Learn anything from the "human connection"? Yeah.
The Mets suck.
Also, for the last two months, she hasn't shaved her legs.
Because of the tremors, she cuts herself.
- The tremors aren't new.
She must always cut herself.
- Exactly.
Something changed in the last two months.
I'm thinking the amount of blood when she cut herself.
So let's start with some blood work.
Collect and send for clotting studies, P.
T.
, P.
T.
T.
, factor five, protein "C" and "S".
The whole shebang.
Good luck.
No pickles, and it's cold now.
- If it's a Reuben, that's the way he likes it.
- Everyone, this is Luke.
- Allison Cameron.
It's nice to finally meet you.
- Yeah.
Save it.
We're busy.
Luke, give us another half hour with your mom.
We need to do some tests.
Nice kid.
Take her off the psych meds.
That way we'll know what's what on the physical side.
And who knows, we might get more out of her.
Don't worry.
No pickles.
Happy birthday.
Okay.
Whose? I was going through your mail, and it was on a form.
Happy birthday.
Oh.
No! No blood! Not mine! For the test.
Dr.
House told us-- You're gonna steal it! Sell it! No! No blood! No! No blood! No! No blood! Haldol, five milligrams, stat.
No! No! No! No! No! No! No! Oh, no! N-No! No.
Well, good news.
The lab says it's not strep, so we're done.
Wait a second.
No, really not strep.
The boys in the lab, sure, they're hard drinkers, but they're pros, you know.
Plus, your kid actually has none of the symptoms for strep.
It was quicker running the test than arguing with you.
My point is, go! I just wanted to ask your opinion, Doctor.
She's having a birthday party next week, and she's upset that I'm getting a sugarless cake.
The other kids hate it.
This is why you're here.
Sugar is the leading cause of obesity in America.
You want a doctor to scare her about the dangers of sugar.
She needs to get her weight under control.
Well, you know, I feel sorry for those other kids, Wendy, who don't have a mom like yours-- a mom who knows that sugar causes heart disease, appendicitis and athlete's foot.
That's not fair.
Oh, yes, it is.
No, I get it.
You want her to slim down a little so she can wear pretty clothes like yours.
Love the bracelets.
Hey, what about matching outfits? You could be twins.
She can't be your daughter.
It's impossible! You look way too young.
Happy birthday.
Get the kid a damned ice cream cake.
Dr.
Wyland to Obstetrics.
Dr.
Wyland, Obstetrics.
- You drugged her.
- Actually, I didn't.
I've taken her off all medication.
Your guy Foreman gave her Haldol.
We needed blood for tests.
I assumed that was the only way to get it.
He knocked her out.
Look, I have a cane, and I know how to use it.
I hired you.
You work for me.
Okay.
Can I go now, boss? The Haldol changes her.
She says it makes her soul numb.
Don't give it to her.
"If there be rags enough, he will know her name and be well pleased remembering it".
You okay? Old days.
"For in the old days, "though she had young men's praise and old men's blame, among the poor, both old and young gave her praise".
Oh! Help! Somebody help! So, when I said no psych meds, I'm just curious-- which word didn't you understand? The Haldol had nothing to do with the bleed.
You know that.
I used it purely as a chemical restraint.
Oh, great.
Well, that's good to hear.
So she won't experience any of those pesky little side effects you get when your motives aren't pure.
Oh-- Those side effects are so rare! What, passing out, increased confusion, depression? That's not gonna happen.
That's not gonna screw up our diagnosis, 'cause you just used it to restrain her.
I'm so relieved.
She spit in my face.
That must have been so frightening for you.
What was I supposed to do, tie her down? Yeah.
Anything but give her drugs.
That's basically my point.
The clotting studies.
Pretty fast.
Did you promise to date the entire lab? No, I save that for emergencies.
I told them she bled out two units and if it happened again, she'd die.
If it had happened at home, she would have died.
The E.
R.
doc, he was gonna send her home.
- I used my best judgment.
- It turns out your best judgment is not good enough.
- Here's an idea-- next time, use mine.
- I think they're choosing a movie.
Why did the patient bleed out? The clotting studies so far are normal.
Well, cover your ears if you don't want me to spoil the ending.
Everything was normal, except for a prolonged P.
T.
time.
- Which means what? - Usually it means whoever drew the blood didn't do it right.
Oh, that's right, 'cause you drew the blood.
- But you were precise because you knew the tube was purely for the P.
T.
study.
- That's right.
And I'm right with you.
I trust this result, for two reasons-- "A", because you are a good doctor, and "B", because five milligrams of I.
V.
Haldol makes for a spectacularly cooperative patient.
The prolonged P.
T.
time makes me think she's got a vitamin "K" deficiency.
Vitamin "K" would explain the bleed, but not the clot.
Without vitamin "K", protein "C" doesn't work.
Without protein "C", she clots.
Clotting and thinning all at the same time.
What about another drug interacting with Heparin, an antibiotic like ampicillin? That would cause the bleed.
Clever, but she's not on ampicillin.
Two months ago, she complained of a sore throat, and he got her ampicillin.
- Which she refused to take.
- He just said she didn't take it.
What is it, everybody lies except for schizophrenics and their children? It's more likely than malnourishment.
Why not scurvy or the plague? Gee, I wish my idea was as cool and with-it as yours.
What is yours, by the way? Do you have one? Alcohol.
Simple.
It causes immobility, which explains the D.
V.
T.
It also causes cirrhosis, which explains the bleed and the prolonged P.
T.
time.
- Let's ultrasound the liver.
- Three theories.
Check out her place for ampicillin and diet.
Then ultrasound her liver.
Let's find out who's right before she bleeds to death.
So House says the kid is sensitive, thinks he takes good care of her.
But if we don't find anything, why let him know we did it in the first place? What's the point? Why not just make old Foreman lift the key from the kid's backpack? Looks like Luke sleeps in the living room.
Nothing in there.
He lays out her clothes? Enough organization, enough lists, you think you can control the uncontrollable.
Fix her meds, fix her clothes, maybe you can even fix her.
Pick that up on your psych rotation? Trifluoperazine, Thorazine, Clozarile.
Whew.
They tried everything.
The ampicillin-- never touched it.
There goes Cameron's theory.
Oh, God, I hope it's not a vitamin "K" deficiency.
Damn.
Breakfast, lunch and dinner.
House was right.
That's the only thing she'll eat.
Yeah.
The problem is, you can't actually live on this stuff.
I checked it out.
I looked on the box.
All the nutritional values are solid.
There's plenty of protein and calories.
Yeah, vitamin "A" and "C", but no "K".
That's why your mom got sick.
So what's the plan then? Load her up with vitamin "K".
That's it? If it all checks out, you can take her home in a couple of days.
Oh, God, you're upset about something.
You're gonna open up to me now, aren't you? It's all my fault.
Here we go.
Okay, I'm gonna say this once: You have done a very good job taking care of your mother.
If this was all she'd eat, then what else could you do? Gosh, just being a kid is a full-time job.
Shut up! I'm 18.
I should be able to take care of my mom.
I almost killed her.
Good example.
Just the time it takes to express those ridiculous, self-centered teenage ideas.
I don't envy your schedule.
No pickles.
My mom doesn't like 'em either.
Smart woman.
Before she got sick, I didn't like how bossy she was.
Always telling me what to do, the right way to do it.
Never thought I'd miss that.
Oww.
You should get that looked at.
I still don't buy a vitamin "K" deficiency.
House was right.
That usually makes you happy.
Less work for us.
The kid feeds his mom a steady diet of booze, and the problem is too many burgers? The kid's in a tough situation.
You do what you gotta do to survive.
Feeding alcohol to an alcoholic is not a survival technique.
Where I come from, if it works-- Yeah, right.
I'm rich.
I couldn't possibly understand what this kid is going through.
Just because you're drinking pricier stuff doesn't mean you don't have a problem.
You've seen someone stagger down that road? No way vitamin "K" is the whole story.
It's not broken.
See this, right here? It's the epiphyseal plate, otherwise known as the "growth plate".
What's wrong with it? Amazing thing, this bone.
If you know how to read it, it can tell you how old someone really is.
- Exactly how old.
- Great.
Mmm, not even 15.
Almost though.
Two weeks away.
Maybe a month.
Last week.
I was 15 last week.
Happy birthday to both of us.
If you're gonna lie though, go big.
Go 21.
That way you won't need your crazy mom to help you buy vodka.
Uh, great.
Thanks for the tip.
Now, when I bring my mom home, is there anything I need to know about taking care of her? I suppose your biggest worry isn't the booze.
You're 15, basically no mom.
If Child Welfare let kids get away with that, they wouldn't need those nice foster homes, and that would make them sad.
They'd put her someplace too.
My life is working.
Not the word I'd use.
Most 15-year-old kids are doing what they're supposed to be doing.
You know, they're huffing glue, catching crabs.
If you turn me in, I'll sue you.
That's privileged information.
Oh, relax.
It's not even your X-ray.
She's awfully calm.
House wrote new orders.
There's a little bit of scarring.
Not much.
Not enough to-- It's cirrhosis.
Oh, but she doesn't drink.
Congratulations.
You win.
Actually, no one wins.
Tumor.
Cystic? Solid mass.
Cancer.
The vitamin "K" caused the D.
V.
T.
and aggravated the liver, but the tumor's the real reason for the bleed.
The tumor's the problem.
Mrs.
Palmero, I'm Dr.
Wilson.
I'm afraid I have some bad news from your ultrasound.
You have cancer.
It's big.
We do nothing, she dies from liver failure within 60 days.
- She needs a transplant.
- That's gonna happen.
- She's 38 years old.
She's a mother.
- She's a schizophrenic mother with no money, on the public dole, in fact, who knocks back vodka every time a breeze blows her way.
Mickey Mantle had a whole bar named after him.
He got a transplant.
Yeah, well, Lucy can't switch-hit.
Plan "B"-- surgery to resect the tumor.
Joe Bergin does the gamma knife thing.
Laser cauterizes while it cuts, saves more liver.
The tumor's way too big.
He won't even consider it.
Not a big risk-taker, Bergin.
Won't even drink milk on its expiration date.
He has no discretion.
the surgical guidelines.
Would he do it at 4.
6? Why don't we just say it's zero? Then we don't need him at all.
Tumors grow, they don't shrink.
This one does.
Ninety-five percent ethanol.
The ethanol dehydrates the tumor cells.
Literally sucks them dry.
It shrinks the tumor temporarily.
How temporarily? Well, if we're lucky, just long enough to fool the surgeon.
Dr.
Shopius, report to Psych Exam.
Dr.
Shopius, Psych Exam.
Good morning, Dr.
House.
Good morning, Dr.
Cuddy.
Love that outfit.
It says, "I'm professional, but I'm still a woman".
Actually, it sort of yells the second part.
Yeah, and your big cane is real subtle too.
Gotta go.
Those running noses aren't just gonna start walking on their own.
The clinic can wait.
How long? Maybe we could catch a movie.
You should know by now my doctors have no secrets from me.
I don't believe it.
Who came running to Mommy? It doesn't matter who.
The point is, I know exactly what you did.
You have no idea what I'm talking about.
Somebody knows about a bad thing you did.
That's a big field.
But somebody you think might've told me.
That narrows it down quite a bit.
Someone who views me as a maternal authority figure.
Ayoung person perhaps? How am I doing? Think I'm gonna get there? Presumably hospital business.
How many patients-- It's Cameron.
She found out about my birthday.
I thought she told you and I'd have to stand here and smile while you gave me a sweatshirt or a fruit basket.
You know, made me feel that deep sense of belonging.
Actually, I was just gonna remind you, you owe me six clinic hours this week.
Oops.
Hi, this is Dr.
Cuddy.
I need all the charts on Dr.
House's current patients.
I've tried everything.
Mm-hmm.
"Pulling the tongue, ice packs on the throat, hitting yourself, the groin pinch".
Well, you've certainly covered all the normal medical bases.
Uh, how are you hitting yourself though? Is it with an open hand or a fist? Open hand.
Uh-huh.
Well, that's-- that's how they teach it at Harvard Med.
How hard though? I'm sorry.
I missed that.
Could you do that again? Uh-- That's-- That's very good.
It's hiccups.
I need to speak with you now.
Mm-hmm.
I need to go pee-pee.
Dial it up a notch and repeat.
I'll be back.
Ooh.
Girl in the boy's bathroom.
Very dramatic.
It must be very important, what she has to say to me.
Yesterday your patient's tumor was 5.
8 centimeters.
Today it's 4.
6.
How does that happen? Well, at a guess, I'd say, "That Dr.
House must be really, really good.
Why am I wasting him on hiccups?" I wash before and after.
You also requisitioned What patient was that for? Or are you planning a party? Do me a favor.
I was gonna say leave, but that works.
- You shrunk the tumor.
- Only way to get the guy to do the surgery.
Fraud was the only way? There is a reason that we have these guidelines.
I know.
To save lives.
Specifically, doctors' lives.
And not just their lives, but their lifestyles.
Wouldn't want to operate on anyone really sick.
They might die and spoil our stats.
Bergin has a right to know what he is operating on.
True.
I got all focused on her right to live and forgot.
You do what you think is right.
You really didn't know? No, I didn't.
And, frankly, I'm angry.
Which I'm guessing is the correct response.
- Ofcourse, I'll know better once you tell me what you're talking about.
- Your birthday.
Oh.
Anger was a bad guess.
Well, normally, I'd put on a festive hat and celebrate the fact that the Earth has circled the sun one more time.
I really didn't think it was gonna make it this year, but darn it if it wasn't the little planet that could all over again.
It's a birthday.
It's an excuse to be happy.
You think that's lame? Why are you here? Did you buy me a pony? I'm just waiting for the surgery.
Yeah, well, go scrub in.
All right, we're done.
Close her up.
The tumor didn't just walk itself into a bar and order up a double shot of ethanol.
Someone shrunk it down.
I'm sorry.
It was very, very wrong.
House is lucky I didn't just close her up.
He tries it again, that's what happens.
I'll pass it on.
It looks like the surgeon got it all, but she's gonna have to have some chemotherapy.
What kind is it? Luke, stop writing.
If you stop for a second, it's not all gonna fall apart.
Give yourself a break once in a while.
The fact is, your Mom's gonna have an extra drink every now and then.
No.
No.
She won't.
She doesn't.
Fine.
There are some things you just can't fix.
That's all I'm saying.
That's how you'd handle it, something like this? You'd just give up? No.
I'd do it just like you.
It's an infusion.
She's gonna have a drain in her abdomen.
You're going to have to check for possible infection.
Lucas Palmero? Trina Wyatt, Child Services, State of New Jersey.
Can I help you? This is a private room.
He's only 15 years old, a minor.
He's in a tough living situation.
We're just here to help.
I don't need your help.
Fifteen? Lucas, you're gonna have to come with us right now.
Where are you taking him? Until the determination is made, he'll be housed at Children's Services.
I don't want to be "housed".
I live with my mom.
Not for the next few days.
Come on.
Let's not make this difficult, huh? Mom? Mom? I love you.
When the Mets lost, you remember? Yeah.
I remember.
I love you.
Cuddy didn't say anything about pushing Bergin to finish the surgery? Not a word.
Some kind of mind game.
She's waiting for me to crack.
Well, either that or she's just being nice.
Yeah, right.
You said you wouldn't call.
You're a real bastard, you know.
Yeah, I get that a lot.
I don't think Mom's crazy.
"For in the old days, though she had young men's praise and old men's blame, among the poor, both old and young gave her praise".
You called Social Services.
It was you.
N-- No.
No.
It's okay, it's okay.
I get it.
He'll have an easier time dealing with the system.
Sure, he won't be with his real mother, but his real mother's sick.
Someone needs to take care of him.
I'm not gonna live here.
What would his future have been, taking you to chemo and back on the bus? And even if the cancer's in complete remission, he'll still have a mother who hears voices.
Talk no more.
Talk no more.
"Look what I do to him, Limpy".
You said that.
I checked the phone records.
Only one call from this room.
Smart, because they charge you two bucks a call.
It was to Social Services, the State of New Jersey.
You're his mother.
You couldn't do it to him anymore.
Good for you.
Schizophrenics can make rational decisions.
On the small stuff, yeah-- when to sleep, what to drink, you know.
"No lemonade, but I'll take some hemlock if you've got it".
Huh.
Your man Socrates.
But giving up your son because it's better for him, it's so sane, it's so rational.
Self-sacrifice is not a symptom of schizophrenia.
It excludes the diagnosis.
She's not schizophrenic? Look, she's 36 years old when she first presents.
It's a little late, but within the parameters.
The internist sends her to a shrink.
One shrink sends her to the next.
She tells them all she's not crazy.
The drugs don't work.
And why would they if she's not a head case? She got clearer when I took her off the psych meds.
You think I'm crazy.
Well, yeah, but that's not the problem.
Didn't we just leave your office? I like to walk.
Is that Dr.
Jeffrey Walters? Hi.
My name is Greg House.
I'm a doctor-- Oh, is that the time? I'm-- Yeah.
I'm sorry.
My watch must have stopped.
Uh, listen, you treated a patient about 18 months ago, a woman named Lucille Palmero.
I wondered if you recalled running any tests at all.
Oh, how terribly foolish of me, Doctor.
Is it that late? Yes, I'm calling from London, you see? Must have got my times mixed up-- I have a headache.
It's my only symptom.
I go to see three doctors.
The neurologist tells me it's an aneurysm.
The immunologist says I've got hay fever.
The intensivist can't be bothered.
Sends me to a shrink, who tells me that I'm punishing myself 'cause I want to sleep with my mommy.
- Maybe you're just not getting enough sleep? - Pick your specialist, you pick your disease.
If it's not schizophrenia, what else presents with psych symptoms? - Porphyria.
- The Madness of King George.
What about that copper thing? What's it called? It's genetic.
The body accumulates too much copper.
Oh, um, uh, Wilson's Disease? Yeah.
Very rare.
Nice.
I like it.
- If any of us did this, you'd fire us.
- Well, that's funny.
I thought I encouraged you to question.
You're not questioning.
You're hoping.
You want it to be Wilson's.
Boom.
Give her a couple of drugs, she's okay.
July 17.
An appointment with a Dr.
Karn.
She didn't keep it.
She never kept another appointment with a shrink he made after that.
Karn is not a shrink.
I looked him up.
He's an ophthalmologist.
Now why would she want her eyes checked? Wilson's presents with cataracts, I think.
Yes, it does.
It also causes slight cirrhosis, which Dr.
Chase so eagerly attributed to alcohol.
So what are we still doing here? Lucy! I don't think you're crazy.
Neither do I.
But I'm crazy.
Come on.
Lean over here.
Come on.
That's it.
Put your hands on the bar here and your chin in here.
Thank you.
You're gonna see a bright light, okay? Your body might be accumulating too much copper.
If it is, this should help us see something called Keyser-Fleischer rings-- copper-colored circles around your corneas.
Wow.
I guess we should start treating her for Wilson's.
That's what I'd do.
"I will talk no more of books or the long war, "but walk by the dry thorn until I have found some beggar sheltering from the wind "and there manage the talk until her name come round.
If there be rags enough, he will know her name and be well pleased remembering it.
" "For in the old days, though she had young men's praise and old men's blame, among the poor, both old and young gave her praise".
Hi, Mrs.
Palmero.
Ready to go home? Almost.
Mom? How are you? I'm good.
Oh! Oh-- Oh, you really need a haircut.
Dr.
House.
Luke, we're making Dr.
House wait.
That's okay.
We're just here for the music.
Luke, come on.
I'm being discharged.
I heard a rumor.
Thank God I had cancer, huh? - It's terrible having everybody think you're nuts.
- Really? - I called to thank you.
Did you get my message? - Yes.
You're welcome.
I'm never thanking you.
You turned me in.
I told you we were doing okay.
It was none of your business.
Look, I don't care how you were living.
I just wanted you out of my life.
That's why I had Dr.
Cuddy call Social Services.
You okay? You were right.
It wasn't the D.
V.
T.
It was the schizophrenia.
I know.
She's not nearly as interesting anymore.
Isn't it your birthday around now?
You killed the cat.
Cut off his head.
Need to take a look at this.
Mom? Mom.
Mom, it's okay.
Just a couple of questions before I can authorize extending her disability benefits.
I don't like her.
She's fat.
I could lose a little weight.
You all right? - Actually, before she signs-- - I killed the cat.
Lots of blood.
It's okay.
I have a couple of questions about some of these dates.
- The first diagnosis-- - Schizophrenia.
Dr.
Walters, May 11, last year.
The letter's in the medical file.
And April 6-- that was the last day she worked? But she received unemployment benefits for that week.
We fixed that.
I know we did.
We returned the money.
That's the canceled check.
Not the real one, you know.
It's a copy.
And you're the dependent? No.
That's my little brother.
I'm 18.
Just helping out.
You're all set.
Just need a signature.
Hey! I'm talking to you! The cat's first.
Now it's your turn, Lucy.
Shut up.
Shut up, shut up! It's okay.
She just-- She just needs a little water is all.
I'll go get it.
Just hold on, okay? Just-- When she comes back, sign it and we're gonna be done.
We need this, okay? Please.
Okay.
The voices-- The voices aren't real.
What? Mom? Mom.
Mom? Mom! Mom! Thirty-eight-year-old Caucasian woman.
Status: post-respiratory arrest in the field.
Intubated, oxygenating poorly.
Dr.
Gregory House, please call Dr.
Cuddy at extension 3731.
This is a good hospital? Depends what you mean by "good".
I like these chairs.
How is she? Stable.
Okay.
Your Mom had a small pulmonary embolism-- a blood clot that got stuck in her lungs, blocked the oxygen.
But the pain started in her leg.
Where the clot started-- her calf.
It's called a deep vein thrombosis.
Basically, a bigger clot.
It never hurt there before.
I would have noticed.
A piece of that broke off, went up the vein, through her heart and blocked the blood flow to her lungs.
No blood flow, no oxygen.
Okay.
Is your Dad here? I have some things I need to talk to him about.
Uh, my Dad's running a little late.
He's dead.
Just talk to me.
I take care of her.
All right.
Your mom's blood alcohol was .
12.
I gave it to her.
Two ounces of vodka.
It cools her out.
But that's the first since Monday.
That was three days ago.
I've been real careful.
She hears voices.
She's schizophrenic.
That explains the D.
V.
T.
The alcohol makes her pass out.
She's immobile for long periods of time.
That doesn't happen.
She's not an alcoholic.
She only drinks when you give it to her? We put her on blood thinners.
You can probably take her home tomorrow.
It's not the alcohol.
It's gotta be something else.
Ofcourse it's the alcohol.
Hello! This guy's a professional doctor.
Plays golf and everything, I bet.
He's not gonna tell you your mom's an alcoholic without proof.
I'm sure he scoped for varices, checked her esophagus, ran all kinds of blood tests.
Doctors like this, they don't make assumptions.
They do the work.
I'd be happy to refer you the case, Dr.
House.
You seem so interested.
What case? It's over.
You're sending her home.
- How old is she? - You're a doctor? Own my own stethoscope.
Did I ask you how old she was? I forget.
A 38-year-old woman with no previous symptoms or history presents with deep vein thrombosis.
How did she get it? Oral contraceptives, smoking, diabetes, obesity.
What's the point here? A D.
V.
T.
is a D.
V.
T.
Put her on I.
V.
Heparin to prevent future clots.
- What's the big mystery? - Fine.
You're all sleepy.
You need a clue.
She's 38 years old.
She's 20 years too young to get a deep vein thrombosis.
I treated a 12-year-old girl once, a soccer player.
She got kicked in the leg.
There was no trauma.
None of the risk factors.
You took a history? I have some notes.
They're not mine, but reliable, I think, for the purposes of this discussion.
As for the immobility, well, she's real active right now, ofcourse.
Paranoia keeps her limber.
- Paranoia? - Oh, yeah.
She's schizophrenic.
And her kid wrote this, so it might be a little biased.
You know, having to take care of his nutso mom and all.
You think there's a connection? - Do we include schizophrenia in the differential for D.
V.
T.
? - Well-- The answer is no.
Abnormal dopaminergic pathways in the brain do not cause blood clots.
Schizophrenia is not the cause of D.
V.
T.
On the other hand, we don't really know anything about schizophrenia, so maybe it is connected.
Well, schizophrenia explains one mystery-- why you're so fascinated by a woman with a bump in her leg.
It's like Picasso deciding to whitewash a fence.
Thanks.
I'm more of a Leroy Neiman man.
And it is only about the D.
V.
T.
She's 38 years old.
She shouldn't-- Right, solve this one, and you're on your way to Stockholm.
We don't even know how to treat it.
Come on.
Fumigation of the vagina? A little louder.
I don't think everyone heard you.
Two thousand years ago, that's how Galen treated schizophrenics.
The Marcus Welby of ancient Greece.
Oh, clearly you're not interested.
Oh, I'm interested.
I'm interested in how voices in the head could be caused by malposition of the uterus.
There's a better place for it? Now, what do we got? We've got lobotomies, rubber rooms, electric shocks.
My, Galen was so primitive.
Where are you going? Going to see the patient.
That all-important human connection.
Thought I'd give it a whirl.
You won't talk to patients because they lie, but give you a patient with no concept of reality-- If it wasn't for Socrates, that raving, untreated schizophrenic, we wouldn't have the Socratic method-- the best way of teaching everything, apart from juggling chain saws.
Without Isaac Newton, we'd be floating on the ceiling.
Dodging chain saws, no doubt.
And that guitar player in that English band.
He was great.
You think I'm interested because of the schizophrenia.
Yeah, I'm pretty sure.
Galen was pretty sure about the fumigation thing.
Pink Floyd.
- Mom, this is Dr.
Gr-- - Gregory House.
Nice to meet you.
Would it be all right if we spoke alone for a while? Well, you're gonna need me to-- I've got your case notes, Doctor.
There's a cafeteria downstairs.
Get yourself whatever you want, as long as there's enough left over for a Reuben sandwich, dry, no fries, hold the pickles.
Should run you about 5.
80 with tax.
I'll page you when we're done.
No pickles.
Nice kid.
How much do you really drink? He's really talking to a patient? I don't know who I am anymore.
It's a blood clot.
What's so fascinating about that? He likes crazy people.
He likes the way they think.
They think badly.
That's the definition of crazy.
Why would he like-- They're not boring.
He likes that.
And the meds? Baseball.
I like baseball.
Very nice.
Very sad.
My boy and me, we went to see a game.
Not "Mets".
Meds.
Medicine.
You take what he tells you to take.
No one believes me.
I do.
I thought he liked rationality.
He likes puzzles.
Patients are puzzles? You don't think so? I think they're people.
Yeah.
Well, he hates them, and he's fascinated by them.
Tell me you can't relate to that sentiment.
You told Luke it never hurt before.
Just rough.
They didn't hurt.
Didn't? Don't lie to him, Limpy.
Lively Lucy never lies to Lucas.
Look what I do to him.
Radiation therapist to Oncology.
Learn anything from the "human connection"? Yeah.
The Mets suck.
Also, for the last two months, she hasn't shaved her legs.
Because of the tremors, she cuts herself.
- The tremors aren't new.
She must always cut herself.
- Exactly.
Something changed in the last two months.
I'm thinking the amount of blood when she cut herself.
So let's start with some blood work.
Collect and send for clotting studies, P.
T.
, P.
T.
T.
, factor five, protein "C" and "S".
The whole shebang.
Good luck.
No pickles, and it's cold now.
- If it's a Reuben, that's the way he likes it.
- Everyone, this is Luke.
- Allison Cameron.
It's nice to finally meet you.
- Yeah.
Save it.
We're busy.
Luke, give us another half hour with your mom.
We need to do some tests.
Nice kid.
Take her off the psych meds.
That way we'll know what's what on the physical side.
And who knows, we might get more out of her.
Don't worry.
No pickles.
Happy birthday.
Okay.
Whose? I was going through your mail, and it was on a form.
Happy birthday.
Oh.
No! No blood! Not mine! For the test.
Dr.
House told us-- You're gonna steal it! Sell it! No! No blood! No! No blood! No! No blood! Haldol, five milligrams, stat.
No! No! No! No! No! No! No! Oh, no! N-No! No.
Well, good news.
The lab says it's not strep, so we're done.
Wait a second.
No, really not strep.
The boys in the lab, sure, they're hard drinkers, but they're pros, you know.
Plus, your kid actually has none of the symptoms for strep.
It was quicker running the test than arguing with you.
My point is, go! I just wanted to ask your opinion, Doctor.
She's having a birthday party next week, and she's upset that I'm getting a sugarless cake.
The other kids hate it.
This is why you're here.
Sugar is the leading cause of obesity in America.
You want a doctor to scare her about the dangers of sugar.
She needs to get her weight under control.
Well, you know, I feel sorry for those other kids, Wendy, who don't have a mom like yours-- a mom who knows that sugar causes heart disease, appendicitis and athlete's foot.
That's not fair.
Oh, yes, it is.
No, I get it.
You want her to slim down a little so she can wear pretty clothes like yours.
Love the bracelets.
Hey, what about matching outfits? You could be twins.
She can't be your daughter.
It's impossible! You look way too young.
Happy birthday.
Get the kid a damned ice cream cake.
Dr.
Wyland to Obstetrics.
Dr.
Wyland, Obstetrics.
- You drugged her.
- Actually, I didn't.
I've taken her off all medication.
Your guy Foreman gave her Haldol.
We needed blood for tests.
I assumed that was the only way to get it.
He knocked her out.
Look, I have a cane, and I know how to use it.
I hired you.
You work for me.
Okay.
Can I go now, boss? The Haldol changes her.
She says it makes her soul numb.
Don't give it to her.
"If there be rags enough, he will know her name and be well pleased remembering it".
You okay? Old days.
"For in the old days, "though she had young men's praise and old men's blame, among the poor, both old and young gave her praise".
Oh! Help! Somebody help! So, when I said no psych meds, I'm just curious-- which word didn't you understand? The Haldol had nothing to do with the bleed.
You know that.
I used it purely as a chemical restraint.
Oh, great.
Well, that's good to hear.
So she won't experience any of those pesky little side effects you get when your motives aren't pure.
Oh-- Those side effects are so rare! What, passing out, increased confusion, depression? That's not gonna happen.
That's not gonna screw up our diagnosis, 'cause you just used it to restrain her.
I'm so relieved.
She spit in my face.
That must have been so frightening for you.
What was I supposed to do, tie her down? Yeah.
Anything but give her drugs.
That's basically my point.
The clotting studies.
Pretty fast.
Did you promise to date the entire lab? No, I save that for emergencies.
I told them she bled out two units and if it happened again, she'd die.
If it had happened at home, she would have died.
The E.
R.
doc, he was gonna send her home.
- I used my best judgment.
- It turns out your best judgment is not good enough.
- Here's an idea-- next time, use mine.
- I think they're choosing a movie.
Why did the patient bleed out? The clotting studies so far are normal.
Well, cover your ears if you don't want me to spoil the ending.
Everything was normal, except for a prolonged P.
T.
time.
- Which means what? - Usually it means whoever drew the blood didn't do it right.
Oh, that's right, 'cause you drew the blood.
- But you were precise because you knew the tube was purely for the P.
T.
study.
- That's right.
And I'm right with you.
I trust this result, for two reasons-- "A", because you are a good doctor, and "B", because five milligrams of I.
V.
Haldol makes for a spectacularly cooperative patient.
The prolonged P.
T.
time makes me think she's got a vitamin "K" deficiency.
Vitamin "K" would explain the bleed, but not the clot.
Without vitamin "K", protein "C" doesn't work.
Without protein "C", she clots.
Clotting and thinning all at the same time.
What about another drug interacting with Heparin, an antibiotic like ampicillin? That would cause the bleed.
Clever, but she's not on ampicillin.
Two months ago, she complained of a sore throat, and he got her ampicillin.
- Which she refused to take.
- He just said she didn't take it.
What is it, everybody lies except for schizophrenics and their children? It's more likely than malnourishment.
Why not scurvy or the plague? Gee, I wish my idea was as cool and with-it as yours.
What is yours, by the way? Do you have one? Alcohol.
Simple.
It causes immobility, which explains the D.
V.
T.
It also causes cirrhosis, which explains the bleed and the prolonged P.
T.
time.
- Let's ultrasound the liver.
- Three theories.
Check out her place for ampicillin and diet.
Then ultrasound her liver.
Let's find out who's right before she bleeds to death.
So House says the kid is sensitive, thinks he takes good care of her.
But if we don't find anything, why let him know we did it in the first place? What's the point? Why not just make old Foreman lift the key from the kid's backpack? Looks like Luke sleeps in the living room.
Nothing in there.
He lays out her clothes? Enough organization, enough lists, you think you can control the uncontrollable.
Fix her meds, fix her clothes, maybe you can even fix her.
Pick that up on your psych rotation? Trifluoperazine, Thorazine, Clozarile.
Whew.
They tried everything.
The ampicillin-- never touched it.
There goes Cameron's theory.
Oh, God, I hope it's not a vitamin "K" deficiency.
Damn.
Breakfast, lunch and dinner.
House was right.
That's the only thing she'll eat.
Yeah.
The problem is, you can't actually live on this stuff.
I checked it out.
I looked on the box.
All the nutritional values are solid.
There's plenty of protein and calories.
Yeah, vitamin "A" and "C", but no "K".
That's why your mom got sick.
So what's the plan then? Load her up with vitamin "K".
That's it? If it all checks out, you can take her home in a couple of days.
Oh, God, you're upset about something.
You're gonna open up to me now, aren't you? It's all my fault.
Here we go.
Okay, I'm gonna say this once: You have done a very good job taking care of your mother.
If this was all she'd eat, then what else could you do? Gosh, just being a kid is a full-time job.
Shut up! I'm 18.
I should be able to take care of my mom.
I almost killed her.
Good example.
Just the time it takes to express those ridiculous, self-centered teenage ideas.
I don't envy your schedule.
No pickles.
My mom doesn't like 'em either.
Smart woman.
Before she got sick, I didn't like how bossy she was.
Always telling me what to do, the right way to do it.
Never thought I'd miss that.
Oww.
You should get that looked at.
I still don't buy a vitamin "K" deficiency.
House was right.
That usually makes you happy.
Less work for us.
The kid feeds his mom a steady diet of booze, and the problem is too many burgers? The kid's in a tough situation.
You do what you gotta do to survive.
Feeding alcohol to an alcoholic is not a survival technique.
Where I come from, if it works-- Yeah, right.
I'm rich.
I couldn't possibly understand what this kid is going through.
Just because you're drinking pricier stuff doesn't mean you don't have a problem.
You've seen someone stagger down that road? No way vitamin "K" is the whole story.
It's not broken.
See this, right here? It's the epiphyseal plate, otherwise known as the "growth plate".
What's wrong with it? Amazing thing, this bone.
If you know how to read it, it can tell you how old someone really is.
- Exactly how old.
- Great.
Mmm, not even 15.
Almost though.
Two weeks away.
Maybe a month.
Last week.
I was 15 last week.
Happy birthday to both of us.
If you're gonna lie though, go big.
Go 21.
That way you won't need your crazy mom to help you buy vodka.
Uh, great.
Thanks for the tip.
Now, when I bring my mom home, is there anything I need to know about taking care of her? I suppose your biggest worry isn't the booze.
You're 15, basically no mom.
If Child Welfare let kids get away with that, they wouldn't need those nice foster homes, and that would make them sad.
They'd put her someplace too.
My life is working.
Not the word I'd use.
Most 15-year-old kids are doing what they're supposed to be doing.
You know, they're huffing glue, catching crabs.
If you turn me in, I'll sue you.
That's privileged information.
Oh, relax.
It's not even your X-ray.
She's awfully calm.
House wrote new orders.
There's a little bit of scarring.
Not much.
Not enough to-- It's cirrhosis.
Oh, but she doesn't drink.
Congratulations.
You win.
Actually, no one wins.
Tumor.
Cystic? Solid mass.
Cancer.
The vitamin "K" caused the D.
V.
T.
and aggravated the liver, but the tumor's the real reason for the bleed.
The tumor's the problem.
Mrs.
Palmero, I'm Dr.
Wilson.
I'm afraid I have some bad news from your ultrasound.
You have cancer.
It's big.
We do nothing, she dies from liver failure within 60 days.
- She needs a transplant.
- That's gonna happen.
- She's 38 years old.
She's a mother.
- She's a schizophrenic mother with no money, on the public dole, in fact, who knocks back vodka every time a breeze blows her way.
Mickey Mantle had a whole bar named after him.
He got a transplant.
Yeah, well, Lucy can't switch-hit.
Plan "B"-- surgery to resect the tumor.
Joe Bergin does the gamma knife thing.
Laser cauterizes while it cuts, saves more liver.
The tumor's way too big.
He won't even consider it.
Not a big risk-taker, Bergin.
Won't even drink milk on its expiration date.
He has no discretion.
the surgical guidelines.
Would he do it at 4.
6? Why don't we just say it's zero? Then we don't need him at all.
Tumors grow, they don't shrink.
This one does.
Ninety-five percent ethanol.
The ethanol dehydrates the tumor cells.
Literally sucks them dry.
It shrinks the tumor temporarily.
How temporarily? Well, if we're lucky, just long enough to fool the surgeon.
Dr.
Shopius, report to Psych Exam.
Dr.
Shopius, Psych Exam.
Good morning, Dr.
House.
Good morning, Dr.
Cuddy.
Love that outfit.
It says, "I'm professional, but I'm still a woman".
Actually, it sort of yells the second part.
Yeah, and your big cane is real subtle too.
Gotta go.
Those running noses aren't just gonna start walking on their own.
The clinic can wait.
How long? Maybe we could catch a movie.
You should know by now my doctors have no secrets from me.
I don't believe it.
Who came running to Mommy? It doesn't matter who.
The point is, I know exactly what you did.
You have no idea what I'm talking about.
Somebody knows about a bad thing you did.
That's a big field.
But somebody you think might've told me.
That narrows it down quite a bit.
Someone who views me as a maternal authority figure.
Ayoung person perhaps? How am I doing? Think I'm gonna get there? Presumably hospital business.
How many patients-- It's Cameron.
She found out about my birthday.
I thought she told you and I'd have to stand here and smile while you gave me a sweatshirt or a fruit basket.
You know, made me feel that deep sense of belonging.
Actually, I was just gonna remind you, you owe me six clinic hours this week.
Oops.
Hi, this is Dr.
Cuddy.
I need all the charts on Dr.
House's current patients.
I've tried everything.
Mm-hmm.
"Pulling the tongue, ice packs on the throat, hitting yourself, the groin pinch".
Well, you've certainly covered all the normal medical bases.
Uh, how are you hitting yourself though? Is it with an open hand or a fist? Open hand.
Uh-huh.
Well, that's-- that's how they teach it at Harvard Med.
How hard though? I'm sorry.
I missed that.
Could you do that again? Uh-- That's-- That's very good.
It's hiccups.
I need to speak with you now.
Mm-hmm.
I need to go pee-pee.
Dial it up a notch and repeat.
I'll be back.
Ooh.
Girl in the boy's bathroom.
Very dramatic.
It must be very important, what she has to say to me.
Yesterday your patient's tumor was 5.
8 centimeters.
Today it's 4.
6.
How does that happen? Well, at a guess, I'd say, "That Dr.
House must be really, really good.
Why am I wasting him on hiccups?" I wash before and after.
You also requisitioned What patient was that for? Or are you planning a party? Do me a favor.
I was gonna say leave, but that works.
- You shrunk the tumor.
- Only way to get the guy to do the surgery.
Fraud was the only way? There is a reason that we have these guidelines.
I know.
To save lives.
Specifically, doctors' lives.
And not just their lives, but their lifestyles.
Wouldn't want to operate on anyone really sick.
They might die and spoil our stats.
Bergin has a right to know what he is operating on.
True.
I got all focused on her right to live and forgot.
You do what you think is right.
You really didn't know? No, I didn't.
And, frankly, I'm angry.
Which I'm guessing is the correct response.
- Ofcourse, I'll know better once you tell me what you're talking about.
- Your birthday.
Oh.
Anger was a bad guess.
Well, normally, I'd put on a festive hat and celebrate the fact that the Earth has circled the sun one more time.
I really didn't think it was gonna make it this year, but darn it if it wasn't the little planet that could all over again.
It's a birthday.
It's an excuse to be happy.
You think that's lame? Why are you here? Did you buy me a pony? I'm just waiting for the surgery.
Yeah, well, go scrub in.
All right, we're done.
Close her up.
The tumor didn't just walk itself into a bar and order up a double shot of ethanol.
Someone shrunk it down.
I'm sorry.
It was very, very wrong.
House is lucky I didn't just close her up.
He tries it again, that's what happens.
I'll pass it on.
It looks like the surgeon got it all, but she's gonna have to have some chemotherapy.
What kind is it? Luke, stop writing.
If you stop for a second, it's not all gonna fall apart.
Give yourself a break once in a while.
The fact is, your Mom's gonna have an extra drink every now and then.
No.
No.
She won't.
She doesn't.
Fine.
There are some things you just can't fix.
That's all I'm saying.
That's how you'd handle it, something like this? You'd just give up? No.
I'd do it just like you.
It's an infusion.
She's gonna have a drain in her abdomen.
You're going to have to check for possible infection.
Lucas Palmero? Trina Wyatt, Child Services, State of New Jersey.
Can I help you? This is a private room.
He's only 15 years old, a minor.
He's in a tough living situation.
We're just here to help.
I don't need your help.
Fifteen? Lucas, you're gonna have to come with us right now.
Where are you taking him? Until the determination is made, he'll be housed at Children's Services.
I don't want to be "housed".
I live with my mom.
Not for the next few days.
Come on.
Let's not make this difficult, huh? Mom? Mom? I love you.
When the Mets lost, you remember? Yeah.
I remember.
I love you.
Cuddy didn't say anything about pushing Bergin to finish the surgery? Not a word.
Some kind of mind game.
She's waiting for me to crack.
Well, either that or she's just being nice.
Yeah, right.
You said you wouldn't call.
You're a real bastard, you know.
Yeah, I get that a lot.
I don't think Mom's crazy.
"For in the old days, though she had young men's praise and old men's blame, among the poor, both old and young gave her praise".
You called Social Services.
It was you.
N-- No.
No.
It's okay, it's okay.
I get it.
He'll have an easier time dealing with the system.
Sure, he won't be with his real mother, but his real mother's sick.
Someone needs to take care of him.
I'm not gonna live here.
What would his future have been, taking you to chemo and back on the bus? And even if the cancer's in complete remission, he'll still have a mother who hears voices.
Talk no more.
Talk no more.
"Look what I do to him, Limpy".
You said that.
I checked the phone records.
Only one call from this room.
Smart, because they charge you two bucks a call.
It was to Social Services, the State of New Jersey.
You're his mother.
You couldn't do it to him anymore.
Good for you.
Schizophrenics can make rational decisions.
On the small stuff, yeah-- when to sleep, what to drink, you know.
"No lemonade, but I'll take some hemlock if you've got it".
Huh.
Your man Socrates.
But giving up your son because it's better for him, it's so sane, it's so rational.
Self-sacrifice is not a symptom of schizophrenia.
It excludes the diagnosis.
She's not schizophrenic? Look, she's 36 years old when she first presents.
It's a little late, but within the parameters.
The internist sends her to a shrink.
One shrink sends her to the next.
She tells them all she's not crazy.
The drugs don't work.
And why would they if she's not a head case? She got clearer when I took her off the psych meds.
You think I'm crazy.
Well, yeah, but that's not the problem.
Didn't we just leave your office? I like to walk.
Is that Dr.
Jeffrey Walters? Hi.
My name is Greg House.
I'm a doctor-- Oh, is that the time? I'm-- Yeah.
I'm sorry.
My watch must have stopped.
Uh, listen, you treated a patient about 18 months ago, a woman named Lucille Palmero.
I wondered if you recalled running any tests at all.
Oh, how terribly foolish of me, Doctor.
Is it that late? Yes, I'm calling from London, you see? Must have got my times mixed up-- I have a headache.
It's my only symptom.
I go to see three doctors.
The neurologist tells me it's an aneurysm.
The immunologist says I've got hay fever.
The intensivist can't be bothered.
Sends me to a shrink, who tells me that I'm punishing myself 'cause I want to sleep with my mommy.
- Maybe you're just not getting enough sleep? - Pick your specialist, you pick your disease.
If it's not schizophrenia, what else presents with psych symptoms? - Porphyria.
- The Madness of King George.
What about that copper thing? What's it called? It's genetic.
The body accumulates too much copper.
Oh, um, uh, Wilson's Disease? Yeah.
Very rare.
Nice.
I like it.
- If any of us did this, you'd fire us.
- Well, that's funny.
I thought I encouraged you to question.
You're not questioning.
You're hoping.
You want it to be Wilson's.
Boom.
Give her a couple of drugs, she's okay.
July 17.
An appointment with a Dr.
Karn.
She didn't keep it.
She never kept another appointment with a shrink he made after that.
Karn is not a shrink.
I looked him up.
He's an ophthalmologist.
Now why would she want her eyes checked? Wilson's presents with cataracts, I think.
Yes, it does.
It also causes slight cirrhosis, which Dr.
Chase so eagerly attributed to alcohol.
So what are we still doing here? Lucy! I don't think you're crazy.
Neither do I.
But I'm crazy.
Come on.
Lean over here.
Come on.
That's it.
Put your hands on the bar here and your chin in here.
Thank you.
You're gonna see a bright light, okay? Your body might be accumulating too much copper.
If it is, this should help us see something called Keyser-Fleischer rings-- copper-colored circles around your corneas.
Wow.
I guess we should start treating her for Wilson's.
That's what I'd do.
"I will talk no more of books or the long war, "but walk by the dry thorn until I have found some beggar sheltering from the wind "and there manage the talk until her name come round.
If there be rags enough, he will know her name and be well pleased remembering it.
" "For in the old days, though she had young men's praise and old men's blame, among the poor, both old and young gave her praise".
Hi, Mrs.
Palmero.
Ready to go home? Almost.
Mom? How are you? I'm good.
Oh! Oh-- Oh, you really need a haircut.
Dr.
House.
Luke, we're making Dr.
House wait.
That's okay.
We're just here for the music.
Luke, come on.
I'm being discharged.
I heard a rumor.
Thank God I had cancer, huh? - It's terrible having everybody think you're nuts.
- Really? - I called to thank you.
Did you get my message? - Yes.
You're welcome.
I'm never thanking you.
You turned me in.
I told you we were doing okay.
It was none of your business.
Look, I don't care how you were living.
I just wanted you out of my life.
That's why I had Dr.
Cuddy call Social Services.
You okay? You were right.
It wasn't the D.
V.
T.
It was the schizophrenia.
I know.
She's not nearly as interesting anymore.
Isn't it your birthday around now?