House, M.D. s03e17 Episode Script

HOU-317 - Fetal Position

Hey.
Thanks.
No, no, no Here.
You got this whole thing wrong, Em.
It's the rock star that's supposed to be late, not the rock-star photographer.
Sorry.
Morning sickness.
Touch the belly.
It's the first time I've been asked to do that.
Come on.
It's good luck.
Okay.
Hit the Kinos behind the drop.
So what do you think? I think people aren't gonna get it.
Come on.
"All-American Rejects.
" Juxtaposing a classic image of Americana with modern pop culture youth.
Oh, yeah.
Everyone loves a good juxtaposition.
My fans were born in the '90s.
You know what? You do this picture, you'll gain 40 years of fans.
Yeah? Yeah.
I love the Rockwell thing.
I thought so.
Okay.
Kill the house lights.
Let's go! Hang on.
Hey, who's in charge of the backdrop? Naomi? Yeah? What's wrong with it? Well, the words are completely jumbled.
What, you can read that? Of course.
You okay? No.
Oh, God.
I could be having a What's the mnemonic? "F" is for face.
Is my smile crooked? What are you doing? "A" is for arms.
Arms.
You should really sit down.
Can someone get her some water? "S" is speech.
I'm slurring? I'm slurring? "F-A-S-T.
" "T" is for time.
Hurry.
Somebody, call 911.
Tell them I'm having a stroke.
Hi.
I'm Dr.
House.
My boss says you're important.
Personally I don't get what's so hard about making Scarlett Johansson look pretty.
Arms out in front of you.
Palms up like you're holding a pizza.
Close your eyes.
It's so easy you should consider a career change.
Probably make a lot more money.
Dr.
Mackman tell you the clot was clear? Yes.
And he said that you and the fetus are fine? Yeah.
He didn't mention your pronator drift? What's that mean? Means Mackman is an idiot.
May I? Yeah.
So, you take thousands of photos of someone, but only one has to look good.
Kind of the opposite of my business.
It's not about looking good.
People are always hiding things.
I just keep shooting until I can see what's really inside them.
My eyes okay? Eyes are gorgeous.
The vessels don't look so hot.
Microaneurysms predict further strokes.
This is gonna happen again? Unless I can figure out the underlying cause.
Puff up your cheeks.
You should be able to keep the air in.
Means there's weakness around the mouth.
So where'd you learn to self-diagnose a stroke? Oh, my baby's biological father is a neurologist.
He once told me the FAST mnemonic could save my life one day.
So Interesting pet name.
Most people go with "husband" or "pookie.
" He's gay.
Just a sperm donor.
So when you You turned him for a night? Just straight for one date? Okay.
He took a magazine and a cup into my bathroom.
A man after my own heart.
Different magazine obviously.
I'm rescinding Mackman's discharge order.
My lackeys will be in to do some tests, take some more blood and empty your catheter bag.
Not a moment you'll want to cherish.
This is definitely different.
It looks almost like He's caring.
Find anything else in the patient's folder? Like a diagnosis? Urinalysis revealed excessive protein and red blood cells.
Chem panel showed a creatinine level over 2.
5.
So first she strokes, now her kidneys are shutting down.
Why? Ultrasound showed no tumors or stones.
No signs of fetal distress.
No urinary tract obstructions.
BP is fine.
No pre-eclampsia.
Any of you guys ever been to the Galápagos? Was our patient there? Dengue fever, avian pox, even West Nile.
No.
I'm looking for a vacation spot.
That mean we get vacation? How would that differ from your current status? You're gonna do what? Relax? Visiting family.
My uncle's a giant turtle.
What if the kidney failure came first? Kidneys could've caused the stroke not the other way around.
Kidneys don't often get stuck in the brain.
I'm saying it threw a clot.
Early symptoms of kidney failure are nausea, vomiting, ankle swelling.
She would've mistaken it for morning sickness.
Heart's way more likely to throw a clot than a kidney.
Echo was normal.
The history indicates no sign of cardiac problems.
No, but if one were to read the history closely, one would notice that she had six cases of strep.
In her throat.
That's the one about 10 inches above her heart.
Let me rephrase, six cases of untreated strep.
She was prescribed antibiotics.
No one takes them all.
They stop when they start feeling better.
All strep is untreated strep.
What happens when strep goes untreated? Leads to rheumatic fever.
Which leads to Cameron? Mitral valve stenosis.
Which is a thickening in the valve of the Kidney? No.
The kidney doesn't have a mitral valve.
We'll go look at her heart.
Be easy to find.
It's the big red pumping thing about 10 inches below her throat.
That was weird.
He was the way he always is.
Which is weird.
Very still, Emma.
Sorry.
No problem.
He caught us with your hand up my shirt.
He's gotta have a reaction to that.
You think that's what the vacation is? Yes.
The pain of losing you is obviously forcing him away.
Coronal slice appears normal.
There's no way House just lets this slide.
He's gotta be planning something.
Maybe he just doesn't give a crap.
Sagittal slice is clean.
You think he just stumbled into that closet? He knew we were there and he wanted us to know that he knew.
Or you wanted him to know.
Now he does and you're annoyed because he doesn't care.
Right there.
Trans-axial slice.
Calcified mitral valve.
Barely.
That's not big enough to throw a clot.
Obviously it is, because it did.
House was right.
A valve in your heart is narrowed.
It caused the clot which lead to your stroke, and the reduced circulation caused the problem with your kidneys.
And this will fix it? The balloon will force the valve back open and you'll be fine.
Can we do this without a sedative? It's very mild.
There really is no risk to the fetus.
We'll monitor your baby's heart rate separately.
We won't allow it to decrease anywhere near dangerous levels.
Thank you.
You're both gonna be fine.
Go ahead, Dr.
Cameron.
Listen to that heartbeat.
It sounds so Start threading the catheter.
No, I don't want a layover in Frankfurt, Taipei, Singapore or London, Ontario.
That's why I asked for a direct flight to Phnom Penh.
How hard is it to not land? Does it matter what I answer? Well, then fine.
I'd be delighted to hold.
What's new? Can you tell Cuddy to stop interfering? It's her job.
What's new? Good news is Emma's heart is fixed.
Bad news is it's not her underlying problem.
Her kidneys are still failing.
You're vacationing in Cambodia? You gonna unwind in the Killing Fields? Nope.
Gonna catch me a fish this big.
Mekong giant catfish.
Weighs over 600 pounds.
Aren't those catfish critically endangered? That's why it's my last chance to catch one.
All of our operators are currently If the mitral valve had been properly fixed the kidney should be getting better, which leads us to the conclusion that you screwed up the procedure.
Or you screwed up the diagnosis.
The mitral valve thickening was so insignificant it probably wasn't the cause of the kidneys or the stroke.
Probably never would've been a problem.
She needs dialysis and we need a new theory.
There are only a few possibilities.
Patient's pregnant, could be pre-eclampsia.
We eliminated it before because Re-check for proteinuria and low platelets.
What else? Hypoperfusion.
The fetus is basically a parasite stealing nutrients, minerals, blood.
Put her on telemetry.
Or the pregnancy is irrelevant.
Could be infection, sepsis, HUSITTP.
A cholesterol embolism is just as likely.
Tiny particles of cholesterol rain down, clog up the small vessels of the kidneys.
Get a smear and ultrasound her vessels for plaque.
That's it.
Has to be one of those five.
You know what would be even better? If we'd narrow it all the way down to one.
Thank you for holding.
We are experiencing extremely high call volume.
Thank you for your patience.
She's 0 for five.
Either the differential was wrong or she's faking it.
Kidney failure has to be precipitated by One of the five we've already ruled out.
The body only has so many ways of screwing with the kidneys.
The labs must be wrong.
We did the labs.
No one else had access.
That's not quite true.
You put all your patients through this many tests or just the important ones? We wanted to explore all possibilities.
And? We've eliminated all the possibilities.
You telling me I'm dying and you have no idea why? Your body is functioning properly.
So why are my kidneys failing? The other body isn't.
There's something wrong with the fetus.
Welcome to the world of maternal mirror syndrome.
Mom's body is like an intricate German metro system.
All the trains run on time.
When she gets pregnant, it's like a new station opening in Düsseldorf.
Bunch or rookies running things.
Bound to be mistakes.
Kids play on the tracks, get electrocuted.
Before you know it, the trains are backed up all the way to Berlin and you've got a bunch of angry Germans with nowhere to go.
And we all know that ain't good for the Jews.
Who are the Jews in this metaphor? A few things can happen to a fetus in distress.
It can become a miscarriage, stillbirth, a very sick baby or on rare occasion a time bomb that kills mom while it's dying.
Good news is, we fix the fetus, mom gets better.
It's the diagnostic equivalent of a two-for-one sale.
I have read the outcome of mirror syndrome is almost always unfavorable.
"Unfavorable.
" Is that doctor speak for "dead baby"? You think she'll be less upset if you phrase it nicely? We can tell her the truth, that she'll be fine as soon as we diagnose a person who weighs about one pound.
Can't touch it, can't ask where it hurts, can't see it.
If only there existed giant machines that could look through human skin.
Mirror syndrome has a limited number of known causes.
Tachyarrhythmia, fetal anemia, placental chorioangioma.
All of which are fixable.
Which would be un-unfavorable, right? Could also be trisomy 13.
Ebstein's anomaly, an aneurysm of Galen's vein.
And Dr.
Storm Cloud rained all over the differential and killed the beautiful little baby.
Heart's easiest to see, easiest to fix.
So let's start there.
When you did Mom's MRI, did you get a look at the fetus's heart? It was in the range but blurry.
The fetus was moving all over the place.
So we need another scan.
Yeah.
We'll just ask the fetus to lie very, very still.
No need.
I'm going to paralyze it.
You wanna paralyze Emma Sloan's baby? Let me guess.
Cameron? Cameron and Chase both had their concerns.
No, Cameron had concerns.
Chase just agreed with her because he didn't want to lose his all-access pass to her love rug.
They're sleeping together? If by "sleeping together" you mean having sex in the janitor's closet.
Here? No, the janitor's closet at the local high school.
Go, Tiger Cats! Do you have one of those camera phones? 'Cause I got a MySpace account.
I will deal with them after I deal with you.
Oh, come on.
Let's gossip some more.
I'm sure she's into bondage.
Paralyzing a one-pound baby risks damaging Not paralyzing the thing risks not getting a clean MRI of its heart, which we need to save its life, which we need to do to save Emma's life.
You're gonna need to get her consent.
Well, that shouldn't be too hard.
"Sign here or you and your baby both die.
" I'm going with you.
Oh, good.
You said sedation was risky.
This sounds insane.
The injection goes into the umbilical cord.
The baby won't feel a thing.
Fetus.
I'm lowering expectations.
It works here and on dates.
The benefits outweigh the risks and the paralytic will wear off in an hour, okay? Must be easier to hear you might die than your baby might die.
But if there's anyone I would trust to save my baby, it would be Dr.
House.
Fetus.
Hold this.
Dr.
Cameron.
The MRI results back? The fetus's heart is structurally sound.
The problem's with the bladder.
It's four times normal size.
Let me see.
The bladder's so engorged it's taking up the whole torso, squeezing all the other organs.
There's no room for the lungs to develop.
The baby has a lower urinary tract obstruction.
We can fix that by inserting a shunt.
I'll give Emma the news.
Are you taking over the case? House won't care.
He has his diagnosis.
Doctor Cameron.
Dating Chase can only end in one of two ways.
House told you? You get married and live happily ever after, or somebody gets hurt and you two can't work together, and I have to fire somebody.
I would hate to see my personal life become such a burden to you.
I'm telling you this for your own good.
I assume you're gonna have this same conversation with Chase for his own good.
Chase isn't the one that's gonna get hurt here.
There's only room for one but I could skooch over.
My social life is my social life.
Couldn't agree more.
What goes on in the privacy of a janitor's closet is nobody's business except She told me to end it.
Is that what you want? I was actually hoping she'd fire one of you.
What are you doing? Trying to avoid altitude sickness.
Couldn't score a direct flight to Cambodia, so I've decided to scale Argentina's infamous Mount Aconcagua.
Perfect except for the fact that you can't walk.
There's a tribe of Mocoví Indians who actually carry the elders up You're insane.
I'm an insane genius.
I set the chamber for low pressure instead of high.
Thinner air builds up the extra red blood cells, creates new capillaries.
Few more days in here, I can save myself six weeks at base camp.
Where's my MRI? There's a blockage in the urinary tract.
Simple terms, your baby can't pee.
His bladder is swollen and it's crushing his lungs.
Can you fix it? We can insert a small tube in the baby's bladder that makes the urine come out straight through his belly for the duration of the pregnancy.
The bladder decompresses and the lungs will be able to develop normally.
When the baby gets better, you should get better.
First we just have to do a test to determine whether the baby's kidneys are functioning properly.
And what if they're not? If they're already too damaged, then there's really nothing we can do.
If this doesn't work out you can always try again.
I miscarried twice when I was married.
After the divorce, I tried in vitro like four times before this.
I'm 42.
Maybe it's just not meant to be.
What are you doing? You're trying to be me, so I thought I'd try to be you.
You don't have the cleavage for it.
But I have a much tighter ass.
Think every day should be naked Thursday or is that an oxymoron? Let me see the results from the bladder tap.
They aren't back yet.
They're gonna be inconclusive.
You think my diagnosis is wrong? Fetus doesn't pee, amniotic fluid should be low.
Mom's level is fine.
Doesn't mean I'm wrong.
Could just mean we caught the obstruction early.
Either way your test will be inconclusive.
The urine you've collected has been sitting in that fetus's bladder for weeks.
As my pappy always said, "Stale pee is useless pee.
" Fine.
I'll do another tap.
Just as useless.
Old urine drops down from the kidney right after the first tap 'cause it's so backed up.
Bladder tap number three will give you the freshest pee.
That's when you'll find out if this fetus has even a fighting chance.
Thank you.
I'll run two more taps.
Since when does the Dean of Medicine run bladder taps? She's an important patient.
Because she takes pictures or because she's you? Woman in her 40s, single, using a turkey baster as a last gasp at motherhood.
Maybe you want to make sure she succeeds so you'll still have hope.
You can't be a good doctor if you're not objective.
It's your file.
I don't want it.
Then why did you just say all that stuff? To humiliate you.
You're taking the case back.
I don't want it.
Your diagnosis is right.
I want to go on vacation.
You can go on vacation after you've cured her.
Good news.
The fetus's urine had appropriate levels of protein and electrolytes, so its kidneys aren't damaged.
Oh, wow.
We're gonna put the shunt in.
Your baby's lungs should have more room to grow and your symptoms should go away.
But he'll still need surgery, after he's born? That's when we'll remove the blockage in the ureter.
You'll be the only mother on the planet who appreciates the value of a wet diaper.
Hey, could you hand me that? I'm keeping a visual memory book of this entire surreal process and this is the best part of the story so far.
Yeah.
Sure.
Thanks.
When'd you take this? She did the second bladder tap.
You should keep it.
Oh, I see her all day at work.
I don't need it.
Maybe you want to see her after work.
I'm right, right? I saw the way you look at her.
Thanks.
The shunt is in the right position.
Bladder is starting to decompress.
No infection.
Did House say anything else? About us? I thought you didn't care about his reaction.
Trying to make him jealous? I like my job.
He can't fire you just because we're together.
We're not "together," and House can do whatever he wants.
How's my baby? Doing just fine, Emma.
So are you.
My stomach's killing me.
That's not her stomach.
Can you open your eyes, Emma? I just need to take a look.
What is it? Emma's jaundiced.
Her liver's shutting down.
Figures.
Just booked my trip to Johnston Strait.
I thought you were climbing Mount Whatever in Argentina.
Apparently I'd have to live with the Mocoví Indians for 20 years before they'd consider me an elder.
Decided to go kayaking with orca instead.
No legs required.
Can't leave yet.
Liver failure puts her case back into the unsolved pile.
Increased AST, ALT and her bilirubin's off the charts.
Even fetuses lie.
We diagnosed a lower urinary tract obstruction because we saw one.
What if that's not the whole story? What if the little bugger is hiding something? The real reason for the mirror syndrome.
Have we looked under its bed? We checked its diary? If it's not GU, could be the heart.
Hypoplastic left heart syndrome.
There were no structural problems.
The lungs.
We won't be able to get a good look until they develop.
It'll be weeks She's not gonna last weeks.
What do you want to do? Maternal mirror syndrome has one sure fire cure.
Deliver the fetus.
That's not viable at 21 weeks.
You'll kill the baby.
Fetus.
Semantics make you feel better? Pretend it's not a person? Can it play catch? Can it eat? Can it take pretty pictures? Who wants to tell her? The swollen bladder was not the only problem.
We can't leave it inside you.
We have to terminate.
Well, can't you deliver him? Put him on a respiratory machine till you figure out what's wrong? We can.
And it won't matter.
The fetus is still at least two weeks away from being viable.
Well, I'll suffer through this for two more weeks then.
You're on dialysis for your kidneys.
Your kidneys can wait.
They don't make dialysis for your liver.
You're not gonna make it two more days.
I'm not gonna let you kill my baby.
It's killing you.
I'm not having an abortion.
It's not a baby.
It's a tumor.
I understand dying for a cause.
Sacrificing your life so your child might live.
But that's not the choice here.
Either it dies or you both die.
Or you fix him and we both live.
I can't fix it.
I'm scheduling a D&C.
I won't consent.
So I guess you have two days to figure it out.
Her kidneys are almost irreparable.
She's developed severe DIC.
You have to force her to terminate.
Did you give corticosteroids to speed up the baby's lung development? No.
I dropped an anvil on its chest to prevent lung development.
I'm trying to extinguish the human race one fetus at a time.
Give the lungs more time to expand so you can see inside them.
See if they're the problem.
My real patient is dying.
Very quickly.
Like I wouldn't advise her to buy any green bananas.
The fetus is nothing more than a parasite at this point.
Removing it is an instant cure.
You're not gonna get Emma to see it that way.
She's probably already named the baby, read him books, had conversations with him.
See, you get it.
She'll listen to you.
No.
If you let this woman refuse to terminate, you're helping her commit suicide.
As her doctor my recommendation is against suicide.
If the baby had a doctor, I think she would recommend exhausting all possibilities before taking its life.
Then she'd be an idiot.
Too bad she's your boss! What if our original assumption is wrong? It isn't.
If we assume she doesn't have mirror syndrome, then terminating her pregnancy isn't gonna help her liver at all.
We eliminated all other possibilities.
The fetus is hydropic and in distress.
Emma's kidneys and liver are failing.
The diagnosis is solid.
Wow! The ass-kisser won't agree with you.
You must be even wronger than I thought.
Fine.
Let's assume she had mirror syndrome but we fixed it when we fixed the baby's bladder.
That means that her failing liver would be completely unrelated.
If it is, we can fix it and we don't have to terminate.
So her theory is that our patient's liver problems were just a giant coincidence.
It's not a surprising coincidence.
Pregnant women can develop liver problems.
If this is the case, we can actually do something here.
Don't you guys think that's worth exploring? Acute fatty liver of pregnancy would have the same symptoms.
Thank you.
Brownnoser.
Viral hepatitis, HELLP syndrome.
Oh, look.
Sticking up for your girlfriend.
Who says chivalry's dead? He's not joking? Be patient.
She's going through all of us.
She'll get that jungle fever eventually.
I'm not going through anyone.
You love him? This can probably wait until after you biopsy Emma's liver, right? We can't.
Her platelets are too low.
Once we pierce her liver, it'll be next to impossible to stop the bleeding.
Come in from above.
Instead of going straight in through her abdomen, go in through the veins in her neck.
Transjugular hepatic biopsy.
If the liver starts to bleed, it'll bleed right back into her own veins.
Why don't you start your vacation now? Threading the guide wire through the right internal jugular vein.
So, the sleep lab You and Cameron not sleeping.
How serious is it? It's nothing.
She's only doing it to make House jealous.
Then why are you doing it? You kidding? You're approaching the inferior vena cava.
Slow down.
You better not hurt her.
She already has a big brother.
She does? You obviously care very deeply about her.
I'm not protecting her.
I'm protecting myself.
A heartbroken, lovesick Cameron would be even more unbearable than she is now.
You're through the hepatic vein.
I'm firing the needle.
Heart rate and BP spiking.
Get that out of her.
Fetus's heart rate just dropped to 50.
We've got contractions.
Pre-term labor.
Start a terbutaline drip! We were able to control the pre-term labor with tocolytics.
The contractions have subsided for now.
And the liver biopsy was negative.
This is definitely mirror syndrome.
Her baby's doing this to her.
We're out of options.
Did the biopsy cause the pre-term labor or did it happen on its own? It doesn't make a difference.
Pre-term labor can be a new symptom.
New information gives us new theories.
Isn't that how it works? Not in this case.
Her body's trying to do what you refuse to, get the baby out and save itself.
Patient's transaminases are 10 times normal.
Her liver is on the verge of shutting down completely.
A torch test could We don't have time for more tests.
We have to terminate or she'll die.
Then let's work faster.
Medicine doesn't work faster just because you hope real hard.
But it could help to see what the baby's been hiding.
The only organ we haven't been able to look inside is its lungs.
The problem must be in there.
We haven't been able to see inside because they're underdeveloped.
We've already got her on corticosteroids, but it'll take weeks for them Then let's drown them in corticosteroids, multiple courses.
Speed up their development.
Giving the baby more than one course will suppress adrenal gland function.
Have long-term adverse effects on fetal organ development.
Worse than death? Emma's already on tocolytics.
The combination could put her into pulmonary edema.
You'll just kill her faster.
It's the only chance we have to see inside those lungs.
We're just gonna have to make the baby better faster than we make Emma worse.
Come on! This is the kind of thing House does every day.
House thought we should terminate six hours ago.
I'll do it myself.
Anybody gonna stop her? Stopping the madness is her job.
Somebody's got to be Cuddy's Cuddy.
Nurse! Pulmonary edema? Who tattled? It doesn't matter.
There's a reason we don't give multiple courses of corticosteroids.
Gee, thanks.
It's time to terminate.
That's not what she wants.
Look at her.
She didn't want to be an incubator for a dead baby, but that's what you've done.
Either get me a laryngoscope or get out! You were right.
You were all right.
Now the mom's lungs are shutting down.
She's dying faster than the baby's lungs are developing.
I had to stop the corticosteroids.
Have you spoken to the family? The only family she's got is that baby.
Well, he's biased.
What do you think House would do? House wants to terminate.
I mean if he didn't.
If he shared my position, what do you think he would do? He wouldn't share your pain.
He'd be objective.
Right.
He would prioritize his problems.
He'd terminate.
He wouldn't be afraid of screwing with her lungs if there was a bigger issue.
There is no bigger issue.
She needs her lungs.
Not right now.
She's already on a respirator.
The machine is breathing for her.
I can do whatever I want to her lungs.
If you're playing catch in the living room and you break your mother's vase, you may as well keep playing catch.
The vase is already broken.
Yeah, except that room can't breathe without that vase.
I'm putting her back on corticosteroids.
It worked.
What worked? I got the baby's lungs to expand.
We should be able to figure Cab's on its way.
I have to finish packing.
I have a whole new appreciation for what you do.
How hard it is to believe when everyone around you is telling you that you're wrong.
Helps to know they're idiots.
Do you think I'm an idiot? You're not objective.
But you're not an idiot.
These lungs are still two weeks away from being viable.
But big enough for a diagnosis.
These tissue buds are new.
Could indicate bronchopulmonary sequestration or diaphragmatic eventration.
I was thinking bronchogenic cyst or bronchial atresia.
Could be lung lesions, CCAM.
What about Move.
Thought you started your vacation.
Somebody had to save our boss's rotundous ass.
Latest MRI of the Sloan fetus.
Small buds in the lungs could indicate Thanks.
Got the multiple choice all worked out.
Question is, how do we pick between A, B, C, D, and none of the above? Portable MRI is in her room.
We could get a current image.
The fetal lungs are so tiny the MRI won't give us the detail we need.
What would we do if this patient were not just a tadpole? Say it was an actual person.
He is a person.
Thanks for playing along.
Pretend it's a one-pound adult.
Forget the mom, forget the womb, the placenta.
How would we get a better look at what's in the lungs? Transesophageal echo.
Can't access his esophagus.
High resolution CT could give us a clearer Too much radiation for a one-pound person.
You can't just shoot everything down, Chase.
You're not me.
Collaborate.
A ventilation perfusion scan would be next.
How do we get a fetus to breathe in a radioactive isotope, idiot? If it were really a person and we had no other options we'd do an exploratory surgery.
Cut into its chest and have a look around.
Let's do that.
You're the one who insists we treat it like a person.
I'll put it back when I'm done.
Me again.
It's your friendly neighborhood belly squirter.
We're gonna do open fetal surgery.
Open the uterus, cut out the fetus so we can look around.
I know you can't talk so I need you to look petrified if you consent.
The umbilical cord won't be cut.
During surgery, your body will basically serve as the baby's heartllung machine.
We find what's wrong and we fix it.
If we can.
Don't lower expectations if you want them to do something.
She should know what she's facing.
This is incredibly dangerous.
It risks both your lives.
The only reason why we're suggesting it is because there's nothing else we can do.
You all here for the fetal surgery? 'Cause we're way over capacity.
Mind each other's personal space.
There are sharp implements in the room.
Like this one.
Uterus is fully exposed.
And we're in.
Start draining the amniotic fluid.
Have you never sucked beer out of the bottom of a keg? Where'd you go to college? Give me that.
Affix the pulse ox to the palm.
House? Sorry.
Just realized I forgot to TiVo Alien.
Fetal heart rate good.
Stats are stable.
Position him for the incision.
I see three well-defined lesions.
It's definitely CCAM.
I should be able to resect them.
It's the mom.
She's in V-fib.
Charging.
Clear! I'm clear.
Looks like asystole.
Paddling isn't going to do anything.
It's fine V-fib.
I'm going again.
Clear! We're gonna lose them both.
Clamp! The surgery's not doing this to her.
The fetus is.
Step away, House.
I'm going again.
The only way to save her is to cut away the anchor holding her down.
You keep going, you're gonna get electrocuted.
Clear! Going again.
Clear! Heart rate's returning to normal.
Continue with the lobectomy.
So my kidneys, liver and lungs are all fine just like that? Just like that.
That's amazing.
What's amazing is how blonde your baby's hair is.
My baby? The thing in your belly that tried to kill you.
You've never called him a baby before.
Any pain? Nothing I can't deal with.
You can only get out of bed to pee, pooh or shower.
And absolutely no sex.
So stop flirting with me.
Sorry.
So this really worked? He'll be normal? Well, if you call being born twice normal.
Hey, thank you.
Don't thank me.
I would've killed the kid.
Wanna grab a bite? In a minute.
Emma asked me to bring up her camera.
I'll walk with you.
When'd she take this picture of you? You look so I'm smiling.
I have a nice smile.
No, I've never seen you like this.
She got you to glow.
What were you doing? What did she say to you? I always glow.
House.
Need you to take a look at something.
I'm off the clock.
Just open it.
A first-class ticket to Vancouver Island.
Shoot! The wrong envelope.
I think it's great.
Yeah.
Who doesn't like Canadians? It's big.
You're trying to have a life.
You're trying to enjoy yourself.
You didn't need to apologize.
I'm not.
I told you why I Screwed up.
I saved a life.
I saved two lives.
You let your maternal instinct get the best of you and nearly kill two people.
Case like this, you terminate, mom lives 10 times out of 10.
You do what you did mom and baby both die Sometimes point one is bigger than 9.
9.
No, it's smaller.
Exactly 9.
8 smaller.
Always is.
Always will be.
Well, not for Emma.
And not for her son.
Now go away and be happy.

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