House's Unethical Act to Save 16-year-old Boy's Life | House M.D.

0:00 There's a problem.

0:02 Complications in surgery?

0:03 Surgery went fine, he's in recovery, but we took a vial of CSF and tested it.

0:07 Wait.

0:08 Turns out the bowling wasn't the cause of his problems, it was a symptom.

0:10 Oligoclonal IgG, which means multiple sclerosis.

0:15 And the reason it takes three days to tell me this?

0:17 Because we're having a disagreement about whether or not it is MS.

0:19 No lesions on the MRI.

0:21 It's early.

0:21 He's had the disease for maybe 2 weeks.

0:23 criteria requires 6 months to make a definitive diagnosis.

0:26 Oh, who cares about McPherson?

0:27 I hear he tortured kittens.

0:28 McDonald.

0:29 Oh, Dan.

0:30 Wonderful doctor.

0:31 Love kittens.

0:32 The VEP indicates slowing of the brain.

0:34 Without the lesions, we can't be sure.

0:35 Well, if it is, it's gone from zero to 60 in 3 weeks,

0:38 which would indicate rapidly progressive MS.

0:40 Not the fun MS with the balloons and the bike rides,

0:43 but cripples and wheelchairs.

0:44 We should wait until we

0:45 Start treating him now, maybe he can walk for another couple of years,

0:48 maybe live for another five.

0:51 Break it to the family, I'm going home.

0:53 There are some medications to manage [music] the symptoms,

0:55 but as the disease progresses, the problems will become more severe.

1:00 Bowel and bladder dysfunction, loss of cognitive function, [music] pain.

1:04 What's it going to hurt?

1:07 The brain's like a a big jumble of wires.

1:10 MS strips them of the insulation and the nerves die.

1:14 Brain interprets it as pain.

1:15 But by starting treatment, we're going to prevent that for as long as possible.

1:20 We're looking into a couple of specialists,

1:21 and until we get you squared away, you'll stay here.

1:30 Security, check the videotapes from all perimeter cameras.

1:33 He's still got to be in the hospital.

1:34 Where's Chase?

1:35 Main floor.

1:36 Okay.

1:36 You take the cafeteria and administration,

1:38 I'll hit the research annex and work my way back to you.

1:41 There are experimental treatments.

1:44 Ongoing research.

1:45 Who knows what they'll discover in a year or two?

1:48 This is where I dropped the ball.

1:50 Dan, we're standing on the roof of the hospital.

1:55 Dan.

1:57 Dan, you're not on the field.

2:00 He doesn't know where he is.

2:01 Dan, Foreman.

2:04 Dan.

2:07 DAN?

2:07 DAN, NO!

2:08 DAN!

2:08 I TELL A FAMILY that their boy almost stepped off a roof, they must be thrilled.

2:12 They're not suing, but I think only because Chase asked them.

2:14 Why does everybody always think I'm being sarcastic?

2:17 This is great news.

2:18 He doesn't have MS.

2:20 Parents should be thrilled.

2:21 Well, the mom, anyway.

2:22 Of course, the dad probably doesn't know.

2:23 Why doesn't he have MS?

2:25 He was on the roof thinking he was on a lacrosse field,

2:27 conscious and therefore not a night terror.

2:28 You want some of this?

2:30 Yeah, sure.

2:31 He was in an acute confusional state,

2:34 which doesn't fit with a demyelinating disease like MS.

2:36 Oligoclonal bands.

2:37 Were real.

2:38 They just mean something other than MS.

2:40 So, what are they telling us?

2:42 That his immune system is working?

2:44 Right.

2:45 He has an infection in his brain.

2:46 What about sex?

2:48 Well, it might get complicated.

2:50 I mean, we work together.

2:51 I'm older, certainly, but maybe you like that.

2:53 maybe he has neurosyphilis.

2:55 Huh.

2:55 Nice cover.

2:56 Sorry, RPR was negative.

2:58 We don't need a definitive test to confirm it.

3:00 Sure.

3:00 Didn't need one to confirm MS.

3:01 Okay, let's wait for you to run titers

3:03 on 1,400 viruses while this kid's brain turns to mush.

3:06 So, the fact that he doesn't have MS, it's it's really not good news after all.

3:10 Well, it is if it's neurosyphilis.

3:12 Likelihood of a false negative on an RPR test, 30%.

3:15 Likelihood of a 16-year-old having sex, roughly 120%.

3:19 I'll start him on IV penicillin.

3:20 No, we're not going to wait for that.

3:21 The most effective way to deliver the drug is right into his brain by the spine.

3:25 We can't.

3:25 In a cramped space like the brain,

3:27 increased intracranial pressure from a high volume drug

3:29 like penicillin can herniate his brainstem and kill him.

3:32 A neurologist in his right mind would recommend that.

3:34 Show of hands, who thinks I'm not in my right mind?

3:38 And who thinks I forget this fairly basic neurological fact?

3:41 Who thinks there's a third option?

3:45 Very good.

3:46 What's the third choice?

3:47 No idea.

3:48 You just asked if I thought there was one.

3:51 Patient has a shunt in his brain.

3:53 There'll be no increased pressure.

3:54 We can put as much penicillin into his body as we want.

3:57 Excellent.

3:57 Inject him through a lumbar puncture.

4:00 The treatment should start helping soon.

4:02 Let us know if it's easier to focus on things when you remember stuff.

4:07 Don't fight it.

4:08 Just let it happen.

4:09 No.

4:10 He'll be dead in 2 days.

4:11 I give it a day.

4:13 Dan.

4:13 Not You okay?

4:14 Dan.

4:15 Night terror.

4:16 Body decomposition once he's in the grave.

4:20 He's hearing voices.

4:26 Push 2 mg IV Ativan stat.

4:30 [screaming] How can you just sit there?

4:32 If I eat standing up, I spill.

4:34 Our son is dying, and you could care less.

4:37 We're going through hell.

4:39 You're doing nothing.

4:41 You haven't checked in on him once.

4:43 Blood pressure is 110 over 70.

4:46 The shunt is patent, well placed in the right lateral ventricle.

4:49 The EKG shows a normal QRS with deep

4:51 wave inversions throughout both limb and precordial leads.

4:54 LFTs are elevated, but only twice the normal range.

4:57 Oh, yeah, and he's hearing voices.

5:00 Go hold his hand.

5:03 Go on.

5:03 I'll bust your train.

5:09 Got any sample bags on you?

5:11 I don't believe you.

5:13 Going to run DNA tests?

5:14 Your son is deathly ill.

5:16 I know it's terrible.

5:18 The fact is, if I don't keep busy with trivial

5:19 things like this, my head I might start to cry.

5:22 You're an ass.

5:23 What's this?

5:23 Parents' coffee cups.

5:27 I can't believe you.

5:27 I've had this conversation once already.

5:29 You got something else to do, do it.

5:30 Otherwise, do this.

5:32 House is right.

5:33 The father's not the father.

5:36 Dude doubled up on me.

5:39 You're not going to believe this.

5:41 The mother's not the mother, either.

5:43 You lied to me.

5:44 We didn't lie about anything.

5:46 You, on the other hand, accused us of molesting our son.

5:49 Perfect.

5:49 Can we get off my screw-ups and focus on theirs?

5:52 Theirs is bigger.

5:53 You're not Dan's parents.

5:54 We're his parents.

5:55 He was adopted.

5:56 He doesn't need to know.

5:57 I do.

5:58 Adoption makes us just as much as Listen.

6:01 When we were taking his medical history, were you confused?

6:04 Did you think we were looking for a genetic clue to his condition,

6:06 or did you think we were trying to ascertain

6:08 who loves him the most in the whole wide world?

6:11 you find out about this?

6:13 I sampled their DNA.

6:15 We didn't give you any DNA.

6:16 Your coffee cups from the cafeteria.

6:19 You can't do that.

6:20 Again?

6:21 Why are we getting hung up on what I did?

6:23 Your medical history is useless.

6:24 No, we gave you a detailed history of his biological mother.

6:29 Her history, non-smoker, good health,

6:32 low cholesterol, no blood pressure problems.

6:35 Dan was adopted 2 weeks after he was born.

6:37 You have his history, there's nothing you need to know that we didn't tell you.

6:39 Sounds reasonable.

6:41 Well, if you want to transfer your boy, that is your choice.

6:45 I still think it's the wrong vaccinated?

6:49 The biological mother, when she was a baby, did she get her vaccinations?

6:52 Dan was vaccinated at 6 months.

6:55 Mhm.

6:56 Do you know why kids get vaccinated at 6 months?

7:00 Because before that, they are protected

7:01 by their biological mother's immune system.

7:05 So, was she vaccinated?

7:11 An infant picks up a regular old measles virus, gets a rash,

7:15 is extremely uncomfortable, has a wicked fever, but he lives.

7:19 And here's the kicker.

7:21 Once every million or so times, the virus mutates.

7:25 Instead of Dan having a fever and a rash,

7:28 the virus travels to his brain, hides like a time bomb.

7:33 In this case, for 16 years.

7:36 Subacute sclerosing panencephalitis.

7:39 I know.

7:40 There's only been 20 cases in the United States in the last 30 years.

7:43 Suppose you can make an argument the kid's still in stage one.

7:46 Once SSPE moves to stage two, it's Boom.

7:49 Stage two is universally fatal.

7:52 I assume it's impossible to know when he might move into stage two.

7:54 He's already started showing symptoms.

7:56 Could be a month, could be tonight.

7:59 Can we treat it?

8:00 Ask the neurologist.

8:01 Intraventricular interferon.

8:03 I'm not going to shove a spike

8:04 into his brain and drip interferon without confirming this diagnosis.

8:08 Tap him.

8:08 You won't get a reliable result for measles antibodies in his CSF,

8:11 not after everything we've given him.

8:13 So, the wrong treatment kills any hope of the right diagnosis.

8:16 Why do people lie to me?

8:20 Could also kill him.

8:21 You're a ball, Foreman.

8:23 Tell me I don't have to biopsy his brain.

8:27 Well, there's one other way.

8:31 You sure this isn't going to hurt?

8:33 Yeah.

8:33 It's just scary as hell.

8:35 See, we go through the pupil, and you won't feel it.

8:38 The eye's been paralyzed.

8:39 The needle travels to the back of the eye,

8:41 which is where we'll perform the biopsy on your retina.

8:50 So, we've confirmed that the problem is this mutated virus.

8:53 The treatment for SSPE is intraventricular interferon.

8:57 Implanting a Ommaya reservoir under the scalp,

9:00 which is connected to a ventricular catheter

9:01 that delivers the antiviral directly to the left hemisphere.

9:05 You want us to consent to this?

9:06 I don't even understand what you're talking about.

9:08 Well, the antiviral Look, I'm sorry.

9:15 I can explain this as best I can,

9:17 but the notion that you're going to fully understand your son's

9:20 treatment and make an informed decision is it's kind of insane.

9:26 Here's what you need to know.

9:29 It's dangerous.

9:31 It could kill him.

9:33 You should do it.

9:35 Hey, good morning.

9:37 Good news on your EEG.

9:38 Treatment is working.

9:40 And your immune system is responding.

9:42 I know it's early.

9:44 Just want to take a look.

9:47 All right.

9:48 Let's see what that brain [music] of yours can do.

9:51 Name as many animals as you can that start with the letter O.

9:55 Ostrich.

9:57 Ox.

9:58 Old elephant Well, that's [music] two better than last time.