Honey?
Are you all right?
Yeah.
Yeah. I'm just fighting off a stomach bug.
I'll be fine.
Did he sleep okay?
Great, as long as I was holding him.
I can't wait for colic to be over.
Oh, shh.
There you go, Mikey. Bath time's coming.
He lifted his head yesterday.
Take the day off.
I mean, you're sick anyway, and you hardly ever see him.
Or me.
I can't.
I got a meeting with Crandall's Kitchens. I think that deal's gonna close.
They called about the car payment again.
It's 2 months late.
We're gonna be fine, honey.
Enjoy your bath, little man.
You know, honey...
Honey, I'm not gonna go in.
I'm coming down with something.
Honey?
Kara.
Kara?
Kara!
Mikey!
Kara!
Mikey!
2X22 - Forever
Original Airdate (FOX): 9 MAY-2006
Before we called in ♪ merged in the bathtub.
Don't know how long. Non-responsive at the scene.
Obviously breathing now.
Continue the blow-by. Stat portable chest.
- Caucasian, female, 32. - Where am I?
Tonic-clonic seizure in the bathroom.
Where am I?
Come on, one, two, three.
Where am I?
On three— one, two, three.
You're in the hospital, honey.
Mikey's here, and the doctors say he's gonna be okay.
Hopefully. He needs to be checked out by the NICU.
What happened?
- You passed out. - What?
Mikey fell.
Has your wife had a seizure before?
No.
I can't mve my head. I want to see him!
He's right here, honey. He's right here.
Tonight...
I Word marathon.
You watch The I Word?
On mute.
I'll pass.
Dinner with Cuddy.
Still sucking up so she'll fund your play space for the chemo kids?
They really ought to save their energy for other things. Like crying.
She's the suck-up.
She asked you?
She's smart. She knows if she buys me enough alcohol,
my defenses just might be weakened.
Doesn't make sense. Unless she ran out of batteries.
Hey... I'm recently single. She's single.
You're too nice for her to like you.
She's not needy enough for you to like her.
She's got an agenda, just not one that includes an appearance by little Jimmy.
I'll poll my peeps.
How many of you think that Cuddy asked—
Or rather, "peep."
Chase caught a case in the E.R. He wants us to take a look.
Unless Chase broke his neck falling off his polo pony, he had no reason to be in the E.R.
Cuddy put him on a two-week NICU rotation.
Patient had an unexplained seizure.
Seizures are cool to watch, boring to diagnose.
How about Foreman?
He needs to get his malingering butt back here.
He almost died.
Almost being the operative word.
Hey.
How are you doing? You look great.
Thanks. I feel great.
Glad you're back.
Cameron makes lousy coffee.
I take mine black, the way I take my brain-damaged neurologists.
Happy to help.
How you coming along?
Tell her everything's great.
Neither of us wants to deal with her guilt.
- I don't feel guilty. - Of course not.
Hell, if people felt guilt every time they accidentally lobotomized a guy...
- I was trying to save his life. - Yeah.
Your heart was in the right place.
It's just his brain is not quite where it's supposed to be.
Tell her everything's great.
It's true.
No more left-side, right-side reversals.
Still some short-term memory loss and spatial processing problems, but
trying not to be too hard on myself.
Yeah. Might pull a muscle.
We have a case?
Seizure that can't be explained by epilepsy.
And accompanied by elevated calcium levels.
Still bored.
Tell her why.
Because seizure with mildly elevated calcium is... diagnostically simple.
It's either hyperparathyroid, cancer, or calcium-mediated neurotoxicity.
Well done.
But until you can remember how to make coffee, hands off the patients.
H ouse.
All those reasons this case bores you...
The ER has already ruled them out.
Lungs are clear. Get an EEG confirming brain function's okay.
Can we focus on the task at hand?
Why did mommy twitch so hard that she tossed the baby in with the bathwater?
You don't need me for this.
Of course I need you. We're a team.
Polyarteritis nodosa.
Inflamed arteries in the brain cause seizures.
Inflamed arteries in the kidneys cause calcium buildup.
You're a moron.
Did you even look at the file? Kidney function's fine.
- Whipple's. - What?
Whipple's.
Test her.
Cameron thinks it starts with a "W."
I'm thinking "V."
Dad vomited this morning. Maybe they've both got strep.
Think you can do a strep throat culture without the swab ending up in the guy's poop chute?
- "V" for vasoconstriction. - It got to be my guess.
Excess calcium makes blood vessels in the brain clamp down.
Best-case scenario: seizure. Worst-case: stroke.
Do a digital extraction angiogram.
Foreman can't tell up from down. Cameron's a girl.
- All that mechanical stuff. - Sorry, Cuddy says I'm stuck here.
You're late.
And you are in my locked office.
Again.
Whatcha got there?
Special panties for your date with Wilson?
It's not a date, and it's none of your business.
If it's not a date, it is business.
And if it was business, you wouldn't say it was none of my business.
What do you want?
I wanna talk about your date with Wilson.
- It's not a date. - This is fun.
Spring Chase from NICU, and I'll shut up about your date.
NICU is short-staffed.
You suddenly lost the ability to lie.
Nobody's quit NICU in two years.
And if you're making up reasons, that means there is no reason.
Which means he asked for the assignment, didn't he?
If Chase needs a break from you, he should take it.
Absolutely.
Both mom and dad are negative for strep.
You'll be back playing with the big toys soon.
Or not. Either way, I'm fine.
You don't have to say that.
It's okay.
I can always work in a research lab or teach.
And you'd be okay with that?
Why wouldn't I be?
You were planning on pursuing grants of your own.
Running a department.
I'm alive.
Changing jobs, not making coffee—
if that stuff bothers me now, I don't deserve the second chance.
Ungaa.
They say that physical contact helps the healing process.
What's happening?
Your son's not getting enough oxygen. Take Mr. Mason outside.
Uhh! Uh! Ahh! Uhh!
Lung's collapsed. He's not getting any air. I need an IV catheter!
Uh!
Aah! Aahh!
You have a seizure?
Her chest muscles are contracting. It's something else.
Aah!
Her whole back is spasming. I need 2 milligrams Lorazepam, stat.
He's okay.
His lung wouldn't collapse if he was okay.
What is happening?
I have no idea.
Aah! Aah!
So... what causes seizures, hypercalcemia,
and the thing where mommy bends like Gumby?
Little busy here.
Uh-oh...
baby's lungs are gonna conk out any minute.
Probably wanna deal with that.
I'll get right on it as soon as I finish indulging my boss.
Multitask.
Chemical pneumonitis.
Bubble bath got into the baby's lungs when he was underwater.
Start him on prednisone.
Keep him on high FI-02.
Let the indulging commence.
Lithium could cause all three of the mother's symptoms.
No record she's on lithium.
And tox screen was negative.
Lithium doesn't show on a basic tox screen, Scarecrow.
Myelomatous meningitis could also cover everything.
Rare complications of a rare blood cancer.
You're not totally hopeless.
Get an S-PEP and an MRI for myelomatous meningitis.
Search the patient's place for lithium.
Baby's lung problem is bacterial, not chemical— start ECMO.
While you're searching for the lithium, take a water sample and check the pipes.
You want me to write this down for you?
I ask you, is almost dying any excuse for not being fun?
I'm not putting that baby on ECMO.
The chance of there being bacteria in bathwater—
Why don't you wanna work for me?
I'm nice, and fun at parties.
I'm not working NICU because of you.
The baby's X-ray suggested chemical pneumonitis.
Not to me.
X-ray was too consolidated.
So why are you down here?
Hoping to expand your make-out pool to include the preemie to nine-year-old demographic?
I needed a break.
From the patients.
They lie to us all the time.
Foreman almost died trying to save a drug-dealing cop.
I just wanted to get away from that for a while.
What a complete load of crap.
What am I, a nurse you're trying to prep with this vulnerability thing?
ECMO could kill him.
You don't start him on ECMO, and that infection could rampage through his body like Pistons fans after a championship.
But you do it your way.
Nothing more honest than a dead baby.
ECMO stands for Extra Corporeal Membrane Oxygenation.
Basically, we remove your son's blood—
All of his blood?
We run it through a machine, which takes out carbon dioxide and adds oxygen.
Then we re-warm the blood and run it back into his body.
There is a significant risk of internal hemorrhaging, and he may also suffer—
You put him on antibiotics. Won't that take care of the infection?
Not fast enough.
Are you sure this is Mikey's best shot?
Absolutely.
- Cuddy's trash. - Not anymore.
Paid good money for it.
Look at what she bought.
Red clover.
What is red clover used for, Dr. Wilson?
It's also used to treat asthma.
Psoriasis... joint pain.
She doesn't wheeze, flake, or ache.
And she didn't ask a pulmonologist or a dermatologist for dinner.
She invited an oncologist.
It's not a date.
It's a consult.
Mom's MRI was negative for masses, abscesses.
- There's no sign she has— - Fascinating.
Call me when we have—
She has a subarachnoid bleed.
So why is our patient bleeding into her brain?
Her blood workup shows her Pro-Time's elevated.
She's bleeding because she's not clotting. So why is she not clotting?
What'd you bring us, daddy?
Only mood-altering drug was vodka. The back of a drawer.
Hiding booze is classic alcoholic behavior. That'd explain the bleeding.
What bleeding?
You don't remember?
She bled all over you this morning.
Kidding. Idiots are fun. No wonder every village wants one.
If she's an alcoholic, she would also be more prone to hypercalcemia.
But the tox screen was negative for alcohol.
Hey, it was your idea.
Now it's even better.
Mommy quits, she gets the DTs. Even explains the seizure.
Also fits conversion disorder.
They're deep in debt. He's working round the clock. They got a new baby.
I think the seizure was a physical response to psychological stress.
Boozy mommy covers more symptoms.
Put her in a nice Phenobarbital coma before the DTs kill her.
Where are you going?
To put her in a pheno coma.
What if I'm wrong? What if daddy's the drunk?
You want us to give her the pheno or not?
I want him to argue his point.
I assumed you considered the father and ruled him out.
What's that saying?
"When you ass-sume, you become a pain in the ass to me."
Why should I argue? You'd just overrule me.
Enough! Get a pony or a watermelon farm.
House!
I need him to react. I need him to act like a human being.
I need him to get over this boring near-death rebirth.
I have changed. It's not something you get over.
Nearly dying changes everything forever.
For about two months. Two months is too long.
I need the guy I hired back, now.
Now matter how much your misery loves company,
it's not getting mine.
I'll talk to the dad. Cameron can take the mom. We'll figure out if mom was a drinker.
Waste of time.
Put her in a coma before the DTs kill her.
So...
Is this a separation or...
Well, lawyers have been hired. Friends divvied up.
Oddly, she didn't fight me for House.
At least there aren't... kids involved.
You just have each other to deal with.
Hmm.
If there had been kids, maybe we would have done more of that.
Do you want kids?
Listen, is there anything in particular you... wanted to—
Hospital business or—
Catching up.
I mean, you know, it's not like...
Either one of us has anybody to run home to.
No.
How are you feeling?
Okay.
A little groggy.
There's somebody here to see you.
Hey, Mikey. Mommy's awake.
Oh, Mikey.
Oh, gosh, I was so scared.
Oh.
Oh, I love you.
I love you so much. Ohh. Shh.
I'm sorry.
You don't have anything to be sorry about.
You were sick.
Turns out she and her husband met in AA.
Obviously, she slipped. Good call.
It wasn't hard, considering my other choice was your stupid psych theory.
Which was not stupid.
I tell you, I'm gonna drop the N-bomb if I have to.
You're addicted to conflict.
Did they change the name?
You could have handled this patient without dragging Chase in.
But that fact that he didn't want in, killed you.
Just like the fact you can't get a rise out of me.
Where's the baby?
Get off me!
No! I have to do this!
No breath sounds. Crash cart and epi, stat!
Uhh! Uhh!
Told you your psych theory wasn't stupid.
Your son is stable.
But the lack of oxygen damaged his kidneys.
She must have rolled over on him by mistake.
Mr. Mason...
I was there.
Your wife tried to smother your son.
That's impossible.
Kara would never hurt Mikey.
He knows.
They said Mikey knows.
You hear voices?
They wouldn't quit saying that Mikey would be better off if...
They were right.
We've been trying to diagnose a seizure that didn't exist.
She faked it when her husband caught her.
I don't think she faked it.
She just happened to seize right in the middle of drowning her child?
Good break for the kid.
Hey, take it easy on Foreman.
He's playing with one lobe tied behind his back.
Postpartum psychosis makes her want to drown her kid.
The internal conflict triggers a seizure.
You know what else might be a trigger?
Physical illness. It's a wild idea, I know.
Especially since she doesn't have any obviously physical symptoms. Like internal bleeding or excess calcium.
I'll draw some blood. Test for a—
Uhh! Jeez, you've done it again! Will you argue with me?
Drinkers don't eat right.
Explains the bleeding and the calcium. This might just be some crazy drunk,
and I'm telling you that she's about to die of myelomatous meningitis.
- We already tested for— - Exactly! It's an insane idea.
Okay. What do you want me to do?
Have an original thought.
In the meantime, stress her into having another seizure.
We can't, she's on haloperidol.
You also can't because it's dangerous and highly unethical.
Therefore, if you get caught, pretend you can't make coffee.
Mental defectives get tons of slack.
Take off the haloperidol. Hook her up to an EEG,
flash some lights. Make her pant. Shoot her up with a placebo.
When she starts twitching, if the machine twitches along, it's real...
if not, call the cops, 'cause she's a psycho killer.
- Stop pushing him. - Stop protecting him.
He needs it.
- Not if he wants to get better. - He might not be able to get better.
Well, then, I need a new neurologist.
He got sick doing his job.
If he got killed doing his job, I wouldn't keep him on the payroll.
I don't care how guilty you feel or how touched you are by his reborn spirit.
- I'm not touched. - Then you're guilt-ridden.
- I'm not guilt-ridden. - Then you're pathetic.
Right now, I'm annoyed!
Keeping him up all night in a seizure lab is not the way to advance his recovery!
- It's too much! - You're right.
You should stick around. Make sure he doesn't screw up.
Kara, look directly into the light.
Keep looking.
Thought you'd be gone for the day.
Thought I'd wait for the bone marrow biopsy results.
House sent you to baby-sit me, didn't he?
He asked me to wait for the results.
- Oh, Cameron, it's fine. - Of course it is.
Look. A few weeks ago, you were upset that I didn't consider you a friend.
Now you're upset that I'm happy?
What can I say? Apparently, I'm a bitch.
I didn't say that.
It's annoying.
Insisting every day of your life is a blessing is basically calling everyone else shallow.
- It gets old. - Sorry.
Oh, give it a rest.
How was dinner?
Cuddy did not mention cancer.
She lost her nerve.
It was a date.
What are you doing?
PCR test.
You're doing it yourself? In the middle of the night.
On a spoon.
Cuddy's spoon.
I'm checking her saliva for cancer markers.
Yeah...
I do that after all my dates too.
People think you're the nice one.
Why are you so worried about Cuddy?
You go first.
You desperately want this to be a date.
Because the alternative is cancer.
Just admit that you like her.
She's smart, funny.
Got a zesty bod.
It's great you can look beyond the fact she's the devil.
I stole a spoon. You stole her garbage.
She's my boss.
She gets sick, the hospital might replace her.
Especially if she dies.
I'd have to learn how to manipulate someone new.
Whoa.
I think I'm gonna cry.
Find me when the results come in.
Mr. Mason...
because of the damage done to your son's kidneys, his potassium is climbing.
It's causing irregular heartbeats.
I'm doubling the meds and starting him on dialysis.
Unless we get his potassium down...
he's gonna have a heart attack.
Kara, just another few minutes.
Biopsy's back. She's negative for myelomatous meningitis.
And she's not seizing.
So we're wrong and House is wrong.
And you're okay with that?
She's seizing.
She's not doing anything.
Brain activity isn't accelerating. It's slowing down.
Muscle rigidity, involuntary grasping and sucking motions.
She's in an encephalopathic delirium.
Mmm, a genuine physiological illness.
That rules outa few things.
Like what, I wonder?
Postpartum psychosisand conversion disorder.
Thing about being a good loser... you're still a loser.
Ouch.
The delirium means her brain is shutting down, reverting to its most instinctual functions.
Since it's progressing, maybe we can assume it's progressive.
Which means it won't be long before the brain closes shop altogether.
Ideas?
He's in V Fib!
Potassium's still too high.
No pulse. Get him off the machine.
Charge at 10.
Clear.
Still in V Fib.
Another amp of epi.
Damn it, Chase shouldn't be wasting his time in NICU.
Could be Wernicke's.
No, treatment for Wernicke's is thiamine. We gave her that together with the pheno.
Delirium points to lithium. I know we didn't find any, but—
She's have to be smuggling it in to be getting sicker.
Whipple's causes encephalopathic delirium.
Test was negative.
The test could have been wrong.
Ideas are not soda cans.
Recycling sucks.
We need something new and shiny.
Or go retro. Take an old idea, shine it up, add a new symptom.
Encephalopathic delirium.
Pellagra.
She drinks. Alcoholics get pellagra.
They eat lousy diets, so no niacin.
He agrees with me. What a shock.
Well, you're right. Lack of niacin starves the brain.
Neurons shut down, causes seizures, encephalopathic delirium, and psychosis.
We give Kara niacin, she'll come out of her delirium and she'll be totally sane.
Don't think she's ever gonna be sane again.
Her son just died.
How do you feel?
Um...
My... stomach kind of hurts.
I need to ask you some questions. See how you're doing.
Mm-hmm.
Tell me your name.
Kara Mason.
Is my son here?
When were you born?
Please... where's Michael? Is he okay?
Do you hear any other voices besides mine?
No! Answer me.
You've been suffering from delusions.
They were caused by a vitamin deficiency: pellagra.
It made you believe things that were not real.
Like the voices.
I, uh...
remember doing things to Mikey.
Were those real?
I'm afraid so.
So I...
You tried to suffocate your son.
But I...
you... you stopped me.
And, uh...
that other doctor. He got Mikey breathing.
Your son's organs were damaged too severely.
He passed away this morning.
Oh, no. No, no, no, no, no!
No!
Oh, my God! No! Oh, my God.
Pellagra doesn't cause bloody vomit.
She's still sick, and getting worse.
So what causes pellagra and crimson spew?
Whack!
Dead baby, while sad, not our problem.
I should have given him more polystyrene.
You killed him.
If you don't get over it, you're gonna kill mama too.
Her alcoholism caused the pellagra. Maybe it also explains the vomiting.
- Gastritis. - Gastritis meds aren't helping.
Which may confirm her story she only slipped once.
You remove the drinking from the equation, internal bleeding, hypercalcemia, seizure, and pellagra are all back in.
Chase, will you get your head out of the dead baby's butt and focus on the barely alive—
How much polystyrene did you give the kid?
1 gram.
His potassium just kept rising.
I need your son.
Who are you?
Your wife's doctor.
Your son may have had the same condition she does.
My son didn't have a condition.
She killed him.
If I biopsy her intestine, she'll bleed out.
He obviously won't.
You're not using my son's body to help her.
Okay. How about trading him for a beer?
Or maybe you're more of a whisky guy.
You didn't have strep or a stomach bug the morning you came in.
You puked because you were hung over.
Accuse a recovered drunkof slipping, most of the time, you'd be right.
So I drink.
You're acting like this is my fault.
People are gonna feel sorry for you.
They'll tell you that you can't anticipate the unthinkable. The fact is, you can.
It's just not all that pleasant.
You don't know anything about—
I know that people don't get crazy enough to kill someone
without first being crazy enough for someone to notice.
How many times did you go out for a drink because she was crying?
How many times did you stay at work because
you couldn't listen to her telling you what a bad mother she is?
You were relieved when she shut down.
Just sat staring for hours at a time.
She held the pillow over his head. You slept while she went nuts.
- Not exactly a draw, but— - What is wrong with you?
What kind of a person says those things now.
Let me do the test.
It'll be one less thing for you to feel crappy about.
Got a dead baby for you to biopsy.
Let Cameron do it.
You love working NICU?
I could get you transferred.
I told you, I just wanted to trust patients.
You don't give a crap about patients.
Your paycheck.
You've been double-dipping.
Taking your vacation time here while drawing a salary in NICU.
Strange. Rich boy doing all that for some extra cash.
I'm not rich.
But your dad was.
Now he's dead.
If you're not rich, that means that daddy cut you out.
I'm not rich.
Don't let it change you.
And do the test.
"Over Yonder" by The American Boy Choir
God of confession, take Michael into your arms.
Welcome him into paradise
where there'll be no sorrow, no weeping, and no pain.
Peace and joy forever more.
I'm sorry.
It was a date.
Cuddy's negative for all cancer markers.
It was a date.
Baby's intestines shows light villous atrophy.
Why would a baby have flattened villi?
He was being treated with polystyrene.
- Polystyrene shouldn't— - It didn't.
Question is, what did they use in the NICU to bind it together?
- Wheat gluten. - That's great stuff.
Unless your body can't tolerate it.
The baby didn't have colic, he had celiac disease?
Just like mom.
Celiac can be triggered by all kinds of stress.
Bills, childbirth, drunk husband.
Every time she had a bowl of pasta or a slice of bread or a slosh of soy sauce,
her small intestine became more damaged.
Less able to absorb the vitamins and minerals into her bloodstream.
Her body couldn't absorb enough niacin. Caused the pellagra.
Couldn't absorb Vitamin K. Caused the bleeding.
And celiac is why the baby's meds didn't work.
His body just couldn't absorb them.
Switch mom to IV nutrition.
It's gluten-free. It'll spruce her villi right up.
No, celiac causes nutritional deprivation. Our patient has excess calcium.
Tell them what causes excess calcium.
With a chaser of bloody vomit.
Celiac patients are susceptible to cancer of the stomach lining.
- She has MALT lymphoma. - Well, she's your patient now.
And it wasn't a date.
You don't have cancer.
You don't have dwarfism.
You have no proof of that.
I, on the other hand, have this.
You ran a PCR on me without my consent?
Hey, it's good news.
Really? It's just hard to access because of this overwhelming sense of personal violation.
Deal with it on your own time.
Bad news...
estrogen is too high.
No matter how many people you tell otherwise,
I am, and always have been, a woman. Estrogen is normal.
Not this much.
Not for at least another week.
That's when you ovulate.
What?
You monitor my periods?
Based on... when I get bitchy or...
Once a month, when you leave the kids'cancer ward, your eyes glisten.
And about three days later, you break your ban on sugar and
chow down a bucket of frozen yogurt in the cafeteria, sprinkles included.
Based on the last yogurt sighting, you've got another week before you ovulate.
You're on fertility meds.
With red clover as an herbal booster.
And that dinner with Wilsonw as an audition.
It's too bad he didn't land the gig. He would have had fun.
I was considering a donation.
Not a party.
So...
When is our... "dinner"?
Ooh, he's gonna be so disappointed.
Right. You two are gonna have a lot of fun with this.
Your patient won't let me touch her.
I killed my son.
Is it my turn to say something obvious now?
Oh, I know. You were insane.
I did it. I chose to do it.
Yeah, like diabetics choose to not produce insulin.
Listen, someone got sick. Someone died.
It happens every day.
The only difference in this case is... it wasn't the same someone.
I could have stopped.
I didn't have to listen to those voices.
Spoken like a true sane person.
This is not your fault.
You're healthy now.
Except for the cancer.
Those voices... felt as real to me as... as Michael's hand.
Right here, when he nursed.
And... the smell of his hair.
You do not... deserve to die.
Maybe.
I don't wanna live.
She said no.
So we gether declared unstable, appoint a medical proxy.
She was unstable. Now she's sane.
She's entitled to refuse the treatment.
You have to change her mind. You can't just walk away.
Fine! Go on in there and tell her that every day is a blessing.
"So you killed your baby. Shake it off. Think positive. At least you're alive."
Hmm.
Kind of hard to sell when you don't believe it, huh?
And you never believed it.
You just wanted all that crap you went through to mean something.
Well, it didn't mean anything. It never does.
Welcome back.
Why are you doing this to me? I was happy.
You were aspiring to be content.
Don't give mea semantic argument. I was content with the way things were!
That's what happiness is.
Yeah, if we were all just satisfied with what we had, what a beautiful world it would be.
We'd all slowly starve to death in our own filth, but at least we'd be happy.
Listen, I need your self-worth to hang on this job.
For kicking ass here to be all that lets you rise above miserable.
If waking up in the morning is enough, I don't need you.
I can live with that.
No, you can't. Not anymore.
If you got treatment, then maybe we could...
When you see Mikey...
Tell him his dad says he's sorry.
Hi.
- Night. - Night. - Good night.
Did you tell Cuddy we tested her for cancer?
Yeah.
And?
It wasn't a date.
Turned out she had some skin lesions.
Guess there was no genetic predisposition.
You TiVo The I Word?
Transcript : Raceman Synchro : Vaccine
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