House (2004–2012): Season 2, Episode 17 - All In - full transcript
On a class field trip, a teacher discovers that her six-year-old student, Ian, is bleeding profusely. Dr. House thinks Ian has the same unknown disease that killed an elderly patient of his years ago.
The human heart is a giant muscle
squeezing our contracting
over 60 times each minute.
That's 3,600...
At this point, your
blood is a deep purple.
Because it's just finished dropping off
oxygen for all the parts of your body.
Come on, follow me.
Come on.
Ian.
I have a question, and I
need to go to the bathroom.
Which would you like to do first?
- The question.
- Okay.
Where's the bathroom?
Who knows where the bathroom is?
I do.
Go with Ian to the bathroom.
I don't have to go.
We're not at school. Nobody
goes anywhere by themselves.
Why?
In case you get lost.
Or in case somebody kidnaps us.
If somebody kidnaps Ian,
they'll kidnap me too.
I want to stay with the class.
Michael, go with Ian... Aah!
Do you need help?
I need you to find a grown-up.
Is the baby coming?
Aah! Aah!
Who should I take with me?
You're fine. Go to the front desk, or...
Or find a security guard.
I really have to pee.
God.
Is... is the baby coming?
I don't know how to do this.
Are you okay, Ian?
Yeah, sure.
I don't think you are.
You're bleeding.
Help!
Help!
2X17
- All In
- 20.
- Call.
You'll call anything.
My stack is bigger than your stack.
You in or out?
You know that relative to their size,
gorillas have smaller testicles than humans.
Well, then you'd probably have an
edge over a gorilla. But not over me.
The reason is, primate teste size inversely
corresponds to the fidelity of our females.
Do you think there might be a better
time to annoy me about my wife?
- I'm talking about poker.
- Right.
Women are evil. You're
right to drive them away.
Call, fold, or raise.
Story time can wait.
We're smaller and better than chimps,
bigger and worse than gorillas.
For all our rationality, supposed
trust and fealty to a higher power,
our ability to create a
system of rules and laws,
our baser drives are more
powerful than any of that.
We want to control our
emotions, but we can't.
If we're happy, things don't annoy us.
If, on the other hand, we're
sitting on crappy hole cards,
little tiny things annoy
us a whole lot more.
I raise.
So are you going to tell me an
annoying story every time I raise?
God, that would be annoying.
I call.
Dr. Cuddy? Got one of
your patients in the E.R.
Ian Alston. Six years old.
Ah... Oh, I know him. What's
the problem? I'm all in.
Bloody diarrhea, hemodynamically stable, but
he's been developing some coordination problems.
It sounds like gastroenteritis
and dehydration.
Order fluids, and I'll
take it on my service.
Bet's to you, House.
They scan his head?
- No, why would they scan...
- Don't play games.
- You gonna call?
- How's the heart rate?
Stable.
I'm sorry. House? It's gastroenteritis.
I'm not going anywhere.
Put the order in, and have someone tell
Alan and Sarah that I'll be up when I'm done.
You in or out?
I'm out.
Stone cold bluff.
You might want to spend a little more
time paying attention to your cards,
and a little less time
staring at my breasts.
They don't match, either.
I'm going to take some air.
Follow my finger with your eyes.
How much longer will Dr. Cuddy be?
Well, given the number of Mojitos
she's knocking back at the party, I'd say it's gonna
be at least three hours before she's even conscious.
Weren't you at the same party?
I don't drink.
I want you to reach
out and grab my cane.
What's wrong?
Your son's brain is losing
control of his muscles.
Dr. Cuddy's message said it was
just dehydration from the diarrhea.
She's wrong.
Is he going to be all right?
I don't know.
So were you in one of those cages?
No.
No, no, no. Those are for tourists.
You were in the water
with a great white.
Sure.
It's no big deal. You just
have to keep an eye on them.
If they get too close,
punch 'em in the nose.
Send them on their way.
- I had you going.
- You are mean.
Hey, how's that anal fissure?
Did it heal yet, or
is it still draining?
Oh, I'm sorry. I didn't realize
you came back for seconds.
I figured that after that girl in the
stairwell, you'd be done for the night.
He's joking.
No Adam's apple, small hands.
It's no surprises this time.
I'll, uh, see you later.
Got a case.
Well, you could've just said that.
You didn't have to screw with me.
Yeah, but if I didn't screw with you, you'd
spend the whole night thinking you might get laid.
Which means you'd be useless.
Better to extinguish all hope.
Get Foreman and Cameron
and meet me upstairs, stat.
What's so urgent?
Two cases, same symptoms.
What do 6-year-olds and
70-year-olds have in common?
Their immune systems don't
work as well. Could be listeria.
I already checked for that.
Leukemia has a higher prevalence
in both the young and old.
So does asthma.
No, no, no.
They can both get diabetes.
No.
The nearly dead and the newly bred have more in
common with each other than with people in the middle.
It's weird.
Some kind of circle of life thing.
This kid doesn't have kidney failure.
He will.
Based on this file, the
kid just ate some bad food.
Was the old man...
They were nowhere near each other
in any of the four dimensions.
- This case is 12 years old.
- Yep.
- And this case is Cuddy's.
- She assigned it to me.
She agrees with you that this is
something more than gastroenteritis?
She wouldn't have assigned it
to me if she did, now would she?
Gohhh.
What were we talking about?
Two patients with two
symptoms in common.
And five symptoms not in common.
While you were all wearing your
"Frankie says relax" t-shirts,
I was treating a
73-year-old woman
who went through this
progression of symptoms.
The last of which was...
In case any of you missed that class
in med school, that one's untreatable.
Kid's got the first two.
Took Esther an hour and 20
minutes to go from two to three.
And less than a day to make it
all the way to the rear exit.
This is all because a child
has some blood in his diarrhea.
He's got a tummy ache.
If there was any reason to think it was
anything worse, Cuddy would be all over it.
Great. Do a colonoscopy.
On a six-year-old kid who probably has
nothing worse than some food poisoning?
If you happen to find any purple
papules, do me a favor and grab a slice.
I want to check for Erdheim Chester.
A disease that there have been what,
maybe 200 reported cases of? Ever?
If Esther's family had
let me do an autopsy,
there'd be 201.
See anything?
No, and I don't expect to.
House usually avoids cases.
If he's actually stealing a case from
Cuddy, there's got to be a reason.
It's not the first time
I've seen this file.
About a month before Cameron was hired,
some trucker came in
here with these symptoms.
House decided he was dying.
Two days and a spinal tap, bone marrow
extraction, and three colonoscopies later,
we sent the guy home with a bunch of pain
killers and a diagnosis of a bad cheese sandwich.
One of the guys who worked here before me said House
tried to cure Esther at least three other times.
You know how people see the
Virgin Mary in Danishes and stuff?
Someone died 12 years ago,
and House doesn't know why.
House sees that case now in paint peeling,
in clouds, and now in this poor kid.
Erdheim Chester is an abnormal growth of
some of the cells that fight infection.
Is that cancer? 'Cause
he seems okay now.
Yeah, the other doctor kind
of scared us about that.
He shouldn't have. We're just
testing. It'll probably be negative.
I don't understand.
You don't think that's what
it is, but you want to...
you want to do this thing to him anyway?
We need to be sure.
Isn't there any other way?
It shouldn't take long.
All right.
Those ridges look a
lot like purple papules.
They're not purple, they're red.
They're probably just blood blisters.
Give me the biopsy needle.
How long is this going to take?
Forget it, Chase. Your punching-out-the-shark
story's good, but she's not waiting for you.
So?
We couldn't confirm the
source of the bleeding.
- But we did biopsy some...
- Blood blisters.
You mean papules.
Come on, Cameron. Who's right?
Chase is.
Negative for Erdheim Chester.
Let me see.
- If it's not Erdheim Chester...
- It's exactly what we said before.
Garden variety viral gastroenteritis.
Can we go back to the party?
Do a kidney biopsy.
Esther's shut down in exactly...
This kid is not Esther.
You screwed up, she died. I'm sorry.
But that does not mean
this kid is dying as well.
Jeez.
You get testy when
you don't get any fuzz.
Come on.
What did the test say?
Colonoscopy was clean.
And the biopsy was negative
for Erdheim Chester.
So Ian's going to be all right.
It was just some sort of virus.
What's that?
Urine.
But it's brown.
Ian's kidneys are shutting down.
Still think it's not the same case?
So, what can cause bloody diarrhea,
ataxia, and kidney failure?
- I'll go do a biopsy.
- Forget it.
That battle's over.
His rising creatinine is his kidneys'
way of saying, "Go on without me."
What explains everything?
E. Coli HO:157 causes bloody diarrhea
and leads to hemolytic uremic syndrome.
Toxins from the bacteria
cause his kidneys to shut down.
We should start him on plasmaphoresis.
Clear, concise, and
completely plausible.
And exactly what I did
last time. Didn't work.
- What else?
- Good Pasture's syndrome.
Circulating antibodies cause
kidney failure and bleeding.
But not the purple papules.
If you throw in Esther's next symptom...
brain... makes me think
heavy metal toxicity.
His hematocrit would have
to be low. It's at 44, and
- Esther's never dropped below...
- 42.
You have the file memorized?
It's my lucky number.
What about lymphoma?
Causes kidney failure, GI bleed, and
can infiltrate the base of the brain.
You check Esther for that?
She never showed any signs of...
If he has lymphoma this far advanced, we
should be able to see it in his blood and brain.
Chase, run a blood smear and
immunochemistries. Foreman, get an MRI.
- I'll page Cuddy.
- No, you won't.
She thinks the kid has a stomach ache.
She'll come right up here
and do one of two things.
If she agrees with me, I don't need her.
If she disagrees, I don't want her.
Can't handle people
disagreeing with you?
She might have a different take on this.
Subordinates can disagree with
me all they want. It's healthy.
People who can shut me
down, on the other hand...
Forget Cuddy. I'll have
Wilson keep her busy.
Keep your answers short and
discreet. Is Cuddy still playing?
The chicken... is still
in Piccadilly Square.
Brilliant.
She'll never suspect that
Normandy is our target.
Is that House?
Tell him that the blinds just went to
20/40, and he's running out of chips.
How's she doing?
Well, what's going on?
The way you took off,
something's obviously...
Love to chat. But got a game to play.
How's she doing?
The patient is on life support.
We're about to pull the plug.
Are you talking about me?
What have you got?
Mmm... Those sound like
high-dose cardio meds.
Two hearts.
You got the flush?
Still waiting on the final labs.
She drinking her seltzer?
No. Hydration is not a problem.
Means she's bluffing. Push her all in.
Call.
Two pair.
Show me your hearts.
Seven of clubs.
Oh, dear. Sounds like I messed up.
You're gonna be stuck
with her for a while.
Talk to you soon.
Oh... Yes.
Why are you taking a
picture of his head?
We're looking for lymphoma, but...
So it's not Erdheim something.
And it's not his kidneys.
But his kidneys are failing.
What... Where's Dr. Cuddy?
Dr. House mentioned another case.
Is there another patient with the
same... same thing that Ian has?
- Not...exactly.
- What does that mean?
Dr. House had a patient a while back who
exhibited the same symptoms as your son.
Then you know what's wrong?
No.
So what do you know?
We know the likely course
the disease will take.
Which is?
- She had multiple system failures...
- What happened to her?
She died 24 hours after her admission.
Mr. or Mrs. Alston, would
you mind giving me a hand?
He's having trouble sitting still.
It's impossible to
get the detail we need.
So I figured he might feel more
comfortable hearing your voices.
Ian, honey?
Just sit still.
You'll be done in a
moment. We're here with you.
I'm scared.
It's okay, honey. It's...
It's only a big camera. It's going
to take a picture of your head.
You love it when I take your
picture at home, don't you?
Yeah.
And you have to hold
still for that too, right?
But this isn't like that.
I know it's scary, Ian.
But you can do it.
You're getting to be so grown up.
So just...
hold perfectly still.
Just for a little bit.
Mommy, are you crying?
No. No, honey. I'm just tired.
Okay. I'll try.
The base of his brain has been
infiltrated by a small mass.
- We think...
- Pituitary?
Looks that way.
Explains the low blood pressure.
Pretty much confirms the lymphoma.
If we'd started Esther on prednisone...
Uh, did anyone see the lymphoma?
No, we saw a mass. The
location was consistent with...
Didn't see any in the blood, either.
White blood cells show no
spindling or abnormal nuclei.
Nothing on immunochemistries,
either. It's not lymphoma.
House.
It's a train.
We don't know what kind of train.
- Whoa, whoa, whoa.
- I'm thirsty.
It's closed.
It's not now.
We got one advantage.
We know where the tracks are going.
The fact that the end
of the line is death...
is an advantage?
The fact that we know is an advantage.
Means maybe we can get ahead of it.
Next station is the liver. We've got...
About 90 minutes before it gets there.
Maybe we can cut down a tree across
the line just outside of town.
I'll do an ultrasound.
No, treatment will tell us more, faster.
How can we start treatment if we
have no idea what we'retreating for?
Treat him for everything.
Give him acetylcysteine. And
interferon. And silymarin.
And whatever else you can
think of to protect the liver.
What's going on?
Oh, just catching up on some TV.
How are you doing?
Well, thanks to your last consult,
the patient has improved dramatically.
Tell House the patient is
about to kill the doctor.
- She says the pa...
- I heard. What d'ya got?
Well, Cuddy just raised, and, uh...
- You're paired.
- What?
Nines?
How do you know?
Anything lower, you
wouldn't sound so excited.
Jacks or higher,
your voice sounds like Debbie from
accounting is sitting in your lap.
Ask Cuddy if she can
beat a pair of threes.
Wait, what's... What's going on?
If you're going to mess with me, wouldn't
it be more fun to do it in person?
Yes, it would.
Um, can you beat a pair of threes?
What did she do?
I left orders for PO fluids, doctor.
Enough with the codes. She
obviously knows it's me.
She's drinking her seltzer.
Did she stop?
- Yes.
- Go all in.
- Um...but...
- Just do it.
You couldn't care less
about this charity event.
You claim not to be messing with me.
Obviously, you're either
trying to keep me...
Shut up.
Look, last time, I
wanted the game to go on.
I still do.
That means that this
time, you get to win.
Hold on.
I fold.
Ho, ho, ho.
House, are you sure you're okay?
Meds seem to be working.
Liver's holding its own.
Good.
But the platelets are dropping.
Even better.
Why? It means he's getting sicker.
It's new. New is good.
Because old ended in death.
I can't breathe.
Chase!
What?
What's happening?
Ian. Come on.
Honey, just relax.
Ian, breathe. Come on, honey.
Breathe, please, honey.
We had to put him on a ventilator.
He's back on Esther's path.
And we managed to make the
train skip a few stations.
Which means that instead of 12 hours,
he's probably got less than two.
Which begs the question, why?
What did we do?
Acetylcysteine could
mess with the lungs.
Mess with them. Not shut
them down in 20 minutes.
Interferon modulates the immune system.
It could affect cancer of the
blood, like one of the leukemias.
It doesn't speed them
up, it slows them down.
It slows down all 500 of them?
Anybody know where we can find
an oncologist at this hour?
What effects would
interferon have on leukemia?
Depends on what type. Could make
it better, could make it worse.
Four-year fellowship to learn that.
Tell House if he wants to play cards, he
should get his ass back down here and play.
You hear that?
She wants me off the phone.
Means she's vulnerable.
Go all in.
But, um, the party's over
in less than three hours.
It's over in less than two hours.
Which means you either have
three of a kind, or just 3s.
I'm guessing 3s.
I bet 500.
Go all in.
You obviously want to
bust me. Why would you...
Either you go all in, or
I tell everybody in the building
that you wear toenail polish.
I'm all in.
I'll call.
I'm betting you have a pair of
threes, but even if you have three...
it's not going to beat trip nines.
Oh. Oh, oh no.
Oh, no.
Oh, oh. That's gotta hurt.
What happened?
I just killed two
birds with one straight.
Good-bye.
Fine. Keep playing.
But I need you to
recommend a good oncologist.
Because if I don't get one up here in the
next few minutes, I got a dead six-year-old.
If you need help, ask.
These games are insane.
Games have a higher success rate.
Well, I don't see anything
that looks like leukemia.
You do a bone marrow biopsy?
No time.
Even if there is an occult blood cancer,
you wouldn't expect
interferon to make it worse.
Certainly not this fast.
What would move this fast?
Autoimmune diseases.
If his body's own defenses are attacking him, then
beefing them up is just going to put fuel on the fire.
Sarcoidosis could be
in his brain and lungs.
No, no enlarged hilar lymph
nodes on his chest x-ray.
The systemic nature suggests
Juvenile Rheumatoid Arthritis.
Or Kawasaki's disease.
Can't be Kawasaki's.
Doesn't affect the elderly.
Uh, these... This is a kid's x-ray.
House had another patient...
Who may or may not have had Kawasaki's.
This kid, on the other hand...
He makes antibodies that are
eating the inside of his arteries.
Choking off blood to his
major organs one by one.
First the GI tract, then the kidneys,
then the brain, now the lungs.
Can anyone think of a reason why
Kawasaki's can't affect the elderly?
Other than that it doesn't?
Nice.
We can confirm with blood work.
We need an ANA, sed rate...
Labs will take two hours.
What was the old lady's sed rate?
Elevated. 98.
You can't use another patient's
labs to diagnose Kawasaki's disease.
Is that like a dare or something?
You don't have time to be wrong.
Fine.
We'll look for Kawasaki where he lives.
Ian's coronary arteries.
This other patient.
The old lady. Esther?
Have you read Moby Dick?
It was a book?
It was 10 years ago. 12.
Obsessionis dangerous.
Only if you're on a wooden ship
and your obsession is a whale.
I think I'm in the clear.
You do realize it's a metaphor?
You do realize that the point of metaphors is to
scare people from doing things by telling them that
something much scarier is going to
happen than what will really happen.
God, I wish I had a metaphor
to explain that better.
Go back to the game.
Don't worry. I'm not going
to get eaten by witches.
Coronary arteries clear. No aneurysms.
Flip the mode. Let's see the flow.
How did that other woman die?
She went into respiratory distress.
Her heart and liver were already com...
No.
Did she suffer?
Was she in pain?
I don't know.
Laminar flow.
No blood clots, no ragged edges.
Damn. Shut it down.
We're just wasting time.
Look at the right atrium.
That's not Kawasaki's.
No.
It's small. But it's there.
Esther didn't have a mass in her heart.
Ian's younger.
He can take more of a pounding.
Esther died before the
disease reached her heart.
The disease made a
mass and made it fast.
Could be bacteria.
- Muscle.
- Connective tissue.
The kid can't take any more theories.
Only thing we know is that whatever
that mass is, that's what he's got.
We need a piece of it.
I'm doing a biopsy.
I'll shut the blinds.
No, let them watch.
I do my best work on the big stage.
Passing through the superior vena cava.
You're in the atrium. Pull back.
You hit the wall of the heart.
These procedures would be so much simpler
if we could do them on healthy people.
And out again.
- V. Fib.
- Cardiac arrest. Call it.
Come on. Paddles.
- Come on.
- Charging.
Clear.
"Code blue. ISO room."
And again.
- Nothing.
- Again.
Have you got a clock on this?
How much longer you
going to be doing this?
Clear.
Wait. Got something.
He's back.
What are you doing?
I'm doing what we came here to do.
- It almost killed him.
- I know. I was right here.
Give me a vacutainer.
His brain's been oxygen-deprived
for over eight minutes.
There might benothing
left. You might be...
Tell the parents. Where
the hell is that vacutainer?
So. What's he got?
Brain damage.
Good chance. I was
talking about before that.
You're not worried about...
Things I can't do anything
about? I try not to.
Things just roll off you
like water off a duck.
Histiocytosis.
Very unlikely
in a 73-year-old.
Whatever this is, is very unlikely.
Come on, more ideas. Let's go, people.
Genetic disorders could
cause masses everywhere.
Tuberous sclerosis.
If it's genetic, he's had
it all his life. Why now?
I don't know. It sure fits nice enough.
We haven't ruled out leukemia yet.
Or sarcoma. He could have
multiple soft tissue tumors.
Or sarcoidosis.
- Multiple neurofibromatosis.
Chondrocytomas.
How's it going? You win?
I got called away by the
angry parents of a patient.
There are three of you here. None
of you had the sense to stop him.
- To pick up a phoneand call me.
- I told them you'd signed off.
The parents are mad
because their kid is dying.
It's understandable.
But if he doesn't die,
they won't be mad anymore.
If he's brain-damaged, they
might still be a little ticked.
- I had to do it to save him.
- You had to do it to diagnose Esther.
You may have killed
a six-year-old
because you're obsessed with a
woman who's been dead for 12 years.
Sometimes you lose,
House. You're not God.
He's not dead yet.
No, but you're done with him.
It's my case now. Go home.
Go ride your motorcycle.
Go brood in a dark room.
Just don't go near Ian again.
So, anything else? Or
is it just these seven?
Drop it, House. She's right.
No, she's not.
- You know she's not.
- We should have called her.
I'm surprised you didn't.
You're going to have to find a way to
let this go... we can't go near Ian.
We don't need to go near him.
We have his tumor.
Cuddy may be right that
we screwed up the protocol.
She may be right about
my screwed-up obsession.
But I am right about the medicine.
How many tests can we do with that?
Look, we cure the kid, we
solve everybody's problems.
How many?
- Maybe two good pieces.
- How many okay pieces?
Three would be pushing it.
Three tests, seven choices.
Okay, what's first?
Uh...sarcoidosis seems most likely.
Yeah, so likely that Cuddy's going
to think of that all on her own.
She's got the kid's
whole body to play with.
Let her do that test. What's next?
It's moving too fast to be spreading.
It has to be growing from
something that's already...
Genetic disorder... Tuberous sclerosis.
Or it's his immune
system. Histiocytosis.
There are more documented cases of histio
amongst older people than tuberous sclerosis.
Let's start with that.
Wing or drumstick?
Gonna need a little more than that.
A little more is more than a third.
If we have to repeat this test
because you didn't cut us enough...
I'm adding one microliter
of the immunoperoxidase.
Make it two.
I don't want House biting off our heads
because we weren't sure if it turned red or not.
That's definitely not red.
The problem could still be an abnormal
cell growth, but a different cell line.
Sarcoma? Muscle cells
are throughout his body.
Would explain the geography.
Genetic disorder is far more
likely in a six-year-old.
Tuberous sclerosis.
Pretty unlikely to cause a GI bleed.
The time course fits.
So, Foreman, you agree with
both of them. Thanks for playing.
If we have enough tissue for
two tests, why not do both?
Then we don't have to think as hard.
Taking the pressure off the choice
makes us less likely to think critically.
Sarcoma is more likely to
hita 6- and a 70-year-old.
Tuberous sclerosis it is.
You think sarcoma is less likely?
It's more likely.
The test for it, on the
other hand, is less reliable.
Nestin's negative.
Well, that's okay.
If the tumor cells haven't matured, the
Ki-67 protein wouldn't have turned off.
What happens if we don't solve this?
- The kid dies.
- I mean for the next 12 years.
Ki-67's negative.
And PCH antigen is negative.
Mighty Casey's down to his last strike.
Mighty Casey struck out.
Thanks a lot. I was going
to read that this weekend.
Chondrocytoma.
Connective tissue has been in
all the places we've been looking.
The kid is too sick for that. We're
better off testing for sarcoma.
We would have seen signs of that
when we tested for tuberous sclerosis.
Tumor cells look like
muscle under the microscope.
No, they didn't. They looked like fat.
I vote for neurofibromatosis.
Why?
Because the other choices suck worse.
Give me a minute.
You want me out of here?
You come up with anything?
No.
Hey.
We can talk about it tomorrow.
I, um...
I won the poker tournament.
I totally played this guy
Berman from business affairs.
I got great cards. But I don't
bet. Just call, no raises.
Berman pairs his King on the flop.
I keep calling, the
river turns, I check.
He can't stand it. He goes
all in. He's sure he's won.
I call, I flip 'em. Pow!
Pocket aces.
I nailed his ass.
The aces were hiding all along.
Test him for Erdheim Chester disease.
Erdheim Chester? That's
not even on the list.
Because we already did it.
He tested negative.
So did Esther.
The disease lied.
Yeah, the tumor's got it in
for you. Diseases don't lie.
Fine, it didn't lie. It slow played us.
We biopsied the colon, but it
hadn't reached the GI tract yet.
It's there now.
It's in his liver, his lungs...
You want it to be there.
Because then you didn't
screw up 12 years ago.
We can't waste our one test on
the one disease we know it's not.
Run the test.
You sure about this?
Wait, let me think about that.
Don't pressure me.
Just run the damn test.
Cells look like macrophages.
That's a good start.
Take your time and say it loud.
CD 68 positive.
Start the treatment.
So Esther can rest peaceful now, huh?
Yeah.
40.
You got lucky.
You gonna call?
What I do...
is not just based on the flip of a card.
You guessed. You got lucky.
It fit.
It could just as easily have been
sarcoma or tuberous sclerosis.
No, not just as easily.
Maybe not. But it wasn't impossible.
Are you going to call?
You know,
relative to its size,
the barnacle has the
largest penis of any animal.
squeezing our contracting
over 60 times each minute.
That's 3,600...
At this point, your
blood is a deep purple.
Because it's just finished dropping off
oxygen for all the parts of your body.
Come on, follow me.
Come on.
Ian.
I have a question, and I
need to go to the bathroom.
Which would you like to do first?
- The question.
- Okay.
Where's the bathroom?
Who knows where the bathroom is?
I do.
Go with Ian to the bathroom.
I don't have to go.
We're not at school. Nobody
goes anywhere by themselves.
Why?
In case you get lost.
Or in case somebody kidnaps us.
If somebody kidnaps Ian,
they'll kidnap me too.
I want to stay with the class.
Michael, go with Ian... Aah!
Do you need help?
I need you to find a grown-up.
Is the baby coming?
Aah! Aah!
Who should I take with me?
You're fine. Go to the front desk, or...
Or find a security guard.
I really have to pee.
God.
Is... is the baby coming?
I don't know how to do this.
Are you okay, Ian?
Yeah, sure.
I don't think you are.
You're bleeding.
Help!
Help!
2X17
- All In
- 20.
- Call.
You'll call anything.
My stack is bigger than your stack.
You in or out?
You know that relative to their size,
gorillas have smaller testicles than humans.
Well, then you'd probably have an
edge over a gorilla. But not over me.
The reason is, primate teste size inversely
corresponds to the fidelity of our females.
Do you think there might be a better
time to annoy me about my wife?
- I'm talking about poker.
- Right.
Women are evil. You're
right to drive them away.
Call, fold, or raise.
Story time can wait.
We're smaller and better than chimps,
bigger and worse than gorillas.
For all our rationality, supposed
trust and fealty to a higher power,
our ability to create a
system of rules and laws,
our baser drives are more
powerful than any of that.
We want to control our
emotions, but we can't.
If we're happy, things don't annoy us.
If, on the other hand, we're
sitting on crappy hole cards,
little tiny things annoy
us a whole lot more.
I raise.
So are you going to tell me an
annoying story every time I raise?
God, that would be annoying.
I call.
Dr. Cuddy? Got one of
your patients in the E.R.
Ian Alston. Six years old.
Ah... Oh, I know him. What's
the problem? I'm all in.
Bloody diarrhea, hemodynamically stable, but
he's been developing some coordination problems.
It sounds like gastroenteritis
and dehydration.
Order fluids, and I'll
take it on my service.
Bet's to you, House.
They scan his head?
- No, why would they scan...
- Don't play games.
- You gonna call?
- How's the heart rate?
Stable.
I'm sorry. House? It's gastroenteritis.
I'm not going anywhere.
Put the order in, and have someone tell
Alan and Sarah that I'll be up when I'm done.
You in or out?
I'm out.
Stone cold bluff.
You might want to spend a little more
time paying attention to your cards,
and a little less time
staring at my breasts.
They don't match, either.
I'm going to take some air.
Follow my finger with your eyes.
How much longer will Dr. Cuddy be?
Well, given the number of Mojitos
she's knocking back at the party, I'd say it's gonna
be at least three hours before she's even conscious.
Weren't you at the same party?
I don't drink.
I want you to reach
out and grab my cane.
What's wrong?
Your son's brain is losing
control of his muscles.
Dr. Cuddy's message said it was
just dehydration from the diarrhea.
She's wrong.
Is he going to be all right?
I don't know.
So were you in one of those cages?
No.
No, no, no. Those are for tourists.
You were in the water
with a great white.
Sure.
It's no big deal. You just
have to keep an eye on them.
If they get too close,
punch 'em in the nose.
Send them on their way.
- I had you going.
- You are mean.
Hey, how's that anal fissure?
Did it heal yet, or
is it still draining?
Oh, I'm sorry. I didn't realize
you came back for seconds.
I figured that after that girl in the
stairwell, you'd be done for the night.
He's joking.
No Adam's apple, small hands.
It's no surprises this time.
I'll, uh, see you later.
Got a case.
Well, you could've just said that.
You didn't have to screw with me.
Yeah, but if I didn't screw with you, you'd
spend the whole night thinking you might get laid.
Which means you'd be useless.
Better to extinguish all hope.
Get Foreman and Cameron
and meet me upstairs, stat.
What's so urgent?
Two cases, same symptoms.
What do 6-year-olds and
70-year-olds have in common?
Their immune systems don't
work as well. Could be listeria.
I already checked for that.
Leukemia has a higher prevalence
in both the young and old.
So does asthma.
No, no, no.
They can both get diabetes.
No.
The nearly dead and the newly bred have more in
common with each other than with people in the middle.
It's weird.
Some kind of circle of life thing.
This kid doesn't have kidney failure.
He will.
Based on this file, the
kid just ate some bad food.
Was the old man...
They were nowhere near each other
in any of the four dimensions.
- This case is 12 years old.
- Yep.
- And this case is Cuddy's.
- She assigned it to me.
She agrees with you that this is
something more than gastroenteritis?
She wouldn't have assigned it
to me if she did, now would she?
Gohhh.
What were we talking about?
Two patients with two
symptoms in common.
And five symptoms not in common.
While you were all wearing your
"Frankie says relax" t-shirts,
I was treating a
73-year-old woman
who went through this
progression of symptoms.
The last of which was...
In case any of you missed that class
in med school, that one's untreatable.
Kid's got the first two.
Took Esther an hour and 20
minutes to go from two to three.
And less than a day to make it
all the way to the rear exit.
This is all because a child
has some blood in his diarrhea.
He's got a tummy ache.
If there was any reason to think it was
anything worse, Cuddy would be all over it.
Great. Do a colonoscopy.
On a six-year-old kid who probably has
nothing worse than some food poisoning?
If you happen to find any purple
papules, do me a favor and grab a slice.
I want to check for Erdheim Chester.
A disease that there have been what,
maybe 200 reported cases of? Ever?
If Esther's family had
let me do an autopsy,
there'd be 201.
See anything?
No, and I don't expect to.
House usually avoids cases.
If he's actually stealing a case from
Cuddy, there's got to be a reason.
It's not the first time
I've seen this file.
About a month before Cameron was hired,
some trucker came in
here with these symptoms.
House decided he was dying.
Two days and a spinal tap, bone marrow
extraction, and three colonoscopies later,
we sent the guy home with a bunch of pain
killers and a diagnosis of a bad cheese sandwich.
One of the guys who worked here before me said House
tried to cure Esther at least three other times.
You know how people see the
Virgin Mary in Danishes and stuff?
Someone died 12 years ago,
and House doesn't know why.
House sees that case now in paint peeling,
in clouds, and now in this poor kid.
Erdheim Chester is an abnormal growth of
some of the cells that fight infection.
Is that cancer? 'Cause
he seems okay now.
Yeah, the other doctor kind
of scared us about that.
He shouldn't have. We're just
testing. It'll probably be negative.
I don't understand.
You don't think that's what
it is, but you want to...
you want to do this thing to him anyway?
We need to be sure.
Isn't there any other way?
It shouldn't take long.
All right.
Those ridges look a
lot like purple papules.
They're not purple, they're red.
They're probably just blood blisters.
Give me the biopsy needle.
How long is this going to take?
Forget it, Chase. Your punching-out-the-shark
story's good, but she's not waiting for you.
So?
We couldn't confirm the
source of the bleeding.
- But we did biopsy some...
- Blood blisters.
You mean papules.
Come on, Cameron. Who's right?
Chase is.
Negative for Erdheim Chester.
Let me see.
- If it's not Erdheim Chester...
- It's exactly what we said before.
Garden variety viral gastroenteritis.
Can we go back to the party?
Do a kidney biopsy.
Esther's shut down in exactly...
This kid is not Esther.
You screwed up, she died. I'm sorry.
But that does not mean
this kid is dying as well.
Jeez.
You get testy when
you don't get any fuzz.
Come on.
What did the test say?
Colonoscopy was clean.
And the biopsy was negative
for Erdheim Chester.
So Ian's going to be all right.
It was just some sort of virus.
What's that?
Urine.
But it's brown.
Ian's kidneys are shutting down.
Still think it's not the same case?
So, what can cause bloody diarrhea,
ataxia, and kidney failure?
- I'll go do a biopsy.
- Forget it.
That battle's over.
His rising creatinine is his kidneys'
way of saying, "Go on without me."
What explains everything?
E. Coli HO:157 causes bloody diarrhea
and leads to hemolytic uremic syndrome.
Toxins from the bacteria
cause his kidneys to shut down.
We should start him on plasmaphoresis.
Clear, concise, and
completely plausible.
And exactly what I did
last time. Didn't work.
- What else?
- Good Pasture's syndrome.
Circulating antibodies cause
kidney failure and bleeding.
But not the purple papules.
If you throw in Esther's next symptom...
brain... makes me think
heavy metal toxicity.
His hematocrit would have
to be low. It's at 44, and
- Esther's never dropped below...
- 42.
You have the file memorized?
It's my lucky number.
What about lymphoma?
Causes kidney failure, GI bleed, and
can infiltrate the base of the brain.
You check Esther for that?
She never showed any signs of...
If he has lymphoma this far advanced, we
should be able to see it in his blood and brain.
Chase, run a blood smear and
immunochemistries. Foreman, get an MRI.
- I'll page Cuddy.
- No, you won't.
She thinks the kid has a stomach ache.
She'll come right up here
and do one of two things.
If she agrees with me, I don't need her.
If she disagrees, I don't want her.
Can't handle people
disagreeing with you?
She might have a different take on this.
Subordinates can disagree with
me all they want. It's healthy.
People who can shut me
down, on the other hand...
Forget Cuddy. I'll have
Wilson keep her busy.
Keep your answers short and
discreet. Is Cuddy still playing?
The chicken... is still
in Piccadilly Square.
Brilliant.
She'll never suspect that
Normandy is our target.
Is that House?
Tell him that the blinds just went to
20/40, and he's running out of chips.
How's she doing?
Well, what's going on?
The way you took off,
something's obviously...
Love to chat. But got a game to play.
How's she doing?
The patient is on life support.
We're about to pull the plug.
Are you talking about me?
What have you got?
Mmm... Those sound like
high-dose cardio meds.
Two hearts.
You got the flush?
Still waiting on the final labs.
She drinking her seltzer?
No. Hydration is not a problem.
Means she's bluffing. Push her all in.
Call.
Two pair.
Show me your hearts.
Seven of clubs.
Oh, dear. Sounds like I messed up.
You're gonna be stuck
with her for a while.
Talk to you soon.
Oh... Yes.
Why are you taking a
picture of his head?
We're looking for lymphoma, but...
So it's not Erdheim something.
And it's not his kidneys.
But his kidneys are failing.
What... Where's Dr. Cuddy?
Dr. House mentioned another case.
Is there another patient with the
same... same thing that Ian has?
- Not...exactly.
- What does that mean?
Dr. House had a patient a while back who
exhibited the same symptoms as your son.
Then you know what's wrong?
No.
So what do you know?
We know the likely course
the disease will take.
Which is?
- She had multiple system failures...
- What happened to her?
She died 24 hours after her admission.
Mr. or Mrs. Alston, would
you mind giving me a hand?
He's having trouble sitting still.
It's impossible to
get the detail we need.
So I figured he might feel more
comfortable hearing your voices.
Ian, honey?
Just sit still.
You'll be done in a
moment. We're here with you.
I'm scared.
It's okay, honey. It's...
It's only a big camera. It's going
to take a picture of your head.
You love it when I take your
picture at home, don't you?
Yeah.
And you have to hold
still for that too, right?
But this isn't like that.
I know it's scary, Ian.
But you can do it.
You're getting to be so grown up.
So just...
hold perfectly still.
Just for a little bit.
Mommy, are you crying?
No. No, honey. I'm just tired.
Okay. I'll try.
The base of his brain has been
infiltrated by a small mass.
- We think...
- Pituitary?
Looks that way.
Explains the low blood pressure.
Pretty much confirms the lymphoma.
If we'd started Esther on prednisone...
Uh, did anyone see the lymphoma?
No, we saw a mass. The
location was consistent with...
Didn't see any in the blood, either.
White blood cells show no
spindling or abnormal nuclei.
Nothing on immunochemistries,
either. It's not lymphoma.
House.
It's a train.
We don't know what kind of train.
- Whoa, whoa, whoa.
- I'm thirsty.
It's closed.
It's not now.
We got one advantage.
We know where the tracks are going.
The fact that the end
of the line is death...
is an advantage?
The fact that we know is an advantage.
Means maybe we can get ahead of it.
Next station is the liver. We've got...
About 90 minutes before it gets there.
Maybe we can cut down a tree across
the line just outside of town.
I'll do an ultrasound.
No, treatment will tell us more, faster.
How can we start treatment if we
have no idea what we'retreating for?
Treat him for everything.
Give him acetylcysteine. And
interferon. And silymarin.
And whatever else you can
think of to protect the liver.
What's going on?
Oh, just catching up on some TV.
How are you doing?
Well, thanks to your last consult,
the patient has improved dramatically.
Tell House the patient is
about to kill the doctor.
- She says the pa...
- I heard. What d'ya got?
Well, Cuddy just raised, and, uh...
- You're paired.
- What?
Nines?
How do you know?
Anything lower, you
wouldn't sound so excited.
Jacks or higher,
your voice sounds like Debbie from
accounting is sitting in your lap.
Ask Cuddy if she can
beat a pair of threes.
Wait, what's... What's going on?
If you're going to mess with me, wouldn't
it be more fun to do it in person?
Yes, it would.
Um, can you beat a pair of threes?
What did she do?
I left orders for PO fluids, doctor.
Enough with the codes. She
obviously knows it's me.
She's drinking her seltzer.
Did she stop?
- Yes.
- Go all in.
- Um...but...
- Just do it.
You couldn't care less
about this charity event.
You claim not to be messing with me.
Obviously, you're either
trying to keep me...
Shut up.
Look, last time, I
wanted the game to go on.
I still do.
That means that this
time, you get to win.
Hold on.
I fold.
Ho, ho, ho.
House, are you sure you're okay?
Meds seem to be working.
Liver's holding its own.
Good.
But the platelets are dropping.
Even better.
Why? It means he's getting sicker.
It's new. New is good.
Because old ended in death.
I can't breathe.
Chase!
What?
What's happening?
Ian. Come on.
Honey, just relax.
Ian, breathe. Come on, honey.
Breathe, please, honey.
We had to put him on a ventilator.
He's back on Esther's path.
And we managed to make the
train skip a few stations.
Which means that instead of 12 hours,
he's probably got less than two.
Which begs the question, why?
What did we do?
Acetylcysteine could
mess with the lungs.
Mess with them. Not shut
them down in 20 minutes.
Interferon modulates the immune system.
It could affect cancer of the
blood, like one of the leukemias.
It doesn't speed them
up, it slows them down.
It slows down all 500 of them?
Anybody know where we can find
an oncologist at this hour?
What effects would
interferon have on leukemia?
Depends on what type. Could make
it better, could make it worse.
Four-year fellowship to learn that.
Tell House if he wants to play cards, he
should get his ass back down here and play.
You hear that?
She wants me off the phone.
Means she's vulnerable.
Go all in.
But, um, the party's over
in less than three hours.
It's over in less than two hours.
Which means you either have
three of a kind, or just 3s.
I'm guessing 3s.
I bet 500.
Go all in.
You obviously want to
bust me. Why would you...
Either you go all in, or
I tell everybody in the building
that you wear toenail polish.
I'm all in.
I'll call.
I'm betting you have a pair of
threes, but even if you have three...
it's not going to beat trip nines.
Oh. Oh, oh no.
Oh, no.
Oh, oh. That's gotta hurt.
What happened?
I just killed two
birds with one straight.
Good-bye.
Fine. Keep playing.
But I need you to
recommend a good oncologist.
Because if I don't get one up here in the
next few minutes, I got a dead six-year-old.
If you need help, ask.
These games are insane.
Games have a higher success rate.
Well, I don't see anything
that looks like leukemia.
You do a bone marrow biopsy?
No time.
Even if there is an occult blood cancer,
you wouldn't expect
interferon to make it worse.
Certainly not this fast.
What would move this fast?
Autoimmune diseases.
If his body's own defenses are attacking him, then
beefing them up is just going to put fuel on the fire.
Sarcoidosis could be
in his brain and lungs.
No, no enlarged hilar lymph
nodes on his chest x-ray.
The systemic nature suggests
Juvenile Rheumatoid Arthritis.
Or Kawasaki's disease.
Can't be Kawasaki's.
Doesn't affect the elderly.
Uh, these... This is a kid's x-ray.
House had another patient...
Who may or may not have had Kawasaki's.
This kid, on the other hand...
He makes antibodies that are
eating the inside of his arteries.
Choking off blood to his
major organs one by one.
First the GI tract, then the kidneys,
then the brain, now the lungs.
Can anyone think of a reason why
Kawasaki's can't affect the elderly?
Other than that it doesn't?
Nice.
We can confirm with blood work.
We need an ANA, sed rate...
Labs will take two hours.
What was the old lady's sed rate?
Elevated. 98.
You can't use another patient's
labs to diagnose Kawasaki's disease.
Is that like a dare or something?
You don't have time to be wrong.
Fine.
We'll look for Kawasaki where he lives.
Ian's coronary arteries.
This other patient.
The old lady. Esther?
Have you read Moby Dick?
It was a book?
It was 10 years ago. 12.
Obsessionis dangerous.
Only if you're on a wooden ship
and your obsession is a whale.
I think I'm in the clear.
You do realize it's a metaphor?
You do realize that the point of metaphors is to
scare people from doing things by telling them that
something much scarier is going to
happen than what will really happen.
God, I wish I had a metaphor
to explain that better.
Go back to the game.
Don't worry. I'm not going
to get eaten by witches.
Coronary arteries clear. No aneurysms.
Flip the mode. Let's see the flow.
How did that other woman die?
She went into respiratory distress.
Her heart and liver were already com...
No.
Did she suffer?
Was she in pain?
I don't know.
Laminar flow.
No blood clots, no ragged edges.
Damn. Shut it down.
We're just wasting time.
Look at the right atrium.
That's not Kawasaki's.
No.
It's small. But it's there.
Esther didn't have a mass in her heart.
Ian's younger.
He can take more of a pounding.
Esther died before the
disease reached her heart.
The disease made a
mass and made it fast.
Could be bacteria.
- Muscle.
- Connective tissue.
The kid can't take any more theories.
Only thing we know is that whatever
that mass is, that's what he's got.
We need a piece of it.
I'm doing a biopsy.
I'll shut the blinds.
No, let them watch.
I do my best work on the big stage.
Passing through the superior vena cava.
You're in the atrium. Pull back.
You hit the wall of the heart.
These procedures would be so much simpler
if we could do them on healthy people.
And out again.
- V. Fib.
- Cardiac arrest. Call it.
Come on. Paddles.
- Come on.
- Charging.
Clear.
"Code blue. ISO room."
And again.
- Nothing.
- Again.
Have you got a clock on this?
How much longer you
going to be doing this?
Clear.
Wait. Got something.
He's back.
What are you doing?
I'm doing what we came here to do.
- It almost killed him.
- I know. I was right here.
Give me a vacutainer.
His brain's been oxygen-deprived
for over eight minutes.
There might benothing
left. You might be...
Tell the parents. Where
the hell is that vacutainer?
So. What's he got?
Brain damage.
Good chance. I was
talking about before that.
You're not worried about...
Things I can't do anything
about? I try not to.
Things just roll off you
like water off a duck.
Histiocytosis.
Very unlikely
in a 73-year-old.
Whatever this is, is very unlikely.
Come on, more ideas. Let's go, people.
Genetic disorders could
cause masses everywhere.
Tuberous sclerosis.
If it's genetic, he's had
it all his life. Why now?
I don't know. It sure fits nice enough.
We haven't ruled out leukemia yet.
Or sarcoma. He could have
multiple soft tissue tumors.
Or sarcoidosis.
- Multiple neurofibromatosis.
Chondrocytomas.
How's it going? You win?
I got called away by the
angry parents of a patient.
There are three of you here. None
of you had the sense to stop him.
- To pick up a phoneand call me.
- I told them you'd signed off.
The parents are mad
because their kid is dying.
It's understandable.
But if he doesn't die,
they won't be mad anymore.
If he's brain-damaged, they
might still be a little ticked.
- I had to do it to save him.
- You had to do it to diagnose Esther.
You may have killed
a six-year-old
because you're obsessed with a
woman who's been dead for 12 years.
Sometimes you lose,
House. You're not God.
He's not dead yet.
No, but you're done with him.
It's my case now. Go home.
Go ride your motorcycle.
Go brood in a dark room.
Just don't go near Ian again.
So, anything else? Or
is it just these seven?
Drop it, House. She's right.
No, she's not.
- You know she's not.
- We should have called her.
I'm surprised you didn't.
You're going to have to find a way to
let this go... we can't go near Ian.
We don't need to go near him.
We have his tumor.
Cuddy may be right that
we screwed up the protocol.
She may be right about
my screwed-up obsession.
But I am right about the medicine.
How many tests can we do with that?
Look, we cure the kid, we
solve everybody's problems.
How many?
- Maybe two good pieces.
- How many okay pieces?
Three would be pushing it.
Three tests, seven choices.
Okay, what's first?
Uh...sarcoidosis seems most likely.
Yeah, so likely that Cuddy's going
to think of that all on her own.
She's got the kid's
whole body to play with.
Let her do that test. What's next?
It's moving too fast to be spreading.
It has to be growing from
something that's already...
Genetic disorder... Tuberous sclerosis.
Or it's his immune
system. Histiocytosis.
There are more documented cases of histio
amongst older people than tuberous sclerosis.
Let's start with that.
Wing or drumstick?
Gonna need a little more than that.
A little more is more than a third.
If we have to repeat this test
because you didn't cut us enough...
I'm adding one microliter
of the immunoperoxidase.
Make it two.
I don't want House biting off our heads
because we weren't sure if it turned red or not.
That's definitely not red.
The problem could still be an abnormal
cell growth, but a different cell line.
Sarcoma? Muscle cells
are throughout his body.
Would explain the geography.
Genetic disorder is far more
likely in a six-year-old.
Tuberous sclerosis.
Pretty unlikely to cause a GI bleed.
The time course fits.
So, Foreman, you agree with
both of them. Thanks for playing.
If we have enough tissue for
two tests, why not do both?
Then we don't have to think as hard.
Taking the pressure off the choice
makes us less likely to think critically.
Sarcoma is more likely to
hita 6- and a 70-year-old.
Tuberous sclerosis it is.
You think sarcoma is less likely?
It's more likely.
The test for it, on the
other hand, is less reliable.
Nestin's negative.
Well, that's okay.
If the tumor cells haven't matured, the
Ki-67 protein wouldn't have turned off.
What happens if we don't solve this?
- The kid dies.
- I mean for the next 12 years.
Ki-67's negative.
And PCH antigen is negative.
Mighty Casey's down to his last strike.
Mighty Casey struck out.
Thanks a lot. I was going
to read that this weekend.
Chondrocytoma.
Connective tissue has been in
all the places we've been looking.
The kid is too sick for that. We're
better off testing for sarcoma.
We would have seen signs of that
when we tested for tuberous sclerosis.
Tumor cells look like
muscle under the microscope.
No, they didn't. They looked like fat.
I vote for neurofibromatosis.
Why?
Because the other choices suck worse.
Give me a minute.
You want me out of here?
You come up with anything?
No.
Hey.
We can talk about it tomorrow.
I, um...
I won the poker tournament.
I totally played this guy
Berman from business affairs.
I got great cards. But I don't
bet. Just call, no raises.
Berman pairs his King on the flop.
I keep calling, the
river turns, I check.
He can't stand it. He goes
all in. He's sure he's won.
I call, I flip 'em. Pow!
Pocket aces.
I nailed his ass.
The aces were hiding all along.
Test him for Erdheim Chester disease.
Erdheim Chester? That's
not even on the list.
Because we already did it.
He tested negative.
So did Esther.
The disease lied.
Yeah, the tumor's got it in
for you. Diseases don't lie.
Fine, it didn't lie. It slow played us.
We biopsied the colon, but it
hadn't reached the GI tract yet.
It's there now.
It's in his liver, his lungs...
You want it to be there.
Because then you didn't
screw up 12 years ago.
We can't waste our one test on
the one disease we know it's not.
Run the test.
You sure about this?
Wait, let me think about that.
Don't pressure me.
Just run the damn test.
Cells look like macrophages.
That's a good start.
Take your time and say it loud.
CD 68 positive.
Start the treatment.
So Esther can rest peaceful now, huh?
Yeah.
40.
You got lucky.
You gonna call?
What I do...
is not just based on the flip of a card.
You guessed. You got lucky.
It fit.
It could just as easily have been
sarcoma or tuberous sclerosis.
No, not just as easily.
Maybe not. But it wasn't impossible.
Are you going to call?
You know,
relative to its size,
the barnacle has the
largest penis of any animal.