House (2004–2012): Season 3, Episode 17 - Fetal Position - full transcript

You've got this whole thing wrong, Emm'.

It's the rock star whose 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.

Hit the Kinos behind the drop.

So what do you think?

Uh, I think people aren't gonna get it.

Oh, come on. All-American Rejects.

Juxtaposing a classic image of
Americana with modern pop culture, you.

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.

- Love the Rockwell thing.
- I thought so.

Okay, kill the house lights, let's go.

Hang on. 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-- I could be having a-- a--

What's-- what's the mnemonic?

F... F is for face. Is my smile crooked?



What are you doing?

A... A is for arms. Arms...

You should really sit down.
Can somebody get her some water?

S is... S is speech.

I'm slurring... I'm slurring?

F-A-S-T.

T is time.

Hurry, somebody, uh...

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. Your 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?
- It means Mackman is an idiot.

- May I?
- Yeah.

So.

You take thousands of photos of someone,
but only one has to look good.

Kinda 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.

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.

It means there's weakness
around the mouth.

So where'd you learn
to self-diagnose a stroke?

Oh, my, uh,

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.

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 preeclampsia.

Any of you guys ever
been to the Galapagos?

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 could've mistaken
it for morning sickness.

Heart's way more likely
to throw a clot than the kidney.

Echo was normal. 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 ten inches above the 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?

It leads to rheumatic fever.

- Which leads to... Cameron?
- Mitral valve stenosis.

Which is a thickening
in the valve of the... kidney?

No. Kidney doesn't have a mitral valve.

We'll go look at the heart.

It'll be easy to find.

It's the big red pumping thing
about ten 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.

Transaxial 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 led to your stroke,

and the reduced circulation
caused the problems with your kidneys.

And this'll fix it?

The balloon will force the
valve back open. And you'll be fine.

Can I 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?
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 kidney's 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.

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 small, 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
preeclampsia. We eliminated it before--

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's irrelevant.
Could be infection, sepsis, HUS/TTP.

A cholesterol embolism
is just as likely.

Tiny particles of cholesterol rain down

and clog up the small
vessels in 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 could 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 5.

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 the 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 Dusseldorf.

Bunch of rookies running things,
bound to be mistakes.

Kids play on the tracks,
get electrocuted.

Before you know it, trains
are backed up all the way to Berlin,

and you 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, 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've 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--

Then 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' 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 want to 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, Tigercats!

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.
- 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' heart is structurally sound.

The problem's with the bladder.
It's four times normal size.

Let me see.

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.

Dr. 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 do the same
with Chase for his own good.

Chase isn't the one
that's gonna get hurt here.

There's only room for one.
Though I could scooch 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 Mocovi Indians
who actually carry the elders--

- You're insane.
- I'm an insane genius.

Set the chamber to low
pressure instead of high.

Thinner air builds up extra red
blood cells, creates new capillaries.

Few more days in here, I can
save myself six weeks in 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.

Well, 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.

A- 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, uh, 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.

You think every day should be
naked Thursday, or is that an oxymoron?

Let me see the results
of 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 tests will be inconclusive.

The urine you collected has been sitting
in that fetus' bladder for weeks.

And as my pappy always said,
"Stale pee is useless pee."

Fine, then I'll do another tap.
Just as useless.

Old urine drops down from the
kidney right after the first tap 'cause

it's all backed up. Bladder tap number
three will give you the freshest pee,

and it'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?

A woman in her 40s. Single.

Using a turkey baster
as a last gasp at motherhood.

And you wanna make sure she succeeds,
so you'll still have hope.

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 wanna go on vacation.

You can go on vacation
after you've cured her.

Good news.

The fetus' urine had appropriate
levels of protein and electrolytes,

so his kidneys aren't damaged.

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 did you take this?

Oh, 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 wanna see her after work.

I'm right, right?

I saw the way you look at her.

Thanks.

Shunt is in the right position.

The bladder's 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 is 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. I just booked
my trip to Johnston Strait.

I thought you were climbing
mount whatever in Argentina.

Apparently I'd have to live
with the Mocovi 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 in 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?

Real reason for the mirror syndrome.

Have we looked under its bed?
Have we checked its diary?

If it's not GU, it could be the heart.
Hypoplastic left heart syndrome.

- There were no structural problems.
- Lungs.

We won't be able to get a good
look until they develop. Weeks.

- He's not gonna last weeks.
- What do you wanna do?

Maternal mirror syndrome
has one surefire 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-- till you figure out what's wrong.

We can.

It won't matter.

The fetus is still at least
two weeks away from being viable.

Oh, 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 and 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 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.

- You get it.
- She'll listen to you.

No.

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.

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.

Brown-noser.

Viral hepatis, 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?
- Are you kidding?

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.

Firing the needle.

Heart rate and BP spiking.
Get that out of her.

Fetus' 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 ten times normal.

Her liver's 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 gotta be Cuddy's Cuddy.

Nurse!

Pulmonary edema?

Who tattled? 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--

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 bronchogenetic
cyst or bronchial atresia.

Could be lung lesions, CCAM.

What about--

Move.

I thought you started your vacation.

Somebody had to save
our boss' rotundus ass.

Latest MRI of the Sloan fetus.

Small buds in the lungs could indicate--

Thanks, got that multiple
choice all worked out.

Question is, how do we pick between A,
B, C, D and none of the above?

Portable MRI's in her room.
We could get a current image--

Fetal lungs are so tiny, an
MRI won't give us the details 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 its 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. Your friendly
neighborhood belly-squirter.

We're gonna do open fetal surgery.

We 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 heart-lung 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?
We are 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 the bottom of a keg?

Where'd you go to college? Gimme that.

Affix the pulse ox to the palm.

Sorry.

I just realized I forgot to TiVo Alien.

Fetal heart rate good, stats are stable.

Position him for the incision.

All right, 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's not gonna 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
blond your baby's hair is.

My baby?

You know, 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,
poo, or shower. And absolutely no sex,

so stop flirting with me.

Sorry.

So this really worked? He'll be...

normal?

If you call being born twice normal.

Hey, thank you.

Don't thank me.

I woulda 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'd she say to you?

I always glow.

Need you to take a look at something.

- I'm off the clock.
- Just open it.

First class ticket to Vancouver Island.

Shoot!

It's the wrong envelope.

- I think it's great.
- Yeah?

Who doesn't like Canadians?

It's big. You're-- 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'm--

You screwed up.

I saved a life. I saved two lives.

You let your maternal instinct get the
best of you and nearly killed 2 people.

Case like this, you terminate,
mom lives 10 times out of 10.

You do what you did, mom and
baby both die 9.9 times out of 10.

Sometimes .1 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.