Occam's Razor - House M.D.

Part 19- Love Sick

With her finalized essay in hand, Madelyn walked out of Cuddy's office with her head high and her shoulders back. Her doctor's coat, for the first time, felt like it fit her just right. Cuddy had approved it to be submitted for the abroad-research competition being held by NMA. 

Madelyn took the elevator upstairs to begin the rest of her day in the laboratory where House had assigned her, but she had no intention of stopping by his office first. Thirteen, Foreman, Chase, and Taub knew where to find her if they needed her. Madelyn wanted space today, not only because work had been particularly stressful, but she wanted time to enjoy her research proposal's acceptance. She thought to herself that House might've been the one to encourage her to try her hand at it, but that Madelyn did the work and was solely responsible for her win. 

After sterilizing her equipment and putting her goggles on, she immediately began her work at the microscope. Today, the team had been assigned a new case: a patient with chronic migraines who has a history of diabetes. House made it clear that the patient is in need of at least one medical diagnoses that could account for the known symptoms, but that they were probably needing two. 

Madelyn's responsibility was to examine the patient's blood for the red blood cell count and oxidation; depending on the results, she was to deduce whether the patient needed a pulse oximetry test that might indicate problems such as anemia. What she found, however, was less likely to be anemia, but something problematic with the patient's vestibular system. 

Quickly after the tests showed results, Madelyn arrived at the patient's room along with Chase and Taub. 

"Got any results?" Chase asked. Madelyn nodded her head. The patient was a little girl who had just begun second grade. 

"Sweetheart, have you ever felt random dizziness?" Madelyn asked the little girl whose face was pale and her eyes bloodshot. 

The little girl looked at her mom who then looked at Madelyn. 

"She's complained sometimes about it being random and sudden." her mom answered. 

"And do you know if the dizziness usually happens after the migraine, in time with, or before it?" 

The patient's mom's eyes darted around a bit, as if she were looking around for the answer. She ultimately wasn't sure, but believed the migraines to happen first. Madelyn wrote this all down on her iPad. Chase and Taub stood behind Madelyn and were beginning to catch onto what she was thinking. She further explained:

"I'm wondering if your daughter's migraines are related not to her diabetes, but to a vestibular disorder called benign paroxysmal positional vertigo or BPPV. Basically, she has crystals in her ears that are responsible for equilibrium and balance, however, the crystals don't operate correctly in BPPV. It's relatively common and could certainly explain all the symptoms.". 

 Before another word was spoken, the door slid open and momentarily distracted everyone. 

"It's probable for sure," House interjected from the back of the room, "trust Dr. Gilmore." 

Madelyn turned around, her lips slightly apart as if she wanted to speak but didn't have the words. Madelyn watched as House stood at the back of the room, cane in hand, looking sincere–– his best look. 

Still, she didn't say anything, she just smiled at the mother and hugged the little girl goodbye. Chase and Taub agreed and assured them both that this type of vertigo could be decently managed with medication and balance exercises. The mother then happily agreed to the team testing her daughter for the disorder. 

Later that day after a grueling day of reading MRIs, CTs etc., Madelyn returned to House's office to grab her things to head home. It was almost five in the afternoon, but House had been more lenient with the team leaving earlier on the prospect that they'd been productive.