House MD Jr

Pilot

"29-year-old female first seizure one month ago. Lost the ability to speak. Babbled like a baby. Progressive deterioration of mental status," Dr. Wilson explained the case.

"See that? They all assume that I'm a patient because of this cane," Dr. House said as he followed his only friend through the hospital halls.

"So, put on a white coat like the rest of us,"

"I don't want 'em to think I'm a doctor,"

"You see where the administration might have a problem with that attitude,"

"People don't want a sick doctor,"

"Well, that's fair enough. I don't like healthy patients. The 29-year-old female..."

"The one who can't talk? I like that part,"

"She's my cousin,"

"And your cousin doesn't like the diagnosis. And I wouldn't either. Brain tumor, she's gonna die. Boring,"

"No wonder you're such a renowned diagnostician. You don't need to know anything to figure out what's wrong,"

"You're the oncologist. I'm just a lowly infectious disease guy,"

"Yes, just a simple country doctor. Brain tumors at her age are highly unlikely,"

"She's 29; whatever she's got is highly unlikely,"

"The protein markers, the three most prevalent brain cancers, came up negative,"

"It's an HMO lab. You might as well have sent it to a high school kid with a chemistry set,"

"No family history,"

"I thought your uncle died of cancer,"

"Other side," Dr. Wilson shrugged off, "no environmental factors,"

"That you know of,"

"And she's not responding to radiation treatment,"

"None of which is even close to dispositive. All it does is raise one question. Your cousin goes to an HMO?"

"Come on," Dr. Wilson pleaded. "Why leave all the fun for the coroner? What's the point of putting together a team if you won't use them? You've got four over-qualified doctors working for you. Getting bored,"

***

"It's a lesion," Foreman reasoned.

"And the big green thing in the middle of the bigger blue thing on a map is an island," Dr. House claimed, earning an eye roll from Alexandra. "I was hoping for something a bit more creative,"

"Shouldn't we speak to the patient before we start diagnosing?" Alexandra challenged.

"Is she a doctor?"

"No, but..."

"Everybody lies,"

"Dr. House doesn't like dealing with patients," Cameron whispered to Alexandra.

"Isn't treating patients why we became doctors?" Foreman asked.

"No, treating illnesses is why we became doctors," House replied. "Treating patients is what makes most doctors miserable,"

"So you're trying to eliminate humanity from the practice of medicine," Foreman challenged.

"If we don't talk to them, they can't lie. And we can't lie to them. Humanity is overrated. I don't think it's a tumor,"

"First year of medical school, if you hear hoof beats, you think horses, not zebras," Alexandra pointed out.

"Are you in the first year of medical school?"

"No,"

House nodded. "First of all, there's nothing on the CAT scan. Second, if this is a horse, her kind family doctor in Trenton makes the obvious diagnosis, and it never gets near this office. Differential diagnosis, people. If it's not a tumor, what are the suspects? Why couldn't she talk?"

"Aneurysm, stroke, or some other ischemic syndrome,"

"Get her a contrast MRI,"

"Creutzfeldt-Jacob Disease?" Cameron suggested.

"Mad cow," Alexandra raised an eyebrow.

"Mad zebra," House corrected.

"Wernicke's Encephalopathy," Foreman added to the list.

"No, blood thiamine level was normal,"

"Lab in Trenton could have screwed up the blood test. I assume it's a corollary if people lie, that people screw up,"

"Redraw the blood tests. And get her a schedule for that contrast MRI ASAP. Let's find out what kind of zebra we're treating here,"