House

Try not to be scared when you see him, okay?

Mom, I've seen him sick. I'm not scared.

This time's different.

The doctors gave him an extra course of radiation and chemo...

I know.

And you understand how proud we are of you, right?

Gloves, mask.

Matty, you said you wanted to see your brother before the procedure.

I know I look like an alien, but I promise not to eat your brain.

When this is done, will you be able to play out back with me?

I'll rip anything you put near the strike zone.

Let your brother rest up, while we take some of your marrow.

You don't need to be in an isolation room,

but I pulled some strings so you could be next door to your brother.

How many games will I miss?

Well, you only have to be here overnight,

but you do have to take it easy for a little bit.

I already missed two. Matty...

I know. It's okay.

It must have been a drag.

We just had to make sure you weren't exposed to any bugs,

because your healthy bone marrow is what's gonna cure your brother's leukemia.

Go on.

He sneezed. Maybe it's just an allergy.

Not with an enlarged spleen and a fever.

He's got one of 10,000 possible infections,

even if it's just the common cold, I do the transplant, he kills his brother.

How long do we have?

Radiation obliterated his immune system.

Even in a clean room, he's got four, maybe five, days left.

No way we can solve this that fast. You need to find another donor.

They're African American.

It makes it nearly impossible to find a full match.

Tell me about it. I can't even find the one I've got working for me.

Where is Foreman?

Nothing like a dead patient to send you back to your choir boy roots.

Hey, you're not gonna believe what happened.

Wilson just killed a kid same way you did.

He's not dead.

Five days are gonna fly by. He didn't look both ways before he nuked.

You done talking to your imaginary friend?

Because I thought, maybe, you could do your job and just...

Start the donor brother on broad-spectrum antibiotics.

Great idea, if you're looking to save exactly one kid.

Broad-spec will take at least a week to work. We need narrow-spec.

How old is Hector?

Our patient's name is Matty. His brother's Nick.

Hector's my dog. He's about 17?

Seventeen? That's, like, a 119 in human years. Why is he still alive?

Five days minus 20 seconds talking about Wilson's dog.

We need to start testing. Stool samples for parasites, antibody tests...

Blood panel was negative for all the usual suspects.

That's because the infection is too small.

We start testing now, it's like looking for a needle in a haystack.

We draw blood odds are we're just gonna come up with hay.

We need to grow more needles.

Okay, that probably needs further explanation.

We make the donor kid sicker.

We freeze him, we soak him, break down his immune system.

Suddenly we're looking at some needle that a camel can pass through the eye of.

Making him sicker risks spreading the infection all throughout his body.

True, but who cares?

Once we know what the infection is, we'll know exactly how to treat it.

As long as he isn't dead yet, we're cool.

We should do what we normally do.

Go to the kid's house, check for sources of the infection.

Waste of time.

You think it's in the house. I know it's in the patient.

Safer than intentionally making the kid sicker.

Fine, go.

So exactly how sick are you gonna make Matty?

He could get quite ill.

It certainly won't be a pleasant experience for anyone, but it's our only...

Ever get caught in the rain without an umbrella?

That's all we're talking about here. Sign the form.

It's a little more complicated than that. We'll also be doing leukopheresis.

We run Matty's blood through a machine that filters out his white blood cells.

But without his white cells, how could he get better in time?

We'll pump the white blood cells back as soon as we have a diagnosis.

Then we should be able to cure the infection in time to do the transplant.

But you can't guarantee?

We're not GM. No recalls, no rebates.

Anymore questions while your son's life slips away?

You really think we should do this?

Yes.

Sorry. Your patient, you tell them.

This is your family. It needs to be your decision.

All you had to do was say, "Yes, I do."

God knows it's a phrase that you've used often enough in your life.

It was a mistake every time. Give it a break. They said yes.

That's not enough for you. You need them to feel good about saying yes.

I treat patients for months, maybe years, not weeks, like you.

I'm taller.

If they don't trust me, I can't do my job.

The only value of that trust is that you can manipulate them.

You should write greeting cards.

Giving the parents a chance to make a bad choice was a bad choice.

At least it would have been their choice.

One they'd regret at their son's funeral.

Kitchen and bathrooms were immaculate. Whatever the kid's got, he didn't get here.

No, whatever the kid got, he didn't get from the kitchen or the bathroom.

Nobody cleans swing sets.

Yeah, because their kid's 10 and hasn't used it since he was six.

You obviously think your time could be better spent. Why'd you come along?

You feel bad about what happened last week.

I'm handling it.

Think the family's gonna sue?

She only had her grandparents, and they weren't close.

Well, that's good. For you, I mean.

A lawsuit makes it even harder to put behind you.

You put yours behind you?

Nope.

When I woke up this morning I...

I couldn't remember what she was wearing when I admitted her.

Memories fade.

I killed her a week ago and I can't remember what color top she was wearing.

I was grateful when I could wake up not thinking about her.

I'm not like you.

Your patient died because you were distracted over the death of your dad.

I made a calculated decision.

You acted like a human being. I acted like House.

Could be Mucor or Strongyloides in this dirt.

No pulmonary symptoms, setting well, breathing easily.

Mom, I'm freezing.

How long do I have to wait?

Matty, we found an old water pump in your backyard.

You ever drink from it?

Yeah it was gross.

We gotta test for Mycobacteria, leptospirosis.

When did you drink the water?

Last summer?

You sure? You haven't even taken a sip to cool off?

It was really gross.

My shoulder's bugging me. Does that matter?

It could. Did you do anything to hurt it?

Just threw the ball around the other day, for a couple hours.

It's probably just a muscle ache. Let us know if it gets worse.

So soreness and stuff, that's not 'cause I'm sick?

Is something else bugging you?

Sort of.

He has acute scrotum. Adorable.

Please, I thought you were dignified.

Come on, how am I not supposed to make that joke?

Best thing about big, honking gonads, well, one of the best things,

is that there's only a few infections that could cause it.

Do urinalysis and cultures for E. Coli, Klebsiella, TB, and Brucella.

Blood tests for enteroviruses and adenoviruses.

Hopefully, the needles have grown as fast as his sack, and we can find it.

Can Chase and Cameron cover that?

Mind if I ask why?

I want to recheck the National Marrow registry for an alternate donor.

In case we're wrong?

It's been known to happen.

Fine, go.

Negative for E. Coli and TB. Why is House taking it easy on Foreman?

He deserves a break.

Yeah, House is all about giving breaks to people in need.

No on Klebsiella.

And it's Tuesday.

It's got nothing to do with Foreman or House. It's just...

It's the day I remind you I like you, and I want us to be together.

Thank you, I'd forgotten.

No on Brucella and both viral antibodies.

You're really gonna do this every Tuesday?

You take the day off, I'll pick it up on Wednesday.

What if we're looking for the wrong thing?

These are the only infections that cause swollen testicles.

Why don't you just say it four times now and leave me alone for a month?

Well, what if it's not an infection?

His temperature's through the roof. There's mucous pouring out of him.

I know he has an infection, but what if it didn't directly cause the scrotum issue?

What if it just caused the thing that caused the scrotum issue?

CK-MB is elevated.

Slightly. There's nothing wrong with...

Indicates cardiac injury.

We stuck him in that room, put his stupid, little runny-nose infection into hyperdrive.

What if it went to his heart?

Pulmonary valve looks clean.

Wait. Stop. Mitral valve, there's a growth.

He'll need a month of antibiotics to clear that.

His brother only has four days to live.

The infection in Matty's mitral valve rules him out as a donor.

This is perfect.

We drove the infection into his heart.

Okay, perfect is too strong of a word, but it's very, very good.

Now we know where the infection is.

All we've got to do is remove the valve, ID the infection, target and destroy it.

Remove the valve?

He'll be fine on antibiotics. He doesn't need open-heart surgery.

He'll be heartbroken, on account of his dead brother.

Either way he's got a dead brother. The infection isn't just in the valve.

Even with targeted medication,

there's no way we can clear his system in time.

We don't have to. We have to clear his marrow.

After the surgery, we harvest the marrow,

marinate it in the targeted antibiotic, simmer and serve.

Could work. It's insane.

It is better than a dead brother.

I'm running this by Cuddy.

Fine. Go. In fact, let's all go.