House M.D. - Season 1, Episode 2
- Dan, no!
I assume you found the kid.
He almost walked off
No, he thought he was on his
lacrosse field. Look, I was gonna
run home, shower, change--
How'd you talk him down?
Actually, Chase tackled him.
How come you didn't do it?
Right. Well, I am black,
but he was closer.
You can ride up with me.
Anybody tell the family that
their boy almost stepped off a roof?
They must be thrilled.
They're not suing,
but I think only because
Why does everybody
always think I'm being sarcastic?
This is great news.
He doesn't have M.S.
Parents should be thrilled.
The mom anyway. Ofcourse,
the dad probably doesn't know--
- Why doesn't he have M.S.?
- He was on the roof, thinking
he was on a lacrosse field.
- Conscious, and therefore not
a night terror. You want some of this?
- Yeah, sure.
He was in an acute
which doesn't fit with
a demyelinating disease like M.S.
They just mean something
other than M.S.
So, what are they telling us?
That the immune system
He has an infection in his brain.
What about sex?
Well, it might get complicated.
I mean, we work together.
- I'm older, certainly, but maybe you like that.
- I meant maybe he has neurosyphilis.
- Huh. Nice cover.
- Sorry. R.P.R. was negative.
We don't need
a definitive test to confirm.
Sure. Didn't need one to confirm M.S.
Okay. Let's wait for you to
run titers on 1,400 viruses while
this kid's brain turns to mush.
So the fact that
he doesn't have M.S.,
it's-- it's really not good news after all.
Well, it is if it's neurosyphilis.
The likelihood of a false negative
on an R.P.R. test: 30%.
Likelihood of a 16-year-old having sex:
I'll start him on I.V. penicillin.
We're not gonna wait for that.
The most effective way
to deliver the drug is
right into his brain via the spine.
In a cramped space like the brain,
increased intracranial pressure
from a high-volume drug like penicillin
could herniate his brain stem.
It'd kill him.
No neurologist in his right mind
would recommend that.
Show of hands.
Who thinks I'm not
in my right mind?
And who thinks I forget this
fairly basic neurological fact?
Who thinks there's a third option?
- Very good. What's the third choice?
- No idea. You just asked
if I thought there was one.
The patient has a shunt in his brain.
There'll be no increased pressure.
We can put as much penicillin
into his body as we want.
Excellent. Inject him through
a lumbar puncture.
One of us is gonna do this to you
twice a day for the next two weeks.
- I'm ready. Go.
- He could get syphilis...
even if he's not sexually active?
Well, it's-- it's unusual,
but it's possible.