- Somebody, please!
Get in here now!
- Is this Ebola?
Is this Ebola?
Hey guys, since we're all in quarantine
because of this coronavirus pandemic,
I thought there was no better time
to watch a "House, M.D." episode about a quarantine.
- [Mom] Can I see?
(glass crashes)
- Ow! - Julie!
- Get her a towel.
What was in that jar? (suspenseful music)
- This acting is awful.
- Smallpox was eradicated over 30 years ago.
- So were Hush Puppies, have you checked out
your local hipster coffee shop lately?
- Smallpox doesn't exist outside of P4 labs
and bio-weapons plants.
- So that's actually true.
I believe there's only four labs,
or four locations in the world,
that have samples of smallpox still available for testing,
because we felt like there would still be
worthwhile evidence that we can collect
from how this virus spreads, how we can eradicate it.
We've limited because of the fear of bio-terrorism.
- She was in Bermuda. - Or she was scuba diving
on the wreck of a Dutch slave ship
that had been intentionally sunk
because an epidemic of smallpox had broken out on board.
- House always presents himself to know
these just absurd things.
How does he know that she was in this shipwreck?
I want to be in the room where he's
questioning his patients.
When a patient comes into my office
and they have high fever or vomiting,
I don't ask if they've been on a pirate ship lately.
I just can't imagine how he extracts
that bit of information.
- Thanks for calling back.
Listen, I'm a screenwriter, and is it theoretically possible
for smallpox to survive for more than 200 years
underwater in a sealed glass jar?
- [CDC Doctor] Well, theoretically yes, but--
- Thank you. (phone clicks)
- Can you imagine, you just call the CDC
and ask random questions like that?
- Isolate, get baseline blood draws for smallpox,
antibodies, and vaccinate the entire family.
- Okay, first of all, I can't imagine what lab
is gonna do smallpox testing nowadays.
It has to be a send-in test to Atlanta,
where the CDC headquarters are.
I don't have tests for that in my office.
Especially on my Epic, the electronic medical record,
I think if I put in smallpox there's gonna be
some major alert to tell me to contact the CDC.
- We should test for the 21st century suspects.
Varicella, measles.
- You're free to perform whatever unnecessary tests
you want, Foreman. - In all honesty,
Foreman here is 100,000% correct.
(bell dings)
If a young woman presents to the office
with high fever, vomiting and bloodshot eyes,
you should rule out everything that it's most likely to be.
Well, first, anything that's most likely to be deadly.
Smallpox should be way, way, way low
on the list of differential diagnoses.
When I think about that old-school saying,
when you hear hoof beats you should think horses,
not zebras, because thinking about zebras,
you'll miss some pretty important cases that are
easily treatable, like the influenza virus, like measles.
(door hisses)
- Why the hell do you guys have us quarantined in here?
- We're just taking every precaution.
- Against what?
- So I think this is a great time to explain
the difference between isolation and quarantine.
Isolation is when you take someone who is sick,
and diagnosed sick with a specific virus or bacteria,
and you keep them isolated from other people.
There's different forms of isolation,
droplet, airborne, contact, what have you.
Then, if you're wondering if someone
has potentially been exposed by something,
they may or may not be sick,
they can be held in quarantine, not isolation.
That's what I'm doing here, I'm technically in quarantine,
'cause I'm not sick, I may or may not become sick,
but that's what we're all doing, social distancing.
- That does not look like tetanus shots.
- It's really not worth going into
because the odds are astronomical.
- Tell me.
(suspenseful music)
- Again, it's-- - Smallpox.
- Smallpox?
- That would've been really awesome if she'd just said,
"You know what you should do?
"You should stay alert, not anxious."
I would've been really proud of
the "House, M.D." show for doing that.
- Negative for varicella and measles,
so all of our ideas are off the table.
- Well, I'm putting mine back on.
Patient's a diver.
Under increased pressure, everything in the blood
gets scared, panics, runs and hides.
- Antibodies could be in the joints.
- Tap her knee, ankle, shoulder
and any other joint in her smallpox-ridden body.
- Doing a joint aspiration to check
if it is in fact smallpox seems kind of dangerous.
There are true times when you need to do a joint aspiration,
like if a patient has septic arthritis
and you need to culture the joint fluid
to see what antibiotics you should use,
or if you're looking for gout.
But just to do it on the off-chance that she may
or may not have smallpox, that actually puts the patient
at risk for septic arthritis, which is
a bacterial infection of the joint.
Oh no, what does he see? - What?
What is it?
- I'm sorry, I have to call the CDC.
- I don't know what he saw.
- I think you do have smallpox.
- Blisters? - Whoa, take a look at this.
- What is it?
- There's a rash under your daughter's arm.
- Like more of those gross bumps?
- No, it's just a regular rash.
- What does that mean?
- It means it's not smallpox.
- I don't know why not,
'cause that still could be a smallpox rash.
House, explain it to me!
- I'm Dr. Broda, head of Infection Control, CDC,
and your protective suits are not adequate.
- Turns out they don't have to be.
Rash under the arm means it's not smallpox.
False alarm, sorry.
Hope the traffic wasn't too bad.
- Rash is consistent with smallpox.
- Not if it presents after pustules.
- She's probably just allergic to the bedsheets
or the hospital gown and you simply didn't notice it.
We're gonna airlift blood and tissue samples to Atlanta.
We'll have the DNA results in 18 hours.
In the meantime, please step out of the room.
- It's funny I find myself agreeing with the CDC doctor
more than I am with Dr. House,
but I know it's probably to my demise.
(eerie music)
- Sir, are you feeling all right in there?
- It's just a headache!
- Oh no, his eyes.
- Baby.
Baby!
- [Dad] Oh my god.
- Dad, you're bleeding!
- Somebody, please!
Get in here now!
- Is this Ebola?
Is this Ebola?
- Why have they stopped?
- You can't go out there.
- Why did you stop?
- Get out of the hallway!
- He does not have smallpox.
- Yes, he does.
- It itches!
- He's just developed pustules.
He's now too dangerous to transport.
- The virus that causes smallpox is called variola.
And before we had vaccinations we used to do variolation,
where you take a piece of the pustule that people develop
and you introduce it to somebody in order to inoculate them,
meaning to get their immune system ready
to fact the real smallpox.
That wasn't as good as the vaccines we have today,
because you actually got sick with smallpox at that case.
However, your case wasn't as bad as those
who caught it naturally.
So this was a way to get sick,
but not as sick as everyone else.
It was only until we got the smallpox vaccine
where we were truly able to eradicate
smallpox from the world.
- Uh-uh, wait.
The soles of your feet, there aren't any lesions.
- No pustules on the daughter's palms, so?
- So therefore your theory is
you asked me to take the dad's blood
but I accidentally injected him with smallpox.
- Exactly.
Although technically it was the vaccinia virus,
which is what the smallpox vaccine is made from.
Same symptoms as smallpox, but only half the calories
and almost none of the lethality.
- You sound like one of those anti-vaccine cranks.
You can't develop full-blown symptoms
from the vaccine this quickly.
- You can if you're immunocompromised.
Am I the only one who reads these things?
Dad had kidney cancer. - Six years ago.
He's been in remission. - Well, it's obviously back.
- I swear, House just walks around
and throws diagnoses on everyone that could be possible.
And I feel like he does this so inaccurately,
that he has such a low success rate, it doesn't matter,
'cause at the end of the day, each time
he gets proven wrong, he'll figure out something else
that he can throw out there, and he'll be right.
Not a fan of this approach, not very realistic.
- You got any proof the kidney cancer's back?
- Well, let me give him this.
When he gets better that'll be the proof you need.
I'll put on one of your fancy spacesuits
and I promise I won't kiss him on an open sore.
- You know who Janet Parker is?
- That's the last person who died of smallpox!
- In 1978 she was working in a university in England.
Someone in a research lab on a floor below screwed up.
Some smallpox virus managed to float up through the vents,
into the room where she was working.
She died four days later.
Last known person to die from smallpox.
And the person in charge of the lab was so destroyed
he killed himself. - Wow.
Didn't know all that. - Now that he's shedding,
I can't open that door for anyone.
- When he says, "Now that he's shedding,"
he's talking about the pustules.
That is the most infectious stage of smallpox,
so you don't want to be anywhere near a person
if they truly do have it.
- Hey! - Oh no, House!
(lock beeps)
- [Broda] Hey!
- This is textbook smallpox.
DDXing at this point, it isn't gonna make a difference.
- Don't say that. - I'm sorry.
House, you screwed up going in there.
(EKG screeching) (somber music)
- Chest compressions, chest compressions,
chest compressions.
Even House fails us with the chest compressions.
He's starting to get the defibrillator ready
instead of doing chest compressions.
I know he's out by himself, but still.
And I'm pretty sure the rhythm I saw
pop up there was flatline.
You don't shock flatline either, House.
You know better than that. - Did the cat get sick?
- [Chris] Smallpox is exclusive to humans.
- Is this toxoplasmosis? - Captains didn't have pets.
Nothing and nobody went on those ships
if it didn't have a purpose. - Hunting mice and rats?
- For the crew, the hold was probably infested with mice.
What if that's the difference?
- What happened to Hairrot?
- Aw!
- Is that a sad aw or a cute aw?
- It said that he dies, it's a sad aw.
- Before he died, did he lose his fur?
- How did you know?
- Mice don't carry smallpox,
but they do carry rickettsialpox.
- My knowledge of rickettsialpox is not up to date.
- Rickettsialpox is mild, self-limited,
zoonotic febrile illness characterized
by eschar formation at the location of a mite bite,
following the onset of systemic symptoms
and a more generalized papulovesicular rash.
Rickettsialpox occurs primarily in urban areas,
where density of mites, mice and humans is high.
They named it in 1946 in New York City, shout out NYC.
In about 2007 there's been 14 cases reported.
Approximately 1.7 cases per million people.
That's why I haven't seen it.
- At least look at the dad's body.
Small patches of black dead tissue will prove I'm right.
Eschars appear with rickettsialpox, but not with smallpox.
- If he had developed eschars I would've noticed.
(suspenseful music)
- Eschar!
Eschars.
- Eschar's just dead tissue on the body.
You frequently see it with abscesses,
meaning when someone has a pocket of infection.
But it's very common, appearing of where a patient
was bitten by a mite in R-pox.
- Start the girl on doxycycline right now.
(door hisses)
- I still wouldn't take off my gear like that!
Oh my god, just 'cause he saw,
that eschar coulda been caused by anything.
My god, this is ridiculous.
Infection control people, this would never happen
in any hospital, ever, ever, ever.
If this truly happened in this manner in a hospital,
House would still be kept under quarantine
just in case he didn't have another infectious condition.
Because god forbid you let him out too early,
and now he's walking around infecting
all the future patients he sees and his colleagues.
No way.
No, no way.
If you're a fan of "House, M.D.," I put together
a playlist of my "House, M.D." reviews, there's been a few.
I also have a bunch of others, so search them on my channel,
Doctor Mike with your favorite show,
or Doctor Mike with a medical condition.
The results will pop up and surprise you.
I'm curious where you're going, to be happy and healthy.