- Dr. House is out of control, but so am I.
Let's watch this episode. Bee-wop!
- [Operator] 911, what's your emergency?
- We got into an accident along the Canal Road,
just outside Kingston.
My mom's unconscious.
- [Operator] Are you hurt?
- She should've asked, "Does she have a pulse?
And if not, start chest compressions."
- I'm fine.
- You're not fine.
You have a metal object going through your body.
- Ow! Can we hurry this up?
- We'll make sure that- - Take your time.
What's your name?
- Hannah Morganthal.
- You have CIPA, Hannah Morganthal.
- What is CIPA?
- No, I don't.
- We have to do x-rays to make sure
you don't have internal injuries,
blood tests to make sure no infections,
EEG for neurological anomalies,
and biopsy a spinal nerve.
- I love how he just decided that,
because he didn't like how she was responding
to the alcohol on her leg.
And first of all, who puts alcohol on a leg?
All you need is a little soapy water.
Alcohol actually disrupts the skin tissue there.
- [Dr. Foreman] Only been about 60 documented cases.
- Yeah, and I have seven reasons
to think that she's one of them.
- Or she has meralgia paresthetica
and she's wearing a really tight belt.
Come on, House, shape up!
- Reason number one,
she knew what it was without us telling her.
- That's true, but she could've also been just acting tough,
you know, because some guy challenged her, like you!
- Two, she's still wet from the snow.
But she's not shivering. That's odd.
Unless she can't sweat or feel hot and cold.
- The ambulance was warm.
I want to see my mother.
- Three, scarring around the lips and tongue.
When she was a baby,
she chewed on herself without feeling it.
- I fell through a window when I was a kid.
- Four, when you cleaned the wounds,
she flexed into the cleaner instead of away from it.
It's hard to fake pain when you've never felt it.
It takes an imaginative leap, Ms. Morganthal.
She wants to see her mom.
If she admits having CIPA,
she knows we're not letting her go anywhere
without a battery of tests.
- If she already knows she has CIPA,
why run the battery of tests?
I feel like House just likes wasting hospital resources.
- [Dr. Foreman] I'm taking her to see her mom.
She was- (cane smacks)
- Imagine he's wrong and he just hit a poor kid.
Oh, why am I laughing?
- Is this a real case or one of those imaginary cases
that happen when you're bored?
- CIPA.
- CIPA is a diagnosis.
Diagnoses happen at the end of cases.
- Thank you.
- She's got no idea what's going on in her body.
There's bound to be something wrong.
- In other words, she could be perfectly healthy,
but you're curious about someone who can't feel pain
because you always feel pain so you wanna go exploring.
- Or maybe because she has CIPA
and was just involved in a major car accident,
you should pan scan her and make sure she doesn't have
internal bleeding or injuries,
which would be a very simple test that House doesn't need
to be present for and he can go home.
- She was in a car accident.
She needs x-rays, blood tests, EEG, nerve biopsy-
- What does she need an EEG for?
What are you looking for,
if she's having a seizure right now?
You can see if she's having a seizure.
- Do your tests, except for the nerve biopsy.
- I need the nerve biopsy- - You'd risk paralyzing her!
- What do you need a nerve biopsy for?
Again, if it's congenital, we know!
There's no need looking for a biopsy and a cause!
- If the EEG reveals a problem, we can talk then.
- But the EEG is not a defining test.
The EEG is gonna show you brainwaves.
Like, what is that gonna tell you?
Maybe they meant an EMG?
And they're just using the wrong acronym?
(machine beeping)
That's an EEG. No idea why they're doing it.
- Spiking on leads C3 and O2.
- She could be going into a seizure.
- What is this? I don't understand.
"She could be"? You can't see it?
- What do you want us to do, hold her down?
- Well, only until you inject her with a sedative.
Then you can let her go.
- We tried.
- Seriously?
- She's strong and doesn't care.
We'd have broken something before we can get her
to sit still enough to inject her.
- So break her arm. She won't mind.
- You're cranky.
- I'm in pain.
- And he's jealous of her for not being in pain.
Little does he know, a world without pain
is a much more dangerous and problematic world
than with pain; ironic.
- Every morning, I have to check my eyes
to make sure I didn't scratch a cornea in my sleep.
- Oh God, stop. I'm in a pool of tears here.
- I can't cry!
- Neither can I.
Every morning I check my eyes for jaundice,
in case the Vicodin's finally shot my liver.
- I can't run anywhere without examining
all my toes for swelling.
- I can't run.
- It's opposite ends of the spectrum.
Neither are good. That's why we have homeostasis.
- I'm sick?
- No, your EEG was normal.
X-ray showed no breaks, blood test showed no infections,
urine indicated no... (foreboding music)
Hannah? (machine beeping)
Call a code.
- Okay, okay, okay.
You do not call a code because someone becomes unresponsive.
She could be having a seizure.
You don't need to call a code.
A code is when someone's heart stops.
- Need ice packs and cooling blankets.
- For what?
(eyes boink)
Do you know what the condition is?
- She's not flushed, she's not sweating. You must mean-
- She has a temperature of 105.
- How does she know?
(bell dings) Oh, 'cause the thermometer
was still hanging out of her mouth?
Normally, if you are a healthy adult,
a fever will be controlled.
If you have a rare condition, it can go out of control
and actually cause harm to your body.
That is why I am a proponent of, in certain instances,
decreasing the amount of Tylenol, Advil, Motrin
that we give to patients when they have a mild fever.
Because a mild fever, generally speaking, doesn't do harm.
In fact, it allows your immune system
to work better and fight off infections,
make your symptoms go away faster,
improve your immune system,
make you spend less time being infectious,
infecting other people.
So like in this case, this is the rare instance
where her fever can fry her brain.
- What if we give her
more pain signals, a lot more pain signals?
Maybe some of them will make it through.
- You wanna torture her?
- No.
Yes, if we do this to anybody else, it's torture.
Doing it to her, it's no different than pricking her finger.
We keep poking sharp sticks into her,
eventually we'll find the part that's already tender.
- That's the most ridiculous thing I ever heard of.
On the off chance that maybe she might feel something
and maybe we'll poke the right area.
What if it's internal?
What are you gonna do then, Chief?
- This is warm, and the other is very hot.
Start here, move to the hot one,
just a few seconds, then back.
We're gonna monitor activity in your brain
while you do it.
If you feel any response to the heat,
it could indicate a vascular problem.
- What?
- She's still in surgery. They tell me it's going okay.
You can take your hand out.
- And you didn't ask anything else?
- [Dr. Chase] Take your hand out of the water!
- What's going on with my mother?
(suspenseful music)
- Hannah!
You just got second degree burns.
- Because you put her arm in scalding water, Doctor!
- I didn't feel anything when you guys
screwed this thing into my head.
- It'll replace missing chemicals in your nerves,
heighten sensitivity.
- What? On what planet?
♪ This would never happen ♪
Oh my god, honestly,
I wish I was this girl simply so I could sue
this hospital and become a billionaire.
Judge, jury, they drilled into my skull
'cause maybe they thought I'd feel it.
I win! That's it, I win.
(machine beeping)
- So what, I just sit here while you guys
drill a hole in me? (drill whirring)
- Just think about it.
If they drill like a centimeter too deep and hurt her brain
and she becomes functionally impaired...
Then what? Like, their pros and cons of this are terrible!
- Stop the drill. (Hannah screaming)
(tool whirring) (metal clattering)
It's okay. What'd you feel? (Hannah whimpering)
Where did you feel it?
Hannah, I need to know how it hurt.
- What just happened?
- Need you.
- What did the nerve biopsy show?
- Never did it.
- Well then, do it! - I can't!
- Why?
- She's gonna jump off the lobby balcony.
- You think I can catch her?
(eerie music)
- House is an ass.
But what did he expect House to do there? (laughs)
Like, for real though, like maybe call security?
I don't know, like- - What do you want from us?
What do you want us to do?
(suspenseful music)
- I can't feel my legs!
- You're trying to pull the same stunt twice in 10 minutes.
- I'm not pretending!
They don't hurt, they're just not there.
(body crashes) (frightening music)
- They couldn't have put something below her
so that if she did jump,
she would at least have a padded surface?
- Anything?
We're not looking for pain.
Anything at all, pressure?
- Nothing.
- You have six broken bones, a fever,
a concussion, erratic heart rhythms,
and a complete lack of sensation below the waist.
- I feel fine.
- [Dr. House] Guilt.
- Guilt, as a symptom?
- (laughs) I've never heard of that.
- Alzheimer's can cause euphoria, pain causes depression,
and B12 deficiency causes guilt.
- If she had a B12 deficiency, she would've been anemic.
They would've seen that on the CBC.
- Give her a shot of B12.
When she gets better, I was right!
- Or check her levels? Like, I don't understand.
- I'm not happy.
Her white blood cell count was low,
and what she's got is just a whole lot of eosinophils.
- High eosinophils could be a worm, a parasitic infection.
- Is it possible for you to just watch me eat,
or do you get some primeval thrill
out of beating the other hunters to the food?
(dramatic music)
- B12 deficiency.
- Are you having deja vu?
We've had this conversation!
She was given B12. She didn't get better.
- Oh, maybe she lacks intrinsic factor to bind it.
- 'Cause someone else ate it.
Get an abdominal MRI.
- What?
- Oh, she has a worm! - What are you doing?
(suspenseful music) (Hannah panting)
- 15.
- You're not going to anesthetize her?
- Relax. It's just a magic trick.
(Hannah screaming)
She's faking it.
We're not falling for it. - "She's faking it!" (laughs)
Lake fishing can be fun.
It can bring the generations together.
If you don't cook that trout or perch well,
you'll be giving room and board to this fella.
And by "free board," I mean all the B12 you could take in.
A tapeworm essentially starts feeding
on the foods that you're consuming,
so it literally takes away nutrients from you.
Most commonly, you can get a B12 deficiency,
but then you would also get a resulting anemia,
which is why this episode's a little confusing,
'cause they said the CBC was normal
outside of a low white count.
(suspenseful music) (guts squishing)
- That's gotta be 25 feet long!
- Dammit, world record's over 60.
- They didn't see the tapeworm
on all of the imaging that they did?
This girl's case is interesting
because she has this condition.
She doesn't feel anything, therefore,
she's not aware of the tapeworm, and that's not unusual.
A lot of people won't be aware of a tapeworm.
But because she has this tapeworm, was not getting B12,
she essentially started having neurologic complications,
as well as having a fever,
because of the infestation of the worm,
and all these other symptoms popped up.
But at the same time, they didn't pop up
like they normally would in a healthy individual.
Her presentation was masked
because she has the condition CIPA.
"Detox Tea is a SCAM!" Click here to check that out.
"Wednesday Checkup" video, it's a throwback.
As always, stay happy and healthy.
(upbeat music)