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Andie
|
I've nEver kissed a boy.
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Chase
|
There's time yet for that.
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Andie
|
There was a boy last summer; I was at one of those cancer camps.
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Chase
|
Uh huh.
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Andie
|
I just nEver had the guts to ask him. You know there's a good chance I'm not gonna walk out of this hospital. Even if I do I'm nine. There's not a lot of kissing going on in the third grade.
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Chase
|
You will walk out of here, alright, and you will kiss a boy. There you go. A smile.
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Andie
|
Will you kiss me?
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Chase
|
No.
|
Andie
|
No one will Ever know.
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Chase
|
I'm! I'm! I'm sorry I can't.
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Andie
|
I won't tell anyone.
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Chase
|
Listen, you're nine years old I'm thirty.
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Andie
|
I just want to know what it feels like. Once.
|
Chase
|
This isn't your last chance for that.
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Andie
|
What if it is? Please kiss me.
|
House
|
Bagels.
|
Foreman
|
You didn't sleep in.
|
House
|
Didn't sleep. Didn't breathe. I'm dying.
|
Chase
|
Pulmonary angiogram of Andie's lungs was clean. Arterial blood gasses and a CT scan were also normal. Her heart and lungs are fine.
|
House
|
Which gives us no explanation for the diminished sat percentage.
|
Foreman
|
Yeah oddly enough sometimes normal is normal.
|
House
|
Sometime we can't see why normal isn't normal. Get her symptoms on the board.
|
Cameron
|
Whoa; you're letting me touch the markers?
|
House
|
It's written down in my advanced health care directive, should I be incapacitated in any way you run the board, then Foreman. Chase you're just not ready yet. What else?
|
Foreman
|
Guys, I know we ruled out infection but if we forget the labs for a minute, there is one infection we didn't test for because of her age. Neurosyphilis.
|
Chase
|
There's no way.
|
Foreman
|
If the infection dipped into her cerebral cortex all peripheral functions could be compromised.
|
Chase
|
No she hasn't had sex, she's nine!
|
Foreman
|
Maybe it wasn't her idea. I mean she's been around a lot of adults; all the hospital visits, the counselors at the cancer camps.
|
Cameron
|
You think she's been molested.
|
Chase
|
She's hiding it pretty well if there's any of that going on.
|
House
|
Yeah, all girls who've been molested want to talk about it. Break out the rape kit.
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Chase
|
She hasn't had sex.
|
House
|
Why are you so sure?
|
Chase
|
She told me she'd nEver kissed a boy.
|
House
|
You read her diary too?
|
Chase
|
She asked me to kiss her.
|
House
|
I rest my case. A regular nine year old girl does not have sex on the brain, not when a doctor is threading a catheter through her vein.
|
Chase
|
But she's not a regular nine year old. She's got terminal cancer.
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House
|
Cancer doesn't make you special. Molestation on the other hand!
|
Chase
|
She wanted one kiss before she dies. If she's nEver kissed a boy it's a fair bet she's nEver had sex.
|
House
|
Tell that to all the hookers who won't kiss me on the mouth. Hey, here's a theory, she has been molested, seeks refuge in roMantic fantasies with older men with great hair. And I think you left out the punch line, victims of molestation learn to work the angles. Manipulate people. You did it didn't you. You kissed her.
|
Chase
|
It wasn't sick. [Foreman and Cameron freak out quietly] It was one kiss for a dying girl. One small! one small kiss before she dies. Thank you. Thanks.
|
House
|
This is exactly why you can't touch my markers. Go see if she's had sex.
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Cameron
|
Okay.
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Andie
|
No one's Ever touched me.
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Cameron
|
We just need to be sure.
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Andie
|
I like your hair. I used to have really curly hair. I always wanted it to be like yours is.
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Cameron
|
Thank you. Alright, that's it, you're fine.
|
Wilson
|
With a Patient.
|
House
|
Is she dying?
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Wilson
|
No.
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House
|
Then she can wait.
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Wilson
|
Would you excuse me, just 2 minutes.
|
House
|
If only she'd been molested then we'd have something to go on. [He tries to open a jar of mentholatum] No forced entry.
|
Wilson
|
One hallucination; maybe it was just bad pork, maybe there's nothing!
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House
|
She's not fine. Her sat percentage dropped another point.
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Wilson
|
Which could suggest a tumor in her lung.
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House
|
Lung wouldn't explain the hallucination. CT scan showed both lungs were clean, which means there's a tumor in her heart.
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Wilson
|
Not a chance. Give me that.
|
House
|
I loosened it.
|
Wilson
|
I opened it. We've got an MRI and an echo of her heart, there's nothing there.
|
House
|
Give me one other explanation for low oxygen saturation.
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Wilson
|
I can't. There's only one condition that simultaneously affects the heart and the brain but she!
|
House
|
Perfect let's go with that.
|
Wilson
|
Tuberous Sclerosis in a kid that also has Alveolar Rhabdomyosarcoma. Two different unrelated cancers at the same time is a statistical no no.
|
House
|
What's the rate of cancer in the general population? 1 in 10,000?
|
Wilson
|
Don't, don't start with the numbers.
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House
|
The way I figure it 1 in 10,000 of them should have another cancer. Little girl won the lottery twice. It happens.
|
Wilson
|
So you're gonna cut her open?
|
House
|
Exploratory surgery, gotta find this thing.
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Wilson
|
You're just going to grope around inside an immuno-compromised nine year old? She could die on the table.
|
House
|
I know it's somewhere near the heart.
|
Wilson
|
House, you've gotta do better than that.
|
Foreman
|
Why are we here?
|
House
|
Better acoustics. Now listen to this.
|
Chase
|
That's a mitral heart valve.
|
House
|
No, get the wax out of your ears. This is the Patient's aortic valve. I downloaded the audio of her echocardiogram.
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Foreman
|
What are we trying to hear?
|
House
|
Tumor.
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Chase
|
They tend to keep quiet on account of them not having any mouths.
|
House
|
But we could hear an abnormality in the sound of the valve, which would indiCate the presence of something; a tumor for example. If we can tell the surgeon where to look this is no longer exploratory surgery it's a precision strike.
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Foreman
|
Her aortic valve sounds normal.
|
House
|
Too bad. Now listen to the dulcet tones of Andie's tricuspid valve.
|
Cameron
|
Normal.
|
House
|
And this is her mitral valve.
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Chase
|
I don't hear anything weird.
|
House
|
You guys make me sad. Listen again.
|
Chase
|
She's had one hallucination. Why are we operating on her? Why are we risking her life?
|
House
|
Because Wilson thinks it'll be nice to give the girl a year to say good bye to her mommy. I guess maybe she stutters or something. Now shut up and listen. Tricuspid. Mitral. Again.
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Cameron
|
Wait. There. There's an extra flap.
|
House
|
I'm gonna ask the surgeon to look at the mitral valve first. Chase, I want you there. I don't like reading surgeons reports, they're boring.
|
Chase
|
I'm not really sure I should be spending more time!
|
House
|
She'll be unconscious you'll be safe.
|
Mom
|
I'll be there when you wake up.
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Andie
|
I'm gonna be fine mom.
|
Wilson
|
Brave kid, she Even gave her mom a pep talk.
|
House
|
Sure. Brave. She's a wonder.
|
Wilson
|
What's your pRoblem?
|
House
|
These cancer kids; you can't put them all on a pedestal. It's basic statistics some of them have to be whiny little fraidy cats.
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