Woman Catches the BUBONIC PLAGUE _ House M.D. _ MD TV

Now, where were we before we were so rudely interrupted by the liver transplant? WD carboxylase was processed normally, and seroloplasma and copper levels were normal, so no Wilson's disease. Gastric content was negative for spores, so no mushroom toxicity. And initial tests were negative for cancer. Which cancer were you looking for? Any of them. We ran blood tests for ovarian, lung, and lymphomas. I'm not going to tell you much. Her blood was taken after she was given immunosuppressants. They fight rejection. They also mess up our ability to get any clear readings. Great battles kick up a lot of dirt. Obscure the battlefield so generals can't see what's going on. So what are your orders, General House? Sound the retreat. How are you feeling? Is Max OK? She's still unconscious, but her vitals look good. We need to stop all the immunosuppressant drugs which are protecting your new liver. But if you stop the drugs, I'll die. You're dead anyway if we don't figure out what caused all this. By removing any outside influences, it'll help us see what's really going on with your body. So you did all this to buy me a couple of days, and now you're taking them back. Will it hurt? As your body goes into acute organ rejection, your liver will begin to swell. That'll put pressure on. Yeah. It'll hurt. We can knock you out. No. If Max wakes up, I want to talk to her. Fever's 106. She's in full rejection mode. Is that supposed to surprise me? Her white count is normal. Normal is not normal. She's been on steroids. Transplant team gave her a cocktail of immunosuppressants. She hasn't slept in over a week. Her white count should be in the tank. Looks like the problem is some sort of infection. Probably caused by hypotension. Shocked the liver. We should stop broad spectrum antibiotics. Yeah, you might want to add some chicken soup. It's just as useless, but it's got chicken. We need to know exactly what kind of infection we're dealing with. What infection causes sleep disturbance, bleeding, movement disorder, organ failure, and abnormally normal white count. What about tularemia? Chest was clear. Tularemia doesn't cause movement disorders. It would if she developed meningitis. There was no ulcerations on the skin. The bleeding, it looks more like leptospirosis. Without conjunctivitis and elevated creatinine? What about typhoid or some kind of relapsing fever? Makes sense if we were in the Sudan. You sure she hasn't been out of the country? She hasn't even been out of the state in at least a year. Neither has Max. Maybe she lied. You talk to her friends, neighbors? You don't know? Come on, if you don't stay up to date on my notes, where's your next article going to come from? Talk to the dog? We're not as up on foreign languages as you are. Has the dog been traveling? It came from a breeder. Where? I don't know. Place called Blue Barrel Kennels. They only had the thing for like two days. Blue Barrel is a kind of cactus. You see many cacti in Jersey? Want to see a magic trick? Oh, no. Where'd it go? Where'd it go? Is it here? No. How about here? There it is. It doesn't look anything like a nose. That wasn't there this morning. Call CDC. Tell them what? Maybe have a patient with the plague. The Black Plague? Looks that way. Plagues carried by rodents, not dogs. Where there's dogs, there's fleas. If they hail from the southwest and those fleas can't tell the difference between prairie dogs and puppy dogs, a small percentage of plague cases present with sleep disturbance. Imagine an idyllic river of bacteria. It's not idyllic for her, but it serves my purposes. The steroids and immunosuppressants acted like a big, honking dam across the river. Physics 101 put a dam up in front of a raging river. The river rises. By stopping the immunosuppressants, we blew up the dam, and a 100-foot wall of bacteria flooded her lymph nodes. We'd better find out where that dog is now. After you restart the immunosuppressants and fill her up to the eyeballs with streptomycin, sulfate, gentamicin, and tetracycline, use a garden hose if you've got one. Get yourself some prophylactic treatments as well. I've got the plague. Don't worry. It's treatable. Being a bitch, though. Nothing we can do about that.