Episode 3: Occam's Razor
Aired 11/30/04
Brandon, a 22-year old male, passed out after having sex with his
fiancée. He had been complaining about a cough and a rash
beforehand. Now he is suffering severe abdominal pain, nausea, fever
and low blood pressure.
A quick scan and exam reveal nothing, so House and team look for
alternate answers. Dr. Cameron points out that no condition accounts
for this many symptoms. House realizes they need to control the
patients blood pressure first, and they run a core stem test
and an EKG test among others.
The tests dont reveal much, but Dr. Foreman sees a result
that signifies that the antibiotic treatment is shutting down Brandons
kidneys. Foreman theorizes that Brandon has a heart infection, not
a stomach infection, which explains each symptom. Yet this is a
10 million to 1 shot. House, looking at a list of Brandons
symptoms, offers that two possible conditions combined -- a sinus
infection and hypothyroidism -- account for all of Brandons
symptoms. And thats only a million to 1 shot. Since theres
no time to wait for test results, he wants to start treating the
sinus and thyroid immediately.
Foreman checks in on Brandon. The patient is feeling better but
is still stuck with a cough. Foreman reports that Brandon tested
negative for hypothyroidism. He insists that it cant be two
illnesses and Houses treatment regimen will only harm Brandons
liver. It could even kill him. House offers Foreman a $50 bet. If
Brandons white blood count goes up, Foreman is correct in
presuming that hes actually fighting off an infection.
Brandons white blood cell count drops. Both of their hypotheses
were wrong. If Brandon gets so much as a cold, his body wont
be able to fight it off and he will die. House has a revelation.
He asks Dr. Wilson which of Brandons symptoms came first.
It was the coughing.
After a little research, House knows the answer. Brandon had visited
a doctor for his cough and his prescription for cough medicine was
accidentally filled with gout medicine. That medicine stops mytosis,
the process in which cells divide and replace dead cells. This is
not occurring, which explains each of the symptoms. But Dr. Cameron
points out that Brandon did improve, but then worsen after checking
into the hospital and stopping the gout medicine.
House meets with Brandons parents and demands to know who
prescribed the cough medicine which led to their sons deterioration.
His mother gave it to him. She produces the pill bottle, which validates
Houses thinking. Chase and Brandons mother visit the
pharmacy. Brandon was indeed taking cough medicine and not gout
medicine, disproving Houses theory. House is incredibly annoyed
that his elegant, thoughtful hypothesis wasnt proven right.
Dr. Wilson suggests exploratory surgery to find out whats
in Brandons blood. During the prep for surgery, Brandons
heart stops beating and the doctors shock him back to life. Cameron
tells House about the surgery emergency and also mentions that Brandon
is experiencing pain in his fingers. House has another revelation.
He barges into Brandons clean room and announces his diagnosis
of colchicine poisoning. The order of Brandons symptoms fits
perfectly, which means that Brandon is doing drugs. Brandon admits
that hes done ecstasy twice, which House notes is cut with
colchicine. A quick fix and Brandon will be just fine.
- From Fox.com
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