"All In" is the seventeenth episode of the second season of ''

House A house is a single-unit residential building. It may range in complexity from a rudimentary hut to a complex structure of wood, masonry, concrete or other material, outfitted with plumbing, electrical, and heating, ventilation, and air c ...

'', which premiered on

Fox Foxes are small-to-medium-sized omnivorous mammals belonging to several genera of the family Canidae. They have a flattened skull; upright, triangular ears; a pointed, slightly upturned snout; and a long, bushy tail ("brush"). Twelve species ...

on April 11, 2006.

Plot

During a field trip in a museum exhibit about the human body, six-year-old Ian Alston is found to have

bloody diarrhea Dysentery ( , ), historically known as the bloody flux, is a type of gastroenteritis that results in bloody diarrhea. Other symptoms may include fever, abdominal pain, and a feeling of incomplete defecation. Complications may include dehydrat ...

. Meanwhile, at a charity casino night at Princeton-Plainsboro, House, Wilson, and Cuddy are engaged in a game of

Texas hold 'em Texas hold 'em (also known as Texas holdem, hold 'em, and holdem) is the most popular variant of the card game of poker. Two cards, known as hole cards, are dealt face down to each player, and then five Community card poker, community cards ...

poker Poker is a family of Card game#Comparing games, comparing card games in which Card player, players betting (poker), wager over which poker hand, hand is best according to that specific game's rules. It is played worldwide, with varying rules i ...

when Cuddy receives the news about her new patient. She dismisses it as

dehydration In physiology, dehydration is a lack of total body water that disrupts metabolic processes. It occurs when free water loss exceeds intake, often resulting from excessive sweating, health conditions, or inadequate consumption of water. Mild deh ...

and

gastroenteritis Gastroenteritis, also known as infectious diarrhea, is an inflammation of the Human gastrointestinal tract, gastrointestinal tract including the stomach and intestine. Symptoms may include diarrhea, vomiting, and abdominal pain. Fever, lack of ...

, but House, recognizing the symptoms and thinking this could be more than what she suggested, decides to drop out of the game (folding a pair of aces to Cuddy's bluff) and take the case behind her back. With his suspicion, House tests Ian's coordination by asking him to reach out and grab his cane, which takes Ian multiple grasps until he actually touches the cane. House concludes Ian has

ataxia Ataxia (from Greek α- negative prefix+ -τάξις rder= "lack of order") is a neurological sign consisting of lack of voluntary coordination of muscle movements that can include gait abnormality, speech changes, and abnormalities in e ...

and begins to assume Ian has the same disease as a former patient from twelve years ago, 73-year-old Esther Doyle, who died under House's care and was never correctly diagnosed. House then drags Cameron, Foreman, and Chase out of the party to perform a differential diagnosis. Drawing up a list of all of Esther's symptoms, House is able to predict what will happen to Ian next, as well as how long it will take him to get there. House first suspects it is

Erdheim–Chester disease Erdheim–Chester disease (ECD) is an extremely rare disease classified as a non- Langerhans-cell histiocytic neoplasm. In 2016, the World Health Organization (WHO) defined ECD as a slow-growing blood cancer that may originate in the bone marrow o ...

and orders a

colonoscopy Colonoscopy () or coloscopy () is a medical procedure involving the Endoscopy, endoscopic examination of the large bowel (colon) and the distal portion of the small bowel. This examination is performed using either a Charge-coupled device, CCD ...

, but tests are negative. House, knowing the next symptom that will develop is kidney damage, orders a kidney

biopsy A biopsy is a medical test commonly performed by a surgeon, interventional radiologist, an interventional radiologist, or an interventional cardiology, interventional cardiologist. The process involves the extraction of sampling (medicine), sample ...

, which turns out to be negative. The rest of the team, annoyed, tell House that all Ian has is a stomachache due to some bad food. But after discovering Ian's urine

catheter In medicine, a catheter ( ) is a thin tubing (material), tube made from medical grade materials serving a broad range of functions. Catheters are medical devices that can be inserted in the body to treat diseases or perform a surgical procedure. ...

bag full of brown urine, they realize that Ian's kidneys are indeed failing and that they are already far too damaged to be saved. The team is forced to do another differential diagnosis, however many of the diseases proposed, House already tested for twelve years ago. Next the team postulates it is

lymphoma Lymphoma is a group of blood and lymph tumors that develop from lymphocytes (a type of white blood cell). The name typically refers to just the cancerous versions rather than all such tumours. Signs and symptoms may include enlarged lymph node ...

and tries more tests. To keep Cuddy busy and off the case, House calls Wilson and has him stall her in the poker game. However, tests are negative for lymphoma. Unable to determine what disease afflicts the two people, House orders immediate treatment to protect Ian's liver, which was the next symptom Esther developed. His plan succeeds and Ian does not develop liver damage, but instead skips the next two symptoms and goes into

respiratory distress Shortness of breath (SOB), known as dyspnea (in AmE) or dyspnoea (in BrE), is an uncomfortable feeling of not being able to breathe well enough. The American Thoracic Society defines it as "a subjective experience of breathing discomfort that c ...

. Thinking it could be cancer, House includes Wilson in the differential. Wilson suggests

Kawasaki disease Kawasaki disease (also known as mucocutaneous lymph node syndrome) is a syndrome of unknown cause that results in a fever and mainly affects children under 5 years of age. It is a form of vasculitis, in which medium-sized blood vessels become in ...

, but before the team begins tests, they discover a mass in his heart. Postulating that Ian, being younger than Esther, has a stronger immune system and can last longer while under assault from this unknown disease, House orders a heart biopsy on Ian. Wilson, recognizing House's ongoing grapple with Esther's case, warns him not to become obsessed, using

Moby Dick ''Moby-Dick; or, The Whale'' is an 1851 Epic (genre), epic novel by American writer Herman Melville. The book is centered on the sailor Ishmael (Moby-Dick), Ishmael's narrative of the maniacal quest of Captain Ahab, Ahab, captain of the whaler ...

as an allusion. During the biopsy, as House collects the sample from Ian's heart, the catheter induces

cardiac arrest Cardiac arrest (also known as sudden cardiac arrest CA is when the heart suddenly and unexpectedly stops beating. When the heart stops beating, blood cannot properly Circulatory system, circulate around the body and the blood flow to the ...

in Ian, prompting an enraged Cuddy to pull House off the case and ban him and his team from performing any more tests on Ian. However, House refuses to give up, stating that they still have the mass obtained from the biopsy and can perform the tests on that. The team suggests seven likely diseases but only has enough tumor mass to perform three tests. First the team tests for

histiocytosis In medicine, histiocytosis is an excessive number of histiocytes (tissue macrophages), and the term is also often used to refer to a group of rare diseases which share this medical sign, sign as a characteristic. Occasionally and confusingly, th ...

, but it is negative. Next they test for

tuberous sclerosis Tuberous sclerosis complex (TSC) is a rare multisystem autosomal dominant genetic disease that causes non-cancerous tumours to grow in the brain and on other vital organs such as the kidneys, heart, liver, eyes, lungs and skin. A combinatio ...

but that is negative also. Desperate and with only one remaining test, House wanders the hospital trying to think of his next move, when he hears from Wilson that he won the poker tournament. Wilson won only because he had kept his hole cards, two aces, hidden the entire game, prompting House to have an epiphany. He realizes that the disease also remained a secret until the end because they biopsied the colon before the disease had reached the

Gastrointestinal tract The gastrointestinal tract (GI tract, digestive tract, alimentary canal) is the tract or passageway of the Digestion, digestive system that leads from the mouth to the anus. The tract is the largest of the body's systems, after the cardiovascula ...

. House then orders his team to perform the final test on the first disease suggested:

. In dismay, the team pleads, telling him they cannot waste their sample on a test for a disease they know he's negative for. House explains his reasoning about the disease not reaching the GI tract and orders the test anyway. The once-skeptical team is pleased when the test turns out positive, Ian is saved, and House finally discovers what killed Esther. The episode ends with House and Wilson playing poker and joking as they did in the beginning of the episode.

References

External links

"All In"
at Fox.com * {{House (TV series) House season 2 episodes 2006 American television episodes