- House: "What were we talking about?"
- Chase: "Two patients with two symptoms in common and five symptoms not in common."
- House: "While you were all wearing your ‘Frankie Says Relax’ T-shirts, I was treating a 73-year-old woman who went through this progression of symptoms, the last of which was [death]. In case any of you missed that class in med school, that one’s untreatable"
- — All In
All In is a 2nd season episode of House which first aired on April 11, 2006. A young boy seems to have the same symptoms as one of House's old patients who ended up dying, and the team attempts to find out what killed her in time to save him. Meanwhile, House tries to keep Cuddy away from him by helping Wilson during poker night.
The boy is one of Cuddy's patients, but she is busy at a charity poker tournament with House and Wilson. When Cuddy hears the boy's symptoms, she figures it is gastroenteritis and dehydration, orders fluids, and returns to her game. However, House gets interested. He decides to fold his winning hand and leave the table.
House heads to the emergency room to see the boy. He tests his ability to follow objects with his eyes and notes that he is having trouble perceiving objects in three dimensions, showing his brain is disconnecting from his muscles. House can't give the parents any reassurance.
House lists seven symptoms on the whiteboard, only a few of them from which the patient is suffering. House lies and says Cuddy assigned him the case. House then stares at Cameron in her gown for a second before getting back to business. He tells his team about Esther, who wound up dying. Chase dismisses House's concerns, but House orders the team to do a colonoscopy and test for Erdheim-Chester disease, an incredibly rare disorder.
Chase and Foreman do a colonoscopy but see nothing unusual. Chase tells Foreman that this is not the first time that House has tried to treat "Esther's disease." Cameron explains Erdheim-Chester to the parents and tells them that they are testing for it no matter how unlikely it is. Foreman does a biopsy on the intestine.
The biopsy turns out to be negative for Erdheim-Chester. House orders a kidney biopsy, but Chase refuses, saying House is making a mountain out of nothing – the kid has a viral gastrointestinal disease. However, when they go to tell the parents, they note that the patient's urine is brown, showing kidney failure – the next of Esther's symptoms.
Although the kid doesn't appear to have Erdheim-Chester, they have to figure out what is wrong as he is getting worse. Chase suggests a treatment, but it's exactly what House did with Esther (it didn't work.) Cameron suggests lymphoma, and House agrees to test for it. However, he orders his team not to tell Cuddy.
House calls Wilson to keep Cuddy busy at the poker game. He has Wilson tell him the status of the hand through the use of blatantly transparent code talk and advises him that Cuddy is bluffing. Wilson misses his flush draw against Cuddy's two pair. Cuddy is now more interested in the game and, of course, out of House's way.
Cameron explains the treatment to the parents and tells them that the last patient with these symptoms died within 24 hours of being admitted. The parents are asked to speak to their son about staying still for the imaging machine.
The scan shows a small mass near his pituitary gland, most likely a lymphoma. However, the blood tests are negative. House leaves and breaks into the coffee shop to get a coffee. He orders his team to give the patient any drug they can think of that will protect his liver – the next thing that is likely to fail.
House calls Wilson again. He gives him more advice, telling him that Cuddy is bluffing again, and Wilson decides to go all in. Cuddy folds, and Wilson is delighted.
The patient's liver is stable, but his platelet levels are dropping. Suddenly, the patient starts having trouble breathing. House goes back to the whiteboard and writes "respiratory distress" – the child has skipped two symptoms Esther had and is now at the trait that had preceded death.
The patient is put on a ventilator, while House tries to figure out why the disease is progressing so quickly. House calls Wilson for an oncology consult, and tells him to go all-in or else he will tell people that Wilson wears toenail polish. Cuddy shows that she has three nines. However, Wilson shows his straight, sending Cuddy away.
Wilson takes a break to give House a consult. However, Wilson doesn't think it is cancer. Wilson believes it is Kawasaki's disease, but it wouldn't have affected Esther. House decides it's their best guess, though, and orders multiple tests. Wilson realizes House is still trying to treat Esther. He tells Wilson to go back to the tournament.
The team checks the patient's coronary artery, but they don't see any problems. However, Chase notes a problem with the right atrium – a mass. House wants a biopsy and does it himself. However, during the procedure, the patient goes into cardiac arrest. It takes them eight minutes to get his heart beating again – the patient might have brain damage. House proceeds with the biopsy.
House still tries to figure out what is wrong despite the fact the patient probably has brain damage from the cardiac arrest. The team keeps coming up with likely diagnoses when Cuddy comes in, angry. House takes all the blame for his team for not telling her. She takes the case back and tells House not to go near the patient. However, House keeps up the differential and tells his team that they can still test the sample from the biopsy. They realize they can check it about three times. There are seven possibilities to test for. They decide to start with histiocytosis. However, the test is negative. The next thing they choose to check for is tuberous sclerosis – it's less likely, but the test is more reliable. However, that test is negative too.
Down to one test, they discuss the five remaining possibilities. Chase wants to test for neurofibramatosis because it's the most treatable. Cuddy finds House with the patient and asks him if he's figured out what is wrong.
Wilson finds House and tells him that he won the tournament. Wilson's last opponent hit a pair of kings on the flop, but Wilson had been slowly playing a couple of pocket aces and caught him when his opponent went all-in on the river. House decides to test for Erdheim-Chester again – he thinks the first test was negative because the disease hadn't reached the digestive tract yet. The team objects, but House insists. They do the test – and it turns out positive – like the aces, the disease had been there all along but had been hiding. House orders them to start the treatment.
The patient starts improving and breathing on his own again. House and Wilson start playing a little poker on the side, and Wilson says that House was lucky when he did the final test.
In this episode, when House pulls out Esther Doyle's file, it is labeled Ester Doyle. However, when House writes her name on the whiteboard, he includes an "h" making her Esther. However, as House is traditionally terrible with patient relationships and frequently forgets patient names, so this could be seen as a deliberate choice by the director.
Zebra Factor 10/10
Erdheim-Chester is an amazingly rare disease, with only a couple of hundred recorded cases. However, it doesn’t present as it does in this episode. Although Erdheim-Chester is usually fatal, it is a chronic disease, not an acute one that kills within a day of onset of symptoms. Besides, Erdheim-Chester is treatable, but not curable.
- It is shown that House keeps the case file of a patient he failed to save twelve years ago.
- Wilson eventually wins the Oncology Benefit Poker Tournament.
- House shows interest in Cameron by staring at her and saying "Woah".
The title refers to two things:
- House's obsession with both the case of the current patient and Ester.
- One move you can do in the game of poker is announcing an 'All in' where you bet your entire stake, forcing other players to push in a high amount if they hope to stay in the game.
Trivia and Cultural References
- House carries a silver tipped dress cane in this episode, previously seen briefly in Sports Medicine.
- The title of the episode is a term from poker played for no-limit table stakes when a player is declaring that he or she is betting all of their remaining chips.
- The piece House plays on the piano at the end of the episode is "Hymn to Freedom" by Oscar Peterson.
- The great white shark is the largest predatory fish in the world (although not the largest shark – the whale shark is larger, but eats plankton). It is common in the waters off of Australia.
- The reference to “Frankie Says Relax” is from the song Relax by Frankie Goes to Hollywood. It was first released in 1983 – a bit early, even for Chase, who would have been under 10 when it was released.
- When Wilson is talking in code in a British accent, he refers to “Piccadilly Square,” but means Piccadilly Circus, a major road intersection, shopping, and entertainment district, and underground railway exchange in London, England. House‘s reply is a reference to the Normandy Campaign involving the invasion of German-occupied France in World War II, the fleet for which gathered at a location code-named Picadilly Circus.
- The reference to Ester’s case being House’s Great White Whale is from Moby-Dick, a 19th-century novel about a whaling ship captain obsessed with the whale that crippled him. Like House, Captain Ahab only had one good leg.
- "Casey at the Bat" is a poem about baseball written in 1888.
- House's statement regarding barnacles at the end of the episode is, so far as is known, accurate.
- The former patient's last name "Doyle" could be a nod to Sherlock Holmes' author Sir Arthur Conan Doyle.
- House says his lucky number is 42, a prominent number in Douglas Adams' "The Hitchiker's Guide to The Galaxy", where it's the answer to the "Ultimate question of Life, the Universe and Everything".
- Hugh Laurie as Gregory House
- Lisa Edelstein as Lisa Cuddy
- Omar Epps as Eric Foreman
- Robert Sean Leonard as James Wilson
- Jennifer Morrison as Allison Cameron
- Jesse Spencer as Robert Chase
- Laura Allen as Sarah Alston
- Mackenzie Astin as Alan Alston
- Carter Page as Ian Alston
- Al Espinosa as Dr. Wells
- Michelle Harrison as Nicole Ballard
- Purva Bedi as Teacher
- Daylon Reese as Michael
- Episode page at IMDB
- Episode article at Wikipedia
- A review of the medicine at Polite Dissent
- Episode review at Blogcritics
- Episode page at House MD Guide
- Episode article at The TV IV
Sleeping Dogs Lie