Cyrus Harry is the sick lottery winner who is searching for his ex-girlfriend Jennifer Williams in the episode Changes. His cousin and limo driver is Phil. He was a refrigerator mechanic before he won the lottery. He was portrayed by actor Donal Logue.
Medical History
The patient has had his appendix removed. He has several tattoos.
Case History
Cyrus collapsed when he couldn't move his leg. His cousin called for an ambulance and Cyrus was taken to the emergency room at Princeton-Plainsboro Teaching Hospital. He was given a CT Scan of his head, a lumbar puncture, an MRI of his spine and an EMG, but all the results were normal. His case was assigned to Dr. House. Dr. Hadley suggested a loss of balance from a neurological problem, but the patient had already been given a vestibular caloric test which was normal. Dr. Foreman thought it was probably exposure to toxins from his former job. Dr. Taub thought that the patient's change in lifestyle may have contributed - collecting something with toxins like ceramics or precious metals which caused atherosclerosis in his carotid artery. Dr. House ordered an environmental scan of his old workplace and a medical history to see if he had any major lifestyle changes.
Dr. Taub asked Cyrus about any new hobbies, but he denied having any. He denied using drugs. However, the patient's diet hadn't changed - he still ate mostly canned foods.
Dr. Chase and Dr. Foreman did the environmental scan. They found metal cutting equipment, but Dr. Foreman felt it would be impossible for that to have resulted in illness as the exposure would have been minimal. However, Dr. Chase did find some unmarked solvent.
The leading theories were heavy metal poisoning from the canned goods or inhalation of a volatile substrate. Dr. Hadley noted that the treatment for both was chelation therapy. Dr. House agreed, but instead ordered forced diuresis for the heavy metal poisoning, and if that didn't work, dialysis for the inhalants. Dr. Foreman pointed out that dialysis risked infection and hemodynamic swings. Dr. House pointed out if chelation worked, they still would not know what caused his illness so they could prevent a re-occurrence.
However, Dr. Hadley ordered chelation instead. However, when she went to see the patient, she had found out that Dr. Cuddy had suspended Dr. House’s hospital privileges.
Dr. House and his team realized Dr. Cuddy had an ulterior motive for suspending his privileges. Instead of conceding, Dr. House discharged the patient. Dr. Hadley explained to the patient it would only be for a little while until Dr. Cuddy agreed to restore Dr. House's hospital privileges. However, as he was about to be discharged, he vomitted even though he didn't feel nauseous. His hands started shaking. Dr. Hadley examined him and realized he was having a focal seizure. He was now not stable enough to be discharged.
The seizure pointed to a brain issue, but ruled out both heavy metals and toxic inhalation. Dr. Cuddy agreed to restore Dr. House's hospital privileges.
Dr. Foreman thought it might be Lyme disease. However, the patient had tested negative for it. Dr. Taub suggested postural hypotension, which would have reduced blood flow to the brain. However, Dr. Hadley pointed out the paint was not orthostatic. Dr. Hadley suggested herpes encephalitis. Dr. House agreed and ordered an EEG to confirm and aciclovir to treat.
Dr. Hadley performed the EEG. It showed no brain problems, but did show signs of metabolic distress. They scanned the patient's abdomen and found a mass on the pancreas. Dr. House went to consult Dr. Wilson who agreed the mass looked like cancer and pointed out paraneoplastic syndrome would explain the neurological symptoms.
They used a CT Scan to guide a biopsy to confirm. However, in addition to the mass on the pancreas, they found one on a kidney and another on his colon. One mass looked avascular, another looked vascular and the third looked calcified. The patient appeared to have three different forms of cancer.
Dr. Hadley suggested multiple cancer syndrome and Von Hippel-Lindau syndrome. However, that doesn't affect the colon. Dr. Hadley suggested the patient was missing a gene that suppressed tumors. Chemotherapy was not an option because the patient's platelet count was too low. Dr. House suggested giving the patient vascular endothelial growth factor to make the tumors grow so they could find where they went next and what they have in common. He instructed his team to get the patient's consent.
Dr. Taub and Dr. Hadley explained the treatment plan to the patient. He agreed to be given the drugs. His blood was monitored. Dr. Taub performed an ultrasound to look for new growths, but instead he found no new tumors and that the existing tumors had shrunk.
The shrinking of the tumors seemed to discount the theory that he was missing a tumor suppressor gene. Dr. Foreman thought it might be an autoimmune disease and the antibodies had shrunk the tumors. However, the growth factor would have treated any autoimmune conditions. Dr. Taub thought that perhaps it wasn't cancer in the first place, but Dr. Foreman pointed out that they had confirmed it with a biopsy, although he admitted it could have been a false positive. Dr. Hadley suggested amyloidosis. The patient’s EKG voltage was on the low end of normal and the tumors may have been protein deposits. Dr. House ordered a new biopsy of the digestive tract to confirm and chemotherapy to treat. However, Dr. Foreman objected. The patient's platelet count was still too low and basing a diagnosis of amyloidosis on low voltage was a stretch. Dr. House would not change his mind.
After an emotional encounter with his cousin, the patient started crashing from multiple organ involvement. Dr. Hadley administered oxygen. The patient suffered a cardiac arrest and even before they started chemotherapy, his lungs and liver had failed. This ruled out amyloidosis.
However, Dr. House was intrigued by the fact that the patient was showing brain symptoms without any brain involvement. He finally determined the patient had a teratoma that was full of primitive cells, some of which turned into brain cells. When they escaped the teratoma and spread in the bloodstream, the body created antibodies to destroy them which caught the patient's real brain cells in the crossfire. The primitive cells also accounted for the tumors. However, because they grew so quickly, they collapsed from an inability to maintain themselves. He just needed surgery to remove the teratoma and the remnants of the tumors.