House cutting big toe S01E02
May 24, 2005
Episode Number
1.22 Rating
Guest Star(s)
Zebra Factor

House (to Wilson): "All I know is he sued some doctors. Who am I to assume that they didn’t have it coming to them? (sees Cuddy) The cutest little tennis outfit! My god I thought I was going to have a heart attack! Oh my! I didn‘t see you there, that is so embarrassing!"
Cuddy: "How's your hooker doing?"
House (to Wilson): "How sweet of you to ask. Funny story, she was going to be hospital administrator, but just hated having to screw people like that."
— Paternity

Paternity is a 1st season episode of House which first aired on May 24, 2005. A 16-year-old boy comes to the hospital complaining of double vision and night terrors after being hit in the head by a lacrosse stick. House is dismissive until he notices a myoclonic jerk in the boy's foot. After a near-fatal hallucination and several faulty diagnoses, House is mystified until he learns the boy's true paternity.


A lacrosse player, Dan, starts suffering from double vision while playing in a game. When he is checked by another player, he falls to the ground and there is blood all over his face. His trainer runs over to him, but Dan is unresponsive and the trainer calls for a doctor.

Gregory House is reading gossip magazines in the clinic when James Wilson finds him hiding in an exam room. House has five minutes until he can leave and doesn't want to treat someone who will take half an hour to pamper. Wilson asks him why he doesn’t just tell Cuddy he has an urgent case, but House replies he has no cases right now. Wilson is incredulous that House and his team have no cases. Meanwhile Allison Cameron is answering mail while Robert Chase does a crossword puzzle with help from Eric Foreman.

When House tries to leave the clinic, he finds a man with a letter, addressed from House, that says he would take his son's case. When House sees the letter, he goes to confront Cameron about forging his signature. She starts describing the case and House gets interested in the night terrors the patient is going through.

He agrees to see the family, against his usual procedure. He examines the patient, who has barely slept for three weeks. The patient can't name any animals starting with the letter B. House thinks it is either post-traumatic stress disorder or sexual abuse. Dan denies abuse, but he admits he was hit in the head during lacrosse, but notes that he had double vision before he was hit. House chides Cameron for not knowing about the trauma. The parents object - the emergency room did a full set of scans on Dan and found nothing, but House in unswayed and tells him to see an ophthalmologist. Cameron objects, but House says she's just objecting because she thinks his behavior is all about what she did. Based on her acting like everything is about her, he surmises that she's an only child, which she denies. However, as House looks into the exam room, he notices a twitch in Dan's leg - a myoclonic jerk which only happens in people who are about to fall asleep. House gets intrigued and orders him admitted.

They start a differential. Foreman is worried it is neurological, in which case it can't be treated. House rules out Chase's suggestion of infection. House also thinks that the patient's father isn't his biological father. Foreman bets $100 on the opposite. House orders a polysomnograph while the patient sleeps. The patient dreams that House is cutting off his toes. The EEG confirms the night terrors.

All the tests come back normal. They look at the patient's MRI scans. Chase thinks he has viral meningitis, but House knows he was only guessing. However, House has spotted something - an upwards arch in the corpus collosum, the joint between the two brain hemispheres. House orders a radioisotope examination to look for blockage. Foreman prepares Dan for the procedure, and looks at the facial structure of the patient and his father to see if he can prove they are blood relations. However, they find the blockage and schedule surgery to insert a shunt to drain cerebro-spinal fluid.

However, the buildup of CSF turns out only to be a symptom. After testing the fluid, they think it might be multiple sclerosis. However, there are no lesions and if it is progressing this quickly, it will most likely kill him within five years. They break the news to Dan but tell him it will take months to confirm the diagnosis as it is in its early stages, but warn him that the symptoms will get worse. They recommend medication to ease the symptoms and advise him that they are looking for a specialist.

However, the patient goes missing from his room. The team starts looking for him. They are worried because he had a lumbar puncture to prepare him for the radiological procedure and he should not be moved. They call House at home. House shows up at the hospital and tells Foreman to keep looking and that he's going home. He tells Foreman to check the roof because the orderlies sometimes prop the door open. Chase, Cameron and Foreman run to the roof and find Dan there. The patient seems to be dazed and Chase reassures him, but it's clear that the patient doesn't know where he is. It soon becomes clear to the doctors that Dan believes he's on the lacrosse field. Foreman keeps talking to him as Chase tackles him to keep him from walking off the roof.

Foreman tells House that the patient thought he was on the lacrosse field. However, House thinks that this shows he doesn't have multiple sclerosis. It also means that he probably has had a brain infection. Cameron thinks it might be syphilis. House wants to use a dose of penicillin, injected directly into the brain using the existing shunt from the surgery to allow any excess fluid to drain. They start the treatment, but the father doesn't think the patient has ever had sex.

Cuddy finds out about the paternity bet. Thinking the father is Dan’s biological father, she bets House's attendance at a symposium against a week of clinic duty. They continue the injections on the patient while Chase tries to distract him by directing his attention to Cameron's low-cut blouse. However, Dan starts having tremors, auditory hallucinations and double vision.

They realize the penicillin isn't working. They start to eliminate just about everything it could be from the mnemonic "MIDNIT". House focuses back on the night terrors. He orders an EEG along with microphones along his oesophagus.

House tells Wilson he's missing something. The parents find him and confront him about doing nothing. The parents say he isn't checking in, but House is totally versed on the patient's condition. He tells the parents to go comfort their son. House plans on using DNA from the father and mother's coffee cups to test paternity. He bets Wilson double or nothing he is right. House checks in on his team and gives them the DNA to test.

The tests are negative, except the paternity test - the father and mother are both not related to the son. House goes to confront the parents. They admit the patient was adopted. House admits he tested their DNA. However, the parents say the medical history they him was about the biological mother. House asks if the biological mother was ever vaccinated, but they don't know and say that the patient was. House dismisses them - he needs to know what happened in the first six months of the patient's life when he was relying on his mother's antibodies like all newborns. The parents don't know.

House explains the problem - an infant gets exposed to measles, has symptoms, but in rare cases the measles hides in the brain - subacute sclerosing panencephalitis. It only happens in babies whose mothers haven't had measles. Dan will need interferon injected directly into his brain, but it will kill him if they are wrong. They need a biopsy, but the only way to do it safely is to go in through the eye and biopsy the retina. They do it and they confirm the diagnosis.

Foreman starts to explain the treatment, but stops in the technical explanation and simply tells the parents it's dangerous, it could kill him, but they should do it. They agree to proceed and they start the procedure by drilling a hole in Dan’s skull.

Cuddy and House argue about the cost of the DNA test. They settle it by having House get to take a week off clinic if he pays for the test. House uses the money he won off the team and Wilson.

They test the patient and he names several animals that start with the letter "O". The patient also says he has known he was adopted for six years - neither of his parents have a cleft chin like he does.

House makes a trip to the lacrosse field, where he imagines watching a game.

Clinic Patient

A baby has a swollen face, but no fever. The mother hasn't been getting the baby vaccinated because she thinks they are a conspiracy of the pharmaceutical companies. House starts talking about another conspiracy: the market for "teeny, tiny baby coffins" and tells the mother a baby's immunity from breast milk only lasts six months and that her not immunizing her baby will force companies to bring down their prices. When the mother gets worried about what is wrong with her baby, House tells her the baby only has a cold.

The next patient has inserted a nail file into his leg to relieve the pressure of a boil on his leg. It has become infected. House gives him some Vicodin. House wonders why the patient drove 70 miles to Princeton-Plainsboro, passing more than one hospital and several doctor's offices along the way, and figures that the patient has sued all the doctors between here and where he lives. House treats him anyway.

However, the patient comes back with a lawsuit and offers to settle it. House tells him he has gonorrhea. The patient doesn't believe him. House says he will have to inform the health authorities, who will contact his wife. They bluff each other. House tells him to have it checked out himself - if he can find a doctor.

Major Events

  • House reveals that he only takes cases that he considers to be interesting.
  • House starts a bet with Wilson, Cuddy and his team on the grounds that Dan, their current patient isn't related to his parents.
  • After learning Dan is adopted, House wins the bets and gets a week off clinic duty from Cuddy as a result.
  • It's revealed that Cameron and Chase are right-handed while Foreman is left-handed.


  • The title of the episode comes from the running bet on the main patient's paternity.
  • Also on the Region 2 DVDs, a new theme tune is used in place of "Teardrop" by Massive Attack as the European distributor could not obtain the rights to use the song.

Zebra Factor 10/10

Subacute sclerosing panencephalitis is very rare. It only appears in one out of every 1,000,000 cases of measles, and with measles being such an uncommon disease now thanks to vaccination, there have been less than 30 cases in the United States during the past 20 years. Even an infectious disease specialist like House would be unlikely to see a case in his lifetime.

Trivia & Cultural References

  • Lacrosse is a stick and ball game that is one of the few modern sports that is native to the Americas, having been played by native Americans in pre-Columbian times. It was first described by European priests in the 17th century.
  • A shot at Chase - he’s doing a crossword puzzle and has to ask for a nine letter word describing iodine deficiency in children. Foreman gives the correct response, cretinism.
  • Maplewood, New Jersey is in the north-eastern part of the state.


Wilson: "*walks into a clinic room*"
House: "Close the door. Close the door!"
Wilson: "*walks in and closes the door* Is Cuddy down the hall counting to fifty?"
— Paternity

House to Cameron on a forged signature in his name:

"When did my signature get so girly?"
House: "If it's not trauma, the other cause is...sexual abuse. So who is it? Teacher? Especially friendly neighbor? I'd say it was one of you two, but you'd deny it."
Father: "It's not us."
House: "I say it here and it comes out there."
— Paternity

House to Cameron on why House asked the above:

"This might be kind of controversial, but...sexual abuse is a BAD thing. I just wanted to make sure he wasn't being diddled by father or mother."

House to Dan in Dan's Night Terror:

"This is going to hurt, Dan."
House: "You know what another good business is? Teeny, tiny coffins for babies. They come in frog green, fire engine red. The fact is that mother's little yummy has antibodies that protect the baby for only six months. These companies think that they can charge whatever they want and that the parents will cough up the money to see their child live. There's a novel idea, though. If you want to see the price of the medicine drop, take a few hundred mothers like yourselves who'd rather see their babies die than pay $40 for a little vaccination, then yeah, the price of that medicine will drop really fast."
Mother: "Please tell me what [my baby] has"
House: "*leans in* A cold."
— Paternity
Foreman: "So when you say, 'Call me when you need something,' you mean don't call you?"
House: "No, I mean call me if I can actually do something."
— Paternity

Dan: "*in his hallucination* This is where I dropped the ball."
Chase: "*in reality* Dan, we're on top of a roof."
— Paternity

House: "Anybody think there's a third option? *Chase raises hand* Great, what is it?"
Chase: "I don't know. You just said there was a third option in that."
— Paternity

House: "I never said I wasn't going to treat you. We'll just drain the pus out of your knee and fix you right up."
Patient: "Why would you do that?"
House: "I'm a people person."
— Paternity
House: "If I don't keep myself busy with trivial things like these, I'm afraid I might cry."
Wilson: "You're an ass."
— Paternity

Dan: "You sure this won't hurt?"
Foreman: "I'm sure. It's just scary as hell to look at."
— Paternity

Foreman to Dan's parents on the proper treatment:

"Here's what you need to know: it's dangerous. He might die. You need to do this."

Cuddy to House on the Paternity bet:

"I will let you off of clinic duty for one week if you pay the $3,200 for the DNA test"

Other Links

prenatal paternity test


This article is also available in Spanish at es.dr-house.wikia [1]

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