Humpty Dumpty
Episode 203 : 2005-09-27
Alfredo, a construction worker at Cuddy's house, complains that his asthma is acting up. She asks him to finish the job. Alfredo falls off the roof onto the concrete.
An ambulance races Cuddy and Alfredo to the hospital. He can't breathe, and Cuddy notices two of the fingers on his right hand have turned purple. At the hospital, the doctors try to figure out the cause of this. House suggests disseminated intravascular coagulopathy. House asks his team for a cervical MRI and treatment for DIC.
Stacy tells Cuddy that, for legal reasons, she should stay away from Alfredo. Stacy is sure that Cuddy will feel guilty, apologize and offer to pay his bills. The hospital doesn't need that. Cuddy is concerned that Alfredo could lose his hand and then his livelihood.
Alfredo demands to be released so he can go back to work. Chase notices that a third finger is turning purple. Cameron finds that Alfredo isn't clotting properly, which would mean minor DIC. House points out that if the hand is dying, it could move up the arm and further. Cuddy orders a stronger medicine -- human activated protein C. The staff is shocked. House points out that this treatment is only for severe sepsis. It is incredibly dangerous and could cause internal bleeding, strokes and more. Cuddy tells them to do it anyway.
Wilson notes to House that he would've ordered protein C as well. Suddenly, Alfredo screams for help because he can't move his arm. Chase tells Cuddy that the protein C caused bleeding in Alfredo's brain. The treatment is stopped and Alfredo is rushed into neurosurgery. Cuddy observes the surgery.
The surgery fixes the bleed. As Cameron examines him, Alfredo suffers from a coughing fit. A chest x-ray shows lung infiltration. His fingers become darker and he has a fever. Cuddy tries to connect this to Alfredo's falling off her roof. Foreman suggests pneumonia, and Cuddy admits that it is a possibility because Alfredo asked to leave the job. House asks Cuddy to check Alfredo's house to look for possible causes. House secretly has Foreman and Chase investigate Cuddy's house as well since Alfredo has been there for the past three weeks.
Cuddy and Cameron find a rat killed by a trap under Alfredo's dresser. The scars on Alfredo's hand must be rat bites. He has streptobacillus, which fits the symptoms perfectly. In Cuddy's bathroom, House notices a fuzzy, black aspergillus fungus on the pipes underneath the sink. Looking an x-ray, Cuddy agrees that fungal pneumonia is more likely. Cameron points out that the treatment for aspergillosis is amphotericin, which is hugely dangerous.
Stacy asks House to take it easy on Cuddy because she actually feels for patients. They're not just a puzzle to her. Meanwhile, Alfredo's little brother tells Cameron that Alfredo hasn't peed since yesterday afternoon. Cameron is concerned, and she immediately tells House that the amphotericin might have destroyed Alfredo's kidneys. Alfredo's mother overhears this and begins crying.
The team reviews what they know. The cause is not aspergillus nor rat bite fever. Alfredo tested negative for moraxella, nocradia and cryptococcus. DIC wouldn't cause a fever this high. House takes Alfredo's temperature and sees that the patient's right hand is starting to rot.
House wants to amputate the hand but Cuddy refuses to let that happen. She blames it on the medicine they gave him. If Alfredo loses that hand, he loses his jobs. House comments that this isn't medical thinking. House tells Stacy that Cuddy now agrees to the amputation and he begs for legal clearance. Cuddy tells Alfredo that it is necessary, and he tearfully agrees to the procedure.
During surgery, the fingers on the other hand start to turn purple. The team gathers afterwards with the news that Alfredo's O2 stats are down to 88 and his lungs are giving out. House wonders about endocarditis, which is an infected heart with little bacterial cauliflowers clinging to its valves. One may have broken off and traveled through the bloodstream to the right hand. Cuddy points out that they tested Alfredo for endocarditis and he was negative. House asks what infection causes pneumonia and culture-negative endocarditis.
Chase puts forward psittacosis, but Alfredo doesn't have any pet parrots. House orders a round of doxycycline, which Cuddy notes will make the clotting problems even worse. Cameron points out that, if House is wrong, Alfredo will lose his hands and feet. House and Cuddy barge into Alfredo's room. House asks the mother, in perfect Spanish, where Alfredo usually works on Saturday night. She says that he doesn't work. House knows that she's lying. House realizes that Alfredo works the cockfights on Saturday night.
Cuddy and Foreman head down to the warehouse district and find a cockfight. They see Alfredo's brother carrying cages of dead birds. Cuddy calls House with the news. House says he put Alfredo on the psittacosis meds as soon as she left. Cuddy later gives Alfredo the diagnosis. He's going to be okay.
203
本集的標題Humpty Dumpty
本集的標題來自於一首非常古老的英國兒歌，歌詞如下：
Humpty Dumpty sat on a wall;
Humpty Dumpty had a great fall;
And all the king’s horses;
And all the king’s men;
Couldn’t put Humpty together again
Humpty dumpty是胖子的意思，前兩句的意思是胖子坐在牆頭上，然後狠狠地摔下來了，這裡對應的是本集的病人，從房頂上摔下來。後兩句我不知道什麼意思，不知道哪裡又來的king，還把humpty dumpty給拆開了單獨用，在網上查了半天沒有滿意的結果，誰知道麻煩跟貼說一下。
House: Friday’s child heads to the kidneys.
House在跟小鴨子們討論病情，說星期四哪裡發病，星期五哪裡發病，星期六又哪裡。
說到星期五的時候用了一個很奇怪的表達手法，“Friday’s child heads to the kidneys”，這個說法也是來自於一首兒歌(強烈懷疑本集的編劇是幼稚園教師出身……)
歌詞如下
Monday’s child is fair of face,
Tuesday’s child is full of grace,
Wednesday’s child is full of woe,
Thursday’s child has far to go,
Friday’s child is loving and giving,
Saturday’s child works for its living,
And a child that’s born on the Sabbath day,
Is fair and wise and good and gay.
星期一出生的小孩長相漂亮
星期二出生的小孩斯文優雅
星期三出生的小孩日子不好過
星期四出生的小孩鵬程萬里
星期五出生的小孩充滿愛心
星期六出生的小孩一生幸福
星期天出生的小孩聰明活潑又可愛
星期天出生的小孩是上帝的孩子
(注：中文翻譯來自于網上，對錯不負責)
順便說一句，俺是星期五小孩
Patient: I didn’t fill that Oreo’s prescription.
門診病人，黑人，說不吃根據黑人的基因特點研究的藥品：我不要那個奧利奧的處方。
我們形容在美歐出生的中國人叫香蕉人，外黃內白，中國人的長相，歐美人的內心；黑人也有同樣的說法，就是Oreo奧利奧，奧利奧大家都吃過，兩塊黑色的餅乾，中間是白色的夾心。我個人認為，香蕉也好奧利奧也好，都沒有錯，在白人的地面上混，就得照著人家的規矩來。
Who is Humpty Dumpty?
Some people think Humpty Dumpty is a big egg. His mother calls him the Prince of Eggs. One day Humpty Dumpty leaves the farm. He wants to marry a princess. So he climbs up the wall and asks the king. But he is too excited and has a great fall. Then no one can put him together. Does Humpty Dumpty die? No! When the egg breaks, a bird comes out.
Some people think Humpty Dumpty is King Richard III(1452-1485)5. In a battle, King Richard III had a great fall from his horse. The horse had a name "Wall". Some people killed King Richard III. So his horses and men couldn’t put him together!
這首童謠開始出現在《少年孵化的聲音》的扉頁中，Humpty-dumpty 是蛋的意思。字典裡解釋為胖矮人，為蛋擬人化的稱呼。還有一個說法是出自《鵝媽媽童謠》的一首短詩，詩中的主人公叫Humpty Dumpty，貌似也是只蛋。
第二種說法說Humpty Dumpty其實是指英王理查三世（Richard III），玫瑰戰爭後期約克家的領袖。這位殘酷好戰的國王是個駝背，因此得了這個諢號，Humpty 可能是 hump（駝峰、駝背）的兒語叫法。理查三世的戰馬也叫做“牆”，wall。國王從他的馬上摔了下來，結果被大卸八塊——Couldn’t put Humpty together again 。正史上的理查三世是英國歷史上最後一位戰死沙場的國王，他的死亡之役是在Bosworth Field，時值1485年。今天的Bosworth Field 還保存有戰場遺址。
Travis有首經典老情歌叫The Humpty Dumpty Love Song，第一段是這麼寫的：
All of the king’s horses and all of the king’s men
couldn’t pull my heart back together again
All of the physicians and mathematicians too
failed to stop my heart from breaking in two
cos all i need is you
易碎的心還是與蛋比較貼近一些，所以我覺得是不是這首童謠是基於真實的歷史背景擬人化地講述了一隻蛋的故事呢？
這個是愛麗絲夢遊奇境記裡面的一幕
蛋摔下來後，國王和王后還有紅桃傑克就出現了
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