|Date of Birth||1973|
Carly Forlano was the CEO patient in Control.
Carly was a young CEO of a cosmetics company who during a business meeting was having minor tremors in her right hand, had difficulty concentrating and realized she was unable to move her right leg due to severe pain. Her staff did research and determined that Dr. Gregory House had the best reputation as a diagnostician in the region and she came to Princeton-Plainsboro to be treated by him. Dr. Cameron immediately suggested a leg infarction, the exact condition that resulted in Dr. House's disability. Dr. Foreman suggested a disc herniation, but Dr. Cameron pointed out that she would have pain elsewhere if that were the case. She also got Dr. Chase to agree that a clot was the most life threatening possible diagnosis as a clot could lead to a stroke. House realized that she had been reading negotiating books, but agreed the patient needed blood thinners and an angiogram. If those were negative, Dr. Chase was ordered to do an MRI on the spine and perform a biopsy on the leg.
Chase performed the angiogram of her leg with one of the residents from radiology. Dr. Foreman went to inform the patient that the initial tests were negative and the problem was probably a clot that broke up on its own, but soon found her screaming in severe pain. He ordered morphine stat. Dr. House asked what the patient's severe pain meant. Dr. Chase assured him the angiogram was clean. The biopsy showed no neurogenic or myopathic abnormalities. Dr. Foreman had ruled out trichonosis, toxoplasmosis and polyarteritis nedosa. Her sed rate was normal - 15, showing no inflammation or immunologic response. Dr. Cameron suggested her sed rate might be elevated for the particular patient, drawing a parallel |ith her aunt whose usual body temperature was 96.2F. Dr. House thought the idea was absurd, but agreed anyway, believing it was inflammation that indicated cancer. He asked Dr. Wilson for a consult, who believed it might be widespread bone cancer, requiring a bone scan. He agreed to perform it despite his busy schedule.
Dr. Wilson met with Carly, who was meeting with her assistant. She knew he was an oncologist because apparently there are only two Dr. Wilsons in the hospital and the other one is an opthamologist. Wilson told her that she didn't have bone cancer, but she might have cancer elsewhere that was causing referred pain in her leg. Given her family history, he though that colon cancer was the most likely culprit - her mother had died from it. However, she refused a colonoscopy. Wilson suggests they do a virtual colonoscopy with a CT Scan instead - much more expensive, but less invasive. She agreed.
However, the virtual colonoscopy was clean, which seemed to rule out cancer. House wondered why the patient didn't have a regular colonoscopy, and Wilson put it down to her not wanting to have more tests. Dr. House realized Carly was only reluctant to have embarrassing tests.
The test results seemed to rule out any inflammatory process, clots or cancer. However, when Dr. House reviewed her angiogram, he saw that it was of her left leg, and he realized that Dr. Chase had X-rayed the wrong leg. He found out it was the resident who actually performed the angiogram. He assigned Dr. Foreman to do the angiogram.
While Foreman was performing the second angiogram, Carly complained that her chest hurt, but her vital signs were normal. However, she soon went into respiratory arrest. Dr. Foreman pulled out his stethoscope and realized her lungs had filled with fluid. He called a code blue.
The patient was revived and they were able to drain the fluid and stabilize her. The fluid was sent to the lab for testing. The second angiogram on the correct leg was also clean. House reviewed her physical symptoms, but soon erased his entire whiteboard and started writing down psychological symptoms: withholds pain, control, and shame. He examined the patient while she slept and found cuts on her thigh. He put her on the transplant list for a heart transplant. Dr. Chase and Dr. Cameron soon reported that the thoracentesis revealed a transudate. They performed an echocardiogram and it revealed she was suffering from severe congestive heart failure. Dr. House informed them she was already on the transplant list.
Dr. House talked to Carly. He told her she needed a heart transplant, as he had realized along with cutting herself, she was bulimic and had been swallowing Ipecac to induce vomiting to keep thin and hide the other symptoms of bulimia. However, the Ipecac she had been taking had resulted in severe damage to her heart and had also caused muscle damage in her leg. She admitted to taking the drug three times a week. Because of her cutting and bulimia, she was too high risk for a heart transplant, which meant that House had to lie to the transplant committee about her mental state. If he did so, he could lose his medical license. He asked the patient if she wanted to live and if her life was important to her. She broke down and told Dr. House she didn't want to die.
Dr. House appeared before the transplant committee and told them that apart from her heart, she was in good health. Lisa Cuddy was suspicious, as House had Carly put on the waiting list for a heart transplant an hour before he started the tests to confirm the CHF. She asked Dr. House how he knew about the CHF before he did the tests, and he said it was just a hunch and he had no foreknowledge of the diagnosis before the tests came back. He denied there were any exclusion criteria, including no drug use or mental illness. Dr. Cuddy reminded him that he would be disciplined if he misled the committee, but he still denied there were any exclusion criteria.
A heart soon became available and surgery was started. Carly’s surgery went well, finishing in just under five and a half hours.
Dr. Chase was afraid of losing his job after messing up the angiogram. He also wondered why Dr. House had not mocked the team after he determined what the patient's diagnosis was. He decided to search Carly’s room. He discovered the bottle of Ipecac in her purse.
House waited with the patient in the recovery area and gave her a fried chicken dinner. She asked why he fought for her when he hardly knew her. House just said that what he did for patients, and not to screw it up.
Dr. Chase took the Ipecac to Edward Vogler the new chairman of the board of directors and the hospital's primary donor. He confronted Dr. House about the Ipecac, and Dr. House denied he knew anything about it, feigning surprise and saying if he had known he would not have fought for the patient, and the transplant committee would have had to turn her down.