While Jordan was having breakfast with some friends, one of them noticed her right foot was swollen. She then noticed her hands were swelling and she collapsed.
The case was referred to Dr. Foreman who sent Dr. House and e-mail of her x-rays. Dr. House arrived at the hospital believing the patient had rhabdomyolysis due to the fact she had said she had jumped into a pool from a height. However, Dr. Chase noted that alhthough the fall would explain the leg swelling, it wouldn't explain the hand swelling. He thought it was deep-vein thrombosis. Dr. Cameron thought it was anaphylaxis from her allergies. Dr. Chase decided to test for all the possibilities. He and Dr. Foreman performed a contrast MRI. There were no signs of obstructions or clots.
However, Dr. House went to Dr. Cuddy for permission to discharge the patient - a necessary formality as Jordan's parents were overseas.
Dr. Chase came back with the results. Her CK levels indicated rhabdomyelitis, but there was no sign of muscle crush on any of the scans. Dr. House went to see Jordan and asked her to pretend she was drumming. Dr. Chase wanted to know what the point was, and Dr. House pointed out that her potassium was low when it should be high if she had rhabdomyelitis. The only explanation is that her potassium levels were very low the previous night. Suddenly, she became unable to move her arms - temporary muscle paralysis. He also realized that the previous night, she would not have been able to climb stairs to the roof, so something else caused both the low postassium and the rhabdomyelitis. He told Dr. Chase to get a better medical history and to be careful because she had lied before.
Dr. Chase and Dr. Cameron took a new medical history. Her friend admitted that they had not been with the band, but instead had been following a comic book writer. They followed him the hotel restaurant.
Dr. Cameron confirmed the patient's story and obtained samples of the food. However, Dr. Chase (while taking a sample), noted that both the comic book writer and a hundred others ate the same oysters and none of them were sick. However, Dr. Foreman realized bulemia would explain her symptoms. Dr. Cameron planned to do a barium swallow to look for Mallory-Weiss tears and start her on nutrional supplements before referring her to psychiatry.
Dr. Foreman and Dr. Cameron performed the barium swallow, but found no signs of tears, ruling out bulemia. The patient's parents arrived, but when she propped herself up to great them, she collapsed again. Her heart rate was normal, but her blood pressure started to drop and she had no pulse. Dr. Foreman started CPR. They realized that Jordan was bleeding into the space around her heart. Dr. Chase grabbed an ambubag and Dr. Cameron inserted a large syringe into her chest and drew out blood.
Jordan was put on anti-arrythmia drugs and the team called Dr. House for a consult as he was away at a convention. They noted that they thought the symptoms with the heart were brought on by stress. Dr. House noted the rapid blood pressure drop ruled out any chronic conditions. That meant it either had to be an infection or toxin, but there were still hundreds of possibilities. Dr. Cameron went to do an environmental scan and Dr. House told them to get another medical history to find out where she had been.
However, when Dr. Foreman asked Jordan and her friend where they had been, it became obvious Jordan was making things up - things she believed were true. Dr. Foreman examined her and realized she was bleeding into her brain. It was affecting her thalmus, leaving her unable to control her lying.
Dr. Cameron caught up with the comic book writer. He remembered Jordan and her friend.
The friend remembed that she and Jordan were separated after they went to their hotel room. She woke up when Jordan returned to the room, but Jordan said she had just been to get ice.
Dr. Chase and Dr. Cameron went back to the hotel to look at the security tapes. However, it only appeared she left the room for about five minutes. However, Cameron noted that she was holding the comic writer's journal. She realized that Jordan was looking for an excuse to meet him. They went to confront the comic book writer, but he denied that she came to his room and shut the door on him. Dr. Cameron was convinced that he had something to do with Jordan's illness. She figured he had given her roofies, she overdosed and that they should treat her with flumazenil
However, Dr. Foreman had ruled out roofies as Jordan was now bleeding behind her kidneys. He had given her a transfusion of 2 units of packed red blood cells, but she kept developing new bleeds. Dr. Cameron thought it looked like a toxic reaction and that the comic book writer must have given her something. She pointed out there are lots of drugs that don't show up on a standard tox screen. She noted that the comic book writer wasn't about to tell them the truth, but Dr. Foreman noted Jordan couldn't tell the truth either. Dr. Cameron pointed out that drugging her with amobarbital would suppress her thalmus and allow her to tell the truth. However, Dr. Chase pointed out that if combined with the anti-arrythmia drugs she was on, it could stop her heart. Dr. Cameron pointed out she was sure to die if they didn't find out what was wrong with her. Dr. Chase told her she wasn't being objective. He wanted to call Dr. House for advice.
Dr. Foreman decided to give Jordan the amyl barbitol. She described going into the comic book writer's room. He gave her something that he said was ecstacy, but it didn't look like it. It also made her tired. She described it as a round tablet. Dr. Chase thought it might be lithium. The comic book writer then started touching her. However, Dr. Foreman had been monitoring her periorbital blood flow, which showed everything she said was a lie.
Dr. Cameron did more research about the comic book writer. He travelled with his dog so they started treating Jordan for Rickettsiaceae. Dr. Foreman contacted Dr. Wilson, who passed on the message to Dr. House. He realized something and called back. He told them to stop giving her transfusions - they were killing her. Jordan's mother objected - Jordan was bleeding internally. Dr. House told them Jordan had Vibrio vulnificus, a common bacterial infection from eating oysters. Dr. Chase pointed out no-one else got sick. Dr. House countered that all oysters have Vibrio, but if a person has haemochromatosis as well, the bacteria thrive where otherwise the digestive tract would destroy them as Vibrio is iron-loving. When they put the swelling down to bulimia, they gave her iron supplements, which just compounded the problem, overtaxed the liver and led to the bleeding. Giving her transfusions just added more iron to the system, making the problem even worse. They needed to give her high-dose ceftazidime for the Vibrio and chelation therapy.
Jordan improved rapidly with treatment. She admitted she only dropped the journal off at the comic book writer's door and never even knocked.