Landon was parentless - his mother had died of a terminal illness and he had never known his father.
Landon had been sent to a training camp for juvenile offenders for shoplifting and was being put through a rigorous physical regimen of exercise every day. His instructor, Driscoll, had recently become ill during one of the training exercises, right after Landon had suffered a lacerated scalp.
Landon was put in a semi-private room with Driscoll. Dr. Taub did a medical history to determine if they had had similar exposures. He tried to eliminate items that the entire camp had access too as Driscoll and Landon were the only people who were sick. He was interrupted frequently by arguments between the two patients.
However, Dr. Taub couldn’t find anything they had in common that wasn’t also shared by everyone else at the camp. Dr. House asked Dr. Taub if he believed Landon, and Dr. Taub noted that Landon had been under intense supervision for weeks - he would find it difficult to use something to lie about. Ms. Masters suggested some type of infection such as legionellosis, toxoplasmosis or brucellosis. However, Dr. House dismissed these as the symptoms didn’t match. Dr. Foreman suggested a tick borne illness like Lyme disease, but Ms. Masters noted neither patient had a rash or tick bite. However, Dr. Foreman countered that many Lyme patients don’t develop the rash, and tick bites are easy to miss. Dr. House agreed and ordered doxycycline.
However, Landon resisted treatment, wanting to wait to see how Driscoll reacted. Ms. Masters convinced him the side effects were minimal and he agreed to take the medication.
However, Landon stole Dr. Masters’ car keys and tried to leave the hospital. Driscoll managed to shout out a warning and Dr. Foreman and Dr. Masters intercepted him before he could leave. Landon was afraid he would be sent back to the camp.
Neither patient improved on doxycycline. Given that Driscoll was suffering kidney dysfunction, Ms. Masters suggested arsenic poisoning. However, Dr. House dismissed it as arsenic also causes vomitting and diarrhea. Dr. Chase suggested Whipple’s disease, but Ms. Masters noted there was no digestive tract involvement. However, Dr. Taub suggested botulism. It also lives in the soil as well as spoiled food. It could have entered Landon’s body through the laceration on his forehead, and into Driscoll through abrasions on his feet. Dr. House agreed to try the anti-toxin.
However, Ms. Masters found something out when she was talking to Landon about stealing her car keys. It turned out his “shoplifting” was nothing more than trying to steal snack food worth a few dollars. Driscoll had told her earlier that most of the kids in the camp were there because of a court order, but all the police did when they caught Landon was call his case worker at the Department of Correctional Services. Ms. Masters asked Driscoll why Landon was the only person in camp who wasn’t there under court order, but he had no explanation. Ms. Masters called the case worker and found out Driscoll had paid to have Landon attend the camp. She used a subterfuge to get Landon out of the room and Dr. House confronted Driscoll about he paid the enrolment fee and why he hid it. When Dr. House told Driscoll the only explanation for that behavior was that Driscoll must be Landon’s missing father, Driscoll begged Dr. House not to tell him.
Landon started having seizures. Dr. House realized that the problem was most likely genetic, but given the delay in finding out it was likely that Driscoll might die before they found the problem. However, Dr. Foreman was still sceptical - genetic illnesses generally manifest themselves when a patient reaches a certain age, not within a week of each other for patients of vastly different ages. However, Dr. Chase noted some genetic illnesses are set off by environmental triggers, and Landon and Driscoll had been sharing the same environment. Dr. House noted that Wegener’s disease could be set off by heavy metals and Ms. Masters did see some generator batteries that contained lead, but Dr. Taub noted that if it was lead, that much would cause lead poisoning in someone else. However, in the absence of a better diagnosis, Dr. House ordered cyclophosphamide.
However, when giving another patient a local anesthetic, Dr. House remembered Landon’s sutures for his head laceration. He realized Landon had been given lidocaine, which is a trigger for variegate porphyria. Driscoll’s porphyria had been set off by antihistamines. They could be treated with hemotin until they received a liver transplant. At that point, Driscoll asked if they could share a liver. When Landon asked how they could possibly share a blood type, Driscoll finally broke the news that he was his father. Landon didn’t believe him, but Dr. House offered a DNA test and reminded Landon that there was no reason why Driscoll would lie about it.