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Mr. Fearless

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Mr. Fearless is case #8 in House M.D. - Critical Cases.

Gregory House is at a monster truck show to see one of his idols, Dave "Mr. Fearless" Cullen, a motorcycle stunt rider.  However, after Cullen successfully completes a jump, he crashes.  House is allowed to give emergency first aid, but finds Cullen, although conscious and suffering no sign of concussion, is blind.  Cullen shows no sign of disorientation and is soon able to tell House that the blindness came on him suddenly just after he completed the jump.  House treats a scraped elbow and a dislocated shoulder before bribing the ambulance driver to take him to Princeton-Plainsboro Teaching Hospital.

House pages and assembles his team, who are upset that their evening has been ruined.  He asks for a differential diagnosis for sudden blindness.

Given the possibility it might be drugs, the team runs a blood analysis.  However, after using 8 body meds, 2 tongue depressors and 2 ward favors, they find the tox screen is clean, ruling out narcotic abuse.

However, imaging shows a small sub-dural hematoma.  After using 10 gland meds, 3 gauze and $575 of budget, the team can rule out brain infection.

The team decides that the hematoma is affecting Dave's optic nerve.  They use 2 ward favors and 12 head meds to treat it, but there is no change in his condition.

Dave goes code blue and has to be defibrillated.

House orders an environmental scan of Dave's hotel room.  They find a prescription bottle.  However, after using 8 chem meds, 2 oxygen masks, 2 ward favores and $575 of the budget, they realize that he was just keeping over-the-counter ibuprofen.  Although this points to a history of headaches, it rules out aspirin poisoning.

The team runs another blood analysis which shows low blood surar.  After using 16 body meds and a ward favor, the team rules out hyperglycemia.

Given the low blood sugar levels, the team treats for hypoglycemia with 12 gland meds, 3 gauze and 1 ward favor.  Dave's blood sugar levels are soon back to normal, but his eyesight doesn't improve, and he suddenly becomes far more combative with staff.  

Dave goes code blue and has to be defibrillated.

Given Dave's new symptoms, House starts to wonder if he is really "fearless" and orders further tests.

The team does another environmental scan and finds a bottle of spray-on tanning solution.  After using 8 digestive meds, $600 of budget and 2 ward favors, the team washes off the spray-on solution and finds blotches on Dave's skin.  This rules out Metoclopramide poisoning.

House orders a further round of imaging.  After using 2 war favors, 6 gland meds and 3 IV bags, they find a pheochromocytoma on Dave's adrenal gland.  This rules out Addison's disease.

The multiple tumors pointed to Von Hippel-Lindau syndrome and Dave was treated fror it with 2 ward favors, 2 thermometers, 15 body meds and $600 of budget.  House had realized that Dave's fearlessness was a result of the pheocrhomocytoma and removing it would make Dave just like everyone else.  He broke the news to Dave who reassured House by assuring him that, perhaps, he still had enough courage.  

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