Twelve year-old Gabriel 'Gabe' Reilich thinks he's cursed after collapsing when his name

comes out of a Ouija board game played with mates indicating him as marked for death. Dr.
Robert Chase cleverly finds out about the boy's secret society's abandoned meeting place
and suspicious substances there. Gabe's scary mix of suddenly appearing symptoms
suggest anthrax and a rare, infectious tropical disease. Chase refuses to have any personal
contact with his father, rheumatologist Rowan Chase, a world authority on auto-immune
diseases, who suddenly turns up and joins the diagnostic joust. Yet House takes a stubborn
interest in Rowan's reason to visit his estranged son now, as well as in Gabe's admired,
separated father Jeffrey Reilich's past

Twelve-year-old Gabe Reilich (Daryl Sabara) is taken to the Princeton-Plainsboro Teaching

Hospital after he collapses with a rash on his arm and a
developing pneumonia. Foremansuggests the presence of chlamydia, while Chase believes
it is caused by tick bites. While the team collects fluid from the rash, Gabe's father Jeffrey
(Nestor Carbonell), a notable donor to the hospital, bickers with his separated wife, Sarah
(Tracy Middendorf). Chase takes Gabe aside to ease the tension, and asks if he went to
anywhere in particular. Gabe states a week ago after school, he went to a secret clubhouse
meeting in an attic of an abandoned house and slipped on something, developing the rash.
As Chase prepares to leave to investigate, his estranged father, rheumatologist Rowan
Chase (Patrick Bauchau), comes in and hopes to speak with him. Chase immediately
brushes him off, sparking interest from House.
Chase returns with the sample from the attic and upon examination, the team is bewildered
to discover Gabe is infected with anthrax. He is quickly put on Levaquin but immediately
develops an allergic reaction and goes into arrest. Rowan suggests sarcoidosis, but Chase is
still determined that it is anthrax. The rest of the team sides with Rowan,
until necrosispresents itself in Gabe, indicating anthrax. House believes they're both right,
and deduces anthrax triggered a dormant sarcoidosis. Gabe is treated with antibiotics for the
anthrax and methotrexate for the sarcoidosis, but skin lesions begin spreading throughout
his body.
The team now diagnoses an autoimmune disease, although Chase states this is suggested
because Rowan is a rheumatologist. To prove his father wrong, he runs various autoimmune
tests, as he argues with Rowan that it cannot be autoimmune. House questions Rowan
about his presence at the hospital. Rowan replies he is here to see his son, but House thinks
otherwise, knowing that Rowan abandoned him and his alcoholic mother years ago. Chase
shows the tests to House, who sides with Rowan's theory of autoimmune. At the same time,
House asks if Chase knows the reason why Rowan is here, which Chase believes is a
conference. House confronts Rowan, noting his macrobiotic diet and neck tattoo for guiding
radiation treatment, suggesting cancer. Rowan confirms stage 4 lung cancer, and tells House
it is none of his business, knowing that he will eventually inform Chase, due to his curious
nature. House takes notice and does not reveal this to Chase.
When Gabe's right hand and forearm are paralyzed, with a returning high fever, the team and
Rowan diagnose neurofibromatosis, but scans show no signs of it. House recalls Jeffrey
suggesting leishmaniasis and filariasis, which are exclusive to Southeast Asia and confronts
him, asking if he has ever been there. Jeffrey confesses he spent two years in India, where
he lost all his money after joining an ashram and was too ashamed to tell anyone. House
immediately diagnoses Gabe with leprosy, which he deduces Jeffrey also has, evidenced by
damage to his ulnar nerve which was misdiagnosed as carpal tunnel syndrome. House
states when the Levaquin staved off the leprosy, Gabe's body produced antibodies to finish
off the dying bacteria. These antibodies then attacked the neural and fat cells, leading to the
rest of his symptoms. Both father and son are treated for leprosy.

As Chase checks in with Gabe, who is angry his father lied to him, he assures the teenager
that fathers always love their children, even when things seem bad. When Gabe answers
that he does not love his father, Chase replies, "Yeah, you do. There's nothing you can do
about it. He's your dad. It doesn't matter what he does; you're going to love him." Heeding his
own words, Chase heads to Rowan's hotel to catch him before he leaves for the airport,
hoping for a drink to catch up, but Rowan must return to Australia. Chase promises to visit
him in the next year, and hugs his father.

The patient is a twelve-year old boy who presented to the hospital with a weeklong history of a fever, respiratory symptoms and a rash. Various kinds of the
atypical pneumonia were considered, including Legionnaires disease and
chlamydial pneumonia. Several jokes are bandied about concerning twelve yearold boys and sex, and the patient gets a sexual history taken. But wait a
minute! Chlamydia pneumoniae, a common cause of atypical pneumonia, is a
completely different from the sexually transmitted form of chlamydia (C.
trachomatis). Any infectious disease expert, and even a medical student, should
know that simple fact.
The team discovers that the patient has developed anthrax, which they claim
would explain both his rash and respiratory symptoms except that cutaneous
(skin) anthrax and inhalational anthrax are two different and distinct forms of the
disease that dont cross over. The skin infection makes sense considering the
opening scene of the episode where he fell on an infected piece of insulation, but
suggesting he somehow breathed in enough spores at the same time to cause
the lung infection is hard to believe. Furthermore, ciprofloxaxin (Cipro) is still the
preferred drug for anthrax, not Levaquin (although Levaquin is suspected to
work against anthrax).
The patient begins to develop symptoms that go beyond anthrax. The team looks
at a variety of additional diagnoses including various autoimmune diseases
and neurofibromatosis. They obtain manyfancy tests (which they run
themselves, with no help from people who are actually trained in the
procedures), but they tell nothing. As usual, they place him on some particularly
powerful and risky treatments based on little evidence. The treatments seem to
help a tiny bit at first, but then he begins to lose control of his hand. Ultimately
the true diagnosis is made: leprosy. Apparently the patient had dormant leprosy
which made him more susceptible to the anthrax which in turn reactivated the
leprosy.
There is also an underlying theme of father/son relationships in this episode,
contrasting the relationship of the patient and his father to Dr. Chase and his
father.
One last question: How did Dr. Chases father, an Australian rheumatologist, get
credentialed to act as a physician in the hospital that quickly? Does he have a
New Jersey medical license? How did the California doctor get similar privileges
so quickly in that Episode 9?
The medical mystery this episode earns a C, but the leprosy solution brings the
score up to a B. The actual medicine is pretty poor with too many freshmen
mistakes and earns a C-. The side plots earn a C, they were just average.