00:00Insert the needle at a slight upward angle, aiming toward the umbilicus.
00:05Dr. Barker, what does it mean if the CSF comes out cloudy?
00:10Meningitis.
00:11And if it comes up viscous, Dr. De Silva?
00:14Cancer.
00:15And yellow fluid indicates brain bleed.
00:21It's clear.
00:23Which means we have no idea what it is.
00:26You did a procedure on her spine for nothing.
00:28You know, it was necessary, and it helped us rule out some things, but we are going to need to
00:32do more tests.
00:33Does this mean they can't go home?
00:35Not for a little while yet, Roxy.
00:39How long has your life been doing that?
00:43I don't know.
00:44Is it from the procedure?
00:46No.
00:47No.
00:49Are you feeling hot at all?
00:51No.
00:53And she's all caught up on her vaccines.
00:55Yeah, of course.
00:55Kids need to be 12 months before they can get their first dose of MMR.
01:00Was she ever sick before she was able to get those shots?
01:04Measles, mumps, rubella?
01:06Yeah.
01:06She had a fever a few times, but nothing serious.
01:09She never had a rash or anything like that.
01:11Measles doesn't always present with a typical rash.
01:14Was she ever around anyone who had it?
01:17No, of course not.
01:18We don't know anyone that ever had it.
01:20Right.
01:21Hazel did.
01:23What?
01:24Hazel.
01:25She had the measles.
01:27When?
01:28She was about two years old.
01:30It was a couple weeks after that big family reunion at Leech Lake.
01:35That was before Roxy's first birthday.
01:36So she gave it to Roxy?
01:38Oh.
01:39Oh, my God.
01:40This is...
01:41You never had Hazel vaccinated?
01:43No.
01:44So this could be SSPE?
01:46S-what?
01:46What the hell is that?
01:47Let's not get ahead of ourselves.
01:50Information is key, and we just got a little bit more, which is good.
01:54We're just going to need a little more time.
01:58I'm sorry, Dr. Rarson.
02:00I wanted to make sure you didn't miss it.
02:02If she had measles as a baby, it could have developed into SSPE.
02:05Of course I didn't miss it.
02:07That's why I was asking the questions about the measles in the first place.
02:11But SSPE is a death sentence.
02:14We don't give that kind of information unless we are absolutely sure.
02:18You're right.
02:18I'm sorry.
02:19This isn't the first time you've overstepped in front of a patient or jumped the gun on a diagnosis.
02:23And if we are going to deliver news like that, there is a...
02:27I can't understand what you're saying, Michael.
02:33Dr. Rarson?
02:35If we're going to deliver that kind of news, there's a way to do it.
02:40I understand.
02:42So what do we do next?
02:44For now, we're going to treat SSPE as a diagnosis of exclusion, so let's start excluding.
02:50We will test for every other possible illness and hope that one of them is the answer.
02:57We will test for every other.
03:02We will test for every other.
03:03We will test for every other.
03:05We will test for every other.
03:06We will test for every other.
03:06We will test for every other.
03:07We will test for every other.
03:07We will test for every other.
03:07We will test for every other.
03:08We will test for every other.
