Lines in the Sand (House episode)

"Lines in the Sand" is the fourth episode of the third season of House and the fiftieth episode overall.

Adam, who is severely autistic, is learning shapes and words in his backyard. His father, Don, is trying very hard to show Adam words, but Adam seems more interested in drawing lines on his chalkboard. While eating his lunch, Adam gags as if choking, grabs at his chest, and screams loudly.

While House and his team are doing the differential diagnosis for Adam, he notices that the blood-stained carpet in his office has been replaced. He goes to complain to Cuddy, who has no intentions of returning the carpet. As a result, House refuses to return to his office. Cuddy suggests working in the Clinic, but he begins to work in other people's offices during the course of the episode. While House is complaining to Cuddy, the rest of House's team tries to strap Adam down and get him into an MRI machine. It takes time because Adam must first finish a video game, which his father insists that the team does not want to interrupt. After the MRI, Chase and Cameron go to Adam's house to run tests. Foreman tells House that all the tests are negative. House then meets with his team in the clinic and orders his team to get a stool sample. Before the team can take the sample, Adam has another fit and coughs up fluid from his lungs. House moves into Wilson's office after he is evicted from the clinic by Cuddy, and Wilson is not happy. The team finds a heart problem, but House brushes this off and continues with his diagnosis. In the end Foreman is instructed to do a biopsy of his lung.

Foreman consults Wilson, who recommends taking a biopsy of the lymph node under Adam's arm to look for cancer. Foreman tricks Wilson into doing the biopsy in order to avoid dealing with Adam himself. The biopsy finds liver cells under Adam's arm. Another differential in Wilson's office suggests that Adam may have suffered liver damage, leading to its cells flowing into the lymphatic system. House then moves to Cuddy's office for the differential and is discussing the presence of calcium carbonate in Adam's stool when he is evicted by Cuddy again, with the news that Adam is in a cardiac intensive care unit. Adam is stabilized, and House considers the possibility of pica, believing that Adam may have been eating non-food items since calcium carbonate is found in blackboard chalk. He orders his staff to get samples from the house. While searching the backyard, Foreman finds jimson weed and suspects that might be the source of the problem. However, House is skeptical.