Well, here's the start of the actual storyline. I will warn you that the medical condition mentioned here on in is rather unpleasant and horrific. It is also real though I have taken a few liberties for the story.

House leaned back in his chair and stretched his legs out in front of him, one hand resting lightly on the handle of his cane. He tilted his head back and let a smug look settle on his face as his thoughts drifted back to the previous night.

"I've got a case for you."

Chase's satisfied voice stopped those thoughts before they could even begin and he turned his head to glare at the young intensivist.

"Sarah Hooper. Twenty-eight year old female brought in by the paramedics," Chase continued, rather blithely ignoring the glare. "Suffering from facial tics and involuntary muscle spasming and palsy."

House ratcheted the glare up a couple notches when Chase stopped there. "That's all?"

Chase smiled triumphantly as he held out the file. "The paramedics had to sedate her. She's a secretary in a legal firm downtown. She seemed fine, if a little under the weather, this morning. Just after lunch she suddenly turned around and attacked a co-worker. She kicked and punched the co-worker then she tried to bite his face. When she was pulled off him, she turned on herself and bit off and swallowed the top joint of her own left index finger before anyone could stop her. She then attacked the people that tried to stop her. They eventually had to get her lying on the floor facedown with people sitting on her arms and legs. They turned her over when the paramedics arrived and found that she'd bitten at her bottom lip so hard she'd actually bitten part of it off and swallowed it. The paramedics sedated her and brought her in."

"Well now, that's interesting," House said as he snatched the file and opened it. "Any history of violence?"

"Not according to her co-workers," Chase replied. "And her parents are dead. She's an only child. We couldn't exactly talk to her as she's still unconscious."

House pushed himself to his feet and limped out into the conference room with Chase behind him. He threw the case file on the table headed for the white board. Foreman and Cameron looked at him expectantly as Chase sat down. House looked over at him and raised an eyebrow. Chase took that as the prompting it was and explained their new case to his colleagues.

"So…what could explain these symptoms?" House said once Chase had finished.

There was silence for a moment.

"Facial tics, involuntary spasming and palsy indicate some kind of neurological disorder," Foreman said slowly.

"But all at once and with such a sudden onset?" Cameron objected.

"Brain tumour?" Foreman offered.

"Is that a suggestion or a guess?" House said acidly. "You haven't explained the sudden aggression and the self-harm."

"Brain tumours can cause behavioural changes," Chase said. "I suppose that could include aggression and self-harm."

House nodded once as he wrote 'brain tumour' on the board. "Alright. Brain tumour."

"Tourette's Syndrome produces the physical symptoms and can involve self-harming," Foreman said with a frown.

"But Tourette's Syndrome doesn't have a sudden onset. It presents in childhood," House countered even as he wrote it down. "Nor does it usually involve aggression towards others."

"Sydenham chorea," Cameron offered.

House gave her a speculative look. "St Vitus dance? Hmm, interesting choice. Explains the facial tics and the spasms and generally occurs in females."

"But St Vitus dance occurs in young girls," Chase objected. "Most often between the ages of five and fifteen and our patient is twenty-eight. And it doesn't explain the aggression and self-harm. And, according to her co-workers, she hasn't been sick lately. Sydenham chorea is a manifestation of rheumatic fever."

"Alright, get her a CT scan and an MRI for the tumour," House ordered. "We need to get a history so let's let the sedative wear off. You might want to restrain her. And give her Diazepam for the muscle spasms. Start with 2mg four times a day. Let's see if we can get that under control. It's likely those spasms are partially responsible for the self-harming."

Cameron, Foreman and Chase stood and headed out of the conference room while House frowned at the white board. A brain tumour seemed the most likely option but something about that just didn't seem right. The collection of symptoms was unusual but could be answered by a brain tumour. He shook his head and limped back to his office; he had some delayed and probably delightful thinking to do. And a medical book to read.

Chase, Cameron and Foreman watched their patient as she twitched and stirred on the bed even while being held firmly in the restraints.

"I thought you said the sedative should have worn off by now," Foreman said to Chase.

"It should have," Chase replied. "They only gave her a very light dose to get her here and it's been nearly two hours. She should be awake."

They made a few attempts to rouse the woman but none were successful.

"She doesn't have to be awake for the CT scan or the MRI," Cameron said decisively. "And we can always restrain her head so that she doesn't move."

Foreman nodded. "The Diazepam will have to wait."

The three doctors moved forward and prepared to take Sarah Hooper down to radiology. Once they had finished they took their still-sleeping patient back to her room and the films to House. They weren't surprised to find Dr Wilson waiting in House's office when they got here. However on examination of the films one thing was very clear.

"No brain tumour," House said decisively.

"Definitely not," Wilson agreed. "The tumour would have to be reasonably advanced for the kind of symptoms you've described and there aren't even signs of a small tumour here."

"She wasn't awake either," Chase offered.

House glanced over his shoulder before turning and giving his team a narrow look. "How long ago was she sedated?"

"Long enough that it should have worn off," Chase replied. "She was twitching a bit."

"Did you try waking her?" House asked impatiently.

"Yes," Cameron replied. "She didn't respond."

"So she's not asleep, she's unconscious," House said, his eyes narrowing. "What do the facial tics look like?"

His team looked slightly baffled at the question.

"Er, she's grimacing," Chase said slowly, trying to follow House's train of thought.

"Grimacing," House repeated musingly. "With muscle spasming. Is it regular?"

"Yes," Cameron replied.

"Like you'd see in someone with Huntington's disease?"

Cameron frowned. "Yes, I suppose so."

House started to limp back and forth. "And she's twitching even though she's unconscious."

He limped back and forth for a few more minutes as he thought. Then he stopped and turned back to his team.

"Test her urine for the concentrations of uric acid and creatinine and get the urate to creatinine ratio," he ordered sharply. "And get a blood sample and test her HPRT enzyme activity."

Cameron opened her mouth but House cut her off abruptly. "Don't ask questions. Just do the tests."

He glared at his team until they left hurriedly then Wilson walked over and leaned on the table.

"Uric acid, creatinine and HPRT," Wilson said with an odd expression on his face. "What exactly are you testing for?"

"Lesch-Nyhan syndrome," House replied.

Wilson went blank for a moment as he thought. "I'm fairly sure I've heard of it but I can't remember the details."

"It's a rare genetic disorder," was all House would say.

Wilson's next question was interrupted by Chase shoving the door open. "There's another one! Just brought into the ER. Twenty-one year old college student. Same symptoms. Facial tics, muscle spasms, palsy. This one attacked her roommate."

Chase left as quickly as he'd arrived and House and Wilson exchanged glances.

"What are the odds of two people presenting with the same genetic disorder on the same day?" Wilson asked.

"Better than two women presenting with Lesch-Nyhan on the same day," House said as he headed for the door, leaving Wilson to frown over his answer.

Wilson almost headed back to his own office but his curiousity instead had him heading into House's office and he dug around among the medical books until he found one that listed Lesch-Nyhan syndrome. He read the few paragraphs of information and gaped slightly, realising what House meant by his comment. Lesch-Nyhan syndrome was a recessive genetic disorder caused by a mutation in the gene for the enzyme HPRT or hypoxanthine-guanine phosphoribosyltransferase and the HPRT gene was located on the X chromosome. Males with Lesch-Nyhan syndrome did not have children and as such a woman should not be presenting with it at all, let alone two women. Add to that the fact that those with Lesch-Nyhan showed their first symptoms as infants, not adults and you ended up with quite a conundrum.

"Damn," he murmured as he put the book away. "I said he needed a case but I was hoping for one he might be able to solve."

For a moment he debated staying to see what was going to happen next but then he looked at his watch and sighed. He had an appointment with a patient and a phone call to make.

House watched from the corridor as his team settled the second woman into the restraints then he glanced down at the case file. Rebecca Upjohn, twenty-one year old Commerce student from Princeton University. Her roommate, Susan McIntyre, had reported Rebecca felt ill this morning and had not gone to her classes. Susan had returned this evening to find Rebecca beating her head against the wall hard enough to split the skin and gnawing on her own fingers. When the roommate had walked in Rebecca had attacked her, screaming and scratching and then finally biting hard enough to tear a chunk of flesh out of Susan's arm. Susan had shoved Rebecca away and Rebecca had hit her head against the wall, apparently hard enough to knock her unconscious.

House wondered at that last bit as he watched the young woman on the bed twitch and shift. He limped over and opened the sliding door.

"Make sure you do the same tests on Miss…" He looked down at the folder. "Upjohn as you did on…the other one."

"Sarah Hooper," Cameron said almost automatically.

"Whatever," House said dismissively, tossing the file to her. "Get me those test results."

He closed the door and limped back to his office, not at all displeased to find Wilson sitting in the chair in front of his desk with a contemplative look on his face. He prodded Wilson with his cane as he limped around to his chair and pulled out his pill bottle, quickly swallowing one before looking over at his friend. Wilson's gaze rested on the bottle before House shoved it back in his pocket then the oncologist looked up.

"How could they have Lesch-Nyhan syndrome? They're women," Wilson said curiously.

"That, Dr Wilson, is a very good question," House said as he leaned back in his chair.

"You have to be wrong."

House gave him a scandalised look and Wilson rolled his eyes.

"It is possible."

"When was I last wrong?" House asked archly.

"Do I have to answer that?" Wilson looked amused.

"Well, if you're too chicken, you could always answer the question of whether you made that phone call today," House countered.

Wilson sighed. "Yes, I did. Then I called Julie. She's not very happy with me."

"Should I hide?" House asked, only half-joking. "Or gird my loins?"

"I didn't tell her about….us," Wilson replied. "Anyway, she wants to talk so I said I'd go home tonight."

"Well, if she throws you out, you already have a key."

Wilson gave him a grateful smile. "I know. Thank you."

House waved an idle hand then tried for a leer again. "Entirely prompted by my own self-interest, of course."

"Of course," Wilson replied with a tiny smile, whether for the attempted leer or the comment House didn't know. He paused. "We should talk about what happened last night."

House blinked. "Now?"

Wilson gave a shrug that was the epitome of false casualness. "We're both here, we both have the time and if we don't we're both going to find reasons not to talk about it."

"What's to talk about?" House said dismissively, leaning back in his chair. "You like me, I like you, warm fuzzies all round."

"Yes, well, completely leaving aside the issue of how I got to this situation for the moment, I am curious as to how you got there," Wilson said, determined to get some answers. "It…wasn't what I expected."

House tipped his head back and stared at the ceiling. It was clear from his body language that he didn't want to discuss this but Wilson was determined.

"Why? Was it bad?" House said with a hint of anger.

Wilson gave an exasperated sigh. "No. On the contrary, I enjoyed it very much. But I was surprised. It's not like you've ever given any indication you liked…men."

"Who says I do?" House countered.

"That kiss was pretty convincing to me," Wilson replied with a small smile. "Or maybe it's just me you like."

"I'm impressed," House said finally looking over at Wilson. "I thought that kind of arrogance only came from me."

"Well, at least it got your attention," Wilson said archly then he sighed. "Greg, I just need to know that this is what you really want and that you're not just being…kind."

House froze then gave his friend an exasperated look. "Do I ever do things to be kind?"

"That's all I needed to know," Wilson replied with some relief.

"Now that we've finished this teenage girl moment," House said acidly, "don't you have patients to see?"

"Yes, I do actually," Wilson replied with a quirk of his lips as he stood. "I'll probably be over after I've spoken to Julie. I can't imagine that's going to go too well so I imagine it will end with me being thrown out of our house."

House looked at him curiously. "If apathy has been the only thing holding you together, why would she get upset?"

"House, if I understood women, do you think I'd be in this position?"

The comment startled a laugh out of House and Wilson left the office with a feeling of accomplishment.

Chase looked down at the results he'd just been handed and frowned. He then looked over at his colleagues as they headed for the Diagnostic Medicine conference room.

"So do either of you know why we just tested those women for their urate to creatinine ratio and for HPRT activity?"

"I know why those tests are usually done but I just can't figure out why we did them," Foreman replied. "What do the results say?"

Chase flipped the folder open. "Sarah Hooper's urate to creatinine level is four point six. Rebecca Upjohn's is three point eight. And both of them show extremely low levels of HPRT activity."

Foreman frowned. "That just doesn't make sense."

"What were they being tested for?" Cameron asked.

Foreman's frown deepened. "Those two tests are used to diagnose Lesch-Nyhan syndrome."

"I don't think I've heard of that one," Cameron said after a moment.

"But what's the problem?" Chase added. "We know what they've got now we treat it."

"Except they're women," Foreman said. "Women don't get this disorder. The gene's located on the X-chromosome and the boys affected don't have children. And sufferers present as children, not adults."

"Okay, that's a problem," Chase said, looking slightly surprised. "So maybe it's something else?"

"The only other thing lack of HPRT causes is gout," Foreman said irritably. "Not self-harm and violence."

By this time they had arrived back and Cameron went to tell House about the results. He limped out of his office swiftly and grabbed the results from Chase, looking them over with a frown.

"How could they have Lesch-Nyhan syndrome?" Foreman burst out after a few minutes.

"Maybe they're carriers and something's happened to allow the faulty gene to be expressed," Cameron suggested.

"Maybe they're not carriers and a mutation occurred," Chase suggested. The others stared at him. "What?" he said defensively. "It's not out of the realms of possibility."

"There's a genetic test available for the Lesch-Nyhan gene," House said firmly. "Test them both."

Foreman nodded and headed out the door. He seemed particularly anxious to find an answer to this question. House then started issuing some orders.

"Cameron, go and talk to…Miss Harper…"

"Hooper," Cameron corrected.

"Whatever," House said with a dismissive wave of his hand. "Go and talk to her co-workers and find out whatever you can about her. Since it doesn't look like she's going to wake up any time soon. Then go and talk to the second girl's roommate."

"What do you want me to do?" Chase asked brightly.

"Go and drag Foreman out of the lab and have a look where they live," House replied.

"What are we looking for?" Cameron asked, looking a little baffled. "If it's a genetic disorder, what are we supposed to find?"

"Anything that suggests a family history of Lesch-Nyhan!" House said irritably. "What else would you be looking for? And anything that might give us some indication of why the onset was so late in life."

Cameron and Chase nodded and scurried out of the room. House looked down at the file containing the test results and limped back into his office. He wasn't sure whether things were getting clearer or muddier.