"What kind of selfish jerk wouldn't take advantage of that fact?"

―TB or Not TB

TB or Not TB is a 2nd season episode of House which first aired on November 1, 2005. House treats a famous tuberculosis doctor who has diagnosed himself with TB. However, the constellation of symptoms convinces House there's a more serious underlying condition. When it turns out the patient does have tuberculosis, his conscience forces him to refuse treatment for it and House has to convince him that tuberculosis isn't the problem, but they will never known unless he agrees to be treated for it. Meanwhile, a comedy of errors occurs in the clinic when a patient who believes she has cancer is seen by Dr. Foreman wearing Dr. House's nametag in order to cover for House. When she demands an apology for the way "House" has treated her, it becomes clear to House and Foreman that the only reason Cuddy 's even considering demanding an apology is not because of Foreman's behavior, but her perception that House always crosses the line. In the end, House finds a way to make it look like he has apologized to satisfy Cuddy.

After returning from Africa, the famous humanitarian and tuberculosis specialist Dr. Sebastian Charles collapses giving a speech to a pharmaceutical company. He is taken to Princeton-Plainsboro Teaching Hospital for treatment.

Charles diagnoses himself with TB. However, House is not convinced and agrees to provide a "second opinion". When House meets Charles, House acts in a typically insulting manner. House is opposed to having Charles sit in on the differential diagnosis. Charles takes over and outlines his own confirmation and treatment plan for TB. However, Charles refuses to take care of himself, constantly speaking to potential donors on his cell phone.

House pages his team to come back in the absence of Charles to continue the differential. House thinks TB is not likely as it has progressed too quickly and the symptoms are too varied. Chase points out some variability in his heart rate and House orders a stress test to see if Charles' heart is causing his symptoms.

Cameron tells Sebastian that House thinks it is sick sinus syndrome, and he will need a stress test and an echocardiogram. However, she does a PPD for tuberculosis anyway.

House is clearly not impressed by Charles' humanitarian work, and attempts to convince Wilson, rather unsuccessfully, that Charles is driven by the same selfish human needs as everyone else.

The echocardiogram and stress test are normal, so House suggests a stress test on a tilt table. He bets Foreman a week of clinic duty that this will show results, and Foreman eagerly accepts the bet. The tilt test goes smoothly until House literally cranks the machine to 11. The abnormal results appear to prove that Charles needs a pacemaker. He is scheduled for surgery.

Charles is clearly taking a shine to Cameron and offers her both a job with him in Africa and a date. However, during an attempt to climb down the stairs with her, Charles vomits and collapses.

Given the new symptoms, the diagnosis of the heart problem is clearly wrong. House orders a MRI. However, after the test is completed, the TB test shows positive. House is still not convinced TB is causing all the symptoms, but agrees to treat the TB. However, because Charles feels taking treatment himself while thousands of Africans can't afford the necessary drugs is somewhat hypocritical, he refuses treatment for the TB.

House continues with the differential diagnosis. House then starts dissing Charles to the media (using Cuddy's name). He then goes to Lisa Cuddy to ask her to force Charles to agree to tests and treatment. However, Cuddy instead joins the media circus surrounding Charles. Meanwhile, Cameron attempts to get Charles to agree to palliative treatment. However, House decides if Charles wants to die of a third world disease, he should live without air conditioning, phones, television, running water, and media attention. House turns off the air conditioning in the room and flushes the cell phone down the toilet.

During the press conference, House watches it on TV in a coma patient's room and notices Charles is sweating instead of turning red (TB makes it nearly impossible for a patient to regulate their own temperature - he shouldn't be sweating at all). He goes to Charles' room and sees that Charles is going into cardiac arrest. House then turns to the TV camera and shouts, "That is NOT TB!"

"Compelling Television, " Wilson says.

House finally gets Charles to agree to be treated for TB as he points out that cardiac arrest while overheated is not a symptom of TB. He threatens to reveal the real cause of death after the inevitable autopsy. Charles points out that while he can accept failure, House cannot, and that is the difference between them.

As the treatment for TB proceeds, Charles' symptoms decrease and the team focuses on the symptoms that remain to try to reach a new diagnosis. Focusing on Charles' occasional low blood sugar in his cerebrospinal fluid, House decides it is a small insulin producing tumor. This would also explain the result of the tilt table test. However, such tumors are almost impossible to find. They decide to attempt to force the tumor to produce insulin, which would cause the patient's blood sugar to plummet, but would indicate its location. Finally, after Charles goes into a seizure during the procedure, the tumor indicates its presence. It is easily removed with surgery.

Cameron decides not to date Charles, saying he will be in Africa most of the time. However, House thinks it is just another example of Cameron being attracted only to damaged men.

Similar to insulinomas (a malignant mass of pancreatic beta-cells), nesidioblastosis (used in this context as a functional disorder of pancreatic beta-cells) is a disorder of the endocrine pancreas causing endogenous hyperinsulinemic hypoglycemia. However, this form of localized, focal nesidioblastosis was until, some five years after the airing of this episode proposed yet undocumented in adult literature. Histologically nesidioblastosis is almost always characterized by a proliferation of abnormal β cells throughout the pancreas rather than localized tumors. Incidence of nesidioblastosis are generally believed to be rather low and cause of functional dysregulation remains unknown.

• The Nobel Peace Prize, unlike other Nobel Prizes, is awarded in Oslo, Norway, not Stockholm, Sweden. The Nobel Prize for Medicine is awarded for a medical breakthrough, not for saving life per se.
• During the press conference, the comatose patient moves his jaw when House says, "Yep."

• Hershey, Pennsylvania is an unincorporated town in Derry Township, Pennsylvania that is the headquarters of the Hershey Chocolate company. Its name was changed to match the company in 1906.
• When Foreman is doing a tilt table test, House turns it up to get a better result, and asks, "Does this go up to 11?" This is a reference to the movie "This Is Spinal Tap".
• Aircraft shown is a Beechcraft Model 18 (Twin Beech), it was a light transport developed in the United States shortly before the Second World War. With over 9, 000+ built and a continuous production run of 32 years, many are still flying today.