House – Episode 18 (Season 2): “Sleeping Dogs Lie”
A clever mystery, and some interesting ethical debates made this a good episode of House. There are some major spoilers for this week’s episode of House below, so read at your own risk.
Hannah, a twenty-five year old woman, can’t sleep. She has not been able to sleep for ten days. She tells her girlfriend Max that she’s going to get a glass of wine and will be right back. When her girlfriend wakes up in the morning, Hannah’s not in bed; instead, she finds Hannah banging her head against the wall after taking an entire bottle of sleeping pills and still being unable to sleep. Hannah is brought to the hospital and assigned to House’s team.
The doctors’ first thought is infection, schizophrenia, or drugs – but they are all ruled out rather quickly (and frankly, not rather well. A single blood count doesn’t rule out a hidden or low grade infection, and there is no simple test to rule out a mental disorder). Next they wonder if it might be a visual perception issue, so they take a look at Hannah’s retinas and optic nerves. While performing the test, Foreman and Cameron notice that Hannah is sleeping, just in little 10 to thirty second intervals that she’s not even aware of.
A CT of the head shows no tumor, clots, or seizure disorders (which is impressive, as CTs don’t show seizure disorders) and the eye studies are normal. House’s plan now is to purposefully keep Hannah awake and see if they can provoke more symptoms. It His plan works too well: they quickly notice bright red rectal bleeding. With these symptoms, the concern becomes a clotting disorder or a tumor in the colon. Chase performs a colonoscopy but it is essentially normal. (Given that House wants to keep Hannah awake, I can see why they would not sedate her during the procedure, but there’s still no reason they couldn’t give her some pain medication). During the procedure, Hannah develops a copious nose bleed. She is transfused with 2 units whole blood (most physicians would have used packed red blood cells instead of whole blood, but whole blood is a theoretically better for people with clotting disorders and that might be why they chose to use it). An examination of the rectal blood reveals nasal epithelial cells, suggesting that the blood came from the nose (Generally, upper bleeding that comes through the gastrointestinal tract ends up dark maroon, black, or coffee ground in appearance due to the digestive process. Bright red blood like this patient had suggests a lower gastrointestinal tract bleed).
The differential now includes a toxin or a coagulopathy (another name for a clotting disorder). Some more history comes to light: shortly before she began having sleeping problems, Hannah had a rash diagnosed as poison ivy, and was given a dog by Max as a gift. The rash resolved on a dose of steroids, and the dog was returned because Hannah was allergic. House begins to suspect Wegener’s Granulomatosis. As Cameron is performing an upper airway biopsy to look for Wegener’s, she notices that Hannah appears to be in REM sleep, but with her eyes open while sitting up (these symptoms never seemed to be fully explained). To House, this suggests a movement disorder of some kind. Foreman thinks rabies, though Chase is concerned about allergies. While an allergy test is being administered (ever notice how many of House’s patients only develop problems during testing? My recommendation: never undergo testing by one of House’s team.), large bruising on the abdomen is seen correlating with severe internal bleeding. Foreman reports that blood tests show that Hannah is in acute liver failure, and without a transplant, she’ll be dead within hours. (In terms of the bruising and bleeding, the liver makes blood clotting proteins, so as the liver fails, it stops making these proteins any more and bleeding occurs).
Hannah’s partner Max volunteers donate part of her liver to her since they have the same blood type. House figures that the transplant will give them another thirty-six hours to figure out what’s wrong with Hannah. Thoughts include viral hepatitis, cancer (splenic or ovarian), non-Hodgkin’s Lymphoma, Wilson’s disease, or poisonous mushrooms. Multiple tests are performed to look for these conditions.
The surgeries are successful (though none of the surgical teams are wearing eye protection, a major safety infraction). All the tests come back normal. House decides that Hannah’s immunosuppressant medicine is hiding the underlying condition, so he stops them all (immunosuppressants are used after transplant to prevent rejection of the new organ). Soon Hannah has severe a severe rejection syndrome with a high fever. Her white count is normal, when it was expected to be low, so this tells the team that she has an infection of some sort. The differential includes tularemia, leptospirosis, typhoid, and relapsing fever (typhus). House suspects that the infection is somehow related to the dog, and when he realizes the dog came from the southwest, he examines the patient and quickly finds a buboe (a swollen lymph node infected with the bacteria Yersinia pestis), confirming the diagnosis of bubonic plague. Plague is transmitted by fleas, so House hypothesizes that the plague-carrying fleas which normally affect prairie dogs infested Hannah’s dog, and then jumped to Hannah. With time and strong antibiotics, she’ll be better.
The medicine was fair. No big mistakes — other than the lack of protective eyewear and the bright red blood — but a number of medium-sized errors. No story breakers this week.
The non-medical soap opera content was the highlight of the episode. This week, it all dealt with ethics. First, there was the disagreement between Foreman and Cameron over the ethics of publication. Cameron had prepared a paper on one of their patients and given it to House to review. Foreman also wrote a paper on the same patient well after Cameron did, managed to get House to review it quicker, and got it published first. This incensed Cameron and she accused Foreman of stealing her work, or at least her idea. At the end, she apologizes to Foreman, but he refuses to apologize to her, telling her that he had done nothing he needed to apologize for, and furthermore, they were not friends, only colleagues. Second, there was the ethics of love between Hannah and Max. Hannah is planning on leaving Max, but there was concern that if Max were to find out, she wouldn’t donate part of her liver to Hannah. Cameron wants to tell Max the truth, but House doesn’t want her to. In the end, it turns out that Max knew all along, and is using the guilt of the liver donation to keep Hannah in the relationship. I liked the way that there were no clear winners or right answers in the ethical debates. Nobody was right.
The mystery gets a solid B+, and the solution earns a B+ as well. This overall medical score gets a straightforward B. The non-medical content was the best part of the episode and earns an A.
Still want more great medical reading? This week’s Grand Rounds are being held over at Fat Doctor. It’s an especially good Grand Rounds this week, and not just because I have an article in there. Make sure you take a look around Fat Doctor’s while you’re there, she’s one of the best of the more recent medical bloggers.
April 19th, 2006 at 2:33 am
I don’t even know where to start regarding the ethical problems, or with Cameron’s numerous moments of disillusion that made up this episode. I think that may have been a driving force behind the way this episode was written–it was as though every belief she has was shattered completely by everyone in it.
First, had it been me needing a liver transplant, I’d have been honest with my lover. I would never risk someone else’s life for mine (for those who doubt this, many traditional Indians, like me, don’t even consider either blood transfusions or organ donation, and having Lupus, I’ve had to come to terms with death rather than transplant long ago as failure of our organs, especially kidneys, is often how we go out, so I, personally, would truly not do this, and have had prolonged stays due to severely low H&H counts, which had to be dealt with via drugs, as no blood or products). Even were I someone who would consider transplant, never, ever, based on a lie. Nor would I ever give part of my liver to someone in order to try to “hold on to them,” though I would, if I were one to be a donor, give it to someone I loved, even if she were about to leave me. Frankly, the two women deserved one another, I finally decided. Good luck trying to find happiness in the moral quagmire that comes with such deception and lack of genuine love on either side.
The Foreman/Cameron bout: I felt that House was to blame more than Foreman–he ignored Cameron’s paper entirely, signed Foreman’s without reading it (is that acceptable, Scott?; wouldn’t errors, were there any, be considered House’s?; not sure about the issues here), which is what got it published at all. Foreman’s points about being colleagues were fine, but he could have apologized for having taken the same case, knowingly, and pushed it under House’s nose (we can picture that easily) for signature. He was a bit harsh, but by then Cameron was in pieces. And again, her passivity was the reason she got beat out.
And so we come to my real problem with the episode. I’ve said before that the writers seem determined to keep her very much a “girl” rather than a woman, with no emotional sophistication, and this is starting to bug me. While we’re past the “in love” with House stuff, she is repeatedly portrayed as naive, irrationally optimistic (rather than merely optimistic), unable to give bad news without falling apart; her honesty is portrayed (as tonight) as always being counterproductive, encouraging it in others is similarly counterproductive, though House’s rants about how patients’ lies are always a problem for him–only his lies seems acceptable, except when he feels he has to tell the truth, so I have no idea what he really feels about truth, except that “ends justify means,” so…what is she supposed to think? What are we? His often brutal truths are always shown as being necessary, while hers seem always to be portrayed as further proof of her naivete. I am a woman, and an optimist, but I’m not wide-eyed or spineless or passive, and I always told the women I served the truth (without brutality–sometimes the truth is brutal enough), so why isn’t she being written with the same backbone the guys have, and why isn’t her truthfulness being shown as a merely different, not pathetic, way to act in the world? Being one who has both given care and now has to receive more than my share of it, I can tell you that honesty is probably the most highly valued thing a doctor can offer me. That and kindness. The women I cared for sought those things, too. So why cannot the writers make her kind and honest AND strong, realistic, professional–in short, a good example of what women can bring to medicine without our “femininity” being seen as problematic? Again House made an issue of her need to learn about “who” the patient is into the “reason” for their ethical dilemma, but in fact there was a real medical reason for Cameron’s asking about whether the “allergy to the dog” issue was real, as they were spending all sorts of time testing for allergies. Hannah then volunteered the reason for pretending the reaction. She could have lied, and told Cameron she just didn’t like dogs and didn’t want to hurt her lover’s feelings. Cameron may have been fishing, but there was a legitimate reason, and it was House who first brought up the issue of deception due to imminent break-up, so why was he castigating Cameron for (very gently) trying to determine whether he was right? It had seemed important to him at the time; to me it just seemed a convenient out for him to blame her, as it did, eventually, present a problem that he chose to solve by knocking Hannah out just as she was going to tell Max the truth. This “need to delve into every patient’s personal life” Cameron indulged in wasn’t an issue until the transplant thing came up; he didn’t object when the information was helpful. Only when it stood in House’s way of being, again, the life-saver (I’m sorry, but I’m having an increasing problem with the “I must save her at any price” posture being the only way the writers can get us through to a conclusion) did he yell at her. It would have been okay with me for the two women to have been honest, and for Max to have done it anyway. Why couldn’t the writers have let Max be “heroic,” rather than House, just this once? It would have had a very different ending, but it would have been just as real. Or maybe their mandate is to make everyone cyncial and self-serving, not just House, and this is part of an effort to transform Cameron, too? I don’t know. This episode upset me, for the first time, as nearly everyone was despicable and Cameron was not only pathetic, but really humiliated for being who she is. I’m wondering if Hugh Laurie is worth it.
I’ll probably get over it and be back next week. Can’t wait to hear what others think.
Scott: I had to rerun the tape to be sure I’d been right about the missing eyewear–the scene was so brief I thought I’d imagined it. Good eyes, as it were, to have caught it first time! And now here’s another episode where the rectal bleeding should have been brown, and it’s missed again! They need a blood-colorist on-set, I think. But at least no one called it “diarrhea.” Thanks for such a good review of a complex episode–coincidentally, today the news says a case of bubonic plague is being currently treated in L.A., for the first time there since 1984. My complaint isn’t about the quality of the writing, but rather its structure and direction re Cameron. Oh-and I’ve been checking out “Grand Rounds,” but having some trouble navigating. Will keep trying.
April 19th, 2006 at 3:19 am
http://www.cdc.gov/ncidod/dvbid/plague/info.htm
I went here to refresh my plague info, and found nothing in symptoms that explained the inability to sleep, so I have a question for you: if fever and fatigue are primary symptoms, and Prednisone, which she was given for the “allergic reaction rash” and which is an immunosuppressor, shouldn’t it have made the infection of bubonic plague much, much worse? I’m not supposed to expose myself to anyone who is sick when I am on it, nor can I start taking it if I have open sores, are travelling, or may need surgery. So why didn’t it get worse, why didn’t the massive post-surgical immunosuppressors make it worse, and what was the real cause of her sleeplessness?
http://www.emedicine.com/emerg/topic428.htm
This site also came up when I searched, and liver involvement and severe bleeding aren’t listed on either sites. So did the plague cause the bleeding/liver failure, or did something else? Now I’m a bit confused as to the medicine. One symptom list says that vomitting or coughing may include some blood mixed in with discharge, but all emphasize serious lung involvement after a few days, let alone 10.
Also, according to them, she should have been put into isolation, her girlfriend treated as well as the docs, the surgeons, everyone who touched her, as she was bleeding all over the place, and Public Health Officials notified. There was no mention of this other than telling CDC–but local and dog-origin area, too, needed to be told, perhaps because it is self-evident, but I keep thinking of Cuddy discovering she has a plague victim in her hospital and going off the deep-end! There is also repeated emphasis on dealing with both patient and all kinds of discharges (blood, aspirated fluid (which I can find no sample of which is black–is it?), tissue, etc., as “high risk” rather than the very casual, non-masked, non-gloved (even though he expected to find Bubonic Plague) House, who aspirates, then hands the uncapped needle to an ungloved Cameron, who takes it! This seems a bit casual too relaxed for me, especially as Bubonic Plague is sometimes fatal even when treated.
Can you please clarify? Thank you.
April 19th, 2006 at 3:41 am
Scott: A Western Journal of Medicine article for you: http://www.pubmedcentral.gov/pagerender.fcgi?artid=1238391&pageindex=1#page
April 19th, 2006 at 6:09 am
How exactly does plague lead to the sleeping disorder?
Cameron should contact the journal and have the publication halted due to authorship issues. Journals have halted publication for far less. I’m surprised that all publications are not lab publications with all the lab members gaining authorship.
April 19th, 2006 at 8:06 am
I searched on Plague and Sleeplessness, and the only articles I found that were even remotely relevant were historical accounts of European Bubonic/Pneumonic Plague epidemics. None of the modern accounts listed it as a symptom, so maybe the writers read only accounts from 1348(?), like the ones I found. And I learnt from further reading that the fluid, if any, from buboes is either clearish or is pus. The “Black” part of “Black Death” had to do with the eventual black/blue sub-cutaneous bruises/spots as more and more necrotic tissue built up, and with the blackish fluid that the dying or the dead often “vomited” up–a combo of blood and necrotic tissue, no doubt. You have to look under a microscope of stained fluid to see the beginning of that “blackness,” so the black fluid House pulled out seems to be incorrect. I am hoping to hear from you, Scott, about all of this, but I know few 1st world doctors see any cases as it’s rare, though not unheard of. But it’s so rare that in the two papers I read, most of the cases died before dx (which occurred at autopsy, something which is discouraged if the dx is confirmed before death, due to danger of release of bacteria into air). Have you ever seen it? The photos I found are pretty terrifying. The friend I mentioned above has seen it in Asia and (if I’m remembering this right) on Indian Reservations here, in the Southwest.
Amnesiac: I’d have thought group-case papers would bear all names, too. Excellent point. I recall that anyone to do with an experiment had their name on the paper (with the Lab Doctor’s, always) back when I worked in an Immunology lab at Yale Med. School. There would often be strident disputes about the order of the names, but until you said something, I’d forgotten about the group-paper. I think (Scott should confirm/deny) that Foreman’s name would be first, House’s last, and the other two in the middle..? I think it depended on how much hands-on each person did, so of course, how could Foreman be the only doctor on the case? He certainly couldn’t be the case-manager, as House would have been (which makes his failure to read it truly mysterious and unforgiveable).
April 19th, 2006 at 8:30 am
Ironically, this is the first headline I saw today
I think that House signed Foreman’s paper without reading it, whereas Cameron insisted he actually read it. Foreman manipulated the situation by having House do exactly what House would normally do; Cameron wanted House to “rise above,” to behave properly instead of behaving like House. Foreman played House, not unethically as far as I can tell, just smart.
In a season 1 episode, Foreman specifically referred to Cameron as “my friend,” so this is either character growth or sloppy continuity. I think character growth, because Cameron has gotten better at being honest with patients and bad news, and we saw that this week as well.
April 19th, 2006 at 9:15 am
Deborah (and everyone): First, I really did not intend to make so many posts for one episode, but I, too, saw that article and after a night of reading about plague, wanted to clear up a couple of things about it and the show’s presentation of “bubonic” plague. First, bubonic plague doesn’t “morph” into pneumonic plague as that article states; if untreated long enough without killing the patient (which epidemiologists say happens as the bubonic strain is weakening, so people are living longer) it will invade the lungs, therefore becoming pneumonic (in the lungs), and therefore airborne. This is when it becomes a real epidemic, as now all one needs to do is breathe to get it, either from the dying or the rotting dead, as more and more bacteria is released into the air (hence the rapid spreading of it in poor, urban areas where people lived on top of one another). Charles II moved the entire court to Oxford to avoid dying in the 1600’s. I DID find the answer to the bleeding, though.
Septicemic plague, which is either directly introduced into the body (and creates no buboes), or is the result of a prolonged episode of full-blown bubonic plague which has remained untreated for a week or more (during which time the patient is very, very ill, has black buboes, not at all like Hannah, who was merely sleepless) causes massive bleeds from the mouth or anus long before day 10, is very transmissable, and causes the gangrene and black bruising which is thought to have spawned the nickname “Black Death.” As it’s the only form that causes such bleeding and kills organs, it would seem to me that this is the form Hannah had. It generally kills within 3 days of exposure, so the writers seem to have gotten a lot wrong about that. It took me hours to read papers on cases, go to Mayo Clinic, CDC, other hospital/research sites to get all of this, so perhaps they didn’t spend as much time on research? I don’t know, but I think it’s a little bit irresponsible to present such a serious and little-understood disease so casually, especially since TV is such a great educator of the public now (and practically the sole one). As most of those who present with it don’t get diagnosed until they’re beyond help or dead, it would seem especially important to get the facts straight. At the end, House tells Hannah not to worry, but if she has septicemic plague, which from the bleeding and massive hemmorhages (however late) it seems she does, she is pretty much beyond help. In fact, she should have died a week ago, or if she’s alive, she’s incredibly infectious and everyone should have leapt into crisis mode.
Again, I’m sorry to have taken over the discusssion to this point, but I was fascinated, don’t have to go to work, and as I don’t sleep at night anyway, I researched Plague to within an inch of its life. Hope that’s ok with you, Scott. Feel free to email me if not.
April 19th, 2006 at 9:37 am
Awi, start your own website. Enough of your pontifications. Jesus Christ, we don’t need six pages of your opinions, that’s what a blog is for.
April 19th, 2006 at 9:56 am
I thought this site was to discuss the accuracy of the medicine. Had I been able to edit previous posts, there would have been one with all the facts, but we don’t have that option. I didn’t mean to pontificate. I apologize and won’t bother you again.
April 19th, 2006 at 10:02 am
Before I go for good, DrFright, this site is called “polite” dissent. You didn’t have to be cruel.
April 19th, 2006 at 10:14 am
I am willing to give all the other symptoms to some form of plague. But like the others, I have difficulty with the sleep disorder. You said the medicine was fair, Scott, so was this part of it? Or was it just the overall diagnostic chain that didn’t cheat?
(Makes me want to write a paper: “The Unreliable Intern: Christie-ian overtones in Medical Mysteries”.)
April 19th, 2006 at 11:00 am
This episode reminded me that the show’s biggest weakness is that the Chase, Foreman, and (to a lesser extent) Cameron remain vaguely sketched ciphers after almost two full seasons. We don’t know who these people are in any meaningful way, just the occasional random detail here and there, and as a result, plotlines like Foreman’s actions regarding the paper don’t have the same resonance that they would on a show with more fully realized characters. It’s not a surprise, it’s not something Cameron should have expected, it’s not something that’s perfectly keeping in Foreman’s character or something that signals a change in his character, it’s merely something that happened.
April 19th, 2006 at 11:19 am
Well, DrFrightmarestein certainly seems like an appropriate name. Not a medical doctor I hope.
Anyway speaking as someone who does nothing here but pontificate on someone else’s blog:
– It’s not your blog, if Scott were to have a problem with Awi’s posting he’s a big boy he can deal with.
– Awi’s comment’s were plentiful but on topic and interesting – not to mention polite and respectful.
– If you don’t want to read any long comments, get a browser that has scroll bars and learn to use them.
April 19th, 2006 at 11:28 am
Dear Awi,
One bit of advice, don’t be such a wimp that one troll’s comment can run you off. Depending on the situation, ignore him or say ?!$$off.
April 19th, 2006 at 11:49 am
Thank you, M. I wasn’t being a wimp, exactly, and I should have said to Frighful (or whatever his name was for that one post) exactly what you said, but I hate to argue, and a couple of eps ago I very gently and diplomatically disagreed with someone who wrote: “Foreman hate House; Chase worships him; Cameron’s in love with him,” and tried to expand, briefly, on who the characters were, actually agreeing with Chris (above) regarding, at least, Cameron’s muddied personality. It was taken personally, though I’d been criticising the writers, not the poster, so I thought: this time, I’lljust step off the bus, as I don’t want to fight. But you’re right–I’m not a wimp, and unless Scott tells me to shut up, I’ll post on-topic, and share whatever info I find on the medicine being presented. As I said, with TV being the main source of info now, it could be very important to know what’s what re Plague, especially for those of us who live in affectd areas. But I am sorry to not have been able to got back and edit down to one informative post so that all info was in one place. Take care.
April 19th, 2006 at 12:02 pm
My problem with the episode had to do with the non-medicine aspects. Specifically, the fleas. Now, I suppose you can confuse flea bites with poison ivy rash, but fleas, once they arrive, are hard to get rid of. Max and Hannah should have noticed them. Getting rid of the dog wouldn’t do much good. Once fleas show up, they don’t like to leave. Max should have had bites, too. Even people who aren’t allergic will have bite marks — they simply won’t be red and itchy. And it wouldn’t be a one time thing. Bites would continue to show up, mainly on the legs. The medicine may have been decent, but they should have consulted a vet as well as doctors on this script.
April 19th, 2006 at 12:19 pm
I’m curious about the mushroom thing, actually. What’s the timeline like for a typical Amanita poisoning, and would it have been consistant with the case? Surviving ten days without treatment seems kind of long. Assuming it was the Death Cap they were testing for (since that’s the most common), or would have tested for had they found actually found spores…
April 19th, 2006 at 12:21 pm
Awi,
IMO, if they made Cameron a good example of what female doctors can be, then they would have no place for her on the show. House is not a show trying to create role models and prime examples of what people in the profession should be – it’s a show where there’s a medical mystery, and most of the people on the show are very screwed up, Cameron included. Maybe it’s because I don’t identify with Cameron in any way, but I have no problem with how they’re writing her, save for the fact that she annoys me from time to time. Truthfully, some people ARE like that. No, it doesn’t make her the best doctor the writers could’ve made her, but it makes her an interesting character on a show, which was their goal. I also don’t feel that the doctors are making her “weak” because she’s female – just look at Cuddy. Her reaction to something like what happened to Cameron would be to use the situation to fuel her fire; the point, I think, was that Cameron doesn’t let her emotions *drive* her actions, she lets them *dictate* her actions (like her rough treatment of Hannah after finding out something she doesn’t morally approve of). In this way, she’s written very consistently.
April 19th, 2006 at 12:28 pm
Jen-I like it that you like Cameron as she’s written. We all come from our own places about characters and situations. What was a bit shocking was House calling Hannah a “bitch”!
April 19th, 2006 at 12:37 pm
Awi, I for one appreciate your research into plague, which is quite interesting. Unlike many people here, I am not a medical professional, just interested. I used to read an ER episode guide that had medical commentary for the first five seasons or so. ER is really the gold standard for accurate medicine on TV. I learned so much from it, and often I will see House (or Grey’s Anatomy, which is terrible in that regard) make a medical mistake, and I will know about it because of ER (like the TPA thing on House a few episodes back).
My friend, a lesbian who lives in New Jersey, pointed out that Max should not have had as much unfettered to Hannah, and as much voice in her decisions, as shown. NJ won’t allow a lesbian partner to act as next of kin. It is unlikely, given the condition of the couple’s relationship, that a signed HCP was present. As a legal, rather than medical, issue, this is outside the purvue of this blog, but I’m sure the issue comes up in hospitals all the time. What do y’all think?
April 19th, 2006 at 12:41 pm
Terrie, I don’t think they ever said that the rash was fleabites. The chronology was
1) Dog exposed to plague via fleas
2) Hannah gets poison ivy and is treated with steriods
3) Dog arrives, Hannah is exposed to plague but her symptoms are suppressed because she’s still on steroids.
Jen, I think you’re right about Cameron. None of House’s team are typical doctors; they’re specialists working more on diagnostics than patient care.
Awi, if you recall “Three Stories,” I think House has reasons to take issues of consent and information between partners kind of personally.
April 19th, 2006 at 12:41 pm
Awi – Don’t worry about that Dr. Fright guy, he was just trolling. You might want to summarize a bit more in your posts though.Terrie – I think the idea was the fleas passed on the disease and caused the rash, and died off due to the poison ivy therapy.
Awi – Try rewatching the episode, most of the concerns you listed were answered therein.
Sorry, not the real Scott
April 19th, 2006 at 1:03 pm
Awi – I think I like Cameron as much as I do, despite being a cynical bitch myself, is because of her constant naivete. She has that “fall down seven times, get up eight” kind of mentality about her optimistic views on people, and I can’t help admire and respect her tenacity and faith, if nothing else. :) Lol, yes, House’s bitch comment really surprised me, but I appreciated the writers putting it in. It showed that, despite all his actions to stop Max from finding out the truth, he really does disapprove of Hannah accepting the liver from someone she was planning to leave. It also highlighted the difference between Cameron and House. Cameron tried to guilt Hannah into confessing to Max, while House just waited until after she had a few more days to live to call her a bitch. Morally, as a person, I feel that Cameron was right in thinking Max had a right to know. As a doctor, however, Cameron also had an obligation to Hannah, her patient, to save her life. House obviously puts the latter before the former, while Cameron…not so much. But she’s young, and he’s trying to wean her off of it, I think, however harsh his methods may be. House is a strange sort of teacher: he teaches by example, not through explanations and lectures. His method relies more on his students and their desire to learn, like, “This is how I do things. You can either learn to do things this way, or not. Your choice.”
Interesting note: This morning, a woman was hospitalized in LA County, diagnosed with a case of the plague, where fleas were also involved in her contracting the disease. What timing, huh?
April 19th, 2006 at 1:04 pm
Scott–Did you mean me on the 2nd note to Awi just above, or did you mean to address to Deb the fleas/rash stuff? My concerns, as others have had, too, were to do with the Plague/sleeplessness/bleeding/type of Plague/Prednisone/casual attitudes, which the ep didn’t address. We still don’t know why sleeplessness was the only symptom, nor why immunosuppressors didn’t make the infection worse. Did you figure those out? (Have you checked your email? I agreed with succinctness comment.)
April 19th, 2006 at 2:23 pm
Just a brief note to say that I read this site every time there’s a new ep. of House, and I love it to death.
This episode, though.. didn’t thrill me. I’ve been studying bubonic plague on and off for a House fanfiction I wanted to write (how ironic, isn’t it?), and I was left utterly confused with the presentation of it in this episode. Someone spoiled me beforehand that it could be plague (they saw the ep. before I did), but up until House’s actual diagnosis, I kept thinking, “It can’t be plague, it just doesn’t fit!”
Anyway, in short, I agree with Awi about how the medicine was a bit off in the ep. last night. I still can’t get a handle on which type of plague they thought she had – maybe they got sloppy and just decided to mix all three together?
As far as the drama goes in this episode, I thought it was overdone. Both Cameron and Foreman were extremely unprofessional by discussing their personal problems with each other about the article during an important procedure that poor Chase was trying to do. I felt kind of bad for Chase in this episode, actually – he kind of got used by Cameron and Foreman as a would-be counselor, and I say more power to him for refusing to get involved. I guess I just thought that Cameron especially acted very immature.
I won’t go any farther because I don’t want this to get too long, but thanks for letting me post this, and thanks, Scott, for posting these articles, because I love reading them! :D
April 19th, 2006 at 2:58 pm
Cameron is, unfortunately, ‘living’ in Houses’ universe, where hopes and expectations are shattered and people conform to the cynical House world view. Cameron is in for a long stretch of disappointment, we’ll see what this does to her character.
April 19th, 2006 at 3:42 pm
According to Wikipedia, the sleep deprivation bit is off too. The world record for longest time awake is 11 days (http://en.wikipedia.org/wiki/Randy_Gardner_%28sleep_deprived%29), and apparently nobody’s ever died from straight-out lack of sleep. My mother’s a mental health worker, and she says she sees bipolar people who haven’t slept in weeks all the time.
April 19th, 2006 at 4:07 pm
So the sleeplessness remains a mystery?! When I first saw the spoilers for this episode I was quite excited that the PoTW mights have fatal familial insomnia. I have always found sleep and its related disorders fascinating (I can’t be the only one) and nearly went into research along this line. So I am very curious to find out what the explanation for the very severe insomnia or the mini sleeps she was having but wasn’t aware of (at this point I have to say that I’m in the UK and haven’t seen this episode but love being spoiled, and being a part of the discussion when it occurs following airing of the episode. So forgive my ignorance!)
April 19th, 2006 at 4:20 pm
Don’t agree that Cameron acted immature. Her reaction sounds pitch perfect for an individual who has problems standing up for herself and, when she gets royally screwed over professionally, can’t get her supervisor or Dean to act appropriately and discipline Foreman. When we feel screwed over and no-one will listen and deal out justice for us we do have a habit of whining and moaning until we get it out our system. I think that House was the one in the wrong most of all. He is the head of the department and the supervisor. He should have been the one to stop this problem from even occurring. But he is too damn lazy. He had no interest in the articles because he’s “been there and done that” and why would he want to read articles about someone he’s already fixed
April 19th, 2006 at 5:21 pm
i liked this episode. medicine- was interesting although i don’t agree with the sleep+plague thing. (there was probably one case in mongolia or something)
i really liked the ethics portion and how nobody was right.
but i didn’t like the cameron-foreman exchange. i thought cameron was just so… argh… whiny! i wanted to tell her to shut up (i thought house would). it doesn’t seem like her.
but i can empathize b/c i’m similar to cameron in many aspects.
i totally was gaping like a fish like cameron when foreman said they are simply colleagues… (boohoohoo).
but it was nice that this was a medicine-ethics centered episode.
April 19th, 2006 at 5:31 pm
amnesic – While I understand why Cameron was upset, she was very unprofessional about how she handled things. She should have talked to Foreman himself instead of shunning his efforts to speak to her, and then running off to complain to whoever would listen. And she definitely should not have let her personal business interfere with the treatment of the patient. However, she brought up the article “stealing” twice in front of Hannah, and one of those times was when Chase was giving the woman a colonoscopy. Hannah was trying not to scream in pain, Chase was trying to do the colonoscopy, Max was comforting Hannah, and Cameron was complaining to Chase about Foreman. That is not professional behavior.
Which isn’t to say that Foreman wasn’t an ass. He definitely was, since he deliberately didn’t tell Cameron he was writing and submitting his own article on the same case. And House did mess up, sitting on Cameron’s article for four months without even trying to read it (or so one presumes). However, when it comes to articles and trying to get them published, I also think Cameron should have done more than submit it to House and sit back for FOUR months. That’s not the actions of someone who wants her article published. I would’ve been bugging House about signing it off after a week; I’m sure Foreman didn’t even wait a day, considering how fast his article got published.
April 19th, 2006 at 5:39 pm
Amnesic: In a way, but I think that she should have been more mature in the way she handled it, especially bringing Chase into the picture – I think that if she had wanted to talk to him about it or rant to him, whatever, she should have waited until the procedures she kept interuppting were done with and then pulled him aside, out of the earshot of the patient.
I don’t know, I just know it would put me ill at ease if any doctors I ever saw did that. In fact, I would probably freak out – that colonoscopy had to be painful enough without being worried that one of your doctors was going to distract the other into causing more pain!
I do agree that House had some blame, though. He should have known better, but then, he does seem to enjoy poking at the embers to heat things up.
April 19th, 2006 at 6:36 pm
Deb: I believe House speculated “what if the poison ivy wasn’t poison ivy?” But they also said she was on the steroids while the dog was there, so you may be right.
Scott: Fleas wouldn’t die from poison ivy treatment.
Here’s why the flea thing threw me. Fleas are not like ticks. They don’t bite and attach. They, instead, bite several times, then go lay eggs in your carpet. If you’re allergic, the bite will have a raised red area surrounding it. It is believable that mild posion ivy and flea bites could be confused.
Flea bites: http://medstat.med.utah.edu/kw/derm/pages/ni11_2.htm
Poison Ivy:http://www.poison-ivy.org/rash/source/arm-spots.htm
It’s simply pushing probability that Hannah would get flea bites without Max getting bites as well.
April 19th, 2006 at 8:36 pm
Catrina — Cuddy mentioned the 11-day sleeplessness record to House as she was walking out the door.
April 20th, 2006 at 3:55 am
Jen: Four months is not a particularly long time to wait for a supervisor to get back to you over an article. Negotiating with a supervisor over how long they are going to take to read through it is very tricky. If you nag them about it then they just destroy the article with harsh criticisms.
April 20th, 2006 at 5:11 am
I think the Foreman/Cameron conflict was so perfectly depicted. It’s always like that in real life. I mean, Foreman definitely took advantage of the situation, but he didn’t “steal” Cameron’s idea as she accused. I mean Wilson, who read both said they focused on different things anyway. But Foreman was definitely in the wrong. So was House. But then again, having worked with House for so long, Cameron should know better. Cameron has too much faith in other people to do the right thing. I think in real life, whilst we all hope that people will do the right thing, we don’t depend on it, because we can’t depend on it. Because people are egocentric and the situation is too often “your loss is my gain” and for an opportunist like Foreman, this was the perfect chance to get ahead. Cameron has been the victim of an injustice and negligence. But it also exposed Cameron’s weakness perfectly. She failed to protect herself, in fact, the episode almost showed that she couldn’t protect herself. Because if she did, she would have to share the same worldview as House or Foreman, and become a cynic like them. And relinquish her moral high ground. And most of all, it showed that Cameron has the worst, absolute worst judge of character. Everything that happened she should really have expected.
Awi- I completely agree with what you said about how the show depicts Cameron. I feel they could have done so much more with her character. Instead of making her some naive, immature, moralising victim who’s always looking for the affirmation of others. I think instead of trying to always justify House’s actions, and making Cameron the naive moralist, they should do something much more subtle and interesting. I think very often Cameron has great points to make against what House does, but because she seems so incompetent as a human being, we then to dismiss her and therefore dismiss her opinions and arguments. I think the show should give a better representative for those viewpoints against House’s than Cameron, and definitely give a more three-dimensional and interesting female representation in the show. I think this is frustrating me the most at the moment.
I may be overreacting, but I feel like the writers are increasingly putting House on a pedestal and House is becoming increasingly unjustifiable.
April 20th, 2006 at 5:15 am
Just wanted to add that this is an excellent site! I can’t wait to read it every week after I watch the episode. The reviews are insightful and interesting.
Thanks Scott!
April 20th, 2006 at 8:30 am
He should have been the one to stop this problem from even occurring. But he is too damn lazy. He had no interest in the articles because he’s “been there and done that” and why would he want to read articles about someone he’s already fixed
I don’t believe he was entirely being lazy, I think he was purposely taking a “let’s see what happens” stance.
House likes to let the dogs run the kennel and see who survives. He considers it a teaching method, and he also gets mischevious (or cruel) pleasure from it.
April 20th, 2006 at 10:56 am
amnesic – House is, by no means, your typical boss. That said, if Cameron felt she could blackmail him into a date, I don’t see why she couldn’t ask him where he was on her article.
April 20th, 2006 at 5:10 pm
I’m glad they brought back the clinic subplot, because these scenes are generally very funny. But on this week’s clinic scene, when House “speaks Mandarin,” he wasn’t actually speaking Mandarin. It was gibbberish at best. Though it was still very funny.
April 20th, 2006 at 7:28 pm
This is my first time commenting, and unfortunantly I did not have enough time to read everyhing that everyone else said, but I hope my opinion’s may be taken with open minds nontheless.
My opinion’s pertain to the drama concerning ethics in the episode, since I don’t really know jack about the medicine. I watch House because it’s a great life-lessons show. From a psychological standpoint (a common sense psychological standpoint, not one that is backed up by any kind of degree or training), all the characters are incredibly stereotypical, but that’s what is so great about them.
Cameron’s generally opinion of people doesn’t seem to be blatent ignorance, but it is an ignorance. I don’t believe their trying to paint her as being stupid, though, because most people you meet have the same idea about the world as she does. Foreman did exactly what he needed to do in order to get ahead, which is so typical of so many people. The fact that he made it through his childhood has given him pride, and he has begun to think he’s better than everyone else. Because of this, he’s started to care less.
As for Hannah and Max, I thought the plot had possibly the best twist I’ve ever seen in any kind of story. It was so perfect, and performed so flawlessly. The idea that they both seem so sincere, while at the same time being so utterly evil (and yes, I think that word is extremely appropriate) was so excellent, and I hope to see more twists and turns like this throughout the series.
That’s about all of my two cents.
I did want to ask Scott, what do you think of Crossing Jordan? I’ve heard that my mother has started watching it, and I watched a few episodes and thought the story was okay. What is your opinion on the medical aspects of the show, if you’ve seen it?
April 20th, 2006 at 10:02 pm
Scott, it seems we need you to tell us about how the paper should have been published! I agreed with Amnesiac that it would have been a group paper, with all names on it (based on memories of such papers from when I worked at Yale Med School), while others think each individual can write their own paper, as though they worked on the case solo. Can you tell us what the professional protocol is?
I think the writers are a little lost regarding the “ducklings” characters, in general, and it seems lots agree. Wonder if the writers read here?
April 21st, 2006 at 7:40 am
Re: Cameron, I agree with the points that some have touched on; I think that many times people expect a television (or movie) character to be the “ideal” character, to represent all accountants, or all blonde women, or all little green men, or all female doctors, whatever the case may be . . . and in my opinion, that’s what few characters need or are intended to be. Sure, if Cameron were significantly slighted on the show, given less to do and say and be, I could see that as perhaps something to be remedied; but I think the problem that some of you seem to have (as I perceive it) is not that she is lesser than other characters on the show, but that she has faults, and in that aspect I don’t see that she is any different than any other character. To be honest, though I often disagree with her, if I were picking a character I disliked most just in terms of their faults I’d pick Foreman, not Cameron. JMO.
April 22nd, 2006 at 2:25 am
House hasn’t really been “put on a pedestal,” he’s just as abusive and rude and uncaring about the patients as ever. It’s just that they need to keep him slightly justifiable to keep the show interesting, since it’s that whole vagueness that makes the show watchable.
As for Cameron, well, the show is called “House” and not “doctors” for a reason. House is the star, everyone else is there primarally to play off of House, and Cameron is necessary as the voice of that conventional morality and innocence that House rejects.
April 22nd, 2006 at 8:58 am
I’m afraid I have some disturbing news. During my normal research I discovered that, in fact, Dr. House does not exist. His real name is Hugh Laurie, an ACTOR. In fact, the deception is deeper than that. EVERYONE on the show is an actor or actress. That’s right — NOT REAL DOCTORS AT ALL. There is no way someone with no medical background could understand as much about medicine as these “doctors.”It gets worse. The “hospital” — Princeton Plainsborough — doesn’t exist. It is what they call a “set” apparently — an entirely FAKED hospital. I nearly vomited when I read the news.
So I guess this is the end of my site. There’s no more need for these kinds of reviews, it’s all a big lie.
Supposedly the whole thing is all just for “entertainment.” How sick.
EDITOR: This post is not from me, the Scott who actually runs the site.
April 22nd, 2006 at 5:04 pm
You’ve been testing out those mushroom theories, haven’t you?
April 23rd, 2006 at 12:01 am
Is there someone in particular that you’re talking to with that last post, Scott? ‘Cause I’m afraid everyone is gonna assume you were talking to the other.
April 23rd, 2006 at 3:37 am
Scott! It turns out, too, that you’re the Mad Hatter and we’re all at your tea party! Dr. Obvious is right–and you’ve been spiking the tea!
April 23rd, 2006 at 9:04 am
Official Comment
There has been someone posting comments under the name Scott and pretending to be me, but it is not me — the Scott who actually runs the site. So feel free to ignore them.
April 24th, 2006 at 6:19 pm
Real Scott: I guess we really did have the Mad Hatter visiting us! Glad to have your real self back. Can you tell us how group papers are usually written?
April 24th, 2006 at 7:32 pm
Does anyone have a problem with their organ matching? Just because Hannah and Max had the same blood type means nothing about their haplotypes. Unless they were related, it seems very unlikely that they would have matching HLAs which would be necessary for a successful transplant.
April 24th, 2006 at 9:44 pm
Official Comment
Liver transplants aren’t as tricky in terms of matching as other transplants are. Usually matching blood types is all it takes.
May 1st, 2006 at 1:40 pm
Hey, quick q – i was half asleep when i was watching this episode of house, having not slept for more than 4 hours in the last week, but did i hear him right when he said a person could die from sleep deprivation after 12 days???
May 1st, 2006 at 1:50 pm
Official Comment
Kim,
I think he may have said 11 days, but that’s the gist of it all right.
May 1st, 2006 at 2:50 pm
ah wikipedia disagrees – “As a cause of death
There are no documented cases of a healthy human dying from total sleep deprivation (excluding accidents). In carefully monitored experiments, several normal research subjects stayed awake for 10 days. While they all experienced cognitive deficits in memory, concentration, etc, none of them experienced serious medical, neurological, physiological or psychiatric problems [1]. Total sleep deprivation in rats leads to death in around 28 days.”
thats a relief- finals are coming up :)
May 10th, 2006 at 9:22 am
I have to poke in just to mention that House /was/ actually speaking real Mandarin in the second clinic scene– it’s just that his bad pronunciation made it sound like gibberish. What he was getting at was, “gongxi, ni kuai dang zumu le.” Which essentially means, “Congratulations! Soon you’ll be a grandmother.”
October 9th, 2006 at 5:05 am
W: House sounded like he was speaking gibberish at the clinic consult. As a native speaker, I had trouble recognising what House was saying. But like Anonymous clarified, he did say those exact words in Mandarin and if you can recall, Cameron did a jab at House later when he asked if any of them talked to the dog. She said “We are not as up on foreign languages as you are”.
I just finished watching this episode and I love coming to this site to read the medical reviews after each episode. Keep it up, Scott!
November 30th, 2006 at 2:07 pm
I wonder if organ transplant from a person who recently also was donor of blood for same patient wouldn’t increase the risk of rejection because of subgroups and antibodies etc.?
March 27th, 2007 at 6:17 pm
when i saw this i went mad about not matching tissues but thanks scott for pointing out that it only needs blood types, but WHY? does anyone know. it just seems strange to me.
and to duduklu tencere i cant see the blood making a difference in that way mainly becasue it would be standard treatment to everyone getting any organ transplant. getting antibodies this way isnt really anything important, the half life of an antibiotic is only 3 weeks anyway, nothing perminate here.
March 29th, 2007 at 10:58 pm
Regarding House’s Chinese (which took me quite a while to discern): Is the girl her daughter or daughter-in-law? Zumu usually refers to paternal grandmother, doesn’t it?
April 18th, 2007 at 12:31 pm
This episode… made me hate Foreman. Especially the last bit, I was like, “WHAT?!” Personally I’m on the side of Cameron, though I do agree that she should have pushed House to review her article – definitely wasn’t her fault that Foreman submitted one without telling her, and then acted like a complete ***** when she apologised for her attitude.
Besides that, House’s mandarin was fairly understandable. =P A bit like one of my supervisors (in the UK) attempting to speak mandarin on occasion – understandable, but not immediately so!
May 14th, 2007 at 7:17 am
@Awi, your posts are collectively a great addendum to this blog (you should really get one though, they delve too deep for “comments”).
@some others, your use of irony is immoral( Oh the irony!
it’s coincidence.
I’m aware that this is an old episode(Wikipedia linked me here), but I’m on a House binge so indulge me.
great blog dude.
May 19th, 2007 at 5:18 am
Da delo dazhe ne v goda. Mckenzie Riikka.
May 23rd, 2007 at 11:04 am
Did someone mentioned that a plague left undiagnosed for the first 24 hours would be most likely lethal?
October 21st, 2007 at 3:30 pm
you had me suicidal, suicida. Andreas Tennyson.
October 24th, 2007 at 3:47 pm
Being a Crohns-patient, I’ve had several colonoscopies, and never, ever has there been any talk of sedating me beforehand. Other Crohn-patients I’ve spoken to say the same thing. I’ve never experienced it as painful as the girl in this episode does, either. I think it was very exaggerated, even if such a procedure is unpleasant. Actually, I think the preparations beforehand is the worst part :)
And what a nice and clean colon she had for someone who hasn’t been fasting for two days before drinking salty liquids that empty the lower bowels in extremely unpleasant ways :)
January 22nd, 2008 at 11:36 am
I haven’t actually seen this episode yet, so I guess I’m cheating by reading everybody’s analysis!
But I’m puzzled by the reaction to Hannah and Max’s ulterior motives re the transplant. I think you can love someone and — if that someone is about to leave you — hope that you can guilt-trip them into staying. Am I alone in thinking that offering to undergo a transplant — even a relatively non-vital transplant like a part of the liver — is by itself a proof of sacrificing love? Just getting a general is a significant risk of death.
As for the recipient, well it would be pretty cold to risk the life of someone who loved you if you were about to dump them, except *the recipient’s life was at stake*. That’s not exactly the same as throwing a loved one under a bus to collect on the insurance.
Anyhow, I’m surprised at the vitriol other posters directed at those two.
February 9th, 2008 at 2:23 pm
Hey everyone! This is my first post on the site, but I love the reviews, Scott!
@academic papers: yes someone pleeeeease clarify if Foreman could have written the paper with no other names. I don’t think House left Cameron’s paper on his desk with a “let’s see what happens” attitude. House doesn’t do anything he doesn’t want to do or doesn’t like doing. I can totally see him not having great enthusiasm for doing this sort of paperwork. How many times has Cuddy mentioned all sorts of hospital paperwork that he’s behind on? Not laziness, selfish arrogance in thinking that he can avoid what he doesn’t like doing. But right up House’s alley.
@franken’s post waaaaay up there: That was harsh and unnecessary. Awi, thanks for researching the plague for us and for sharing your personal medical experience.
@the moral dilemma: Just giving up an organ or having major surgery is not necessarily a sign of great love. Max wasn’t doing that for Hannah, she was doing it out of desperation for herself. Someone said these two deserved each other. I agree. I mean, we can hope that Hannah’s response to Cameron “You’d die?” (implying that she too thinks that if she’s honest with Max, then Max won’t donate her liver piece and Hannah will die) was a product of her impaired judgment due to sleep deprivation. But people do scary stuff and have frighteningly selfish logic when confronted with death or great personal danger. Still, that’s a pretty selfish. Also, who’s to say that Hannah didn’t know that Max knew that Hannah was planning on leaving her? Maybe as they were headed into surgery, Hannah wanted to ask Max why she making this huge sacrifice when she knows.
@Mckenzie Riikka. “Da delo dazhe ne v goda” rough translation: “It’s ok, it’s not about the year (time).” I believe this was in reference to papavb’s post directly above, but a translation for foreign languages would be nice. I’m sure not everyone knows Russian.
Great discussion folks. I spend entirely too much time reading this. But I’m glad I’m not alone ;-)
April 12th, 2008 at 12:20 pm
I have no idea if you read comments about posts from so long ago, Scott, but I’d like to point out a tiny mistake on your description of the episode. You said, “As Cameron is performing an upper airway biopsy to look for Wegener’s, she notices that Hannah appears to be in REM sleep, but with her eyes open while sitting up.” Cameron wasn’t in that scene at all; the one performing the test was Chase, and Foreman was there as well (as always discussing their own issues in front of the patients).
By the way, I must say I’m not crazy about the new layout. It doesn’t fit my screen, so I have to zig-zag the scroll bar to read the text, and the comments come out clustered, with no clear paragraph breaks, which makes them very hard to read.
Other than that, this blog rules.
January 21st, 2009 at 6:47 pm
I don’t know if anyone is still checking on old episodes, but when I watched a rerun the other night, I wondered about the sleep deprivation debate, Scott, you said that House was essentially correct. Inasmuch as I don’t take Wikipedia as gospel, did you mean that someone would go insane after 5 days, and die after 10 (more or less)? Thanks!
June 4th, 2009 at 4:08 am
Sleep deprivation varies by individual. Some people have had damage to brain sections forcing them to remain incapable of sleep forever.
Normally after 24 plus hours many become increasingly paranoid and less rational.
August 16th, 2009 at 5:39 pm
First post here, but I’ve followed this for a while and it’s always informative. I have little to no medical knowledge, but there was something I wanted to ask about. I found it strange that the dilemma revolved around a liver, as this is the only internal organ which regenerates. Aside from the dangers of doing the transplant, would Max have suffered any adverse effects until her liver grew back? And what impact on day to day life do other donated organs have (i.e. if you donate a kidney, does this affect you at all)?
January 6th, 2010 at 3:01 pm
I love spoilers and take benefit of others, like you, being far ahead of us.
I read with interest the comments, and would like to add colonoscopies can be very much pain in the butt. I felt like Shawarma on a stick! Having like two meters of “gardenhose” inside feels bad, and I was even slightly sedated by a nurse!
But I agree the powder-stuff you are supposed to drink is not pleasent either. Only way to sink it is to remember it tastes no worse in big sips than smaller ones and take huge sips! It is like Castor oil mixed with sour lemon!
February 12th, 2010 at 1:51 am
Interesting bit about Amanita, it’s generally not considered a high cause of toxic death… not unless it is ingested intentionalls, and I don;t think the DEA would let a show talk about Amanita so very openly. They like to keep the legal dissociatives on the down low.
But, cool note, Amanita is supposed to be the drug behind alice in wonderland, and through the looking glass.
Also, to all you silly folk interested in amanita…. it is not a good drug. It is extremely dangerous. They did call one species death cap for a reason. The hallucinations provoked are terrifying and uncontrollable, indistinguishable form reality. To use a colloquial expression: baaaaad news bears
April 13th, 2010 at 2:18 am
On the lack of more obvious, more lethal symptoms of the plague:
It was explained away in the episode as being suppressed by steroids, this may or may not make sense, but it wasn’t mentioned by a lot of earlier comments
On sleep disorders associated with the plague: there is no real account of this, but no doubt the writers read about one case somewhere which presented with this as a symptom and decided to throw it for fun. Combined with the above point it may be almost medically sound.
May 17th, 2010 at 8:18 am
I find myself amused by the initial comments made in this blog for this episode. Awi certainly should have proof-read all of the dozens of posts they had made, and least used the ‘preview’ button. And perhaps just simply added some spaces between points so their point could be made more easily. However Awi is not the only poster around that does this, and I personally think it should belong in the dozens of forums already out there, instead of diluting one of the few very professional reviewing websites.
As for Cameron, I’ve already had many diatribes about her in previous episodes but just the sake of continuity of the discussion, my opinion would be that she would not last 5 minutes with her own case load because of the fact she throws patient confidentiality out the window any time and her patients would either sue and/or she’d lose reputation/career. The fact she cannot keep her feelings to herself (which is probably the writer’s fault for making their points with a sledge hammer) and the it’s obviously impact on her professional and team development is extremely immature and superficial. So many problems could be solved in the workplace if there is appropriate staff mediation and communication. Barring legal issues, Foreman’s last comments in the episode are hardly rare and not confined to medicine, despite how moral people claim to be.
To leave on a good note, I really enjoyed the ethical dilemmas in this episode, despite the fact it rare to see the partners equally cruel to each other. I think TV show Scrubs also made a good example of a similar case where a father needed a kidney and the son was convinced by the doctors to give a part of his, only to find out that they’re not blood-related. The difference is, that where bitchiness and self-preservation ruled House, “doing the right thing” and family ties surrounded Scrubs. My point is that the former appears to really strives to show the worst side of people to exhibit an ethical debate and this is the result: people arguing what they would do in that situation based on their own ethics and various backgrounds.
For those who would have thought the patient would have gotten off scot-free about using her girlfriend to survive, look up Survivor’s Guilt in any reputable resource.
December 26th, 2010 at 1:18 am
“I liked the way that there were no clear winners or right answers in the ethical debates. Nobody was right.”
HOUSE was right. He basically explained this concept to Wilson when they spoke about whether Cameron was justified in being upset. It’s true, everyone else lost but don’t forget the last scene, House is sleeping like a baby.
May 12th, 2011 at 7:03 am
I didn’t see a fight coming over the site. Well, being friendly is always good for you.
What I really want to say is it’s miserable that you are not treated like a friend when you thought you two are friends. That’s kind of cruel.
Before this episode, I thought Cameron was too serious sometimes. But today I think Foreman is totally a jerk over the article thing.
January 13th, 2012 at 3:08 pm
Hi
I’ ve just seen the episode. In my opinion, I think House just didn’t bother to read either Cameron or Foreman’s papers. It is the same attitude he takes when he ignores patients to play with his Gameboy or doesn’t bother to turn up in their rooms until it is absolutely necessary. As for the Cameron/Foreman verbal fight, yes, I think, he didn’t interefere because he just wanted to see how far they (particularly Cameron) would go. He even makes a remark to Wilson implying something like Cameron should learn from him or sth like that.
Leave a Reply
Contact Me
About
Subscribe:
The Best Of...
Special Topics
Archives
Categories
Twitter
See Also
Comic Blogs
Medical/Science Blogs
Currently Reading
Arbitrarily Interesting Medical Condition
Syndrome
The Net:
Contents may have settled during shipping. Past results are no guarantee of future performance. No animals were harmed during the production of this product. Void where prohibited by law. All rights reserved. Not valid with other offers or specials. Professional driver on a closed track. Your financial institution may impose other fees. All models are over 18 years of age. Employees must wash hands before returning to work. Results not typical. Many suitcases look alike. 18% gratuity added to tables of six or more.
Do not taunt Happy Fun Ball.
© 2004-2012 Polite Dissent. Powered by WordPress