House – Episode 21 (Season Three): “Family”
Another “just average” episode of House. I’ve come to expect more exciting and improbable medicine, and the show is just not delivering lately. To some extent, tonight’s episode was an ethics episode instead of a medical episode, and as such, it was still average.
Matty and Nick are brothers. Nick is fourteen and has leukemia. He has received total body irradiation to kill off his own bone marrow so that he can receive a transplant from his younger brother Matty, who is a perfect match. On the day of the procedure, Matty is found to be sick: he is sneezing and has a fever and an enlarged spleen. House’s team has only a few days to find out what is causing Matty’s infection and get him cured so that he can donate his blood marrow before his brother dies.
The team decides to make him sicker so that it will be easier to find the cause of the infection. They expose Matty to cold, wet condition and they also remove his white cells (the infection-fighting cells of the blood) through leukophoresis. Matty is getting sicker, but no clear causative agent has emerged. In addition to a snotty nose, Matty complains of a sore right shoulder and a swollen testicle. House suspects Matty’s acute scrotum is infectious and has the team runs tests for E. coli, tuberculosis, Brucella, Klebsiella, and entero- and adenoviruses. The tests all turn up negative (which really is no surprise as an acute scrotum in a ten year-old is unlikely to be infectious). Looking over other test results, Chase notes a high CKMB (an enzyme that is often elevated with heart damage or injury). A transesophageal echocardiogram is obtained and shows a thickened mitral valve. The team believes that Matty has bacterial endocarditis and that this is the source of the infection. The normal treatment for endocarditis is several weeks of antibiotics, but House decides to rush things. He wants Matty’s mitral valve to be surgical removed and replaced to eliminate the source of infection. He believes that this will allow Matty’s bone marrow to be ready in time to donate to Nick. Of course, Matty will probably end up on blood thinners for the rest of his life (depends on whether they would use a mechanical valve or a porcine valve).
As the surgery is being performed, Wilson discovers that the mitral valve growth is fibrous and not infectious and the surgery is called off. The team now suspects that Matty’s condition may not be infectious, but instead an autoimmune disease such as Lupus or Behçets Disease. Tests show no evidence of autoimmune disease.
Meanwhile Nick has started to bruise, suggesting that he needs the bone marrow transplant fast. Foreman suggests pressing ahead with a partial match donor, but House and Wilson believe that there is too much of a risk of graft versus host disease.
Matty is now bleeding from his ears and his blood counts are dropping. Whatever infection he has is suppressing his bone marrow — or it could be the medicine he’s on that’s suppressing the marrow.
The partial match bone marrow transplant is carried out, but Nick has developed high grade graft versus host disease and the medication is not controlling it. His prognosis is very poor.
The team stops Matty’s medication, but there was no bone marrow recovery, so it is unlikely to be the medication’s fault (though they only waited a few hours and it can take days for medications to clear the body, particularly in ill patients). Blood cultures are negative. Knowing that Nick’s condition is fatal and he is immune suppressed, House wants to expose him to Matty’s infection so they can get a better chance to identify it. The parents refuse. Wilson and Foreman continue to run tests on Matty, hoping to find the cause of the elusive infection. In the meantime, House talks to Nick and convinces him to save his brother’s life. Nick agrees to play incubator to Matty’s germs. Luckily, at the last moment, Wilson and Foreman have discovered that Matty has contracted histoplasmosis, a fungal infection he developed because his house was built on farmland and he was exposed to soil from an old chicken coop. Matty should be cured with a course of Amphotericin B. The parents ask if he’ll be better in time to donate bone marrow to Nick. Cuddy sadly tells them no, that the infection has weakened Matty’s bone marrow too much. This doesn’t stop Foreman: he straps Matty down and performs a painful bone marrow collection procedure (which seems to contradict what Cuddy just said). It all ends happily, with both brothers recovering and living happily ever after (one presumes).
The medicine was mediocre, and I expect better from House. The mystery was good and the solution logical, but there seemed to be a great deal of forgotten symptoms (and/or red herrings) this episode: shoulder pain, the increased CKMB, and acute scrotum for starters. At the very least, the team needed to ultrasound his testicle to rule out testicular torsion, a devastating condition. Histoplasmosis generally causes only mild disease in immunocompetent patients; diffuse disease occurs in immunocompromised patients (such as AIDS patients). Of course, Matty’s white cells were removed so that did compromise his immune system — but fungi are slow growing so it would take at least several days to see any response (and similarly it would take at least several days of Amphotericin to treat the infection, not one dose then slap him down and take his bone marrow). Taking his white cells may have seemed a good idea in theory, but really wasn’t a good idea in practice. For one thing, white cells are responsible for many of the signs of infection we look for such as fever. The contradiction between what Cuddy told the parents and what Foreman did right after didn’t help the storyline either. And I hope I don’t need to mention that Foreman’s actions were entirely unethical. He needs informed consent, and a ten year-old is way too young to truly understand the risks and benefits of the procedure. What Foreman did was no better than assault and child abuse. So as not to end on a downer, the show’s portrayal of Nick’s acute graft versus host disease was well done.
There were a bunch of stupid lines that stood out badly in this episode. First was House’s contention that narrow spectrum antibiotics work faster than broad spectrum ones. The spectrum of the antibiotic has nothing to do with its speed, they’re unrelated. Then there was Cameron’s claim that Matty’s blood was “literally turning into water.” Even if there aren’t many blood cells left, there are still plenty of other proteins, enzymes, and chemicals in blood to make it a lot more than water — I sure wouldn’t drink it. Finally, there was Foreman’s statement that Matty was too sick for sedation. That’s simply ridiculous. Collecting bone marrow without analgesia is a hell of a lot harder on the body than anesthesia — or at the very least pain medicine — would be.
I give the medical mystery and the solution both a B. Like last week, the medicine was haphazard and and just average, which is why it earns a weak C. The House/Wilson/Hector soap opera was good, but the Foreman scenes were too heavy-handed for my taste. I give this aspect of the show a B as well as an N (Needs more Cuddy).
The previous House review
A list of all prior House reviews
May 1st, 2007 at 11:32 pm
Anyone else but me notice the GLARING ripping off of Jodi Picoult’s, My Sister’s Keeper?
May 1st, 2007 at 11:47 pm
My jaw dropped at the seemingly wild way Foreman was extracting the kid’s bone marrow toward the end – I’m like, What the hell is he doing???
But I was very affected by how the parents were forced into one dilemma after another. Try to save both sons and risk losing both? Letting one son die so the other may live? Take a chance? Don’t a chance? I hope I’m never put in that position.
May 2nd, 2007 at 12:07 am
I wouldn’t take Cameron’s line too literally. That seemed a pretty minor flub.
I did wonder about why he was too weak for sedation. I’m mildly belenophobic, so that was a flincher.
May 2nd, 2007 at 12:22 am
Cameron always suggests autoimmune and it never turns out to be the problem. What is up with that?
May 2nd, 2007 at 12:32 am
Hmmmm…. I thought that easy bruising and bleeding from your IV site = DIC until proven otherwise. (no coag panel ordered this time?) Which to me meant that poor Nick already had a serious infection/ sepsis even though he was in a clean room. Didn’t someone also mentioned something about how Matty’s blood cells were schistos and frags…. That usually suggests MAHA (Microangiopathic Hemolytic Anemia) and since there was a possible infection going on –> DIC right? So both these kids had DIC symptoms and no one seemed to really care.
Plus the bone marrow collection at the end was interesting. Kinda looked like he took it out of the kid’s femur? I know he’s still technically a kid, but I thought they usually take it out of the hip, and he had a way too easy time of obtaining it (it hardly ever comes out that quickly and smoothly.) I’ve been on a few bone marrow biopsies, and even with pain killers and locals some folks scream in agony. I can’t believe Foreman didn’t even do any sort of numbing!!!
It still amuses me that this hospital has no lab techs and that House and the young guns seem to do everything themselves.
Who did Chase kill again?
May 2nd, 2007 at 12:37 am
Erin, Dr. Cameron is an Immunologist, so she has a tendency to see problems from that angle, I guess.
May 2nd, 2007 at 12:44 am
If I may review Scott’s review, I’d note that:
(a) the kid would end up with a plastic valve eventually, even if they implant a porcine valve now, because porcine valves degenerate in about 10 years (and often faster in adolescents),
(b) spectrum of antibiotic does affect speed of eradication: one doesn’t speak of broad spectrum antibiosis unless the therapy is empiric, and it is clearly the case that the speed of eradication is statistically slower for empiric antibiotics as opposed to antibiotics whose choice and dose are guided by in vitro sensitivity testing (which, by the way, is always done in endocarditis),
(c) saying “histoplasmosis generally causes only mild disease in immunocompetent patients” is not relevant because, first, “generally” doesn’t apply in the Housiverse and, second, because one never knows if an *apparently* immunocompetent person has a small immunological blind spot that allows a narrow range of pathogens to fluorish (best example is complement deficiency and neisseria spp.),
(d) blood is basically seawater plus impurities so, yes, the line sounded clunky, but I don’t think it was horrible, and
(e) I think the contradiction between Cuddy’s statement and Foreman’s action helped the storyline, as it further highlighted the over-the-top Housian nature of Foreman’s actions.
Yok
May 2nd, 2007 at 12:52 am
I liked the whole foreman aspect at the end where he was taking the bone marrow, the outcome of it was the whole confrontation between him and House at the end. He quit becuase of what he did, at how unethical it was.
I love your reviews though Scott, and I agree entirely. I just don’t agree with the line “What Foreman did was no better than assault and child abuse”. I understand its Child abuse and assault, but It is better in the fact that he only did it to save both their lvies in a desperate attempt to find himself after last week. It wasn’t an unintential burst of anger normally associated with child abuse cases.
It was a once in a life time thing Foreman did in a desperate moment. I thought it was a good character development scene.
May 2nd, 2007 at 1:01 am
So, is Foreman leaving? If so, wonder what the replacement wil be like? Or will something happen to keep him around in those last two weeks?
May 2nd, 2007 at 2:09 am
Scarlett97,
Refer to the episode “The Mistake” back in Season 2.
May 2nd, 2007 at 2:45 am
“Nope, I need a lot more” was one of the chilliest lines House (the show) has ever had. I’m going to have nightmares.
May 2nd, 2007 at 5:13 am
“ultrasound his testicle to rule out testicular torsion, a devastating condition.”
This is very, very, very true. Of course it hurts a LOT so if he had it, hopefully he’d mention the constant feeling like someone was kicking you in the crotch…
May 2nd, 2007 at 6:12 am
The episode seems to indicate that Foreman got the bone marrow out of the younger brother and put it in the older brother – wouldn’t the older brother first have to have full body radiation treatment to get rid of the bone marrow that causing the problem? And would he have survived?
May 2nd, 2007 at 6:42 am
Just a quick question about marrow.
Would it be possible for bone marrow to break off during the setting of a broken leg bone?
If this is possible, what would happen?
P.S. Great site Scott, it’s interesting to see a doctor’s take on house.
May 2nd, 2007 at 6:49 am
They’re really pushing the melodramatic undertone in the two most recent episode. That’s just not what we expect from House. I hope, they’re either getting rid of Foreman quickly, so they can get on with the sarcasm and humour (maybe a new employee for House, who could change some dynamics and bring new zest to the show…). But probably, they’ll find a way to keep Foreman, and they won’t get rid of the melodrama that seems to be inevitably linked to every screen appearence of Foreman.
I’m disappointed that the show is suffering from the usual 3rd-season-fatigue. The writers try to stress the aspects of the show, which are liked most by the audience. Which usually goes wrong. Like masking cruel bone marrow collections as a “thing House would do”, which it isn’t. All the insane stuff, House does is never truly insane, it just seems unethical at first sight. They tend to call every unethical/ boarderline criminal action a Houseian thing.
May 2nd, 2007 at 6:59 am
The only problem with your reviews is that you seem so adamant about the show being “just average”, which is a matter of opinion, not fact. Others may see it as a quality show, even if some of the medicine is flawed in real life.
May 2nd, 2007 at 7:37 am
No one loves Lupus like the writer’s of House! Soon we’ll have a cameo by the corpse of Flannery O’Connor!
The writing is still nowhere near the quality seen in the first two seasons. There’s nothing to hang onto. House has gone from a bitter doctor who still cares, to a bitter jerk whom I can’t like.
A plus from this ep: No seizures!
May 2nd, 2007 at 7:50 am
I’m beginning to realize that to watch HOUSE, I will have to do it under the umbrella of “Medical Fiction”. I agree that the show’s medicine is just average: Two big points:
1. Matty was a baseball pitcher and Chase and Foreman were throwing around his baseballs without thinking “maybe we should test the dirt these balls are landing in for something”.
2. The National Registry considers 4/6 a positive HLA match. Unless Matty was Nick’s twin brother (which he was noted to be the younger brother), there is almost no chance he would be a 6/6. Parents are at the most a 50% match and siblings are often 25%. The writers assumed that the viewers would except that a sibling must be a perfect match and this is not medically accurate. (check out http://www.marrow.org)
As an aside: Foreman should be fired, or at least sewed, despite the fact that his miraculous cowboy medicine saved Nick’s life.
May 2nd, 2007 at 8:31 am
Hmm, a point that jumped out at me, because I watched last week and this week’s episode in the night (after returning from vacation):
In last week’s, they said they couldn’t run the tests for autoimmune problems because they wouldn’t be back in time, but THIS week, they said they’d know very soon. Um, if you’re going to contradict yourselves, don’t do it in episodes designed to be presented back to back…
May 2nd, 2007 at 8:44 am
Will there be a review of Monday’s episode (House gives himself a headache), or have I missed it?
May 2nd, 2007 at 8:50 am
Chase’s ‘Mistake’ occurred during the Season 2 Episode aptly titled “The Mistake’. The patient was a woman named Kayla who walked up to him literally seconds after he got a phone call not only informing him of his father’s death but that his father hadn’t bothered to tell him he was dying the last time he saw him. Chase forgot to ask her a routine question about her stomach pain and it all went downhill from there.
May 2nd, 2007 at 8:56 am
PSU,
Monday’s episode was a repeat. It was the season 2 episode Distractions which Scott reviewed here: http://politedissent.com/archives/1119
May 2nd, 2007 at 10:10 am
Not the greatest episode, but I was tickled by the short shot of House w/ the Sherlock Holmes-esq pipe. And the new cane. Makes him look fast.
May 2nd, 2007 at 11:00 am
Been fiddling with this comparison for a while, and last night’s episode reminded me again. Anybody remember a movie with Harrison Ford, Hellen Mirren, and River Phoenix called “The Mosquito Coast,” based on the Paul Theroux novel?
House is turning into Allie Fox.
May 2nd, 2007 at 11:27 am
I agree that the medicine has been weak lately, and since they haven’t been doing much in the way of character development either, I’m getting House fatigue. I feel like in the early seasons, medically, they were usually pursuing the most logical hypothesis at a given time, but they didn’t have all the information, or they’d overlooked something subtle. Lately, it seems like they just run from one hypothesis to another in desperation. It’s disappointing to watch. Thanks for your reviews so I can find out if it makes any medical sense at all!
May 2nd, 2007 at 12:25 pm
What, no one wants to comment about the Westie’s sympathetic limp in that last scene? That made the episode for me. My own Westie has done that on numerous occasions when I or my wife have been injured.
May 2nd, 2007 at 1:02 pm
Dan, I loved Hector’s limp! Question – at the end, did Hector get a pill as a “treat”, or did House eat doggie treats rather than popping a pill?
May 2nd, 2007 at 2:37 pm
YES JESSICA!! As soon as I saw the preview I immediately thought that! So initially I thought he faked being sick to get out of doing the transplant, but you can’t fake a swollen testicle! :)
May 2nd, 2007 at 2:50 pm
About bone marrow transplants, it’s true that it’s more difficult to find a match for a patient of African ancestry. Basic reasons: (1) They’re a minority in the US so the pool of potential donors is smaller. (2) Humans originated in Africa; non-Africans are descended from a subset of Africans, so the HLA antigens (what are tested for a possible BMT match) are more diverse in Africans, so it’s harder to find a match.
May 2nd, 2007 at 4:10 pm
Dan,
I thought the dog’s limp came about because House slammed the door on him in a previous scene. Not so cute, but more Housian.
May 2nd, 2007 at 4:11 pm
Were House’s eyes a bit wet after his final confrontation with Foreman? I fancied they were.
So that’s what the staph-aureus screwball episode was all about; to set up this one. Medicine aside, I rather enjoyed it.
May 2nd, 2007 at 5:05 pm
@Scarlett97 (#5)
Some hematology analyzers can verify whether a hematological problem is more likely to be productive (i.e. bone marrow related) or consumptive (i.e. MAHA etc.) by measuring the ratio of, e.g., immature/reticulated platelets to total platelets: In a consumptive disease, the percentage of immature platelets will be high, because mostly mature platelets are consumed, and the bone marrow tries to make up for the losses. In a productive disease, the ratio is normal, but the number still low, the bone marrow simply makes less. So if they are well-equipped, an initial blood analysis will have ruled out DIC and pointed at bone marrow suppression. Incidentally, this can also be used to track the success of a bone marrow transplant, since in most cases, the reticulated ratio will rise observably quite a bit earlier than a general count.
May 2nd, 2007 at 6:55 pm
Just one thing I noticed.. The surgical wound from the open heart surgery appears has a probably one month old scar.. Two or three days after the surgery (as I suppose it is the correct timeline) the wound should look a lot “fresher” and would still be covered by a dressing, and you would certanly, if it was exposed see the stitches/staples… Am I right?
By the way.. Love your reviews! Keep on going!
May 2nd, 2007 at 10:12 pm
did anyone notice the daylight outside the windows when House asks Wilson if he wants to catch a movie? Can’t be building lights as when compared to other shots at around the same time in other episodes.
May 2nd, 2007 at 10:46 pm
The team seems burnt out and acting out in every way possible, which I think is what the writers are trying to convey, along with House’s depression. Great job!!
Loved the House/Wilson scenes and Hector. I want a Westie. Gosh they’re so cute and determined.
Hated EMO!! Foreman. Technically a good actor but I just find it hard to connect with him on an emotional level. Thank God for TiVo.
I still cannot watch the scene of Foreman’s abuse of the child. That’s just too painful.
Yes it was child abuse of the worse sort and Yes Foreman, House, and the Hospital should be sued. And in another Universe, Foreman would be in jail.
Didn’t like the implication of House hurting Hector and the subsequent limp. Reminded of Cuddy’s comment to House in W&D. “Everyone’s the worse for knowing you”
May 2nd, 2007 at 10:50 pm
The medicine may have been sub-par but I thought the ethical dilemmas were good and the actor playing the parents did an excellent job of conveying both desperation and a refusal to give up.
When House was complaining about Wilson not manipulating the parents as much as he could have, Wilson said he had a relationship with his patients that carried over months while House didn’t. If Wilson behaved like House, his patients would be in much poorer condition.
Scott, I love your reviews but “Needs more Cuddy”? We’ve had so much Cuddy this season, between the cunning plot, the Tritter episodes, getting custody of the little girl, saving the mother and baby in Fetal Position, a whole episode of just her and House on a plane, the date with Wilson and all the flirting with House, she’s been on so much I was wondering if they’d decided to rename the show House & Cuddy M.D.s. One of the things I liked about this episode is that there was no shippiness, especially given the suddenness of House & Cuddy. As it was, she was already too sandwiched into this episode; the statement that there isn’t enough marrow to transplant should have come from the boy’s oncologist, not a hospital adminstrator and part time endocrinologist.
May 3rd, 2007 at 4:03 am
If the patient was suffering advanced graft vs host disease, would giving him a compatible transplant help? Or do I assume that he has gone through a second whole body irradiation to kill the first transplant?
May 3rd, 2007 at 10:22 am
A lot of you guys and gals seem to be pissed about the drama aspect in which House is heading. I agree that House, a medical show, should not put the medicine on the back burner for a random episode about Wilson – but if they’re doing it so that we can start to see these characters on a deeper and more meaningful level, then I love it!
Who wants season 1 characters for 12 seasons? The smart bet is change and character exploration. In this episode, for example, we see a father/son type deal between Foreman and House. Foreman realizes that he’s becoming likes House and he’s having a lot of problems with that, thus developing his character a few steps.
I think the writers are making a really smart choice in balancing out the medicine and drama, as far as the big picture goes. I said it before and I’ll say it again, there is only so much we can discover about House. After we drain the House well, what happens then? Giving episodes here and there focusing on other charcters is a good way to keep up some of the mysteriousness of House while making the other characters more likeable and stronger as far as carrying a show goes (except for Cameron…God have mercy on what they did to her character).
Thanks, guys, for reading and thank you, Scott, for writing!
May 3rd, 2007 at 1:06 pm
Personally, I was grateful for this recent episode. I am 29 and was diagnosed with a very rare and potentially life-threatening form of HISTOPLASMOSIS called Fibrosing Mediastinitis (FM). I have 100% occlusion of my RT PA, stent in SVC, partial occlusion of my left brachial-cephalic vein and jsut recently spent the week in the hospital due to a blood clot which formed from a failed angioplasty and am now on coumadin for life. I have been through 7 angiograms, 12 CT Scans and 3 Angioplasty procedures. IF FM doesn’t kill me then I will most likely get cancer from all of the radiation that I have been and will be exposed to. I am doing everything in power spread awareness of this disease! There is no research and no treatment! Maybe this show sparked an interest in research companies and physicians!!
Check out my website to learn more about FM and HISTO and how you can help…
http://www.mrsnewengland2007.com
Thank you!
Gina Starks
gina@mrsnewengland2007.com
May 3rd, 2007 at 4:01 pm
@Mary (#30)
In the scene where Wilson is leaving with the dog, the dog is walking with both front paws. But when House walks out after Wilson to leave in the opposite direction and the dog hears him, he goes back to limping… That was very cute!
I still wander if House threw him a Vicodin or a dog treat. (?)
May 4th, 2007 at 1:11 pm
Benmast: I was also thinking that his eyes were moist. “A very special House moment.”
May 4th, 2007 at 2:15 pm
Brian/Benmast: His look reminded me of a father who realizes that his son has finally grown up. In a twisted Housean sort of way of course. :-)
May 5th, 2007 at 1:16 pm
Kyle,
I see your point, and I’m sure that a lot of people (especially actors) share your view, but I, for one, don’t care to “explore” the characters of a show. In my opinion, the characters should communicate the story, they shouldn’t be the story. The only exception is a daytime soap opera in which the story truly is nothing more than the characters day-to-day lives. In any other show, such as House, character development is, to me, an annoying distraction from the real point of the show.
May 5th, 2007 at 1:28 pm
When they were rattling off the list of diseases that can cause scrotal swelling, why didn’t they mention mumps??
May 5th, 2007 at 4:57 pm
Kyle: Although I agree that characterization shouldn’t dominate the plot, neither should the characters become complete ciphers, either. There ought to be something to distinguish the characters, or else the story becomes rather two-dimensional. In any case, it really shouldn’t be that difficult to do both reasonably well. It’s not an either-or sort of thing.
May 5th, 2007 at 4:57 pm
Oops, that was addressed to Gary, not Kyle.
May 6th, 2007 at 6:07 pm
Imo we have seen far to much Foreman, I like the character development but i would really like to see more Chase or Cameron development,or really ne thing that is different and thus better than these last two epis they were extraordinarily dull.
May 6th, 2007 at 10:33 pm
Haha, yes, totally My Sister’s Keeper — but I’m sure it was unintentional.
May 9th, 2007 at 7:39 pm
I think homeopathy would have been more ‘effective’ and dramatic than leukophoresis. I’d dig seeing House talke for a few seconds about homeopathy.
May 12th, 2007 at 12:36 am
Do you think there is a chance to build a rating across all seasons, and post here? No doubt, your choice will find vigorous support.
May 26th, 2007 at 9:44 pm
In contrast, I saw the portrayal of the kid’s GVHD as highly inaccurate. He would have had to have already engrafted, and GVHD occurs typically at >30 days post transplant. Also, they were indicating that he had grade IV skin, however he wasn’t blistering or anything. He appeared to have completely intact skin!!! He just looked like he could’ve used a little lotion and some lip balm. I was shocked at how inaccurately this was portrayed. There’s no way there would be a time of 1 day or less to onset!!!
August 3rd, 2007 at 2:48 am
A lot of you guys and gals seem to be pissed about the drama aspect in which House is heading. I agree that House, a medical show, should not put the medicine on the back burner for a random episode about Wilson – but if they’re doing it so that we can start to see these characters on a deeper and more meaningful level, then I love it!
I didn’t read where anyone was complaining about Wilson. Wilson is the primary reason I watch House. Any episode more Wilson and more House/Wilson is a great episode in my book.
August 22nd, 2007 at 7:30 pm
I just saw the rerun last night. When I realized that Foreman’s bone marrow harvesting technique wasn’t part of a dream sequence. . . as a nurse, I could only imagine patients and their families switching on the TV for a fun hour of TV as part of their stay in a bmt unit. brrr.
November 26th, 2007 at 2:29 am
This episode treated a very serious disease in a blatantly erroneous manner. Unfortunately, having a step-daughter who went through a bone marrow transplant, I know more than I would like to know about this subject. The medical inaccuracies felt like a slap in the face. And I like House as a rule. But I am really disappointed tonight.
January 11th, 2008 at 10:34 pm
So I was just wondering, if Nick had the Graft vs host disease from the 4-of-6 marrow, how did the 6-of-6 marrow get rid of it? or would they have removed all of the 4-of-6 marrow first?
February 7th, 2008 at 4:43 am
Why has no one commented on the absurdity of using his dying brother as an incubator for the unknown bug? I guess I don’t have a logical argument against this sort of thing but I cannot believe it has ever happened.
May 5th, 2008 at 4:21 pm
What more obsurd is treating bacterial endocarditis by replacing the mitral valve. How could this ever work?
September 10th, 2008 at 8:28 pm
I love the dog hector, i love the end where he walks with a limp, so like house
September 27th, 2008 at 4:00 am
I thought the ending of this episode was ridiculous. First off Cuddy says there’s not going to be enough marrow, then foreman goes and tortures the kid in a dangerous procedure anyways, and without any meds or numbing(too sick to sedate…they’ve used this lame excuse before for dramatic effect, enough already). Yeah, in the end it worked, but what are the chances? He was acting desperately and could have very well ended up killing another patient. House should have been lecturing Foreman, not praising him.
November 15th, 2008 at 12:29 pm
The parents ask if he’ll be better in time to donate bone marrow to Nick. Cuddy sadly tells them no, that the infection has weakened Matty’s bone marrow too much. This doesn’t stop Foreman: he straps Matty down and performs a painful bone marrow collection procedure (which seems to contradict what Cuddy just said).
Totally! I was yelling at the screen “What the hell is he doing!? Cuddy just said it wouldn’t work! He’s assaulting the kid!”
December 5th, 2008 at 10:06 am
I should make a correction here. Cuddy said there wasn’t enough marrow, not that it was weak.
December 6th, 2008 at 4:01 pm
I don’t know too much about medicine; however, I’ve been researching a bit about graft-versus-host disease and bone marrow transplants, and after re-watching this episode, I’m wondering something…
Many websites say that peripheral blood is used for transplants nowadays rather than actual marrow. I’ve read that removing the marrow from the hip is considered a ‘traditional’ process. Apparently, after several injections of filgrastim, the donor can undergo aphaeresis to remove the blood stem cells directly from their blood. Is this true, and if so, how often do they perform transplants using this method? Why has it not been brought up? Would it not have worked for the two brothers in this episode?
April 8th, 2009 at 2:42 am
Um… I came here with the SAME question as Steve. It bothered me the most. How could a SECOND bone marrow transplant cure a bad response to a first one? Forget the inaccurate time stamps, like it taking a month for somebody to get acute grafts vs hosts… (couldn’t it ever be like this? How do we know it couldn’t?) Although, after reading the medical criticism I’m beginning to see as writer(s) how there is a pattern in their inconsistencies.. (They need a sense of urgency to every show and a timetable.. where the end equals death. And they need to show how incredible they are and how difficult the problem is… despite messing up and almost killing the patient, although I think most viewers have gotten more and more desensitized to the urgency. I have NOT gotten to season 4 yet, but I know they change the cast up and I am curious. Anyway, fitting all these parameters causes a predictable writing formula that is creativity stifling.)
April 8th, 2009 at 2:44 am
PS. Somebody please answer our question! Steve asked it first- Go up a few if you want to see- but I couldn’t BELIEVE nobody else asked it yet. It’s the most confusing unanswered question I’ve seen (medically) in any episode so far.
April 12th, 2009 at 9:29 pm
Hmmm…Cameron keeps saying that it’s autoimmune, House always says that it’s lupus or that it can’t be lupus, Foreman tries to link things with neurology, Wilson always wants it to be cancer, and Chase doesn’t have that kind of pattern.
I think they all just want it to be related to their specialty. And why not? Wilson probably wants more moolah because House keeps borrowing his, after sooooo many malpractice suits. And if you think that lupus isn’t related to House’s specialty… House is doing diagnostics. He gets excited from rare and unusual cases – lupus is pretty rare in their city, I’m sure.
=)
July 23rd, 2009 at 1:55 am
Hmmm… What does this episode have in it that is totally not copying “My Sister’s Keeper”…???? Hmm… Oh that’s a tough one. But wait! I think I got something! Well, the brother wasn’t born specifically for the purpose of treating his brother–That’s a big one. There was no law suit–That’s kinda important. The characters were different–Yeah I’m pretty sure that’s important too. Oh, and the happy ending.
But obviously because it was about a brother trying to donate bone marrow to his brother who has cancer, it must have been ripped off from that book. Oh yes. That’s clearly a very keen observation, and not just a stupid thing to say.
January 2nd, 2010 at 7:46 am
The medicine may have had it’s flaws – and yes – would be better if it didn’t – but I enjoyed the drama.
One of the worst things a show can do is STAY THE SAME. Characters need to change as a result of what happens to them. If they don’t, it gets boring.
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