House – Episode 7 (Season 4): “Ugly”
A mediocre episode tonight. There were several good ideas (the facial deformity, the documentary crew), but it never gelled into a good episode. The medicine was spotty and the soap opera focused too much on a few characters instead of spreading the wealth.
Kenny, a sixteen year-old boy with a prominent facial deformation has arrived at Princeton-Plainsboro Hospital for reconstructive surgery. A documentary team is trailing behind, filming everything. As Kenny is being prepped for the operation, his heart rate shoots up and he goes into ventricular fibrillation. This requires defibrillation and the placement of a pacing wire to get his heart beating normally again (a temporary external pacemaker is being used to restore a normal heart rhythm). He is admitted to House’s team for the work-up of his heart problem.
The initial differential diagnosis includes increased intracranial pressure, a congenital heart defect, or endocarditis. House dismisses all these. He has noticed some darkened skin under Kenny’s nose (identified as acanthosis nigricans) and suspects that he has been inhaling (”huffing”) Freon, which has damaged his heart. He orders a nuclear study (a test which uses a radioactive dye or marker) to look for scarring in the heart. The nuclear study is essentially negative, and Dr Taub (the plastic surgeon candidate) suggests that Kenny might have Toxoplasmosis and he wants to perform a lumbar puncture. House points out that Taub doesn’t really think that Kenny has toxoplasmosis, he just wants to do the lumbar puncture to check the intracranial pressure; Taub admits as much. House still thinks that Kenny has been doing drugs and orders an EP study (an electrophysiology study is one that uses tiny catheters to look for and treat abnormal rhythms in the heart). Dr. Taub starts the EP study, but stops when he determines that Kenny has never used drugs. About this time, Kenny starts coughing up blood.
The differential is now a Mallory-Weiss tear (a bleeding rip in the esophagus from prolonged coughing or vomiting), a nasal papilloma, a peptic ulcer, nasopharyngeal angiofibrosis, stomach cancer with paraneoplastic syndrome, or liver failure. An EGD is performed which shows no stomach cancer, but does show bleeding varices (distended veins of the esophagus), which go with liver failure.
Dr. Terzi suggests an autoimmune disease like Scleroderma, but is shot down. A mitochondrial disorder is suggested as well, and Dr. Taub continues to think that Kenny has increased intracranial pressure. His retinas are examined. They show no degeneration (said to be a sign of mitochondrial disease), but do show papilledema (a type of retinal swelling — a sign of increased intracranial pressure). When informed of this fact, House points out that Kenny’s skull deformity gives him an increased intracranial pressure and he’s lived with it all his life so House doesn’t think this is the problem. Instead, he suspects JRA (juvenile rheumatoid arthritis) and wants to start Kenny on steroids. There is a dust up between Taub and House and Cuddy ultimately gets involved. A head CT is obtained. House believes that is shows signs of JRA, while Taub thinks it shows something different. Cuddy sides with House and steroids are started. Taub is fired (but told not to leave).
Kenny shows some signs of improvement on the steroids, but House notices his little finger twitching and decides that he must be wrong and he does not have JRA. The team suggests Kenny may just be nervous about the operation. Dr. 13 suggests Lyme Disease but House points out that Kenny has no rash. Amber suggests Rheumatic Fever. Everyone else thinks that House was correct with the JRA and the steroids have it under control. The pacing wire is successfully removed and Kenny proceeds to surgery. Dr. 13 hangs around, concerned that House is right and something besides JRA is wrong. Looking closely, she realizes that Kenny does have a rash, it is just hidden by his deformity and hair. Shaving his hair reveals the classic erythema migrans rash of Lyme Disease.
The candidates (those that talked this week, anyway), all came up with some pretty good possible diagnoses. House, on the other hand, just seemed to randomly throw out diagnoses with little logic behind them
Lyme Disease seemed quite a stretch to me. You’ll notice they were quite vague about the time course because Kenny was exhibiting symptoms of both acute and chronic Lyme disease simultaneously. Only 60-80% of people with Lyme have the classic rash — so not finding it does not mean it can’t be Lyme Disease (but finding it almost guarantees it is). They never even mentioned ticks once.
Performing a lumbar puncture on someone with increased intracranial pressure can be very dangerous. The sudden release of pressure from the LP can lead part of the brainstem to herniate downwards, killing the patient or rendering them comatose. Getting a CT scan first is always a good idea (and admittedly there’s no suggestion that Taub would not have gotten a CT before doing the LP).
House’s reaction to the increased ICP was a little strange: it’s not an increased ICP, it’s not an increased ICP, oh, of course there’s an increased ICP but he’s always had it so it doesn’t matter. Why not just tell Taub that at the beginning and be done with it?
No joint pain in either JRA or Lyme Disease?
Did Kenny have bloody cough — as his symptoms suggested to me — or was it gastrointestinal bleeding? The differential focused entirely on the GI aspect, ignoring the pulmonary possibilities.
I can (almost) accept the Young Guns or candidates performing x-rays and CT scans, but not electrophysiology studies. They are very complex, and can be quite dangerous (one of my patients had one 2 weeks ago and his heart stopped twice during the test requiring defibrillation). It takes specialty training beyond regular cardiology to get certified, and no plastic surgeon is going to have those credentials.
Acanthosis nigricans looks nothing like Erythema Migrans and there’s no way you’d ever confuse the two. Acanthosis doesn’t show up on the face like that, either.
Was Foreman in the bathroom for the entire case? Nope, he was there, just so bland I forgot him.
The medical mystery just wasn’t that compelling this week and earns a mere C. The solution was a stretch, and House ruled it out earlier when he should have known better, so another C. The medicine overall was only average at best — the diagnoses were good, but then dismissed with little logic for House’s pet diagnoses. This also earns a C, for a medicine hat trick. The soap opera was mostly forgettable. Dr. Terzi seemed like an intriguing character last week, but you couldn’t have told that this week. Cuddy was mostly toothless. The spotlight on Dr Taub had promise, but neglected too many of the other more interesting candidates. The House/Wilson banter nearly salvaged the soap opera and brought it up to a B-.
The previous House review
A list of all prior House reviews
November 14th, 2007 at 1:02 am
I’m really quite suprised Terzi was hired and fired so quickly. Did the writers intend to put her on the show and remove her? Or was that a decision that was changed later?
November 14th, 2007 at 1:03 am
Yes, Dr. Taub was slightly interesting, especially when he tried to have House tossed out of the case. Wilson’s lines were perfect.
Cameron was silly. How come Chase gets to do such cool surgeries? Isn’t he at best a newbie?
November 14th, 2007 at 1:03 am
I didn’t like this episode much, to be honest.
True it had some character moments, especially when House had to reflect on his reasons for hiring them…
I did appreciate how the presence of a camera made them all look so self-conscious and idiotic. Nice confession by Cameron too. :D
I see Thirteen, Taub and Kumar being the candidates I would have chosen.
November 14th, 2007 at 1:08 am
You might have found this already but:
“I can (almost) accept the…” compley -> complex.
And Forrman shows up a lot in this episode. He was only in the bathroom at the start. (He’s House’s sanity check, remember?)
Nitpicks aside – I totally agree, this was a blah episode save for the House/Wilson bits. (Although I thought the twist at the end was pretty good too.)
November 14th, 2007 at 1:10 am
Oh Dr. Supermodel, how barely we knew thee…
So it’s settled then, Chase really is a surgeon after all, probably. Until he’s needed to be something else, then he will do the Cliffs notes training course between episodes. I imagine removing a deformity like that wouldn’t be something a “normal” surgeon would do anyway, certainly a specialist would have done that?
This whole “nobody knows 13’s name” business is really getting irritating now.
Also, the whole business of cameras going into every room, filming every procedure, going to every diagnostic meeting was nonsense. No hospital/doctor/insurance would ever agree to that. Some limited filming with sterile camera equipment in controlled circumstances like an operation where the surgeon can kick them out, yes. A free pass to go around the whole hospital harassing staff, film patients without their consent, and spread germs around? No way.
With the strike going on, after tonight there are five episodes remaining. Here’s hoping for some serious improvement.
November 14th, 2007 at 1:12 am
I found the documentary crew a distraction, in what was a clever tie-up of a number of simmering issues:
1) House the perv— he discovers he has to rein in his tendencies, and he actually does what Wilson suggests.
2) House the dictator— he discovers that he has cowed his subordinates into an unjustified faith in his diagnostic abilities: He has to argue that he may be wrong.
3) House the jerk— it is rather plausibly asserted that he doesn’t want the kid to have this surgery.
4) House the dictator II— he’s actually reduced to asking someone he’s just fired for a date. In front of a room full of onlookers who are also (for the most part) his subordinates. We’re not used to seeing him ask anyone for anything–let alone get rejected like that.
IMO the soap opera would’ve been much better without the camera crew which accomplished jack-squat as far as plot driving (except for the scene with House & Wilson reviewing the rushes).
And finally, has Kal Penn done -a-n-y-t-h-i-n-g- except furnish a convenient target for defibrillator based humor?
November 14th, 2007 at 1:12 am
Thanks for putting up your review so fast. Didnt like the whole lyme disease.
November 14th, 2007 at 1:12 am
Well, with a diagnosis of Lyme Disease, I believe I am officially out of running for the competition.
And I thought Acanthosis nigricans was associated with excessive insulin? (at least, that’s what I learned last week for my test which is tomorrow, ha!)
The only redeeming part of the episode for me was the mixing of House’s lines for the documentary at the end. “I got into medicine because of the movie Patch Adams.” And I don’t much like plastic surgeon guy, so I won’t be too sorry to see him go.
November 14th, 2007 at 1:24 am
Well, House was supposed to be out of whack/hormonal for this episode, so that’s an excuse for any diagnosis problems. Glad they ditched Terzi too; she was not nearly as hot as House acted. Surprised she didn’t hit him at the end.
-
I notice you don’t give a humor rating; understandable that it is kinda fitted into the Soap Opera category. I’d say this episode was around an A or so for humor, so it’s a winner to me. (So much better than Scrubs, which has such horribly forced humor. I’ve tried to give that show a shot so many times, but it’s just painful.)
November 14th, 2007 at 1:30 am
Episode was pretty weak. Worst part was the way that I found it actually hard to follow what people were saying, I suppose in order to create a
It’s clear that House was right to fire Terzi given the context that it was shown on the show, but I’m disappointed that House wasn’t able to pick up on her abilities in diagnostics before then.
November 14th, 2007 at 1:30 am
When Lyme Disease was brought up, I thought “I hope they checked his scalp”. I only thought of this because this case was on Scrubs two weeks ago and even then it seemed like a lame solution. I couldn’t help but feel a little disappointed, even if the explanation is coincidence.
November 14th, 2007 at 1:33 am
Oops pressed post instead of preview:
Episode was pretty weak. Worst part was the way that I found it actually hard to follow what people were saying, I suppose in order to create a more “reality show” atmosphere.
It’s clear that House was right to fire Terzi given the context that it was shown on the show, but I’m disappointed that House wasn’t able to pick up on her abilities in diagnostics before then.
Overall this episode really added nothing of value to the series. But the WORST part was that Scrubs already covered the Lyme Disease under the hair idea three weeks ago!
http://en.wikipedia.org/wiki/My_Own_Worst_Enemy_(Scrubs)
November 14th, 2007 at 1:35 am
[...] You can read the rest of this blog post by going to the original source, here [...]
November 14th, 2007 at 1:53 am
Why on earth was that doc crew shooting in black & white? Oh, right, to make this episode look like the movie “The Elephant Man.” (”I am NOT an animal…!”)
November 14th, 2007 at 2:10 am
Man I picked the wrong tick bite illness!
Before the first time they were going to perform the reconstructive surgery, wouldn’t they have shaved the kid’s head before going into the OR? Wouldn’t that be part of his preop?
Ok, let’s go with the kid’s head not being shaved before the surgery….. I’m surprised that they didn’t check his scalp or other places that have hair because in season 1 or 2 the girl that had a heart transplant had a tick bite in an unusual place. I also thought it was unusual that they did no lab testing for the mitochondrial disease, juvenile arthritis or lyme disease. It would have at least given them some direction to go.
I enjoyed this episode because of Wilson. When he said that line about House being a practicing wicca, I was laughing hard. It still makes me laugh.
November 14th, 2007 at 2:59 am
Jay: I thought someone posted that intensivists in Australia surgical subspecialists… if so, Chase being part of the surgery would not be unusual, and he said he had several specialists there, likely ENT and neurosurgeons. Also, the cameras are completely explained for hospitals/doctors/insurance. The cameras are paying for the medical care (insurance not involved), Cuddy approved the cameras, and the doctors really have no say…
Cheryl: Seems like they should have checked his scalp (and theres no way they saw the discoloration as 13 suggested but thought it was acanthosis) but I don’t know that shaving pre-op is part of it, especially since his surgery was on hold. No point in shaving a couple days early just to have stubs grow back.
Overall I thought the medicine wasn’t great (thought to myself that the “no target lesion means no lyme disease” didn’t make any sense), but there were several funny moments… House realizing he becomes an idiot around hot women, Cameron’s admission and attempt at a retraction, and especially the end with the out of context video.
November 14th, 2007 at 6:14 am
Started reading the reviews just before this season began – they’re great. Anyway, a few thoughts:
1) I actually rather liked the documentary crew, as well as a few self-aware jokes they provided (especially the ‘walking’ joke towards the beginning, which I thought was brilliant). Obviously a gimmick, but one I felt worked well within the context of the episode.
2) I think House’s failure to recognize the Lyme diagnosis worked within the context of the episode. Towards the end of the show, he seemed predisposed to not trust anything either CIA or 13 said, given his worries over his own perceptions with regards to the validity of their suggestions. That was why 13 was the obvious choice to pick the correct diagnosis. It showed a clear difference between the two ‘hot’ female doctors. While CIA was effectively useless, 13 showed she did in fact belong, confirming that House was right to pick her as a finalist in the first place.
3) At some point, some of the ‘new guns’ are going to need to differentiate themselves from the ‘old guns,’ in the sense that Drs. Mormon, Bitch, and 13 are to varying degrees foils for Cameron, Chase and Foreman (though Dr. Mormon has been moving away from that distinction with actual Foreman’s return – much less antagonism in his direction from House). It looks like 13 will be getting some more backstory in the next episode, so it’ll be interesting to see how they handle that.
Keep up the good work!
November 14th, 2007 at 7:04 am
I liked the scene when House asked 6/9 to say what 13 & CIA woman just said. I just figured they shot the documentary in black and white so you could distinguish it from the normal camera. The rest of the episode wasn’t that great, though.
November 14th, 2007 at 7:48 am
I had the same thought too, Cheryl. He would have had his head shaved bald hours before the first prep for surgery.
And given what team House has seen, were I on his team, I would visually inspect every inch of skin on every patient.
I also wonder about stool and urine testing that seems mostly absent on the show. Is the LUAT so specific that even if someone had looked at his urine they would have had to test for the specific antigen to find it?
****HEY GUYS AT FOX!!!!***** (I know you read this site ’cause Scott’s that good!)
The final documentary would make a great extra that would compel me to buy the season on DVD just to see it.
November 14th, 2007 at 7:56 am
Oh I forgot to add this about Freon. Freon isn’t cheap anymore. The small bottles are $12 or so even when you can find them. Someone looking for an escape from reality and too young to have a regular job is going to have a hard time getting his hands on Freon.
November 14th, 2007 at 7:57 am
Hey Scott.
Just make sure everyone knows about House going on hiatus because of the writer’s strike. I mean, almost every show is going on hiatus, but House obviously means a lot more than any other show here.
Apparently, there’s only a few more episodes after this one that have been shot, so there won’t be many more unless the strike clears up.
I was just thinking that it might confuse a few people when you just stop doing reviews.
Maybe EVERYONE already knows this – I don’t know. I just thought I’d say it, you know?
November 14th, 2007 at 7:58 am
“IMO the soap opera would’ve been much better without the camera crew which accomplished jack-squat as far as plot driving (except for the scene with House & Wilson reviewing the rushes).”
Ohh, you completely missed it. Thirteen, it’s all about Thirteen. The way she acted in front of the camera is some sort of clue about her. She’s incredibly insecure, the episode is also called “Ugly”, and we know that House likes to have hidden meanings in its titles. I imagine we’ll be finding out about Thirteen next week, “You don’t want to know”.
Also, I was just studying Lyme’s disease a few weeks ago, and I’d have to contest your rating. Sure, they didn’t mention a tick bite, but would that question have made much of a difference? The time scale was …out there as well, yes. But the symptoms, as far as I’m aware, fit pretty well. I don’t think Lyme’s disease was a stretch at all.
Ps. Liked to see House have a little thinking time in this episode, he doesn’t do that so much anymore.
November 14th, 2007 at 8:03 am
I think there’s enough episodes already filmed to last a while. According to TV Guide.com, there are 5 left. I imagine it will be all repeats (unless there’s a Christmas episode) until February though.
BTW, it’s Princeton-Plainsboro. Not Plainsborough. Plainsboro is an actual neighboring town of Princeton.
November 14th, 2007 at 8:58 am
Terzi did deserve to get fired; she was nowhere near good enough to be on House’s team. On the other hand, his firing her in front of everyone and then asking her out, that was just nasty. The look on her face said it all. What was the point? I liked the part about House getting stupid around a woman he’s attracted to, but the way it played out seems like it would only appeal to sadists. Is that what the writers are going for? Sometimes in this show, I am certain that it is.
Writers, please. House is brusque, brutally honest, careless, insensitive, unsympathetic, blunt, rash and a whole heap of other things, and we love him that way. With his personality, he steamrolls over people’s feelings all the time. There’s no need to add sadism to his list of personality traits. He’s improved since the low point last season (or was it the one before?) in which he insulted and verbally abused at least one little kid for no comprehensible reason other than the intent to hurt. Please continue to refine House’s insensitivities so that it’s a bit more obvious he’s not going out of his way to stomp on people’s hearts. He’s still going to do that of course, just not for the purpose of doing so–in other words, his hurting people should come from his belief that honesty is better than lying to spare someone’s feelings, rather than from some twisted desire to make people suffer.
Wilson’s yarn-spinning about House (soliciting gay sex in the bathroom and being a witch) was outrageous and hilarious. I’d love to see more of Wilson’s devilish side!
House to Cuddy: “There’s no part of you that’s small.” ROFL! Terrible thing to say, and untrue, but could be taken as a form of sneaky/sideways flattery as easily as an insult. Because Cuddy is able to take House in stride, his insults to her don’t have a sadistic feel like they do when he’s insulting, say, a sick little girl.
November 14th, 2007 at 9:09 am
I too, was surprised that House tossed out Lyme because there was no rash. As someone pointed out its not there in up to 1/3 of the cases. I can see the lack of joint pain because the kid had been living on acetaminophen. As for the test for Lyme, it has a very high false negative rate and can take up to a month after infection to show the disease.
November 14th, 2007 at 9:23 am
Right about that, Alex. There’s just two more episodes filmed at the moment, the last being shown November 27th. Darn writers! First they give us a very uneven House season, and now we’re not getting anything at all.
Ah well, it’ll clear over. :)
Like the rest of us, I really liked Wilson this episode. It’s a shame he’s being used far less than previous seasons, although I can see why.
November 14th, 2007 at 9:39 am
Okay.. two problems. Mainly because this kid was all set to go into the surgury then his heart goes wonky.
1) Wouldn’t they do a CT scan as part of the prep for surgury to confirm the position of the nerves/viens etc. Get the latest and greatest map of the area they’re about to cut into?
2) Considering the amount of cutting they were going to have to do wouldn’t they have shaved a good portion of his head anyway?
November 14th, 2007 at 9:42 am
I’d like to see some reason why House and Wilson are friends…they don’t appear to have any chemistry, they don’t hang out together; why are they friends? As a matter of fact, House doesn’t appear to have any positive human characteristics at all. Lately, he doesn’t seem to be a good doctor, either. Why isn’t House living in a cardboard box under a bridge somewhere, drinking himself into oblivion and cursing society?
The writing on this once-good show is really starting to depress me.
November 14th, 2007 at 10:10 am
Just would like to say I enjoy this great site, I always check what a doc has to say about House episodes. I really enjoy this season humor, the show is different but still great!
Re: Keith. Hum “The writing on this once-good show is really starting to depress me.” Hum are you sure you have watched last seasons? Wonder how you can say: “I’d like to see some reason why House and Wilson are friends…” when plenty of episodes have been devoted to just that… Wilson/House friendship is the core of the show.
November 14th, 2007 at 10:17 am
I’m not so sure that we won’t see the ex-CIA supermodel again. I can imagine a storyline in which she makes House’s life difficult for awhile. A woman who can kill with one finger might hold one heck of a grudge.
November 14th, 2007 at 10:23 am
This season is so busy. Every episode has twelve things going on and none of them get fully fleshed. The documentary was an interesting device. The “am I that guy?” thing was interesting. Taub’s backstory has value. But none of it got any legs because it all overlapped sloppily.
The Lyme Disease thing pissed me off. I live in the Northeast; the brochures handed out at every school and left at every doctor’s office say that the rash doesn’t always appear, and if it appears it isn’t always detected before it goes away. If I know it just from living in the New York/New Jersey area…! Joint pain and fever, though, are much more common and typical, and Elephant Boy didn’t have those.
The Wicca reference was fun.
November 14th, 2007 at 11:06 am
Best part of the episode was House and Wilson talking about asking 13 out or asking “Cut Throat Bitch” out. It was the most I’ve heard the term bitch on tv in a while and it was just ridiculous.
November 14th, 2007 at 11:55 am
I’ve JRA (always fun to explain THAT when you’re 43…), and I’ve had attacks without jointpain… It was a nice episode, but I often made the mistake
thinking the black/white images were what House saw.
November 14th, 2007 at 12:13 pm
Am a relative House newbie (started last spring), love this site and finally feel compelled to post. I thought this show was a marvelous self-sendup. House’s directions to the camera crew were spot on: (shoot from a low angle so I look god-like, walk backwards and show me walking and talking to pretend something is actually happening). Especially fascinating to me, was the (at last) addressing of the Why Are All Women Doctors Gorgeous issue. Next up: where are the AsianAmericans? Very astute – previous post regarding the double meaning of “ugly.” Also agree with the poster who says House himself is getting too nasty. Having caught myself up to speed with all the seasons over the summer (do I have a life? I think so) I think Mr. Laurie & writers need to take a deep breath and make sure they’re still presenting a psychologically plausible personality. And that would include the daddy-iced-me-when-I-was-bad backstory which very nearly jumped the shark. Paging Sylvia!
November 14th, 2007 at 12:16 pm
whoops, I meant “paging Sybil.” I’ll take multiple personality disorders for 400, Alex.
November 14th, 2007 at 1:33 pm
All I want to know is when did Chase get to be a plastic surgeon? Why was it HIM talking about the surgery in the beginning?
Boring episode. I’m disappointed.
November 14th, 2007 at 1:41 pm
Hi Scott,
First off, a great forum you got up here. I read your review every week after the show. I’m not much of a medical professional but I agree with you, the medicine was pretty lacking this week. First when House suggested JRA, I thought “where’s the joint pain/swelling?”. Then Lyme disease, I thought “where’s the tick”?. Did I miss the part where they mentioned the kid went camping or something? Where’s the kid from (he came in Jersey by train)? Anyway, may be House did get really distracted (got stupid) because of Dr. Supermodel. Best parts of the show were “witch-hunt” bit, the b!tch banter and the last part where the documentary made House look like this loving caregiver. Thanks Scott, keep up the good work.
November 14th, 2007 at 2:16 pm
Well, I may be the only one but I was entertained by the “soap opera” part. Not the best episode I’ve seen (I hadn’t been a regular watcher until midway through last season) but still enjoyable enough.
November 14th, 2007 at 2:43 pm
If pressed, I might give the episode barely a B. I do like House & Wilson together, so there were some good moments in this episode.
I was wondering if Dr. CIA is actually a doctor? I mean, wouldn’t the CIA have a top-notch doc on staff? Maybe she’s a sort of covert agent or something with some medical training? Anyway, that character was a distraction, glad she’s gone.
Just Netflixed Season One for getting through the strike.
November 14th, 2007 at 2:47 pm
What about those great zoom-ins to the innner-workings of the human, pig(Mob Rules: Season 1 Episode 15) body? I love the molecular view of diseases and blood cells. Did they just give up that device? I think the soap opera aspect of the show has ofically taken over- WHERE’S THE BEEF (medicine)?
November 14th, 2007 at 3:49 pm
I’m just relieved that no Proteus syndrome was involved – the trailer they ran the evening before had started with the kid in the train station screaming at the sight of Kenny, and I thought, “oh great, the makeup team must have seen Proteus syndrome in the script and jumped at the chance to do Elephant Man makeup without further research…” That would have sunk it for me.
November 14th, 2007 at 4:00 pm
I felt this episode marked a bit of a return to the morally AMBIGUOUS House that we knew and loved, what with his remarks to the kid and all.
November 14th, 2007 at 4:10 pm
I loved how House had to run everything Terzi said by someone else. “Foreman, does that make sense?” And how House was having a little identity crisis, “I can’t believe I’m that guy!”
I thought it was okay, comparing it to the beginning of the season. IMHO, the first couple episodes sucked a lot worse than this. Plus, next week looks even more fascinating!
November 14th, 2007 at 4:47 pm
Fairly boring episode of House, the documentary thing was a bit stretched, and the lyme’s disease thing was a little rediculous, in part since the hidden rash would be a grave mistake to make, though it could have resulted from the fact that House never lets any nurses near his patient, and nurses are the only one’s there regularly enough to notice it, that or Taub should’ve noticed it during the retinal-swell test.
The Defibrillator joke was pretty funny though, and Kutner’s oddly proud reaction.
November 14th, 2007 at 5:39 pm
One thing that I think stood out in this episode, something rarely seen, is House acting like Cuddy and Wilson are his colleagues, perhaps even friends, not his objects of abuse. The scene where Wilson and House are watching the tape, House shows a level of trust and intimacy with Wilson without much sarcasm or abuse, a level of comfort. They don’t show that very often, and it seems to me that sort of interaction is the underpinning of their relationship, why Wilson can stand House being House and why House can stand Wilson lecturing him all the time. That is what makes all the other crap believable. He actually asks Wilson for advice. Shocking. The scene at the end with Cuddy ribbing House and him taking it, without tearing her to pieces, is something I’d been waiting for. They have never really showed something like this that suggests Cuddy and House do enjoy each other’s company, which makes her willingness to put up with all his crap more believable. He really lashes out on her sometimes, and no boss would ever take that – but with a foundation of a friendship to some degree at least and mutual respect (we see Cuddy respects House, but usually not the inverse, which is what seems to come across here), she could take it and know that he may be an ass, but an ass that she knows cares about her. The whole thing with House keeping Cuddy’s attempts to get pregnant a secret even after blurting it out accidentally is right in this vein.
But is it me or is Cuddy getting better looking each season?
As far as the medicine, I don’t seem to be bothered by it as much as some other people here. Then again, I have a degree in English not medicine so my ignorance may be my shield against it.
One thing that strikes me though is although some things seem so unbelievable, the writers do stick to willing suspension of disbelief most of the time (though not always). Things that simply shouldn’t be possible, his doctors running their own tests, no mask in surgery, are waived. Those things wouldn’t happen, but it’s an accepted norm in this fictional universe they do. Aliens from a galaxy far away can’t fly because of our yellow sun, but we watch Superman movies and don’t care because the defined rules say it may be impossible for us, but here it is possible. It seems the same for House. The no mask, cure or kill, all these things that are just wrong are right in House’s universe and a given. It seems to me they’ve at least been sort of consistent in sticking to that, which is one of the reasons I can still enjoy it when even *I* can tell the medicine isn’t right.
But I do understand the complaints because the flip side of the willing suspension of disbelief is something that is quite possible but highly improbable happening, particularly character wise. Superman may be able to fly, but if he suddenly one day came out of the closet and killed Lois Lane, we wouldn’t accept it since it’s possible, but highly highly improbable. One example is the damn thing with Tritter. He just simply walks away? Possible, yes, but not likely and it detracts from the credibility of the writing since if we can’t depend on the more intuitive level of reality working with its own rules as opposed to the unreal but established medical imposed rules, then anything can happen and the whole thing breaks down. This is what I see slowly happening and it worries me. The whole thing with 3rd world frat boy suddenly out of nowhere acting in what seems a contradiction to his character faking polio (when he must have known House would figure it out right away) seems definitely possible, but not likely to happen at all. Or is it just me?
House sticking a knife in an outlet (itself not really being possible much less in a balanced system like they’d have in hospital with consistent voltage, not like a rickety old warehouse turned crack den) is just improbable. Doing something else to give him a similiar experience yes might happen, but going and sticking it in an outlet (and looking weak in front of his minions)…no not quite.
House does seem a lot goofier than usual. I don’t know if this is better or worse, but it’s different. To me it seems like maybe the writers thought, ok, he gets his leg back, then he loses it, then he gets back on the pills, then he gets in trouble with Tritter, then he loses his team and his life is utter hell… but now he gets a chance to start over and put all that behind him and he’s actually enjoying himself because of the events of last season, not in spite of but due to. Does anyone else think this makes any sense? The guy has gone through a lot of hell since the first episode, and I think if he were the same as in the first season it wouldn’t show any character development and people wouldn’t like him for staying the same, but if he changes, people don’t like him for changing.
In regards to not as attractive as we’re told she is CIA chick, I think House firing her and asking her out like that is totally in character. He didn’t think about her reaction or her feelings, just what he wanted and the most efficient way to get it. Early in the episode, he actually shows concern for her, guilt for possibly having to fire her after she gave up her CIA job. He didn’t seem comfortable with that. He very well might have just been as blunt as possible so he could bypass that tar pit of emotions and not get caught while treading in it, since if he showed sensitivity it’d make it more uncomfortable for him. He may be an ass and rude, but he wouldn’t go to the effort of being so unless it had some benefit for him.
In short, I think the writers are sticking to the established miracle medicine with no masks or germs just as much as they have since the first season (though maybe the ideas aren’t as good medically), so it’s still pretty consistent – just different in content, but the same in form. He’s still always almost eventually right. I’d rather see it just develop into something else than have what happens to other shows happen – fans of the show become writers and end up writing a caricature of the show to be as ‘House-ish’ as possible for what they want to see themselves, and not what’s good for the show.
What I’ve always liked about the show is it’s a mix of drama and humor. With the whole Tritter arc last season, I’m glad it’s dwelling on the humor a bit more rather than being as morbid as it was last season. Hopefully, if they’re playing the comedy up this much (seeing House do a victory dance was great and I enjoyed it but… a bit too much for me, too goofy), they’re going to be introducing more drama back into it after they settle on his new team (and get rid of cut throat bitch – she just straight out annoys me, which is either good writing or just an irritating character).
Is it just me or does Cameron look better with blonde hair? It seemed like brown hair made her head look really small somehow, maybe it was the bangs. Chase’s hair is still better.
Scott, thanks for this website. I really enjoy reading it after watching. How on earth do you get the reviews up so fast? I’m on the west coast and they’re usually up before it’s even over in my time zone. It’s great to be able to read about all these medical things that are greek to me, more than greek actually since I can read greek, argh you know what I mean.
Thanks to everyone else posting too. The level of dialogue on this site is usually head and shoulders above dialogue found anywhere else, smarter people better comments (even if I disagree with some of it – give this season a chance, it’s got a lot of potential and may look better after a few more episodes in context with the rest of the season!) I liked this episode though. But will it be more shocking and outrageous than every other shocking and outrageous episode advertised? Perhaps they will be including electrodes and a car battery with testicular attachments (or the female equivalent) to make good on their promise advertised. Definitely would be the most shocking House episode ever.
Oh, and I really hope as a promotion for next episode they auction off one of Lisa E’s personal thongs. She just looks better and better, 40 year old women don’t normally have that happen to them. Does wanting this make me a bad person for wanting this???
November 14th, 2007 at 8:43 pm
I have a burning question:
About that deformed kid’s head on House last night – why do you think they waited so long to do anything about it? This is a point of heated debate on another board. I say they had to wait until the kid reached a certain age and his bones stopped growing (like you wouldn’t perform a rhinoplasty on a child until his teens). Others say, what about the small children with deformities from other countries,brought here to be operated on, they don’t wait for those kids to stop growing.
Any reason deformed boy wouldn’t have already had surgery when it first became apparent?
November 14th, 2007 at 11:42 pm
[...] Read the rest of this great post here [...]
November 15th, 2007 at 1:46 am
I’m really confused about the JRA diagnosis – what was House thinking?! The patient lacked not only joint pain and swelling, but the possible fatigue, wacky fevers, and eye symptoms, as well. Also, I thought that it was lupus that attacked the liver, not JRA (it’s long-term use of JRA medications that’s bad news for the liver).
Sorry, I’ve got JRA, so I guess I get a little defensive when this show throws it around without reason.
Could someone clarify what the rationale for JRA might have been? (Or do we assume House was just bamboozeled by cameras and pretty women at the time?).
November 15th, 2007 at 1:53 am
OMFG – did you see just how MANY PPE violations were made during this episode, I was shock. During the scene ALONE where they find the rash, people had there GLOVED HANDS on their hips, below their waists, behind their back (this, after the fact that even Chase didn’t believe it was Lyme Disease, so why would the rest of the surgical team just deside o break protocol at 13’s request to check beneath his hair line once she comes back after talking to House? Shouldn’t they have ATLEAST been objective to that, and stuck with the protocol?) Also, during the first operation scene (after Chase says “it’ll take 5 surgeons…”) the surgeon that walks up to Kenny as he says this is (the say one that informs Chase of the problem) is UNGLOVED and touching a preped patient – do anesthesiologists not have to wear gloves while prepairing to administer anesthesia? Also, a nurse is wearing a PPE gown backwards which I found funny. During the nuclear study scene, Cutner touches with GLOVED HAND to his head, while Taub touches his chest in a later scene when prepairing to preform the EP study.
I can’t believe that this show is going down hill SO fast, not only in the little things like this but also in the writing I believe; isn’t it always the second half of the season where the writing’s supposed to go down hill? This episode could’ve been MUCh better, but instead I think this has to be the WORST episode ever out of the whole SERIES!
November 15th, 2007 at 2:08 am
Hello
I saw this episode yesterday. It was stated that porphyria is due to deficiency of the enzyme HMG co-enzyme A carboxylase. Actually the deficiency is that of uro-porphyrinogen synthetase.
Comments?
November 15th, 2007 at 9:17 am
dg, where are the Asian Americans? Excuse me, did you notice Kal Penn? I guess you mean Far Eastern, but last I checked, India was in Asia.
November 15th, 2007 at 12:59 pm
I feel like I am the only one that is really enjoying this season so far. :(
November 15th, 2007 at 3:11 pm
sorry, first year here, but just wondering if there are ways other than via a spirochete that Lyme’s disease can get transmitted? I mean, this kid was under a pretty tight leash and there was no explanation as to how he would get a tick. And the Scrubs parallel just pisses me off. If they truly wanted to be postmodern, some kind of reference to Scrubs would be the only way of redeeming that omission, even then, playing off a stupid mistake for humour is slapdash writing.
November 15th, 2007 at 4:01 pm
my bad, Deborah, shoulda said where are the Pacific Rim Americans?
November 15th, 2007 at 5:43 pm
Jason, it’s not just you, I’m really enjoying this season too. It seems ‘fresher’ than the previous one. The whole Vicodin issue and him going into withdrawals and getting in trouble, is he or isn’t he addicted got overdone last season, it’s good to see it not being a major issue (though I may have spoken too soon, the next episode preview sort of made it look like he’s in withdrawals, and that is 13’s “secret”. Then again, her secret may be a monkey fetish so who knows..). Not just you.
November 15th, 2007 at 6:53 pm
Weep not for Dr. Terzi’s job status – as soon as House fired her, my husband blurted, “She still has reinstatement rights as a federal employee! They have to take her back!” If she comes back to haunt House because of her lost career, it may be all over for him and the show. Too much disbelief, not enough suspension.
November 16th, 2007 at 3:01 pm
El Jefe, that was a lengthy post(#49), and every word was important. Well done. As an arts person who’s gradually becoming a medical one, it was great to see that sort of analysis of the narrative.
I think being a House fan is a little like being a sports fan; sometimes you need to overlook your team’s shortcomings in order to celebrate their high points. And nobody can pick apart their missteps like those who follow them most passionately.
November 16th, 2007 at 3:54 pm
About the rash: it looked different to me than a Lyme’s rash should look like (circular and/or ringed with a non-red circle in between). S/o asked how he could’ve gotten the tick. It just might be that he walked in a park or forest; ticks may land on you from then.
The dismissal of Lymes’ because of the alledged lack of a rash was not only stupid but even dangerous: shows like these should convey the message that Lymes can be contracted without that rash visible.
I really loved the final documentary as presented by Cameron. Otherwise, the episode was mediocre. House should get a bit more depth.
November 16th, 2007 at 4:24 pm
“They forked.” “And then they spooned.”
That line was so good it should have had a mention ;)
November 16th, 2007 at 7:13 pm
Don’t understand one more thing, House didn’t pop any pain pills during the show. Does pretty things distract you till the point that you forget your pain?
November 17th, 2007 at 4:49 am
I feel let down by this season. I keep watching with a vague hope it will improve, but honestly a few more poorly done episodes and I might have to go back to watching Law and Order reruns. the Wilson/House scenes don’t feel as natural as they did, everything is getting a slightly forced feeling to it. I guese the fact that House has a loyal fan base make the network believe they can change the feel of the show and still keep the ratings.
also one other thing. House was fine to me as stagant because HIS changes weren’t really the focus of the show. it was more what how his team changed themselves in the face of his overwelming personality. At least that was the idea I took away from it. We don’t want to see House change, we want to watch what other personalities do in contact with him. How Cuddy has changed since she hired him. Foreman’s metamorphis against his will, Cameron dealing with her idol worship. when he fired the whole crew I was looking forward to a new (smaller than current) group watching themselves change day to day just by being around him. I’m really not enjoying watching House’s monolithic arogence crumble.
November 17th, 2007 at 10:02 am
I enjoyed the final documentary excerpts which showed that what we see as an actual documentary is really a result of a film editor’s decision on what to show and what to leave out. If they could make House seem a warm and fuzzy doc, they can make anything look like anything else just by creative editing.
I loved House’s disgust and Cuddy’s glee at his portrayal.
November 17th, 2007 at 10:56 am
A few people have mentioned that House shouldn’t have dismissed the Lyme disease because of an absence of a rash. I thought the whole point this episode was that he was saying stupid things because he was blinded by hot women?
November 18th, 2007 at 12:15 am
“I’m not happy about it either. I don’t want the cameras watching you checking out my ass and questioning my wardrobe.”
“Would you prefer that I checked out your wardrobe and questioned your ass?”
Pretty crappy patient, the documentary didn’t do as well as it could have (interestwise), little development on the “House and pretty women” theme, but… some of the lines weren’t so bad.
November 18th, 2007 at 2:14 pm
I loved all the House/Wilson moments. Wilson’s doc interview was made of awesome. House’s brief observations about people’s attraction to pretty shiny things was perfect, just perfect. It appears next episode, House is going to reach a new low.
November 19th, 2007 at 12:12 pm
I think House has finally realized that its concept is ludicrous (guessing three diagnoses a minute and treating them all), and that the only reason people watch it is because they enjoy House’s character and the comedy on the show. After all, think the writers, how many viewers know that our medicine is awful? So they decided to overdose on the witticisms between weird characters and accept the faulty medicine.
What they don’t seem to realize is that viewers (at least the ones I know) laugh at the show, not with it. Personally I just watch it when I’m bored.
November 19th, 2007 at 10:44 pm
“This season is so busy. Every episode has twelve things going on and none of them get fully fleshed. The documentary was an interesting device. The “am I that guy?” thing was interesting. Taub’s backstory has value. But none of it got any legs because it all overlapped sloppily.”
I agree with Deborah. The show had several good ideas but nothing that connected them, no central theme. Perhaps the writers didn’t have time to write four or five good episodes, one per idea, before they went on strike, so they just threw everything together into one confusing plot and left the building.
November 20th, 2007 at 5:14 pm
Don’t forget to check your DVR for space and instructions. Tonight it’s “Bring me the thong of Lisa Cuddy.”
November 25th, 2007 at 9:08 pm
Maybe the rest of network TV sucks so outrageously, but I haven’t seen an episode of House I didn’t like, except the few with my old school chum trying to arrest House into oblivion over drugs. The writing and the irony and the acting were fine – I just hate true power intimidation of any kind. Hope the writer’s strike ends soon.
November 27th, 2007 at 5:21 am
El Jefe : The whole “does House have a Vicodine addiction” story was already answered WAY BACK in season 1 (episode 11 ‘Detox’) – I think that’s why season 3 wasn’t as great as season 2, becuase the writers when back to that plotline that was already answered before hand. Yes, House is addicted to pain killers, no – he doesn’t believe he has a problem with them because he “goes to work, pays his bills, makes his meals…”
I agree with Deborah, and that’s the reason why I’m so down about this season. There’s just too much stuff going on, it’s like the writers used a shotgun across a board of ideas; whatever had buckshot in it, was in the episode. It’s like the last episode of season 2 and the beginning of season 3 – House gets shot but, woops, the guy got away before anyone could stop him and nobody even cares to look for him at all. It’s just bad writing, the episodes themselves were fine on their own (hell – I LOVED the nod to Holmes with naming the character Moriarty and all, but I doubt they’ll have him back on in a future episode,) maybe even great (as it seem the last and beginning season show always are.)
And what ever happened to showing House watching his soaps – I always found those amuseing, because of the fact that House makes oh-so coy remarks on the diagnoses that they come up with.
Don’t get me wrong though, I’m still a rabid fan of this show, but the writing is just getting worse and worse – they’re taking each season and cutting it into two seperate parts (to which the first half just goes out the window in the second half) and it seems like the second halves are the worset.
As far as picking on the little medical mistakes and why it bugs me – it just does, being that I work in the field (and that it’s been slammed into my head so many times throughout my schooling.) I hate to do this, but I see no other choice – look at the show ER, they hire in REAL doctors to check the writing of each episode to make sure that what’s happing in the show, is mostly correct (as far as medicine goes and so forth.) I’m not saying that they’re 100% accurate or anything as far as that goes; just that I think that the production staff of House should do something like that. I say that, because either the writers are just dartboarding their episodes, or googling them (and not reading more than the first page that pops up.)
Ok, sorry for the rant – just had to get that off my chest.
December 2nd, 2007 at 5:53 pm
I just discovered your site through a link on Fark.com. I have been watching this show from the start and have always wondered about the truth behind the medicine. It will take me some time to catch up on the whole series as I am a (40+ year old) nursing school student. But I have it bookmarked for those times I don’t have my face in a text book. Looking forward to more.
March 11th, 2008 at 8:57 pm
Lassie sez: “I have a burning question:
About that deformed kid’s head on House last night – why do you think they waited so long to do anything about it?”
Remember the bit about the Documentary paying for the surgery? Maybe they just couldn’t AFFORD the surgery previously.
July 2nd, 2008 at 1:39 am
Just curious, watching the final version of the documentary at the end it shows the kid post-op. Is there some reason his eyes look screwed up (almost looking in different directions)? Is it possibly because of his deformity?
September 2nd, 2008 at 1:02 am
I was getting rather angry about the Lyme Disease thing too! I’m glad you mentioned that. I had Lyme Disease too, and my only symptom was joint pain – my hip joints started hurting for no reason while sitting on a sofa – AND I never had a ‘bulls-eye’ rash. I was thinking when they mentioned it “What about joint pain?” and when they discarded it “But _I_ never had a rash either!”
September 28th, 2008 at 10:56 pm
i have to agree on a comment that has been repeated from earlier 4th season episodes
the series started lacking emotional deepness… i remember a whole lot of episodes on season 2 and 3 had me about to cry my whole eyes out… because the themes had so much meaning, you could relat to the drama…. issues like paternity, emotional bonds between lovers, even family dealings that were portrayed so realisticly that one could feel with the characters
don’t know if fox decided to switch the scope because the actual scheme draws more views to the show, but i think it was a loss, i expect these kind of peisodes to come back
November 20th, 2008 at 6:15 am
The medical nonsense is annoying in this series. I would never let me film during my treatments, and i don´t think (hope) it´s like that in the US. Furthermore, pacemakers are electronical devices that can be turned on and off – and there is no need to pull the catheter to test it them. In Lyme disease, there is no need for the rash, and there are easy serological tests. Not to mention the symptoms don´t fit. And where were the tests for JRA?
July 4th, 2009 at 11:34 pm
I agree with everyone’s comments. Love this site; enjoy the series despite the sometimes sloppy medicine; would NEVER want to be treated by these mad doctors – would love, however, to go out for a drink with these characters!
My story: you don’t have to have the rash to have Lyme disease, but if you *do* have the rash you almost certainly have it. I went hiking last Sunday; felt not very good the days afterwards but thought I had just overdone it. On Thursday I noticed what I thought was an unusual mosquito bite; on Saturday morning I had the idea – thanks to this episode! – to take a look at Lyme rash photos on the internet. Had to spend all of Saturday afternoon at an emergency room but am now on antibiotics. So, despite its flaws, am grateful for the episode because it helped me catch this relatively early!
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