House – Episode 12 (Season 4): “Don’t Ever Change” (likely the Season Finale)
Quite likely the final episode of House in this strike-shortened season. Overall, it was a good episode even if it was another exploring the House-versus-religion theme. While the medical mystery was just moderately interesting (at least initially), the solution was clever, and the medicine mostly correct. Good soap opera too.
Roz is a Hasidic Jew, recently converted, and even more recently married. At her wedding ceremony, she loses control of her bladder, and a large stain of bloody urine appears. She collapses and falls, breaking her leg. She is admitted to House’s team for the evaluation of her condition. Dr. Thirteen reports that Roz’s urine culture was negative (meaning no urinary tract infection) and there is no history of trauma or sexually transmitted diseases. A CT scan was negative for cancer and kidney stones. She reports that Roz’s sodium was low, however, and suggests that Roz may have endometriosis of the bladder. Taub counters that the low sodium may be related to Roz fasting before the wedding, while House posits that Roz may have been exposed to a toxin, carboxylic acid in particular. House agrees to let Thirteen start Roz on treatment for the possible endometriosis (with AIs, i.e. Aromatase Inhibitors) and get a cystoscopy . Meanwhile, he sends Taub and Foreman to search Roz’s apartment where they find no carboxylic acid, but discover that prior to her conversion, she had been a heavy metal record producer. She admits to a history of heroin use, but not for some time. A hair sample is obtained, but the tests are negative. Additionally, the treatment for endometriosis has been unsuccessful and the cystoscopy clean.
Taub suggests Roz may have cryoglubulinemia (abnormal proteins in the blood that thicken with cold temperatures), but House feels she has porphyria (problems in the synthesis of hemoglobin), and her sudden conversion to Judaism suggests the mental problems commonly seen in certain types of porphyria. Roz’s husband considers this an insult, and requests a new doctor. Cuddy agrees with the cryoglobulinemia diagnosis and wants to start her on Indomethacin (a potent non-steroidal anti-inflammatory drug, the same class as Motrin). Meanwhile, Roz has become hypoxic with her oxygen saturation dropping to 85%. This argues against both cryoglobulinemia and porphyria. She is kept on oxygen and her saturation improves. Foreman mentions Wegener’s Granulomatosis, but House now believes it to be Lupus with a hidden heart problem. He orders a stress test. Roz makes it through the test well and has no evidence of heart problems. After the test, she develops sudden leg pain and the team believes that she might have a blood clot. An MRI is obtained, which shows no clot, and an fMRI (functional MRI, which works by detecting increases in blood flow within the brain, and these are believed to represent area of brain activity) is ordered as well, ostensibly to look for subtle signs of a stroke. The fMRI shows activity in her limbic system (one of the emotion centers of the brain) when Foreman is placing an IV (a painful situation) which House believes shows that Roz has masochistic tendencies, but Thirteen discovers she was praying during the IV placement, so that might explain the limbic activity.
As Roz stands up after the test, her blood pressure and heart rate come crashing down. When she sits or lies down, she is fine — she only has a problem when standing (orthostatic hypotension — low blood pressure when standing). She is started on fludrocortisone and ephedrine (two drugs that can be used to treat extreme cases of orthostasis). The differential now includes pheochromocytoma (a tumor that releases high levels of adrenalin and similar compounds), systemic sclerosis (better known as scleroderma, an autoimmune disease), and a heart arrhythmia. An EP study (”electrophysiology study”, which looks for abnormal rhythms in the heart) is ordered, but the results are normal. The suspicion now turns to an autonomic nerve disorder such as Riley Day Syndrome. A thermoregulatory sweat test is ordered, but instead of becoming overheated, Roz becomes hypothermic (an abnormally low temperature) and has a seizure.
Infection is now considered as a possible diagnosis, as is Addison’s Disease (a condition where the adrenal glands do not make enough steroid hormones). Roz is started on Cortisol to test for Addison’s and she starts to feel better (cortisol is a steroid hormone). As Thirteen examine her though, she notices a swollen abdomen and Roz reports that she is starting to feel dizzy. Thirteen quickly realizes that Roz has internal bleeding. Chase (apparently the only surgeon in the hospital this season) wants to perform an exploratory surgery to locate the source of bleeding, but Roz decides to delay the surgery until after she has had a chance to celebrate Shabbat with her new husband, even though it might cost her her life. The differential diagnosis now includes DIC (disseminated intravascular coagulation), hydatid cyst (a tapeworm cyst), volvulus of the small intestine (a twisting of an intestinal loop), polycythemia vera (too many red blood cells in the blood), thrombocytopenia (low platelet count) and even Parkinson’s Disease. During the brainstorming session with the team, House has a sudden revelation and realizes that Roz has a nephroptosis, also known as a floating kidney. Instead of being firmly secured to the underlying tissue, her right kidney is hanging loosely, just supported by a few blood vessels. This explains the blood in the urine, the internal bleeding, and the orthostatic hypotension. The strain this is putting on the right adrenal gland (located on top of the kidney) likely explains most of her other symptoms. The floating kidney was not noticed on the scans because they were all performed with her laying down and it only shows up when she is standing up. Surgery should be able to fix her problem and stop the bleeding.
I really don’t have too many medical complaints this episode, other than my usual litany of untrained people doing potentially dangerous tests and results comic back to quickly. Now, you’ll notice I didn’t say I had no complaints, just not as many as usual:
Roz didn’t just have a slight bit of blood in her urine, that was gross hematuria. In my mind, that should have necessitated a full bladder and kidney work-up from the very beginning that should have caught the nephroptosis.
Was it just me, or did they seem to keep forgetting about her broken leg? It never seemed to be splinted or cast. She did get to do the arm stress test, instead of the treadmill one, but that seemed to be the only acknowledgment of the broken leg.
I’m not clear on what caused her shortness of breath (that improved overnight) or her sudden leg pain (other than, you know, that fracture thing). Maybe blood loss and anemia led to her shortness of breath, but that much anemia should have been easily noticed on her labs.
They sure like to jump to the big guns early, don’t they? Aromatase Inhibitors. Fludrocortisone. Ephedrine. I’m not saying these drugs don’t have their places, just not first thing.
From what I read, there is some debate in the medical community over how significant a “floating kidney” actually is. All of Roz’s autonomic symptoms (hypotension, low sodium, low temperature, etc) are quite a stretch, especially when you remember that she was lying down when many of them happened.
The medical mystery was moderately interesting, frankly not something that would I would expect to pique House’s curiositu — I give it a weak B. The medicine was better than it has been recently, though still not without mistakes or unexplained symptoms — another B. I thought the solution was clever and elegant, though the severity of her autonomic symptoms were straining credibility. Still, I give the solution an A-. The soap opera was good and almost — almost – had me liking Amber. It was nice to see Cuddy back to her normal acerbic self, especially when she was talking to Wilson. I also give this aspect an A-.
All in all, not a bad quasi-Season Finale. Not a grand slam, but at least a solid triple.
The previous House review
A list of all prior House reviews
I’ve also posted information about next season’s Challenge, for all who are interested…
February 6th, 2008 at 12:27 am
Apologies if this shows up twice.
I found the last two episodes (”Frozen” and “Don’t Ever Change”) pretty enjoyable. All in all, a reasonably solid fourth (semi-)season.
February 6th, 2008 at 12:55 am
Man, the stuff House gets away with despite owing his career and freedom to Cuddy (remember that arc?). “I need to you have sex with Wilson” (what, no “good morning” first? :-P)
Since it’s apparent that even if the strike ends tomorrow, new episodes could not be produced by the beginning of summer (unless they bump off a summer series to make up for it), so this is probably the end until the fall.
Which of course means I must do all of my Thirteen ranting now or hold my peace for several months (the horror!).
This character is nonsense; a poor attempt to either clone Cameron or to have a generic “female” presence on House’s team. Blandly predictable to the point where the writers feel it necessary to throw in constant surprises to continue her tired, unnecessary, plot-draining “mystery” arc. The desperation here is so ridiculous that even after a “full” season, she doesn’t even have a NAME! Absurd! Tonight we learned out of the blue seemingly that she is bisexual. It’s almost as if they are coming up with random ideas about how to shape her character. She doesn’t even have a good come-back when asked about it and is left as a deer in the headlights, thus confirming it. Her participation in diagnosis work is nothing to write home about, she is being eclipsed rapidly by Kumar (how?? he’s supposed to be the idiot here who shocks himself with paddles!) and Taub. The premise in my mind is that bisexual tension will some how play her into the scene as it were and somehow give basis to her character. This is pathetically weak and disappointing. Is there nothing that can be done to make her more promising rather than having her on the team as the “token woman” and now “token bisexual” member? And of course there is the more involving argument about why she is being played up as bisexual just because she doesn’t immediately try to get into House’s pants, but I’ll spare you all from that. Needless to say I won’t be disappointed if she somehow gets fired or quits (maybe they can turn that into a big crying session just to complete the stereotype).
Other than that, as with the last episode I will spare any more serious criticism due to the obvious effort made to improve the quality of the episode. If they want to win Emmy awards though, they will need to grow beyond this and start hitting home runs with more regularity.
Just in case this is the end for the year, I just wanted to thank Dr. Scott and all the regulars here for all your intellectual stimulation and the fun times. Stay safe out there and let’s hope to be back in action here again soon!
February 6th, 2008 at 1:02 am
i thought this was a mistake in the show but apparently not – you can get endometriosis in the bladder? there no endometrium!
love your reviews
alex
February 6th, 2008 at 1:21 am
@Alex B: As I understand it, endometriosis is when the endometrium grow outside of the uterus, so by definition endometriosis can only happen where there’s normally no endometrium, like the bladder.
February 6th, 2008 at 2:01 am
They did show a cast on Roz’s left leg in the scene at the end where they lift her up from the gurney.
I’m not sure why her husband didn’t avert his eyes at that point.
February 6th, 2008 at 2:38 am
[...] Taub suggests Roz may have cryoglubulinemia (abnormal proteins in the blood that thicken with cold temperatures), but House feels she has porphyria (problems in the synthesis of hemoglobin), and her sudden conversion to Judaism suggests the mental problems commonly seen in certain types of porphyria. Roz’s husband considers this an insult, and requests a new doctor. Cuddy agrees with the cryoglobulinemia diagnosis and wants to start her on Indomethacin (a potent non-steroidal anti-inflammatory drug, the same class as Motrin). Meanwhile, Roz has Source: hasidic jew – House – Episode 12 (Season 4): “Don’t Ever Change” (likely the Season Finale) [...]
February 6th, 2008 at 3:33 am
I hope they don’t make Thirteen’s orientation too much of an issue in future episodes.. This show is popular and intriguing enough without having to resort to this type of crap for publicity. Btw how is it that nobody knows 13’s name after all this time?
February 6th, 2008 at 3:40 am
I believe the toxin they were suspecting was carbolic acid (an outdated
name for phenol). In any case, carboxylic acids, being a large group of
compounds, would not make any sense here; especially since many of
them are not particularly toxic at all (e.g. acetic acid, citric acid,
…).
February 6th, 2008 at 5:50 am
Yeah, it was carbolic acid they were looking for at the apartment, not carboxylic acid. Carbolic acid (phenol) was Joseph Lister’s original antiseptic.
February 6th, 2008 at 6:11 am
I thought the episode was OK. I am getting a little tired of House’s “Religion is the opiate of the masses” rants. It would be OK if they started making a joke about it, like they do Lupus. Actually, that could be kind of funny. Someone comes in with Lupus, but House thinks its religion. Or even some crazy Athiest comes in, and the team keeps telling House he needs to consider Denial as a symptom, because the guy won’t admit he is a closet Baptist (he is crazy, after all). Something like that.
One thing that is interesting is that according to the final solution, I guess she WASN’T a masochist, and WASN’T crazy… though no one pointed this out to Dr. Uber Athiest. I would expect Foreman to, just to stick it to him, or even Wilson to reflect the other attention on Amber. Or someone.
Kumar’s obsession on Star Wars and Star Trek was a stretch that didn’t work. “I gave up my life, my music, and my drugs.” “My God! You mean you can’t watch Star Wars???” Huh? Did someone do a survey and find out that Trekkies liked House or something?
Another problem is they never resolved the: “I want a different doctor” scene. And I thought House went to far with the “In this temple I am Yahweh” line. In fact, right up until there, I thought he was making a great argument that the guy would accept, and resolve the issue. Instead he blaspheme’s to the point any hasidic Jew would be screaming to have him replaced. Bad writing there. They had a perfect “House understands people” moment, and they threw it away to get a Lenny Bruce type laugh…
Dr. BiSexual has me worried. I can see her now having affairs with Wilson, Chase, and Cameron. Great. Just what we need. The way that both House AND Foreman deduced it was good. I hope that is the end of the plot-line. I really don’t need to see her seducing both men and women in the hospital. Maybe she doesn’t have Huntington’s. Maybe its Syphilis.
Great Lines:
Unfortunately, House doesn’t have the great lines this week. (Maybe that’s why I thought the episode was off. House gets retreads on his religious rants, and everyone else gets the good stuff.) Wilson gets the best lines, I thought.
The “My God, you’ve been sleeping with me!” line would have been better if we hadn’t seen it in the previews. The follow-up with Wilson telling him: “We’re a couple” will have the “House and Wilson are secretly gay” forums buzzing this week. I wonder if the writers threw them a bone (so to speak) before heading off to strike. That guarantees the show will be talked about SOMEWHERE while in reruns.
I give the Best line of the episode to Wilson. Given to Cuddy when she starts harassing him: “House, what a terrific disguise!”
I give runner up to Cuddy. When House tells her she has to sleep with Wilson to save him, she replies: “I can’t. As Chief of Staff, I have an obligation to sleep with three guys from Accounting first.”
February 6th, 2008 at 6:56 am
Isn’t House supposed to be specialized in Nephrology ? Why did it took him so long to guess a kindney-related disease ?
February 6th, 2008 at 7:18 am
No pill-popping lately, but at least we’re back to having regular seizures! And nice to see the writers showing House’s human side again.
Scott, in the future, please begin rating the actors on the believability of their seizures. Yesterday’s was, I thought, a bit over the top.
February 6th, 2008 at 7:26 am
I have to say I really laughed out loud when House and Wilson had the conversation in the restaurant about Wilson dating House. The expression on Wilson’s face was priceless! House’s even more so! And Cuddy’s line about the Wilson chalk line was great, too… still makes me smile thinking about it. I hope there’ll be some new episodes but I, too, think this was the last episode until next fall or whenever they settle the strike…
February 6th, 2008 at 8:17 am
Best one-liner:
“C’est la vie. And… I say it in French, because… you’re an ass.”
February 6th, 2008 at 9:19 am
Anon, that was my favorite line as well. Both Cuddy and Wilson had me in hysterics.
February 6th, 2008 at 11:00 am
I just want to thank you again for such informative reviews of this program. After video-taping the episode so I can fast-forward through the commercials the next day, reading your reviews has become an integral part of my viewing pleasure. House, M.D. is a smartly scripted and well acted series. I find some of the lines funny enough to really make me laugh out loud. And compelling enough at other times to bring on some tears.
Daniel Reicher in Montreal, Canada.
February 6th, 2008 at 12:28 pm
As a computer geek, I found it interesting that the medical mystery this week was essentially the biological version of a Heisenbug.
February 6th, 2008 at 2:11 pm
@MarkJoel: Her ailments turned out to be caused by floating kidney. That doesn’t mean she wasn’t a masocist or batshit for that matter.
Agreed about the best line tho’. Had me loling in real life.
February 6th, 2008 at 3:14 pm
@ Mr. Uber Athiest:
Maybe so… but her Religion was not a symptom of her kidney.
@Tamara
Yeah, the Wilson Chalk Line was great. It was a toss up on that one. But Cuddy’s line about sleeping with the accountants came from nowhere, so got the nod based just on the suprise factor alone.
And I forgot to mention earlier:
@Jay:
I agree. I am HOPING that 13 becomes a patient in an episode real soon, is cured, and then leaves. I’ll bet she can do a great seizure…
And I wouldn’t mind a half season of House conning Chase into joining them in the differential from week to week (like he did this week).
February 6th, 2008 at 3:38 pm
There are several shots of the leg (with a cast on it). Somehow though, the cast appears very inobtrusive, not the cliché ski accident type.
Anybody think we’ll see a situs inversus in a future episode? Having no medical knowledge, that was my first thought when House had his epiphany moment this time, as he was muttering “Of course that doesn’t mean things are where they SHOULD be”.
February 6th, 2008 at 5:09 pm
I normally never really comment on this, as I’m a huuuuuge lurker XD
Buuuut, I’d like to thank you for your wonderful reviews, I always turn to this website and read after watching the episode :)
second: I have no problem with thirteen. I like her, she has a…pleasant vibe. I think it’s funny though that’s she’s bisexual…again XD She was also in The O.C., and was bisexual there too. Is she the only one in hollywood to not mind playing a bisexual woman? XD But really. I read a comment here (can’t be bothered to look up who wrote it, somewhere way up) that said: Is she going to be the token-bisexual in the show? I think it’s stupid to even consider that. Is Wilson the token-heterosexual? No. Of course, bisexuality is apparantly ‘cool’, totally hip and whatnot, but don’t make any conclusions based on nothing? Thanks.
And thanks again for the review!^^
February 6th, 2008 at 7:30 pm
I think my favorite line was Cuddy to Wilson about CTB taking him home, hanging him upside down and laying her eggs in him.
February 6th, 2008 at 10:32 pm
@MarkJoel
Not that you meant your comment this way necessarily, but it really bothers me that people stereotype bisexuals as promiscuous. Nothing about the character thus far indicates that she would have affairs with multiple people, sleep around or be unsafe.
I think the Girls Gone Wild generation has really hurt bisexual girls in this country. Just because some girls make out with other girls for attention (namely when they are drunk) doesn’t mean that all bisexual girls are promiscuous attention-whores.
As a bisexual person it affects me to have to deal with stereotypes and prejudice and I imagine its no easier for girls. If the writers are actually being progressive with their choice, I applaud them… on the other hand, if they are aiming at shock value and in the future plan on playing in to the same stereotypes I’m decrying here, it’ll be very disappointing.
February 6th, 2008 at 10:49 pm
I thought she had Cortisol deficiency AND floating kidney. No?
February 6th, 2008 at 11:23 pm
Official Comment
The cortisol deficiency was (more or less) linked to the floating kidney as cortisol is made by the adrenal gland, which is located on top of the kidneys and would be subject to the same “floating” trauma,
February 7th, 2008 at 12:03 am
Does anyone else think CB could be pregnant.
I mean, big shirt, it looked like house gave a weird look when he drank her drink.
She as always in jackets any other time we saw her, and mostly with a scarf covering the stomach.
And this was one of the episodes where i thought the medicine was “bad”, as in I didn’t like it.
February 7th, 2008 at 1:28 am
“From what I read, there is some debate in the medical community over how significant a “floating kidney” actually is. All of Roz’s autonomic symptoms (hypotension, low sodium, low temperature, etc) are quite a stretch, especially when you remember that she was lying down when many of them happened.”
If floating kidney causes Cortisol deficiency then can not the latter account for the significance of other symptoms? I mean after they gave her Cortisol all of her symptoms vanished except for the internal bleeding. Right?
February 7th, 2008 at 6:07 am
@ Brad with a Cane
First off, I don’t think they introduced 13’s BiSiexuality to be progressive (whatever that means). I think they thought it gave them plot possibilities. There were three “flings” that I can remember on the show so far. The Foreman/Nurse fling — went nowhere. The House/Stacy fling — was part of the story arc. And the Chase/Cameron fling — which the writers seemed to really like, since it stayed in the conversation (”It’s Tuesday”) and eventually became permanent.
Now… what do you think the writers will do with her BiSexuality? My guess is she will end up with at least one male and one female before her time on the show is done. Otherwise, why would she be called BiSexual? She could be a Lesbian or a Heterosexual — but they went for “Bi”. And frankly, her “outing” was unprovoked, so they revealed it for a reason. Since the fling dealing with a non-character sort of flopped, I think it will be with one of the main characters for 13. I’m betting Cuddy and Kumar. And I really don’t want to see it — I think it will ruin the show.
BTW, I think one needs to define Promiscuity. I would say that Wilson, for example, is Promiscuous. (He has sex with a patient after buying her groceries?)
I would also say that BiSexuals, as a group ARE more promiscuous. According to Durex (who have a reason to track such things) a BiSexual woman has almost three times as many partners as a heterosexual female. She even has more partners than a homosexual woman. A biSexual man has three times the number of partners than a Heterosexual man. Though, the homosexual man has more partners than anyone — by far. As a group, it is fair to say they are more promiscuous…
@ Emma:
No, Wilson is not the token Heterosexual. He is the token Handsome doctor who cares about his patients. :-)
February 7th, 2008 at 10:09 am
Regarding Doctor Thirteen’s bisexuality –
I’m not convinced she IS bisexual – she seems pretty good at dead-pan psychout expressions. If it turns out she IS, that’s fine. She doesn’t seem to be the sort of person to go in for circus acts the way some of the others on the show talk about.
If the writers just threw it in for diversity’s sake, I really wish they’d kept the “wheelchair doctor” as well. It really irritates me when shows introduce a character with some sort of disability just to make some Grand Moral Point, or in the case of “House”, an excuse for House to be rude to yet another person, and then that character disappears forever. Wheelchair Doctor & Dwarf Mother both are strong female characters who stood up to House, thus making them great fun to watch.
February 7th, 2008 at 4:15 pm
@MarkJoel
First off, I was referring to 13 having flings, not other characters in the show. Secondly, is there a reason you didn’t link to your source for those statistics? I would be interested to see them and analyze their methodology. I have no idea if they are accurate or not, but I am interested. Also, promiscuous means “characterized by or involving indiscriminate mingling or association, esp. having sexual relations with a number of partners on a casual basis.” (dictionary.com) The number of people someone has slept with does not convey whether or not they are promiscuous. I can have twice as many sexual partners as you, but always be discriminate and formal (as opposed to casual).
Also, promiscuous alone was not what I meant to convey. I think I said promiscuous attention-whores and by that I meant people who flaunt their promiscuity and are overly (I guess by my definition) open about their sexuality in public. I don’t think number of partners alone says very much and I think it can be argued that a huge contributing factor to LGB people having more partners is the lack of legal marriage and the child factor. Straight people (obviously) more frequently get locked into relationship-contracts and are told by so many institutions that they have to stay together, especially if children are involved. I think its easier to escape a bad relationship where there won’t be a court battle and custody issues to face. So I would argue that those statistics are skewed by other factors than just a sexual orientation’s natural promiscuity, which I think is a ridiculous notion.
Lastly, how can you say you didn’t think the writers were being progressive when you didn’t know what I meant by it? I personally feel that although very gradually we are having more accurate representations of ‘everyday’ gays and lesbians, we are rarely shown bisexual people on TV and when we are, usually its like in the closing scene of Dodgeball: its about chauvinism and exhibitionism.
February 7th, 2008 at 4:22 pm
@MarkJoel
I would like to add that your logic about potentially why they labeled her as bi (so she could be with partners of both sexes) is sound. I agree with you there and I hope they don’t do that. This ties in with what I meant by progressive… showing bisexual people as they more frequently are, not how they are typically shown on TV, not for ratings or shock or anything like that. I don’t have statistics, just my experience with the LGBT community and I feel that most people I know are “regular” people, not sexual deviants flaunting their differences (again, unless for chauvinistic and/or exhibitionist purposes and those are usually people who don’t identify with the LGBT or especially the B community.)
February 7th, 2008 at 7:11 pm
I’m curious as how Foreman picked up on 13 being bisexual – is wish they would have him explain how he knew. Does she just have that bi twinkle in her eye? House apparently has picked up on it too, and Foreman doesn’t seem like the type to gossip.
I’m liking Kumar more than I thought I would, his “dumb guy-really smart doctor” charm is a refreshing way to cleanse the pallete of the show’s usual snarkiness.
And boo at Cutthroat Bitch being back – she’s still boring as ever, it really would have been more interesting if she was just using Wilson to get to House.
February 7th, 2008 at 7:19 pm
Hey I’m a pharmacy student and I love to read your insight on these episodes. A lot of the time I wonder why they make some of the medications choices they do, they certainly jump to big guns a bit hastily.
February 8th, 2008 at 12:31 am
@Emma
Wilson is not a “token” anything. He has a fully-developed character central to the show. Can you really say 13 is in the same category?
February 8th, 2008 at 4:46 am
Thanks…I admire your site.
February 8th, 2008 at 5:57 am
@kimberly42
Interesting thought. I hope you are right, since that would make her more interesting. But, I doubt it. You bring up a good point about the Wheelchair doctor who fought him for his parking space. I’m surprised that she has never been back. I guess they feel having someone else with a handicap would diminish House’s? Which is why no one else ever takes a pill for anything.
@ Schmapdi
Exactly my point. She makes one comment about not wanting to be labeled and Foreman instantly knows. And House wasn’t even there when she made the comment. So, that is an interesting leap. Which is why I am convinced the writers forced it into the plot for a reason.
As for characters I miss, I wish they had not gotten rid of the old guy who wasn’t a doctor, but who gave Taub a run for his money. I thought making him an assistant was a cool work-around. I wish they would have done it.
However, on the topic of strong female characters, maybe we have a shot of the Miro Sorvino being back. There is an interview with her on the Fox House MD site. Turns out she is a huge fan of the show, and wants the role to become semi-permanent. Here’s hoping…
@Brad With a Cane
Not going to debate BiSexuality here with you as it is rather off topic.
February 8th, 2008 at 6:27 am
CTB – the restaurant scene was interesting and Cuddy-Wilson/House-Wilson exchanges were classic. So – quality return.
13 – I have more minimalistic approach: they could make her bisexual only to let House use “You do it both ways” line. Without us knowing earlier, that she’s bi, it wouldn’t make sense.
Bisexualism – it’s obvious that bisexuals have, by average, more sexual partners. The pool of potential partners is twice as large for them as for monosexuals.
House as Yahveh – he _had_ to say the line in Cuddy’s office to create a mini-arc solved with Chase line: “Joshua got god to make the sun stand still. No reason god can’t speed it up. And, by god, i of course mean you”. So “I’m the Yahveh in this building” fits perfectly.
February 8th, 2008 at 10:25 am
I did not think she ‘converted’ to Chassidic (which is just an observance level) Judaism. I thought she was already Jewish, but due to her lifestyle and issues, found solace in the strictures and lifestyle of Chassidism. They also mixed and matched several Chassidic groups in the wedding scene. There appears to be at the least Chabad-Lubavitch and I am not sure what else, there was a guy with a Streimel (big fur hat, not common in Chabad). Just an interesting aside from a Chassidically inclined House viewer (naughty I guess from the no TV aspect)
February 8th, 2008 at 11:55 am
TRad: Why would the size of the pool of potential partners strongly affect the level of promiscuity? Unless you’re living in a remote area, you can probably find people to hook up with if you’re so inclined. By your logic gay men ought to be much less promiscuous than straight women, because there are more straight men than gay men.
February 8th, 2008 at 1:22 pm
@MarkJoel
I really wasn’t aiming for a debate, I just wanted to clarify what I had meant previously because it seemed you may have misunderstood. I have just one question; why do you capitalize the S in bisexuality? I don’t think I’ve seen that before.
February 8th, 2008 at 8:12 pm
I’ve studied the brain only in passing, but I was curious about the fMRI.
What Foreman starts doing the IV thing, Roz starts praying, but House interprets the neural activity as happiness.
Aren’t there different areas of the brain for happiness and religion? So a conclusion of happiness wouldn’t/couldn’t be reached since that area would not lite up, right?
February 8th, 2008 at 9:26 pm
Regarding the Star Wars reference, I am a big Star Wars Fan, and also House M.D. is my favorite show.
February 9th, 2008 at 9:28 am
Schmapdi, I think Foreman picked up on it from 13’s “Just because of who she is now doesn’t invalidate who she was before.” That’s a fairly clear sign that 13 has herself been a target of those thoughts. Bisexuality is a pretty good guess, so Foreman would try it first.
February 9th, 2008 at 3:29 pm
Not having had a chance to see the episode yet (so maybe this was addressed in it) but the idea that Roz would not have the surgery so she could celebrate her first Shabbat with her husband seems a little unrealistic. Surgery isn’t something you’d normally do on Shabbat, because it involves banned cutting, sewing, turning on and off of lights and a few other forbiddens. However, Jewish tradition dictates that the rules of Shabbat and any other rules of ritual are laid aside in an emergency, especially the saving of a life. In fact, a Jew who died because of failure to break the Shabbat rules in such an emergency could be ruled a suicide.
February 9th, 2008 at 10:45 pm
Hi Lisa,
I think she wanted to celebrate it because it was the first Shabbat with her husband, and remember, she’s only been Hasidic for 6 months and may be still pretty zealous and enthusiastic about it all. On the other hand, she was pretty despondent at that point, maybe she wanted to die or just didn’t want to have surgery. Also, that detail then lent itself so easily to House being able to “play God” and at Chase’s suggestion speed up time so she could celebrate Shabbat and let him get on with the all important goal of saving her life.
Personally, even though House’s bending the truth and outright lying are, of course, a staple mode for his “saving the day,” it really rubbed me the wrong way that he tricked her into celebrating Shabbat when it really wasn’t Shabbat. I’m sure we could argue physical reality vs. condition of the heart and agree that for her it really was Shabbat in her heart. We could even assume that “Hey, it’s sundown somewhere, right?” and say that she’s just celebrating a few miles too far west. But it’s the fact that her tricked her. I know he rarely considers his patients wishes, but really this seems a step too far. Screwing with someone’s faith and religious rituals behind their back like that seems incredibly disrespectful even for House.
February 10th, 2008 at 4:27 am
It seems that the writers will be back on Monday (11th Feb) any estimates when House will return??
February 10th, 2008 at 6:34 am
Everyone seems to have missed the real best line in the show, when House was criticising the patients religion and wilson said ” sure, we can just give her 10cc’s of atheism and send her on her way” maybe my sense of humour is different but that line was classic.
February 10th, 2008 at 6:42 pm
as a religious jew i’d just like to say the realism of the chassidic element was way off
February 10th, 2008 at 7:45 pm
I’m not sure about how i feel about the new season i just wish they’d get something decided. They keep adding new things, bringing back people like CTB.
The Wilson/Cuddy lines were briliant. – Chalk shaped Wilson!!!
February 10th, 2008 at 7:46 pm
Oh yes and I forgot to mention that 13’s real name is Remy Hadley. When Chase was holding the bet on who House would fire next there was a slip with they’re names on it.
February 11th, 2008 at 12:13 pm
TV Guide says House is expected to shoot 4 to 6 new episodes to air in April/May.
February 11th, 2008 at 6:33 pm
A couple of comments.
First, I think they dropped 13’s sexuality as a “teaser”. When pretty attractive females hook up on prime time, ratings tend to go up. I think they want 13 to be in a relationship arc later in the series and they wanted to expand their options. Plus it set up the house quote about doing it both ways. It gives the writers some room to play since they couldn’t do this with Cameron or CTB.
As for Roz’s desire to observe Shabat, I think the overwhelming reason that she was willing to do this was that she thought she would die either way (remember the questions about her chances with and without the surgery?) and wanted to celebrate one Shabat with her husband before she died.
And regarding Kutner, I think that most of us remember the bright but clumsy guy from our college days that had no social skills. That’s Kumar. I know that many of those guys from my past eventually grew up and matured into functioning members of society. I think that they are just speeding up his maturity, but doofy-guy-matures, will definitely keep some of the geeks out there watching. As long as they remember to keep mixing in examples of his cluelessness (in waning amounts), it seems realistic to me.
February 12th, 2008 at 3:52 pm
I am the only one tired of the “newbies”. The premise for the “survivor” type episodes in finding replacements for Chase, Cameron, and Foreman were interesting, and the new docs are ok, but I’m ready to get back to Chase, Cameron, and Foreman. They had great chemistry, especially with House. Chase has House figured out better than anyone, and 13 can’t compare to Cameron for sexual tension with House. They are still billed as the “stars” on the opening credits, so surely this experiment has to end sometime. I would be fine with leaving some of the newbies on (Kumar is hilarious) and 13 should definitely get her own “sick” episode – they’ve hinted at it enough!
Maybe I’m just resistant to change, but the chemistry of ALL the characters is what sucked me in in the first place. The shows seem too formulaic now.
February 13th, 2008 at 10:12 am
13’s name is Amber just incase nobody knew
February 13th, 2008 at 11:23 am
I’m sorry, Kal, but “Amber” is Cutthroat Bitch’s real name, not Thirteen’s.
February 13th, 2008 at 3:33 pm
You all seem to have missed the biggest problem with the episode. If she was suffering from floating kidney… Why did the symptoms crop up now?
@MarkJoel: Just accept that not everyone in this world believes in your magic light bulb and your life might get easier.
February 13th, 2008 at 3:51 pm
Official Comment
haha,
House postulated that the kidney was jolted loose during the dancing (well, sitting on a chair held up by dancers) and that’s why the symptoms started then.
February 13th, 2008 at 6:50 pm
Hi,
sorry this isn’t in any way related to this episode, but have you seen this House fan site:
http://itsnotlup.us/
I thought it was hilarious. Both the logo and the video in the bottom.
February 14th, 2008 at 1:31 pm
This has nothing to do with the episode either…”But it could be”
If the writers need to shake the dust their creative powers, how about this:
I half expected to read a quote from Princeton Plainsboro spokesman Lisa Cuddy :-)
February 14th, 2008 at 1:31 pm
Sorry, here’s the link:
http://www.foxnews.com/story/0,2933,330667,00.html
February 14th, 2008 at 9:59 pm
@ aggievet
I agree with you that the new characters are not as well developed, and I’m not sure where the writers are going with them.
On one hand, having residents come, stay for awhile, and then leave, is a great device. It solves the big problem that most TV shows face. They can actually have the characters mature and change, which usually a TV show cannot do.
OTOH, if they keep expanding the universe exponetially, it will become harder and harder to find some time for everyone, and the show will get really confusing.
I have to say that I never really cared for the Chase’s character, but when he came in and House asked him to stay for the differential, I wanted to cheer. In some ways, I find that I enjoy his character more than the others of the original 3 now.
@ Sox Fan
OMG! That was too funny. I agree. It sounds like something House would do…
February 15th, 2008 at 3:14 pm
Mark-
Thanks for validating my missing of the original characters. I agree, Chase was always a little irritating, but I think he is also more like House than just about anyone, he just hides it really well. It’s not that I don’t enjoy the new people and they’re interactions, but it would be fun to change them around and have them interact with the other original characters more.
I too was very excited he asked Chase to stay, and also at the previous episode where Cameron was more involved. It is always fun to watch the originals interact with the residents and see the “twinkle” in their eyes as they try to deal with House (Been there done that!).
I am worried that this season is going to end up like the last season where House went through all the crap with the cop and re-hab, etc, only for it to materialize into……..nothing?! Nothing changed. The cop disappeared and House is still an addict.
What was the point? Something needs to come out of the residents stepping in. If nothing else, House may realize he really did have a great team and he does “need” them. The newbies haven’t really contributed much other than as a foil for House. At least the other three actually figured out a diagnosis without House occasionally.
Ok, now I’m just ranting.
Damn writers strike, now we won’t even get a full season!!
February 15th, 2008 at 10:30 pm
Hi,
Regarding the broken leg ignoring situation. There are some scenes where she’s lying down and her leg has a cast. However, it was rather weird to see her standing up in the climax of the episode and not having her cast. They surely screwed up the continuity on this one.
February 17th, 2008 at 12:21 am
i hope they dont have thirteen have a relationship with anyone, and i did enjoy having CTB back, especially as it led to the whole “your dating me” thing. Also, don’t know if anyone said anything, but does anyone know what 13’s real name is? because if they don’t start using it then it could just get stuck that way. now THAT would be intertaining.
February 19th, 2008 at 2:35 pm
Fox announced today new episodes will be shown starting Monday, April 28. I have the relevant part of the Press Release here: http://housemd-guide.com/showinfo/2008return.php. Just thought I would let you know.
February 21st, 2008 at 3:37 pm
Scott, thanks again for the review! They had quite a lot of lingo this time which meant nothing to me, so it’s always nice to have it explained for me.
Edwin lindsay: I thought so too, I wouldn’t be surprised if either the actress or the character appears to be pregnant. It would fit the “needy” part of Wilson – and prove House right.
Mark Joel: Thirteen *does* have a name, it’s just that no one uses it. House prolly knew it right from the start from reading her resumé. He did read them, because that’s how he knew “old fraud” to be an old fraud. But he calls his best (only) friend by his last name.
February 22nd, 2008 at 12:59 am
Apparently the next episode will air on Monday, April 28th.
February 22nd, 2008 at 7:32 pm
@Shmapdi: I think it was a lucky guess. If she doesn’t like to be labelled, it’s most likely because of religion or sexuality, and being an attractive woman, if she’s bisexual she’s likely to have been on the business end of a lot of mislabelling. Someone mentioned Girls Gone Wild earlier, and there have been a lot of comments saying “oh no now she’s gonna have sex with everyone!” – that’s the kind of thing she’s wary of. Not convinced it’s true though, the character is a good actress (that does make sense, I think…) and playing along with this would be a good way to throw people off the track of anything she’s hiding…
Also, April 28th? Excellent. Only 2 months to go.
March 8th, 2008 at 7:07 pm
I think this season was excellent.
The cases were quite entertaining and keep you on the edge of your seat, as well as House’s subtle change in personality, in terms of caring a bit more, while remaining his amazingly handsome and interesting and jerk-ish self. There’s just something about him, every episode makes me love him even more.
Anyways, this actually was not the Season Finale at all, I believe there are four episodes left. One of which airs on April 28th, 2008. It’s going to be veeery exciting that episode. ;D
I think all the subtle storylines they have weaved in there are going to start showing themselves a bit more, and something big is going to happen with House.
Oh the suspense! I love this show. :)
Thanks for all the information, I like seeing exactly what their chosen diagnosis are and such. :D
March 9th, 2008 at 6:55 am
I am a great fan of this show but does anybody else think that, in Season 4, some aspects of the programme have degraded?
I am thinking specifically of the characterisation of all the main protagonists.
House’s aberrant personality quirks now seem like gentle, even sentimental eccentricities rather than symptoms of his physical pain and concomitant drug addiction. Equally, Wilson’s character has stopped evolving – he’s the wisecracking best friend now – while Cuddy has regressed into being one of those flirtatious, supposedly sexy stock older women so beloved of TV executives casting for Boston Legal or Sarah Jessica Parker vehicles.
What I am trying to say is that while I really enjoyed some of the new plot devices of Season 4 – the reality show/elimination game for example – I think some of the subtler nuances of previous seasons have been abandoned. Am I alone in this diagnosis? As in so many other things?
March 9th, 2008 at 1:07 pm
Thirteen’s name was originally supposed to be revealed at some point during the story arc, but her not having a name turned into an in-joke and they kept running with it.
As for her sexuality, my comedy-option theory is that the writers just said “to hell with it” and are going all-out with the fanservice. Since they gave us House/Wilson in this one, I’m calling 13/Cuddy when they come back next month.
Ooh, I just had a House-style epiphany: 13/Cameron! Thirteen might drop dead at any moment, and it’s well-established that Cameron goes for the tragic types . . .
March 11th, 2008 at 5:57 am
I’m so, so glad that other people are starting to get sick of 13 now. Aside from her being no more than a Cameron substitute – notice that with both teams, it’s been the women who are always offering the cases while House and the men are happy to discuss matters like Cut-Throat Bitch and threesomes with the wife’s college room-mate – I cannot be the only person who thinks that the writers are trying to portray her as a character almost without flaws. She’s not quite a Mary-Sue, but with this new quirk bisexuality she’s very rapidly getting there.
March 11th, 2008 at 4:55 pm
I’m with Alex.
The season has had it’s moments. But all the characters are becoming cartoons of themselves. I’m ready to move on past the newbies.
I think Baker has hit on something with the Cameron/13 exchange. Jesse and Allison have broken up in real life so why not on the show. And what better way to have Cameron exert her independence again than with a homosexual fling!! I like it…….it shows promise.
I would like for House to try to have a “real” longterm relationship, not just an infatuation (ie CIA chick and Anartic babe). His interactions with his Ex in season 2 were some of my favorite shows.
We’ll have to see where the writer’s take us!!
March 13th, 2008 at 8:05 pm
The Season has just began. The storylines have just began. They have barely started, and not finished everything with the characters’ development including Wilson, Cuddy, Cameron, House, Thirteen and so on. So don’t think that they are becoming “cartoons of themselves.” They are just evolving, and since we haven’t seen any new episodes I think we should be patient and wait to see exactly how they evolve and what happens with all these new ideas. I am very excited for the new episodes. There are so many possibilities. We just have to be patient. :D It’s coming soon. :)
March 28th, 2008 at 2:42 am
I can’t wait for my beloved Huis to come back (I love the Dutch word for house). I am a proud House/Wilson shipper so this episode did make me happy in a lot of ways. It was also weird that the rule of saving lives before keeping Shabbat was forgotten. Shabbat is a beautiful holiday, and probably my favourite – even though it’s not really a “holiday.” They just did it for the soap opera, which pisses me off but I’ll get over it. Also, Shabbat doesn’t end until Saturday’s sundown, and it would be pretty hard to simulate a day actually passing.
I actually really like this season, and not for the H/W moments, but it’s funny and insightful as well.
April 5th, 2008 at 3:08 pm
aww i’m i the only one who likes thirteen?? i think her character is nothing to do with cameron, i would like her to stay for good… and if she’s bi ah don’t care i just hope we’ll learn more bout 13 in the future xD and i love kutner as well xD
April 5th, 2008 at 3:14 pm
hehe i’m half agree with aggievet aggievet… doesn’t bothers me what the writers doin’t with the show, they’re being pretty creative, i love the old team but i like changes though… so i’ll start to pray, pleaaase let 13 staaay!! teehee
April 11th, 2008 at 10:23 pm
I think that they have Chase, Cameron and Forman do all the tests and surgeries because the show would get a lot more confusing/ less interesting if we had to meet a new specialist several times in each episode.
April 21st, 2008 at 12:12 pm
As it’s about time for House to come back, I have to ask:
Do we know what Kumar and 13’s fields are? We know Taub is *evilplasticsugeronguy,* but what about them?
(sorry if it’s been mentioned and I just can’t find it somehow!)
April 21st, 2008 at 6:01 pm
According to the Wiki adrienne, Kutner is a sports medicine specialist and Thriteen is an internist.
April 22nd, 2008 at 9:03 am
Did anyone TIVO this to confirm something for me. When she comes out of the MRI i think she had a metal watch on. As i understand it that is a no-no. Was it put there intentionally as a catch for obsessives like me to make?
April 26th, 2008 at 2:57 am
I only discovered House about 2months ago and I’ve been watching it obsessively online ever since! Just finished today in time for the new episodes Monday. I think that so far Season4 has been nowhere near as good as 1-3. I didn’t much like ‘the game’ I thought it went on too long. And I feel like all the new characters are just predictable stereotypes. I know there’s been alot of different opinions about Thirteen but I actually think she’s the best of the newbies because there’s room to develop her character and they haven’t given everything away already. Taub and Kutchner are a bit two dimensional…the tired promiscuous jewish plastic surgeon and the goofy geeky cheeky nerdy asian guy.
There were also a few potential storylines/ relationships from season 1-3 that I’m sorry were just dropped for Season 4. For starters Cuddy’s now on birth control (what???)…up to this she was trying to get pregnant, there was never any resolution and it was always there in the background thought they should have continued that one…she could have had a baby/ had a miscarraige….there was lots of potential with that one. Then there was Wilson and Cuddy’s little dates…I thought they could have gone somewhere with that. Wilson sleeps with her then regrets it … maybe even gets her pregnant….ooo, that could be good…then you’d get to see a more interesting Cuddy/Wilson/House relationship…and it would never just be Cuddy and Wilson, House would always be there giving his little insights and stirring things up….I should totally have been the one writing the season!!!
And I can’t stand CutThroat Bitch…she’s not even a good actor…although I actually do buy the Wilson/Amber relationship it can’t last…Please…get rid of her!!! She’s so annoying!
Anyway my main point..what I hope to see in the new epsodes is…More Cuddy/Wilson/House …wish they’d get rid of CTB, Kutchner and Taub…and I wouldn’t mind seeing a bit more of how Cameron and Chase are doing.
Love your site btw! Its great to come here when I think something is completely unrealistic to see what you say! See you back here Monday!
May 13th, 2008 at 3:18 am
Cryo? This just proves that Taub shouldn’t be practicing medicine in House’s league…I have cryo and I’ve never had these symptoms, ever. >_>
May 24th, 2008 at 12:57 am
A few points…actually mainly for those curious about the religion. Unfortunately I am too lazy to go look up who said what, so my apologies:
Someone mentioned that they mixed up the religious sects, by pointing out a rabbi in a shtreimel (the round, furry hat). Although that is worn mainly by Haredi men (a sect of observant Jews) the Hasidic would wear it too.
As for her conversion to Hasidism. She could have been Jewish or not before the conversion. Jewish law does not stipulate that you must be born to be a Hasid, just that you go through the conversion process on their terms with their rabbis.
The point of not having the surgery on Shabbat was so she could spend it with her husband. She was not doing it to observe Shabbat because it is a Halakic (Jewish law) no brainer to have the surgery.
As for House and Chase speeding up time, here is the Jewish legal argument for why it’s ok. As was mentioned in a comment, all laws of Judaism are null and void when it comes to saving a life (except for under no circumstances can you take another life, even if it is to save your own life). That is why religious Jews in a hospital on Shabbat or a holiday still can be attached to a monitor or have an EP study. Since there is a mental element (a love of G-d and faith, etc) and therefore if she genuinely believed it was Shabbat, there is no reason why she could not have celebrated it in earnest; also, since the husband is commanded to save her life by the Torah, there is no reason he can’t help with the lie. Nice, huh?
As for the modesty issue, it goes to the same issue as above. Hospitals protect modesty (in theory), but his obligation to his wife outweighs that.
I would argue that it is not terribly inaccurate. Some have commented it was grossly inaccurate, but I would suggest that what would be inaccurate if she weren’t dying, are ok because of the context of the doctor-patient relationship and saving a life.
Great review site!
June 5th, 2008 at 4:51 pm
Greetings from the UK. This episode was aired on channel five this evening.
In accordance with the standard diagnostic principle of endocrinology (if you suspect a gland is underactive, try to stimulate it) you don’t do a “cortisol stimulation test” for Addison’s but an ACTH stimulation test!
I was pleased to see House say that normal urinary catecholamines rule out a phaeo – let’s hope some doctors watching will remember this!
June 22nd, 2008 at 10:42 pm
Hi from Montreal,
I’m a pharmacist in Quebec, Canada. Just a little precision, here: the medicine used to treat endometriosis in the episode (danazol) is not an aromatase inhibitor (as for example anastrozole)… it is a gonadotrophin inhibitor… just a little different.
Thnaks… and good word for all these reviews.
September 25th, 2008 at 6:40 am
I’m 1. year med student so exuse me if i got this wrong . :-)
Just wondering if House can really hold the kidney up by putting his arm below the patients rib cage? Despite kidneys being situated retroperitoneal ?
December 15th, 2008 at 10:42 pm
Greetings from Philippines..They should rule out Addison’s first and start corticosteroids…They should run the ACTH Stimulation test if suspected at first and it will explain endometriosis and therefore should have ordered for intravenous urography if uremia was manifested. It can be confirmed even supine…
December 19th, 2008 at 7:00 pm
Actually, the cast on her leg is visible in many scenes, so they did in fact care for her fractured leg.
Good job on the reviews!
February 21st, 2009 at 10:25 pm
With all the medical personnel who post on this board, nobody found it odd that they were feeding Roz before surgery?
And House is a Nephrologist. He would have caught onto the nephroptosis far sooner considering kidneys are his specialty!
October 14th, 2009 at 12:02 am
JAS, with apologies, you clearly don’t know what you’re talking about. Chasidim are a subset of Charedim, and have themselves about a dozen subsets (depending how you count), only some of whom wear streimlach.
As for “conversion”, she self-identifies as a ba’al-teshuva. That’s someone who was born a Jew but became religious as an adult. (The phrase literally means “one who returns/repents”, and she really should have said ba’alas teshuva, the feminine version.) It can be a fairly short process — six months is on the fast side, but not unreasonable. Conversion, OTOH, generally takes 1-3 years. Or longer. And if she were a convert, she would have said “ger” (or giyores).
Her husband should have pushed her to have the surgery, Shabbos or no. Not doing so is tantamount to suicide, as was mentioned above. She might have picked the emotional appeal of Shabbos with her husband, but how was he swayed so easily?
Bobby, Shabbos ends at full dark. It begins at sunset.
But really, no one has pointed out the worst religious mistake. That BEARD and mustache!!! yikes!
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