House — Episode 3 (Season 5): “Adverse Events”
A fairly ho hum episode of House, with far too many red herrings and not enough real medicine.
Brandon is, at best, a mildly successful artist. At the beginning of the episode, he is painting a portrait of a woman, but when the woman and her husband take a look at the finished product, they are shocked because the subject in the painting is horribly distorted. Even stranger is the fact that Brandon cannot tell that anything is wrong; the portrait looks completely normal to him.
Brandon is admitted to the hospital for evaluation of his acute onset visual agnosia. The initial differential diagnosis include stroke, brain tumor, drugs, or environmental toxins. An initial MRI was negative, but House wants an MRI with contrast. He also sends Taub and Kutner to search Brandon’s apartment for toxins. The search turns up nothing suspicious and the MRI is negative.
Toxins and drugs remain on the differential diagnosis, but a cavernous angioma of the brain (large, abnormally dilated blood vessels in the brain) has been added as well. When Brandon shows little emotion when told he requires a risky surgical biopsy, House deduces that he is hiding something. It turns out that he has had to make ends meet by enrolling in clinical trials of new drugs. He is currently a participant in three separate drug trials. House assures him that his symptoms were due to the experimental drugs, and since they should be out of his system by now, he’ll be discharged in the morning.
As usual, being discharged from Princeton Plainsboro is a sign of problems to come, and Brandon has a sudden seizure. By now, the team has discovered what drugs Brandon was being given: an anticoagulant, an autoimmune drug, and a statin (a cholesterol medication). They suspect the interaction of all three drugs is causing his symptoms and House elects to give him dialysis to clean all the drugs out of his system. It seems to work at first, but then Brandon develops massive swelling of the tissues of the head and neck occluding his airway. Foreman performs an emergency tracheotomy and Brandon is started on steroids. The differential now includes a thrombosis, Chagas disease (both of which would block the venous drainage, causing swelling), infection, or cytokine storm, with the team favoring the latter. House and the team are unsure whether the cytokine storm is a withdrawal symptom from the experimental drugs, or a new symptom entirely. To solve the puzzle, House elects to put Brandon back on all three drugs, and then wean them off slower this time.
Once again, withdrawing the drugs seems to work at first, but then it becomes obvious that Brandon’s libido has been put in overdrive. A punch to the nose from Dr. Thirteen solves that problem, at least temporarily, but it is a new symptom to consider. Kluver-Bucy Syndrome (a condition caused by damage to both temporal lobes of the brain) is suspected, and an MR Angiogram is obtained to get a closer look at the blood vessels. It shows some narrowing of the vessels of the Circle of Willis (the main arteries supplying the brain). That should not be enough to cause symptoms, but Taub suspects there may an underlying cardiac arrhythmia that worsens them. An EP study (electrophysiology study — it looks for abnormal conduction in the heart) is ordered, and is decidedly positive. During the test, Brandon goes into ventricular tachycardia and needs to be defibrillated. At this point, House notices that Brandon’s hair is turning red around the temples.
Kluver-Bucy is abandoned and Waardenburg Syndrome is suggested, but when Kutner notices a prolonged QT on the EKG (a potentially dangerous heart rhythm), the suspicion shifts to Romano-Ward Syndrome (a common inherited form of Long QT Syndrome). A cardiac sympathectomy (a surgery that reduces the effect of the sympathetic nervous system on the heart) is ordered. When Brandon once again develops visual agnosia, Taub begins suspects the symptoms may be due to lingering toxins, and seeks out Brandon’s old paintings. The paintings show the same distortion every other month — the same time he was on all three experimental medications together. It turns out that in a previous research project, Brandon had been on an experimental antacid which allowed the formation of a bezoar in his stomach. This bezoar trapped many of the experimental pills and has slowly been releasing them, causing Brandon’s symptoms even though he has not been taking any new medications (which means the team had it right halfway through, it was the combination of the experimental drugs, and the last half of the episode was spent chasing one red herring after another. After all, who can argue against the symptoms of “experimental drug reaction”?) The bezoar is removed surgically and Brandon should be good as new.
Major complaints are in red, minor in blue, nit-picking in green:
Romano-Ward is NOT caused by five separate gene mutations. It is caused by a mutation in any ONE of five (actually six) particular genes.
That’s a weird type of agnosia Brandon is experiencing, if it’s agnosia at all. He seems to recognize people and things (at least initially), but can’t paint them – which makes it more of an expressive aphasia than an agnosia. Later on in the show, it shifts entirely and he now can’t recognize people he should, which is a type of agnosia.
None of the neurological syndromes or conditions the team mentioned fit the pattern, but again, why have a logical pattern when it can all be explained away with “experimental drug reactions.”
The standard treatment for prolonged QT interval (including Romano-Ward) are beta-blockers or an ICD, treatments that Brandon can’t have, with no good explanation given as to why.
A sympathectomy is a legitimate treatment for prolonged QT syndrome if the beta-blockers and ICD fail
Why is Taub, a plastic surgeon, running an EP study? It requires not just a cardiologist, but a specially trained cardiologist.
But he’s better than Kutner. Shocking v-tach at 60 and then 120? Wrong.
Most phytobezoars can be non-surgically removed (91% by a recent study).
With swelling of the mouth and pharynx, a standard intubation is difficult, so a tracheotomy makes more sense this week. The procedure was surprisingly smooth for a patient that swollen (no landmarks) and for a doctor who doesn’t do them regularly.
Once again, no eye protection during surgery.
The medical mystery was moderately interesting, though annoyingly inconsistent, so earns a B-. The bezoar was clever, but the final solution relied too much on mysterious experimental drugs and their interactions rather than actual potentially-interesting medicine, so only earns a C-. Most of the medicine was flawed, and the rest “experimental”, but it was still better than last week so earns a D+. The soap opera was better. The Taub part was good, House’s names for the experimental medications were fun, but I didn-t buy any of the Cuddy/PI/House interactions. I give the soap opera a C+.
September 30th, 2008 at 10:25 pm
OK, so the medicine’s shaky as usual, but I understand you find “Grey’s Anatomy” unwatchable.
Things I liked about this week’s episode:
1. The artist yanking Thirteen onto his bed and Thirteen’s response involving a swift right jab (poor artist guy gets punched in the nose twice in the same episode!).
2. The bit of visual trickery of having two other actors stand in for Taub and Thirteen (when they showed up, I thought at first the team had gotten the good sense to bring in a cardiac surgeon to explain the situation to the patient).
3. Chase’s exasperated reaction when House called – yet another instance of the show’s last-second-reprieve-from-unnecessary-surgery routine. But instead of saying don’t operate, House tells them to operate somewhere else (would a surgical team be willing to change course so abruptly, or wouldn’t they want a chance to start all over?).
The triple cross involving House, Cuddy and the PI were pretty funny, IMHO.
September 30th, 2008 at 10:29 pm
I have to admit, I thought the drama between the PI and Cuddy was great. Wouldn’t it be hilarious if they hooked up behind House’s back?
September 30th, 2008 at 10:30 pm
Scott, I completely agree with you on this on. While this episode was definitely better than last week’s, this was sub-par as well. I think it’s really weak that they just attributed every symptom to “experimental drug interactions”. That doesn’t really make for an interesting story.
I kind of got into the Cuddy/PI/House thing, but I am still too distracted by missing Wilson. At least we apparently get to see him next week. Cute picture of House though, I chuckled.
September 30th, 2008 at 11:13 pm
Scott, your reaction to this episode sounds a little peevish, as if it doesn’t fit the mold you happen to like. I thought this one was great fun. When House figured out that the guy was in multiple clinical trials at the beginning of the show I thought “Hey, they just gave us the diagnosis, how is this going to play out for the next hour?” There was no way to predict where the story was going to go. I loved the little flourish of the signature, right at the beginning, to be a factor near the end. For a show in its fifth season to break out of its mold so crisply was, I thought brilliant. I did not see that bezoar coming!
September 30th, 2008 at 11:15 pm
Last week I asked for an episode where the patient was developed enough for me to actually remember his/her name, and on this count at least the writers delivered. I did know his name (although I did refer to him as Breckin Meyer in my head), I could keep a running tally of what his general problems were, and I wanted him to get better. So thank you, writers, for giving us an episode that returns to the lands of yore where the guest characters actually matter in the show.
I don’t know enough to tell how accurate the medicine is, and a lot of the big names go right over my head, but I did like the final solution–clever, and unlike ones we’ve seen before. When Taub had his “it’s the poison leaking out of his fat cells!” theory I was really hoping that the writers hadn’t decided to reuse that solution from the previous episode (I forget the name–the one where the boy had naphthalene poisoning from the termite nest in his home). I actually did like how the team was essentially chasing red herrings through the second half, as it was a departure from the usual flash-of-inspiration-at-the-last-minute formula. I liked the idea that House and his team could be fallible, in the sense that even they don’t always know when they’re right.
However, I still don’t like Lucas, I don’t see why he’s necessary, and I didn’t think that the House/PI/Cuddy interactions were anything special. Cuddy may be desperate for a relationship and family, but surely not that desperate! Plus, I thought that one of the quoted reasons for bringing in the PI was to have him search the patients’ houses, yet in this episode who do we see searching but the team. Why is the PI there at all, then?
Overall, while this episode was a refreshing return to medicine-centric storytelling, it didn’t have that sparkle that attracted me to the show in the first place. House is House, Foreman is Foreman, the team is the undifferentiated team (with the exception of Taub, which I was glad to see–maybe he’ll finally become more than “that short plastic surgeon guy” in my mind). Cuddy is acting stupidly and irrationally, in my opinion, but that wasn’t interesting or funny, just annoying and strange. Wilson is gone (boo!). For the second episode in a row, Cameron is mysteriously not around (I’m not sure whether I prefer unexplained absence of Cameron or the let’s-shove-Cameron-in-wherever-she-might-possibly-fit approach that got worked to death last season). It would be almost a stock episode of House, one that isn’t memorable but that gets the job done, except that the presence of the ever-annoying PI brings the quality down further.
But I forgot the one funny moment for me–Chase, dropping the bezoar in the bowl, facing the camera and announcing in his best dramatic voice “And THAT’S why I won’t let CAMERON get a cat!” Cue mysterious and significant eyebrow wiggling. Subtlety, we hardly knew ye. And he wasn’t even wearing eye protection.
September 30th, 2008 at 11:17 pm
Official Comment
Peeved is probably a fair assessment. Irked would be another.
September 30th, 2008 at 11:18 pm
Yeah, they should’ve realized that they need a Cardiac Electrophysiologist for the EP study. I mean the name of the doctor is in the test for crying out loud!
September 30th, 2008 at 11:46 pm
I’m fairly certain the straight to Trache that the show seems to be on these days is someone a Fox got tired of seeing doctors jab things down people’s mouths, and wanting more drama by slicing open their throats.
::eyeroll::
September 30th, 2008 at 11:50 pm
The Cuddy/PI scenes really didn’t interest me at all-with this new team and new sidekick I really miss having Wilson around to play House’s conscience…
I was wondering, how common is it for a dialysis to be used to clear out someone’s system like that, or is that ever even done? His Kidneys were fine, wouldn’t they clear the drugs out themselves?
October 1st, 2008 at 12:03 am
If the phytobezoar were removed via non-surgical means would that endanger the patient? I mean to ask since House suspects that whole pills may be trapped inside wasn’t surgery the right call?
PI guy is growing on me.
October 1st, 2008 at 1:30 am
“And THAT’S why I won’t let CAMERON get a cat!”
A great line indeed. Except for this… who calls their girlfriend by her last name?
October 1st, 2008 at 1:47 am
I’d say a “below-average episode of House” is the way to describe this. Not a whole lot of laughs or interesting stuff this week.
The problem with the show is that I honestly think they’ve run out of interesting medical conditions. The medicine was never perfect, but I was outright disgusted by how badly the writers misinterpreted the nature of cancer stem cells in last week’s episode. It was just one step above just making up stuff.
The show needs fewer characters (the PI is not bad, but nor is he compelling) and to bring back clinic duty for House (source of many laughs and examples of the show’s wit). I feel like because there are so many characters on the show, it’s hard to get to know the new team. Even with Wilson and Cameron MIA this week, I feel like the show is struggling to give all the actors time on the air. The show is still introducing the new team, yet they randomly added the PI this season. I agree that after 3 seasons, some cast members had to change, but why cut out clinic?
October 1st, 2008 at 2:39 am
I was very worried when I read the description of this episode, looking through an artist’s paintings to diagnose him, but I honestly liked the episode, though I’ll admit the drug-interaction aspect was a tad convenient.
The medicine didn’t seem to have TOO many gaping flaws, and the episode seemed to flow pretty well, unlike last week’s. I actually like Lucas, probably because I know he wont be around forever. It’s fun to see how he is a nice, happy version of House, yet the two click together pretty well.
Missing Wilson and Cameron though, although I am slowly getting used to the new team. Thirteen had her character development episode this season (501) and Taub has had his this week, but I would like to see Kutner made a little less expendable. I’m still entertained by the guy, but we know the least about him.
Overall, a good episode.
October 1st, 2008 at 5:03 am
I really liked this episode. I can’t judge the medicine, having hardly any relevant knowledge (apart from what stuck to me when I shared room for 3 years with a medicine student :-D ), but I really liked the mystery and I thought the solution (bezoar) was clever and original. I also liked how they got the acutal cause (experimental drugs) fairly early, but didn’t have the complete picture until the end.
I like House being manipulative again and prying into his team’s private lives – it reminds me of Season 1, but this time it goes deeper (using a P.I.). I’m finally beginning to like Taub, and I hope the show will explore his background and character more.
And I really dig Lucas. He’s such an idiot at times, but in a likeable way. He’s obviously good at his job, but very awkward in social contact – rather like House, but unlike House (who doesn’t give a damn about social skills), he’s really trying to be good at it – and that’s what’s so funny about him. His scenes with Cuddy were hilarious.
I laughed so hard at House’s university cheerleader photo, and even more when it turned out that it was actually a real thing – House’s expression when he admits it was priceless.
And I loved Lucas and House playing together. I always enjoy when we get to see House play one of his instruments, because Hugh’s such a great musician.
October 1st, 2008 at 5:05 am
Also, Scott, I believe the episode’s title is “Adverse EVENTS”, not Effects. At least that’s what was on Fox.com last week…
October 1st, 2008 at 5:20 am
Does anybody notice that PI looks _exactly_ like House – exactly the same hairdo, exactly the same scruff?
Exactly the same “oh I am so smart” convoluted logic (in coversation with Cuddy).
PI shows us “almost House, but not a jerk”
I wonder why the show needs him.
Did they change writers after season 4?
October 1st, 2008 at 5:40 am
That bezoar? what did they use for a prop? half a pomogranate dunked in ketchup? [Please tell me cat-balls arent that icky!]
Wank On: I turned it on, saw the guy painting & went “soon there will be a crack about toxic paint.” & I was right. But lead? what did they think he was using? housepaint from 1970? sure looked like acrylics to me.[actually it looked like a glycee of a predone painting but that just makes sense so if they wreck it during production another is easily obtainable :P It's a good fake though- the brush- deerfoot stippler, wrong type for what he's doing- has been aged well- cream on the bristles, brown on the ferule, but if you squint when hes paining you'll notice there is no paint-trail on the canvas itself.]
Why not oils with cobalt or any of the other fun chemicals that have nice obvious health labeling right on the tube? I supose i should be glad they didnt do the “& toxic paint made van gogh see wierd too yukyuk” line i was expecting. *facepalm* Plus the standard “you are artist? ha! you must be poor & take drugs!” What? thanks for the stereotype writers! This is why I can’t stick “Artist” on my resume. >_>
another nitpick from the artsy side: wonky face paintings like the ones they used to diagnose him? thats an actual style. [Not one I'd hang on my wall, mind.] i can’t think of the name off hand, but always thought it was based on a “faux-picasso” look.
Also, scene with everyone staring at the rack of pictures? all the nudes looked to be by the same guy, [acrylics again i'd wager] but the white-house one?different artist, looked like oils. [you can see the impasto from here] did they give credit for the canvaii on the credits? i didnt see & am curious.
also, the bit where he says hes broke & needs the drug-money to keep the GF happy? Did you take a good look at his studio? two stories, windows, the quality of the props, the all large canvaii? Stacks of supplies?I don’t care if it’s jersy [or, rather a set], spread like that takes serious cash. Painting is a ducedly expensive proffession. no wonder he didn’t want the GF to leave when she found out about the no sales- obviously she’s his meal ticket. Wank Off. :)
^__^ You look for the medical stuff in shows & comics Scott, this is what I look for.
October 1st, 2008 at 7:48 am
I got to say I’m a bit suprised you didn’t like the experimental drug bit. I didn’t think any real doctors would be in love with the idea of using experimental drugs as a way to hide a disease, but I didn’t think it’d annoy you into a harsher grade. I don’t get the medicine to any notable degree, but I thought the idea of using unreal, but (I hope) realistic experimental drugs was brilliant as opposed to dragging the team through the same procedures that had been done more often than not.
Second thing I wanted to say on the review itself was that I thoroughly disagree on the dramatic aspects of the episode. The tone of the interactions between House, Cuddy, and the P.I were pretty believeable. Well, if you take into account that House and the P.I. are basically established as friends (that I would say is unbelievable as House has known him for one episode, but meh). Lucas is basically House-lite (not Foreman brand House-lite, but an even kinder more fun guy than even him) and Cuddy and House flirt constantly, so Lucas mixing into the action doesn’t really suprise me. I still don’t like Lucas though, personally. I just don’t buy that he’s able to become so buddy-buddy with House over an epiphany and some traded sarcasm between them. Actually, Lucas alone is alright, but the fact that he’s apparently House’s new Wilson irks me. House doesn’t like change, after something drastically changes he sulks for a LONG time- as seen with the season 3 finale and season 4 opening.
Final point on the review: Is there really a D+? Where I grew up, at least, D was always a 70 with everything above being a C and everything below an F.
And now, about the episode itself… I think it was much more enjoyable than the premiere and last week’s outing. It really brought House back to the standard formula. Maybe they’re still a little rusty on the medicine, and my guess is that the episode two weeks from now they’ll still be rusty, but eventually that’ll pick up too. Mostly I was glad to see a patient that didn’t fade into the background while House (or Thirteen, in the case of the premiere) dealt with personal problems. The patients always brought some sort of dilemna with them befor now that the team and House were at odds about and, while I was thinking Taub would turn out to be a pretty mediocre character, he really suprised me. Hopefully when Kutner gets some spotlight it’ll be just as good- maybe I’ll be able to overlook Thirteen’s horrible plotline…
And how lame was the Chase scene?! “And that’s why I won’t let Cameron get a cat.” Seriously? Someone already pointed out how he used his girlfriend’s last name, but not only that, he said that to some random nurse that may or may not have known who he was talking about- meaning the comment was way too obviously meant for the viewer and that right there kind of broke the believability of the entire show for a brief second. I seriously sat there for about five minutes wondering why they put such a lame line in there in the first place…
P.S.: Kutner crawling 20 miles is absolutely amazing. And he’s in the Guiness Book of World Records!
October 1st, 2008 at 8:57 am
My husband (not in the medical fields) wanted me to point out that House was getting irradiated during the angiogram (or whatever test they were doing at the time). He wasn’t wearing a lead vest. “There go all his sperm,” Ryan said.
October 1st, 2008 at 10:38 am
I like the growing integration of the PI into the storyline! The way he and House and Cuddy are all lying to one another to satisfy their own ends reminds me of the complex storylines from my other favorite show, the shield.
I feel that any resistance to the PI stems from pining for further inclusion of Wilson. But come on. The dude is quick-witted, charming, talented at his craft… a little whacked, which this show’s characters pride themselves on, and did you hear that duet between him and House at the close of the episode? Brilliant! I look forward to his continued time on the series, however long or short he’ll be written in for.
PS: do I get an award for ending that last sentence with TWO prepositions?
October 1st, 2008 at 10:47 am
The PI is the new Wilson.
For now.
This was a fun episode.
October 1st, 2008 at 11:00 am
Your reviews are better than the actual shows. Funny call on the shocking VTach with 60 and 120 – even E.R. tends to get that part right. As for the red herrings, are these docs getting reimbursed by the fish count? Half of them have nothing to do with the initial complaint of visual agnosia (Wardenburg? Romano-Ward?). It’s like the writers randomly look in their medical dictionary just to fill in the middle 30 minutes of the show.
- the other scott (I’m using a different login name so as not to confuse anyone)
October 1st, 2008 at 11:02 am
Oops, sorry webmaster. I meant to post under the name ‘medeasin’.
October 1st, 2008 at 11:36 am
@Brian:
The way my University (U of Hawai’i @Manoa) handles grade assessment since implementing the plus-minus system is:
A=90% plus about 1.5% range both directions (e.g. between 88.5% and 91.5%, apprx.)
B=80% ditto
C=70% ditto
D=60% ditto
A mark of “plus” takes care of the 3% or so above the specified grade range, and a “minus” the 3% below. So, C+ = 72%-74%, B- = 75%-78%, B “regular” 78.5%-81.5%, et cetera.
Grade Point Average (GPA) is expressed as a numeric value in accordance with the grade received. An A or A+ gets 4 grade points per credit, which is where the value and the phrase 4.0 GPA comes from.
If a student takes a 3-credit course and gets a B, each credit becomes worth 3 grade points, a total of 9 grade points earned. Her course GPA can be calculated by dividing the number of credits she took from her total grade points; of course in a single class the value per credit is all the same, so doing the math is unnecessary. A cumulative GPA for one’s academic career is calculated by dividing all grade points earned by all credits “attempted” (taken):
3 credits of C (3 x 2.0) plus 3 credits of A (3 x 4.0)
(6 + 12) = 18 grade points
(3 + 3) = 6 credits attempted
18 / 6 = 3.0 GPA (B average)
Technically, the lowest non-failing (above F, 0.0) grade you can receive is a D-, clocking in at 0.7 grade points per credit . However, most classes require a 1.0 (D reg) to pass and a 2.0 (C reg) to count as a prerequisite and move on to the next class. I’ve always been annoyed that UH Manoa utilizes a system that makes it easier to hold a student back with a minus grade (I had to repeat my second-to-last Japanese class because I received a C-, enough to get credit but just low enough to hold me back from taking the final course) but doesn’t allow phenomenal students to achieve a 4.3 (A+ average) as some other schools do. It only seems fair.
The math when dealing with plus-minus is quite messy even for simple examples — which is why I avoided them here — but you get the idea: The plus-minus system gives educators the ability to more precisely express students’ levels of performance.
SO! To finally answer your question: Yes, D+ exists.
Random PS: I’m a guy.
October 1st, 2008 at 11:55 am
I’m surprised about the criticism of Chase’s use of Cameron’s name – she’s head of the ER, everyone who worked at PPTH would know exactly who she is, never mind the fact she’s worked there for over four and a half years.
That said, yet another boring episode (Chase was the best thing in it). Didn’t care about the patient, didn’t care about Taub & his wife, Foreman & Kutner & 13 added nothing & found the PI frankly creepy, as well as the plot line that House & the PI are competing to bed Cuddy is really offensive. Irked & annoyed are exactly how this ep left me, I’m seriously wondering why I continue to watch.
October 1st, 2008 at 12:09 pm
The thing I keep thinking whenever I see the PI is “backdoor pilot.” I wonder if the creators of House are winding down the series and are hoping to get a spin-off going with the PI?
October 1st, 2008 at 12:38 pm
My take on the House/PI relationship blossoming so unusually fast – House is able to justify to himself that he is controlling the situation with Lucas (monetarily, even though the running gag seems to be that House will never really pay him). This to me explains why he is buddy-buddy so quickly with someone he just met. House always acted like he was controlling his relationship with Wilson (true or not). He loves controlling / messing with his team. So the illusion of control over Lucas would make him feel comfortable.
I feel lukewarm towards the PI – don’t actively hate him (as I thought I might), but don’t like him particularly either. Reminds me slightly of D.B. Sweeney, but they already had him on the show. I won’t watch the new PI show if they start making it. I only watch THIS show because of Hugh Laurie’s tremendous talent and ability to act everyone else off the screen, even with terrible plotlines.
Question: Does anyone know if that actually was a picture from Hugh Laurie’s younger days? I know he rowed for Cambridge, but hadn’t heard he was a cheerleader. He’s very athletic still, and would have been strong enough back then to be an asset in pyramid cheers.
October 1st, 2008 at 1:20 pm
@kimberley42: That picture is obviously photoshopped. If you look closely enough, the lighting on the girls’ faces versus the lighting on Hugh’s face is slightly different. Hugh just gave the FX team one of his photos and they just put it into the picture. But it’s well done, at a first glance you wouldn’t recognise the fakeness. Also, I’m not even sure they have American-style cheerleaders in UK (or had in the 70s).
The whole idea about having House be a former cheerleader was hilarious, though. I laughed so hard when I saw the photograph. :-D
October 1st, 2008 at 1:22 pm
Hunh. After the cold open, I wondered aloud if he was some sort of aphasic. Then they said “agnosia”…
@Brian: The problem with the experimental drugs bit is that practically anything at all can be ascribed to three factors you know next to nothing about. It’s, as the saying goes, “an explanation that explains everything, and therefore nothing.” For a fleeting moment, I thought House might have tried to get samples of all three and feed them to the New Guns one at a time in order to monitor their effects, but no dice.
I thought that Taub detecting the “drug on, drug off” pattern was fairly clever, but what are the odds that it works out perfectly like that? In most cases, month granularity wouldn’t be enough for the pattern to be clear.
@CGW: People don’t call their girlfriends by their last name, generally, but they do refer to them by their last name. Especially on House where practically no one gets called by their first name–even to their face. (Remember that Stacy referred to House as “House,” but called him “Greg” when addressing him.)
@Nonny Amous: Plus/minus helps granularity–I use it myself–but I would prefer it if grades in the U.S. were given as percentiles or something like that. There’s a large perceptual difference between a B+ and an A-, and there’s no good reason for there to be. Just as a practical matter, I try to make sure that the cutoff for an A- is way above the highest actual B+ score, but that’s an artifact of students complaining, and I’d prefer to avoid that if possible.
October 1st, 2008 at 1:29 pm
“Most phytobezoars can be non-surgically removed (91% by a recent study).”
So… you would just disolve the thing thereby releasing a lethal drug cocktail?
October 1st, 2008 at 3:11 pm
1. Love the PI and Cuddy
2. I’ve Ignored the medicine since last season
3. 13 is just too ridiculously attractive to take seriously. Also, she seemed pretty lame last episode
4. I see Taub as the adult of the group. He’s definitely the most interesting character after House.
5. I like how the PI keeps showing up everywhere, and House doesn’t even blink when he finds him in the closet.
6. When they announced that the patient (did he even have a name?) was being released, I automatically said “He’s going to have a seizure.” and, I wuz right.
October 1st, 2008 at 3:12 pm
Unlike most of the folks here, I actively dislike the PI. His interactions with everyone seem forced, like he’s been very awkwardly transplanted from another writers’ workshop. If he’s on House to generate interest in a spinoff, I certainly hope he gets spun off PDQ.
The agnosia confused me, so maybe someone can help me to understand it. If his paintings were accurate representations of what he saw (vice Picasso knockoffs), then why did he see Taub and Thirteen as “real” (albeit different) people? If you have agnosia and are seeing things in a severely distorted manner, do you not realize it? If so, how did he manage to live his life? If the episodes are short-term, why didn’t he see one of his paintings before taking it to the warehouse and realize he was a few staves short of a barrel? Is this due to the magic of “experimental drug interactions”?
October 1st, 2008 at 3:27 pm
I, along with a few others, enjoyed this episode. One thing I’m trying not to fall into is the “catch-up trap”. I watched seasons 1-3 on DVD and got a whole lot of House all at once. I didn’t care if an episode was sub-par, I was more concerned about catching the next glimpse of the story line, and of course the great one-liners. Now I ahve to watch episodes one week at a time and if an episode isn’t great, it tends to weigh on me more.
I’ve grown attached to the central charatcer, and good or bad, I’ll probably see this show through to the end. All that being said, I definately liked this episode more then last weeks. The PI is growing on me, now that I can see that he might be more then just a putz with a knack for digging up dirt. I’m personally glad to see less of Cameron and Chase because we need other characters to get more screen time, I actually wouldn’t mind if they only made an appearance once every three or our episodes. I think I buy the Cuddy / PI thing because … well I just do, to explain it would destroy my “suspension of disbelief”. And I can’t actually keep up with the medical mystery like I used to because unfortunately we’re still watching season four (again) over here on AFN, so I get my episdoes streaming and in poor quality. My wife said I can buy them off of ITunes without encouraging her scorn … but I’m never sure if I’m truely safe from that.
October 1st, 2008 at 3:32 pm
Official Comment
EngineeringDr,
You’ve hit the nail on the head with this episode’s presentation of agnosia: it wasn’t consistent (or logical). When Brandon mistook Taub and Thirteen for other doctors, that was a good example of agnosia. The rest of it doesn’t square with the understood definition of agnosia at all. And if it was intermittent, you’d think he’d recognize the abnormal art later on.
October 1st, 2008 at 3:45 pm
A minor point, but I huh?ed when they said they would treat the edema with IV and topical steroids. Doesn’t the use of IV steroids obviate the need for topical?
October 1st, 2008 at 3:57 pm
Official Comment
John,
Usually, but not always. For example, in bad cases of poison ivy, I will use a steroid injection as well as a steroid cream. But that involves a clearly defined rash and this generalized head and neck swelling is very different.
In this case — which was I wondering about too — where were they going to apply the cream? Just slather it all over the head and neck?
October 1st, 2008 at 6:26 pm
Next weeks episode looks very promising.
October 1st, 2008 at 7:42 pm
Well, Amber’s Ghost, I guess it’s just you and me feeling that the interaction between the usually formidable Cuddy and the oddball PI was disquieting. Even if she were a lonely old maid (which, please) the fact that he invaded the office of a senior administrator, and is invading the privacy of her staff, to say nothing of the prior incident where he /tampered with a patient/), I should think she would break his kneecaps.
Oh, right, it’s supposed to be about medicine. I’m beginning to wish the show would just stick to that, even if it is spotty in accuracy. Between the stalker PI business and House’s quite illegal intrusion into his staff’s private affairs, I’m rather put off.
October 1st, 2008 at 8:24 pm
Could someone help me get why Taub was disappointed with the car his wife got him? I can’t imagine why any decent doctor would keep on working for House and put up with these blatant intrusions into their lives. If working with him is such a privilege and opportunity to learn, why doesn’t Forman ever get anything right even after all these years?
October 1st, 2008 at 9:02 pm
I feel mixed about this ep – definitely better than last week but not up to par. And the PI/Cuddy interaction was way too stalker-y for her to actually like him.
My question for Scott is, would Breckin Meyer really have been able to speak (and shout “Ow” everytime he was shocked) when he was in V Tach? I thought that people were generally rendered unconscious during V Tach.
October 1st, 2008 at 9:11 pm
“Could someone help me get why Taub was disappointed with the car his wife got him?”
He’s got some sort of confession that he wants to get out, and the fact that she got him a car is guilting him in to a confession, kind of like House predicted.
October 1st, 2008 at 9:29 pm
@ nonny: (PS: do I get an award for ending that last sentence with TWO prepositions?)
Everybody has their particular area of nerdiness. Well, doll, I’m an editor. I hereby award you my patented Grammar Self-Consciousness award.
@Bensana: Taub feels he doesn’t deserve the car. Seeing that delicious midlife crisis mobile made him feel soooo guilty that he needs to ‘fess up. Which is what House said he was going to do all along. So, there you get some full-circle story action with that “we need to talk” at the end.
October 1st, 2008 at 9:29 pm
eh,
the throw-away “anything is possible” with experimental drugs, so there was really no need to connect any of the medical dots, they all just magically fit together under one umbrella
what are they planning to do with the OLD team?
cameron looks like she’s been kicked off the show, foreman should be called backman (as he’s in the background with no further character development), and Chase’s face is always behind a mask now
WHAT IS GOING ON?? As much as I liked House seasons 1-4, the newest season is falling apart. While the newer characters are interesting, PI guy just sucks. The concept is interesting, but his dialog is horrible. I agree with Scott, I don’t buy it.
October 1st, 2008 at 9:49 pm
The PI will get a spin-off series.
He’s only on house, because the creator of both shows wants to push his new series. And it’s a stupid move.
October 1st, 2008 at 9:56 pm
@ the last few commenters:
It was revealed last season that Taub cheated on his wife with a nurse; previously they explored the fact that he had to give up his practice because of it, now they seem to be hitting the home side. That’s why he’s not so happy with his wife being so nice to him – he hasn’t told her the truth.
October 1st, 2008 at 11:04 pm
@ Scott – thanks for confirming that… I was reading papers during the episode tonight, so I wasn’t sure if I’d missed something or symptoms were being played fast and loose.
@ karasu amagoi – I also really disliked the PI / Cuddy interaction in this episode. If Cuddy has hospital security guards keeping House out of a patient’s room (previous episode) to stop his normal shenanigans, you’d think she’d have them turn Lucas into a pinata. Then having coffee with him? Argh! The only reason I didn’t complain about this earlier is that apparently (?) Cuddy is playing Lucas against House, so arguably her behavior makes some kind of sense. Still, I’m counting the hours until Lucas leaves.
October 1st, 2008 at 11:08 pm
“Between the stalker PI business and House’s quite illegal intrusion into his staff’s private affairs, I’m rather put off.”
I loved the episode and will forgive the agnosia issues because I loved what came from it–just as i did with the steak eating and sandwich seeking in Son of a Coma Guy–sometimes the fudging is worth it. To my surprise, PI guy is really working for me. I love his interactions with both House and Cuddy. On the intrusion comment above, didn’t they open the series with House spilling the beans about Foreman’s criminal past to the rest of the team in front of Foreman? That digging into other’s lives has been a constant hallmark of House’s, and it fit that he needed a distraction, because that’s what he does when he’s upset at someone leaving his life. After Stacy left, he poked at Von Lieberman because he needed a distraction.
On the noticing the painting issue, Scott, I think the artist wasn’t a particularly dedicated artist and he stored his paintings in some kind of cellar lock up, stacked so you couldn’t see them until you pulled one out. And he wasn’t selling any. There was a point made in dialogue that there were hardly any paintings in his studio.
October 1st, 2008 at 11:30 pm
I kinda liked this episode. Kept it interesting at least, I thought. There’s a couple of things that keep bugging me ever since last season.
The first is, what’s the deal with the actors playing Chase and Cameron? They continue to be listed as lead characters in the credits, yet they have bit parts anymore. And the three fellows (13, Kutner, and Taub) are all listed as guest stars.
Also, if I understand correctly, Chase is supposed to be the head of the surgical dept at the hospital. Even if he is general surgery, how does he have so much supposed experience/training to do some of the surgeries they have him do? How can a general surgeon do brain surgery? And it seems that a cardiac sympathectomy should be done by a cardio-thoracic surgeon or a cardiologist. Am I the only one that gets aggravated by this?
October 2nd, 2008 at 12:36 am
Indeed, Jackie, House himself has always behaved that way. Cuddy (and his prior staff) put up with him because he was worth it to her and they learned from him. What baffles me is why in the world Cuddy would put up with someone /else/ behaving that way. And his new staff doesn’t seem to be learning, so I wonder why /they/ put up with him. The PI actor is good, he can keep up with both Laurie and Edelstein, but if he’s a mini!House then why have two of them? If people respond to him as they do to House (what a rascal, but what can you do ha ha) and if House himself is behaving as he always does, then what’s the story?
As EngineerDr points out, having Cuddy play him could be fun to watch, because that’s using her brains against both of theirs. I bet on her. But to show her get all giggly without properly justifying it (the guy isn’t that charming) struck me as a disservice to a strong character.
Just seems to pull focus from the medical mystery, and that seems a mistake, particularly when the medical aspects are appearing slapdash.
October 2nd, 2008 at 1:13 am
So what’s with House noticing the red hair? If they’re not going to integrate this in any way, that should have been left on the cutting room floor. It would have lots of company.
Notice that Laurie got a new (new to me, anyway) credit, IIR it was Executive Producer. Hmmmm.
It seems as if whenever the writers start running out of ideas, they add characters. Last season, they saddled the show with more cottages, whilst promoting Chase to Surgeon-Of-All Specialties and leaving the other two to drift in and out. This season we get the PI, who is even more of a charade. This is not a satisfying approach to script-writing. If they’ve run out of ideas, it’s time to wind down the series. What they’re doing now is not adding to the mix, but is diluting it. The focus should remain on Laurie/house, and we are seeing less and less of him.
October 2nd, 2008 at 3:04 am
Please stop complaining when House’s team does all of their own tests/procedures/etc.
House does not trust the lab results of any other hospital and routinely has his team redo full batteries of tests that other hospitals have charted.
If he doesn’t trust other hospitals, he’s not going to trust the rest of the doctors at his own.
Note also that the reality-of-TV-shows reason for his team doing everything… they need to give the growing cast more screen time. They can’t bring in a new actor every week when they have highly paid cast members who get less than 2 minutes of air-time a week.
October 2nd, 2008 at 8:07 am
Thanks for keeping up with the reviews Scott, it’s the ONLY place to come to on the web for some intelligent discussion’s and viewpoints on the show!
That said I know sod all about medicine (but still very interesting to see how much is fact and where it is stretched) and I’m now going to pollute your comments section with mindless remarks regarding the soap opera element! Hoorah.
Lisa Edelstein is lovely and I want to marry her. I absolutely love the way they are going with her, it’s like they’ve honed in on my main reason for watching the show and are doing it just for me. I see myself in the new PI guy to some degree, honestly – it might as well be me. It’s like they’ve personified every typical horny 25-35 yr old that watches the show who lusts after her. I agree he is the temporary Wilson for the time being too. However, I also dislike the character to some extent, the competition element between him and House is a tad irritating somehow, it’s a shame that it will almost certainly end in disaster…bah.
Taub, Kutner, 13 I’m warming to slightly after this episode, but revealing their interesting personal lives does not neccesarily make them more interesting or likeable caracters unto themselves. Purely character wise Kutner easily has the edge. I would like them more if the previous ducklings were completely out of the picture, instead they make limited cameo-like non-integral appearences and with no focus on how their personal lives are developing (although I understand this is addressed in a forthcoming episode with Camerson/Case – still, a one off doesn’t really make up for it somehow.) With that said I don’t want the show to become Grey’s Anatomy with a big team so perhaps focussing on a handful of the main characters is for the best.
I’m sure I had some other very interesting points to make, but I can’t remember. I’ll finish by reiterating my main point. I want to marry Edelstein!
October 2nd, 2008 at 8:33 am
I’d just like to add I’m 25, I liked Cuddy as soon as I saw her on tv in season 1 wearing a gorgeous red dress ( I was about to dismiss the programme as more American nonsense but then caught a glimpse.) The striptease was like a dream come true but actually personifying the everyman into the show is actually a better move and an improvement on the level of shameless pimping by the creators in last season’s finale!
October 2nd, 2008 at 9:13 am
Wouldn’t a rock the size of a tangerine inside the guy’s stomach show up on x-rays and throw his blood chemistry off in all sorts of ways? Not to mention the agony having such a rock in your torso would cause.
It explains the antacid, but what kind of patient wouldn’t mention horrible, shooting stomach pains requiring massive doses of antacid to his doctors? When my doctors interview me, I went so far as to tell them the specific type of daily multivitamin I took. If I was guzzling Pepto nightly, I think it would come up.
October 2nd, 2008 at 11:32 am
I’m honestly a little bit shocked that this episode went the way it did. I swear, my boyfriend almost strangled me by the end, I was so annoyed. I realize that House is a show that totally ignores pharmacists, and indeed just treats them like silly little pill-pushers that supply House, but as a pharmacy student…ohhh, it irks me to /no/ end when a drug is given that would /never/ be given to that patient for that reason (and a pharmacist on rounds/verifying the drug would easily catch and change it).
And especially this episode. Seriously? Bring the paperwork from the clinical trials to any pharmacist, give them an hour or two (hell, doesn’t even need to be a pharmacist, give it to a 4th, 5th, or 6th year pharmacy student!), allow them to check the mechanisms, and then come back and they will tell you how the medicines will interact, possible side effects from this, and how to fix it. The bezoar would still have to be House’s concept, but the – is this from the drug? I don’t know, is /this/ from the drug? silliness would be solved simply. It is the pharmacist’s job, in fact, to know mechanisms precisely for this reason (interactions)!
Toss off this new PI character – House needs a PharmD at Princeton-Plainsboro!! (Can you imagine the interactions about him attempting to get more controlled medication?)
October 2nd, 2008 at 2:07 pm
Soooooo glad it turned out to be the drugs and not “toxic paint.”
Sable Hope, you can definitely buy lead-based paint today, though I think it’s a lot harder to find than it used to be. You wouldn’t want it peeling off your walls, but most people assume you won’t be licking your fine art paintings. Lead-based white would probably be labeled as “flake white,” as opposed to “titanium white” or some other color. (Remember, there’s no such thing as “plain white” — different whites give a different tone to the painting. Think color temperature on your computer monitor.)
There are all kinds of other toxic art materials, too — you wouldn’t want to drink a bottle of cobalt dryer, for example. But the thing about all of these is that they’re EXPENSIVE — an artist who wasn’t making any money wouldn’t shell out for them. He’d buy “flake white hue,” which is a look-alike based on artificial pigments.
What’s more, most of the toxic stuff applies to oil paints. If he was able to sign his name on the painting with a silver paint marker (good god, do any artists actually do that??) then he had to be using acrylics — oil paints wouldn’t have dried yet. And most acrylic paints these days are 100% non-toxic, as are the related mediums and texturizers etc., and they clean up with plain water and maybe a little soap.
October 2nd, 2008 at 3:57 pm
“Harsh toke, dude.”
This episode was so much better than last week. At least the show is back to normal. What with all the blood and guts, and ideas being thrown around and twisted so much, I forgot what the ep was about.
They’re really not doing justice to Cuddy. As others have said…. she posts guards to stop House, but goes out with the PI who snoops in her study?
So many characters! Hey, pick some, concenrate on them. I keep getting mixed up when they show Foreman, then Taub, then 13, then Kutner, then Cameron, Then chase, then House, then cuddy, then PI guy…. and why, oh why, did they have to get rid of Wilson? It was a great last scene, nice bit of ‘hard truth’ from Wilson there. But please, the House Wilson interaction was the best on the show… House: “you’re happy!” Wilson: “how dare you!”
October 2nd, 2008 at 6:00 pm
You assume a tracheotomy was performed, I wonder why they seem to prefer that procedure over emergency crycothyrotomy, which has definitive advantages over a tracheotomy (not only in a situation of massive neck swelling).
And it generally seems to be a bad idea to say “no landmarks” first and then slice his neck open blindly. You could at least try to find the hyoid bone as a landmark first. Makes a prettier scar.
October 2nd, 2008 at 8:06 pm
I feel stupid asking this but…
The guy was in 3 trials at once, taking 3 different drugs at once. They let him do that? Wouldn’t that screw with the results? Or was he just an idiot and knew better but did it anyway.?
October 3rd, 2008 at 6:12 am
I would say that the medicine was really hazy and not quite as good but the drama was pretty ok!
And we can finally confirm thirteen’s last name. The guy referred to her as doctor hadley. ( after she punched him and the little DDS after that. )
October 3rd, 2008 at 4:08 pm
@Nekolux: We knew Thirteen’s last name way back in “House’s Head” when Cuddy referred to her as Dr. Hadley.
October 3rd, 2008 at 11:35 pm
LOL LOL Neil
I know you can buy it, heck I’ve got some![& some cobalt based & some brown/red tubes that I forget at the moment] -bought em on rock bottom clearance [cuz im cheap & 3 bucks for a big tube o oil is a darn good price, toxic or not. originally 30-60$/tube...which is why, i expect, they'd were on clearance"purity of colour" my foot!]
I saw a couple people whip out the marker in art skool [& used it to mark my canvaii before i learned the hard way not to] learn from the radon clock painters not to eat the paint! oooh “mixing white” FTW! that stuff is great! [but makes me crave sushi when i use it, oddly enough]
The way he was waving the painting around five minutes after he says “im done!” has to be acrylics- but even then, they don’t dry *that* fast XD
October 4th, 2008 at 8:33 am
I agree with your overall sentiments of the show. Probably not one of my favorites because of the significantly decreased focus on the medical aspects.
That said, i do have one thought to add to your analysis. While watching the show, I did not consider the painter’s difficulties to be an expressive aphasia, although i can see why you may have suggested that as a possible explanation. I was thinking more along the lines of some chemically-induced fuciform face area disturbance which would have allowed him to paint the rest of the body but show disjointedness among the facial features. Because he had not met the couple (i’m assuming) prior to the scheduled portrait appointment, he did not recognize the distortion in his perceptions. His medical team, on the other hand, appeared differently to him once the drugs took effect again because he had a baseline image of them already.
no medical degree- just my take on the story.
October 4th, 2008 at 10:07 am
Unless I missed something, it looked like they were injecting the MRI contrast agent at the bedside. I’ve never heard of that before. You would want to inject it while in the magnet so that you have an accurate before and after image, not to mention the possibility of dynamic contrast enhancement.
I’m new to this site so maybe it’s been mentioned before, but I always find it amusing that all of House’s people can run the MRI and CT by themselves, not to mention a lot of the assays they seem to know how to do in the lab. Based on the hospital I work in, that’s far fetched.
October 4th, 2008 at 3:15 pm
Cuddy is old enough to be that PI’s mother for crying out loud. Yuk.
October 4th, 2008 at 6:32 pm
Pharmacist would not be able to predict how the drugs interact. No one would. The whole point of the trials was to learn how the drugs act *individually* in a human. It’s not like a pharmacist can look at the molecular structure and know exactly what the drugs will do.
No way the PI will have his own series. First, this show has a history of getting multi-episode characters (Vogler, Stacy, Trotter, even Amber) and then having them fade away. Second, the PI has no gimmick that would make viewers want to tune in.
Spoony One has the cause and effect mixed up. The anatacid action of one of the drugs created the conditions where the phytobezoar could form. They can be painless, symptomless.
Spoony One also assumes that all patients are on the ball and can coherently and completely inform their docs about medications. I wish it were so…
October 5th, 2008 at 5:53 am
What I really liked in this episode was the team recognizing Foreman as their superior, when House asks them for a procedure they disagree with.
I’m still not sure how I feel about the PI: he’s a funny character, but he doesn’t fit the series. Maybe in his spin-off he’ll be better. I love Cuddy and secretly count the days until she and House get together, but this whole triangle that’s forming is just boring.
October 6th, 2008 at 11:40 am
I WOULD LIKE TO MENTION THAT I AM A 17 YEAR OLD MED SCHOOL STUDENT FROM INDIA.COMING TO THE MEDICINE PART,I WAS SERIOUSLY SHOCKED BY KUTNER’S SHOCKING
TO EVEN THINK OF HOUSE GOING OUT WITH CUDDY FEELS DISGUSTING.THERE IS NO EQUAL FOR HOUSE.AT LEAST ‘WOMAN EQUAL’.HE WOULD BE FINE IF HE CONTINUES TO BE A BACHELOR.
October 7th, 2008 at 10:19 am
Why is there no House tonight, why do we have to wait till next week? :(
October 8th, 2008 at 2:30 am
My big complaint is that the show simply isn’t funny this year. Yes, I watch for the medical mystery, the people interactions, the good acting….but mainly because of the wonderfully smart, acerbic wit, which has been in nearly nonexistent supply so far this season.
Two other notes: Could we have one year when a member of the medical team doesn’t die or nearly die? House alone has died altogether too many times by now.
And, how did House’s addiction become a virtual non-issue over the past year?
October 8th, 2008 at 9:41 am
On the addiction question, I would say because we were not supposed to take Tritter at his word and not only does House need the vicodin, he functions better with it than without it. He stole the prescription pad while fearing the ketamine was failing and not only might he have cognitive damage but no pain relief, but also that Wilson might not believe he was back in pain because of his own desire for House to change. Those were specific circumstances that don’t necessarily mean House is out of control on how he takes vicodin as an ongoing thing, and based on the last season and a half, he’s not.
October 8th, 2008 at 9:50 am
The writers have been missing basic medical stuff for quite sometime.They are so obvious that an amateur like me is able to pinpoint it .I am pretty sure that the writers would go through all the reviews posted by Scott . it is really helpfull for medical students like me to not get carried away by what is shown in the show.
Kudos to SCOTT!!!!!!!!!!!!!!
Coming to the soap opera , it would be fine if they make the incorrigble doc to realise at least something from Wilson’s heartfelt advices.He seems to be moved whenever a patient or Wilson talks about values But in the very next episode he proves what a jerk he is.
The soap has been boring so far…….. I hope the writers go deeper into his days at JHU as a student.I am aware this show has been inspired by the literary character Sherlock Holmes.We get to know about his starting years in the books.Likewise it would be interesting to see House as a student…..
October 9th, 2008 at 12:36 am
Don’t understand how Gray’s Anatomy is unwatchable? I got two words for you: Sandra Oh.
October 9th, 2008 at 5:17 am
Chuk the PI and bring Wilson back!
October 9th, 2008 at 5:17 am
OOPS!!!!!!!!!! CHUCK THE PI AND BRING WILSON BACK
October 9th, 2008 at 1:19 pm
I´m a bit disappointed with this season. I found the first episode quite funny nevertheless I wasn´t impressed with the patient. The next one was simply about nothing (or I didn´t get it???). Now that I think the plot was exaggerated. I can´t believe anyone could take part in multiple trials but I was pretty sure the patient didn´t have Romano-Ward syndrome cause it would have probably been found out before and than he wouldn´t be able to participate in clinical trials. On the other hand many drugs can cause prolonged QT interval, so this was probably just another of the adverse effects-events.
There are six mutations that can cause Romano-Ward.
Dialysis can be used to help even healthy kidneys clear drugs out of a system.
October 9th, 2008 at 10:37 pm
Hate WILSON-Free episodes. The medicine seemed an afterthought. I don’t like the PI. I’m not a big fan of facial hair. It just looks unsanitary.
Looking forward to the next episode which will definitely have some Wilson.
October 10th, 2008 at 10:33 am
The PI, in my opinion, is the best recurring guest since Sela Ward.
October 16th, 2008 at 9:10 am
Capo – drug mechanisms are generally well-understood by the time they get to human trials (remember, by the time they hit extensive human testing, they’ve already gone through years of animal and lab testing). There is the occasional drug where while we know what it does, we don’t know quite how it does it (however, knowing what it does allows you a bit of leeway in extrapolating). Any pharmacist worth her salt would be able to look at the paperwork from a clinical trial, and look at the mechanisms.
Also. I’m not sure if you’re a doctor, but, if you are, do you remember your Medicinal Chemistry course? For classes of drugs, there are always some features on the structure that stay the same (for instance, alpha-2 agonists will have an imidazoline parent/guanido group and have two halogens on the ring) in order for them to hit the receptor/do what they do. Depending on the class of drug, yes, you can recognize a drug by its structure.
However, in a clinical trial that has progressed to human testing, you would generally not need to look at the structure only, the mechanism would be understood. Odds are low that all 3 drugs would have ‘unknown mechanism’. Perhaps one of them.
October 22nd, 2008 at 11:05 am
You said “Most phytobezoars can be non-surgically removed (91% by a recent study).”
I don’t know if anyone mentioned this, but it seemed to be a pharmacobezoar and not a phytobezoar.
I’ve been eating a lot of persimmons lately and have been reading up on my bezoars…
October 26th, 2008 at 2:08 am
two things. 1. was the red hair thing ever explained? and 2. wouldn’t he not be allowed to do three drug trials at once? I mean, not only could that possibly cause unexpected side effects, but it could obscure the results of any one of the studies, making it worthless to what the trials are supposed to be trying.
October 26th, 2008 at 2:10 am
oh yah, and sela ward is by far the best guest in all of house. this PI guy is only mildly interesting so far and i got sick of the cop really fast.
October 27th, 2008 at 5:20 am
Hi, I’m delurking just to say I looove this site, which I religiously check after viewing each ep :)
@ Sarah: Yeah, he’d probably wouldn’t be allowed to test all three drugs simultaneously… IF they were all provided by the same lab. Since he was desperate for money, he could have signed up for two or three different labs at once. Another option is that he was supposed to see if those three were incompatible when taken together.
November 28th, 2008 at 12:08 am
I have a few questions:
Are patients able to speak so freely after they had a tracheotomy?
Is it normal to leave the wounds of the tracheotomy without any protection? (The patient had a scar (or a hole?) in his throat)
I really like your medical reviews though I liked the house-cuddy-PI part. I miss Cameron and Wilson…
December 15th, 2008 at 8:47 am
Lilorfnannie,
I would totally disagree!! Just how young is Lucas supposed to be?? And how old are you placing Cuddy at, sheesh!!
Cuddy seems no more than early 40s to me, and the PI mid to late 30s. He certainly cant be any younger, if we are to believe he knows anything about his trade and has any experience. I agree he has a bit of a babyface but thats just how some people are. I would place no more than TEN years between the two characters ages to me, at the most.
And geez…why so harsh on Cuddy?? Older guys go for the hot young thing all the time, whats wrong with seeing her with a younger man? and as I’ve already said, the PI is not that much younger than her (by my calculations at least).
January 11th, 2009 at 5:56 pm
Lets see,
i know some people love to get involved on the real medicine and stuff, some conclusions and the big errors, …
i forgot about the medicine -not that i tracked it all- long a go
now i seek only the emotional side of it,
Taub was superb, for those who apparently don’t remember the detail, he CHEATED on his wife, therefore any move his wife does to please him get him to be guilty, very guilty.. now they’ll talk, nice
Cuddy/Lisa Edelstein flirting was badass, i mean you have many beauties in the show, but none posses that fresh smile, mixing mature and soft woman, damn they did it right this time
June 24th, 2009 at 12:18 am
That’s one big bezoar. It’s the size of a pear.
For some reason I still remember goat bezoars being the panacea for most poisons in Harry Potter.
September 17th, 2009 at 1:24 am
Due to my living in a furrin’ country, I’m only just now seeing season 5 of House. I am not a doctor (nor do I play one on TV), but I respectfully disagree with Scott’s analysis. The agnosia (etc.) symptoms were a MacGuffin — it could have been any random set of dramatically interesting symptoms. The medical mystery was why do the symptoms keep appearing and disappearing, seemingly at random? Thus, the solution didn’t really depend on the symptoms themselves, but on the *real* symptom. I have to admit that my initial guess was that it was a fat-soluble chemical being released into the body as the patient lost weight. Close, but no cigar.
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