House — Episode 11 (Season 5): “Joy To The World”

Two good episodes of House in a row, what are the odds? Sure, the medicine was a little sketchy, but overall it was pretty well done.

Spoiler Alert!!

Natalie is a sixteen year-old overweight high school student and the victim of frequent bullying. At the school Christmas show, she develops visual hallucinations and vomiting. After admission to the hospital, she is found to have liver failure as well. The initial differential diagnosis is Wilson’s Disease, alcohol abuse, or something the other kids slipped her. Sure enough, some of the kids in the choir do admit secretly giving her a hallucinogenic mushroom. Additionally, a search of Natalie’s locker reveals a large bottle of acetaminophen (Tylenol) — an over-the-counter painkiller than can cause liver failure — raising the possibility of a suicide attempt. Natalie denies any suicidal thoughts or intentions, but Cuddy wants to go ahead and start her on acetylcysteine, the antidote for acetaminophen poisoning.

Next, Natalie develops a rapid heart rate and increased blood pressure, along with pulmonary edema (fluid filling up in the lungs). The differential now a toxic exposure (glue sniffing is mentioned), or infection. When House discovers she has been volunteering at a homeless shelter, he sends Taub to check it out. He returns suspicious that Natalie might have TB (tuberculosis) because one of the residents there has a severe case of it. About this time, Natalie has a seizure. Cuddy remarks that Natalie’s liver functions are very bad; she suspects hepatic fibrosis. Other possibilities mentioned include a severe mold allergy or a fungal infection. House has the team test for the allergy (the prick test) and start her on antifungal medication. The allergy test is negative. One of her “friends” from school visits and drops off some homework for her. He mentions that she used to be a heavy drinker, but stopped a few months ago. This again raises the specter of alcohol abuse, or possibly even alcohol withdrawal as it can cause seizures. Cuddy wants to start benzodiazepines (“benzos”) because they help with alcohol withdrawal, but her parents refuse. House decides to go ahead and start them, but not for alcohol abuse, but for her seizures (“wink, wink” — though they are used to treat seizures as well).

Natalie now passes out and is found to have a dangerously low heart rate. The differential shifts to multiple endocrine neoplasia, a hypothalalmic brain tumor, or leukemia. Wilson and Cuddy want to start treatment for the suspected leukemia, but House wants to wait for a bone marrow biopsy to confirm the diagnosis. Cuddy remains concerned that they may be missing something. She mentions autoimmune disease, particularly microangiopathic vasculitis (inflammation of tiny blood vessels such as capillaries and arterioles). When House tells her about a clinic patient of his, she has her own Eureka! moment and realizes that Natalie has eclampsia (toxemia of pregnancy). It was not caught initially because Natalie gave birth prematurely several weeks before her symptoms appeared and eclampsia has been known to occur several weeks postpartum. Unfortunately, the damage to her liver and heart are permanent and it is likely that Natalie will die in the next few days, particularly when the transplant committee turns down her case. On the bright side, Natalie’s daughter has miraculously survived — she was found by a homeless couple — and now Cuddy wants to adopt her.

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The medicine was not particularly deep this week, but there was nothing I’d consider a big error. Minor complaints in blue, nit-picks in green.

Giving antifungal medications — which are universally hard on the liver — to a patient in liver failure is not a good idea.

You don’t give chemotherapy for leukemia without first determining what type of leukemia it is.
phenobarbSurely the leukemia showed up on an ealier blood count. They did check a blood count, right?

Acetylcysteine is used for treating acute acetaminophen poisoning, not for treatment well after the fact.
phenobarbChecking an acetaminophen level first would be a good idea — it’s an easy test.

Magnesium sulfate is the treatment of choice for seizures due to eclampsia (of course, it helps to know that you are treating eclampsia). Benzodiazepines are not as effective, though they do work.

What shot was Cuddy giving Natalie in the leg when she was having the rapid heart rate and high blood pressure? Any “code” medication should have gone in the IV (faster action).

HouseYes, eclampsia can occur after delivery — I was taught that it could occur up to six weeks later (and you’ll notice it was one of my original predictions for the show). The β-HCG (the hormone checked for in a pregnancy test) drops after delivery, and within a few weeks it generally is back to normal, so it is entirely possible to have eclampsia without a positive pregnancy test.

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The medical mystery was modestly interesting this week and deserves an B. The final solution was good and earns an A. The medicine was shallow (lots of jumping to diagnoses that make little sense, no good testing), but not terrible. I’ll give it a weak B. The soap opera was well done — Wilson yanking the team’s chain and Cuddy’s happy ending were both high point, though I don’t buy Foreman/Thirteen — so I’ll give it an A-.

Last week’s House review
A list of all prior House reviews

183 Responses to “ House — Episode 11 (Season 5): “Joy To The World” ”

  1. Leaving medicine aside:
    I LOVED this episode, and I do like 13’s actions, and Cuddy probably adopting the baby – she deserves it.

  2. Also: Yay for Cuddy solving a case! even if we didn’t get to see much medicine, she was the leader, and did well.

  3. I thought that the episode was decent myself, but is this really the last episode until January? That’s what the promos implied, but it didn’t seem like a strong Christmas episode. I would have liked some of the storylines to be more fleshed out. I don’t believe Foreman/Thirteen myself, it seemed totally random.

    I feel bad for Cuddy though; I know the writers wouldn’t let her be happy with a baby. I want to hear more about the girl though.

  4. Best episode of the season.

    I loved the “virgin birth” side story in the clinic.

  5. Good episode. I agree that this might be the best of the season.

    One question though… can the “clinic story” really happen? Or was House just trying to poke holes in the Immaculate Conception theory?

  6. @Doctors: What are your opinions on the medical possibility of “virgin birth” as presented in this episode?
    House sold it good and made me believe it!!!

  7. I looked it up and it has never happened to a human, so we’re safe.

  8. Ok, the parthenogenesis story was clearly a joke. Parthenogenesis (a kind of asexual reproduction, in which the female gamete by itself start self-dividing to form a full individual) is known to happen with some frequency in certain insects (aphids, particularly) but not in mammals. As House himself explained later on, he was just trying to be “nice” so he would get a thank-you present to show to Wilson. A big tell-tale sign before House’s confession was his total, absolute lack of a further-testing-leading-to-publication drive he showed. I mean, c’mon, human parthenogenesis? Who wouldn’t pursue that first paternity test? Incidentally, I find it very weird that House seems to be nationally (and, judging by earlier episodes, even internationally) recognized as one of the top physicians in the country in spite of the fact that he doesn’t seem to care about publishing. How do you get such a reputation without writing anything? Without any studies conducted? Just by healing people? And how the hell do you get tenured at a teaching hospital if you don’t teach and you don’t do research?

  9. Regarding virgin birth — Pay attention carefully: Towards the end of the episode, House tells Cuddy that he faked the test to save the couple’s marriage and Cuddy responds that House might be confusing good and evil again!

  10. If positive pregnancy test is not necessary is ther any reason why eclampsia wasn’t considered in the first differential?

  11. Because they had no idea that she had been pregnant. Post-pregnancy eclampsia is very, very rare, particularly several weeks out (though admittedly no rarer than some of the other diagnoses on the show). If this were anything like the real world, the team would have had trouble controlling the seizure with the lorazepam and then wondered why it didn’t work as well as expected. At that time, they probably would have entertained the diagnosis of eclampsia.

  12. Normally I kind of give the show a pass on anything to do with normal legal and medical proceedings, but WTF. Cuddy goes off to find what she thinks is the three-week-old corpse of a premature baby, without so much as notifying any legal authorities at all, finds the baby alive (how?) and just… brings her back to the hospital, the grandparents decide to give her up for adoption (and the father is never mentioned, but I’m assuming he pretty much ran screaming), and Cuddy just sort of gets first priority as foster parent?

  13. I had thought House had jumped the shark but the last two episodes have been going back to the original feel of the series and I’m really happy with that.

  14. I enjoyed the return to clinic duty, especially with House doing it to show up Wilson as a twisted Christmas present, and I hope that they’ll show him back on clinic duty more in the future.

    The team teasing House when they discovered House trying to get them with the tossed present was great fun, too.

    Also enjoyed the two Sherlock Holmes’ references… to Irene Adler and Dr. Joseph Bell. (Unless the book was written by a different Bell than Doyle’s professor. Although even then the names are the same.)

    The network that airs the show in Canada has a brief time-filler that mentions an interesting fact about actors in the show. This week it was that the actor who played the overweight man running up the stadium steps when the exercise guru has her attack/fall last week is the brother of an actor on Heroes. (I don’t watch that show to know the character, but he’s dark haired and well built, although I wouldn’t say fat.)

    I’m not happy with the Thirteen/Foreman new plot line. Hey, do I look like an idiot?

  15. Yep, the parthenogenesis thing was so clearly a fake-out; House was just too ’shocked’ when he opened the folder. Nothing surprises this guy :) And the I personally checked it 5x? Icing on the cake. “Everybody lies…”

    As an aside, this is the 1st time I ever got a lump in my throat during a House…when the baby appeared from nowhere (well, from behind a curtain). It was tear-jerking writing to be sure, but still effective, I thought, because contrasted vs. the young girl’s almost certain imminent death. (Also, you can’t beat a newborn-in-a-little-cap shot for tugging the heartstrings.) I thought the teenager’s acting was good, too, when she said, “who’s that?” as the baby entered…her voice rising in hope, because, she instantly knew who it was.

    Aside #2: Nobody mentioned Kutner’s little epiphany/make-good. That seemed way sudden & out of character, no?

  16. If human parthenogenesis were to actually happen, the offspring could only be female (no daddy means no Y’s in the mix), and I would think would have significant genetic damage as a result of whatever freak mutation caused the parthenogenesis. Probably terminal?

    Just a little tidbit to start religious arguments with people over the holiday. :-P

    The clinic patient with the inhaler. Yeah. ;-)
    Moving to Mondays in January… ugh…

  17. The writers were telegraphing Foreman/Thirteen at least as early as the previous episode, so it didn’t come out nowhere. Whether it really suits their characters, of course, is another thing.

  18. Part of the soap opera was too transparent. I didn’t believe the Irene Adler story Wilson told for a second and neither did I believe House about the virgin birth.

    Does anyone know if Bell really wrote a book like the one House received?

  19. Thirteen has to go. Sure she’s easy on the eyes, but I’m not looking forward to the dreary pathos her character will be generating in the near future.

    Foreman is a good character, but he’s not strong enough to lead a story arc through multiple episodes.

    The combination of the two are rather bewildering. What are the ethics of the situation–are lead authors allowed to have romantic relationships with test subjects? Surely the guy hired solely to keep House in check would know this.

    And why does Thirteen know that she’s in the treatment group? Didn’t Foreman’s partner indicate that the study was double-blinded?

  20. Regarding Joe’s query, there is a company namely, http://www.castleconnolly.com/ that selects “top” doctors. It doesn’t appear that doing clinical research or publishing is an absolute requirement.

  21. Part of the soap opera was too transparent. I didn’t believe the Irene Adler story Wilson told for a second and neither did I believe House about the virgin birth.

    My ears pricked up at the name “Irene Adler” – wasn’t that the name of the woman who outsmarted Sherlock Holmes in “A Scandal in Bohemia”? (And yes, we all know that House is supposed to be medicine’s answer to the detective of Baker Street.)

  22. I wasn’t surprised by Thirteen/Foreman. Starting with “Last Resort” it was clear they were planning a relationship between the two.

    I do have a hard time believing the parents of the dying patient would choose not to raise her infant child.

    Maybe it’s my tepid heart, but for how so few of the patients die on the show, I would have liked for this one to have had more of an impact on me.

  23. So I correctly predicted Foreman/13? To be honest I was a little disappointed myself. Of course the writers did it clever by making Foreman nicer – and 13 totally fell for the not so nice/nice guy. The problem is I didn’t really bought it – and I do not think anybody did – as Foreman made the impression he was just playing nice (while also deceiving the patient! new meds not so noxious bla bla) just like House would do to get what he wanted. But hey jus so long as he gets some action! Plus now he can actually try to reform into a more polite and better version of himself – changed by love…(c’mon on House? That’s not Grey’s anatomy we are watching right? Am I on the wrong forum?) And there is hope for House himself after that right?
    On the medical side – the main test for liver problems is the ultrasound of the liver and then an MRI right? (yeah sure enzimes too I mean imaging)? I would love for D-r Scott to correct me here cause it was a clever mystery for my opinion and I loved the fact that Cuddy had the Eureca! this time. How about a distended uterus seen on both these occasions thought?

  24. I just wanted to say two things quickly, they have been hinting at the 13-Foreman hookup at least since last episode. I believe everyone looked over it though because of the House Cuddy soap opera.

    Also the name Irene Adler, I do not know about the Sherlock reference, but Adler was the last name of the very first patient on house and Irene was the name of the patient who had ergot poisoning.

    Also Dr. Scott, I love your review I read them every night after I watch a new episode!

  25. [...] House — Episode 11 (Season 5): “Joy To The World” House — Episode 11 (Season 5): “Joy To The World”Two good episodes of House in a row, what are the odds? Sure, the medicine was a little sketchy, but overall it was pretty well done. Natalie is a sixteen year-old overweight high school student and the victim of frequent bullying. At the school Christmas show, she develops visual hallucinations and…Read the full post from Polite DissentTags: tv, Medicine via Blogdigger blog search for eclampsia. [...]

  26. I get that with Christmas the episodes are a bit more fluffy, but my first reaction was:

    Blah. We’re back to all the soapyness.

    Just when things were looking up ( I liked last weeks ep)
    Slow moving episode and all too convenient/unbelievable that the baby was still alive after all, the girl wasn’t going to make it, the parents didn’t want to hang on to the one remaining part of their daughter, and Cuddy probably is going to end up getting the baby (and not all the other 100000s of parents on the list).

    Thirteen and Foreman, don’t much care.
    House Cuddy, don’t much care either, hope that’s over with already so they go back to the flirty/teasing/hinting stuff.

    Clinic duty: fun! White coat, ironed shirt, tie and all. But he only did it to win the bet with Wilson.

    Count me grinchy, I hope at I at least got some points in the House challenge..

  27. My big non-buy-in moment for the soap was when Cuddy managed to convince the crazy junkie lady to give up the baby with one sentence. I agree that Foreman/13 is questionable, and also, do we really need the 2 team members romantic storyline again? It’s a little predictable. The most interesting of the team members continues to be Taub, IMO. He just seems to have a little more depth, and a little more strength to stand up to House/willingness to get slapped down for it.

  28. Lol at the first sentence. Some of that cynicism from house rubbing off on you eh? Yeah gotta say though this whole season hasn’t exactly been top notch. They started filming the moment the writer’s strike was over though so we can maybe push it to that for this season. But if house is continuing to 6th they have to do better.

  29. Irene Adler was the woman who outsmarted Holmes in “A Scandel in Bohemia. She is also described by Watson as the one woman that Holmes ever truely seemed to like as a woman. He kept her picture for years.

    I just love the gratuitous Sherlock Holmes references, although when Wilson said her name, I immediately knew that it was a lie. it was still hillarious.

  30. I squealed when I saw clinic duty was coming. :D
    It nearly made up for the horror that is Foreteen. I have only one thing to say about that; ugh.

    I would have thought that the parents would want to hang onto the baby as well, especially since they were losing their own daughter, but we MUST forward this plotline at the expense of everything else.

    For the record; as a long time lover of House/Cuddy, I am hating this arc. Hating. This dance of theirs is getting to be long winded and annoying, not filled with tension. I’m bored.

    I actually found it to be a very solid, enjoyable episode, though. Not the best, but House seems to be looking up.
    It’d be great again if it would only stop drabbling in soapyness, I say.

  31. The last 5 minutes made my head explode – besides all the soapyness, why would anyone wear an isolationgown like a coat? Even the nurse in the background was doing it.

    Is there something I’m missing, or is this another eye-protection/sterile technique moment where the basics are thrown out?

  32. Foreman/13…I love how nobody buys it, but everyone claims to be the first to have predicted it. Guess again…

  33. I watched the episode twice, and still can’t figure out how Cuddy knew EXACTLY where to go to find the baby. Any help? What did I miss?

  34. I’m only about ten seconds in to the episode, but I can already spot an error: why are they singing Christmas carols at school? This is New Jersey, after all.

  35. Irene Adler–”To Holmes, she was always _the_ woman.” (quoted from memory). Joseph Bell was the doctor who taught Arthur Conan Doyle in med school, and is alleged to be the main model for Sherlock Holmes. So Wilson’s gift was a tribute to House–saying he was like the original, medical Holmes–and his stream-of-consciousness produced Irene Adler as House’s innamorata.

    Holmes admires Adler because she managed to fool him, or at least to see through his attempt to fool her. House does seem most interested in very smart women, though he never seems to get very far with them.

    Judy

  36. Add me to the list of people unable to buy “Foreteen” (good one, Anonymous). I’m really hoping that the plan for House doesn’t involve the combinatoric coupling that occurred in e.g. Boston Public, wherein every character hooks up with every other for a few episodes to “explore the relationship.”

    @ Scott – would it be possible for a patient to have eclampsia without displaying any preeclampsic symptoms? Or were the preeclampsic symptoms her hallucinations, vomiting, and fainting at the school?

    @ Dale – I was also confused at how Cuddy knew right where to find the homeless couple, and also that they gave up the baby after less than a minute’s discussion. I also thought it somewhat far fetched that Kutner’s high school victim lives so conveniently close by.

    Those gripes aside, I did like this week’s episode, especially the clinic scenes! Here’s hoping for many more…

  37. “I’m only about ten seconds in to the episode, but I can already spot an error: why are they singing Christmas carols at school? This is New Jersey, after all.”

    To YRB:

    Private school.

  38. John Bell wrote the Principles of Surgery (1801), Joseph Bell(1837-1911) was the inspiration for Sherlock Holmes. I think the similiarity in name is a coincidence — though would have been great if it was the same guy.

    Great catch on Irene Adler’s name MrBuddwing! I missed that — what a kick!

  39. I love it. I love this forum. I loved this episode. Count me as one of the dissenters, but I am loving this Foreteen thing, and (I bet this is precisely what the writers want from the audience) just can’t wait to see House break down and give into Cuddy.

    And I, too, literally, yelled YAY! when I saw House enter the clinic. And it didn’t disappoint me at all — au contraire, this was the episode I have roundly laughed out loud and smiled the most from all the episodes in this year.

    House M.D., as I loved it, is finally back.

  40. If Cuddy adopt that baby, it’s be a serious barrier against Huddy. House can’t father.

    Wouldn’t there be problems with that virgin couple if the baby is born and doesn’t look like Mom? I guess House saw that it was a girl before he sold them the story (Mom can’t give baby a Y gene, so you can guess what House’s opinion on the real story of Chirst’s conception was) but he couldn’t tell if the baby was mixed race or something. Not his problem, of course.

  41. Ha Ha! Foreman and 13. 14!!! Get it. Or did someone else patten in first?

  42. I did sort of wonder if Cuddy should have told the girl her diagnosis without the parents present first. Aren’t there privacy issues with a pregnancy-related disease in a sixteen-year-old?
    And, honestly, the giant-sized acetaminophen bottle should have been tied in to the diagnosis; it was certainly the only OTC painkiller one was supposed to take during pregnancy back when I was pregnant.
    We taped this episode, allowing me to fast-forward the Thirteen/Foreman ickiness at the end. It was much more interesting in fast forward.

  43. Not only was the brilliant, observant Joseph Bell the model for Sherlock Holmes; on one of the DVD commentaries, the creators of the series said that Holmes was the model for House. The reference to Irene Adler was clever.

    As to why the team didn’t include eclampsia in the differential diagnosis: one reason was surely that the patient was a fat, unpopular girl.

  44. “I watched the episode twice, and still can’t figure out how Cuddy knew EXACTLY where to go to find the baby. Any help? What did I miss?”

    The girl said she went into labor at school and gave birth in an abandoned house down the street.

  45. I was really annoyed at the Foreteen ending. That did seem extremely random. They have *that* much the hots for each other after a few exchanged glances and one, very brief, albeit personal note from 13??

    And then the camera lingered on them for a good half-minute (in which I had to look away, I was so turned off by it). Wow! That a pretty passionate kiss for characters that barely know each other beyond a general collegue to collegue way. Even a caring collegue to collegue. In the House verse, who needs any admittal of personal interest, or any such pedestrian thing as a first date or two, before people start swapping tongues (and whole faces just about)?? I’m all for hot on screen kisses, but damn, that seemed completely forced and unnatural to me. Not mention a bit premature. (I guess those two have just been burning for each other for SO long. AS had been carefully showed on the show, of course!)

    once again the series is jumping the gun, throwing random lips together at odd and disjointed moments, when *perhaps* a friendly caress, or a caring hug might be more *appropriate*. and they are doing very little or no backstory at all in order to shove their “new” and “improved” twice-as-much-as-the-original SOAP content down our throats. thanks, Fox. way to go for artful storytelling!

    at least with House and Cuddy, it could be said that they had been secretly attracted to each other for at least 4-5 years. But these two?? wha?? and why???

    I guess 13 had her female partner quota already met in the recent weeks (Lucky 13) so its on to the first hot-blooded unattached male under 50 she can find.

    If theres a stronger motivation then that in there for her, they sure didnt show it! (or are we to beleive shes so distraught over the Huntingtons the process of going thru the study sparked these intense feelings in her.?? well, seems just as lame a premise to me.)

    And I do NOT see the chemistry. I actually had to look away it was so unattractive to me. just my reaction.

    Why oh WHY is my onced loved show becoming such a shameless SOAP????????? anyone?…….anyone?

    And did anyone else the entire script this episode was on the simplistic side?? it just struck me that way. I guess I need to stop reminiscing of seasons 1 and 2 so I could try not to be as struck by the huge flaws and weaknesses and few compensating qualities in the current season.

    at least I was Very happy for Cuddy that she was finally able to make her dream of motherhood come true (very poignant to wrest triumph from tragedy there), though I called that the moment she went to find the baby in the abadoned house. The setup felt totally contrived to me (I could think of instant good reasons why either set of grandparents or the boy would want to keep the baby and would *not* consider it too painful) but the scene itself with Cuddy, House and the baby felt genuine to me. It was nice to see Cuddy happy for once, after everything she’s been through recently.

    Although, I dont expect her happiness to last long. I have dropped all my expectations from the writers this season, as amateurish as they play things now. I’m sure they will be jerking us, the viewers, around once again, and something terrible will likely happy to the baby early in the new year, so they can throw Cuddy into even deeper misery again. (the cheap gut punche being the only way the writers know how to add drama to the show anymore…)

  46. First, @MrBuddwing: Well, that *would* explain Wilson’s (Watson’s) analogy of Irene as “the one who got away”. Clever, these parallels.

    And “Foreteen”? I want to say it’s too sickeningly similar to “Bennifer” or any of the other blended couple names… but I can’t help it: Foreteen is just too clever! :-D

  47. She said she started giving birth at the homeless soup kitchen, not her school. I doubt there would be an abandoned junkie house down the street from a rich, private school.

  48. I now wonder when the inevitable Kutner/Taub love affair will be getting underway.

  49. Did any one else catch House’s reference to Keyser Soze from the movie The Usual Suspects? No junkie in their Right Mind(!) wants any responsibility. I believe House is glad because cutty is glad- a higher form that love can take.

  50. @Dale-I wondered that same thing, since I thought it would be pretty implausible that a teenage girl on the edge of unexpected labor onset, rushing into the closest private shelter, would *not* have exactly been motivated to note the address of the place before lying down to give birth! But then I assumed Cuddy was able to speak to her and the girl give her a good enough description of the house by its appearance and location on the street, and likely even the street’s name name, (as the girl volunteered at the homeless shelter one street over, its very likely she could have known this), so that Cuddy was able to figure it out (likely after trying 2 or 3 houses near that spot first, though they dont show this of course.)

  51. All in all an ok episode. Only one thing really bothers me and I can’t find in the listings the name of the Actress that was the “junkie” woman who saved the baby. Did anyone else think that she was Becca (The girl who gave birth to Joy in episode 6) It looked just like her and she was an admitted drug-user. I guess I have to watch the Episodes side-by-side to compare. Just wondered if anyone saw that as well.

  52. The inhaler woman… LOL! House’s expression was a poem!

    The miracle birth… Nice touch.

    14.. (foreteen)… I had the feeling that was going to happen. At least the kiss was better than the one House and Cuddy gave each other. Different situation tho.

    Great episode… If this is the last one this year, then i wish days last just 12 hours from now on.

  53. I didn’t care much for this episode.

    @Dale: There’s a difference between predicting a story arc and buying the story arc. I knew from “Lucky 13″ that TPTB was going to have Foreteen (credit Television Without Pity), but I’m not buying it. I could care less about either Thirteen or Foreman, their “relationship” is happening way too fast (it’d be better if they became really good friends and eased their way into a relationship. Sort of a repeat of Chase/Cameron), and the acting just isn’t there–OW and OE don’t act like Thirteen and Foreman really connect.

    I call BS on the “Cuddy gets a baby” storyline. I didn’t want to see it. Everything is going to be about that baby now. And the timeline is completely screwy there.

    What I would have preferred is Cuddy identified with the girl because she was bullied in junior high and high school. This is what drove her to succeed in college and med school. This is what made her be one of three women who are Dean of Medicine at teaching hospitals in the nation (and the second youngest Dean to boot)! For me the “POTW is PREGNANT!” came out of nowhere–maybe the medicine was sound, but they could have chosen another disease or plot point to write around.

    Heck, even Cuddy being a bully would have worked better for me. Although we did get that with Kutner. (Can we please explore more of Kutner and Taub? Please? I get so sick of Foreteen.)

    I’m also embarrassed that I bought Wilson’s Irene Adler story. But, it’s been a long time since I’ve read any Sherlock Holmes stories. What made me go “Huh?” during that story is how would Kutner and Taub have known about Stacy? But, Wilson has handwriting that can be mistaken for a woman’s? Good to know. From what I’ve seen of it, it’s pretty illegible. House has neater handwriting. Also, I have never heard Wilson call House “Greg,” so I call BS that he would put “Greg” on a note on a Christmas present.

    As a Christian, I wasn’t entirely comfortable with the Immaculate Conception story. I knew it wasn’t real, because I’ve heard that there is no evidence that mammals can give virgin birth. (Also, House wasn’t going to do a paper on it? I was also wondering how he could be an internationally renowned doctor in a teaching hospital, like we know he is, without wanting to do a paper on THAT!) I knew it was fake, and I knew why he did it when he was giving the story. But, it still made me uncomfortable.

    Things that I loved:

    I did like the Irene Adler story, though.

    Dr. Greg being nice and giving up halfway through the first time he saw the “Immaculate Conception” woman.

    House willingly putting on a lab coat! Hee! And “Greg” just killed me.

    The woman using the asthma inhaler wrong. Hee! At that point, I thought that Wilson was paying these people to be so stupid that he would win that bet against House. I don’t have asthma, and I know how an inhaler works. The only two times I’ve ever used an inhaler, due to bronchitis, I knew how to work an inhaler. What I had to be shown was how to inhale while using it.

    Kutner apologizing to the guy he bullied in high school.

    Although I don’t like Thirteen, I did like her talking to Lori Petty (I can’t remember her character’s name!) That was great.

    A Monty Python, Blackadder, Untouchables, and Usual Suspects reference within 2 weeks! This is one of the reasons I love this show!

    Boo to Fox moving House to Monday nights. Now I have to figure out how to watch House, along with “The Big Bang Theory” and “How I Met Your Mother.” Hmm… I don’t have Tivo or DVR, and my DVD recorder will only record on the channel I’m watching. I hate conflicts!

    Kat

  54. A very serious question on the medical side…why on earth was no pelvic exam done on the girl? With no diagnosis, a good GP would have checked mouth/eye/ear and then done an internal exam first without question. Of course, that would have ruined the story line, but is that even possible to not have that done on the first day? Patients may lie, but their bodies don’t. The House team (and modern doctors?) seem to have forgotten the simple things, like looking at the whole body first. They seem to have forgotten that there were good diagnosticians long before there were MRI’s.

  55. Favorite line:

    Virgin Girl – You can get pregnant from a toilet seat, right?

    House – Sure… (Under his breath) …as long as there is a guy sitting between the toilet seat and you….

  56. Oh, sorry, Dale. My comment about the difference between predicting a storyline and buying a storyline was directed at 13.

    I apologize.

    Kat

  57. @Chicken

    No kidding!!!!! thats pretty much everyone whos left right??? lets make random pairings of everybody!! wait, whos it gonna be for Wilson?? OH wait, that blonde lady who was running the drug trials with Foreman. Yeah, that would make sense!

    rolfmao. it is getting so ridiculous. and 14 are exceedingly uncomfortable to watch getting romantic. is there anyone whos going to even care what happens with them in that arc?? certainly not me.

  58. What was House’s gift to Wilson?

  59. Sabero: he re-gifted the present that he got from the “virgin birth” woman. That was his proof to Wilson that he’d won their bet.

  60. I had my different things I liked/disliked about this episode, but I will just note that its nice to see Cuddy dressing (somewhat) like a professional again.

    She still has the 20 inch heels going on (those must be so comfortable after a 12 hr workday) but at least the cleavage shots werent so gratuitous as before and her outfits were overall much more suited for work then the ridiculous ones last week (and some other eps I cant think of right now). Although some of them still looked a bit cutesy for “Lead Hospital Administrator”, at least it was an improvement.

  61. In regard to the “virgin birth” subplot, House, in trying to save the couple’s marriage, saddled the cheating woman’s unlucky husband with supporting a kid he didn’t father. As someone who pays child support, and will be for the next two years at least (until my son is 21, maybe longer) , I find that scenario worse than awful.
    “House” will be on Mondays in January, probably starting Jan. 19. “24″ will return Jan. 11 and 12, for two hours each night, cutting back to its normal hour length on the 19. That move will pair up the two best shows on TV on the same night.

  62. I’m not certain that the episode ever explained Cuddy’s obsession with Natalie. Cuddy had exhibited this kind of behavior before, in the Season 3 episode “Fetal Position” (about the celebrity portrait photographer), but in that one, Cuddy was affected by the patient’s pregnancy – Cuddy didn’t discover Natalie’s pregnancy until well after she got involved.

    But, as noted by others, it was terrific to see Cuddy come up with the final diagnosis.

  63. I dunno if anyone has mentioned this before, but wasn’t Irene Adler House’s first case at PPTH?

  64. This episode had two hard-to-buy scenarios (besides the Fore-teen kiss, that is):

    I think we’re all in agreement that, in character or not, House giving back the gun in the hostage show was a really stupid idea. I think this week tops it, though – a supposedly well-educated, city woman like Cuddy goes into an abandoned junkie house ALONE??? I was screaming at her the whole scene. Stupid.

    The other one is sillier: since when has Wilson EVER called House “Greg”, let alone on a holiday present? Unless Wilson was trying to disguise his own identity (with Taub’s “girly” handwriting?) to trick House into opening it?

    But I really liked this episode in general – looks like the writers are trying to pay attention to what the fans have been saying, even if they’re not quite there yet. Much better than earlier in the season, at least. Let’s hope there’s not another strike to mess things up again this year….(even though I’m pro-union).

    —Kimberley

  65. I actually predicted that foreman and 13 would hook up back in the lesbian slutty 13 episode. There were plenty of hints if you rewatch some of the episodes. All I can say is about time.

  66. Well, the good thing is that we’ve seen some clinic duty and that was great fun.

    But.

    House/Cuddy, Cuddy/babies and Foreman/Thirteen are just laughable. Blah.

  67. DG728,

    No that was Rebecca Adler, whose first name was also confused with “Rachael” by Wilson.

  68. I would praise myself for predicting Fore-teen from the beginning of the season, but then I would be lying. The truth – I only suspected something in the last episode – then I re watched the whole story back from Lucky thirteen and saw a couple of hints(because I was looking for them – I have got to stop watching Grey’s anatomy, they make me see love and romance everywhere. I am getting giddy and starting to be afraid that Kutner/Cameron is next…)

  69. Back to medicine, the virgin birth bit reminds me:
    Q: What is Jesus H. Christ’s middle name?
    A: Haploid.

  70. Loved the clinic patients! Spraying your neck with an inhaler???? How dumb can you get???? ;p
    Now I wonder; is Cuddy FINALLY getting a baby?

  71. I’m sorry, but I just wanted to be counted with the many others who gave such verbose praise to the return of clinic duty.

    So here it is … Clinic Duty’s back! Woot! (Whatever that means)

    Oh yeah.. HOPEFULLY clinic duty is back, I mean this may have been a one shot occurence designed to string us CD fans along until they can randomly drop it in there again.

  72. Judy
    December 10th, 2008 at 7:26 am
    Is this the book?

    Yes, Judy, that’s the book. (And thank you for the link.) And it is by Joseph Bell, Doyle’s inspiration for Sherlock Holmes. (BTW, there was a British short-run series about Bell helping the police in a murder investigation. It aired on PBS, in my area anyway, a few years ago.)

  73. The episode was great, but one thing is bothering me.
    The girl not only had eclampsia but also HELLP syndrome otherwise she probably wouldn’t have hepatic failure. The problem for me is that neither of those usually cause permanent damage, be it renal, hepatic or cardiac. She could’ve suffered a heart attack due to the hypertension but permanent liver damage? I just don’t buy it. If anything could cause that it was her drinking, not eclampsia, and she said it herself that she didnt even drink that much. The writers just stretched the medicine to kill the poor girl so that Cuddy would get her baby.

  74. What about the case of the cheating girlfriend. Is this something that can theoretically occur?

  75. Anybody could have “predicted” Foreman and 13 since the Lucky 13 episode, come on, it was the first time Foreman had actually gone out of his way to try to help anybody.

    I was looking forward to it too, but, I’m also disappointed at how it played out this episode. Did anybody else find Foreman’s comment about the ghost of christmas future incredibly rude/mean? Maybe there’s some truth to it but how could you say that to somebody the way he put it? almost as if he was cracking a joke. Then a few scenes later, they’re making out. It was just too rushed for a plot line that they’ve been slowly building for most of the season, but then again, they probably wanted an over the top ending since its winter break now.

  76. I’m only about ten seconds in to the episode, but I can already spot an error: why are they singing Christmas carols at school? This is New Jersey, after all.–the uniforms make me think it is a private school, I may be wrong, but i visit Jersey like once every few weeks

  77. Okay- the clinic patient spraying her neck with the inhaler like a Perfume Vial? Absolutely priceless. [C'mon guys, that was deliberate, not "stoopid patient doesent know how to use it"] that was where i tuned in- was making Evil GingerbreadHouse & forgot the time. found the rest rather dull, maybe cause i missed the first half, i dunno.

    BD: “…why would anyone wear an isolationgown like a coat? Even the nurse in the background was doing it.”

    Cold? Cleaning something icky? Spill your lunch on your shirt? Nick an isolation coat. everyone did it, nurses, food minions, cleaning staff. [I never did- hated the too-tight cuffs on the sleeves.] XD

  78. @MrBuddwing

    I would predict that after so many trials to get pregnant/adoption, Cuddy developed 6th sense for sniffing babies in trouble, that she could save/adopt.

    As for “Virgin Brith”, the whole story is very far stretched, but mostly because there is no way it couldn go on without spreading very very quickly (friends, church, press and so on), and House would be in serious trouble. I call shenanigans on this plot… (which was ingenius idea for Christmas episode by the way, though badly thought out)

    As many GPs, especially from smaller towns, would tell you, there is no limit to people’s ignorance or idiocy for modern medicine. Every year you will get one or two cases, where is feels like the patients came straight from God-forsaken jungle. So the “Inhaler Lady” or “Virgin Birth” is not impossible scenario.

  79. Just a few things.

    First, Scott, I love these reviews. Really help a non-medical person like me.

    Second, to all who are complaining about the show, why are you still watching it? Take your whining some where else.

    Third, those who are commenting on Wilson’s girly handwriting and the use of House’s first name, House admits that he never opened the present before giving it to himself to mess with the team. It is possible that he wrote the card himself.

  80. Loved the Wilson and H/W scenes.
    Cuddy is a whack job. I hate baby story arcs. Hate them. Hate them.

  81. wow. it’s good to see some quality clinic scenes again!
    great episode and i loved the review(once again).

  82. One comment…all those saying virgin births are not found in mammals may need to do some searches on a couple of shark and/or dolphin virgin births that have occured in aquariums recently.

    Not saying that it will show up in humans any time soon…but there have been two (I think) this year that have made the news.

    And I squelled when Wilson said Irene Adler, had to explain it to the daughter, though…no point of reference in the young, sigh.

    14, I can leave it as well.

    Love the medical info. Thanks.

  83. i was just wondering the feasability of the clone thing they were talking about when house was trying to be nice

  84. Am I the only one happy to see a character reference a past story arc? Sometimes it just seems like they forget about Vogler/Stacey/Tritter. Way to go Wilson!

    House is definitely back on track.

  85. to Ancientone51 :

    sharks are most certainly not mammals

  86. So, doesn’t Thirteen+Foreman’s relationship compromise the integrity of the clinical trial?

  87. The pop-culture references are my favorites: “on the Heathers scale.” —-PRICELESS!

    As for those asking how Cuddy knew where the baby was, the teen precisely described the event/birth and how she ran from the school to the building and where it was that she covered the “apparently” dead baby with her coat and “didn’t even bury” her.

    Nice site – good job….but eesh, it’s entertainment, why be so critical?

  88. BD
    December 10th, 2008 at 6:16 am

    The last 5 minutes made my head explode – besides all the soapyness, why would anyone wear an isolationgown like a coat? Even the nurse in the background was doing it.

    —–

    BD, I have seen many nurses or other staff who have worn isolation gowns as a jacket. In fact they had to put up signs on the floors in our hospital specifically saying NOT to wear isolation gowns as jackets. So if she was just wearing it to keep warm, I think it’s completely plausible. Of course if she was wearing it because of isolation then not so much.

  89. One comment regarding parthenogenesis in mammals: It has actually been induced in the lab, in both mice and monkeys, although as one might expect, the animals are left with various developmental problems.

    Also, there are many species of fish and lizard which undergo parthenogenesis regularly, and in fact have entirely lost their male populations. In some cases, the species are entirely genetically-identical, since the various eggs don’t even recombine with themselves. Of course, purely-parthenogenic species are extremely vulnerable to environmental change and invasive diseases and the like.

  90. Oh, and also, just a few weeks ago I had suddenly realized (after watching an old first-season episode) that what’s been missing from House lately is House’s clinic duty. This week confirmed that realization.

  91. You are THE MAN! Thanks so much for this :)

  92. Anyone notice the woman with Huntingtons is the gal who played Tank Girl back in the 90s? Lori Petty right.

  93. About the 14 thing i think they have been setting it up against the Beginning of the season. Opposites attract.

    Foreman from the beginning of the season they have showed Foreman as they have been throwing “Foreman is boring” at us. Even in previous seasons there are examples. (Foreman eating alone after the Gypsy kid was cured is one that comes to mind.)

    13 has been self destructive all season. But they have said that she loved her father and i think its easy to see how foreman could be a father figure.

    I think it is at the very least an interesting situation for the foreman character. Way back in season one i believe when we found out about Cameron’s husband foreman made the remark that their relationship wasn’t a commitment because there was an expiration date. I think this is going to be fun to watch.

  94. Any sneaker here sent a mysterious gift to House recently?

  95. I was appalled at Cuddy’s happy ending. I mean I’m happy for Cuddy, but what cheesy script-writing, that two sets of grandparents and a high school senior boy are all willing to say buh-bye to a baby that is theirs. Natalie appeared to be an only child—their parents are willing to give up their only connection to having had a child? And Simon is alive—irresponsible but alive. It was all too too TOO easy.

    You do know that the Keyser Soze reference is a direct shot at House creator (and my third cousin) Bryan Singer, right?

  96. For those of you left in the dark about the pop culture reference:
    HEATHER’S SCALE

    http://www.tv.com/joy-to-the-world/episode/1240256/summary.html

    ALLUSIONS
    # House: Depending on where this school falls on the Heathers scale…
    Referencing the 1989 black comedy showing a clique of high school girls, three out of four which are named Heather, who essentially rule the school. The movie chronicles the attempts of the fourth girl, Veronica (Winona Ryder), to break free of the group but her attempts soon end in murder.

  97. In my opinion, the key to bringing house back to former glory (well lets face it, seasons 1-3 were way better) lies in two VERY simple aspects of the show :
    MOAR WILSON
    MOAR CLINIC

  98. My TiVo blew up on me so I missed this episode. It’s good to have this site to come to to put the threads together. Judging by the jargon in many of these blogs, the second major demographic seems to be screenwriters trying to sharpen their claws. What better excercise than to nitpick an ambitious Emmy contender? I admit it’s lost a lot of its early edge, but how many Holmes-class madical mysteries can you come up with on a deadline? If this is senescence it’s still worth watching. The only other non-NPR program I try to catch is Mad Men. Life’s too short.

  99. Two mistakes I noticed that haven’t been mentioned yet, from what I see:

    1) The clinic patient asks House if it’s possible to get pregnant from “other stuff”; he disregards this possibility. Pregnancy from mutual masturbation is in fact possible (and in fact forms the basis for a plot arc in the far more medically accurate “scrubs”).

    2) Calling the study “double-blind” made no sense. A double-blind study is a study with a subjective method of testing (unlike the computerized system shown in a previous episode, which measured the response time), in which neither the experimenters nor the experimentees know who’s in the control group and who isn’t, so as to avoid unintentional bias. A medical trial’s control group simply means people who aren’t in the trial, which is why it’s mostly a term for psychological experiments.

  100. Wouldn’t it be a usable viable arc if, on this second go-around, Cuddy again loses the baby due to some last minute grand-parent change of heart, or worse, baby health/death? Wouldn’t this lay a believable foundation for driving House and Cuddy together, perhaps revealing some deep sympathetic vulnerability of House’s character. Maybe over a short time they both regret falling into each other’s arms–House out of pity, and Cuddy out of sorrow/need…

    Uncle Ron

  101. regarding the “virgin birth” story he called parthenogenesis…
    in humans, wouldn’t this form a non-viable ovarian teratoma, if all the chromosomes are of maternal origin?

  102. It is possible that he wrote the card himself?
    Maybe the prostitute from the last episode, who still had some time “paid for”, wrote the card for House with House coming up with the plan to prank the team a second time inspired by having pranked Kutner and Taub over Kutner’s email “patient”? There’s no hint of it, but it’s fun to think that House thought up the second prank just after the first with that explaining the girly handwriting.

  103. First time ever posting, but I love the blog.

    I do have a question about the whole baby storyline. The young lady states she left the baby in the abandoned building because it was not breathing. I am no doctors but wouldn’t the people who found the baby have had to found it literally seconds after it was left? Would it be possible to regain breathing just by being picked up?

  104. Anyone else catch that Kutner’s apology visit is a nod to/riff on Adam Sandler’s “Billy Madison,” in which Sandler’s character calls people he bullied in school to tell them he, now an adult, is sorry? One person he calls tells him unseen on the phone that it’s okay, no problem. Then it cuts to that person’s room where we see him cross Madison’s name off a “wall of death.”

  105. Adam,
    I think it’s probable that the mother was so freaked out by the birth that she missed the fact that the baby was breathing — though probably pretty shallowly.

  106. The thing that really offended me was Foreman’s study partner’s disquisition on treating the patients like numbers and that’s what a double-blind trial means. Double-blind means only that, as someone else pointed out, no one knows who’s on the real drug and who’s getting a placebo. It *doesn’t* mean you can’t treat the subjects as patients or even people.

    wg

  107. I didn’t feel bad for the PotW this time. I actually felt angry. What kind of human being delivers a baby and just leaves it there? Who can deliver a baby by themselves anyway? Isn’t that a 2-person job?

    Someone once told me that you CAN get pregnant from a toilet seat. How the hell is this even possible?

    I agree with Wendy’s comment about the double-blind.

  108. Thanks Scott. I love reading the blog! Keep up the good work!

  109. I found this episode rather droll. I’m not big fan of Mommy!Cuddy (why does desiring motherhood turn a strong, take-charge woman into a simpering idiot who mothers everyone under 18 as a surrogate?), we’ve already done the Foreman-is-House plot to death, Wilson gets another run as an ass in a season where he’s never been anything but an ass or nonexistant, and “Somebody Kisses on Christmas OMG!!!” is a tiring twist. Oh, AND, the “She’s really teen pregnant!” has been done already as well. I saw it coming the minute a boy showed up on screen.

  110. Wilson is getting more and more alike House now.
    Wilson would probably be the next House if the latter virtually stopped being a jerk. He needs this. At least I think he is the only one who enjoys it, beside you bunch of idiota, I mean.

  111. @ ancientone51:

    Sharks ARE NOT MAMMALS.

    @ Fluffy:

    Lab-induced parthenogenesis does not mean it can happen in nature. And regarding reptiles, their embryology is too different from that of mammals to even compare them.

    @mauricev:

    Thanks for the link. I still find it very odd that House, being tenured as he is in a University-dependent, teaching hospital, has no academic duties whatsoever. Even Foreman and Cameron had been shown publishing papers about the cases in the past. I still don’t buy it. Unless he is just a healer and not a real scientist.

  112. There has been 1 recorded human virgin birth which is widely accepted but it occurred
    back in the year 0000.
    Isn’t human parthenogenesis a more likely explanation than “miracle”?

  113. There have been no human virgin births that are widely accepted in the SCIENTIFIC community. Just saying.

  114. I liked the mom’s reaction after House said “virgin birth”, it looked like “wow I really dodged the bullet on that one”.

    Of course a virgin birth did happen before…..Darth Vader, born from the will of the Force.

  115. I didn’t buy the grandparents giving up the baby to start with, either, but then I got to thinking – it could easily be explained away that the girl’s parents would think of the baby as “what killed our daughter” and be unable to feel love for her. The boy’s parents, well, let’s face it, guys and their parents don’t usually have the same connection, especially if they didn’t even know and have time to prepare mentally.

  116. There has been 1 recorded human virgin birth which is widely accepted but it occurred
    back in the year 0000.
    Isn’t human parthenogenesis a more likely explanation than “miracle”?
    ————————————————————–
    If the Virigin Mary did have human parthenogenesis, she would have borne a daughter, not a son, beacuse the mother’s genes do not contain the codes required in the Y chromosome.

  117. A bit of trivia: Irene Alder of the Sherlock Holmes series, whom the show paid homage to in this episode, was actually born in New Jersey.

  118. D-r Bulgaria wrote:
    “On the medical side – the main test for liver problems is the ultrasound of the liver and then an MRI right? (yeah sure enzimes too I mean imaging)?…How about a distended uterus seen on both these occasions thought?

    And Annie B. wrote:
    “A very serious question on the medical side…why on earth was no pelvic exam done on the girl?”

    Both excellent questions, to which I add my own: Wouldn’t the girl be lactating?

  119. I wonder from some of your ‘reactions’ to Foreteen if Foreman was white–you wouldn’t be ‘creeped’ out etc.

  120. @Nin: Yes, the woman was really not that surprised/shocked unlike her husband on the “virgin birth”. But more likely surprised at House not saying that she cheated. She probably kept thinking to herself what she would tell her husband when test comes back and shows that her husband is not the father during Houses testing(about 6 hrs i think). Thats probably why she gave House a present , since as House told Cuddy, he saved their marriage with the Immaculate Conception.

    Btw this is a great site!
    Thanks Scott for giving us non medical practitioners an insight into House’s medicine.

  121. This was such a tearjerker, it really was disgusting to watch. I couldn’t bring myself to care for the girl for this reason alone.

    Otherwise, it was fine. Foreteen was too predictable, and it did look artificial, as have all relationships here, apart from that of Cameron and Chase.

    Clinic duty seemed great until the “miracle birth” – the cheater got to pretend to have “saved herself for marriage”. It seemed really unsatisfying.

  122. I wonder from some of your ‘reactions’ to Foreteen if Foreman was white–you wouldn’t be ‘creeped’ out etc.

    Or if Thirteen were black?

    I’ve refrained from commenting on “Foreteen” (terrific wordplay, by the way), but my own thought is: It’s not creepy, just unconvincing – I think there’s a lot of chemistry lacking between the actors/characters. IMHO.

  123. “Foreteen” is pretty clever, but shouldn’t Foreman + Thirteen = Seventeen?

  124. 写的很好,让我有学医的冲动!

  125. I made some checks and I now know that you would not see signs of labour 3 weeks old on an ultrasound made for liver problems. You might see such signs on the MRI though however the MRI is usualy targeted on a specific area of the body so seeing somthing on the side is less likely. If an abdomen CT or ultrasound would have been performed then sure they would see the uterus. And the lactaion? Hard to say tree weeks post labour, since she did not feed the baby the lactation probably stopped on itself. Her breasts could be soar and lumpy due to mild inflamations of the “collected but not used” milk.

  126. I am not creeped out by Foreteen beeing a black/white couple (I am not creeped out at all as it turns out…) I find it hard to believe that either of them had feelings for the other. On the other hand neither Foreman is blind or gay(and Olivia Wilde is firecrackingly hot espesialy with the lesbian add on) nor is thirteen completely gay (ok of all the guys around who would she most likely sleep with – Taub the dwarf, or Kutner the joke guy. Or may be “I enjoy reminding you you are going to die” House, or… “I now officialy hate the human race even though I still love needy people like you” Wilson? Please. If she is looking for some non gay action Foreman is the way to go. I do not like particularly 13 as a character because I am biased – I was hoping they would bring Amber (who was hotter) back in as a regular. Helas that did not happen and so I was left hating 13 (and finding her still incredibly hot…)

  127. 1. I don´t buy Thirteen really hooked up with Foreman, but I keep wondering about the Huntington´s trial. Is it possible the trial is really double-blind and she´s getting placebo? I got this idea from Janice being nauseous and Thirteen not, although she may not necessarily develop the adverse effects. Btw. my former colleague once mentioned a clinical trial where placebo-patients really suspected they were getting placebo.

    2. Eclampsia is normally cured by giving birth, so what should they have done for the girl? I just guess she could have been cured.

    3. The parthenogenesis theory made me laugh. In humans?? No way!!!

    4. Cuddy´s explanation for the junkie not being the mother seemed a bit ridiculous to me. A few of my friends brought their babies home and looked like they never were pregnant. Sure, it´s not so common.

    5. The inhaler story is possible. One doctor at pharmacy school told us a story like this. And many people don´t really know how to use their inhalers (not taking off the cover, using it upside down etc.).

  128. Jamie:

    Re #3: It wasn’t a theory, it was a story House told to get the guy’s fiancee off the hook.

  129. I liked this episode too, nice to see some clinic action, which also got me thinking about last weeks discussion here. More than a few have mentioned how they’d like to see clinic duty return, it did. There was some discussion about the clinical trial phase which also got revealed this time around, and lastly the whole “Foreteen” thing developing, although I saw that coming, just didn’t expect it quite this soon.

    Seems to me like the screen writers are reading this page and maybe plucking some inspiration? :)

  130. The mother told Cuddy that she became depressed and withdrawn at the onset of puberty. Doesn’t this strike anyone else as a red flag? An extreme personality change at the onset of puberty says to me something hormonal, and hormone panels may have led the doctors to pregnancy earlier. Any thoughts?

  131. Not really related to this episode, but I realized watching one of the 4am repeats (S2E2 — also hooray for MythTV) that they’ve never used a cardiac-gated CT for diagnostic purposes. I guess Princeton Plainsboro doesn’t have one (and the producers didn’t get a sponsor wanting to promote such a machine)

  132. gxxx:
    I don’t need to be House to say you’re an idiot. you’re an idiotic idiot. 1. It takes 2 to conceive a baby, not push one out. Women have been doing it for, I don’t know, always? 2. You also missed the point of House’s sarcasm- you CAN’T get pregnant from a toilet seat! 3.Women with post-natal psychosis have done far worse than abandon a child. 4. Do yourself a favor and stick to Scrubs.

  133. To Daniel (Brazil) I have had HELLP Syndrome twice in my life, and believe me when I tell you it is VERY plausible to think that she could have permanent liver damage. My liver was tanking rapidly, I was symptomatic in my first pregnancy without realizing how ill I was for 2 days. I find it implausible that she didn’t die FASTER.

  134. “Regarding Joe’s query, there is a company namely, http://www.castleconnolly.com/ that selects “top” doctors. It doesn’t appear that doing clinical research or publishing is an absolute requirement.”

    Maurice,

    I actually was the head of IT there in years past.

    The selection process is done (at least it was when I last checked) via peer nomination. Department heads and chiefs of medicine are also polled.

    The quality of results can therefore vary depending on how seriously the pollees take the poll.

    While frequent publication is not necessarily linked to being a good physician, generally speaking better physicians will tend to have a substantial publication history simply because they are documenting the techniques and cases that make them good physicians.

    The show doesn’t make a big deal out of *anyone’s* publication on the show, although it was the subject of the conflict between Cameron and Foreman early in the show. I’m guessing that like most dramas, the writers just don’t go into the details of the less interesting parts of their characters’ lives–and collecting the evidence, researching cites, and having a paper peer-reviewed are pretty boring.

    Most likely Dr. House published extensively at least early in his career, when he was a fellow. He may not care anymore about publishing–it’s been implied that Cuddy is the only Chief of Medicine who would put up with him, so he’s essentially unemployable & therefore not exactly burning to build his career. (He also seems quite comfortable where he is and doesn’t seem to harbor any ambition to become Chief of Medicine or an academic posting that would need an extensive publishing history.)

    That said, it’s my guess that, being House, he has his fellows write the papers and then puts his name on them; it’s not exactly an unknown practice in academia, at least. It may not seem fair on the face of it, but it spares him the chore of preparing the research and it gives his fellows an important credit–co-authoring a paper with House is probably more prestigious than writing your own as a fellow, unless it’s one heck of a paper.

    Whew.

    As far as choosing a doctor, it’s very difficult to predict anything from her training. But at a minimum, you should check to see if the doctor is board certified, and if possible see what she did her fellowship in, as that can give you an idea of what conditions she is most familiar with.

    Also it is said that if you are choosing a doctor, look for one who graduated between ten and twenty years ago–long enough to have gained experience, but recently enough to be up on the latest research. What truth there is in that I leave to smarter people than me.

    –Cat

  135. I didn’t particularly care for the ending of the episode. Too E.R for me (which suits that show fine back when it was good, but not House MD).

    However, what I really, really liked in this episode was the send up on Bryan Singer, the show’s executive producer. :)

  136. I wanted to comment on someone’s input about how this new team isn’t really doing it for them.

    I can’t help but see similarities between the following groups of characters and feel that, in a way, House hired the same team all over again just with different bodies and faces:

    Cameron – 13
    Chase – Kutner
    Foreman – Taub

    Does anyone else see it?

  137. Somethings really wrong with this series. I now look back now even at series 4 with fond memories. It’s just bizarre – it’s totally failing to grip me at all, it just leaves me uninterested at best and really cold at worst. It all just feels really overly contrived and it’s just not working. The only glimmer of hope is that the new guys’ names aren’t on the opening credits yet which might mean a REALLY long story arc, and that things might either return to normal in a while or that things will be shaken up again pretty soon. The more things change the more they stay the same. It’s virtually unwatchable these days though. Could not care less about thirteen! Chase is a breath of fresh air in every scene recently! His acting/character has improved tremendously. House himself hasn’t got the slightest endearing quality anymore, he’s just detestable. As for the other characters, just not getting anything from them at all. Even Foreman and Cuddy just bore me now. Wilson remains ledgendary, I have seen enough Cameron this season but still she’s a thousand times more interesting than new people. Seriously missing the dynamics of the old crew! It seems the creators of House have reinvented the reason for watching a ‘favourite’ show – to eagerly anticipate it rising back from the dead to former glories. I hope they don’t win a single damned award this year, I seriously do. I’m sure we’ll all be looking back at these episodes and realise it was maybe ahead of it’s time and that it wasn’t that bad really, but my god is it painful to watch at present. Past two episodes are hardly a return to form for me, they’re just slightly less atrocious than the travesty that was ‘Last Resort’.

  138. I never thought it would come to this, but I find myself missing Amber. In the face of all this Thirteen sadmongering, I realized that Amber brought a much more interesting dynamic to the show. Amber was a complete bitch all day, every day, and was pretty much the only able to have a sustained argument with House without being crushed.

    Dr. Remy Hadley, on the other hand, is a gigantic suck. I think the writers are keeping her around so they can mine the “tragedy of the inevitable, painful death” vein (writers LOVE LOVE LOVE stuff like that).

    Amber’s potential was wasted, but at least she HAD potential. 13 sort of petered out after she killed the dog.

    On another note: Why are Taub and Kutner even on this show? They don’t seem to be plugged in to any of the storylines in any meaningful way. They should get their own spinoff.

    “Kutner and Taub: Goofballs, MD.” They could come up with harebrained schemes to make extra cash and be reprimanded by Old Man House after they use an MRI machine to pull change out of people’s pockets.

  139. As for why I’m still watching – “… you can’t always get what you want, honey
    You can’t always get what you want
    You can’t always get what you want,
    But if you try sometime, yeah,
    You just might find you get what you need!

  140. I don’t think Foreteen is really all that awesome or all that much of a travesty. But I DO think it’s interesting how many people seem to be annoyed that they are “going so fast”.
    How many ways are there to start a relationship which (supposedly) is based on physical attraction? Moving in with someone (as Wilson did with that cancer patient, oh so long ago) so quickly no one even notices you’ve got a relationship going… now thats fast.
    Having a first kiss at Christmas (so romantic and all…) well, I guess they skipped hand holding, but maybe we can forgive them for that.
    We’re hot for each other, we know each other reasonably well (as well as third daters, maybe), we can’t think of reasons not to (although maybe they should?)… so lets kiss already.
    Yeah, I’m sure they both went through that thought process ;)

  141. This episode was awesome!! The episodes for this season are pretty good and it´s getting better on each next episode. But I have to mention, Cuddy deserves a baby, yeah; but a baby that was born from an alcoholic teenage mother, without any prenatal AND postnatal care, that was born premature, probably with a neonatal respiratory distress synd. maybe with some infection from this “house”, with a high risk of having congenital malformation, brain damage, etc. I think Cuddy need to think a little bit more about adopting THAT baby.

  142. As an adoptive parent I hope, hope, hope that they will give Cuddy a success with this one.

    Also, the Irene Adler mention was a solid tip-off that Wilson was being bogus, for those of us who are dedicated Sherlockians.

  143. Great website.

    I see a certain amount of Taub-bashing on this blog, and I would like to rise to the man’s defense. I think he’s vital, the only grownup on the team, and he’s funny. Plus his background in plastic surgery has brought an interesting angle to some of the story lines (as with the astronaut, when they needed an excuse to cut into her chest).

  144. Way too predictable. My wife has foreseen the baby plot & I could not believe they have put something Telenovela-style in House! Cuddy finds baby! Cuddy gets baby!

  145. Could anyone tell me something about Septicemia? Both my maternal uncle and mom have died of it.Is it a genetic disease?Both had ulcer.Isn’t there a proper treatment for it?

  146. This episode was very good, I think one of the best this season, but predictable – when Kutner said he wasn’t bullied, I knew that this means he was a bully, that the whole partenogenesis is a prank, I also knew, just looking at the title, that Cuddy will end up with a baby.

    I was quite surprised by House so totally rejecting the possibility of a woman getting pregnant without being penetrated – of course it can happen. It’s not very common but it’s possible, especially if heavy petting is involved.

  147. Sripradha: Sepsis (Called septicemia here, but same deal. Whenever you see an “emia” think “blood” – Anemia/Polycythemia/Thalassemia et cetera) refers to an infection in the bloodstream. Causes and mechanisms of tissue & organ damage probably vary quite a bit but can generally be summarized as overwhelming the immune response (in reality, it’s a big question what really goes on: http://scalpel.stanford.edu/articles/Pathophysiology%20of%20Sepsis.pdf – NEJM article from 2003).

    Odds are the underlying cause of sepsis in your mom and uncle were different. You’re probably well aware a host of things can result in infection.

    Scott might know more on what our current knowledge on sepsis really is, I don’t want to fill you in on details here that might be outdated or inaccurate already :)

  148. Jesus was a mail, this is a clever but ill founded attempt to justify the virgin mary’s birth.

  149. regarding people’s questions about the whole parthenogenesis thing:
    while the calcium mutation house mentioned would work to get the cell dividing initially, it wouldn’t yield a viable embryo because of imprinting…while both parents contribute one half a future kiddo’s genome (consisting of the same genes), for certain genes it is only the maternal (or, in other cases, paternal) copy that are expressed. for a viable embryo to form there needs to be a paternal copy of a gene called IGF2 because the mother’s copy is imprinted (ie, inactivated). interestingly, that’s also why you can get totally different presentations for the same gene deletions like in angelman’s and prader-willi syndrome. we’re pretty awesome creatures!

  150. BD:thanks very much BD.THAT WAS A BIG HELP.i personally mailed Scott.haven’t got a reply yet.but thanks awefully.

  151. We finally got Thirteen’s real first name, Remy!… unless you cheated and looked it up online…

  152. I scanned the comments, but didn’t see anyone addressing the horrible social issues aspect of this particular episode.

    A sixteen year old girl get’s pregnant, delivers and abandons the baby, and at the very end, when all this is revealed to the parents/medical staff, no one acts surprised?
    The whole family needs a real psych workup. The parents for failing to notice their kids pregnancy, the kid for abandoning her baby – among other things – and the medical staff for acting as if all this is normal.
    It’s appalling.

    Other than that, I enjoyed the rest of the episode. And I really like House.

  153. Just a brief clarification from a Catholic reader: Some of you are confusing the Virgin Birth with the Immaculate Conception. The Virgin Birth is Mary, by the power of the Holy Spirit, conceiving and giving birth to Jesus while remaining a virgin. The Immaculate Conception refers to Mary being conceived in the usual way but without Original Sin.

  154. Unlike you, medical review guy, I do buy Forman and 13 kissing. And I would buy a 12 pack of it. Ive noticed that throughout the history of the show, all of the characters have had relationships that have a big impression on the show, except for Forman, (not including Taub and Kutner, even though Taub is married). House has had his hookers and sort of Cuddy, Wilson has had a number of women, from new nurses, to patients, to (dead) Amber (tear). Cameron and Chase have had, well each other. Sure Forman dated that blonde nurse (dont even know her name) and some other lady he slept with. Either way I was kind of expecting something between him and 13.

  155. I’m so prescient that I predicted the Foreteen plot development when Omar Epps was on ER in 1997, and Olivia Wilde was…13.

  156. I don’t buy the Foreman/13 thing either, even though I saw it coming.

  157. loving the foreteen

    the name of it, not the actual partnership.

    now…when was the episode where house kidnapped the tv star, and when are we going to get another hospital accreditation inspection? i think that’d make for another great ep. especially if, say, the inspector was a chick and house slept with her?

    in a clinic exam room. and cuddy walked in.

    Hmmm

  158. also, @throatybeard

    haha, lol

  159. and btw, what is up with the credits still being the same ones from season 1? is it just me, or does that seem lazy?

    (they should’ve re-done them and put amber in them an episode or two before killing her)

  160. about house saving marriage by lying to those couple? how bout the ethics??

    is there any research about parthogenesis on human??

  161. “Jesus was a mail, this is a clever but ill founded attempt to justify the virgin mary’s birth.”

    @ Dan: If you read the other posts, one asked about the possibility of Mary’s virgin birth by parthenogenesis.

    The reply was no, Jesus’ birth could NOT be because of parthenogenesis, since parthenogenesis is caused by duplication of the female’s chromosomes. Only X chromosomes would be present because a female can only contribute X chromosomes to a zygote. There wouldn’t be any Y chromosomes (XY = male).

    Therefore, any parthenogenic birth would have to be female.

  162. I wonder who House’s “outsider nemisis” is going to be this season.

    It seems that every season they bring in one outsider whose role is to be House’s temporary arch enemy. In Season One it was Vogler, in Season Two is was Stacy’s husband, in Season Three we had Tritter, and in Season Four we had Amber. The arch nemisis of Season Five doesn’t seem to have appeared yet. I wonder who it will be?

  163. hey what was the real name of simon ?
    the cute blondie guy

  164. One other Holmes connection. On a previous episode (I do not remember the name, it was the one with the gay man infected by a parasite contracted from a fox carcass encountered while hunting with his father) the address of House’s apartment, seen over his shoulder, is 221B. Does he live on Baker Street?

  165. I had eclampsia. It does cause seizures and increases your blood pressure but I would like to clarify what Jamie said. “Eclampsia is cured by giving birth”, what she should have said was pre-eclampsia is cured by giving birth.

    And from my experience you don’t need to get pre-eclampsia symtoms then get eclampsia. I just got eclampsia (high blood pressure and seizures).

  166. >>Mitch wrote:
    >>Anyone else catch that Kutner’s apology visit is a nod to/riff on Adam Sandler’s
    >>“Billy Madison,” in which Sandler’s character calls people he bullied in school

    Even earlier it appeared as a device in “Flatliners”.

  167. “I wonder who House’s “outsider nemisis” is going to be this season….The arch nemisis of Season Five doesn’t seem to have appeared yet. I wonder who it will be?”

    Well, although he wasn’t House’s enemy or anything, I think you can consider Lucas, the P.I. as the temporary character of this season. I’m not sure if there’s going to be any “enemy-like” character, at least not with the current story line going on. But who knows.

    I did like this episode, I’m actually okay with 13/Foreman. Hoping for more clinic scenes in the future, looking forward to January 19th!

    Anyways, nice review. I know nothing about medicine, so it’s interesting to read your opinion every week. Keep it up!

  168. The part I found least believable was 13’s gift to Foreman… a gift certificate to a day spa. World’s worst gift, unless she thinks that he’s bisexual too.

  169. Well, unlike most of people here, I loved the new couple, think they’re really 2 beautiful and sexy people and look great together! Beautiful 14!
    Scenes with Cuddy and the baby were a little bit hard to believe, specially finding her alive… (well, it’s fiction after all). But it’s not so hard to believe the grandparents wouldn’t want her, they could associate her with the event (giving birth) that took away their child, it’s not unusual that one might feel like that towards babies whose mothers died from the birth or short after. (Well, I myself would keep her, as part of my own daughter and a new joy after a tragedy. But then Cuddy wouldnt get her baby and…)

    Hey, and thanks dr. Scott, I love this forum and love your medical reviews on House!
    :)

  170. Just a little tidbit ~ NAC(n-acetylcysteine, Mucomyst) is the most revolting substance ever to leak from the burning, diseased, sinful depths of hell. In addition to smelling like a fresh puddle of puke, it tastes like it too. The nurses who prepared my NAC/Mucomyst for me tended to gag from the smell.

    Lucky for me, they mixed it with some delicious hospital served O.J. for every dose. Oh, and a full round of Mucomyst is 17 DOSES.

    Anyways, the past 2 seasons of House have left much to be desired. The whole Cuddy/House thing was quite awkward. I squirmed a bit.

  171. Love this site! Thx, Scott. And I’m happy with the season so far. I thought the PI made an interesting foil to House’s acerbicism.

    Anway, that part is over, but I just want HL to know that he cost me $100 on that one. I read an interview with Hugh somewhere (pre-Season 5) in which it was reported that Wilson would be off for about 8 episodes, but not to worry because he would return. So when the PI appeared and hubby started ditchin’ him, he bet me that the character wouldn’t last a full month. Since I had read the interview, I took that bet. OUCH!

  172. Anyone know why they stopped calling Ati-Van Ati-Van? They’ve been going by Lorazepam for a while. I remember the last mention of Ati-Van was by Chase in Season 1… Is it a copyright issue?

  173. wow. we are in the 21th century and people still freaks for seeing a black man kissing a white woman?

    That’s pathetic.

  174. After telling the couple that the woman was expecting a virgin birth, House goes into the room with the rest of the team and says “Gotta tell you about this clinic patient.” The team isn’t interested because Natalie was getting worse.

    But what are we to suppose House was intending to say? That he’d just lied to a patient’s boyfriend?

  175. I’ve started commenting here in chronological order from season 1, so unfortunately I could not foresee the deluge that was to come of other posters named ‘Daniel’. Oh well.

    Isaac already pointed it out, but the most ridiculous thing about the alleged parthaneogenesis story was the complete dismissal of the ’sperm ricochet’ explanation. Quite plausible for some sperm to have a happy landing (or accidental manual transfer, etc.) It especially seemed liked a plausible explanation considering the female partner’s readiness for a paternity test – she seemed rather confident.

  176. Did Chase invent the story about improperly dried mushrooms to freak out the kids, or do some people actually believe it, akin to the classic “makes your brain bleed” story?

  177. What the hell was Cuddy thinking walking into some house with homeless people in it… by herself?

    And finally he goes back to the Clinic. It’s been what? 2 seasons of no clinic at all?

  178. Nitpicking on comments, but there is no “year 0000″ (Western mathematics had no concept of 0 when the supposed year of Jesus’ birth was decided).

    Also, the Immaculate Conception and the virgin birth are two totally separate concepts, and many Christians don’t believe in the Immaculate Conception (though out of ignorance they may say they believe in it – heck, many Catholics get it confused with the virgin birth!). The Immaculate Conception is (fairly recent, at least in terms of it being official) Roman Catholic dogma which states that Mary was conceived without Original Sin (though not necessarily through a virgin birth).

    But anyway, the “oh my god, these people are actually buying this, and it’s so awesome, but I still have to pretend to be the nicest guy ever” act during the parthenogenesis “revelation” made the episode for me. It all just proves the Emmys are rigged. :P

  179. “Western mathematics had no concept of 0 when the supposed year of Jesus’ birth was decided”

    Sure, it’s irrelevant six months later, but it is astounding how many ways this is nonsense. Could more errors be compressed into 16 words? What’s fun is that while doing the research just now I kept finding additional falsehoods among its implications.

    1 AD became 1 AD in the year 525 AD. (http://en.wikipedia.org/wiki/Anno_Domini#Numbering_of_years)

    “Western mathematics”–as unhelpful a category as that is–is documented to have included a symbol for zero by 130 AD. (http://en.wikipedia.org/wiki/0_(number)#History_of_zero)

  180. And I’m a big fan of you reviews, by the way. [/suckup] :)

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