House — Episode 22 (Season 5): “House Divided”
An episode of House with some decent medicine this week. There was also a bachelor party and House may be slowly going insane…
Seth Miller is a fourteen year old who has been deaf since he had meningitis at the age of four. He is a high school wrestler and is competing in a wrestling match when he suddenly screams and clutches his ears, where he is now hearing painfully loud explosions.
Seth is admitted to House’s team. Foreman immediately rules out “the usual suspects:” insomnia, migraines, and head trauma. House suggests it is temporal lobe epilepsy and sends Seth to the seizure lab where they try to induce a photosensitive seizure with flickering lights. He suffers no seizures, but loses the vision in one of his eyes. The team now suspects it is subclavian steal syndrome (blood that should go to the brain goes to the arm instead) and wants to perform an angiogram. House agrees, then has a conversation with himself and decides that Seth has optic neuritis. He interrupts before the angiogram can be performed and shows that Seth has neuropathy (he cannot feel the vibrations from the boombox in his hands, but can elsewhere in his body). 
The differential now includes increased intracranial pressure (ICP) from a brain tumor, or rhabdomyolysis (a muscle disease, in this case felt to be caused by losing too much weight for wrestling). House disagrees at first, but then changes his mind, deciding that Seth must have neurofibromatosis (neurofibromatosis, type 2 — i.e. NF2 — to be precise) tumor in his brain. An MRI is obtained and shows no tumor, but it does show a bulge in the wall of the fourth ventricle that was not present on an MRI from several years earlier. House thinks the bulge represents a tumor and has Chase perform a biopsy. House also has Chase install a cochlear implant while the patient is undergoing surgery.
Seth now develops a fever. The team suggests a post-operative reaction, an Arnold-Chiari malformation, pseudotumor cerebri, or Epstein barr virus. Foreman, who’s in charge now, favors that latter and starts Seth on ribavarin. Seth now develops urinary incontinence, which makes the team rethink their diagnoses. They suggest sarcoidosis, glomerulonephritis, and pheocromocytoma. House, after another conversation with himself, believes the problem to be heart related and wants a four-hour EKG on the patient. Foreman ultimately relents, but the heart study is normal. The team now suggests it may be Hashimoto’s Thyroiditis. House wants to continue studying the heart, but Foreman chooses to go with ordering a thyroid panel. House decides to induce an arrhythmia in the patient with some asthma medications, but when he arrives at the room to perform the dastardly deed, he discovers that Seth has pulled out his cochlear implant and in the process knocked himself into an arrhythmia, saving House the effort. Thrombocythemia is suggested as a possible diagnosis as is a pulmonary embolus. House tells Foreman that Seth is experiencing the Uthoff phenomenon, a sign of multiple sclerosis, and has him start him on interferon.
Everything goes well at first, and Seth is improving, but then he goes into “lung failure” and needs to be intubated and placed on a ventilator. This means multiple sclerosis is the wrong diagnosis. Eosinophilic pneumonitis is suggested. Hoarseness is a hallmark of this condition, so Foreman goes to check if Seth is hoarse. He is not, but while there, Foreman notices tobacco stained teeth and Seth admits to chewing tobacco in the past. This is enough to let Foreman know that Seth has sarcoidosis. When he was chewing, the immune suppression from the tobacco kept it in check, but now that he has stopped chewing, the sarcoidosis has flared up.
As usual, major complaints are in red, minor in blue, nit-picking in green. I didn’t really have any big complaints tonight, just blues and greens:
The medicine was fairly good, but also fairly superficial tonight. There was a great deal of jumping from half-hearted diagnosis to half-hearted diagnosis and abandoning previous diagnoses at the drop of a hat (you can have glomerulonephritis without brown urine, and eosinophilic pneumonitis without hoarseness). The whole heart arrhythmia thing was essentially a red herring and it didn’t affect the speed of the final diagnosis at all (now if they had gotten an echocardiogram, or at least a good look at the heart — which they usually do after an unexplained arrhythmia — they would have noticed granulomas and made the correct diagnosis earlier. Funny how they skipped that step this week.)
House’s prescription bottle read “Zolpidem” (i.e. Ambien, a reasonable choice for a sleeping medication), but then it said 200MG (the dose of zolpidem is 5-10MG. It doesn’t come in 200MG, after all, that’s twenty times the highest recommended dosage). The bottle also read “take three times a day.” Zolpidem is only to be taken at night. What’s the point of taking a sleep aid 3 times a day?
Seth must have been chewing an awful lot of tobacco to suppress his immune system enough to suppress the sarcoidosis.
How accurate are MRIs and CTs at determining ICP, particular the subtle increases seen in tonight’s episode? I thought the opening pressure of the lumbar puncture was the best way to determine ICP — though IANAN (I am not a neurologist).
Lung failure — not a common medical term at all. Respiratory failure would have been a better choice.
Why didn’t the sarcoid granulomas show up on the chest x-ray?
Not all seizures can be induced with flickering lights, only people with photosensitive seizures.
How can you tell is someone who is just extubated is hoarse? Intubating, extubating, and being on the ventilator can all cause hoarseness.
MRIs aren’t used to diagnose a broken nose.
The medical mystery itself was good this week and deserves a B. The final solution fit, but the tobacco-suppression was was quite a lucky coincidence; I give it another B. The medicine was pretty good, though the reasons to choose and discard diagnoses seemed more superficial (and incorrect) than usual. It earns a B-. The soap opera was excellent. I enjoyed the look at how House’s subconscious worked, and using Amber’s ghost to play that part was perfect. The bachelor party was well done too, I particularly liked how he held in it Wilson’s apartment. A.
April 27th, 2009 at 11:42 pm
I don’t know about anyone else, but I love Dead Cutthroat Bitch!
April 27th, 2009 at 11:54 pm
Maybe Amber’s ghost has lupus? oh nvm… it’s not lupus and it never will be.
So anaphylaxis from fake strawberries? If Karamel had used the juice of the white strawberry Chase would have been able to enjoy her berry goodness with no allergic reaction. Sweet!
April 28th, 2009 at 12:02 am
I don’t know good medicine from bad for the most part, but as a teacher at a school for the deaf, I can say that I was pleased with how they handled the “deaf” issues. Most TV shows make a mess of it when they try. The signing was decent, and I’m glad Thirteen mentioned the cultural perspective, although I wasn’t surprised to see the rest of the doctors pretty much brush that aside.
A few nitpicks of my own:
- If he lost his hearing after the age of 4, I would expect him to have SOME memories of what it was like to hear, especially something simple like the sound of his own name.
- He’s all about Deaf culture, not needing hearing, yet to maintain intelligible speech after 10 years of profound deafness implies a LOT of speech therapy (which doesn’t seem to fit), or else he had significant residual hearing (which makes a cochlear implant an unlikely option).
- It was the mom’s choice whether to implant him or not when he was 4. When he’s 14, I don’t believe a parent should make a unilateral decision about something like that. It’s kind of like rehab — the patient needs to want it for it to work effectively.
- Install a cochlear implant, Chase taps a few keys (pretty sure the surgeon doesn’t do that, anyway), and voila! Perfect hearing, just loud and overwhelming! Keep dreaming, Hollywood…
April 28th, 2009 at 12:03 am
I like how they have cochlear implants on standby in House’s bizzaro world.
btw you have a typo on the homepage: it’s episode 22 not 21 :]
April 28th, 2009 at 12:10 am
Do you have any idea what it was that Cuddy was using to sober up House’s team? I remember reading somewhere that sucking pure oxygen can do the job, but it looked like she had them on a drip of some sort.
April 28th, 2009 at 12:21 am
I tuned into this one late, and heard them mention NF2 and then they called it cancer which turned the episode into a big fat epic FAIL for me (as someone who has NF1, I find it incredibly annoying to have NF1 and NF2 represented incorrectly in the media…We already have to try to tell people that the Elephant Man didn’t have NF….but to have a popular show describe it as cancer? Sheash! I stopped paying attention at that point).
I wish the writers didn’t misrepresent these (and by these I mean-pretty much all the “rare” ones) conditions so badly (NF in this show has NEVER been described accurately, and they get 1 and 2 messed up all the time)…..because it does tons more damage then it does good in “getting the word out”.
April 28th, 2009 at 12:31 am
At http://politedissent.com/house_pd.html, both saviors and house divided says episode 21.
April 28th, 2009 at 12:47 am
What an episode. Best of the season, without a shadow of a doubt!
April 28th, 2009 at 1:41 am
First off, I should say that I’ve been looking for a site like this for a while as I’ve wanted to hear an MD’s take on House, my new favorite soap opera (I’m finishing up my 2nd year of med school now).
Running a thyroid panel for Hashimoto’s after he’s been in the hospital for a few days seems weird, its usually one of the first labs they run, right up there with a CBC, but hey, maybe they are trying to cut costs at PPH. Also, good calls on the odd uses of MRI’s in this episode.
@Kestra, while I don’t have NF1 or 2, I think NF2 can present with bilateral acoustic neuromas, and while NF2 isn’t cancer per se, it does lead to an increase in certain cancers. I also thought that it was weird that they did a brain biopsy before some sort of genetic screening to look for NF2. But I don’t know how long that takes to get results back (probably too long for house).
April 28th, 2009 at 2:52 am
I have an implant, though I’m also culturally Deaf … so many inaccuracies in the way they handled the implant, I was amazed you said the medicine was B-! The most blatantly obvious error (though there were several to choose from) was that he ripped out his implant – that’s not actually possible, given that it doesn’t stick through the skin. You’d have to tear open your skin, and pull the implant out of a fairly tightly drilled socket in the bone … not feasible even if he wasn’t recovering from surgery.
April 28th, 2009 at 3:38 am
WTFFFFFFF were they thinking with that Ambien bottle!??!?!?!?! omg i nearly died. It takes 30 seconds to go to ambien.com to learn how to write it correctly, not to mention i bet you could get it from wikipedia too. What were the writers thinking? They seriously dropped the ball on that one. LMAO it was 20x the dose you’d need, and dosed TID? I guess that is good for inducing comas, hold on lemme check. I screamed out loud when i saw it, then i stopped paying attention … till all the strippers — that made me calm down :)
-Pharmacy Student
April 28th, 2009 at 4:32 am
I loved this episode and while I am not a doctor i am a sick science student with a sister who is a doctor so i generally can tell a lot of what is going on and good and bad stuff.
My favorite part even though it was all of 2 seconds was them mentioning my condition. Arnold Chiari Malformation!!! Yay. They really should do a whole episode about it, it is something highly under diagnosed and not often heard about. I am amazed it came up. of all the different doctors and specialists i have seen over the years only 3 have actually heard of it and they were neurologist who specialize in it. All of doctors had maybe heard of it in passing and don’t know what it is or never heard of it. I loved how after my 2nd surgery i found a web print out for everyone in my file saying what my condition is.
yay house!
April 28th, 2009 at 5:33 am
They should have had a blinking-lights warning for this episode. It’s all well and good to try and give the kid a seizure, but do you have to give me one as well?
Also, how much real strawberry do you find in body butter? These things are all added fragrance. And who uses the same body butter for 9 years? (They did say she was at Wilson’s party 9 years before. She’s still a stripper and still that hot? hmph.)
April 28th, 2009 at 5:47 am
I think I will not be the only one who enjoyed Amber back for a whole new episode!CB was is and will be my favorite applicant and I still sob nostalgically that they decided to kill the character instead of including it in the cast . And boy does Anne Dudek has the most incredible and breathtaking set of legs that side of the Atlantic! Seeing them from 5 different camera angles was bliss and I cannot but envy Hugh Laurie who enjoyed some good close ups on those babies! And the one thing that was actually good thinking from the writers this weekend – they made a multi-episode story ark from that! Bravo Brian Singer and David Shore you are recapturing the early House vibe! It is kind of funny also that so far in any episode that House is having a conversation with himself he chooses Amber or Cuddy to be his subconsciousness. Does he have some suppressed Oedipal complex or is he just a man that needs to get some loving instead of dirty whore sex? Who knows… Hopefully Cuddy will cure him soon :) Ok now to medicine:
1. The kid’s a wrestler. Why did Foreman exclude head trauma from the DD so fast?
2. They did blood works couple of times on that kid but never checked ANA levels? (they usually check that to rule out “autoimmune”) Increased ANA would suggest sarco and they would have found the answer twice as fast.
3. So they checked his heart but never actually did a trans esophageal echo? How exactly did they check it?
4. Who did the patients history (and missed on such a major problem as tobacco chewing and how come they never looked up the usual suspects (drugs, toxins, bad habits and addictions)?
5. If he had Epstein bar virus in his brain he would of had a lymphocytosis on his blood panel. (and like D-r Scott I’m getting tired of repeating that infections – all kinds – have very specific (and non specific) reflection on the blood panel and complete blood count will reveal at least leucocitosis with different increase in specific types of cells for different types of infection – Lymphocytes for viral, neutrofil granulocites for bacterial, eusinofile granulocites for parasites etc.)
6. Hashimoto is an autoimmune. ANA anyone?
Apart from that – great episode wich gets an A+ for the soap. Way to go! Cant wait to see the season finally!
April 28th, 2009 at 5:56 am
My medic friends seem to be able to take a bite out of both drunkenness and hangovers with IV fluids. I understand the hangover bit, since your more than likely dehydrated but drunkenness?
maybe its just because you think its helping with your drunkenness. But a question on that, would increasing the volume of fluid in the circulatory system with IV fluids reduce BAC? after all, more fluid less concentration. just curious, I’m not in a medical field at all, quite the opposite actually.
April 28th, 2009 at 6:02 am
I just love that you are checking the labels on the prescriptions that House gets. What a catch that you noticed that it said take 3 times a day!
Very fine bachelor party. And I was totally surprised that Chase came in to House’s office and told him he would need to be kidnapped. A great “kidnap.”
April 28th, 2009 at 6:03 am
I sort of assumed that he had the MRI due to concerns about other injuries from whatever trauma caused the broken nose, but I admit I wasn’t watching too closely.
We were shouting at the TV during the checking-for-hoarseness bit about the ridiculousness of doing such on someone who just had a tube in.
We did love the pseudo-sober medical team and Wilson trying to walk home from his own apartment, though.
April 28th, 2009 at 6:09 am
I have sarcoidosis and have been cheering for it every time it was mentioned all these years. Finally, it WINS! And I discover that I should take up chewing tobacco….
I was interested in Rachel’s comments on the Deaf issues. There was a Law and Order CI episode on the Deaf community and cochlear implants that I liked very much, and I was not so happy with this one. (I am not deaf, just interested–I guess there is a certain envy of that quiet world.) They did give a feel for the culture at the beginning, and of the contrast between Seth’s self-sufficiency pre-op and the barrage of noise and challenges after the implant. But House’s attitude was crude. equating deafness with his own painful disability or with blindness. And in the end his attitude was the one that was justified, because he is House and because Mamma wants Seth to be able to hear her when she tells him what to do…. I just felt it was simplistic.
April 28th, 2009 at 6:44 am
AFAIK stimulants won’t sober anyone up much faster but will make someone feel sober faster. Time is the only cure and exercise, O2, excessive hydration, etc might shave a couple of minutes off of the hours needed to metabolize the alcohol. A tiny portion of the alcohol will not be metabolized but will leave the body through the skin, breath, urine, and feces. A man may have 5 to 6 liters of blood in his body so if he were transfused over and over again… nah just wait the liver will do its magic.
April 28th, 2009 at 8:01 am
I loved the House-Wilson scenes this week. Some great Wilson lines.
“What you did was an act of kindness… immoral and illeagal, but… baby steps.”
And then Chase, when House thinks he’s going to ask him to cut back on the bachelor party or cancel it altogether, asking to be kidnapped! Great!
April 28th, 2009 at 8:30 am
It was a pretty good episode.
What really irks me is that Chase seems to be some kind of super surgeon now? Didn’t he start out as an “Intensivist” (In Germany, that term doesn’t even exist, he would have been an anaesthesiologist)?!
And now, he’s not only a abdominal surgeon (as shown in earlier episodes), but also a neurosurgeon and ORL surgeon. Nice….
April 28th, 2009 at 9:11 am
That is interesting, what you say about the Ambien
prescription. Perhaps the large dose is what accounts
for the appearance of a split off personality. Compare
with the many anecdotes of ambien induced odd behavior
including sleep walking,
sleep driving, sleep sex with strangers, sleep binge
eating. However, a contributing factor appears to be
that a disturbing
event (Kutner’s suicide,as House acknowledges at the
end of the episode) has precipitated a psychotic
reaction. After all, a split off personality, complete
with voices and directives, is a classic
sign of schizophrenia. That does not seem like
’slowly going insane’. House is there, even if only
for an episode.
April 28th, 2009 at 9:30 am
According to the article below, the material on the show is based on real although rare cases:
http://www.montrealgazette.com/Entertainment/real+finds+maladies+House+cure/1535213/story.html
That was some wild bachelor party. Real fire hazard with all that hard liquor aflame and the hot strippers……
April 28th, 2009 at 9:47 am
I got a kick out of House rocking out to Public Enemy.
That, and I’m wondering if the patient is loosely based on Matt Hamill:
http://en.wikipedia.org/wiki/Matt_Hamill
April 28th, 2009 at 9:59 am
My biggest nitpick about his episode was the cochlear implant. My sister has progressive hearing loss and got the surgery. While there is always the timing issue on the show (no way he had hearing that fast), but the implant is internal. There is an external hearing aid device and microphone which is attached magnetically on top of the skin. Simply put, there is no way he could have ripped it out of his head and caused damage, because there is nothing on the outside of his body to pull out.
If he ripped off the microphone it would cause no more damage than ripping off a bluetooth headset.
April 28th, 2009 at 10:01 am
Everyone seems to be missing the bigger point… Wilson walked home pantless from the party at his own house. That line has to be one of the best I have ever heard on this show.
April 28th, 2009 at 10:14 am
Hey, long-time reader of these reviews, first-time commenter.
At one point, Pseudotumour cerebri is suggested, and ruled out because an eye exam showed no papilloedema [swelling of the optic discs caused by increased intracranial pressure]
I have this disease [though in the UK it's usually referred to as Idiopathic (or benign) intractranial hypertension], and have absolutely no problem with my eyes, even though my IC pressure was at one point so high i was having fits, so it annoyed me that the disease was ruled out so flippantly.
Though, to be fair, IIH usually occurs in overweight women of childbearing age, not adolescent boys. Even so, an eye examination could not effectively rule it out – diagnosis is by measuring IC pressure by lumbar puncture only.
In response to the question about measuring ICP by CT or MRI – as far as I’m aware [and i have a biomed degree and am pretty clued up on issues around my disease] you can’t measure ICP by imaging, though some things can SUGGEST a high pressure [smaller ventricles in the brain].
the only way to measure ICP is to stick a needle in there and see how high it rises up the damn tube. I went through a stage where i was having LPs every 6 weeks to monitor my ICP, and it REALLY annoys me how easily doctors, both on TV and in the real world, send patients off for LPs. those things HURT. they’re distressing and incredibly painful. Feeling a needle scratch around against the bones of your spine while some clueless doctor attempts once again to get it into the right place, even though you’ve been TELLING him he’s too far to the left for about half an hour is indescribably nasty.
end-rant.
My essential point was that it’s poor medicine to rule out PTC on an eye examination, and that high ICP can only be confirmed by lumbar puncture!
April 28th, 2009 at 10:29 am
Huh, you guys liked the hallucinations? Is it medically possible for someone to have such vivid hallucinations? Isn’t it a sign of schizophrenia? I did not like that aspect of the episode at all.
April 28th, 2009 at 10:49 am
The cochlear implant issues made me crazy – there is nothing external to “rip out,” it isn’t typically turned on that soon after surgery, I have doubts about its usefulness after that many years of deafness, it takes serious rehab to learn to listen and speak, and it can be turned off or on, so no need to remove it if he didn’t want to use it. Just don’t wear the external pieces, and nobody will ever know you have one! They made it sound like a pair of glasses – pop one in and magically hear!
April 28th, 2009 at 11:51 am
Interestingly, a similar condition to Arnold-Chiari malformation – mentioned in passing in this episode – is frequently found in cavalier King Charles spaniels. It was fun to hear a diagnosis go by that I actually recognized.
April 28th, 2009 at 1:01 pm
“I particularly liked how he held in it Wilson’s apartment. A.”
Should be ‘it in’.
Great episode!
April 28th, 2009 at 1:32 pm
I really didn’t like the way the approached the CI part.
I know that the House team are inordinately clever and trained to use evey piece of equipment in the hospital, hah, as if! But Chase just implanting a CI, no audiology tests, not selection of the best for the patients residual hearing, etc etc.
I am waiting for CI surgery, I reckon I now have to reassure everyone that I won’t need to have by head opened up, that I won’t be able to hear perfectly the very next day, that I won’t have a bandage round my head.
bah humbug. Just a bit to personal for me this one.
April 28th, 2009 at 1:35 pm
This episode was one of the darkest house episodes I’ve seen. I don’t complain though, I like where the writers are taking us; House is getting more and more insane and he’s finally starting to decay. Or maybe it’s just Laurie getting older.
Anyway, I really enjoyed this episode. I actually raised my eyebrows a little when House realized he was killing Chase. This one and House’s head is a two-way tie for #1 soap opera on this show.
April 28th, 2009 at 1:42 pm
Was I the only person who thought the actor playing Seth looked a lot like a young Matt Damon?
April 28th, 2009 at 1:46 pm
@ Thor D:
Yeah, I can’t believe no one’s really touched on that fact either. House subconsciously tried to kill Chase, and no one has really mentioned how dark that is. That’s a pretty intense realization that I think deserves discussion. With that said, I got nothing to get it started. I’ll let someone else throw in their two cents.
April 28th, 2009 at 3:49 pm
@ Thor D and M-II:
This episode was indeed the darkest ever, and awesomely so. Laurie looked like crap, with almost a full beard and baggy eyes (I think there was some makeup enhancement there). The bachelor party where he has his realization was so surreal, what with the flames and eerie red lighting and such. It was like a Halloween Special of “House”.
Interestingly, this is the first episode I can remember where House grapples with his morals without any direction from Wilson… and the first where he’s not sure what his own motivations are. Usually he’s cock-sure what he’s doing. I can’t wait for the next episode.
April 28th, 2009 at 4:31 pm
nice little cultural-reference:
Karamel – with a ‘K.’
references to an song by the hooters: “Karla – with a ‘K.’
http://en.wikipedia.org/wiki/One_Way_Home
April 28th, 2009 at 5:34 pm
Was I hallucinating (too) or is CTB looking a bit pregnant?
Also, You’d think they could spare the patient a few band-aids for his skull-halo drill holes.
I liked the ep this week a lot.
April 28th, 2009 at 5:34 pm
Was I hallucinating (too) or is CTB looking a bit pregnant?
Also, You’d think they could spare the patient a few band-aids for his skull-halo drill holes.
I liked the ep this week a lot.
April 28th, 2009 at 6:02 pm
theOriginalKeith: Anne Dudek was pregnant after Season 4, so this might be post-birth chubbiness.
And I agree with a poster above, this was definitely the best episode of the season. This was the good old House like from Season 2.
April 28th, 2009 at 6:17 pm
At the start they speak of exploding head syndrome. I have that, and they’re wrong on quite a few aspects of it:
- They very rarely happen twice, to my knowledge never in short succession.
- They very rarely happen in broad daylight, to my knowledge never while wrestling
- There is never any pain
April 28th, 2009 at 6:43 pm
As an amateur firebreather, I just have to point out how obviously fake the alcohol flames looked in this episode. I am also unfamiliar with any alcohol that burns blue, a color associated with much higher temps than the standard yellow-orange fires.
April 28th, 2009 at 6:58 pm
@Adam (from way up at the start)
Yes, both NF2 and NF1 lead to an increase in certain types of cancers (for NF1 it is MPNST, and there’s only a 3-5% lifetime risk of that…..which is basically nothing considering the general lifetime risk for cancer is significantly higher then that). But the tumors all three types of NF cause are not cancerous themselves. Tumor does not equal cancer….it’s such a shame a lot of people can’t get that into their heads.
There is a genetic test for both NF1 and NF2 (I don’t know about Schwannomatosis-I think they’re still trying to isolate the gene), and they do take a few months to get back, but that’s never stopped House before from tweaking the timeline (They did it in Daddy’s Boy).
April 28th, 2009 at 7:34 pm
best episode ever.
April 28th, 2009 at 7:59 pm
i’m a bit confused about the hashimoto’s part. i have hypothyroidism, and it just seems odd that hashimoto’s would come out of NOWHERE to be a diagnosis – what is the logic of it coming up?
April 28th, 2009 at 9:13 pm
Wouldn’t a person deaf for that long not really be able to understand spoken words. And wouldn’t their speech still be a bit slurred?
April 28th, 2009 at 9:51 pm
Found the Bingo Card by _thickasabrick @ Livejournal in an older post and decided to do an 4th/5th season version !
http://i40.tinypic.com/xaxtgj.jpg
April 28th, 2009 at 10:10 pm
Just a quick note to people who have suggested that house’s hallucinations may be due to schizophrenia, I’d say this is pretty unlikely. Although hallucinations are a classic (positive) symptom of schizophrenia the fact that house is so aware of them, and knows them to be part of his own subconscious, combined with the lack of other symptoms (such as paranoia, flatness of affect, delusions etc etc) pretty much rules out the disorder.
April 28th, 2009 at 10:35 pm
This episode was a work of art. I liked the way the lights and the darks were changed for the episode, how House/Himself/Amber interacted and thirteens coments. Overall a very enjoyable episode.
P.S. even though I like the way the lights were changed I hope is only for this episode.
April 28th, 2009 at 11:09 pm
I was really happy to see that House’s hallucinations didn’t go away with sleep. So now we can rule insomnia (and schizophrenia) as causal.
Last ep, this was my prediction based on things that commonly cause hallucinations (schizophrenia, dementia, temporal lobe epilepsy, barbiturate abuse, narcotic abuse, & Vitamin B12 deficiency): “My money’s on narcotic abuse. Vicodin causes liver damage which can cause thiamine (Vit B1) deficiencies which can cause Wernicke-Korsakoff syndrome (and hallucinations are a symptom)”
That would be cool if I’m right & the authors are using opiate side effects as a story arc (again). I really want to know what’s causing it!
-Pharmacy Student
April 28th, 2009 at 11:51 pm
When I read the episode description I was so excited that they were doing an episode about cochlear implants. My dad received an implant after losing his hearing during treatment for a staph infection.
I really wish that they would have spent more time on it because its such a fascinating process. However it was kind of insulting how inaccurately it was portrayed. As was said before the implant is two pieces. on contained within your skull and another magnetically attached to your head. Even thought the whole idea that you would “slip” someone an implant is so completely crazy, even for tv, had he not wanted it all he would have to do is take of the external piece.
also the process of learning to hear can take weeks even months, as the brain has to relearn what sound is. Yes it would be very jarring to hear with an implant for the first time, even more so than they portrayed. but not because you could hear every minuet thing as the sequence portrayed, but everything would sound very fuzzed together.
I could go on, but suffice it to say that they left so much out that would make great tv.
PS how can you not have any rush limbaugh jokes in this episode?
April 29th, 2009 at 12:04 am
I think the whole scene with house the bartender was cg…
April 29th, 2009 at 12:27 am
@psychologist
Thanks, I was hoping someone would say something about the plausibility of how House was hallucinating (which was, imo, actually the most interesting medical question this week). I’ve had brief interactions with a few hallucinating schizophrenics, but I never got the impression that their hallucinations were so…well…realistic.
Also, is it possible that House’s being more self aware than the average schizophrenic may be due to something along the lines of John Nash’s “enforced rationality”? He may be able to control his symptoms better than most people simply because he has superior mental control in the first place.
(Not a doctor, don’t even play one on the interwebs)
April 29th, 2009 at 12:41 am
Official Comment
Alex,
It looked like Cuddy had the team on banana bags — IV fluids with multivitamins; commonly given to alcoholics who are admitted to the hospital. They don’t do anything for hangovers, but help prevent some of the complications of chronic alcohol abuse.
April 29th, 2009 at 1:01 am
Hi, Dr. Scott! First time caller, long time listener, etc.
Just a quick note about the MS diagnosis. Multiple sclerosis severe enough to cause Seth’s symptoms (Primary-Progressive MS is the only flavor that even comes close) would have caused huge plaques on his brain and spinal cord which would have been spotted immediately on an MRI.
Having said that: fantastic episode! Best of the season.
April 29th, 2009 at 1:11 am
I was a little surprised, Scott, that you said so little about House’s hallucinations, since I thought that was by far the best part of the episode. I was really expecting for someone to notice that House was holding the door for someone who wasn’t there, since he held the door for Amber to precede him out of every room.
I also enjoyed the little taste of how House gets his flashes of inspirations, assuming that the things Amber said or showed House were the words or images that pop into his head when he is working on a diagnosis.
April 29th, 2009 at 1:41 am
To all the people who mentioned it “House tried to kill Chase” I thing Amber’s (=House’s) rationalization that he just couldn’t accept other peoples happiness was the right one – it also meant that he was not trying to kill him just mess with him and his happiness. As a dentist one of the most “bash this into your head till you know it by heart” conditions is Anaphylaxis. It is an extremely dangerous condition however with the right measures you can prevent any major complications. I literally can wake up in the middle of the night and still will know what to do. So I doubt that a doctor can die in a room full of doctors in the house of a doctor from anaphylaxis. Of course without an Epi pen he’d be toast. Still a doctor usually has some med at his home including an emergency kit which always has Epis. So while House did play a rather cruel and tasteless joke to Chase (can I add a medical nit-pick here and point out that allergies to strawberry is unlikely to be triggered by a strawberry tasting body lotion or cream – they do taste and smell like strawberry but the ingredients are usually quite different!), so as I was saying – cruel and tasteless but not a murder attempt per say. I’d like to give a prediction for House condition that has nothing to do with the House challenge but would be fun to watch if I’m right – his hallucinations are not caused by insomnia (I’d argue that artificially drug precipitated sleep has nothing to do with normal REM sleep and the sleeping pills are not actually a cure (whoever wants to argue with me check the episode from season 2 “Sleeping dogs lie”). Still it is not the insomnia nor is the Vicodin (Vicodin contains codeine which is a sleeping pill by it’s own right!). It is purely psychological aggravated by his drugs and insomnia but the problem is in his head! That is my prediction – and until House realizes that and starts fighting issues that’s been troubling him for months and may be years now he’s stuck with himself (at least he chose good company – Amber – you want your subconsciousness to have a face and a smoking body Anne Dudek is the way to go!)
April 29th, 2009 at 3:22 am
@Izzy
If you take a look at the bottle, they are tailor made to be a flaring training tool and is actually unbreakable when thrown.
If someone can juggle, which House clearly can, then flaring may require less time to learn in terms of some flaring moves as opposed to those who might not be able to
April 29th, 2009 at 8:10 am
I’ve been taking Ambien for years so I laughed when I saw his bottle and saw that he had 200mg capsules. On a camping trip once I accidentally took four 10mg pills (it was dark in the tent) and that was a very surreal and somewhat frightening experience. I can’t even imagine what a 200mg pill would do.
Also, I’ve never heard of Zolpidem in capsules before.
I liked the color desaturation when he was conferring with Amber in the presence of his team. Nice touch.
April 29th, 2009 at 8:29 am
Did anyone else find House with his ‘ghetto-blaster’ and Calvin Harris style glasses, the funnest House moment ever. I was in stitches.
April 29th, 2009 at 8:55 am
House: “I have seen the cut throat bitch, and it is I!”
April 29th, 2009 at 11:23 am
Yeah, when there actually is a mental illness that lets you hallucinate hot blonde women, give me all the drugs it takes to trigger that!
Even I caught that the strawberry thing wouldn’t work, unless Karamel gets her sex toys from some ‘all organic; sex toy manufacturer–bet you they are out there! (I’m a sad man who wants to hallucinate hot blondes…no use in my checking, is there?)
Does Chase go into shock from Strawberry Quik, too?
April 29th, 2009 at 1:12 pm
@ ninguem
“Is it medically possible for someone to have such vivid hallucinations?”
Go take 750mg of diphenhydramine hydrochloride. I’ll wait.
April 29th, 2009 at 3:08 pm
As a chemist, I’m used to burning alcohol lamps. They are blue and so faint they can be hard to see in daylight, resulting in accidental burns. The lower primary flame in a candle is also blue–the yellow part of the flame is caused by heating of an aerosol of carbon micro-particles which results from incomplete combustion of the candle wax. Alcohol, methane, and propane burn completely, so their flames are entirely blue.
April 29th, 2009 at 4:09 pm
Travis, you’re right. Ambien only comes in tablets (and now a spray). Did the bottle say caps too? Uhg the writers messed it up in so many ways! Oh, and Ambien is sometimes used for Parkinson disease off-label with initial dosages typically 10 mg nightly with gradual titration to dosages as high as 40 mg/day or 10 mg every 2 hours. But House defo doesn’t have Parkinsons, and still his 600 mg/day is nuts.
-Pharmacy Student
April 29th, 2009 at 4:34 pm
The thing with the strawberries was so stupid it was insulting to the viewers in my opinion. But there is a lot of bad writing on this show…
I can’t believe anyone finds CTB attractive…yuk.
April 29th, 2009 at 4:36 pm
PharmStu and others. They went to a lot of trouble to give us a close up of the label, so I wonder if the many mistakes were put there on purpose. An inside joke, perhaps, for the medical professionals watching the show.
April 29th, 2009 at 6:48 pm
In response to Amy, putting on glasses is not always a quick fix. Not to be too boring but I had a patient with L: -1.00/-12.00×90 R: -1.00/-12.00×90 (axis is a little ‘ish’. After they tried them (first time with specs!) they put them in the case and (with help) left. Any sudden change to the norm is hard!
April 29th, 2009 at 8:24 pm
If you want to bring a cherished character back, DON’T KILL HER IN THE FIRST PLACE! Same thing goes for Kutner.
April 29th, 2009 at 10:55 pm
While looking at photos of strippers, does House say something like, “I don’t want her. She is the one who introduced me to Madoff.”?
April 29th, 2009 at 11:21 pm
Attractiveness is sometimes in the eye of the beholder. Maybe Amber is not as conventionally pretty as 13, but she’s hardly ugly, she has a nice figure, and she is a much more interesting character than 13.
On the downside, she is dead, while 13 is only dying.
April 30th, 2009 at 1:32 am
I must say, I’m pretty shocked to hear such favorable impressions of the hallucinations and this episode as a whole. I can’t find the original comment now, but I totally agree with the person who said it was insulting to the audience to act as though flavored body butter would trigger a strawberry allergy! Absurd! And ripping the implant out? Wow.
Even with all that aside, I just thought the Amber hallucinations felt totally canned, cheesy, and forced. It all seems a bit too easy, too divided, too clean. And Amber as House’s alter ego? Arbitrary much?
I hope this arc doesn’t last long. Just strikes me as fake and creepy!
April 30th, 2009 at 2:47 am
It’s one thing to lament the loss of CTB, but quite another to see what the show is like with her after all. The show already had too much money committed to regulars, and offed CTB, only to watch Kutner leave less than a season later. This means not only did the show likely jump the shark by killing off a minor one season character (not many can pull off that feat), but now that they’re able to fix that mistake (monetarily), they no longer can.
I’m not ready to anoint House Divided “best episode ever” as some seem to, because it’s not. The medicine may be shoddier than first thought (especially regarding the implant), while the scenes with Amber might actually be better (as a superb mirroring of House’s thought process, rather than a picture of his insanity and evil). But the one thing the episode did was to show exactly what the series has been missing in Season 5. Sure I enjoy the new team more than most, but the spark Amber provides is undeniable. Even in a CTB/House’s thought process form, which was clearly different from the actual character (we all know Amber was kinky, but certainly wouldn’t have been interested in strippers to any degree like that).
I still maintain that they needed to go the Hamber route for Season 5. Having House actually have a girlfriend, plus the built in drama of dating Wilson’s ex, would’ve kept the show feeling better than ever, rather than the slow death it appears to be dying now. But the producers made the wrong decision, entirely because of money, and the show unfortunately prides itself too much on realism to ever be able to rectify it. I do applaud them for finding a way to bring her back for at least a few episodes (although I actually expected that if they did, it would’ve been earlier in the season as opposed to now), although when she inevitably leaves again, it’s just going to be that much more painful. And any of the horrible soap-opera conventions of bringing a killed character back (dreamed a season, identical twin, etc.) would absolutely destroy the show’s basis in reality.
As much as I’d wish they could find a way for her to stay, I’d probably respect the show less if they did (ugh these producers!). I still maintain that House has yet to admit his feelings for Amber (or what would’ve been his feelings if not for the strike), and although it looked like that would never happen, perhaps he finally will now.
However, I haven’t ruled out that Amber’s appearance might actually have something or (sadly) more to do with Kutner. Of course, the true problem is that House can’t see outside his character, which he would have to do to realize that the actor playing Kutner (Kal Penn, I know) left to take another job, and that’s why his character is dead. It would be very surreal, but there’s no point for that to happen. I’ve postulated that Kutner’s asking out of Amber actually had more to do than just with her legs “up to Canada”. Perhaps her death actually hit him much harder than he ever let on, and he “just couldn’t go on” anymore. That’s a definite retcon, but one of the only somewhat plausible explanations a guy who loved life so much would suddenly and inexplicably end it all. Perhaps Amber appearing is actually the solution to the puzzle, although I hope it’s more than that.
(@gamik: Yes, that’s exactly what he said.)
April 30th, 2009 at 5:43 am
House didn’t try to kill Chase intentionally, simply because when he confronted “himself” (Amber) about it, “he” said that “he” only picked Karamel because she was good in Wilson’s party. “Subconciousness” don’t lie, and House misses details like these all the time.
“He” did admit that he can’t deal very well with other people’s happiness though.
April 30th, 2009 at 9:08 am
I have to agree with D-r Bulgaria and everyone else who pines for more cutthroat bitch-time… but we can’t blame the producers on this one. She (Anne Dudek) had a baby in December, which explains both why she couldn’t ‘make it’ to the final team and why she’s now back with a vengeance…
Also, I have to say I think Kutner was a good egg on the show… again though, a higher calling/purpose meant he had to go, and fast. Pity, although it’s made for some good episodes!
I’ve never missed an apisode or one of Scott’s reviews… long may they continue
April 30th, 2009 at 11:09 am
Looking forward to the new ep for whole two weeks and now House´s hallucinations are the most interesting part of it?:-/ And seems like they won´t be gone soon…
1. Thanks for the explanation why Amber gained weight in heaven;-)
2. Shouldn´t they use acyclovir to treat the EBV? As far as I can remember, it´s usually effective and less toxic than ribavirin.
3. I also doubt strawberry cosmetics contain any real strawberries. The subconsciously-killing-Chase part was really silly. Btw. I developped rash from cranberry body milk but I still can eat cranberries (and touch them) with no side effects:-P
4. IV fluids may help a little to feel better when you´re hungover, but clearly they don´t sober you up. Cuddy should have sent the team home to get some sleep!
April 30th, 2009 at 12:02 pm
@Anonymous
“Go take 750mg of diphenhydramine hydrochloride. I’ll wait.”
I guess I’ve had a sheltered life. What’s that, a bottle of benadryl?
April 30th, 2009 at 12:08 pm
@juan
re: the ambien.
Yeah, I’m pretty sure the crazy 200mg tid was intentional. House always takes “heroic” doses of any chemical he’s presented with – opiates, alcohol, LSD, caffeine, and plenty more I’m probably forgetting.
April 30th, 2009 at 3:12 pm
If you go to the Body Shop and look at their Strawberry Body Butter, it does have strawberry seed oil in it. Apparently the allergen in strawberries resembles the allergen in birch pollen, which to my unscientific mind suggests seeds. So maybe….
As for Amber telling House that he chose Karamel for non-strawberry-body-butter qualities, everybody lies, even to themselves.
Though that whole plot has more holes in it than a strawberry has seeds. I did kind of like Foreman and 13 checking out the strippers, though.
April 30th, 2009 at 8:46 pm
I find this the greatest episode ever for one reason.
FIGHT THE POWER!
How has nobody mentioned the single greatest scene in House history?
April 30th, 2009 at 8:52 pm
I even made a gif of it it was so epic.
http://i27.photobucket.com/albums/c171/zygote7/house2.gif
April 30th, 2009 at 10:42 pm
@Judy: That’s Oral Allergy Syndrome, which is a mostly benign response to certain foods. I have it, and all I get when I eat a “bad” food is an itchy throat and gums.
April 30th, 2009 at 11:44 pm
Does anyone else think that the lighting in this episode being slightly brighter than normal and the faded out look the show had when House was fully concentrating on Amber was really the show giving symptoms of a disease House has? I mean with the hallucinations not going away with sleep means that House probably has something wrong with him so maybe the show was trying to foreshadow that by the odd lighting throughout the whole episode and giving us a sign that House’s vision isn’t exactly right either. Maybe even that blurry vision from House’s point of view at the end of the episode a few weeks ago was the show trying to give us a hint of what’s to come.
…of course I told a few of my friends this theory and they all looked at me like I was nuts, so oh well.
Plus I have a quick question. Doesn’t the acute form of eosinophilic pneumonitis often come associated with a change in smoking habits as well? A few months ago I had a PBL case that mentioned that, so as soon as they asked the mother if the son smoked I thought for sure that would verify the disease was eosinophilic pneumonia. Of course maybe it’s not true with chewing tobacco.
May 1st, 2009 at 2:54 am
So even if the Ambien script is supposed to be a joke to medical professionals everywhere, I think it’s a pretty good principle not to joke about taking over dose quantities. Honestly, the general public is not that smart. Even if one person sees it, thinks it’s okay, and does it — that could potentially leave them with a lot of liability. As a health professional, we’re taught to CYA (cover your ass) in all circumstances, you have to be careful about your jokes. –Pharmacy Student
May 1st, 2009 at 5:24 am
I can’t sleep so I decided to read all of your rantings. I actually hate humanity more.
Time to prank call Foreman.
May 1st, 2009 at 6:14 am
I just assumed that they killed Amber off **because** of Anne Dudek’s pregnancy. As someone upthread said, she gave birth in like December. I suppose this ep was shot shortly after she gave birth–thus a bit of post-pregnancy pook.
If they hadn’t killed her off, they’d either have to write the pregnancy in, or they’d have to have a fairly major character simply missing for most of season five and then mysteriously reappear when post-Christmas filming began.
I get tired of all this badmouthing of Thirteen. I think she’s great.
May 1st, 2009 at 7:02 am
I really liked Amber as part of House’s brain, and I really like that the last few episodes of S5 have been considerably better than the rest of it.
But seriously, Hashimoto’s can cause all that ???
(Simple TSH/FT4/FT3, anti TPO – is it called that in the US too? – could have ruled it out…but even after all the other stuff came back negative they hadn’t checked thyroid levels, and it still was a possible diagnosis?)
May 1st, 2009 at 8:14 am
Damon: And who uses the same body butter for 9 years? (They did say she was at Wilson’s party 9 years before. She’s still a stripper and still that hot? hmph.)
I thought the exact same thing. Not that being attractive is the issue, but who makes stripping a career choice? Even House said the girls were law students (though you need to take everything he says with a grain of salt).
I, too, noticed the vivid, glowy effects throughout the episode. I’m certain it means something.
May 1st, 2009 at 11:15 am
@Privateer: so it would have had to be basically a nut allergy, or a beesting allergy, but NOT a strawberry allergy, for Chase to be in real danger? Being allergic to strawberries basically means you get an itchy mouth? Chase would have been more likely to die from drinking shots than from scarfing strawberries?
Of course, there are as has been pointed out many holes in the Karamel “plot,” but this is surely a biggie.
May 1st, 2009 at 11:34 am
It was the best episode since House’s Head. I can’t really say anything about the medicine since I’m not an expert but the whole Amber-as-insane-House was fantastic and unexpected. Glad that for once 13 didn’t mention her Huntington every freaking 5 minutes – that actually made me stand her for once.
May 1st, 2009 at 1:22 pm
I also enjoyed the seizure I got from this episode. Thanks, fox!
May 1st, 2009 at 4:44 pm
“@ ninguem
“Is it medically possible for someone to have such vivid hallucinations?”
Go take 750mg of diphenhydramine hydrochloride. I’ll wait.”
Funny you mention that, i’ve taken 400mg in one shot before (don’t ask why, I’m not sure I could answer in this forum) and can recall extremely vivid -audio- hallucinations when I had my eyes closed in silence.
All of a sudden i’d hear my mother (who lives quite far away now) call my name clear as a bell from seemingly across the room and in my skull at the same time, or a co-worker say a random sentence with not a person around me. Creepy. However it didn’t work if there were any other -real- sounds around.
Anyway, ya good episode. One of the top 3 for sure.
May 1st, 2009 at 5:16 pm
actually the patient is also deaf in real life
http://www.imdb.com/name/nm2647455/resume
May 1st, 2009 at 8:09 pm
And, yet again, an initial diagnosis of MS is followed by interferon as a treatment, rather than steroids (which, oddly, they DO give him for the next diagnosis). I wish they’d read a few books on MS.
May 2nd, 2009 at 5:01 am
So, assuming that strawberry body cream actually has trace amounts of strawberry (or something) in it, would that actually be enough to send someone into anaphylactic (sp?) shock? There can’t be much, and it’s not like he ate a huge spoonful. Wouldn’t he just get hives or… something? O__o
May 2nd, 2009 at 7:49 am
Official Comment
Anaphylactic shock doesn’t take much of an exposure at all. You’ve probably seen how some processed food contains a warning that they’re made in a facility that also manufactures peanut products. They’re not worried about a stray peanut, but just a little bit of peanut dust is enough to cause anaphylactic shock is someone with a bad peanut allergy.
Even if Chase was just having a localized reaction — swelling and angioedema — it would be dangerous as it would involve his mouth/throat/trachea which are fairly important in terms of breathing….
May 2nd, 2009 at 3:26 pm
My point was that the ingredients were not strawberry just strawberry analog or something (to get the smell right) Of course I have no idea how exactly those lotions are mixed and what’s in them. So it might be some kind of strawberry derivative close enough to provoke reaction (still doubt it though!). As for the amount – the “strength” of the allergic reaction greatly varies from one person to another. If Chase is one of those guys that are unfortunate enough to have well “strong” reaction to strawberries (anaphylaxis) than the trace amount is irrelevant – even as much as a touch of the stuff would be enough to set it off and once started… well you’d better grab and use that EPI pen and than rush to the ER (cause he’d need way more stuff than just EPI). I have also read that anaphylaxis can be provoked from inhaling some small amount of the allergen (practically just smelling the stuff you are allergic to can set it off) I’m not sure if that is true though or just online gibberish…
May 2nd, 2009 at 5:58 pm
Some people said here that all that cochlear implant idea here was rather poorly handled. I am not a medic and I don’t live in the US, but I was wondering – even if they have those implants on standby and a single doctor can abruptly decide on usefulness of such an implant, doesn’t the procedure cost an awful lot, like around 50-100 thousands of dollars? Is House forcing the kid’s family to pay the sum by installing the implant?
May 3rd, 2009 at 11:51 am
Pete – I remember getting glasses as a kid, when the prescription would change pretty drastically from one year to the next. There was always an adjustment period with that weird visual hump effect, which went away after a bit. Fun while it lasted, though.
May 3rd, 2009 at 2:17 pm
Ive read of cases where allergic reactions were set off lthough there were no real trigger – just the person thinking it has eating someting were he\she was allergic against. <aybe thats what happend? Good episode though.
May 3rd, 2009 at 5:12 pm
When sarcoidiosis is present, one would expect to perhaps, outlandishly enough, see some sarcoids. Where were they? They show up quite well in the lungs and brain, where they cozily resided this episode.
(see http://medgenmed.medscape.com/content/2003/00/46/06/460652/460652_fig.html)
Now, if simply seeing sarcoids and going ‘Hey, Sarcoidiosis!’ is too simple for our pet genius doctor, possibly they could have been clued in by, perhaps, elevated calcium levels, or some other sign. But that’s too straightforward, not to mention dangerously realistic. Instead we need another fantasy-based exhortation on the dangers of drugs (I suppose Fox must balance the fact that the lead is a charismatic pill-popper) and have it diagnosed based on the patient’s past habit of chewing tobacco (apparently, this suppresses the immune system much better than steroids). I await an episode where a patient arrives complaining of a burst spleen, edematous legs, a frontal lobe that liquified and dripped out of his nose, an extra eyeball imbedded in his genetically-mosaic uterus and cough. The team will then proceed to find a hash brownie in his abode, and thus all is explained.
The conception of House’s subconscious was distinctly Freudian (i.e: all-knowing, hidden forbidden urges, etc.). Giving credibility to Freud is never good. What seems strange to me are the extremely vivid hallucinations (delirium, really) yet with intact cognition (mostly, House was indeed slow, but not anywhere near the extent expected) and social functioning (relative to House’s usual, of course). This is similar to the Ukrainian girl who saw her dead mother a few episodes ago, and likewise seems bizarre.
Lastly, I make the following prophecy: House will deteriorate, be in danger, and this will serve as the catalyst for his relationship with Cuddy. We’ll see.
May 3rd, 2009 at 5:25 pm
What was that disease called again? The disease in which he gushed out urine? I never really caught the name and I can’t find it on here/Wikipedia….
May 4th, 2009 at 6:17 pm
I still think that of the 100+ episodes, Wilson’s line, “Baby steps”, was so funny and delivered so expertly by Leonard, is the best line of the series!
May 4th, 2009 at 9:11 pm
@Michelle……When the ‘team’ dissolved into black and white, and their voices somewhat muffled by “Hamber’s” diff dx, I thought I heard Foreman say, briefly, “Devic’s”. From the Mayo Clinic comes thhis:
Devic’s disease is an inflammatory disease of the central nervous system in which there are episodes of ……………..and bladder or bowel dysfunction from spinal cord damage.
It is similar, it seems, to one of their provisional diagnoses of MS for Seth.
May 5th, 2009 at 4:16 pm
This episode mentions Chase having a cat… but earlier this season, he made a joke about not letting Cameron talk him into getting a cat. Not sure if this is good continuity (maybe he broke down and got a cat since then) or bad continuity (the writers forgot he had mentioned a cat previously) but it’s still interesting either way.
May 6th, 2009 at 11:54 pm
“According to the US National Institute on Deafness and Other Communication Disorders, the estimated total cost is $60,000 per person implanted.” – Cochlear Implants Wikipedia Page
Would they put that in without permission with it costing so much?
May 7th, 2009 at 10:42 pm
@Nonny Amos: Brandy burns blue. My family starts a bit on fire every Christmas. I believe that actually applies to most if not all alcohol. It might be a chemical thing–different salts burn different colors, too. It’s nothing to do with temperature.
Flames did look totally fake, though, I agree with you on that.
May 8th, 2009 at 1:27 pm
I am disappointed you rated the medicine so high, because the issues with the implant mentioned by others are just HUGE.
To Paul, who said that there shouldn’t be any pain…
Looking at it from the patient’s perspective, he’s unfamiliar with noise, which causes a reaction of severe discomfort- which would make him writhe in “pain.”
All of that is overlooking the fact that they messed up the medical facts of deafness at 4yo. At any rate, a congenital deaf person could have a reaction like that to the noises he was experiencing.
May 8th, 2009 at 10:37 pm
I missed three episodes of House in a row, and just caught up with them on surfthechannel.com
Was this this episode in which Wilson tried to talk Chase out of his own bachelor party?
And in which Wilson advised with a straight face, “Have you ever seen “Caligula”?
Priceless soap opera. Building up to a surprisingly strong end for the fifth season. Anyone else remember Malcolm McDowell and Peter O’Toole in Wilson’s reference? Those of us in Generation Jones howled.
May 9th, 2009 at 10:34 am
As somebody who has actually had an anaphylactic episode, I was dismayed at how it was portrayed.
First of all, usually one does not immediately fall on the floor. It takes longer than that.
IF Chase’s reaction was that intense, it means he’s had previous serious anaphylactic reactions–and should have had his own damn Epi-pen on his person. I carry one at all times, anybody who’s ever had anaphylaxis should.
Instead they had to grab an epi pen from one of the ‘interns’ that was there. Huh? Chase is a doctor, and while doctors tend to be the worst patients, I didn’t think he was THAT dumb to not have an Epi-Pen on his person.
Also, yep, as somebody else pointed out, unless there were real strawberries in there, it’s unlikely Chase would have had that immediate reaction. I suppose it’s possible Karamel makes her own homemade body butter with pureed strawberries, but I doubt it.
Definite holes in the medicine.
May 9th, 2009 at 12:01 pm
hm, even if he was used to Zolpidem, that amount of the drug would for sure knock him out. I’ve taken 300mg once and I only have fragments of the day after that night.
May 11th, 2009 at 9:20 am
read most of thread and replies.
i hope this is NOT publicly regarded as one of best ever.
the Deaf culture was handled horribly! as noted by above comments….. tho’ it was indeed nice that 13 said some wee positive thing…and they actually showed decent signing – some of the time. those were the only positive / real portrayals in the entire show.
and of course the implant issue was handled horribly as well.
! house called both seth and mom ‘idiot’ and ‘moron’ for the sin of Deaf pride !
even as obnoxious as he is, even he doesn’t call any other culture that.
why does this show win awards?
May 11th, 2009 at 8:38 pm
My favorite part was Cuddy referencing Wilson getting picked up by the police and not being able to find his ID because he wasn’t wearing pants!
May 13th, 2009 at 6:06 pm
eridanis – House does call those with dwarfism “freaks” in “Merry Little Christmas”, and belittles the mother for being reluctant to treat her daughter’s growth disorder. I don’t remember if he calls her a moron, but it’s clear that he considers it foolish, or indeed stupid, to raise her daughter as a dwarf if there’s a treatment that would allow her normal growth.
It would have been strange indeed if House had simply accepted his patient’s desire to go untreated for what House obviously considers a disorder. Not completely unprecedented, but I don’t think you can expect House to treat deafness differently than anything else he comes across just because some people say it’s no disorder at all.
Other than the technical nonsense about how the CI worked, why do you think it was handled “horribly”? I don’t think the show came down against Deaf culture at all, and I didn’t feel we were supposed to take House’s side on the matter of implanting without consent!
June 15th, 2009 at 11:57 am
I’m not a doctor, but the only thing I can think of that would sober one up would be alcohol dehydrogenase. I don’t think that comes in IV bags, and I don’t even want to think about all the ethanal and ethanoic acid that would be released all at once.
July 8th, 2009 at 2:39 pm
Anyone notice that House’s address is also incorrect on the Zolpidem bottle? Unless he’s moved from 221B?
August 31st, 2009 at 2:05 am
On the chewing thing to lose weight, I’ve used the tactic before to make weight in high school and I would literally go through a canister a day to get it to work. I don’t know if that is enough to suppress the immune system to suppress scarcoidosis but it was more than I’ve seen anybody you just chews to chew use.
October 3rd, 2009 at 8:47 am
There’s plenty of talk on here about the amount of strawberry/allergen. Trace amounts etc. I’m not sure the immunology behind anaphylaxis is being fully appreciated by the Docs in here. It is not a simple dose related phenomenon like most toxic adverse reactions. Hyper sensitivity type 1 is frequency dependent with the first exposure being “asymptomatic” and in line with the general population. It is the second exposure which results in the idiosyncratic widespread mast cell degranulation etc.
October 7th, 2009 at 2:21 pm
Great site Scott ! Lets not be under any illusions… just about all the medicine in House is extremely suspect . Luckily every other aspect of the show is usually spot on and makes the whole thing great viewing. This episode was a brilliant probably just because of Amber . So good.
November 3rd, 2009 at 1:48 am
eridanis,
isn’t it funny how everyone loves a show until it makes fun of their little beliefs\culture\favorite animal?
House makes fun of everything. His statement to the dwarf is relevant: ‘you want her to be strong? Why stop (at her height) there? Poke out her eye.”
Leave a Reply
Contact Me
About
Subscribe:
The Best Of...
Special Topics
Archives
Categories
Twitter
Comic Blogs
Medical/Science Blogs
Currently Reading
Arbitrarily Interesting Medical Condition
Syndrome
The Net:
Contents may have settled during shipping. Past results are no guarantee of future performance. No animals were harmed during the production of this product. Void where prohibited by law. All rights reserved. Not valid with other offers or specials. Professional driver on a closed track. Your financial institution may impose other fees. All models are over 18 years of age. Employees must wash hands before returning to work. Results not typical. Many suitcases look alike. 18% gratuity added to tables of six or more.
Do not taunt Happy Fun Ball.
© 2004-2010 Polite Dissent. Powered by WordPress