House – Episode 4: “Maternity”
Ethics and parenting were the themes this week, the former just hinted at while the latter was stated rather blatantly — especially in House’s overdone diatribe against antibiotics. The final diagnosis and the path to reach that decision all made good sense, and there was barely any random jumping from idea to idea this episode. The medicine seemed sound and logical (though I’ll happily admit that neonatology is not my specialty). I was surprised that they “forgot” that babies initially share their mother’ antibodies, since that was the “a-ha!” moment of the second episode.
Robert Sean Leonard’s character (oncologist Dr. Wilson) is growing on me, as is the previously-quiet Dr. Chase (James Spenser). This was a strong character episode for Dr. Cameron (Jennifer Morrison).
As an aside, we saw that not only do the Young Gun doctors run every test and procedure themselves (notice that they ran the MRI, ran the laboratory equipment and drew the blood), but Dr. House himself has the same compulsion (and where did he get credentials to do autopsies?).
Best line of the season so far! Dr. House to patient: Sometimes the best thank-you is never having to see you again.
December 8th, 2004 at 9:20 am
I was wondering about the autopsy too. It seemed a bit specialized and away from what we’ve seen as his areas of expertise, but I wasn’t sure if I was just unaware of much doctors can multi-specialize.
December 8th, 2004 at 9:25 am
It’s not unusual for a specialist to sit in on an autopsy with the pathologist, but I don’t know of any situation where a non-pathologist actually does an autopsy (and I doubt the hospital would let him for medical-legal reasons).
Maybe he is double boarded in infectious disease and pathology…?
January 25th, 2007 at 7:37 am
House has a double specialty in infectious disease and nephrology. He mentioned it in his cool speech in ‘Occam’s Razor’: “Hello sick people and their loved ones. In order to save time and avoid a lot of boring chit-chat later, my name is Dr. Gregory House, you can call me Greg. I’m one of three doctors staffing this clinic this morning. I am a bored certified diagnostician with a double specialty of infectious disease and nephrology. I am also the only doctor currently employed at this hospital who is forced to be here against his will.”
February 2nd, 2007 at 11:10 pm
Chase is played by Jesse Spencer, not James.
February 17th, 2007 at 7:52 am
I noticed when the team realized the babies were dying of a viral infection and they have to narrow down the list of ‘thousands’ of viral infections to a few 8 that would potentially affect the babies. In the list of viral infections that did not seem plausible, house (or i think one of the young ‘uns) suggests toxoplasmosis. Toxoplasmosis is a parasitic infection caused by Toxoplasma gondii that can be detected by stool examination (least invasive) or by antibody titres in the blood. It is not contagious, newborns can get it through the mother by zoonoses.
May 23rd, 2007 at 1:28 pm
And what about all these “antibiotic shut down the kidneys” thing? I don’t know much about healing babies but, I still don’t think this is true. It was not Amphoterecin B or gentamicyne…
June 4th, 2007 at 12:38 am
Wouldn’t be the first time on House that Antibodics were assumed to be shutting down the kidneys, it happened earlty in the prevous episode, Occtum’s Razor. It was later discovered it wasn’t the meds fault, but the fact that it can is enough to be considered. Note that no medical training here, just House, M.D. and Polite Dissent.
June 14th, 2007 at 4:10 am
Remember that part of the theme of House is to echo 19th century medicine, with the notion that House being a Holmesian character himself is going to handle all the autopsies himself. (Also see: Using maggots to clean away dead flesh, ludicrous drug use, etc.)
August 23rd, 2007 at 6:41 am
what about their not considering a viral infection?? i think they jumped to the conclusion about the infection being bacterial
October 23rd, 2007 at 2:40 pm
Maybe the difference between top dogs in the sty and the rest of us is we let others do the important autopsies.
October 30th, 2007 at 3:05 am
house specializes in Infectious disease and Nephrology
November 7th, 2007 at 8:10 pm
Quick question:
At the end, when we see the old lady that was the disease vector, I made the comment that she should be held legally accountable for the death and endangerment of the newborns. As for what the charge would be, I think reckless endangerment at the minimum, manslaughter preferably. So, what are the rules for cases like these?
November 12th, 2007 at 9:43 am
I noted that dr House misspelt “coxsackie” in his listing of possible viruses which seems strange, as he is supposed to be a specialist in infectious diseases.
November 21st, 2007 at 7:17 am
Vancomycine is indeed known to be nephrotoxic..
November 27th, 2007 at 3:40 pm
Re: the point on reckless endangerment or manslaughter, you would have to show (oddly enough) recklessness on the part of the accused. I am only passably familiar with English law, where the relevant requirement is laid down in R v. Cunningham (the accused has foreseen the possibility of harm and nonetheless gone on to take the risk); but it seems that the requirement in American law similarly requires a conscious taking of a risk regardless of the consequences, or one where the accused does not care about the consequences. In either circumstance, there is no way that the elderly lady would have met the test; she does not demonstrate foresight of the potential harm.
January 2nd, 2008 at 5:48 am
That line actually read: Sometimes the best gift is the gift of never seeing you again.
May 30th, 2008 at 7:02 pm
toxoplasma can indeed be trasmitted from mother to baby, which is one of the major complications for this parasytal infection.
June 9th, 2008 at 9:42 pm
Great line indeed, that to the pregnant patient, and the whole sub-plot was quite hilarious. Another line: “The most successful marriages are based on lies; you’re off to a great start”. Nice moment the one with the tie as well; we hadn’t had a chance to see the students before (and I don’t remember seeing them afterwards, either).
Question: has anyone found any parallels between “Maternity” and “Paternity” worth mentioning? The naming doesn’t seem like co-incidence. The basic common element so far seems to be the issue of a baby’s father’s identity, but there must be more. (Well, “must” is a strong word; people have a knack for noticing patterns where none exist. It’s one of the so-called “cognitive biases”.)
July 17th, 2008 at 7:56 am
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September 12th, 2008 at 1:26 am
I don’t get “overdone diatribe against antibiotics.” Sounded like a reasonable summation of the problem to me. So what if the writers used a bully pulpit–it’s a serious issue that could use some awareness raising.
December 1st, 2008 at 11:53 pm
Registered nurse and new House fan chiming in …
All the characters have done procedures that they wouldn’t in real life. It’s called “dramatic license” and you’ll go crazy if you nitpick every action that logically would be done by another hospital employee (from drawing blood to doing CT scans and MRIs. About the only thing I’ve seen the young guns do that they WOULD do in real life are the spinal taps (and talking to the patients & families).
I agree 100% that we overuse antibiotics and a reckoning is due. I actually have to tell our health care providers that I don’t want an Abx unless it is clinically indicated and I don’t feel shortchanged if I leave the office without a prescription for something.
What’s also unbelievable is that the coughing volunteer was allowed to go around seeing patients. Sure wouldn’t have happened in any hospital I’ve worked at, ESPECIALLY with newborns. If the volunteer supervisor didn’t catch her, the first nurse who heard her coughing around the babies would have thrown a fit.
I liked the tie bit, too. ;) Every study I’ve ever read shows doctors are the WORST about basics like handwashing between patients.
I hope everyone remembers the line from the first episode about when you hear hoofbeats, think horses, not zebras. I love this show but it should be called “zebra of the week.” There’s nothing wrong with the premise that House is called in when it turns out to not be a horse, but this is NOT everyday medicine.
Finally, the intuitive leaps don’t bother me at all. Brilliant diagnosticians in real life make those leaps as well. My old boss at M.D. Anderson Cancer Center used to say “This doesn’t smell like a” whatever, and he was usually right. It’s inexplicable and rare but the patients benefit from it.
March 4th, 2009 at 12:27 am
[*Spoiler*]
Viewing HOUSE as a mystery show, I was happy I guessed “whodunit” within seconds — “get that teddy bear out if his face,” I muttered to myself.
I’m watching the first season on DVD, and if you happen to do so as well, look for all the times they have the teddies in the shot. Sort of a reverse red herring in a way. Hidden in plain sight. I swear in one scene I thought Cuddy was standing next to one while directing the search.
May 6th, 2009 at 7:33 am
I was surprised that they didn’t use Linezolid. Especially since it has a better side effect profile. But then, Pharma isn’t my best subject. And neither is Neonatology, come to think of it.
May 18th, 2009 at 4:33 pm
When deciding the culprit virus they rule out the herpesviridae because the babies had already received acyclovir and paramyxoviridae because of lack of lung involvement, yet put Cytomegalovirus and Epstein Barr virus (both herpes viruses) and respiratory syncitial virus (paramyxovirus) in the yes column, and at a later point the no side says orthomyxo and the yes side and cuddy says influenza A (an orthomyxovirus). somebody has not done their homework. I assume the herpes mistake is because they meant to say it can’t be the herpes simplex viruses, which is what house wrote on the board and is the most susceptible to acyclovir. I’m too good for this show
November 15th, 2009 at 3:21 am
although this is a great episode, the show crew completely screwed up the virus list: TORCH is not a syndrome. first they exclude all torch infections and then they regard cmv as a candidate. on the left they put echovirus (house puts, although said to put enteroviruses in general) and coxsaсkie separately though these two are the same (and one of them wins in the end! :)
March 18th, 2010 at 3:40 am
I’m not surprised House knows how to perform autopsies, and well. His character is an modern Renaissance-man type of mind and soul, akin to a Da Vinci. It is so often the peripheral worldly disciplines that House is educated about that imbues part of his incredible prowess as a doctor of diagnostics.
As for a completely plausible justification for having House perform the autopsy himself, it was “deemed too important to his life-threatening ongoing investigation” into the cause of the epidemic; and, given that Dr. Cutty owns the legal and moral jurisdiction at the hospital, naturally Cutty would permit him to conduct his business.
SS RN I <3 your post!
March 21st, 2010 at 1:15 pm
Speaking of the baby on the autopsy table, that was perhaps the fakiest baby I have ever seen! It only looked slightly more real than a rubber chicken! LOL
May 23rd, 2011 at 4:01 am
I’m only a second year in Uni, and I just started this show, so I’m sure this question is going to sound somewhat ignorant, but I’d like to know in any case…
Wouldn’t it have been a relatively simple matter to culture a sample and check for the presence of bacteria?
Is there any reason they couldn’t?
August 11th, 2011 at 4:28 am
[...] House – Episode 4: «Maternity», Polite Dissent, 7.12.2004 Возможно, вам также будет интересно почитать проHouse M.D. — S01E02 — Paternity [...]
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