House — Episode 12 (Season 6): “Moving The Chains”
The team in this week’s episode of House followed a more logical approach to the patient, but they were still hampered by bad medicine. But hey, an opossum!
Daryl is a 22 year-old college football player hoping to be spotted by pro scouts. In the middle of practice, he suddenly becomes uncontrollably violent. He grabs his opponent and drags him around by his helmet until it finally comes loose, and then he bashes himself in the face repeatedly with the helmet until he starts bleeding.
He is admitted to the hospital for evaluation, but has no memory of the incident. A head CT scan and a psychiatric evaluation — both obtained in the Emergency Room — were negative. House suspects Daryl’s symptoms are due to steroids, even though he tested clean in the Emergency Room. He believes he is on the “good stuff,” i.e. steroids that don’t show up on tests. The rest of the team suspects a pituitary adenoma (a tumor in the pituitary gland) caused by repeated head trauma. Tests for GnRH (gonadotropin releasing hormone, which controls the gonadotropins, which control the production of testosterone in men) are high, but a pituitary MRI is negative, which lends credence to House’s theory of steroid abuse. He tells the team to start Daryl on a somatostatin-analog (a medication which inhibits the pituitary gland) to block the effects of the elevated GnRH.
Daryl denies any use of steroids and begins to suffer a racing heart rate and chest pain. He has an episode of paroxysmal tachycardia (sudden onset of an abnormally fast heart rate) that requires cardioversion to return it to a normal rhythm (by definition “cardioversion” means returning the patient to a normal heart rhythm. This can be done chemically, such as with adenosine, or electrically). Taub reports that the cardiac symptoms do not fit the diagnosis of steroid abuse, so the team gives Daryl’s heart a further work-up including EKG and sestamibi scan (a test that looks at perfusion of the heart itself), but they are completely normal. The differential diagnosis now consists of a PFO (patent foramen ovale, a hole between the two sides of the heart) or hypertrophic cardiomyopathy (muscular thickening of the heart). House favors the latter and has the team put Daryl on a treadmill to stress him until he develops cardiac symptoms. Unfortunately (or fortunately, really), Daryl is in good enough shape that his heart rate never rises high enough to cause a problem. Going for “plan B”, House decides to chemically induce heart stress by injecting Daryl with a vasodilator (such as adenosine or dipyridamole — they mimic the effects of exercise on the heart). Before he injects the medication, however, he notices that the palms of Daryl’s hands are unusually white.
This new symptom causes the team to reassess their diagnosis. Taub thinks Daryl’s pale hands are due to Raynaud’s phenomenom (spasm of the smooth muscles around the small arteries of the fingers), which he thinks is caused by rheumatoid arthritis. Thirteen suspects that Daryl has plaques in his arteries, and these are breaking off and sending tiny clots blocking the arteries in his hands. Chase believes Daryl has Takayasu arteritis (inflammation of the aorta and other large arteries), and Foreman, ever the optimist, blames lymphoma. House likes the last two ideas the best, and tells Foreman to put Daryl on an ethanol drip. If he develops itchiness, it’s a sign of lymphoma, and if he loses his radial pulses, it’s a sign of Takayasu. Daryl develops itchiness while on the drip, so Foreman’s suspicion of lymphoma appears to be correct. Daryl is taken to surgery for a splenectomy, but during surgery Chase notices that his spleen is fine but his liver is inflamed.
Biopsies reveal no lymphoma and a non-specific liver inflammation. The new differential diagnosis includes polymyositis (a chronic inflammation of the muscles), Felty syndrome (rheumatoid arthritis + splenomegaly, which doesn’t fit at all), and viral hepatitis. Blood is drawn for further testing, but Foreman reports that the blood clotted almost immediately after being drawn. This suggests that Daryl has cryoglobulinemia (abnormal proteins in the blood that thicken with cold temperatures), brought on by football practice on cold days, and needs to be started on anticoagulants (blood thinners). This isn’t good enough for Daryl; he doesn’t want to miss his shot at the pros, so he leaves the hospital, promising to come back the next day. At the exhortation of Daryl’s mother, Foreman tags along to look after him — it was a good thing he did, too, as Daryl starts to experience shortness of breath and blurry vision. He is admitted back to the hospital. As the team begins to evaluate the new symptoms, Foreman admits that their really aren’t any new symptoms. He had dosed Daryl with nitrates (a class of blood pressure medication) to drop his blood pressure so he’d feel bad enough to want to come back to the hospital.
Looking over the chart, House notices that Daryl has only lost one pound during his stay in the hospital and he should have lost more. This lack-of-weight-loss could be due to steroid abuse, or paraneoplastic syndrome — only there’s been no evidence of cancer. The team performs blood test after blood test, and scan after scan, but can find no cancer. House then realizes that the cancer they are looking for is not inside the body, but outside. It turns out that Daryl has melanoma, a skin cancer hard to spot on African-Americans, and this cancer (or course) is causing paraneoplastic syndrome, which explains his symptoms.
(Here’s my take on what’s going on: you may have noticed during the episode that the team gave two different definitions of paraneoplastic syndrome. First, they described a situation where a cancer produces a hormone which can cause systemic effects: in this case, the melanoma is apparently producing GnRH which increased Daryl’s testosterone and gave the appearance and symptoms of steroid abuse including “roid rage,” weight gain, and probably the heart symptoms. Second, House describes paraneoplastic syndrome as a situation where the body is making antibodies against the cancer, and this produces the systemic effects. This would explain the kidney failure and liver inflammation. The apparent cryoglobulinemia may be an effect of the extra paraneoplastic antibodies, or cryoglobulinemia can occur with certain cancers. Both definitions of paraneoplastic syndrome are correct, but I’m not certain if a patient would ever experience both situations.)
I admit that I’m somewhat confused by House’s take on steroids. If Daryl was taking steroids, his GnRH should be suppressed — lower — not higher. Or is House suggesting that Daryl was receiving GnRH itself, or a synthetic substitute — and if that’s the case, the body generally downregulates GnRH receptors when GnRH levels are unusually high, actually leading to hypogonadism and less testosterone.
As usual, major complaints are in red, minor complaints are in blue, and nit-picking ones in green:
The clotting in cryoglobulinemia resolves at normal temperatures, so why would Daryl be clotting in the presumably warm hospital room. Did Princeton-Plainsboro not pay the electric bill?
Why didn’t he show abnormal clotting during surgery as most operating rooms are kept PDC (pretty damn cold).
Surely they drew blood before surgery, at least a blood type/transfusion panel, and should have notoiced the clotting then.
Blood thinners are not the recommended treatment for cryoglobulinemia.
Giving a patient enough of a nitrate to intentionally cause hypotension (low blood pressure) is dangerous. How did Foreman know he didn’t give too much? I’d also expect Daryl to develop a severe headache — the most common nitrate side effect – before any other symptoms.
I guess he learned it from House, who was trying to induce a cardiac event in a patient without even having him hooked up to any cardiac monitors.
Stress tests aren’t used to test for hypertophic cardiomyopathy, at least not as a first-, second-, or even third-line test. An EKG has already been obtained. A structural test, such as an echocardiogram or MRI is the next logical step. If needed, cardiac catheterization may also be performed.
Sorry Taub, steroid abuse can cause heart problems, including tachycardia.
Is there really a link between repeated trauma and pituitary adenoma, a type of cancer? I haven’t been able to find one, but then again, I’m not a neurologist or sports medicine specialist.
GnRH is released into the pituitary, not from it, so why would a pituitary cancer lead to “leaking” GnRH?
There is a condition known as the “lymphoma itch” that is a severe itching, primarily of the lower extremities. It is most commonly seen in Hodgkin’s lymphoma, but even then it only occurs in 10-25% of patients.
It is not associated with alcohol. A separate condition (severe aches and pains) can be worsened by alcohol intake in certain patients with lymphoma.
I don’t know it alcohol will really shut off blood flow in the radial arteries in patients with Takayasu’s arteritis, but who in the hell would thank that is a good idea. Personally, I like my hands to have full blood flow, thank you.
Return to full contact football a day after abdominal surgery, even a laparoscopic one? Nonsense.
Blood in the urine is really not a sign of kidney failure. It suggests that there is a problem with something farther along in the urinary system. This is especially true in patients on blood thinners, were urinary bleeding is more common – maybe from inserting the catheter in the first place.
Why would a melanoma secrete GnRH?
It is certainly possible to have rheumatoid disease with a negative rheumatoid factor.
Wasn’t Chase the one who shot down Taub’s suggestion of rheumatoid arthritis? So why would he later suggest Felty’s, which requires rheumatoid arthritis?
Paraneoplastic syndrome has become the lupus of this season.
I found the medical mystery interesting this week. Not great, but better than recent episodes. I give it a B+. The final solution clever (hidden melanoma in a black male), but too much of “Been there, got the T-Shirt” feeling (paraneoplastic, again, and a nearly impossible one at that). I give the solution a C-. Overall, the medicine was more driven this week, and followed a logical progression, but too much of it was questionable or downright wrong. Another C-. The soap opera was decent. I liked the Foreman and Foreman scenes, and the Wilson/House scenes were good, but I figures Lucas was the culprit fairly early on as Mark Michael Weston was listed as a guest star, but nowhere to be seen. I give the soap opera a B.
The review of the previous episode of House
A list of all prior House reviews
February 2nd, 2010 at 12:16 am
An interesting episode, moreso for the drama then the medicine IMO..
I didn’t see beforehand that Cuddy already knew it was H&W who bought the condo…. I thought Lucas didn’t tell her so how did she know?
Next weeks episode ought to be VERY interesting, as Cuddy get’s for once to be the main focus for the entire hour… I’m hoping that it doesn’t bomb b/c I’d like to see more of Lisa in future episodes….. ;)
February 2nd, 2010 at 1:05 am
Did House’s remark regarding the guy that went something like going white and thus not needing football any more to get a good job sound racist to anybody else? I didn’t quite catch it; just checking…
Who spends hours and hours peeping on House to catch him using Wilson’s bath and then breaks in to loosen the screws on the wall. Geez get a life, Lucas.
February 2nd, 2010 at 1:38 am
I spent most of the ep hollering at the tv. I assume that when House said “start him on warfarin” that included a heparin bridge? Then contact sports while on blood thinners? Chase spent the whole night monitoring the anticoag or something? It takes 5 days for warfarin to work. And seriously, does no one check creatinine EVER? Slipping a patient anything is so unethical but that’s old news. They were so quick just to pull out his spleen but it’s not like those fight infections or anything. -Pharmacy Student
February 2nd, 2010 at 2:06 am
Athletes on anabolic steroids have been known to take synthetic GnRH (Factrel) if they suspect they’ll be tested soon. It used to cause false negatives: I don’t know if it still does.
February 2nd, 2010 at 3:43 am
Koray, of course it was kinda racist, but that’s why it was funny. It’s just House being House.
“What’s wrong?”
“You’re turning white?”
“What’s that mean?”
“Means he doesn’t need football to get a good job any more”
February 2nd, 2010 at 4:22 am
Aside from anything medical, there is no way that guy weighed as low as 310 lbs at 6′7″ as was said in the show. If he was truly 6′7″ He had to be well over 400 lbs by the look of him, believe me I know. He had to weigh probably somewhere in the 400s.
February 2nd, 2010 at 4:30 am
“I didn’t see beforehand that Cuddy already knew it was H&W who bought the condo…. I thought Lucas didn’t tell her so how did she know?”
Lucas did, in fact, tell her. He lied to House so there would be no retaliation.
February 2nd, 2010 at 4:38 am
@steve, I don’t know how ‘you’d know’ but Shaquille O’Neal has hovered around 325-350 for most of his career and has 6 huge inches on that player. Look at Rookie Dejuan Blair of the NBA as well who is 6′7/270lbs. 310 doesn’t sound unreasonable.
February 2nd, 2010 at 5:48 am
So Lucas is quite the jerk, isn’t he? Really having trouble seeing any humor in loosening the grab bar, with the potentially lethal consequences of a sudden fall into water. Nice bathtub, though.
Amazing that House was able to stage that melanoma just by looking at it. It would really suck if that melanoma happened to be further along than House thought, now wouldn’t it?
February 2nd, 2010 at 6:17 am
I guess they should have put a spoiler alert before the guest star credits.
February 2nd, 2010 at 6:51 am
Just a couple of grammatical things I noticed: the episode title was “Moving the ChainS”, not “Moving the Chain”, and the guy who plays Lucas is Michael Weston, not Mark.
But besides that, great review again, as always. I look for these posts the morning after every House episode to see how much of what I saw was believable, which is really good to know. Thanks!
February 2nd, 2010 at 6:55 am
Official Comment
PharmStu,
The warfarin use caught my attention as well, but I figured I had complained enough for one episode already.
I assumed the team used heparin as well given that Chase mentioned he and Thirteen were in the hospital all night managing the blood thinner. That fits heparin more than warfarin (but even then, most hospitals have a preset Heparin algorithm so don’t require a physician, let alone two, to micromanage).
February 2nd, 2010 at 7:49 am
So if one inappropriate blood test shows positive, doctors immediately perform abdominal surgery and remove internal organs?
I’m staying out of hospitals forever.
February 2nd, 2010 at 7:55 am
Wow, Lucas was a raging jerk. Nobody stole anything from Cuddy. It was a bit underhanded to put an offer in secretly, but if it really was her dream house she’d have already had a deposit on it. Free market is still free. Here’s hoping House is plotting an appropriate retaliation.
Also, awwww on Foreman and his brother uniting against a common foe. Wilson was right, House does have a heart (even if it is 3 sizes too small sometimes).
February 2nd, 2010 at 8:11 am
Yea. I agree. Can’t stand lucas. It would have been so much funnier if it was their neighbour behind the prank. Like maybe she wanted to get back at them for what they did to her. But it was lucas. Then it just became like “oh. What’s his problem” Haha.
February 2nd, 2010 at 8:14 am
Even if the blood flow from the radial artery was stopped, wouldn’t the supply just increase from the ulnar artery to compensate?
February 2nd, 2010 at 8:26 am
on a sidenote ..
Jeremy Renner has been nominated for Best Actor in the movie “The Hurt Locker”
some might remember him as a certain Rock-Musician as POW
February 2nd, 2010 at 8:33 am
Official Comment
sinan90
Probably, but I wouldn’t bet my thumb and index finger on a probably, especially when there are better tests available.
February 2nd, 2010 at 8:37 am
Did I understand correctly that House found the melanoma between the patient’s toes? Doesn’t it seem unlikely that it would form there, as opposed to somewhere else on his skin that received UV exposure while he was out practicing football? I don’t buy the “you have less melanin there” bit, since his toes would always be inside his cleats.
I suppose maybe he liked to wear flip flops during the off season.
February 2nd, 2010 at 9:15 am
*This episode went a little bit meta, with Dr. House impersonating Poirot just as Hugh Laurie did in the otherwise unfortunate movie “Spiceworld.”
http://www.youtube.com/watch?v=XWe1oyhqhhc
*The beginning of the episode was ultra-realistic, but the thinly disguised “Senior Bowl” is only the first step in a long process in the N.F.L. draft process. Three weeks or so after the East-West game, there is the N.F.L. combine and there is also “Pro-day” at the player’s home stadium. Even if Daryl isn’t drafted this year because of health concerns, he can always be drafted next year. 6′6″, 320 lbs. men with quick feet just don’t grow on trees. The guy who protects the quarterback is the second most valuable person on any team.
*I loved the drama involving the war veteran, but there had to be an easier way for him to get out of service. House mentioned shooting yourself in the foot precisely because it is cliche. There has to be a way for trained ballistics specialists in the Army to be able to tell that he deliberately shot himself in order to avoid deployment. Instead of letting his foot fall off, he should have just kissed a dude on base or something.
February 2nd, 2010 at 10:10 am
EngineeringDr, melanomas can and do occur on parts of the body with little or no UV exposure, e.g. armpits, crotch, feet, mucous membrane. In non-whites something like nearly 40% of all melanomas are found under the nails, esp. the big toe (go figure).
February 2nd, 2010 at 10:23 am
RE: “I didn’t see beforehand that Cuddy already knew it was H&W who bought the condo…. I thought Lucas didn’t tell her so how did she know?”
She’s the hospital administrator and they are her employees. I imagine she knew they got her condo when they submited the change of address forms. However, House and Willson both appear to be under the impression she doesn’t know either which seems silly of both of them.
February 2nd, 2010 at 10:41 am
@tetracycloide – I only know this because I’ve been snowed in for three days watching House reruns, but when Wilson bought the condo, he said he had changed their address to a P.O. box so Cuddy wouldn’t find out. Also I doubt she would be handling address changes herself.
February 2nd, 2010 at 11:35 am
#racism. House’s response of the good job without football is more a sign of everybody’s racist. The kids comment later of “God loves me more than he loves you.” was more of a racist comment.
#His given stats. 6′7″ 310# sounds like a reasonable size for a large sized football player. The actor must be far heavier though. For comparison I am 10# heavier, 3″ shorter, mostly sedentary, and I look thinner.
February 2nd, 2010 at 11:50 am
Exactly, I am about 6′5″, I weigh 325, (Not to make this about me, but I’ve been losing weight for over a year now, I started out weighing 509, my final goal is to get into the 230s sometime later this year. Although I have been lifting weights for several months, I’m not all that muscular.) The actor, Mr McDonald who played the football player Daryl, clearly weighs somewhere around 400 or over if he’s 6′7″ or close to it.. I know shorter people at smaller weights it would be hard for them to understand how weight works for us taller guys.
Remember 50 lbs of extra weight on 5”9″ or shorter person doesn’t look at severe on a person well over 6′.
February 2nd, 2010 at 11:59 am
I wasn’t saying 6”7″ 310 lbs in an unrealistic weight for a football player, I meant by taking a good look at the actor in many of the scenes he clearly weighs a lot more than the numbers on the stats mentioned for him, that’s all.
February 2nd, 2010 at 1:00 pm
Paraneoplastic Syndrome was the lupus of season 2, too (which is why it’s been on my challenge roster since then, and it’s finally pulling its weight this time around…)
It’s pretty close to a perfect disease for the lazy House writer: it can explain almost any set of symptoms, and once it’s diagnosed it leads to a secondary “where’s the cancer” mystery for the last act…
February 2nd, 2010 at 1:05 pm
Quick Notes:
-The writers need to take a day and read up on Paraneoplastic Syndrome if they want to continue to use it every week.
- I know house likes making a clear cut work up more involved but why didn’t he order and echo, instead opts to attempt to kill the patient with a stress test.
- I thought all along the final diagnosis was going to be a Glycogen storage disease like a Pompe’s or McArdle’s, something along those lines.
-When they called for the workup of cancer wouldn’t the test of detected some biological tumor markers (S-100) ?
February 2nd, 2010 at 1:40 pm
So someone tell me what the point of guy who shot his foot was? I didn’t get that at all.
February 2nd, 2010 at 1:57 pm
Indiana Dave, he was a military man. His girlfriend was pregnant and he wanted to stay home with his to be son, so he tried to get a doctors note on it.
February 2nd, 2010 at 1:59 pm
I figured it was Lucas when they showed him in the background of the scene where House was tripped in last week’s preview.
February 2nd, 2010 at 2:09 pm
Scott
Speaking about the Challenge (anyone else is watching the House rooting for specific syndroms? Lymphoma, yoo-pee-kah-ay!) – what is the official solution: paraneoplastic syndrom or melanoma?
February 2nd, 2010 at 2:27 pm
That guy was bigger than 6′7″. The way he towered over House and Foreman, he had to be at least 6′9″ – 6′10″. Guessing his weight is completely beyond me. Actor is Davon (Da’Vone) McDonald.
February 2nd, 2010 at 3:16 pm
Interesting episode, although I have to say I liked it better in the earlier seasons when there was more focus on the medical drama, and how House fought to win through with his crazy medical plans. He seem more detached and uninterested in the medicine these days.
I also have a question, and I hope no one will take this the wrong way. I am only being curious. I noticed that Daryl’s mother had a much lighter skin tone than Daryl himself. Is that plausible, for African-Americans having different skin tones when they are closely related?
February 2nd, 2010 at 4:17 pm
Yes, it is plausible for Daryl to be significantly darker than his mother.
1)Genetics can do some things that aren’t immediately logical (until you start looking deeper).
2)We didn’t see how dark Daddy was.
If he was darker than *both* parents, it would be odd but not 100% impossible. Darker than just 1 isnt odd at all.
February 2nd, 2010 at 5:30 pm
Part of me thought that it was Wilson that had done those things and he got Lucas to admit to it, especially after the Lucas/Cuddy scene, and that was the whole shot-himself-in-the-foot metaphor. But then I remembered that he was alone in the apartment when he found the opossum, so I guess I’m wrong.
February 2nd, 2010 at 6:33 pm
I agree with MongoTheGeek about the “racist” job-comment. He is in no way indicating that he’s got something against african americans. He’s just referring to a well known problem caused by racism. It’s hard to find jokes about black peoples skin color that isn’t in any way racist, but this is actually one of them!
February 2nd, 2010 at 6:38 pm
@Indiana Dave
It was another way of making the “sacrifice for your family” point.
The guy deliberately lost his foot so that he could stay with his pregnant girlfriend.
February 2nd, 2010 at 7:28 pm
Sprinklers are not supposed to work that way, especially not in a fairly closed space like an apartment. The amount of water they release would probably cause more damage then a small fire, and then there are all the false alarms.
Marine users prefer hi-fog-systems (a registered trademark), where a small nozzle would produce water in a mist form, which still would extinguish fire perfectly well without the risk of water damage.
I see no real reason for having such a destructive system in a home, especially not when there are better alternatives available, such as the hi-fog I mentioned.
February 2nd, 2010 at 7:44 pm
I had to roll my eyes when the show diagnosed his problem as a melanoma. It’s “Oh, let’s nip this mole in the bud and everything will be hunky-dory.” What? No follow up tests to make sure hasn’t traveled to the lymph nodes? No chemo or follow-up, Better To Be Safe Than Sorry treatment? It’s a “malignancy of the melanocyte, the cell that produces pigment in the skin.” It is an aggressive skin cancer with a high mortality rate. But then, I’m biased. I just had squemous cell skin cancer which is nice, slow and boring. In my case all the doctor had to to was to cut it out. I call the scar my “shark bite ’cause it looks kinda like one seeing as the surgeon (under a simple local–I was sitting in a chair when she did it) cause they also had to cut out the underlying tissue underneath.
But as for the other–a computer instructor of mine died from a melanoma–after giving it a hard, long, fight. He probably didn’t spot the skin lesion in time–because he was blind.
This is what makes me so very angry about television. All this time and money making a TV show–and what does the public get for this? Misinformation and on a massive and dangerous scale? I shudder to think of all the people watching this TV show, having a weird wart-like thing oozing pus–like mine–and thinking, “Oh not to worry because real soon now I’ll have the thing cut out.” but–unlike me–is really a deadly melanoma.
I don’t know whether to scream or weep.
frame-gray
February 2nd, 2010 at 7:59 pm
The genetics of skin colour are controlled by more than one gene, so yes, you can get all kinds of combinations that leads to different tones in a family.
There’s even a case where a biracial couple (if i remember correctly) had fraternal twins where one had darker skin and hair than either parent and the other was white and blonde.
February 2nd, 2010 at 8:00 pm
I was sitting here, watching House on Monday, and I kept saying to my girlfriend from the start of the head bashing: “it’s gonna be cancer, it’s gonna be cancer” to which my girlfriend replied “well, given this is House, if it’s cancer it’s gotta be something rare or unusual…melanoma in a black patient?”
Also, at the start: was it really rage? I get the whole head bashing thing being rage, but the “get off my QB” seems more like dominance (thus why I kept thinking testicular cancer).
February 2nd, 2010 at 8:03 pm
Also, it’s great to see House back to his usual jerk self. He has a bit of a human side to him now, but not so much as in the beginning of the season.
February 2nd, 2010 at 8:22 pm
@ Hibbleton – Thanks, didn’t know that. One more thing to worry about! :^)
I was confused about the soldier that shot his foot. When House unwrapped the bandage on his foot, his smallest toe was black, but I didn’t see a bullet hole anywhere. To me, the toe looked more like it had been crushed (this opinion comes from painful experience). Did anyone see a bullet hole? Or did he shoot his toe?
Also, perhaps I’m biased a bit, but how on earth do two grown men not have a single slotted screwdriver between them??
February 2nd, 2010 at 8:56 pm
Long Time First Time here…lol
BOOOO…on the writers for going a little too far out to manufacture drama on this episode…
As was mentioned by someone else there is NO WAY…an NFL prospect is going to lose his draft status by missing one game. If the player was that good that he was expected to be a draft pick teams would have been researching him LOOOONG before the “big game”…these teams have people that look at prospects going all the way back to their Freshmen and Sophomore year…(some of them even going back to high school now)…if he’s “moving up the draft board” like the coach said at the beginning of the episode…he’s going to have plenty of opportunities with the Combine and Team workouts well before draft day.
February 2nd, 2010 at 10:13 pm
Taub: “And he got a full psych evaluation – he’s not crazy.”
What kind of ‘crazy’ are you talking about, Taub?
Did anyone else notice that, or am I overthinking this?
February 2nd, 2010 at 10:25 pm
Come on, guys. No real comments on Foreman’s brother? I thought the guy was amazing, personally. He’s supposed to be a permanent character supposedly.
And did NO ONE get the joke on the skin color thing? Hello. Michael Jackson, anyone?
I’ve always thought all along that Lucas was a son of a…sailor… who needs to go bury his head in the sand with all the other ostriches. Or, maybe come up from the sand, the…jerkface.
Lucas pisses me off, what can I say. Cuddy would have known as soon as both House and Wilson submitted a Change of Address form.
The opossum was adorable, though.
And moving onto the episode. Mom and I called cancer from the beginning.
I’m only 16, but I didn’t think it was too bad of an episode, looking at it from the soap opera point of view.
February 2nd, 2010 at 11:03 pm
I’m sure someone brought this up, but what Foreman did, putting drugs in the patient’s water (basically drugging him without his consent) is very illegal. I really hope the team gets in trouble for it, or it really is a sad day for liberty and freedom.
February 3rd, 2010 at 12:39 am
@ Tom – sadly, that wasn’t the first “ends justify the means” drugging on House – I recall that Cameron drugged the overeater with lung cancer in Season 3, Episode 6.
Morally objectionable, yes. But if you’re going to mourn for liberty and freedom, you might want to check out the routine disregard of Constitutional rights and criminal procedure that is a staple on Law and Order, CSI, Bones, Cold Case, and every other police procedural I’ve ever seen. As an example, my wife was watching a TiVo’d Cold Case this evening. When the suspect declined to provide a DNA sample, one of the cops smacked him around, then put him in a headlock and forced the swab into his mouth to get the sample. Think that character will get in trouble for it? I’d put the odds at about the same as Foreman getting in trouble for drugging Daryl.
February 3rd, 2010 at 12:49 am
I’m sure someone brought this up, but what Foreman did, putting drugs in the patient’s water (basically drugging him without his consent) is very illegal. I really hope the team gets in trouble for it, or it really is a sad day for liberty and freedom.
…
You’re new to watching “House”, aren’t you ? :p
I liked this episode, liked less the poor soldier story. House obviously had some sympathy for the guy’s plight, enough to enable his self-mutilation. But apparently not enough to write him a note that he sees spots or something ? Heck, we know House is very good at inducing spurious symptoms in his patients when he wants to. Good luck to the wife, instead of having a baby alone she’ll be having a baby while dealing with a husband in rehab. Still better than nothing I guess…
LOVED House’s reaction to the Vietnam comment.
February 3rd, 2010 at 12:53 am
Also isn’t there any other possible to get out of the military without destroying a limb or body part? I was under the impression it is far easier to get out of the military now than it ever was in the past.
And I stll can’t get over 6′7 looking that heavy while being said to weigh 310. And if he’s taller than 6′7, that make 310 lbs is even more ridiculous. He’s gotta be 400 plus.
February 3rd, 2010 at 2:26 am
I’ll quickly recite what I did not like about the medicine this week, since the episode was very pleasing to watch overall and the drama sopa was well done and well played by pretty much everybody. I am at work and do not have much time plus I could be interrupted by my boss any second:
- Heart condition (of any kind) in a sportsman? Not impossible just so unlikely not to find it out during the usual tests that sportsman undergo. The fact that they could not stress his heart enough to produce cardiac arrest or even tachycardia means his heart is healthy – testing it more in any way is redundant and out of line even for House. Sure I know how House just hates to leave an idea in the middle of testing but if I have to refrase Duglas Addams: “If the heart looks healthy sounds healthy and acts healthy you have to consider the slightest possibility that it is healhty :)”
- The medicine was more coherent and logical this time around so I praise it. The way the fellows kept shooting blanks was ridiculous for a third year student and awfull for a third (or sixth) year House fellow. Takayasus artrites? Lymphoma? Felty? Plaques in arteries (why not call it atherosclerosys 13 like a doctor would do? And in a 22 years old that does sports?) It kind of reminded me off med school when a student did not have a clue what to say they just said anything and hoping to hit the truth – well the chances to actually do that in medicine are pretty slim :)
- When exactly did Foreman slip this guy nitrates? Cuz those things work pretty fast and I doubt they will wait for the match to kick in :). May be he gave him a coffey sweetened with nitroglicerin while they were in the tunnel :):):)
- Melanoma is one of the worst tumors possible. They grow fast, spread early and are almost uncurable overall. The Greys anatomy crew got it right when they said – 5% chance of suvival (when you have 4th stage). I doubt that daryl would have paraneoplastic syndrome whithout some metastases as well – melanoma placed where it was would be irritated and spread early. So the way House brought the news was ridiculous and out of line. And somebody already mentioned tumor markers – if they checked for everything they checked for those too…:(
The mystery of who was the evildoer against House and Wilson was well played by everybody and I loved it. Did not have a clue about Duglas – I suspected Nora first (which would have been fun and prove some jealous spark for Cuddy) or Cuddy herself (which would have been fun and prove that she is not over House yet) the way the writers actually suggested there are doubts and hidden rocks between Cuddy and Lucas was clever and Lisa Edelstein played it well even though her presence in the episode was so limited. The interactions between RSL and Hugh Laurie were hillarious as always – they are what they are and the show needs them both to be what it is :). AND the final showdown with Lucas was actually credible as well – he outsmarted House and outbluffed him as well and the guy did not even wanted to get even – that is how much he changed (the Foreman subplot simply proved that point to extension :) He is a genuine good guy now – sure he does his good in an evil and twisted ways but he is still good :). Oh Cuddy will fall eventually – I have no doubts about that. She will fall and understand that getting a House Lite is not what she wants – I foresee action and trouble there :) Let us wait and see :)
February 3rd, 2010 at 4:43 am
tetracycloide,
“She’s the hospital administrator and they are her employees. I imagine she knew they got her condo when they submited the change of address forms. However, House and Willson both appear to be under the impression she doesn’t know either which seems silly of both of them.”
Either House or Wilson (I would have to check but I think it was Wilson) mentioned, in a previous episode, changing their address to a PO Box. They did this specifically so that she shouldn’t know it was them who bought the condo.
February 3rd, 2010 at 4:53 am
Koray,
“Did House’s remark regarding the guy that went something like going white and thus not needing football any more to get a good job sound racist to anybody else? I didn’t quite catch it; just checking…”
In season four when Cuddy gave House a performance review, she mentioned that the majority of his comments were either racist or sexist. Throughout the span of the show, from the Pilot onward, he has a habit of saying racially insensitive things. It’s built into his character. I’m not sure why this comes as a surprise midway through season six.
February 3rd, 2010 at 9:09 am
Really tiny detail, but when Chase came to hand House the MRI of the pituitary, House says, “Let me guess, CT was clean.”
CT doesn’t show the pituitary. But that’s ultra nit-picking.
February 3rd, 2010 at 9:53 am
In Jersey, house sales are published in the local papers. There’s nothing secret about them. It’s easy to find out who owns any house in your neighborhood. The only way to protect your identity is to buy or sell your house as a corporation or some other legal entity. Still, I got the impression that in the end Cuddy didn’t really care that much about the condo, but Lucus, dirt bag that he is, found out who bought it and told her to stir up trouble with House.
Lucus is this season’s Vogler or Tritter. He annoyed Wilson by putting the opossum in the tub but he endangered House by loosening the grab bar and tripping him in the cafeteria. He’s got a real mean streak in him and he’s after House.
February 3rd, 2010 at 1:16 pm
Many have complained about how much better “House” used to be in the first two seasons than it is now. That seems to be a nearly unavoidable part of being a fan of a long-running TV series.
I am not one of the complainers, but there are a few things about the first two seasons that I miss:
1. House’s relationships with the other senior doctors in the hospital have been downplayed. When he wants to perform a questionable surgical procedure he just has to order Chase to do it. In earlier seasons he couldn’t issue orders, he had to persuade (or blackmail) other doctors who were nearly as arrogant as him. A fair fight, in other words.
2. The medical animations. We don’t see enough of them any more.
3. The clinic. I agree with the many posters who would like to see more clinic action.
February 3rd, 2010 at 1:39 pm
Yes, more clinic, more doctors! And why does he have absolutely no contact with nurses? Hospitals are full of nurses!
Aside from everything else already mentioned, I enjoyed Taub’s mincing little “you were right, you’re a genius.”
Apart from all the story problems, I give props to the writers for doing something almost unheard of on US television: radically changing a character. House’s drug use was a major part of the original seasons, and now it’s gone! It’s really improved the show for me.
February 3rd, 2010 at 2:41 pm
@Keith. Yes, the drug use is something that I do *not* miss from the first few seasons.
On the other hand, I don’t want “House, MD” turning into “Marcus Welby, MD*, either. :-)
February 3rd, 2010 at 6:15 pm
I was definitely rooting for Raynaud’s as an underlying condition. Seemed to fit, honestly.
February 3rd, 2010 at 7:31 pm
Scott, as an ex air force physician could you address the soldier story? Is it really so difficult to get out of the army? Was House telling the truth about missing a toe not being a ticket out?
February 3rd, 2010 at 7:50 pm
To Keith and Juan: The rate of recidivisim for “rehabilitated” drug abusers is roughly 78%. The odds favor House lapsing back into his old habits which, if the writers want to keep the medicine as “accurate” as possible, should ramp up his addiction to a stronger narcotic, such as morphine.
As for Lucas, I, for one, like him. The House/Cuddy flirtation was a big snooze (hookers are always more interesting) and I think its time to move on.
February 3rd, 2010 at 9:05 pm
If I can weigh in. . .
I am overweight and most of the people I know don’t know it. When I actually tell people my weight they don’t believe me and I am always being told that I don’t need to lose weight. I also have friends who are taller and look overweight, yet weigh less than me. I suspect that weight has a lot to do with bone and muscle density, as well as the way in which the weight is held on the body.
Loved the pranks, hoped it wasn’t Lucas, hated that it was Lucas. Hate Lucas.
Personally, I think that Cuddy is smart enough to have figured out who bought the condo. Maybe she even got Wilson to buy it and pretend that he had outbid her. That’s certainly along the lines of what she and Wilson have cooked up before. At any rate, I agree that she wouldn’t see the change of address forms (even had they not been PO boxes) but did know the realtor. She could also look up the property address and find out who owns the property. It’s easy enough to do online.
February 3rd, 2010 at 11:10 pm
I personally don’t like Lucas either. He’s a stupid SOB who needs to go curl up in a corner and die. A horrible painful death.
As someone said, most tv shows do blatantly disregard the rules. But, Bones, for the first two seasons, seemed to stick closely to the rules. House, I don’t really know about. I’m into medicine, but I’d more likely be the one always in the clinic. I deal well with people. I couldn’t be like House and his team.
I’m in Mock Trial, right now, so I’m learning quite a bit of law regarding medicine because one of my witnesses is a druggie and an alcoholic, and the other is a alcoholic. So, I’m learning quite a bit about the medicine used in rehab, and by proxy, other things about medicine.
Cuddy’s definitely smart enough to team up with Wilson to get back at House.
When is she going to dump that arrogent SOB?
February 4th, 2010 at 1:34 am
I was thinking about the relapsing most junkies suffer…. It is certenly a viable plot line for House however I would personally hate it. He is doing fine without drugs – he has proved to himself that he does not need tham. Sure a collapse in his personal life could make him fall (usually as 13 said once: “Drugs are always a symptom of somtehing else!” – you need a big and seemingly unresolvable personal issue to reach back when you do not need the pill. Of course there are weaker people who would fall back to the habit just because they do not see any other way – they choose to deprive themselves of options or are too alone or proud to ask for help. It is a complex matter but one that is simple for House at the moment – he said it himself – he wants to be happy and he cannot be happy while popping pills. So Let us all hope and pray that the vicodin is trully over forever.
February 4th, 2010 at 2:55 am
What bugged me about the soldier is how we jumped from losing a toe to the whole foot with no explanation. How did that happen?
I thought the pranks were done by Cuddy as payback, but I was ok with it being Lucas, as long as it ends with this episode as promised and doesn’t become this season’s Tritter.
February 4th, 2010 at 8:57 am
@Joel: House needed to change the patient’s antibiotics and said that if he didn’t, he would lose his foot. I think we are supposed to assume that the patient decided to stay on the first antibiotic.
@Tom: I am not in the military, but I was under the impression that it is very difficult to avoid deployment these days for medical reasons. Heck, even reaching the end of your enlistment contract doesn’t guarantee anything.
Still, taking advice from a doctor — especially one that never served — was stupid. What if he has to prove to the military that it wasn’t an accident? What if they send him anyway, just not in direct combat? I don’t think House was as serious about his advice as the patient assumed.
February 4th, 2010 at 12:10 pm
I like Lucas because he seems to be a really good boyfriend to Cuddy, which she deserves. I was relieved to find out that he was honest with her about the condo. I don’t think she cared as much about losing it than Lucas cared about it on her behalf. Cuddy has a demanding job, a baby and a man in her life. She wouldn’t waste her time trying to find out who the buyer was. She would just move on.
February 4th, 2010 at 3:37 pm
felty’s syndrome may present only with neutropenia before RA and splenomegaly
February 4th, 2010 at 7:21 pm
I mentioned what Dr Bulgaria wrote an episode or two ago about the nature of house moving more towards the soap opera side, and yes house’s struggle to win Cuddy’s love and get over Vicodin has tended more to the soap side, many stories attempt to the philosophical discussiun of extremes, such as the episodes House Vs God and the one with the priest , the Cat which could predict death, the psycopathic woman Vs the act of remorse,I could go on but I’d like to keep this post short.
As I haven’t commented much on this board i’d also like to make my brief summary of the episode;
The search for steroids sounds like knee jerk reaction that was obviously going to fail, the football player smashing his head in at the start seemed to resonate with the talk later on of his ankles being messed up from playing football so much. Basically destroying himself for the game, but i guess these are familiar themes in many shows.
Lucas’s attack was emphasised to be more brutal than anything house or wilson would do. (Well, house might have done the opussum, and Wilson did cut his cane), but I think loosening a safety rail next to the bath would be beyond Wilson, and my only other suspect for the oppossum was cuddy, but again, not the safety rail, who’d be able to turn Wilson and Hoouse against each other and be able to find out about their squabbles over the tub? lucas was the obvious choice, they’re building him up for a showdown with house, their won’t be revenge next episode and maybe not the one after that, but when it comes it will be spectacular (or house does nothing to lucas and cos he doesn’t cuddy decides to forgive him for everything… cue graphic sex scene.)
February 4th, 2010 at 7:23 pm
whoops sorry meant noticed not mentioned at the start of that :s
February 4th, 2010 at 7:59 pm
D-r Bulgaria: Happy endings aside, in order to be true to the character of House, he should relapse. He is narcissistic, arrogant and an egomaniac, and, not in spite of being a genius but because he is a genius, he will delude himself into believing that he can “handle” self-medicating himself with painkillers. There are rarely happy endings in real life.
In addition, based on the fact that the show’s ratings have slipped this season, it appears as though many people don’t want to see a “kinder and gentler” Dr. House. They want the man they love to hate. And to state a favorite House-ism: “People don’t change.”
February 5th, 2010 at 12:26 am
Lots of typos in this review. I don’t recall ever noticing typos in your reviews before.
“I don’t know it alcohol will really shut off blood flow in the radial arteries in patients with Takayasu’s arteritis, but who in the hell would thank that is a good idea. Personally, I like my hands to have full blood flow, thank you.” – was the worst part. Too many beers? :P
February 5th, 2010 at 2:41 am
“He is narcissistic, arrogant and an egomaniac, and, not in spite of being a genius but because he is a genius, he will delude himself into believing that he can “handle” self-medicating himself with painkillers” – I must say I agree with that – hate myself for agreeing but it is true. There is the slim hope that what happened in the pilot (House actually relying on someone else to help him deal with pain – emotional or physical – would mark a character change that sticks, but not a great hope… I am just hoping. Back in the days when I watched “Buffy the vampire slayer” I kept on hoping for certain chars to bounce back even from the most unthincable depths of misery – and they did; such as Faith my favorite “broken hero” or Spike – who went on from “have to be good” to “want to be good, because of the bonuses” to “want to be good without expecting anything in return”. Now House is becoming a better version of himself and he is not expecting a reward for that – he is even done hoping for Cuddy to change her mind. Well to be honest he seems to be hoping – but with the kind of determination that actually helps junkies to stay of the drug… He does not want a reward he wants to be eligeable for a reward but he does not want it or need it. So there is hope for him and I am hoping as well :)
February 5th, 2010 at 6:15 am
Boy, I really thought the culprit was Nora, who considers House & Wilson “mendacious dirtbags!”
February 5th, 2010 at 9:18 am
I doubt House will relapse unless it’s a very temporary, like one episode, event as long as the show is in the 8:00 o’clock hour. There are certain guide lines to what can be shown when children are still watching and having a junkie as the show’s lead/hero is definitely on the no-no list. As soon as I saw Fox was making the show its Monday lead-in, I knew they’d have to clean him up.
February 5th, 2010 at 1:02 pm
I’m no MD, but I am heavily involved in football (I officiate HS and NCAA levels):
If the kid was good, the scouts would run him through private workouts throughout his senior year, especially afterwards. One game does not make or break a player. Scouts have tape, want coaches opinions, schedule private workouts… if he is pro material, missing one game isn’t going to change that.
Having cancer, though, may end up being a red flag in a scouts mind, but at the very least, he would probably be invited to camp as an undrafted free agent… So having his pro dreams wiped out by missing one game? Highly unlikely…
Looks like the writers know about as much about medicine as they do about football ;)
February 6th, 2010 at 12:47 pm
In my opinion as a huge fan of house since the very first few episodes this episode was probably the worst written episode i remmember watching. Forever house has been the evil genius you cant help but love no matter what prank he pulls what boundary he crosses and regardless of his motivation(there always is one and rules are there for him to break). However in this episode they did a horrible job showing any of that instead they showed him breaking new boundaries for the greater good with the foreman battle and the dead mother incident.(old house, but slightly different that he would go out of his own way to improve any of the teams personal lifes.) Then allowing someone to get their foot amputated for no apparent reason he wasnt proving a point to himself or anyone else he did it for the sake of doing it (something not typical of his character but within his capability with regards to morality a more realistic way for house to have reacted would have been to test the guys commitment this was set up with the toe needing amputating but one would then expect house to find a different way out for him.) However feeling guilty about the patient losing his leg is totally out of character. Last but not least Lucas been the ideal nemesis for house shoots any retaliation down with “Im going to tell cuddy” When has that ever stopped house? Or even the new improved slightly mischevious wilson. I feel the whole back story to this episode was way off if they are infact changing his character slightly from the from the careless, meticulous, selfish and sometimes obsessive genius that he is. I cant see myself watching any longer might aswell be E.R. or some other random hospital series. I do hope this was just some horrible mistake that was allowed to happen and not part of some bigger plot of making his character well behaved and self conscious… Still puzzled at how they could make house unlikeable and very normal in parts of this episode do they not re-read the script or watch an episode before the release it. Never have i ever posted about any episode of any show but this was complete and utter rubbish.
Opinions?
February 6th, 2010 at 1:14 pm
“D-r Bulgaria: Happy endings aside, in order to be true to the character of House, he should relapse. He is narcissistic, arrogant and an egomaniac, and, not in spite of being a genius but because he is a genius, he will delude himself into believing that he can “handle” self-medicating himself with painkillers. There are rarely happy endings in real life.
In addition, based on the fact that the show’s ratings have slipped this season, it appears as though many people don’t want to see a “kinder and gentler” Dr. House. They want the man they love to hate. And to state a favorite House-ism: “People don’t change.””
Read this post and couldnt agree more I do think house could pull off the narcissistic, arrogant ego maniac and lets not forget genius without having to relapse but i havent seen much of any of his characteristics that has brought the show this far. you say love to hate I say love and hate this new nice and not so outstanding version of house they are developing. Come to think about it there is zero chemistry between house and cuddy he has no influence over her but hasnt had to display it due to not making a nuisance of himself its almost like cuddy doesnt need to be their at all anymore but their chemistry made for some funny scenes. The only thing i can see that has improved in the past two seasons or so is wilsons character and how he has become alot less forgiving clearly the show is suffering elsewhere though. Have the screenwriters changed? I miss the master of every situation perfect manipulator house and very rarely he was beaten to the win by anyone else but now he loses too many battles.
February 6th, 2010 at 1:37 pm
@EL + a few others
I believe it has been clear for a long while that wilson would be in houses corner before cuddys. Wilson was the go to guy and the one to go far out of his way to look after house post rehab and mental institution as he has taken on more characteristics of house in recent times I think he bought the apartment because he knew it would be ideal revenge on cuddy for hurting house especially considering it was he that convinced house to step up and take her. In turn taking sweet revenge on houses behalf getting some self satisfaction out of it too.
Lucas is second only to house when it comes to pranking but generally with cuddy hes just a kiss ass I really cant see her keeping him long she is used to always been the boss and the one person she was really attracted to was the only one she couldnt control. Cuddy loved taking all of houses crap his pranks, his boob and arse comments there was just more attraction there. hmmm i dont think house and cuddy will ever get together but i do believe there maybe another kiss somewhere down the line house will win he has to. but unfortunately for house to be at his best he has to be miserable been with cuddy that wont be the case.
February 6th, 2010 at 4:04 pm
“but unfortunately for house to be at his best he has to be miserable been with Cuddy that wont be the case.” I must say I agree with this too but the writers have been trying to prove the exact opposite from some time now. I think that is the main thing that changed in the show. All in all I disagree with the idea – I guy can be “House” and can be happy at the same time – however the success of the show clings on that idea – that he needs the pain and the misery to be who he is…. Frankly I see no good way out of this situation, but I still hope for some happy ending :)
February 6th, 2010 at 4:04 pm
Oh almost forgot – I am pretty sure some real not hallucination Huddy sex is in order one way or the other :)
February 6th, 2010 at 5:33 pm
Adam: House didn’t allow the guy to get his foot amputated. For all we know the guy cut his own foot off. House mentioned in an off-hand way that he’d have to lose his whole foot (rather than the badly infected toe) in order to not be redeployed and the next time House sees him he’s missing his foot. House is genuinely shocked that he went this far. Most likely the guy just stopped taking his med.’s when told of the consequences of not switching to a better antibiotic. House’s guilt is related to not believing how deadly serious the guy was about staying out of the army and not doing anything about it (like fudging the medical records, something old House would definitely do.). The guy lost his foot because for once House didn’t act like House.
February 6th, 2010 at 7:57 pm
@ Hibbleton I agree with your reason as to why the soldier lost his foot however.
Clearly each time he saw the patient he continued to suggest the next step shooting ones self in the foot was clearly a joke however after that house clearly knew this man was willing to do anything to not be shipped back out but continued to mock him as he does. Each time suggesting the next course of action do correct me if im wrong but i seem to remmember when he discussed the fact that the soldier would probably need to at least have his foot amputated im sure in that scene he also stated that the current anti biotics were not working and If he continued to use them he may need to get his foot amputated?
Regardless of actually saying that word for word or not he always has a little fun with the clinic patients when has he ever let something slip by him like the patient willing to do anything but do a 4th tour. I think we can be confident in assuming his foot was definately allowed to get to the state of needing amputation rather than the soldier taking a hacksaw or whatever to it however the fact this was going to happen either totally slipped past house, didnt slip past house but he didnt care about standing up against “the man” anymore in addition to feeling guilty about it either way none of them interpretations are anything like the house weve enjoyed watching for so long. The only thing house ever really missed on another person was kutners suicide but thats for a whole different conversation on bad writing.
Even when house has been wrong he has always done it elaborately i.e. nearly killing chase. and when he thought he had all the answers whilst in the mental institutions everything made sense to the viewer as everything is always meticulously planned when it comes to manipulating people or the sytem.
I dont mind house been a little more human, and i dont mind him been drug free but clearly his arrogance and perhaps some of his genius is missing in recent episodes. When was the last time he was two steps ahead all the time? In the last few episodes foreman was playing more of a house role… both with the pay rise incident and breaking the rules to drug a patient for the greater good. Since house has become too much of a nice guy and less of a calm calculating mastermind the shows sideplots are severely lacking in entertainment. Another example been the incident with the side rail is he really average enough to sit up wait to declare war on wilson and not remmember until the next evening that he had to borrow a flathead screwdriver to get the job done?
Im glad to see all these dissapointments with the changes in the show are shared by the majority and it has inspired me to research into the reasons behind the sudden change for the worse anyone capable of shedding any light on this?
February 6th, 2010 at 9:36 pm
I was thinking the same thing about them over-using paraneoplastic syndrome. I think it’s getting to be a bit of lazy writing. It lets them use random neurological symptoms, and then just pull up any type of cancer.
I also agree that with a guy whose supposed to be that big and that good would still be drafted, and would certainly have more chances to show his ability. Now, the medical problems might knock him down a round or two in the draft.
Not sure, but would he be able to request another year of eligibility for medical reasons? I like pro ball a lot better than college.
February 6th, 2010 at 11:14 pm
“how on earth do two grown men not have a single slotted screwdriver between them??”
Part of the fun of this episode is how inept these two are at normal living. It’s like the odd couple with two Oscars.
February 8th, 2010 at 2:46 am
Am I the only one who thought the soldier was either A) Really stupid or B) a hypocrit? Why? I’ll tell you why – he does not want to go to Irak and is ready to lose a foot for that – but he is not ready to quit the army altogether? Why not do that? Spit your C.O. in the face, beat a fellow soldier with a shovel, pretend to be gay, do whatever you like and get discharged – disonorary of course but who cares? But noooo – get your foot choped off and protect your army “future” or at least your army retirement funds. Idiot (or jerk or both). The fact that House felt guilty for this guy was actually sickening for me – he is not responsable for every moron who decides to cheat the system because he is too much of a wuss to beat it.
February 8th, 2010 at 9:38 am
I’m willing to give House writers the benefit of the doubt and assume that the changes in his personality are leading up to some grand catharsis during the February sweeps.
I work in Manhattan and I’ve known guys who don’t keep one tool in their apartments.
As has been mentioned, the football story line was incredibly weak. No one of star caliber is going to lose his one shot at the NFL by missing one game/practice/tryout.
February 8th, 2010 at 2:37 pm
D-r. Bulgaria,
It’s not so easy to just “leave” the army. Some of the things you suggested would lead to jail…not an improvement for someone who wants to be home with his wife and child. Other things may lead to loss of income. I don’t think that House felt “guilty” about the soldier. When I saw the look on House’s face upon seeing the soldier, my first thought (agreeing with an earlier poster) was that he was recalling his own situation. Here was this guy who was willing to do just about anything to be with his family; on the other hand, there was House, who chose his leg over the woman he loved.
February 8th, 2010 at 3:08 pm
If House is really based on Sherlock Holmes (as the creator says it is), then isn’t it really less of a doctor show and more of a detective show?
Is it possible, without medical training, to listen to the symptoms and block out the distractions and arrive at the correct diagnosis, that is and figure out whodunit?
February 9th, 2010 at 1:43 am
ruthinor – I understand your logic and may be I was a little blunt :) but my point is still valid – there were ways for the soldier to leave the army altogether (loss of money and face of course!) and not get crippled. But he just wanted to cheat – to get it all if possible. He did not have the guts to choose between the army and his family. As for House – your revelation is a startling one. I agree – it was not guilt it was sheer disbelieve that someone is willing to go THAT far! He felt a little guilty (may be?!?) because the whole time he did not take this guy seriously – all his advise was taken seriously while he was merely pulling the guys chin while trying to scare him into not cheating the system (which is kind of weird for House – he loves chating. Or may be LOVED cheating before?!?)
February 9th, 2010 at 4:23 am
A few points:
1. Regarding the possibility of Foreman getting penalized for drugging the patient: Bear in mind that Chase did something *far worse* earlier this season.
2. Is it just me (I admit I watch a lot of O’Reilly and Beck), or is it becoming SOP for NBC-Universal to insert left-wing politics into their programs? I heard it happen with “Law & Order” and saw it happen in “Heroes”. Now they have two consecutive episode with such politics. This one shows their opposition to the Iraq War, and the following episode includes a heavy-handed criticism of the Big Evil Insurance Companies, apparently to help Obama sell his health care reform. Fortunately, I’m nowhere near the point of no longer watching “House”. (Although I stopped watching “Heroes” for other reasons, and I never really got into L&O.)
3. I didn’t realize that stop-loss was still in effect. With the economy the way it is, the military isn’t exactly hurting for recruits. In fact, I heard (from a recruiter) that the Army hasn’t been granting *any* waivers for almost a year now. Perhaps they still need stop-loss to keep the more experienced soldiers in the Army for a while longer.
4. Kissing another guy on base won’t work. I believe there is actually a penalty for pretending to be gay in order to get out of the military.
February 9th, 2010 at 10:35 am
Very true, Chris. It’s extremely difficult to get out of the military. Nowadays, the military is so desperate for recruits even flagrant acts of rule-breaking are unlikely to have any effect whatsoever, unless it involves making the soldier’s life more miserable.
February 9th, 2010 at 2:50 pm
Hey I am not American but is the army some sort of prison? I I want out of the army how could they stop me (what was the name of that film with Owen Wilson and Gene Hackman? They discussed the issue there extensively… I cannot disobey orders while I am a soldier – fine. But I can still leave right?
February 9th, 2010 at 4:32 pm
D-r. B,
Sure you can leave the army…but you would end up in jail! The point is not only did this guy want to leave the army, he wanted to be with his wife and child. I think he saw the “medical” way out as a route to achieve that end.
Anyone who watches O’Reilly and Beck with any regularity (not to laugh, but to actually soak in their B.S.) is beyond repair!
February 9th, 2010 at 4:57 pm
D-r. Bulgaria, i think house may have been deliberately manipulating the patient, each time suggesting an incrementally larger step so that the guy would go through with it, shoot yourself in the foot, loose your toe, lose your lower leg. If he’d suggested chopping his leg off at the start, the soldier would have never gone through with it. I bet by the end he wished he’d just moved to canada.
Oh and Chris Graewin, i’m not sure i agree with you, but this show has supported obama before, there’s an episode, i think in season 2 and that it was made sometime around his decision to run for president featuring a black senator running for president
February 10th, 2010 at 2:45 am
I still cannot believe that in the most free country in the world they would put you in jail for breching your work contract. On one hand – it is a job like any other job. You sign for it – you can choose to resign whenever you like. There would be consequences sure but jail?!? Is there a military person here who could clarify the issue? On hte other hand – it is a job with A)significant risk of getting killed and B) you basically sign for becoming a payed killer an assassin if you like (and yes murder is murder even in combat). So what if you cannot do it anymore – you are not willing to risk your life (case in question!) or you cannot kill? They put you in jail? They put a gun to the back of your head and say “Kill or be killed” They force you to be a soldier even after you are not fit and able to be anymore? I doubt it. There are ways, legal ways, unpleasant for sure and with reprecussion that go far – but those ways I am sure are better than chopping your food of. And a soldier who is ready to loose a foot to escape traveling for Iraq is by deffinition a soldier who should not go to Iraq – an army psych with a D on all his exams could confirm that. So I stik to my point: the soldier is A)Crazy, B)Idiot or C) Hypocrit
BTW the name of the film was “Behind enemy lines” The pilot (Owen Wilson) said to his C.O. that he was unsitisfied with his job in the army and since he have served what he was due he is leaving (the soldier did say that he served his term right?). No way for the C.O. to do anything except ruin his Christmas with an extra patrolling :) So I think that proves my point sufficiently and I will let the matter to rest until somebody who is really into the army laws decides to pitch in with a tiebraker :)
February 10th, 2010 at 3:47 am
Responding in order:
How difficult it is to leave the military depends on the specific branch. The Air Force and Navy have been downsizing over the last couple years (they temporarily increased their numbers in 2001-2002). Although the Army has changed its age limits, as I said before, they are not granting any waivers, as it appears that many people are enlisting due to the bad economy. This might change when the economy recovers. These factors (among other things) have made it difficult for me to re-enlist in any branch of the military.
The military is not a prison. When you enlist, you sign a contract, so you are contractually bound to serve for a specified number of years. The controversy surrounding “stop loss’ is that soldiers’ time in service is extended beyond the end of their enlistment. And no, you can’t just leave. (I think the term for that is desertion.)
BTW, I think the movie you are thinking about is “Behind Enemy Lines”. I never saw the movie myself, though.
I’ll let ruthinor’s comment (re: O’Reilly and Beck) slide this time.
When the soldier’s foot got chopped off, I had a feeling he would be worse off, especially given the current job market (or lack thereof). He would be with his wife and baby, but would have no way to support them. Granted, if he was deployed, there was a chance he could be killed, but there was also a chance that he could return with his body intact.
I do remember the episode with the Obama-esque senator, although I didn’t see the connection until it re-ran on the USA Network a few months ago. I didn’t notice any left-wing politics in “House” until just recently. Hopefully it was just a fluke.
Finally, if anyone though my political rant was out of place here, I apoligize. That was my very first post on this site, and I don’t want to be responsible for ruining this thread.
February 10th, 2010 at 7:51 am
There is one thing I do not at all understand about this episode, and that is the meaning of the title “Moving the Chains.” I’ve watched it twice, and so far I failed to notice any mention of chains or anything else the phrase might refer to.
February 10th, 2010 at 2:35 pm
If I actually had rules to a House drinking game, this episode would have gotten me thoroughly wasted, as paraneoplastic syndrome is definitely worth a drink per mention. (And a “finish your drink” for being the actual answer.)
February 10th, 2010 at 11:06 pm
“Moving the chains” is a football term; it means scoring a first down (and thus getting 4 more attempts to get another first down or score). If there’s another meaning I missed it.
February 15th, 2010 at 3:46 am
D-R Bulgaria, you asked for a military person to comment on your thoughts. I am a veteran, ex USAF medcorp officer. I am also incredibly angry at your posts, and trying to remind myself that you are not familiar with the U.S. military and probably don’t have any idea just how much you’ve insulted me and those I’ve served with and know now as other veterans. I’m writing that just so that you know how upsetting that kind of post can be to some of us.
To try to answer your questions: No, you cannot resign from the military. At all. And no, it is not at all like a work contract. No work contract requires you to work 24 hours a day, 7 days a week, 365 days a year until the contract is completed and even then can require you to stay on for an indefinite period of time until whoever you work for decides you can leave. No work contract gives your boss the absolute right and ability to have you put in jail for the rest of your life for a crime that outside of the military is not a crime punishable by any jail time at all. No work contract allows your boss to tell you who you can talk to, where you can go, and what you will wear during the time you are not actually in the office. I could go on, but consider just that much and think if you’d really call it “just a work contract” anymore.
I have the movie you mention. The pilot in it is at the end of his time and is refusing to sign up for another tour; ie he has finished his contract and will not be signing another one. The movie is several years old and that is is not the situation now. The Iraq and Afghanistan situation has changed many things about military service here. One of those changes is that National Guard is sent overseas –previously active duty military went overseas but the Guard stayed at home and were deployed in other ways. No one expected the Guard to be sent overseas, they were for these situations because the downsizing that took place in the 1990s left us with a too-small active duty military to do the job and the politicians didn’t dare start the draft to force people into the military because that would have been political suicide. So you have the Guard suddenly being used in a war situation overseas, and you also have “stop loss”. Stop loss has been around for a very long time but it was never used except in time of war and primarily for military members who had specific training and skills that would take time to replace. Now stop loss is being used extensively just to keep people going back overseas again and again and again. The brutal truth, as you will hear from many veterans, is that politicians are “using up” the current military and Guard personnel –ie military people are being sent back again and again until they die or are too injured to go back, because again there are not enough to do the job without a draft to replace those who should have been discharged.
Here are another couple of facts. From what I have heard there are people being sent back to Iraq with permanent problems like a severe loss of function in one arm or serious untreated PTSD. And to put your idea of “just leaving” into perspective…”just leaving” means such penalties as being put into jail for the rest of your life (which HAS occured) or being executed as a traitor. Punching out an officer or kissing some guy will get you the same penalties, not a simple discharge of any sort. And even if you ARE out that’s no guarantee; I could be reactivated at any time myself, although I am 50 and disabled. (That is not to say it’s likely, but the point is it could be done and I would have no choice but to go overseas…or go to jail for YEARS.)
And here’s my biggest reason for getting angry at the kinds of things you wrote…I don’t know you, and maybe you do know what it is like. If you do, I apologize. But if you have not yourself been in some war zone three times, finished your tour alive, intact, and married with a kid on the way, and then been told you are going back with no idea how many more times and a huge possibility of returning each time in a body bag or missing not just a foot but arms/legs/brain….then I personally don’t think you have a lot of room to call a veteran names.
February 16th, 2010 at 3:44 am
Army duty has been a long time issue over the world. Countries are always in need of a ready army as long as it stands threatened by others. And these threats will never cease to exist as long as politicians/rulers use “foreign threat” for mass fear effect, which would fortify the position of the user and generate unity among the countrymen. Even some countries creat their own enemies in order to establish the latter. (btw: i am not implying anything to anyone AND it is true that some rivalties and some enemies are not generated by someone)
So, military duty is often viewed as patriotic duty which expands to a meaning that “every able should serve for military because a) there are threats b) it is the payment for a citizen to gain the rights that is provided by this country.”
This applies mostly for the countries with compulsory military service.
On the other hand, military service is not a job even for the countries with non-compulsory military service. Each member of that army fortifies his country’s global position and strength. It is a guarantee of that country’s freedom for the fact that “freedom is not a right given by others, but taken with your own hands”. Enlisting makes you a reliable asset to a critical position that is called “safety of fellow countrymen”. In countries with non-compulsory military service, you have the right to choose before enlisting. And if you choose to enlist and sign your every right to be sacrificed for your country, you can’t get cold feet after time. You should have thought twice.
Yes, in a developed country if someone sees himself unfit for the job he should be transfered to another position or may have an option to quit with his honor.
But leaving an easy transfer or an easy quitting option would harm an army more than anything.
It is a stressfull job and in time even the toughest soldier doubts his position. There is always a chance for you to get killed or leave crippled. This job needs psychologicaly potent laws surrounding the subconscious of its members saying “your life belongs to your country and noone else” so that noone feels that there is always a backdoor.
so, as an army, if you rely on everyone’s free thoughts, you’d lose the battles before starting. And all of us knows that majority of the people don’t have a tendency towards making good mental decisions. for example there are lots of people who takes drugs before getting advice from a doctor and cause serious health problems on themselves. You can find these kinds of people in military service also. So what happens if you leave cool options to the people who can take drugs without doctor’s consent?
They may choose wrong.
Most Army laws prevent these pre-failed decisions.
Most Army laws don’t care if you have a great surgeon’s mind because Most Army laws are based on people who can’t make good free decisions.
Every Army law is there to establish Order.
But for the case of that private in House: it is easy to build empathy. A time may come for you that you can’t take much longer and feel a strong urge to desert or run away. It’s just psychology… he is not crazy, not idiot, nor hypocrite… he is just afraid and blowing his ankle is the only option to get away from LAWS. (*)
it may be a dishonorable action in the code of a fighter but he is just a human being with emotions.
i live in a country with compulsory military service and which has an ongoing war on its soil. Every couple of days soldiers get killed by an ambush or by stepping on a mine. Sometimes young men feel afraid for their lives, not just because of getting killed on battlefield, but because of a fight that has been going on for over 20 years and wasting your life for a hypocrite political manuever.
For others this fear may be caused by birth of a child or for the love of your wife behid. it’s just human nature. you have things to lose, things you left behid and you don’t want to get killed. it’s survival instinct. it is ordered by chemicals in your brain and, for most of the people, no higher meaning (honour, duty etc) can overcome it.
in my country there are straight men who get themselves photographed in a homosexual sex positions in order to declare themselves gay to avoid military service.
and one time there was a man who hijacked a passenger plane and tried to flew it to Rome with the idea to get political asylum from Pope himself.
it is called being desperate and this character, here in House, portrays that situation perfectly.
i apologize if i’m offended anyone.
——–
(*) = mostly laws dictate that there should be an investigation about that lost feet. if attorney suspects that it wass an accident with intent, he’d get into a serious trouble and probably put in jail for sometime or lose his pension.
other than that, i agree with DJB, a man without a limb can still be a useful asset to an army and still send him overseas to take care of less critical jobs.
March 8th, 2010 at 4:05 am
Now I am a vet not an M.D., but something rather odd caught my attention during this episode. Why did they link GNRH overproduction with the guys large size? Isn’t GNRH responsible for inducing FSH secretion, and the secretion whole other sexual hormones? Or is STH production related to GNRH in case of humans? Even if it were the guy would show other signs of hormone hyper-production, probably causing increased scent, and constant hyperaggression instead of the single occurrence of it.
March 15th, 2010 at 11:47 am
I’m sure there’s been a few mentions of it already, but it does actually upset people when you diagnose someone with melanoma and then give it the ole “it’s JUST skin cancer” routine. We melanoma survivors don’t really like people blowing it off as non-serious, but that’s the exposure they get to it.
Another show had a doctor with melanoma and mets in her brain and she DIED but of course they brought her back to life, fired her, and now the character is leaving the show. Great, but that’s not how stage 4 melanoma works, either.
Love House, but didn’t like this diagnosis.
March 15th, 2010 at 11:50 am
They could have at least said “Hey, this is how Bob Marley died!” and made it a little more realistic, but what can you do?
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