House — Episode 13 (Season 6): “5 to 9″
An atypical episode of House as it focused on a day in Dr. Cuddy’s life, moving every other character to the background. A change of pace, but a solid and enjoyable show nonetheless.
Cuddy gets up at five AM and starts the day with some yoga. Her daughter Rachel wakes up a little while later, sick, and Cuddy comforts her while getting ready for work. The nanny arrives, and then Lucas, who’d been up all night on a stakeout. He talks her into a quickie before work, but unfortunately he was a little premature in his efforts and she heads off to work unsatisfied.
Cuddy arrives at the hospital at eight and things are already going crazy.
House strolls up to discuss his patient he thought had resistant Staph, and who he wanted to treat by infecting him with malaria.
Cuddy walks off, telling House that she has to finish a proposal before an important 8:30 meeting and there’s a crisis in the pharmacy where some paperwork, and some ephedrine, is missing. Next, there’s a problem in surgery, where one of the surgeons is complaining because House has turned on the air conditioning. She gets the heat turned back on and heads to her meeting.
Meeting Cuddy in the hallway, House informs her that his patient now has boils and a large abscess.
Cuddy hears from the nanny that Rachel is still sick, only now she’s running a fever and vomiting. She finally makes it to her 8:30 appointment with the contract negotiator from AtlanticNet Insurance, the largest insurance company in the area. He and Cuddy have been arguing about a contract for eight months, and today Cuddy lays it all on the line. She agrees to capitated care, but wants a 12% increase in rates. He refuses. She tells him that this is the hospital’s final offer and he has until 3PM to agree, or she will make a public announcement that they are no longer accepting AtlanticNet, and why.
Thirteen and Taub report to House that their patient is now hallucinating and has a falling blood pressure and rising heart rate. They suspect congestive heart failure, but House disagrees, telling them that the patient has [elevator door shuts before we hear the answer].
On the way to the hospital board meeting, Cuddy has a run in with Dr. Thomas, the hospital’s Chief of Surgery. He is seething about House — upset primarily about the fact that he stole Chase back from the surgery department. She heads into the board meeting where the board makes it clear that Cuddy’s job is on the line if she can’t pull off the contract with AtlanticNet.
House skipped clinic again, so Cuddy fills in for him. The patient is an older man with metastatic cancer who wants a prescription for breast milk. He has heard that breast milk can help with his cancer, and wants a prescription so the insurance company will pay for it. She refuses, pointing out that even with a prescription the insurance company won’t pay for it. He accuses her of being in the pocket of the insurance company before insulting her and storming out.
Back at her office, Cuddy finds a lawyer waiting for her. He is representing Martin Acevedo, a man who had his thumb reattached after cutting it off with a saw. He is suing because he didn’t want the thumb reattached — he is poor and that was too expensive — but Chase went ahead and did the surgery anyway. When confronted Chase admits that he did sew the thumb back on even though that was not what the patient wanted because he felt that the reattachment was the best option for the patient medically.
A little while later, Cuddy meets with Gail, the pharmacy tech who stole the ephedrine. She tells Cuddy that it was to help her lose weight and asks Cuddy not to fire her. Cuddy takes a little pity on her and tells Gail that she has to fire her, but she won’t report her to the DEA. She grabs a quick unhealthy lunch from the cafeteria.
House is sitting in Cuddy’s office – in her chair – waiting for her. He tells her that his patient has renal cell cancer (kidney cancer) and he wants to treat with malaria in addition to chemotherapy.
Lucas swings by the office, bringing Cuddy a real lunch. He tells her that Rachel seems to be doing better — she is no longer running a fever — but she has developed a rash. Unfortunately, Lucas accidentally grabbed the nanny’s phone, and turned the ringer off on Cuddy’s phone at home, so there is no way to reach the nanny.
With Lucas’s help, Cuddy tracks down the CEO of AtlanticNet at lunch and confronts him about the contract. He blows her off, telling her he doesn’t care if her PR campaign makes him out to be a rich bastard, as long as he stays rich.
Back at the hospital she meets with the head of the pharmacy and discovers that a lot more ephedrine is missing from the hospital than previously suspected — $50,000 dollars worth — and the thefts have been going on for at least three years. She realizes that Gail has been lying to her and has been stealing the ephedrine to sell to a meth dealer (ephedrine can be used to make methamphetamine)
The negotiator from AtlanticNet returns and offers an 8% increase as their final offer. Cuddy declines, wanting the full 12%.
Now House’s patient has liver failure and needs a transplant.
Three o’clock arrives, and as there have been no new offers from AtlanticNet, Cuddy calls a staff meeting and informs the physicians that the hospital has terminated the contract with the insurer. This causes widespread disbelief and dismay among the staff, as many of them made much of their money from AtlanticNet patients.
Foreman arrives, telling Cuddy that they’ve found a liver, but now there’s another conflict. House wants Chase to do the surgery, but Thomas refuses to put him on the schedule. Foreman needs someone who outranks both House and Thomas to schedule the surgery.
Cuddy meets with Acevedo and his lawyer. She tells them that not only will the hospital fight the lawsuit tooth and nail, but that she wants Acevedo to pay the remaining bill for his care.
Next, Cuddy arrives at the surgical suite and breaks up a brawl between Drs. Chase and Thomas. She then returns to her office and confronts Gail, the recently fired pharmacy tech, about lying to her. Gail freely admits the theft and tells Cuddy she can’t do anything about it because she’ll lie to the DEA, telling them that she did it on House’s orders, and that House and Cuddy were having an affair. Frustrated, Cuddy walks out of her office, telling the staff that she quits. She sits quietly in her car for a few minutes until House arrives. He cheers her up, as only House can, by insulting her, but this is enough to get her to head back into the hospital.
Cuddy confronts Gail again, who once again brags of her theft and her plan to lie to the DEA. Luckily, Cuddy captured it all on one of Lucas’s hidden recording devices. The nanny calls and tells her that Rachel is doing fine. To complete the hat trick, the negotiator from Atlantic Net arrives and tells Cuddy that the insurer has agreed to her 12% proposal. Ecstatic, she informs the board and staff, who share her enthusiasm. Finally, she heads home to Lucas and Rachel after a long, exhausting day at work.
No significant medical complaints, and no grading this week either, as the episode didn’t give me much to work with in that regard. Just a few thoughts and comments:
Though I know nothing of its use in Staph infections or cancer patients, before the advent of penicillin, malaria was used a treatment for syphilis. The malaria gave the patients a high fever — high enough to kill off the syphilis germs — and malaria was curable with quinine.
On one hand, you could argue that Cuddy should have acceded to the patient’s wishes and given him a prescription for breast milk, since, as House said, “it might work.” However, I have to side with Cuddy on this one. First, she’s right: the insurance company will not pay for it, even with a prescription — they’ll consider it an experimental treatment. Second, it’s her signature on the prescription, and she should not write any prescription she is not comfortable signing. Finally, and she should have pushed this part harder, the breast milk is at best a shot in the dark — it’s wishful thinking — and by writing the prescription she would be confirming the patient’s false hope. She handled it well: she was upfront and truthful and told the patient she would not write the prescription. He didn’t like what she said, but he’s free to find a new physician.
Though it was mentioned briefly at the beginning, both Cuddy and the lawyer are glossing over the key fact that the treatment Mr. Acevedo received was not covered by the informed consent he signed. Chase may have done what he thought was best for the patient, but he did it through lying and dishonesty. Sure, Mr. Acevedo kept his thumb, and this will probably restrain the jury’s and judge’s enthusiasm for a large payout, but there is clear written evidence that Chase was deceitful in his treatment of the patient. The hospital’s insurance company will pay this off long before it sees a courtroom. And as for Chase, skipping informed consent or lying on it is a good way to lose a medical license.
Every place I’ve ever worked has a two people count the controlled substances in the pharmacy, just so situations like Gail’s can’t happen. And why does the hospital have so much ephedrine? It’s not that common a drug.
Anyone know what the rules in New Jersey are for surreptitiously recording a conversation? I know in Illinois it needs the consent of both parties involved, but I believe this is the exception, rather than the rule.
The review of the previous episode of House
A list of all prior House reviews
February 8th, 2010 at 11:30 pm
No medical mystery this week, but I enjoyed it none the less. Really liked that song in the opening sequence too… what music genre was that? I know it sounds familiar…
No letter scores for anything? I suppose “Drama” is the only thing you can really score on this week…
February 8th, 2010 at 11:35 pm
This one was a nice change in pace.
February 8th, 2010 at 11:41 pm
Nice to see Lisa shown in a positive light this week and given the focus of an episode…
For 6 and a half years we’ve seen a Cuddy that was basically nothing more then a fawning “yes girl” to House and every other strong male authority figure she’s had to deal with.
It’s also interesting how the perceptions of the “supporting cast” support that… From the Head of Surgery trying to browbeat Lisa to the Meth lab Pharmacy Tech and all the others, NONE of them were able to deal with this new aspect of her personality.
Only House seemed to understood why she had to be the way that she was in this episode and I think that on many levels, he gained respect for her as a result.
She took a helluva risky gamble and while it was well played, she really wasn’t thinking about the repercussions of what getting fired would have meant to her rather fragile family dynamic…
It’s great that Lisa Cuddy finally has grown a set, shoulda happened years ago and hopefully “5 to 9″ will not be the last time we see the new and improved Cuddy 2.0..
February 8th, 2010 at 11:46 pm
Official Comment
Adamantyr,
It was Break Up the Concrete by The Pretenders.
February 8th, 2010 at 11:47 pm
Oh yea, I almost forgot…..
It was GREAT to see that PPTH actually has more then 6 employees… :D
February 9th, 2010 at 12:14 am
Agreed, it was literally a revelation to see that Cuddy might actually be doing something with her day other than sign unspecified papers and wait for House and the team to bust into her office. This was an episode I was surprised to thoroughly enjoy.
As for recording a conversation, Oregon has the same rules as you mentioned for Illinois – both sides must give consent (IANAL). Maybe it’s not as much of an exception as you thought! So, that part interested me as well – I’ll be interested to hear if an ‘I AM a lawyer’ can answer what the NJ rules would be.
February 9th, 2010 at 12:20 am
Hi Scott.
New Jersey law regarding wiretapping is a one party consent state, and as such, Cuddy’s actions were legal.
February 9th, 2010 at 12:29 am
From: http://www.citmedialaw.org/legal-guide/new-jersey/new-jersey-recording-law
New Jersey’s wiretapping law is a “one-party consent” law. New Jersey makes it a crime to intercept or record an in-person or telephone conversation unless one party to the conversation consents. N.J. Stat. §§ 2A:156A-3, -4. (link is to the entire code; you need to click through to Title 2A, Article 156A, and then locate the specific provisions).
Thus, if you operate in New Jersey, you may record a conversation or phone call if you are a party to the conversation or you get permission from one party to the conversation in advance.
So Lisa did nothing wrong in recording the conversation with Gail, the Meth Lab supplier and with the DEA involved… Gail’s gonna be someone’s prison b**ch soon enough as Cuddy just handed them an airtight case…
February 9th, 2010 at 12:30 am
Surely will be submitted to the Emmys.
Regarding the recording… I think Cuddy would use it to scare Gail, rather than as evidence.
February 9th, 2010 at 12:42 am
First episode of House that I watched this season, and I found it a refreshing bottle episode (bottle episode is an episode that can be filmed on standing sets (ones that already exist), usually at the same time something else is (aka while House is going through a DDX, on another set Cuddy is argueing with a lawyer) in order to save time and fill a hole in the schedule).
I wonder if Wilson will get this kind of treatment in the future? I doubt it, but he’s always been one of my favorites.
Not sure what I’m saying or if I’m making sense, so I’ll just stop now before I start rambling.
Oh, and I bet the doc that gave the breast milk guy the prescription is House.
February 9th, 2010 at 12:55 am
Interesting episode, though not one of my favorites this season.
Regarding New Jersey recording law, http://www.citmedialaw.org/legal-guide/new-jersey/new-jersey-recording-law is a nice summary… essentially, in NJ only one party to a conversation (in this case Cuddy) needs to consent to a recording for it to be legal.
February 9th, 2010 at 2:11 am
TayJK,
They already did an episode this season based around Wilson. Try watching the show more.
February 9th, 2010 at 3:46 am
It may not be *legally* correct, but I have to side with them that morally or whatever reattaching the thumb was the right thing to do. Although I would also say that that’s the decision the guy should’ve made anyway, regardless of financial hardship. As various of them pointed out, having a thumb is extremely important to living a normal life, it seems to me that’s a worthwhile investment even if you go bankrupt in the process.
As for the rest of the episode, I found it more emotionally charged and engaging than any I’ve seen for a long time, or maybe ever. It was definitely unique to abandon medicine and focus on drama, and an unusual character, but it was very well done.
And for yet another subject, this is my first time replying to any of these so just let me say thank you, they’re great. I’ve read them all. It’s interesting to see a medical evaluation of the episodes as well as the evaluations of the story in the original posts and the comments.
February 9th, 2010 at 5:16 am
I agree, a welcome change of pace, and a terrific showcase for Lisa Edelstein as Dr. Lisa Cuddy, but I did find myself wondering: Why the hell would anyone want to run a hospital???
February 9th, 2010 at 5:31 am
I’ve always felt that the fact Cuddy kept House on staff showed a lot of strength; as she says, he runs a unique facility and she must get a lot of flack for supporting it. In this episode she almost functioned as court jester.
I found the scenes between House and Cuddy touching. In the first seasons they seemed more friends than lovers, and it is nice to see the friendship has survived Lucas.
I did not understand Lucas’s carelessness about Cuddy’s anxiety about Rachel. It seemed as though he was doing his best to “protect” Cuddy from knowing what was going on at home, while at the same time mentioning the rash etc. which would hardly calm her fears. Between taking the Nanny’s phone, not knowing what a fever breaking means, and the bet…. I suppose thinking romantically about House lowers one’s expectations.
February 9th, 2010 at 5:31 am
It was great getting to look at Cuddy for an entire hour. :)
February 9th, 2010 at 5:40 am
Sorry–in this episode HE almost functioned as HER court jester.
February 9th, 2010 at 6:47 am
I liked this episode very much. Like the Wilson episode before it it’s great to see the hospital from another point of view, and seeing the House cases in crazy little snippets is funny (wouldn’t want that too often of course). Interesting that they’ve done this twice now this season when they didn’t do it at all in the previous seasons (?). Not that it’s the first time they shake up the formula by any means, but this specific way I don’t think I’ve seen them do before. It’s a great change of pace.
Also, the final caving in of the insurance company – I’d been thinking during the episode “gee it would be so lame if they just give up at the last second for no apparent reason” but as it turned out it worked quite well. Gotta love the YESSSS !
snafubar : It may not be *legally* correct, but I have to side with them that morally or whatever reattaching the thumb was the right thing to do. Although I would also say that that’s the decision the guy should’ve made anyway, regardless of financial hardship. As various of them pointed out, having a thumb is extremely important to living a normal life, it seems to me that’s a worthwhile investment even if you go bankrupt in the process.
It seems to YOU. Would you want anyone else to make that decision for you ? If he lost his thumb maybe the guy could be a stay at home dad and the family would live off his wife’s income and disability checks, and would be better off than if they became homeless (with two kids !) because of that bill. Or maybe not. Either way, not your call, not Chase’s call.
I agree that the hospital did the right thing in reattaching his thumb… but you can’t go after that and ask him to pay for something he didn’t agree to in the first place. The situation is complicated by the fact that “the hospital” didn’t do anything at all – Chase decided to reattach the thumb, leaving the subsequent mess to others. Hmm, when have we seen this before ?
Anyway, good on Cuddy for ripping up that check. And boo on the US healthcare system for making that situation occur in the first place.
February 9th, 2010 at 7:19 am
Interesting episode, though one would have to hope this is an atypical day for Cuddy (if I had a week of days like that, I’d end up quitting and opening a practice somewhere.)
I have to say they really stressed getting the ‘B’ word in there at Cuddy, didn’t they? Are they trying to make us sympathetic to her, or illustrating that her tough position requires her to act b*tchy and hard to get things done? Just my opinion but it felt forced.
February 9th, 2010 at 7:24 am
Fever, vomitting followed by a rash…
Anyone else thinking that Rachel’s illness is going to come back as a hook in a later episode?
February 9th, 2010 at 7:29 am
Oooh what an exciting episode of Dr. Cuddy, Hospital Administrator.
In next week’s exciting episode: Watch as clinic patients fill out insurance forms.
February 9th, 2010 at 7:54 am
Now I better understand House’s comment to Cuddy from a few seasons back: “You haven’t been a *real* doctor for years!”
February 9th, 2010 at 8:02 am
This episode gave me what I asked for last week: House locked in combat with another senior staff member (the chief of surgery). It was nice to see House picking on someone his own size for a change.
This episode also had some interesting insights into the balancing act that doctors have to perform between practicing medicine and running a business.
February 9th, 2010 at 8:04 am
No letter grades this week, Scott? But I agree with Adamantyr that you really can’t grade anything besides Drama, and maybe the whole malaria concept as the medicine.
In any case it was definitely an enjoyable episode. Even though I watch House primarily for the medicine, it was definitely a nice change of pace to see what Cuddy has to go through besides dealing with House’s craziness; although it would be a lot nicer if they could go into a 3-week break after a normal medicine episode instead of an atypical episode like this one, since we’re not going to have another new episode until March 1st.
February 9th, 2010 at 8:10 am
Does anybody know the music played at the end of the episode? I really like that one.
Thanks for the help!
February 9th, 2010 at 8:14 am
Well I hope this gets re-run soon but I kinda doubt it. I had to miss the broadcast due to a family commitment, and that was definitely disappointing once I learned that this was a Cuddy-centric episode. I couldn’t agree more with Dave’s comment above.
Say, if Lucas can’t even last long enough for a “quickie” does this mean there’s hope yet for “Huddy”?
February 9th, 2010 at 8:18 am
Scott, any comments on the insurance negotiation? I was looking forward to reading your thoughts on how realistic it was or was not.
February 9th, 2010 at 9:01 am
Do no harm is a mantra for doctors so I can see Chase using that as a reason to reattach the thumb (I can also see common sense as being a reason). Of course I can also see going against the patients wishes as doing harm so who knows.
February 9th, 2010 at 9:10 am
All-in-all I’d rather not peak behind the curtain. But . . .
I did like the pushing match between Chase and the other surgeon. “Boys will be boys” -esp. with House pushing people’s buttons.
I think it was necessary for this show to display the value of House to the hospital beyond saving a few lives. With Cuddy shacking up with someone else, her tolerance of his antics seemed less plausible. In this show, several times she emphasized the stature of the place as a preeminent diagnostic hospital. It now makes more sense that she keeps him, worlds foremost diagnostician, on as head of diagnostics.
This episode reminded me of my grandmother telling me of a relative who had the malaria treatment for syphilis in a NYC hospital before antibiotics were discovered, and then the breast milk guy reminded me of her saying that many years ago, mothers could take their babies to a building in downtown NYC where lactating women would nurse the children.
Odd relationship between House and Lucus. They spent the night on stake out together? Lucus discussed having sex with Cuddy with House? After last weeks episode, I find that hard to believe. I guess it was fIlmed out of sequence.
February 9th, 2010 at 9:14 am
@SpotWeld, as a mom, I would have to diagnose teething for Rachel. A fussy baby, a quick fever, vomiting and a rash are all common symptoms, especially if the baby is fine within a day.
But I have to ask… I may be dense, but why did Cuddy tear up Mr Acevedo’s cheque at the end? Didn’t this mean he was willing to pay for the surgery? Or did her tearing it up mean that she knew the hospital would lose and pay him, so she acted out of kindness so he wouldn’t go bankrupt paying for it himself?
February 9th, 2010 at 9:43 am
“The hospital’s insurance company will pay this off long before it sees a courtroom.”
That might be true, but in the negotiation with the patient, the deal between the hospital and the insurance company hadn’t gone through. Wasn’t the hospital effectively without an insurance company in that scene?
February 9th, 2010 at 9:53 am
Official Comment
Liza,
Two different insurance companies. Cuddy is negotiating with a health insurance company about the rate her hospital will get pain for seeing their patients.
The court case with be covered by the hospital’s malpractice insurance.
February 9th, 2010 at 11:11 am
Enjoyed the episode but I felt as if I was watching Grey’s Anatomy with the lack of medicine and focus on the soap opera.
February 9th, 2010 at 12:13 pm
Great episode. I get the feeling that what we saw last night wasn’t so much of an “oddball” day as much as a “regular” day. A few thoughts:
1. We’ve got this conceit that House is right (by the end of the episode, mostly) and untouchable, and we never see the other people who’re affected by his prima donna status. The chief of surgery’s comments about House’s team receiving special treatment are a little more real (to me, anyway) when you realize that House’s approach can put other patients that aren’t his at risk.
2. The chief nurse… poor woman. She’s Cuddy, Jr. and doesn’t even know it. That’s one thing we don’t see enough of in the show: the people that clean up the blood, pee, and poo. Nice to see them in action.
3. House as a friend… like someone else already said, it was nice to see House acting like Cuddy’s friend rather than her wooer. The few moments when he wasn’t acting like a prima donna kinda gave us a hint as to why Cuddy really keeps this prima donna around.
4. Lucas… is useless. He’s acting like a 14-year-old. I don’t care about the shipping… I just can’t stand the character. Wrap this storyline up soon.
5. The insurance company… just as an aside, I hate it when “evil corporations” and so blatantly stereotyped. I’ve known quite a few folks in the insurance biz, and while I’m sure there are plenty who aim to remain rich bastards… most just want to make sure their companies are profitable (and their employees are employed and their stockholders are happy). There’s a hell of a lot more to negotiating than an insurance company rep being given an ultimatum by a hospital administrator (without authorization from their board) and then caving in right before her board meets to fire her.
6. The whole Gail storyline shows us that the drug problem’s a bit bigger than House getting prescription dope. Good for them.
7. The reattached thumb… I’ll agree with another poster: reattaching the thumb was the right thing to do, but the hospital should’ve billed for what the man asked for.
February 9th, 2010 at 12:18 pm
hi, had the same questions with @Nathalie , why would Cuddy tear up the check?
by the way, did House did something for the insurance deal? thanks for the review.
February 9th, 2010 at 12:20 pm
As a European….
Somebody in a hospital making the decision to lose his thumb… Horrible…
Don’t want to make this political… But, come on. That’s the worst decision that guy could make society wise. Originally from the Netherlands, we have a health care system similar through Hillary care. Private companies (or consumer cooperatives) insuring a government mandatory package (for both parties) which covers over 90% of health costs. It just works. Private companies are nibbling on their bottom lines to get customers (and sell them premium packages). I know NOBODY in the Netherlands that ever worries about health care costs or goes broke by them… As for the country i now live in, China,, people literally jump out of hospital windows after a consult that would drive their families into debt.
Sorry, seen to much BS lately coming from the US about health care… It just doesn’t make sense…
February 9th, 2010 at 12:28 pm
Yeah, I’m also a little confused about the meaning behind Cuddy tearing up the check
February 9th, 2010 at 12:28 pm
how it would have happened in real life:
Board: “Make a deal with the insurace company or you’re fired.”
Cuddy: “If that’s all the support I get for what I’m trying to do, screw it then. I’ll accept their 4% offer.”
February 9th, 2010 at 12:36 pm
From seeing all the posts of what people were looking at during the episode I notice that no one has the thought that I’ve had. I think Lucas is sleeping with the nanny.
Cuddy was trying for hours to get ahold of the nanny, but she wasn’t responding, neither was Lucas. When Lucas shows up unexpectedly at the hospital to bring Cuddy lunch he has the nanny’s celphone in his pocket and says he must have grabbed it by mistake.
I know it may seem a bit thin to most people, but House is a show where there is very little that doesn’t have some sort of importance in one way or another. The few things that happened and the few minutes of screentime that were given to them have some importance or they wouldn’t have done anything with them.
Maybe I’m wrong, but I just don’t see Lucas and Cuddy going long term, and I think they’ve started setting up for it.,
February 9th, 2010 at 12:48 pm
Even if they had been in IL, while it may not have been admissible by the prosecution in a case against the ex-employee, it might have been admissible by the hospital as a defense if the FDA chose to believe the ex-employee and they tried to pursue action against the hospital.
At the very least, the FDA likely would have chosen not to press the case when made aware of the recording, regardless of its admissibility, plus Cuddy could have “accidentally” leaked the recording to the press so everyone knew what was really going on.
February 9th, 2010 at 1:03 pm
What I found interesting was that if AtlanticNet had prevailed, the result would have been lower medical costs for the patients and lower premiums for their customers. While I remain unsure of what I think is the best way to reform health care, one thing I have come to believe strongly (as this topic has become the most prominent area of public policy debate) is that insurance companies have been unjustly vilified.
Even though Cuddy was cast as the good guy and AtlanticNet was the bad guy I couldn’t help but feel like the writers were making an esoteric point – despite who your heart may be pulling for, if you just “look at the numbers” John Q Public should be pulling for the guys who are trying to lower your cost.
February 9th, 2010 at 1:10 pm
And as for Chase, skipping informed consent or lying on it is a good way to lose a medical license…..
But killing an African dictator is an even better way. Seeing as how he got away with that one, I doubt he’ll have much trouble with the other.
February 9th, 2010 at 1:42 pm
Re tearing up the check, maybe I have this wrong, but the note said that the patient was dropping his law suit. Cuddy responded to that good news by ripping up his check. Everybody wins.
Could someone explain the hospital insurance system to me? I understand malpractice insurance, but hospitals have to pay other insurance companies too? What is capitated care? And what do the percentages mean, i.e. 4% vs. 12%?? Thanks!
Enjoyed the episode. I don’t hate Lucas as much as many of you. I don’t think he’s sleeping with the nanny. He seems to be very thoughtful about Cuddy and her child. But I do wonder what he and House were doing on a stake-out together???
February 9th, 2010 at 1:47 pm
@Piraeus
While being costlier for society as a whole? The guy was aiming for disability benefits while the good surgery he got should help him to get some more full time employment (with taxes and insurance payments)?
February 9th, 2010 at 1:58 pm
Only 12 states require ALL parties to consent, the other 38 have the one party rule.
Under New Jersey law it is a one party state. meaning only one party to the conversation must give consent for recording.
I see no reason why it wouldn’t be admissible, although it will probably end up forcing the woman into a plea deal, especially since we can assume she is supplying someone else to make meth. The recording promises her a conviction unless she rolls on the manufacturer.
February 9th, 2010 at 2:08 pm
I did not understand why Gail bothered to to come back to the hospital after she was fired. She had nothing to gain, and the risk was too big for basically nothing. It would make more sense if she just disappeared.
February 9th, 2010 at 2:12 pm
I spoke to one of our local DEA agents and his assessment of the “recorded conversation” was as follows: If the State of NJ chose to prosecute Gail, then the recording would have been permissible in court as Jersey is, in fact, a “one party” state. However, if the DEA became involved (and considering the amount of ephedrine that was diverted, they surely would), the case comes under Federal jurisdiction and the recording would raise constitutional and Federal statute questions. It may or may not be allowed. Additionally, the pharmacist in charge of that pharmacy would be facing possible suspension (or even revocation) of his license because (as Dr. Scott pointed out), controlled substances must be counted by two people (one of whom must be a pharmacist) when receiving a shipment and upon dispensing. In addition, orders of ephedrine that large over such a long period of time should have been reported to the DEA by the drug wholesaler at some point. Finally, the hospital itself would not be without liability and censure. In the real world, Gail would have cost many people their jobs, licenses and hundreds of thousands of dollars in fines.
February 9th, 2010 at 2:22 pm
OUTSTANDING episode! It had a feeling of “ER” to it from/during the early years of that show. I thought he opening music set a great tone for what followed.
Letter grade? I’d give it an “A” .
February 9th, 2010 at 2:25 pm
Thanks Chinaman, we’ve all seen Sicko.
February 9th, 2010 at 2:31 pm
It was a very nice episode and I was expecting something like this from the episode “Wilson”. Was it just me or are the writers really taking pointers from this forum :) May be one of them is even a poster here :) The one medical thing that was worth commenting is the story about the thumb. I had a similar (in terms of parties involved and job done, not in magnitude) case today. A guy came with a split tooth – it was a medium split ot a lower molar with one part hanging on the gum. The major complaint here was pain, but the bigger issue was the complete loss of the tooth. I tried to explain to this fellow what the problem is and that while risky we have a fighting chance of saving that tooth – by surgically correcting the gum in the fracture area and than rebuilding form zero. The total cost would have been something like 120 euro – a small amount for Europe but a significant (although not unreasonably big) amount for Bulgaria. Pulling the tooth (which was covered by the national health service) was a way worst option for many reasons the least important of which was partial loss of mastication function. More importantly – the tooth was endodontically treated but it was very well done – no loss of bone neither periodontal nor parodontal. All in all a very salvageable tooth – and I had to pull it out because the guy did not want to spend the money. So I did it (felt bad about it but did it anyway because that was the patients wish (and informed consent is exactly about that – to clarify what kind of medical care one should receive. So sorry Chase – I think you should lose your license for that :)
February 9th, 2010 at 2:31 pm
@Chinaman. I’m not sure I follow you or I may have been unclear. I wasn’t addressing the issue of the man who had his thumb re attached. I was saying that AtlanticNet was trying to reduce the amount it paid the hospital for the services rendered by the hospital to Atlantic’s patients. Had they succeeded the result would have been lower prices for medical services and lower premiums for customers.
February 9th, 2010 at 2:46 pm
@Drake
Seems plausible given that evidence, but who would cheat on Dr. Lisa Cuddy? Take a look at that nanny in the opening scenes… there’s no fucking way I’d trade Cuddy for her! Brains, beauty and a doctor/administrator’s salary, what else could you possibly want in a woman? What kind of moron would rock that boat?
February 9th, 2010 at 3:05 pm
@Piraeus. Or the saved money would go on making the (admittedly cartoonish) boss even richer. As is often pointed out, insurance companies are businesses, and as such are run for the benefit of their shareholders. It might make good business sense lowering the premiums of their customers, but on the other hand the money might be used elsewhere. The nasty boss scene was no doubt inserted to make it clear that -in the context of the show, at least- the greater good would be served by a higher payment to the hospital.
February 9th, 2010 at 4:07 pm
Cuddy: Do you know how much it costs to re-attach a thumb? How many years of training it takes to teach a doctor how to do it?
Thumb Guy: Really? ‘Cause that Dr. Chase is only like 30-something, and he does every kind of surgery there is!
February 9th, 2010 at 4:19 pm
@Will Fair enough (especially w/r/t “in the context of the show, at least”). But I don’t think there is much debate that health insurance premiums closely track the actual cost of health care.
See http://www.statesman.com/news/content/news/stories/nation/2009/10/26/1026insurance.html
and
http://www.rwjf.org/files/research/101508.policysynthesis.costdrivers.rpt.pdf
February 9th, 2010 at 4:32 pm
I asked my father (he’s a lawyer) about the laws regarding recording a conversation without consent. For face-to-face conversations, there is no law requiring either party to receive consent from the other. He noted, though, that such evidence could be considered ambiguous in court. An example would be in the case of a poor quality or distorted recording in which it is not obvious who is being recorded unless they explicitly state their name or other identifying information.
He also reminded me that he works in casualty insurance and that I should stop asking him questions about criminal law. >.>
February 9th, 2010 at 5:05 pm
@ruthinor: The 4/8/12% increase they were referring to is how much the insurance company reimburses the hospital. So for example, you have AtlanticNet insurance and go to PP for some procedure or another. AtlanticNet says they will cover $100 of that procedure. The hospital (probably) knows this, and thus (possibly) charges you $100 for it.
But costs go up and eventually this procedure costs the hospital more than $100. So they either have to make the patient pay the difference out of pocket, or negotiate with the insurance company to get them to reimburse more than $100. This is the negotiation they were talking about.
February 9th, 2010 at 5:11 pm
@Benedikt
The song played at the end of this week’s episode was “Shine on” performed by Eric Bibb from his album “Diamond Days”.
February 9th, 2010 at 5:29 pm
John, thanks for the info about the insurance company. Not knowing the details didn’t detract from the episode, but I had no idea that this is the way things run at hospitals.
February 9th, 2010 at 6:26 pm
@skooma: Is that the only thing guys think about? Finding a hot, rich woman to fuck?
Anyway, when the hell are they going to get Lucas out of the picture?
February 9th, 2010 at 6:45 pm
I think this episode might suffer a bit in comparison to the Wilson-centric episode earlier in the season. That one wasn’t actually TOO too different from a regular episode, aside from the simple fact that it centered on Wilson and not House. This one was a total change of pace. I didn’t really understand a lot of it (perhaps it’s the naivete of someone who is 24 years old and has never had her own health insurance), but I enjoyed seeing Cuddy featured for once. I do agree though, that this seemed much less “a day in the life” than “an extraordinarily unusual day in the life.”
They delayed resolution of the 12% thing just long enough for me to start to suspend disbelief – certainly I didn’t think Ms. Edelstein was being written out of the show, but I was thinking okay, might they introduce a recurring character while her story becomes more Lucas-centric for a few episodes.
I was kind of confused by the breast milk guy too. I thought Cuddy said the insurance would pay for the prescription if she wrote it, but she still wouldn’t? I understand not wanting to sign something you don’t want your name connected to, but is there any tangible downside?
February 9th, 2010 at 7:09 pm
While it was an enjoyable epsiode, despite the ham-fisted stereotypes of the insurance industry, reading an article about different ways to view classic films got me thinking about the last 10-15 minutes.
It bothered me that it was too neatly wrapped up and that Cuddy got everything that she wanted. I was especially perplexed by the insurance company caving so quickly and his comment of “Call of the dogs”. We only saw her address the employees and announce a press release would be issued. Where was the pressure that would cause a large company to cave just a couple of hours after the rejection?
Instead, what if the ending is all in her head and next week we find out that she either quit or better (worse) killed herself in her car? Think of the new storyline possibilities. House blames himself for her leaving(death), maybe the board asks House to be the temp chief since he has so much free time. We could explore Wilson’s emotions and how he would treat it and the potential revenge Lucas would plan as he’s blinded by grief and blames House. It’s not like they haven’t shocked us before.
I’m sure that the happy ending is real, but wouldn’t it be interesting if they went with my ‘what if’?
February 9th, 2010 at 7:33 pm
I hated the “insurance companies are greedy bastards” meme which was perpetuated in this episode. The numbers don’t add up the entire profit of health insurance industry is just 0.5% of what Americans spend every year on health care.
February 9th, 2010 at 7:51 pm
Good god, if I had her job, i’d be done with my first pack of cigarettes by lunch…
February 9th, 2010 at 8:11 pm
Remember that Lucas was originally cast as a guy who helped her with the kid as a caretaker? Now he’s a sex maniac who is no help at all.
Another point – just what hardball do you think the insurance negotiator is talking about? They already knew about the press release and the CEO was blase about the bad publicity.
What if House and Lucas had taken action on their own and went after the CEO personally? Manipulating individuals is what the two of them do well, right?
February 9th, 2010 at 8:18 pm
I thought it was ridiculoous really ridiculously boring. And the Dean of Medicine genrally relies on the Personnel Department to handle terminations due to misconduct. Already deleted off my TiVo.
February 9th, 2010 at 10:22 pm
@ citizen
cuddy already told her nurse/assistant to give the recording to Stan the Pharm guy to give to the DEA agent when he comes by.
February 9th, 2010 at 11:03 pm
Anyone count how many times Cuddy was called bitch this episode? A social message if there ever was one…
February 9th, 2010 at 11:23 pm
Every time Cuddy go from one Strong Woman moment to the next, I would laugh and think, Way to go Dr. Scott, some House writers obviously read your blog! Those Rebecca Howe comparisons hurt. But the tough administrator is back, watch out,
The only moment she didn’t stand up for herself? After Lucas’ as you say premature efforts … when she whined about being frustrated…I’m not a doctor, but I think there’s a couple of other things she could have him do for her.
Thanks for standing up for Cuddy. Power to the blog.
February 10th, 2010 at 12:26 am
@Erik – LOL
@Zabby – Rich doesn’t matter.
I actually like the Lucas character. He’s always been a kind of proto-House, extraordinarily skilled at his profession and that skill allows him to neglect interpersonal stuff since people give him a pass. If nothing else the character has been consistent. He just hasn’t had House’s (many more) years of practice to refine his technique.
Also, I took the insurance CEO’s ‘as long as I stay rich’ dismissal as a pure negotiating tactic. His other comments gave away that he was at least personally aware of, or involved in, the PPTH negotiations. They were trying to intimidate a vulnerable opponent. They ended up blinking first but their tactic was still reasonable.
Finally I guess I was the only one here that took calling Cuddy a ‘bitch’ as a term of endearment or respect? It may have been overused, but I’m thinking of the terms I used for my buddies just today and not many would be family friendly.
February 10th, 2010 at 12:34 am
Even assuming your numbers are correct, that doesn’t mean that insurance companies aren’t greedy bastards. For-profit health insurance siphons off more than just profit. They have a much higher overhead than non-profit insurers or Medicare, and reward the executives of the companies handsomely.
For example, the CEO of United Health Group received $124.8 million over the five years 2001-2005. Not a penny of that was profit for United Health Group. You can be sure that there were a number of other executives at United Health Group who also received a lot of money, if not the payout that the CEO received. None of that was profit either.
February 10th, 2010 at 12:45 am
There is no indication that AtlanticNet was trying to lower premiums. They were just trying to eek out a little more profit.
Cuddy said that AtlanticNet paid some hospitals more than what she was asking for, so we can assume that the premium AtlanticNet charges is more or less independent of the contract they have with any one hospital. At most, it would be based on an average of what they pay to all hospitals, and the AtlanticNet representative pointed out that Princeton-Plainsboro is the smallest of the hospitals that they contract with.
To lower costs, John Q. Public should be pulling for a single-payer health care system, rather than trusting a for-profit insurance company to take care of them.
February 10th, 2010 at 7:49 am
Now that that’s out of the way, maybe the show can get back to what it is: a fantasy show about a super antihero (House) who rescues us (the POTW) when no one else can. Societal conventions and medical ethics only prevent us from getting well; he breaks the rules to save us. Like all superheroes, money is not an issue. No test is too expensive. No drug is too costly. Insurance is merely an abstract concept that exists to pay bills. Like all hippie fantasies, his enemies are those who would make him conform; Vogler, Tritter, and his father. The diseases he fights are exotic like comic book villains. That’s what I want to watch.
A show about Cuddy, Wilson, and the rest of the hospital staff is too grounded in reality. Basically, “5 to 9″ was an hour long drama about insurance coverage.
February 10th, 2010 at 8:00 am
@ AlternateView :
“Call off the dogs” was referring to the high priced/powered PR firm that Lisa retained to present AtlanticNet Insurance in a less then flattering light to the public, many of whom were policy holders that could no longer receive treatment at PPTH.
February 10th, 2010 at 12:13 pm
@Xaphon
Thank you for straightening out all the idiots (including OP) who are somehow coming to the conclusion that wiretapping law covers recording face-to-face conversations. I’m not even a lawyer and I know that’s bunk.
February 10th, 2010 at 12:52 pm
I have worked in 19 different pharmacies and in the majority of them only one person was in control of controls. And that was only C-IIs, that had nothing to do with the other schedules.
It’s probably not that uncommon of an occurrence because of that fact. If it would have been occurring for 6+ years, the wholesaler wouldn’t notice because they would deem that normal usage.
That and I’m sure they are using one of the major wholesalers (McKesson, Cardinal, Amerisource, etc) and it is unlikely they would monitor the usage of that particular drug in one particular location. It is kind of an oddball thing to steal (although it makes sense) there is more profitable endeavors in a pharmacy.
The Pharmacist-In-Charge should be suspended and, since there is proof, the tech itself probably should have been arrested on the spot for several felonies. At least thats what we have done when we have caught people stealing.
February 10th, 2010 at 12:56 pm
Re the torn up check. I mistakenly said earlier that the patient had dropped the lawsuit. Not so. The note just said that he “dropped this by”, meaning the check. I guess Cuddy was so happy about the way things turned out generally that she tore up the check. She also was no doubt steamed at Chase for not following the patient’s wishes.
February 10th, 2010 at 2:47 pm
Lucas’ not knowing what a fever breaking means sounds forced, like what Star Trek nitpickers called “Cabbageheadisms:” When one of the crew would play dumb about something they should both know so the other can give an explanation for the audience. (Terry Pratchett calls it The “As you know, your father, the king” Speech.) Yet we didn’t get an answer. Probably because anyone who ever got sick as a child knows what it means when a fever breaks.
February 10th, 2010 at 3:14 pm
That was how I interpreted it. The fact that the patient wrote a check pretty much indicated that he wasn’t going to pursue his lawsuit.
Cuddy was psyched about winning her negotiation with the insurance company, and since the hospital would be receiving a lot more money than they would have otherwise, she decided that they could afford to eat the unreimbursed cost of the surgery (especially since as others have pointed out, the hospital was in the wrong legally, even if they did the right thing morally).
No one should be forced to lose their thumb based on financial concerns.
February 10th, 2010 at 5:32 pm
Stopped watching in the middle. This episode failed to engage me even for a second.
February 10th, 2010 at 7:23 pm
I was catching up on the comments on the previous episode, Moving the Chains, and I had a thought about the disgusting bet that House and Lucas made in this episode.
Last episode Lucas played all those stupid tricks on Wilson and House…. and House said he wasn’t going to retaliate. But if he is hanging out with Lucas and betting that Lucas will (a) persuade Cuddy to have sex when she is late to work and (b) not answer her phone during the act–and then seeing that Cuddy finds out–perhaps he is getting a much cooler and more subtle revenge.
February 10th, 2010 at 7:26 pm
Hmm…regarding the stakeout: could it be House and Lucas were staking out the Insurance guys? Maybe getting some dirt on them that Lucas could suggest to Cuddy as a bargaining tool? House must have known that something big was going down between Cuddy, the hospital board, and AtlanticNet. And rfemember Lucas knew where the insurance CEO was eating lunch…
Just a thought.
A good episode, and who’s to say that many of Cuddy’s days for all the “years” House MD has been on haven’t been like that? All we see prior to this is little snippets of her day. I liked it.
February 10th, 2010 at 7:55 pm
To Phathead: Your vast experience in various pharmacies notwithstanding (I’ve OWNED a pharmacy for the past 12 years), McKesson, Cardinal and ABC have ALL been smacked down by the DEA in the past decade more than once for failure to report abnormally high orders of any controlled substances, not just C-II’s. As you are aware, ephedrine is a controlled substance, albeit not a C-II. However, as you are also probably aware, an individual must sign for any dispensing of any OTC product containing ephedrine (which by Federal statute is to be kept behind the counter) and their purchases are limited at any one retail pharmacy. The amounts of ephedrine purchased by this hospital’s clinic pharmacy as indicated by the pharmacist was quite a ways over what anybody in the industry would consider reasonable or “normal usage” for that setting.
You are correct in that the Rx Tech should have been arrested immediately, and that the pharmacist should be sanctioned. However, at my store, we stand by the two-person count for EVERY controlled substance. As you and I are both aware, the number of health care providers, nurses, pharmacy personnel, etc., who either use, divert or both is increasing at an alarming rate. And drug diversion within the “Big 3″ wholesalers occurs more commonly than we realize. Think about the last time your wholesaler’s DC was temporarily shut down for “inventory” or “administrative” purposes and I’m certain you’ll agree.
February 10th, 2010 at 11:23 pm
Addendum: Under the heading “Shooting off my mouth before I’ve finished my research”: My pharmacy maven informed me that one cannot purchase ephedrine in any form; you just cannot get it anymore in the United States. Pseudoephedrine, however, IS available in several over-the-counter products, but is “controlled” in the same manner as C-V’s and is therefore monitored by the DEA. To that end, this storyline is not plausible.
February 11th, 2010 at 3:00 am
A single payer system might lead to almost everyone getting care, but almost nobody getting the best care. Just look at the VA, they get good basic care but many vets end up buying their own insurance or paying out of pocket to go elsewhere. Maybe this is preferred for those at the bottom, and those at the top might not mind paying out of pocket for better care, but many people in the middle will be upset when their new government insurance won’t cover as much as their old insurance and they don’t have the money to buy the same care themselves.
February 11th, 2010 at 10:44 am
I think that, at one point, Cuddy says that she saw the consents signed by Mr. Acevedo. I thought Chase had informed him correctly. Am I wrong?
February 11th, 2010 at 10:55 am
Official Comment
He signed a consent for the surgery he was told he was going to have (sewing the flap of skin over the bone), but he did not sign a consent to have the thumb reattached.
February 11th, 2010 at 1:44 pm
Ignore this comment.
If you have ever seen the show Scrubs, this episode was pretty much the opposite – it starts out all sad and depressing, and ends in a pretty nice way.
And Cuddy succeeding was such total bullshit. It doesn’t seem realistic
February 11th, 2010 at 1:49 pm
Really unusual ep, that´s right. Cuddy negotiating with the insurance company guy was great. Even my mother believed she was quitting. Just asked me “what´s she gonna do now?” and I told her “never gonna happen!” and I was right. Just expecting Cameron coming back! Lucas grabbing nanny´s cell and turning off the ringtone at home was kinda Houseian, don´t you think? I´d sware he did it both intentionally!
February 11th, 2010 at 3:42 pm
Yeah, after Evil Lucas last week, I sort of assumed he did that on purpose.
But if Lucas grabbed the nanny’s phone, why on earth wouldn’t they try to reach the nanny by calling his phone? Or was it stated at some point that he had left his phone elsewhere, and I missed that bit because I don’t pay too much attention when Lucas is on-screen?
February 11th, 2010 at 5:40 pm
@skooma Yeah I don think that Lucas would be crazy to do something like cheat on Cuddy and ruin his relationship with her. However, pretty much everyone in that series is kind of broken in one way or another. Maybe that’s Lucas’. Aside from that though, just because Cuddy is certainly desirable on many different levels that doesn’t mean that Lucas wouldn’t/couldn’t be attracted to the nanny. Attraction is a funny thing, it’s not always physical.
Either way, wether I’m right or wrong about Lucas sleeping with the nanny, I think SOMETHING happened that will likely be the catalyst for Lucas and Cuddy’s relationship ending. The spent too much time on it for it not to be important.
February 12th, 2010 at 12:46 am
Leaving aside the fact that treatment through hyperthermia is disputable – WTF malaria? Can’t one use Pyrogenal or any other medicine specially designed to cause hyperthermia without causing the damage malaria causes? There’s plenty of pharmaceutical stuff for that purpose…
February 12th, 2010 at 3:47 pm
I don’t think the recording needs to be admissible in court to be useful to Cuddy. Her only goal is to get the DEA to focus on the Gail, the criminal, and not her. It’s the DEA’s responsibility to corroborate her information with evidence that would pass muster in court, not hers. It’s enough to buy Cuddy some piece of mind since she has evidence to back up her story while Gail doesn’t.
February 12th, 2010 at 4:30 pm
Regarding Dr. Cuddy tearing up the check: The letter at the end said the hand-injured man had decided to drop the lawsuit (which would’ve been expensive for both parties due to legal fees and given bad publicity to the hospital). Dr. Cuddy had just negotiated a hefty increase in payments from the insurance company for admitting patients to the hospitals, meaning the hospital could afford to take the loss on that one patient. Dr. Cuddy knew Chase was in the wrong (period – you can’t make a man pay for something he didn’t want, or I could theoretically throw a sandwich at you on the street and force you to pay me), and even though she had successfully intimidated the man into dropping the lawsuit (by threatening to come after his home), she felt comfortable just taking the $60,000 (or something like that) loss. A lot of hospitals set aside part of their budget for “indigent care” (i.e., care provided to people who the hospital knows can’t afford to pay for it).
Regarding: The negotiation – I’m pretty sure the writers were trying to drive home the idea that the insurance company negotiator was underestimating Dr. Cuddy’s resolve because she’s a woman. First, he made the crack about not knowing what taking care of a sick child would be like because his wife takes care of his kid – implication being Dr. Cuddy belongs at home with the child. Secondly, he called her out for “being too emotional.” The CEO and negotiator pretended to not care about bad PR, but keep in mind insurance companies spend millions on advertising to boost their reputation – that would’ve taken a hit when the media reported the insurance company was denying their policy-holders access to “the best hospital in the area” to use Cuddy’s phrasing, that has “the world’s most creative diagnostics department.”
February 12th, 2010 at 5:32 pm
Thanks for the review – really clarified some hazy bits of a very interesting and, as you mentioned, a very atypical episode.
February 13th, 2010 at 10:54 am
The pacing of this episode was frenetic: it grabbed for reasons completely different frmo what one normally received from a hosue episode: the constant glances at the clock (not subtle at all), the three or four times cuddy took a breather, all too short…the opening music, the footsteps, the opening and closing of doors, presentation-wise fantastic.
One last query: so NJ wiretapping law applies only to phone conversations and such, and not to private conversations? So I can record any of my private conversations anytime?
February 13th, 2010 at 8:38 pm
@Zabby February 9th, 2010 at 6:26 pm
>@skooma: Is that the only thing guys think about? Finding a hot, rich woman to
>fuck?
the only thing guys think about is finding a hot, smart, great, noble, motherly, loving woman making an awesome work to help people, to fuck and love.
It seems that Cuddy is a wonderwoman any guy would love to be loved by.
February 13th, 2010 at 9:20 pm
@ Hugh L.: “For 6 and a half years we’ve seen a Cuddy that was basically nothing more then a fawning “yes girl” to House and every other strong male authority figure she’s had to deal with.”
Perhaps that’s because we have been seeing this show from the perspective of House. I have never been bothered by seeing Cuddy pushing papers, because that is much of what you do as an admin. We also never really see what Cuddy is doing in most episodes of House because House is normally not in the meetings that Cuddy is in as an administrator, nor for that matter, is he even in the clinic much. House is just one of Cuddy’s many tasks as administrator. In other words, the show is not about Cuddy, it’s about House. This episode recognized that in that we see much less of House’s ongoing case(s) than we did in the Wilson episode (his medical life overlaps more with Wilson’s). By the way, I do wish that we would see House in the clinic more. I would have liked to see his interaction with “breast milk patient”.
@ zimbabwe: I don’t know how your friends and you address each other: but as a woman, watching this show, every time someone called Cuddy a bitch to her face, I cringed. This is not acceptable in my world and if you called me a bitch I would not take it as a mark of respect. Although, at the end, I think that the insurance negotiator meant it in the manner that you suggest, I still think that it is demeaning. He would never have called a man a bitch. Think about that. How many men would you call bitches? If you went to see your doctor would you call him/her a bitch as a term of respect? Would you call your employer bitch? Just in case you are a doctor, this is something that you should think about when addressing patients. I was always more polite to the people I saw while in practice than I would ever be to my friends. That went for things waaaay less offensive than demeaning people by calling names.
@ oomu: Sorry guy. Most intelligent women do not wish to be a mother to grown guys (unless he actually is her son, and sometimes not even then). So you’re out of luck. Sometimes life is such a. . .
About the wiretap. Aren’t there two issues here? One issue is whether the wiretap is legal or not. Another issue is that of entrapment. So maybe the wiretap is legal, but wouldn’t it get thrown out (as others have said) as evidence.
February 13th, 2010 at 9:55 pm
David Shore recently revealed that House and Cuddy will be getting together and something will happen with Lucas. This episode is probably setting up something to happen along those lines. and i also think this episode purposely focused on a what a strong character Cuddy is so we understand House’s attraction to her. House is attracted to intelligent, strong women (Stacy was a lawyer, german lady at the psych ward).
February 14th, 2010 at 9:54 am
Cric — where did you read/hear that? In a January interview he just said Cuddy and Lucas will say together for a while, but not forever. That’s not much of a spoiler, as no recurring character has ever become permanent on the show. I’d be surprised if he had just blurted out such crucial information.
February 14th, 2010 at 9:55 am
Sorry, I meant to write “Crik”. My own username confused me :)
February 14th, 2010 at 12:16 pm
Jeebus, what a waste of time.
Was the team on strike or was this just some kind of prep work for things to come.
Most boring episode ever, seriously.
February 15th, 2010 at 8:39 am
Cuddy is not a cop nor a member of CSI. She doesn’t care if her wiretap is admissible in court. She’ll play the recording to the DEA when the meth twit gets arrested and slanders her, house, and the hospital. That’ll stop an investigation of those accusations in its tracks. That’s all Cuddy cares about. Whether the recording can be used in court is irrelevant to Cuddy and the show.
February 15th, 2010 at 10:09 am
Side note – PPTH is a TH… But so far i’ve seen only Chase moving from being all in one guy – to Surgeon – still all in one.
There was occasional appearence of students, but do they even learned something over the course of 3 years? This part seems to be never covered.
I liked episode, cuz it showed Cuddy and all, but i wonder if there will be an episode that would show either case from different angle, or someone actually spying on House?
Last thing… House has being on Vicodin for a long time, and then he suddenly get almost pain free thanks to cases, but before that it didn’t happened, since there was several episodes that made House detox or even worse, and it didn’t showed any indications that Case is helping him with pain. Looks like that Mayfield really did it’s number at House, but is he really that different now?
February 15th, 2010 at 1:18 pm
Re: the pharm tech
They don’t need the recording to press charges against the pharm tech. She has readily admitted to stealing the medications, and the documentation backs up that confession.
The only use for the recording is to shut her up before she starts in on trying to lie her way out of it.
Plus, everyone on here is making one hell of an assumption – that the tech wasn’t already informed via employment contracts that she may be recorded at any time. Such things are not unusual at all. If the hospital has security cameras, she probably signed a consent to be recorded when she first hired on there, so she has no expectation of privacy and therefore cannot claim that her 4th amendment rights have been violated through the recording of the conversation.
Re: Lucas
He sucks. He was a reasonably interesting character at first, but now he is just irritating. He didn’t appear to give a damn about Rachel being sick, Cuddy being late, spilling his guts to House about his relationship with Cuddy, or placing a wager on his sex life with his live-in girlfriend. The most amazing part of the episode is that she hadn’t choked him by the end of it all, but I suppose dealing with House for god-only-knows how long requires the patience of Job.
Re: Insurance companies
Blue Cross Blue Shield of California announced last week that they will be seeking a 30-39% rate increase despite having reported an eight-fold increase in profits in 2009.
Defend these bastards all you want, and disparage single-payer all you want. It only makes you look like an insurance company shill who’s too thick to see what the rest of the civilized world sees – that we are getting this pathetically wrong and people are dying and going bankrupt as a result all the while hollering that the US is #1 as if that were even remotely true.
For all the scare-mongering about single payer, I’ve yet to find a senior citizen voluntarily give up their Medicare, a vet voluntarily give up their health care, or a Canadian who wishes they could pay $15,000+ a year for sub-par coverage complete with enormous deductibles, high co-pays, and no prescription plan. If you find one, please, I’d like to meet them. On the other hand, I’ve yet to meet an American that has private insurance and has actually used it that likes it….if they can even persuade them to provide the coverage they paid for in the first place. But you just keep on telling yourself whatever it is that makes you feel better about you, to hell with everyone else.
February 15th, 2010 at 11:29 pm
This episode sucked hard.
February 16th, 2010 at 2:22 pm
Chic:
“It’s Official: House and Cuddy Will Do the Deed”
http://ausiellofiles.ew.com/2009/01/22/its-official-ho/
I love this site because it so effectively diagnoses the medical drama. On the other hand, the people here miss the action that takes place below the surface. In other words, you guys are great at being House, but lousy at being Wilson.
I’ve come to this conclusion because I’m a recent House fan and am catching up on the first several seasons. Reading past posts here–it’s fascinating how much of the story and plot is missed in your comments. The Tritter storyline for instance. Not one person pointed out how Tritter was a mirror-image of House. Especially the scene in the clinic where Tritter pops nic gum into his mouth and House pops vicodin. House then predicts Tritter will be back on cigarettes within the month. House had recently fallen of the vicodin wagon. Tritter tells Foreman that everyone lies. Tritter was the nicotine-addicted carbon copy of House. Which also brings into play the much contested debate of good vs. evil. It’s okay to be addicted to nicotine b/c it’s legal? Cops are good? Doctors are good but addiction to (prescription) meds are bad. So much of this was missed in that thread. Very disappointing.
February 16th, 2010 at 8:44 pm
Not everyone cares to point out the obvious.
February 16th, 2010 at 10:05 pm
As I understand it, Princeton Plainsboro is a private hospital, and Cuddy was not acting as a police informant when she recorded the conversation, so concerns about entrapment and constitutional issues that might arise if she were an actual or defacto state agent are moot.
However, the recording is hearsay and therefore not directly admissible (unless an exception is met), BUT it is admissible to impeach the witness’ credibility. So while the tech is on the stand and under oath, the attorney asks her if she stole the drugs, and when she says “no” he can play the recording to show the jury that she’s a liar.
February 17th, 2010 at 11:19 am
Hibbleton: that’s something House would say : )
there I go, pointing out the obvious again.
February 17th, 2010 at 12:48 pm
Crik: Though we often drift off topic, remember that this blog is called *Medical* reviews of House.
February 17th, 2010 at 2:46 pm
Really Juan,
Then why does Scott mention the “soap opera” every week??
February 17th, 2010 at 6:35 pm
a lot of these comments question House’s motives. how House practices medicine isn’t 100% mutually exclusive from his character. (re: putting himself in the shoes of an autistic character when he was treating an autistic patient.) it seems that part of the way House solves cases is by asking himself what he would do if he were in that position (re: que sera sera)
February 17th, 2010 at 7:07 pm
Re Gail:
Bit of fridge logic here, who the hell would believe the wild story Gail made up about House and Cuddy, and furthermore who would care? Media wouldn’t dare espouse the views of someone who’s accused of supplying a meth lab, any mention of this stuff in court would be objected to immediately, and besides it’s ridiculous apart from that. House doesn’t have that much authority.
I was kinda hoping that Gail would threaten to uncover an actual misconduct of the hospital and not some stupid fairy tale. If I was Cuddy, I would have laughed in her face and told her to get out of my office. I can’t see why Cuddy would even take something like that remotely serious.
February 17th, 2010 at 7:40 pm
@Belf
Because House has a history of drug use, because House has just completed drug rehab, because House has been on trial for drug trafficking.
February 18th, 2010 at 1:02 am
Like others, I think it completely unreasonable to try to charge the thumb guy for surgery that he expressly forbade. If anybody’s going to pay for it, it should be Chase.
February 18th, 2010 at 1:29 am
@smidget
“Blue Cross Blue Shield of California announced last week that they will be seeking a 30-39% rate increase despite having reported an eight-fold increase in profits in 2009.”
No, Wellpoint saw their profits increase 8-fold for one quarter. And that was because of a 1-time sale of NextRx for $4.7B. Meanwhile in the BCBS companies they run, they are seeing a decline in enrollment and revenue.
And as for single-payer systems, you should ask a friend of mine’s grandfather how he liked waiting 6 months for a heart bypass operation in Germany. Well, that’s hard to do now since he’s dead. Not all the people might want to give up their systems, but that’s because they haven’t yet felt the effects of their almost bankrupt health care systems.
And if you think the US government can do a better job and that the bureaucrats who have no experience with health care are not in this to pad their pockets, maybe you should take a look at the >$1T deficit we got last year.
February 18th, 2010 at 7:15 am
RE: The Insurance Companies
I can understand Newark Beth Israel and Robert Wood Johnson (two of the hospitals mentioned by Cuddy in the episode) getting more money than PPTH, because Newark and Robert Wood Johnson are friggin HUGE hospitals. Newark is pretty much the main hospital in Newark, NJ, with a huge pediatric cardiac ward and then Robert Wood Johnson is also a pseudo-teaching hospital, being affiliated with UMDNJ
Also, to the person who said no American is satisfied with their health care – I am satisfied with my health care. $36 every week for the family, $20 co-pay at the most for doctors/prescriptions ($10 co-pay for general practitioner/pediatrician)
February 18th, 2010 at 6:58 pm
@bros: $36/wk for dependent coverage and a $20 copay is great for you; however, I promise you – your employer is paying big, BIG bucks for your premiums. This sounds like a Blue Cross plan and I suspect you work for a large employer – good for you; you’re very lucky. But you are clearly not cognizant of the real world, certainly not of the real world of health insurance. PPH’s success in obtaining a 12% increase will simply translate into higher premiums, higher copays and higher out-of-pocket expenses for the patient. As so many before you in this website pointed out: insurance companies are in the business of making money. Altruism is not in their nomenclature.
And while we’re on the subject: check your own health insurance policy, especially the language under the heading “catastrophic illness/event.:” One bout of cancer can and will use up your entire lifetime benefits and once they are exhausted, good luck finding coverage elsewhere.
My point is, the people who are participating in this blog are outraged at the state of our health care industry, and rightly so. I cannot think of any medical or Rx insurance company that writes its policies to the benefit of the patient or health care provider. Your employer is likely paying a MINIMUM of $20K annually for just you and your family. Did your medical expenses come anywhere near that last year? Wait a few years, until your my age, or until you are old enough to draw Social Security (and Medicare, if its still available), and a few hard truths will be revealed to you.
@Dr Scott: Thank you for allowing us to explore more than just the medicine on your blog. I enjoy reading everyone’s opinion, however “off subject,” and this episode has certainly brought out some interesting opinions and experiences. Cheers!
February 18th, 2010 at 9:01 pm
Ephedrine is actually common any place surgery is performed or OB areas. It is a vasopressor and is used to maintain heart rate and blood pressure. Was used in OB when blood pressure dropped to keep perfusion to the uterus. Kept under lock in a lot of anesthesia carts along with the epinephrine and phenylephrine.
February 19th, 2010 at 12:59 pm
People like Bros are always so quick to brag about their excellent health care copay/contributions. I’m not sure if they realize that they’re the minority. If the company they work for is suddenly taken over, bought, or goes under and they start paying real-world contributions and copays, it will be a tough reality check. Showing some humiliation now will lessen the blow for you if, or when, you work for a different employer who doesn’t take the brunt of your copay fees. And when I say ‘lessen the blow’ i’m not just referring to your lighter pockets, but the reaction from the rest of us who aren’t going to have any compassion for your new predicament.
And you will have a reality check. Chances are that your kids will one day work for a company that doesn’t cover health care as comprehensively as your plan.
February 19th, 2010 at 10:54 pm
Re: Health Insurance
I think of health insurance as a sick sort of bet, in a way. I am betting $6,000.00+ a year that I AM going to be seriously ill (more than $5.000.00 worth). If you think about it, that’s sick. But what’s even sicker is that I hope I don’t get ill. As an older grad student, I can’t use the student health care and can’t really afford the insurance. A bet where I lose no matter what. How cool. . .