House — Episode 15 (Season 6): “Black Hole”
Tonight’s episode of House tried to hard to be edgy and ended up losing a coherent plot and any semblance of logical medical care along the way.
Abby is a seventeen year old high school senior who becomes unresponsive while on a school outing to the planetarium. Foamy red sputum drips from her mouth and her boyfriend reports that she’s not breathing; she is rushed to the hospital and admitted to House’s service.
Abby is found to have pulmonary edema (fluid build-up the lungs). The team understands this to mean that she has either a heart problem or a lung problem. Her drug screen was negative and her blood alcohol level was barely positive. Foreman suggests she may have developed heart disease from binge drinking. A C-13 pyruvate MRI is ordered (a test that looks at blood flow within the heart muscle itself). It doesn’t show the heart disease Foreman was looking for, but there appears to be something wrong with the mitral valve. Fungus is considered as a possibility, but the team decides a fastidious enteric bacteria infection is more likely (enteric bacteria are found in the human intestine, and fastidious means they are difficult to culture). A TEE (transesophageal echo — an echocardiogram performed from the inside of the throat which offers good views of the heart valves) is ordered to get a better look at the mitral valve. Under echocardiography, the valve appears normal, but during the test Abby develops an aortic dissection (a tear in the wall of the aorta), a life threatening emergency. She is rushed to emergency surgery where Taub and Thirteen manage to successfully resuscitate her.
The question now is how did Abby develop the aortic weakness which led to the dissection? A genetic defect is mentioned, but quickly dismissed with the aside that she is not Marfanoid (Marfan’s syndrome is known to cause aortic dissections — of course, there are other genetic defects besides Marfan’s). An allergic reaction is also suggested as a likely cause. Thirteen believes that a severe immune reaction could have led to the aortic weakness. She goes on to suggest that Abby may be allergic to her boyfriend’s semen. A quick test is performed but shows no reaction. However, during the test, Abby develops excruciating abdominal pain and is found to have blood in her urine. “Kidney failure,” screams Chase.
The differential diagnosis now consists of neuropathy (by which they mean syphilis, which can lead to a weakened aorta), a blood clot, insterstitial cystitis, or cancer. A full body scan is suggested, but, for the second week in a row, House mentions how much he hates them (a point on which we agree — of course, House’s opinion would carry more weight if they hadn’t already ordered five or six this season — and he wasn’t a fictional character). Out of other options, House agrees to the full body scan, which is negative. This being House, no test can go smoothly, and Abby starts to hallucinate during the study. This causes the team to reevaluate their differential, which now consists of a vascular disease (probably vasculitis from the way Foreman is talking) or an aneurysm. An MRA (an MRI that looks specifically at blood vessels) is ordered to find the aneurysm, but it also is negative. Foreman suggests a parasite found in the Middle East, but House shoots him down abruptly, saying it was too ridiculous to even consider.
Abby continues to hallucinate, but now has also started to have seizures. House convinces the team to try an experimental technology (conveniently available at that very hospital): cognitive pattern recognition. In a scene more at home on Fringe than House, the team see the image of her boyfriend playing baseball, then the universe, then an older man (“her late father” they surmise) from Abby’s brain. Unfortunately, this isn’t enough to build any sort of diagnosis. Grasping at straws, Thirteen suggests something may be wrong with the liver. Chase suggests she may have polycystic kidney disease (which really would have been seen on that full body scan he wanted). Foreman notices the MRI shows that her pineal gland is calcified (which is normal), but wonders if it may be hiding a tumor. A high powered MRI is ordered to check but is completely normal. House is at a loss until a conversation with Taub triggers his Eureka! moment. It turns out that Abby boyfriend’s father travels extensively, to the Middle East even, where he picked up the parasite that Foreman mentioned earlier, which he passed on to Abby in a drunken sexual encounter. The parasite itself died, but it left enough behind to cause a severe allergic reaction which is causing all of Abby’s problems (Cerebellar schistosomiasis hypersensitivity allergy). A quick brain surgery (to the remove the parasite, presumably) and she is fine physically. Emotionally…is a different story.
As usual, major complaints are in red, minor complaints are in blue, and nit-picking ones in green:
Schistosomiasis is infection by the liver fluke. It is endemic in much of the world, including the Middle East. So far so good, however:
1. It is the eggs of the fluke that illicit elicit a potent immune response. The fluke can cause an immune response itself, but not the level the eggs do (the level Abby demonstrated)
2. The body walls the offending agent off in a granuloma which absolutely should show up on a scan.
3. Schistosomiasis is not transmitted from person to person; it has a complex life-cycle and needs an intermediate host.
Coincidentally, just this past Thursday, NPR ran a segment on using a computer and pattern recognition to read human minds. Suffice it to say that the scene on House bore little in common with reality.
5cc of Adrenalin is a high dose. Even in emergencies, it is generally given in 1cc doses (though it will likely take more than a single dose). Plus, in the medical profession in the United States we call it “epinephrine,” half the OR staff wouldn’t know what you wanted if you asked for “adrenalin.”
Taub is suddenly a cardiac surgeon now? There’s a great deal of difference between a plastic surgeon and a cardiac surgeon. They only share one year of residency — the rest is completely different.
We’ve discussed this before, many times, and in great detail last week, but once more: blood in the urine is not a sign of kidney failure.
If the offending parasite’s body was so small it didn’t show up on a scan, how did they know where to operate to remove it?
Only in the hospital for a few minutes, Taub breaks HIPAA (Health Information Portablilty and Accountability Act, a Federal law which deals with, among other things, patient privacy) by telling Abby’s boyfriend about her medical condition. That’s a big fine for the hospital. $$$$ Nice going, Taub.
I know I often complain about the unrealistic time course of tests on the show, but this week’s deserves a special mention: fungal cultures are very slow growing — weeks, not days — so there’s no way they’d be negative so soon.
To my knowledge, there are no blood cultures for parasites. They are generally detected by O&P (ova and parasite) studies of the stool and blood smears.
She seized for just about a minute, yet in that time they managed to hook up a multi-lead EEG and record the waveforms. That’s damn impressive.
And can we stop the “OMG! If she has another seizure she’ll stroke out!” That’s unrealistic and insulting to people who actually have a seizure disorder.
The medical mystery was average — nothing we haven’t seen before: C. The final solution really didn’t make much sense. If they wanted her to have schistosomiasis, they should have given it to her in a way which could actually happen. If they wanted the edginess of sex with her boyfriend’s father, they should have just made her allergic to his semen, as was discussed earlier. Combining the two was a bad decision: D. The medicine had holes this week, though no more than usual, other than House giving up so fast. I give it a B. The soap opera was good, though not as strong as the last couple of weeks: B+.
The review of the previous episode of House
A list of all prior House reviews
March 15th, 2010 at 11:02 pm
First?
I had a feeling the brain imaging scene was pretty much medical fantasy. I thought the spacey visual effects were fairly well done, but otherwise a pretty forgettable episode. “Wilson shops for a table” wasn’t much of a B story, but it had more similitude than “Wilson was in a porno.” Remember when Wilson actually contributed to the medicine? Me neither.
Question for the author of these (wonderful) reviews (apologies if it’s been asked and answered an nauseum, which it probably has) – you often qualify a criticism with “I’m not a ______” (transplant surgeon is one I remember a couple times). What sort of doctor are you?
Fine reviews even for us medical neophytes, keep ‘em coming!
March 15th, 2010 at 11:04 pm
As soon as I saw the boyfriend walk into the hospital with his father, I asked myself what the father will eventually have to do with it all.
When the computer was showing an animated pitcher I changed the channel. Pointless…
March 15th, 2010 at 11:19 pm
I hit the Schistosomiasis Jackpot, baby!
Alexandra, Scott’s a Family Physician; a good, well rounded specialty.
March 15th, 2010 at 11:51 pm
The super-duper brain scan just completely ruined the episode for me. The medicine has been shoddy as of late.
Scott every member of House’s team has been through extensive medical school trials lasting decades I suppose.
March 16th, 2010 at 12:05 am
Taub’s wife is a beautiful woman.
March 16th, 2010 at 12:05 am
The Joe’s are in agreement (so far)
March 16th, 2010 at 12:23 am
Even as a layman, I was taken aback by Taub’s indiscretion in discussing the young woman’s condition with her boyfriend and the boyfriend’s father, and even more so by the way House forces the boyfriend’s father to admit his indiscretion with the young woman in front of the father’s wife and son – my mind instantly flashed back to a much earlier episode in which Cameron asks the father of a college graduate to leave the room so she can ask him whether he’s been to Jamaica against his father’s wishes.
I’ll take Dr. Scott’s word for it that the final diagnosis doesn’t add up. Something else that didn’t add up for me was the universe motif with the camera zooming through the galaxy – it sure looked pretty, and the “black hole” sequence was pretty spectacular, but after all was said and done, what was the point the episode was making? That the fault lies not in the stars, but in ourselves???
And boy, was I disappointed in Taub at the very end – almost as much as House was.
March 16th, 2010 at 12:26 am
I can’t believe you thought the soap opera was actually good. This has probably been my least favorite episode of the season so far, possibly of the entire series. The B (well, C) plot with Wilson and his inability to express himself through furniture was pointless. Which would be okay if we at least got some hilarious Wilson/House antics and lines, but there was nothing remotely memorable from that plotline to me.
House not only gave up way earlier than normal, but his banter with the team and Wilson was just bad. The only thing I enjoyed was him sexting Taub’s wife.
Speaking of Taub, his B story was also lame. I think I realize why he doesn’t have more episodes centered around him, because his character doesn’t have much of a personal life to explore and professionally he’s a bore. I thought we’d explore Taub and his far-too-hot-for-him wife trying to rekindle some semblance of their relationship by the episode’s opener, but it turned into a rehash of the cheating storyline he had last year (or was it 2008?) Knowing the writers of House, they will expand on the epilogue with Taub walking away with the hot nurse, though, so maybe it won’t be a total waste.
We didn’t even get to see that much of Cuddy, which is a crime in and of itself.
I don’t know about the medicine (although I was fairly certain when they started the brain mapping stuff that this episode was overplaying it, actually I had a feeling around the black hole hallucination) but the dramatic aspects of this episode were definitely sub par.
March 16th, 2010 at 12:39 am
I just couldn’t believe the brain scan… Too much, just too too much.
March 16th, 2010 at 1:05 am
I don’t know which was more of a turn off- The brain scan machine that shows pictures of what you’re thinking (SURE it does) or House actually carying about Taub’s marital faithfulness. I’m surprised we didn’t see him showing up at Taub’s in the middle of the day and hitting on his wife.
March 16th, 2010 at 2:15 am
I feel that hands down this was the WORST episode of the season bar none.
It felt slapped together and haphazard, from the whole “Wilson find your inner self” furniture snipe hunt to the quasi-mystical stars to the futuristic brain canner to a father sleeping with his sons girlfriend…. yet another re-used plot development… I’m tellin ya, the writers this year have SERIOUSLY run out of ideas..
And lets not talk about the medicine….breaking HIPPA… that’s just sloppy and inexcusable writing trying only for ratings and not realism..
I noticed that Lucas was missing in action this week (thank god) & Cuddy was back to having 3 lines the entire episode, PLUS the entire Hospital is back to being staffed by 6 people…
This ep was nothing more then a big disappointment that I hope is not a harbinger of things to come.
March 16th, 2010 at 2:47 am
regarding the equipment for the experimental test, when House told the the team to go do it he said “the equipment should already be there”
meaning that he previously requested it while the team was doing the MRI, it’s not that hospital happened to have it “conveniently available”
March 16th, 2010 at 3:13 am
IMO this was a Taub centric episode (sure Wilson was hunting for furniture but that was not new or interesting – he is known of being dependent from women for everyday choices – and the final solution for him – to go to Cuddy for advice and get a decorator as a result – was well in character for him. Moving on). Taub is an amusing character and since the show needs a comic relief (it was Kutner before than Taub took over) I like watching him in action. I was dissapointed by his complete lack of inventiveness on this one however (flat tire?!? Come on!). Not only he was unable to lie convinsingly to House (or anybody for that matter) he was unable to invent a single working idea for his life (and his wife:). The final solution? Re-proposal – corny and classic and I kind of thought his wife was smarter than that. The fact that he will go on cheating? Funny; in char for him and kind of sad…All in all I was amused by him, by his interactions with House and the others and that made me like the episode. The very ideea that a short, chubby, bald mid 40ies guy is so incredibly atractive to women is funny enough – back in the days House was calling Taub “mini-stud” – apparantly he was right to do so :).The rest? Well… what to say. Our host pretty much said it all and frankly I do not know much about exotic parasites anyway. The technology looked cool but I seriously doubt it actually works that way – it kind of reminded me of “Locked in” where they show something real but twist it out of proportion. The final solution was a bit too convuluted IMO. I was thinking they will go to STDs in the end the moment they started working the “Dad” angle, but apperently I was wrong. As a matter of fact I only cought one screw up (and I was watching without translation so it is a lot!) was the 5cc of adrenalin (we call it adrenalin here in Bulgaria) it immediatly made me think of “Crank” :). Oh and since D-r Scot mentioned the dosage screw up I’ll mention something else – a persone who resives 5cc of adrenaline would have his newly repaired heart in a sea nod as soon as it starts – no way the heart rythm to be that slow it will go more like 3-4 times faster and probably rupture the repaired aortha. So much for the “Adrenaline” :)
March 16th, 2010 at 4:12 am
Hate to provide an anti-nit, but I got the idea that House sent the equipment over as soon as he first talked about it. IT was delivered why the other test was being run. (Which was probably still too fast, but otherwise would directly contradict the statement before that they would have to “get the equipment.”)
March 16th, 2010 at 4:53 am
Wow, what a bad episode… Chase and Thirteen were basically not in this episode, Foreman was unusually (and unnecessary) annoying, and Cuddy got marginalized. The biggest fail was that all 3 plots in the episode sucked badly… I mean, watching Wilson doing furniture shopping was like watching Desperate Housewives, Taubs personal life is uneventful and boring (I can’t get used to him, even after almost two seasons), and the Star Trek medicine… Well, no comment there.
I kinda feel sad they’d written out Jennifer Morrisons character out…
March 16th, 2010 at 5:01 am
AGAIN with the kidney failure already! Maybe they have a stock of donor kidneys out the back getting near their use-by date, and they want to get them out the door before the FDA does an inspection?
March 16th, 2010 at 5:07 am
What’s with Foremans’ anhedonia? There was no explanation what so ever. Building a bigger storyline perhaps? Why else bring it up and not give a reason for it? Foreman might naturally be a little unenthusiastic, but its usually not this bad.
Taubs’ thing was just marvelous. I really hope he’s actually having an affair like it was hinted at the end. All that happily ever after crap was just tiring.
March 16th, 2010 at 5:31 am
“Elicit,” man, “elicit.”
March 16th, 2010 at 5:57 am
Did no-one else think the hallucinations were light induced? (possibly caused by an aneurism or cancer in her brain pressing on parts that affect the control of her organs, or light induced seizures that cause hallucinations as well and damage the control areas of her brain? or was that in clear contrevention of how her organs were failing?0 (surprise surprise i’m not a doctor, i’m just guessing based on past house episodes)
I was really surprised none of the house team mentioned the fact that large amounts of light were present or her first 2 hallucinations. (unless i missed it), the planetarium, the lights in the full body scan. (and light could have possibly reflected off the ring into her eye? long shot i know, actually the 3rd hallucinations started before the guy got the ring out and it was quite dark.)
I was dead sure she was going to have another in the MRI at the end while house had his eureka moment (though i wasn’t sure how the father would be related to that, and if it was something that simple surely house would have picked up on it ages before)
and the “magical computer” annoyed me to, especially as a computer scientist, the way they set it up seemed to be that they were “invoking the black magic of computers!” Through a ritual involving the ever popular “random flashing images and wires hooked up to the brain” which in fairness had a vague reference to the type of “dark science” they were doing. (oh and i think they said they got it brought in from somewhere)
Not the first time computers have been over exaggerated in house… e.g. the dream machine in locked in, and i doubt the thinking “up”, “down” machine would work properly either. But then House does like to play fast and loose with the science.
March 16th, 2010 at 5:58 am
They kinda lost me with the Fringe/X-Files magic thought reading machine. The field of medicine seems interesting enough in itself, with all kinds of cool technologies. Why make stuff up?
The furniture hunt was more interesting than the medicine. I agree with House’s philosophy. Ever know anyone with a soulless all-white home? Creepy.
My spouse nearly swooned when House unveiled that Hammond B-3 organ. Sweet.
March 16th, 2010 at 7:26 am
In spite of the verb illicit, I wanted to say how grateful I am for Scott’s excellent summary this week. I was thinking, didn’t Foreman actually propose this cause and House said “Which of two ways do you want to be shot down? She hasn’t been exposed to Middle Eastern parasites, and secondly she tested negative for parasites.” Or something like that. It would be nice if the episode acknowledged somehow that House was wrong at that point, just to make it clear that we are allowed to remember the middle of the show when we get to the end.
The HIPPA stuff was bothersome. Traub is not the kind of guy to forget about it, is he?–surely plastic surgeons have to be extra aware of these laws. The final confrontation in front of the son and Abby’s mother was an example of House’s bullying but also it just didn’t make a lot of sense (for one thing, you’d expect Dad to avoid Abby, not hang over her at a time when she had less self-control than usual; for another, why would he blurt it all out in front of his son when he could have taken a doctor aside to explain the situation?). It would be nice if t he writers gave Laurie and the others some less Himalayan improbabilities to act.
March 16th, 2010 at 7:43 am
I agree that this episode was shoddy on all counts (I’m usually annoyed with how neatly the theme of the soap opera links in with the theme of the POTW, but this time I was annoyed by how much they didn’t connect).
Anyway, I wanted to give out two points extra credit to Foreman stridently pointing out that the brainscan-thingy was utterly absurd. It was as if whoever on the committee wrote his lines reads your site and knew we were paying attention.
Minor nitpicky detail, but there was a passing mention that the hyper-experimental brainscan thingy was beiing sent from somewhere else.
I heard the NPR article, too, and immediately thought, “Whoops! That’s gonna be on House!” Didn’t figure they’d work it in so soon…
March 16th, 2010 at 7:59 am
I can’t express how pissed I am at what the writer’s have done to Taub. Seriously, just bring in another gunman and kill him off.
House, the show and the character, has become more and more intolerable. The man doesn’t want to shop for furniture – there IS no deeper meaning. For some of us, furniture is just furniture. His terrier-like insistence on always getting his own way and being “right” is just annoying.
March 16th, 2010 at 9:57 am
House made reference to the ‘half plus seven’ rule for calculating the ‘optimal’ age of a man’s woman. I think it was during the confrontation with the father. I think the line ran something like “What do you do when half plus seven is still too old for you”
While I’ve seen the rule referenced in the news occasionally (most notably associated with the diet Dr. Tannhauser killing), I seem to remember it has it’s beginnings in some English novel.
Can anyone help with discovering it’s literary roots?
March 16th, 2010 at 10:17 am
This was a goofy episode – it felt like one of those ‘wouldn’t it be funny if’ episodes that tv shows put on to break up the usual routine. Except in this case it wasn’t humor, it was exploit some science concept unrealistically (something X-Files would do routinely.) Boo.
March 16th, 2010 at 10:46 am
I did like some of the camera work this episode, such as the cardiac emergency where the camera tracks ahead of the gurney as Taub and Thirteen push it. Cutting through walls to show succeeding scenes during “Whiter Shade of Pale” was good too. Even though the medicine sucks, I like it that they show the team together actually consulting more than heretofore. The subplots may be poor, but they don’t take over the show like they did the last 4 seasons. It wouldn’t trouble me if Taub and Thirteen simply vanished with no attempt at explanation. After all, they still haven’t made the opening credits. The only program I’ve ever seen which tried to show real medicine and real surgeries was a Fifties series called “Medic”. Anyone else remember it?
March 16th, 2010 at 10:50 am
You would think, as a *neurologist*, Foreman’s opinion of the brain scanning device would have carried some weight.
March 16th, 2010 at 11:13 am
Is C-13 pyruvate MRI being considered as a possible substitute for cardiac catheterization? I hope so. I had a horrible experience with the latter. First, the probe tore a flap of arterial wall loose which cut off circulation to my right leg. When they tried t stent it they couldn’t reach it through the right leg and had to go all the way up through the left leg. This gave me two hemhorrages which refused to clot due to the blood thinners they had put me on. I spent two sleepless nights flat on my back with sand bags on each hip joint, under orders not to change position or get up to urinate. Finally a duty physician came in and clamped each artery to the bed frame to stop the bleeding. I ended up with internal bleeding from my waist to my knees that stayed livid purple for weeks afterward.
March 16th, 2010 at 11:29 am
Correct me if i’m wrong, but wasn’t Thirteens comment on “The liver is the site of blood manufacturing” incorrect
That makes sense in so much as the major blood proteins are produced there (Albumin, Clotting Factors) but the role of blood manufacturing falls to the bone marrow and kidneys (Erythropoietin)
March 16th, 2010 at 12:04 pm
I can’t comment on the medicine since i’m not in the field, but I can comment on the soap opera. This week was just bad. I even deleted it from my DVR. The only scene worth rewatching was when House texted Taub’s wife and held the phone far over Taub’s head. It’s a shame I can’t watch that scene again. I’m very relieved that this was not the episode Laurie directed because the direction was the worst I’ve seen on House. (i’m not a director either so the fact that I even noticed the direction says a lot).
Again, not in the medical field, but as soon as i saw that imaging machine I called BS. It was cool to watch, but knowing that it just wasn’t based on fact made it really corny. Just a terrible episode all around. I know we’re moving toward a Huddy hookup but the entire episode focused on Taub’s penis–an image I do not want in my mind, ever.
March 16th, 2010 at 12:28 pm
I may not be a doctor, but from what I learnt in high school, the blood is made in the marrow of the larger bones.
March 16th, 2010 at 12:45 pm
Even as someone who’s not close to being a doctor, the request for “adrenaline” stood out. That’s something that other medical shows always get right, too.
March 16th, 2010 at 12:53 pm
I don’t think that the scene with Taub and the nurse is supposed to mean he’s having an affair with her. It’s just flirting, but it shows that no matter how much he wants to be in love with his wife he can’t change his nature. House is disappointed because it shows him that people can’t change who they are no matter how much they try to will otherwise. Considering who he thinks he is himself, a drug-addicted misanthrope, it is depressing for House to see this.
House starts off mocking Taub for trying to save his marriage, then jumps on board, then sees in Taub what he’s known all along: people can’t really change.
PS Taub’s wife is hot? In what universe?
March 16th, 2010 at 1:28 pm
Another quick question – If this “subconscious visualization” thing was as experimental as House said it was, why on earth does Princeton Plainsborough have a rather sizeable lab dedicated to it? At best, it would receive small dusty machine hidden in a old housekeeping closet, and not the amount of funding required to host a large wing.
Overall a disappointing episode, I was watching some of the prime years – 1 through 3, and last nights can not even compare in terms of quality.
March 16th, 2010 at 2:33 pm
I have this question nagging me-
Since the fluke affected brain it likely to be S.japanicum species and this is in advance state…how could house say the urine samples were normal? Wouldn’t they show lots of eggs?
Being a med student fresh out of my pre-clinicals and stepping into clinicals I ve got to thank you Dr.Scott for making sure I would never do this mistake.
Haematuria = Kidney Failure.. No!
March 16th, 2010 at 2:36 pm
Hey mr. medical reviewer,
considering the statistics and the huge number of house episodes, shouldn’t some patients with weaker bodies have already died already from all of these open heart and brain surgeries being done?
March 16th, 2010 at 2:37 pm
“Correct me if i’m wrong, but wasn’t Thirteens comment on “The liver is the site of blood manufacturing” incorrect”
Well, you’re not wrong that the statement would be incorrect, but I’m pretty sure that she didn’t say that. She said that the liver is a major site of protein manufacturing, and then elaborated on how that could create the problems with the other organs.
“not the amount of funding required to host a large wing.”
They were in the Cog Sci lab. Cognitive science is not limited to the futuristic brain scan.
Overall a remarkably disappointing episode. I fear that the writers are running out of ideas and are thisclose to killing one of my favorite shows.
Also, if they keep spacing these shows out with one or two episodes followed by a month of no new shows, I’m going to get pissy about it. What is the justification for not showing another new episode until April 12? That’s crap, man. Total crap.
March 16th, 2010 at 2:55 pm
@ Hibbleton -
Taub’s wife is attractive in the universe people who are attracted to attractive women live in.
March 16th, 2010 at 3:08 pm
It was almost as if Foreman was looking directly at the camera and saying “This plot device is stupid. There is no way Dr. Scott will allow us to get away with this.”
March 16th, 2010 at 3:25 pm
If they suspected schistosomiasis, particularly one causing an allergic reaction, they would have done a Schistosoma IgG assay. I know because have run that assay. That would have at least shown that she had come in contact with it and developed antibodies to it. I also like the points about the life cycle of the parasite.
March 16th, 2010 at 5:38 pm
I have to chime in with the people who found the “brain scan” unrealistic and stupid. It ruined this episode for me. They already did another very weak epsisode with fancy computer stuff (the one with the sick gamer), but this one was really, really bad. I hope that in the future, they concentrate on quality writing again to come up with a good plot, not on laughable CGI and pseudo-technology that belongs in the Twilight Zone..
The “soap” part was utterly boring and without much depth.
Btw, Taub drives a Porsche Carrera S and these cars don’t have a “spare tire”, there’s just a little kit with repair foam to save space and weight that allows you to get to the next dealership if you ever have a flat. I’m not making this up, I drive one myself.
This is just a minor detail, but it shows just how badly this episode was written. One could argue that Taub just made up some dumb excuse for his showing up late for work, but even then a smart guy like him would’ve been able to come up with something a little more realistic, don’t you think ?
March 16th, 2010 at 5:43 pm
To add a musical nitpick to all the medical ones, a Hammond organ doesn’t sound like that unless you’ve got it plugged into a rotating speaker cabinet about the size of a chest of drawers, which I couldn’t see in the room…
March 16th, 2010 at 6:39 pm
Joseph–House said “What do you do when half plus seven is still too old for you?” to Traub, though it didn’t seem terribly appropriate (more so for the food import guy, of course). I had never heard it but it is very googleable, with no source named. However,it reminded me of a similar bit of math in a Kingsley Amis novel, “Girl, 20,” in which a wife says, of her philandering husband’s new girlfriend, “I don’t know anything at all about her, but they’ve been running at about twenty to twenty-two over the last three years or so. Tending to go down. Getting younger at something like half the rate he gets older. When he’s seventy-three they’ll be ten.” The narrator, impressed by the math but not the logic, replies, “And when he’s eighty-three they’ll be five.”
March 16th, 2010 at 7:04 pm
lol @rainyrat and @Andy,
Those poor house writers can’t get anything right, can they?
@toni h, you’d think, but on house the doctors don’t make deathly mistakes unless they’re suffering from some deep emotional trauma at the the time, its almost a rule of the show, like the emergency just before each ad break
March 16th, 2010 at 7:12 pm
GoogleBooks’ consensus on the half-plus-seven formula is that it was French (or Muslim, or Plato): http://bit.ly/cDMf4c
(But I struck out with Stendhal’s “De l’amour”, the obvious first choice)
March 16th, 2010 at 7:25 pm
I thought no episode could ever be worse than the Season 4 one where the writers made up the guy’s condition (”mirror syndrome”). Now they made up the technology.
The only way to top this would be to have a patient contract a disease from aliens.
March 16th, 2010 at 7:26 pm
@ Alexandra: The truth about Scott is in the ‘about’ section at the top. I’m in the UK, but I imagine Family Practice translates as General Practitioner…
I’ve not left a comment, before, but I’ve been catching up on Fringe recently, and was struck by how reminiscent of it the opening scene – and the absurd mental image stuff – were of it. I think the House writing team admitted a long time ago that they’d rather sacrifice good medicine for drama, but it’s surely difficult for anyone to maitain the suspension of disbelief when the science is that absurd. I’m beginning to feel that watching House is more of a chore than a pleasure!
As this is my first post, a little thank you for all the interesting facts I learn from Scott is in order (I noticed the gaffe about the ‘failing kidneys’ from last week). This week, I think reading your comments was more entertaining than watching the episode.
March 16th, 2010 at 9:13 pm
Judy and Jorn,
Thanks for the replies on my 1/2+7 obsession :)
I had completely forgotten the google books search tool and thank you for the reminder of its existence.
The source had remembered was ‘Little Women’ probably garnered from reading Heinlein’s ‘The Number of the Beast’ in my younger days.
Memory is a slippery thing.
Thanks.
March 16th, 2010 at 9:20 pm
Ooops
Corrected:
The source I had remembered was ‘Little Women’ probably garnered from reading Heinlein’s ‘The Number of the Beast’ in my younger days.
March 16th, 2010 at 10:18 pm
Just a detail I would like to point out… it’s probably nothing, but at the beginning of the differential diagnosis, when 13 is discussing the file and her profile is shown, you can see a red spot in her neck, a little below and posterior to her right ear. She even puts her finger on it as if she was trying to hide it. When I saw this, I thought to myself, oh here we go again, that can be a clue to a possible sideplot of that being a Chase’s hickey on 13’s neck that House could have spotted. But definitely my inagination went way too far from this single and quick observation which was probably a make-up failure…but funny to think of that being a possible side-plot :)
March 16th, 2010 at 10:55 pm
Pretty long fellowship for Foreman…. going on 6 years…wow thats rough. I don’t know many healthcare professional that could take that.
March 17th, 2010 at 1:47 am
Well, the machine from “Until the End of the World” made for some interesting special effects – but considering the first episode of the season had Ramachandran’s “Mirror Box” which is not only cool but actually *exists* – I don’t see why the House writers can’t take actual cutting-edge medical research instead of complete bullocks.
March 17th, 2010 at 2:06 am
It has been established on a multiple occasion, that Foreman doesn’t really have a choice. He has pretty much burned the bridges all around him. He couldn’t even get a recommendation from Cuddy the last time he was fired.
March 17th, 2010 at 2:50 am
I asked this the last time Marfan Syndrome came up in an episode and never got an answer: Aren’t there physical characteristics to Marfan that would be obvious even to a layman?
March 17th, 2010 at 7:55 am
Official Comment
Usually, but not always. There are times the signs can be subtle and missed. I have at least one patient who is Marfan’s, but you’d never guess. He is slightly,/em> taller than average — but that’s it. He was diagnosed purely by lucky coincidence.
March 17th, 2010 at 8:16 am
Re half plus seven–the only French source on Google books that mentions this proverb claims it is Chinese (La lumière des mots : quand les proverbes nous éclairent, By Paulin Duchesne, 2003).
Looking at the wonderful list of citations in English that Jorn found, it seems as though the main point of this proverb is that it comes from another culture–French, Oriental, etc.
The Heinlein ref. to Little Women is surely way off base–perhaps a joke?
March 17th, 2010 at 9:06 am
Hi Scott, great review.
Just a bit of nitpicking: Schistosoma are not “liver flukes” although they do live/lay eggs in the enteric circulation.
Sloppy medicine this episode culminating in that terrible subconscious imaging thing they did, and the crux of the problem was only a small variation on the cheating wife that got Trypanosomiasis from sex many seasons ago. I guess they had to run out of ideas sometime.
March 17th, 2010 at 11:01 am
I’m confused on the schistosomiasis. In the online descriptions, I don’t see anything saying that it is sexually transmitted, though that’s what House told the father.
This was a terrible episode, maybe the worst in the entire series, from just about every angle. Unfunny, unimaginative, not even well acted. The whole furniture riff was dumb and I don’t see Wilson giving in to House’s uncharacteristically unsubtle order for him to buy a piece of furniture. The Taub scenario was equally unconvincing–somehow a ring is going to make this woman think he doesn’t cheat? and at the very moment when he is in despair over the possibility of losing his wife, he’s flirting with another woman? you’d expect him to take a week off–and the brain image science fiction was beyond lame. The mom finds out this older man had sex with her daughter–and is the cause of her nearly dying–and she just stands there?
The one nice moment–Cuddy’s hair was looking particularly good, don’t you think?
Ouch.
March 17th, 2010 at 11:12 am
Official Comment
I don’t believe Schistosomiasis can be sexually transmitted. I don’t think it can be directly transmitted from person-to-person at all. It requires fresh water and an intermediate host to make it infectious.
March 17th, 2010 at 11:39 am
I can’t believe they took up so much of the episode with the fanciful dream-TV when it didn’t even produce results!
This isn’t the first time House has used “unorthodox” treatments and created results, but the result here was such medically irrelevant schlock.
I suppose it is more realistic in a way – experimental treatments can never guarantee anything.
Although it was almost worth it to see Wilson in the giant Cheerio chair :D
March 17th, 2010 at 1:20 pm
The only House-like moment for me in this whole episode was when House unveiled the organ. It was a nice moment between House and Wilson. The rest of the episode was just bad. If there’s a House canon it should be wiped from it.
The acting seemed very rote in this one esp. Foreman. Since it’s the same actors as before, I’ll blame the director. The story itself went past implausible and into impossible even for House. The show looked rushed like everyone wanted to be somewhere else. Something very basic is not right for them to put out a show of this low quality.
March 17th, 2010 at 2:13 pm
And to top things off, we have at least 2-3 MORE weeks before the next new episode airs….
‘Cmon Fox, you can’t blame the Olympics for delaying things this time….
March 17th, 2010 at 8:17 pm
Being a gut microbiologist, I was rather intrigued by the reference to fastidious enteric bacteria. Most bacteria are fastidious (great plate count anomaly). Therefore most intestinal bacteria are fastidious. However, looking through the link to the review of bacteria causing endocarditis (thank you Scott) — Most endocarditis causing bacteria are not intestinal and those that are, are either not fastidious (such as Salmonella) or would involve some major underlying cause (such as the patient being immune-compromised or having an underlying genetic disease). So why on earth did the team come up with fastidious enteric bacteria? Fastidious oral bacteria would have been better.
I kind of liked the furniture hunt. I do think that furniture, books and possessions can tell you about someone. Speaking of the white house — My best friend in vet school did like white. Her house was white, she had white uncomfortable dining room chairs. She did have a wonderful white leather lounger, but because it was white, you couldn’t put your feet up on it (kind of defeats the purpose). To top it off she had fake (plastid and silk) houseplants (because she had a brown thumb, but liked plants). I was generally uncomfortable when I was over at her house. But she insisted that she liked white.
March 17th, 2010 at 9:27 pm
You won’t believe this, but the actress who plays Mrs. (Rachel) Taub is Billy Crystal’s daughter Jennifer. And she’s 37.
Man, if that doesn’t make you feel old, nothing will.
March 17th, 2010 at 9:56 pm
lol at the semen allergy test. That’s what I call a prick test.
March 17th, 2010 at 10:30 pm
I couldn’t believe who “Taub” was dining with in the movie “As Good As It Gets”.
March 17th, 2010 at 11:36 pm
“us, in the medical profession in the United States we call it “epinephrine,” half the OR staff wouldn’t know what you wanted if you asked for “adrenalin.””
so half of the Or stuff should be fired, if they don’t know, what “adrenalin” means.
March 17th, 2010 at 11:44 pm
The writers didn’t run out of ideas, they tried one last one: shrooms. I mean from the mental image tech to the way the patient was spacing out over outer space. I can see why Foreman was unimpressed, he knew it was all fake. Sadly this ep seemed like it came from someone who was high on something. There’s a whole medical dictionary they can use to drive episodes for years if they looked hard enough.
BTW the best part of the ep was how the intro was tied and house hittin on Taub’s wife.
March 17th, 2010 at 11:46 pm
Quick question to Scott: I doubt it is but is it possible to open up someone’s heart in less than a min and can a doctor do what thirteen did to a heart to start it pumping again?
March 18th, 2010 at 4:35 pm
well, some forms of shisto live in the bladder (and turn the urine bright red) I guess some of the parasites could possibly be flushed out during ejaculation if they were already in the urethra. but I don’t know if they would do anything once in the partner’s body.
March 18th, 2010 at 5:26 pm
I know that many people have already wrote it here, but this kind of “direct perception imaging” was a great dissapointment for me. I did not expect such nonsence from House.
Inaccessibility of our perceptions to anyone else and isolation of the sence of “qualia” within one’s mind is the hardest problem in philosophy of mind. I try to be in the picture of news in this field, and I’m sure that if only a slightest hint on such technology is known, there will be so much sensation about it, that…
Well, I mean House is considered to be a serious medical and “scientific” show by some people. This episode can convince them of existence of such technology. Writers should maintain reputatation of the show, don’t they?
March 18th, 2010 at 7:33 pm
Hello, during the cardiac arrest, is the cardiac massage enough to reboot the rhythm, or it was the combination of the massage and the five cc epinefrin?
Interesting, they spent all the first season saying the commercial name of lorazepan and in this episode, Foreman does actually say lorazepan.
March 19th, 2010 at 12:55 am
@bobby: I was thinking the same thing. I don’t necessarily expect nurses (or, for that matter, physicians) to know as much chemistry as I do, but I am kind of surprised to find that they don’t know at least as much chemistry as I did IN HIGH SCHOOL (and, yes, I went to a public school in the US).
I generally like Taub… in fact, he’s probably my favorite of the current crop… but I’m not really that interested in his relationship with his incredibly shallow wife, and that confrontation with the father at the end was ridiculous. Forget all about HIPAA for the moment; if you’re really concerned with getting someone to tell the truth, you don’t put them in a position where they’ve got a GREAT incentive to lie, you get them in private and say “Look, just tell me, and nobody else ever needs to know about this.”
March 19th, 2010 at 8:29 am
[quote]If the offending parasite’s body was so small it didn’t show up on a scan, how did they know where to operate to remove it?[/quote]
I asked myself that when i saw them operating the girl.
About the soap, Wilson giving House the church organ was an excellent bit, and both their reaction, also great.
Heishiro
March 19th, 2010 at 8:49 am
@Bob, et al re father’s confession. Having a third party at such dénouements is fairly typical in the visual arts. They serve as a proxy for the audience. Their reactions, shock; surprise; anger; etc, are meant to mimic our reactions. However, I agree that it was a little ham-handed here. I think that choosing another doctor, esp. Cuddy, would have been more plausible.
I’m thinking back to how many times Cameron ably filled that role.
March 19th, 2010 at 11:42 am
When I heard “read your dreams”, I thought it’d be a machine that spent weeks mapping your brain through pattern recognition, then it would be able to possibly give you ‘categories’ of what was scene in the brain.
So if she thought of her boyfriend playing baseball, maybe ‘excitement’ and ‘love’ would bubble up as possibilities, not on the fly rendering of 3d images. After only 6 hours?
I’m no MD, but I am a computer engineer. The requirements of such a program would require a room of very powerful machine to do that much… and only 6 hours to map the brain? AI (which is generally pattern recognition) was a specialty of mine in college. A sample set of 6 hours isn’t going to fly. Maybe attach her to the machine for 6 hours a day for a month and we may have something…
March 20th, 2010 at 7:09 pm
“half the OR staff wouldn’t know what you wanted if you asked for “adrenalin.””
…what?! I’m 23 years old and from Sweden. I have absolutely no medical training (in fact, I didn’t even finish college), and even I know this. I hope I don’t get sick if I ever visit the US…
March 20th, 2010 at 7:39 pm
I noticed that most recent episodes I’ve watched this season, House solved the case by some a-ha House moment where daily conversation sets off a sudden realization.
Scott should mark down the Medical Mystery ratings on the count of writers relying heavily on deux ex machina !
March 21st, 2010 at 1:52 am
Hey,
I wanted to comment about the seemingly lack of Chase/13 drama this week:
Nobody Is Sure About 13/Chase
Ok, there was a maybe moment last week where you are wondering if Chase and 13 might might be more than friends…and I can’t see why people think this is a bad thing. Both characters had rebounds, have dated someone in the office already, and have known each other a while. So will it happen? Nobody can be sure.
Critical Detail
I want to redirect your attention to one detail in the prior episode many people missed. 13 mentioned her bf was 30 and she realized he was a tool. Does anyone remember how vital this is? 13 shares NOTHING. Not her diagnosis, her mother, not even the fact that she used an inhaler. She willing shared something with Chase. A sign she likes Chase, she is starting to open up, this means SOMETHING. I’m just not sure what.
March 21st, 2010 at 2:13 am
Also, I hope the doctors do get sued. I like them as people, but they keep up illegal activity:
1) Taub violating HIPPA
2) Foreman and 13 drug patients without consent
3) House and Chase give a placebo and advises them that its legitimate medicine
4) Chase re-attaches the whole thumb of a patient when it was made explicitly clear to him not to do it
March 21st, 2010 at 8:03 am
“High dose” protocol for adrenalin is used by some EMT-P I know (they usually use 3mg, but I think there are even some places that use more).
March 21st, 2010 at 8:41 am
David:
“House solved the case by some a-ha House moment where daily conversation sets off a sudden realization.”
Too true; this has been irritating me, too. The worst was probably last week’s “Crap…”
March 21st, 2010 at 12:37 pm
I’m going to defend the “a ha” moments because I’ve had so many of them lately. They taught me in a class about creativity to do tasks like bounce the balls, consider bad ideas, and a whole lot of other seeming non-sense. And I can tell you, it has worked. I’ve had people talk to me, they throw in something seemingly unrelated, and voila…a bad idea comes to mind, and with minimal tweaking, I make it workable, and with slightly more consideration, a good idea is made.
Now I can’t testify to medicine, but I’m sure there is some applicability. It isn’t as unrealistic as people give it credit for…
March 21st, 2010 at 12:46 pm
Luke,
(sorry for all the comments)
The writers actually did not make up “mirror syndrome.” There was a case in Italy if memory serves me correctly. However, I believe that case was the first of its kind and it has not been seen before.
March 21st, 2010 at 5:18 pm
Well, I was super-disappointed this week! No shocking a flat line, and no liver failure (which of course ALWAYS presents itself as a large, painful looking bruise on the torso. In the liver-ish area of the torso.).
March 21st, 2010 at 6:08 pm
I always love Scott’s reviews, but reading all the reactions is great too, because having just watched a so-so episode, reading all the ‘worst episode ever’ and ‘script writers have run out of ideas’ comments always puts the actual episode in a better light for me.
I liked House searching for inspiration by lying on the patient’s full body scan.
I loved the ‘organ moment’ – but knew exactly what House was going to play. (Is that good or bad?)
Loved the facials – Chase giving Taub away, the flicker of Foreman’s faux Eureka moment, prompting the best line, ‘Don’t polish the notion, Foreman …’ – for once not ironic, but House genuinely appealing for inspiration. Then House’s faux Eureka, in this case misleading the audience, because ‘I got nothing. Ironic now, because Foreman does have the solution, but House shoots him down. 13’s role – to connect thoughtfully with the ‘smart girl’, wondering how House detects intellect in a photograph, to the extent that she saves her via direct cardiac massage. I found it oddly moving. And, of course, it seems as if Taub is a far better liar than he’s been given credit for.
I’m flummoxed that people thought the episode was badly acted, because so much of it was about this attention to expression and body language and couldn’t be communicated if it had been badly done. Therefore the cognitive imagery thread was relevant, in my opinion. And we knew the solution was the Black Hole of an unspeakable secret – either daddy or boyfriend’s daddy. Can I possibly have recognised the culprit from the pretty pictures? At any rate, I thought he was the figure shown.
I must be alone at being OK with the freaky technology. Obviously it was exaggerated (as so much is), but I can fully credit that one day this will be possible, if not in the condensed timeframe suggested, and there have been much less credible ‘highly experimental’ solutions on House. If I remember correctly, they usually fail. (The one that worked – the locked-in guy moving a curser up and down by ‘thinking up and down’ – is not sci-fi at all.)
So thanks, guys, for helping me remember everything I liked about this episode and why l’ll be tuning in to the next one.
March 22nd, 2010 at 4:03 am
After reading about 20 pages of gibberish about flatworm, I have a theory, that could actually make sence for the human to human transmission that House suggests. Just stick with me for the long shots guys and we’ll get there eventually:
1. The father gets infected the old regular way; he carries the parasites inside his body for a couple of years wihtout noticing (possible – some forms of this infection are so subtle that you can live without noticing the symptoms)
2. The parasite after going trought his entire body, as once House playfully described it: “Living, breeding, having parties” goes trought his usuale life cycle, lays eggs and they develope normally turning into “wormlings” excreting the normal way and possibly infecting sewage watters and going throught the usual life cycle of a worm. However the eggs (not the little wormlings) are able to breach blood vessels and get logged into intestinal walls, return to the liver, move throught the body and get pretty much everywhere including the bladder and the urinary tracts. They are not infectuous per say but are viable and can produce a severe imunological responce (acute alergie!) just like the one we saw in the POW.
3. Here’s the plot twist – let us say eggs got into the bladder from there into the semen (inverse orgasmes can cause the “shooting” to go backwards and into the bladder so my guess here is that that happened and the eggs mixed with the… stuff. It is a long shot but (may be) possible.
4. From there the eggs landed into the muscosa – vaginal or may be oral? (what kind of sex – did they say? My bet is here:) Sure it is another long shot but still possible) If there are ulcerations in the mucosa may be the eggs went into the bloodstream and than travelled to the brain (the usual way from the, well… lower body parts :) to the brain is long and more improbable but still possible while an oral “infection” bypasses the liver-heart-lungs route and can travel straight to the brain throught the facial veins) so that as I said is my bet here :). Form the brain blood vessels the eggs could penetrate becides the blood-brain barriere and finally land where House placed them.
So couple of long shots and we are there – the explanation by House makes sence. He said thet the eggs died but the “shells” provoked the alergic reaction. That while still another long shot is also possible :) Whether the alergic reaction described can do all the damage that it did well that is another question :). I am upgrading the explanation grade to a C+ and may be D-r Scott will be kind enough to say if my “theory” actually makes some sence :). On a different note – blast those guys at FOX for delaying us for a whole month without our favorite fix. Blast them!!!
March 22nd, 2010 at 10:30 am
As a long time House watcher, I don’t think that the acting was bad in the sense that these people can’t act. I think it was bad in the sense that it was done in a very formulaic manner. I saw nothing of the usual complexity in Foreman’s role, esp. However, maybe I’ll feel differently watching it the second time around. I’ll look past the dialogue and key on their physical expressions (I’m not being sarcastic).
As for House’s faux eureka moment, I thought it was the writers’ way of saying we got nothing so we’ll just wink at the audience.
March 22nd, 2010 at 1:08 pm
OK, let’s get one thing straight: Taub’s wife is not hot on ANY planet in ANY universe in ANY dimension, except to dweebies who live in their Mom’s basement. I don’t care if her Daddy is Billy Crystal (who isn’t hot, either, even if he IS the funniest man on any planet in any universe.) She looks 52-years-old (and she’s still in her mid-30’s.) How bad will she look when she’s really 52?
I’m giving up on this show for a third time. It would be so easy to get all these things right. It’s clear they don’t care at all.
March 22nd, 2010 at 2:02 pm
[...] le allucinazioni e le imbarazzanti confessioni a parenti ed astanti. La soluzione è semplice (ma poco verosimile) e la strada per raggiungerla passa come al solito attraverso segreti e bugie: si tratta di un [...]
March 22nd, 2010 at 2:49 pm
@kayper54
Sure, but if Taub’s wife were hot, his philandering wouldn’t make sense. She has to be a plain Jane to fit the role. I imagine he married her before he became a very successful plastic surgeon. As a poor medical school student, he probably thought he did okay. But after he started making the big dough . . . In any case, now that he’s back to making beans as part of House’s staff, he should be careful.
March 24th, 2010 at 5:50 am
I only had an issue with the part of the review here:
“Plus, in the medical profession in the United States we call it “epinephrine,” half the OR staff wouldn’t know what you wanted if you asked for “adrenalin.””
Seriously if American doctors and nurses do not know what most of the world calls epinephrine (as it is really the hormone adrenaline from the adrenal gland, and only called epinephrine *USAN and INN regulation* due to a copy-rite issue on a drug in the USA spelled differently but similarly pronounced) they should not pass through medical school.
Come one. I am certain any OR or ER personnel would know the hormone excreted from the adrenal gland and received by adrenergic receptors.
Cheers.
March 24th, 2010 at 9:07 am
Official Comment
The use of epinephrine vs adrenalin goes a lot deeper than a mere copyright issue. It is the term the last generation (at least) of doctors and nurses uses and understands exclusively. In four years of medical school, the term adrenalin was mentioned off-hand twice, and the term epinephrine was used the rest of the time. A quick (and non-scientific) survey of my co-workers (doctors/nurses/MAs) show similar results: epinephrine was the term of choice (and norepinephrine as well).
Think of it the same way as paracetamol. You could walk into any hospital in the US and order paracetamol (and I guarantee every hospital would carry it), but few if any would know what you were talking about. The term is simply not used in the US, and would not even be recognized as a medicine by most of the hospital personnel.
March 24th, 2010 at 12:03 pm
I guess I don’t understand your rating system. I’d give the medicine a very large and very red “F” for employing current methods in very bad science fiction rather than actual biological or medical fact or even conjecture. Come to think of it, more bad fantasy than even bad sci-fi, considering that, as you stated yourself, direct human to human transmission does not occur and also, because completely non-symptomatic disease up to a point of lethality does not occur, nor does the sort of spontaneous clearing ont he parasite with then hypersentsitivity reaction as described. Further, given hypersensitivity reactions (which do occurm but not at all as described) surgery is NOT the method of treatment. There was nothing whatsoever in the episode that corresponds to reality.
March 25th, 2010 at 12:40 am
Splitting hairs here, but HIPAA stands for “Health INSURANCE Portability and Accountability Act.” :)
I knew as I was watching this episode that the medicine would get shredded haha. I knew it was too psychedelic to be true.
However, I thought the space sequences were INCREDIBLE; it made me miss the season 1 “inside the body” CG sequences. Hope to see more of those in the future.
The “read thoughts” technology sounded pretty stellar but I think it would be on par with being able to video someone’s dreams…how to transfer chemical reactions in someone’s brain to make it visible to other people?
I’m a lifelong (since the first episode) House fan and I am still happy with it in general :)
March 25th, 2010 at 12:40 am
also, I was SO GLAD to see Hugh play A Whiter Shade of Pale!!!! When he sat down I thought “ohhh please play!! A Whiter Shade of Pale would be awesome” and he did!! :D
March 25th, 2010 at 8:14 am
what a bad episode!
March 25th, 2010 at 8:17 am
Do they leave Patients with a bare hyperemic wounds after heart surgery????? Bare sternotomy wound???????? Don’t cardiac surgeons use Dressing over their wounds after slicing people’s chest open??? C’mon!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
March 25th, 2010 at 1:22 pm
Taub is a humorless sanctimonious dullard. I really don’t see how he could attract a woman.
March 25th, 2010 at 7:43 pm
@G
For every pot there’s a lid.
March 27th, 2010 at 12:24 pm
I have suffered two aortic dissections and after almost three years we are still working to determine whether Marfan (or Ehlers Danlos) is involved. The almost immediate conclusion that the patient is not marfanoid I found very disappointing. What symptoms justify a diagnosis of marfan apart from clear genetic evidence is still rather controversial and surely not decided in a mere glance. A lot of different factors are to be considered.
March 27th, 2010 at 8:55 pm
Scott –
a) I’m also curious what your specialty is.
b) You were way too easy on the mind-scanner McGuffin. It had nothing to do with reality at all, and isn’t even plausible as future tech. Thoughts aren’t nearly that coherent.
March 30th, 2010 at 8:13 am
For me this was one of the worst episodes ever. Whty they even brought Taub back is beyond me, and WHY he and Thirteen are performing open heart surgery is another mystery. Where was Chase, the real surgeon? Where, for that matter, was the real heart surgeon or ER doc who I could believe knew how to do open heart massage?
I thought the mind scanner was cool, though. My husband, an engineer, found it implausible that Foreman, the neurologist, was unimpressed. “If that were real, he should be pissing his pants with excitement.” Of course, the writers did make a very clumsy, obvious point there, that Foreman is so jaded and bitter that even if an elf riding a unicorn pranced in front of him he’d be skeptical and depressed.
Taub is just gross. Sleazy and boring. Somebody fire him for HIPPA violations, or for perhaps just being a nurse-flirting joke of a doctor.
March 30th, 2010 at 9:27 am
The possibility of the brain scan picking up images of what the person is thinking is not as “Fringey” as the author and the commenters seem to think. This Nature article
http://www.nature.com/nature/journal/v452/n7185/full/nature06713.html
is more representative of what they were trying to do in the episode than the NPR piece cited. Granted the technology is not there yet, but it is getting closer to reality than residing in the realm of science-fiction.
March 30th, 2010 at 1:37 pm
Anyone know when the next new episodes airs?? {yawn}
March 31st, 2010 at 1:17 pm
u said,
The differential diagnosis now consists of neuropathy (by which they mean syphilis, which can lead to a weakened aorta)
this is not possible logically bcoz, it takes atleast ten years from introduction infection of treponema (organism causing syphilis, ie primary syphilis) to turn into tertiary syphilis.
since the characters age is 17, he should have got infection at 7.. and syphilis is a sexually transmitted disease (except for health care workers)
even in third world countries cardiovascular syphilis is rare with the advent of penicillin.
March 31st, 2010 at 4:30 pm
on the house-homepage it says the next “all-new”-episode will be aired on 12th April
http://www.fox.com/house/index.htm#home
looking at Fox-Homepage, there was a show this monday ..
http://www.fox.com/schedule.htm#showtype:drama~week:2010-03-28
but this one sounds familiar …, looks like they do some reruns of old shows …
wow.. cool-thing this “internet”
*_*
April 2nd, 2010 at 12:33 am
Are there any parasites that can be sexually transmitted?
April 2nd, 2010 at 4:01 am
Scott, have you heard of Miami Medical, just saw this piece about it on BoingBoing, wondered if you’ll be watching?
http://www.boingboing.net/2010/04/01/miami-medical-new-cb.html
April 2nd, 2010 at 7:48 am
Official Comment
Alison,
Yes. Trichomonas is a very common one.
Ross,
I plan on watching the first episode and then I’ll decide if it deserves further viewing.
April 4th, 2010 at 8:21 pm
The brain scan was out there. Would have been awesome to see on Fringe, but it was insane on House. Although I think such things will be eventually be possible (and we have actually seen “pictures” in the minds of apes IIRC) it would be nowhere near that easy or that fast. We can just barely get a computer cursor to be controlled by a paralyzed persons brain, and that requires cutting their head open and inserting an implant.
I did like the reaction to Foreman’s nonreaction though, and I liked the Taub storyline. Taub is an interesting character because he’s not like the others. He isn’t young and sexy, he really has a pretty normal life, and seeing the drama in it is interesting.
April 7th, 2010 at 12:33 am
i lost my marbles around the time they started doing the whole brain scan jiznit…
it was just ridiculous! …overall such a bad episode… i was quite disappointed.
also, the taub part at the end was coming from the moment the ep opened with taub and his wife in an argument. i was still disappointed in him anyway. but house texting taub’s wife was quite entertaining.
a bit of comedy with the foreman being a party pooper thing…so that kind of made the terrible mind scan/brain thought thing better.
but wilson storyline was …contrived. the wilson in a porno storyline was MUCH better, and funnier.
April 13th, 2010 at 1:34 am
Hmmm, the brain scan thing reminds me of an old movie, “Strange Days.” It was a pre-Y2K movie that supposed that by 1999 we’d have portable and concealable brain scan devices, intended for undercover work to play back the person’s entire experience, directly into someone else’s brain. But inevitably they made it to the black market where they were used for entertainment purposes. An interesting movie and murder/coverup mystery, and definitely strange :)
April 17th, 2010 at 5:14 pm
“I know I often complain about the unrealistic time course of tests on the show, but this week’s deserves a special mention: fungal cultures are very slow growing — weeks, not days — so there’s no way they’d be negative so soon.
allTo my knowledge, there are no blood cultures for parasites. They are generally detected by O&P (ova and parasite) studies of the stool and blood smears.” -Scott
You are correct on the fungal cultures, we are lucky to have any sign of anything significant growing out within 2 weeks, and at my institution we hold all fungal cultures for 8 weeks.
And you are also correct on there being no “blood culture” for parasites, blood born parasites, such as Babesia and Ehrlichia which are endemic in my area, are detected on a peripheral smear. O&P studies are the only sure-fire way you are going to get a definitive parasitic ID from the laboratory. And again, the granulomatose response would have surely been picked up on a scan for this particular parasite, likely before the O&P study is complete and resulted.
I enjoy this show a lot and am a die-hard fan, but lately they need to work on their laboratory facts so I don’t become distracted by the inaccuracy.
April 18th, 2010 at 3:00 am
Based off some general knowledge, technically the black hole scene was scientifically incorrect (I think). Black holes are so powerful that not even light can escape. So the black hole should have been, well. Black, non-visible.
April 19th, 2010 at 5:47 pm
I think it’s possible that matter (which has a default speed of 0) would move toward a black hole faster than light (which has a default speed of about 3 hundred thousand meters per second outwards) did, so someone actually falling into a black hole might overtake light and see something.
April 20th, 2010 at 5:48 pm
An astronomer here, from far away… never thought I could contribute anything to a House review, but here I am. The vision of the black hole was actually reasonably accurate comparing what that which is actually known, surely they had some help from scientific designers…
Black holes are indeed black (no light escapes from them) but are surrounded by large swirls of matter that spirals down into them. In the falling, matter gets heated and radiates huge amounts of energy (visible, X rays, …). There are also jets that escape perpendicularly to the swirl plane. Just like there were in the hallucination.
Come on, she was going to do Physics in Stanford, she should certainly know how to hallucinate a decent black hole!! :)
Love your reviews–thanks a lot!
April 20th, 2010 at 5:51 pm
Me again… just read the almost simultaneous comment from Caustic Guy… sorry, that does not make much sense. First, you left a x1000 factor out in the speed of light, and second you could never overtake light, no matter when or where. Neither whether you are moving outwards or inwards.
Unless we are willing to skip all known physics of course. Perhaps there should be another grade for Physics in House MD episodes!
April 20th, 2010 at 11:11 pm
The Scarsdale Diet Doc’s name was Herman Tarnower. He was an atrocious person.
The brain scanner is crap, pure crap. I went right to Google during the show to check on “”cognitive pattern recognition. ” The work that’s being done is in extremely early stages. Holographic projection of thoughts is too Star Trek for words. What are the writers thinking??
April 27th, 2010 at 3:56 pm
Regarding Adrenaline/Epinephrine, Paracetamol/Acetaminophen – here in the UK we generally use adrenaline/noradrenaline and in my opinion that’s a good call since it’s from the adrenal, is the ligand for adrenergic GPCRs etc. However, we seem to be encouraged more and more to use epinephrine interchangeably with it and our adrenaline autoinjectors for anaphylaxis are universally called “EpiPens”. For paracetamol/acetaminophen – they’re both good approximations of the non-IUPAC name for the compound.
It seems to me lay-people in America are far more familiar with brand names for drugs anyway, most people seem to recognize it as “Tylenol” – whereas in the UK we’ll usually suggest taking a “paracetamol” in almost every context.
Also for the medically enlightened amongst you currently working in the US – do you find a similar thing in your hospitals? Something like Lasix we would generally refer to by its name furosemide, and plavix by clopidogrel and so on. Is that a private healthcare thing – the drug guys over there drum their product name into you more so than over here?
Of course prescribing the Generic vs a Brand Name isn’t always equivalent. Still, i’m interested to read more people’s experiences on it.
Oh and to caustic guy – where were you taught that matter, with any mass whatsoever, could overtake the speed of light? That’s horrifying.
May 4th, 2010 at 4:46 am
Re: epinephrine vs. adrenaline
Scott, I agree with you that “adrenaline” was probably used years ago. I’m not a doctor (my dad is), but I remember on the episodes of M*A*S*H, they would use the term “adrenaline” as a type of shot most of the time.
That show was on mostly in the 70’s, and it was supposed to be realistic back to the Korean war from the 50’s…
Other than the obvious for getting adrenaline into a stopped heart, what other common reasons would you want to make someone’s heart race/beat faster by using epinephrine?
Love the site and all the analysis, thanks!
-Bryan
June 9th, 2010 at 6:43 am
Watching this episode I was worried for a moment that I would have to eat humble pie…
A friend recently told me that it was now possible to image dreams. I have a postgrad degree in neuroimaging, and I told him that probably what he’s heard about is fMRI studies that can tell the difference between stimuli, but don’t actually image thoughts.
And then I watched this episode…
The funny thing about it is how it is described as oldskool in the episode. Imaging people’s thoughts is *so* last year…
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