House — Episode 20 (Season 6): “Baggage”
Though the medicine was sloppy and at time contradictory, I liked this episode of House. The way it was staged was clever, and it was nice to see Alvie again — though a little goes a long way as far as he is concerned.
This episode starts with House arriving at the office of his psychiatrist Dr. Nolan for his weekly session. Nolan can clearly tell that something is bothering House, but that he is reluctant to share it. Instead, Nolan has House tell him about his week, and House relates the tale of the amnesic patient. Alvie, House’s manic room mate from his stay in the mental hospital, also makes a return in this episode.
A young woman is brought to the ER with a complete loss of memory. She was found jogging down the middle of the street with no idea who she was. An MRI was obtained but was normal. The patient had no ID, just her heart rate monitor and clothes — expensive clothes, House mentions. He also deduces that she is an ultramarathoner from her general physique and metabolism.
House takes a closer look at the MRI and notes a region of that shows some “loss of differentiation between the grey and white matter” (grey and white matter are the two types of brain tissue). Chase points out that the area of the brain affected is the part that controls memory, so he doesn’t think it’s a coincidence. The differential diagnosis consists of bacterial infection, multiple sclerosis, a history of head trauma, or toxin exposure. House thinks that he can track down where she bought her heart rate monitor by its serial number. It’s possible someone will recognize her at the running store, or he figures that the store is likely to be close to where she lives, and the view might spark some memory. While no one at the running store recognizes her, it turns out that she’s a regular customer at the donut store across the street. Through them, House is able to track down the patient’s house and husband — none of which is recognizable to her. It turns out that her name is Sidney and she’s a high powered civil rights lawyer who spends almost all her spare time running. Her husband mentions that she recently won a settlement for some individuals who had been exposed to high levels of methane, and House thinks methane exposure might account for her symptoms. He takes her back to the hospital, but she trips in the yard, reporting that her foot has gone numb. She also loses bladder control. House suspects that she has developed partial complex seizures.
Back at the hospital, Sidney’s been under observation for twelve hours with no sign of any seizures. House tells the team to stress her more in an attempt to bring out any seizures, but his team tells him that she’s already under a great deal of stress from fighting with her husband. She suddenly becomes acutely short of breath and starts struggling for air. She is found to have pulmonary edema (fluid in her lungs) that appears to be related to diabetes insipidus (A condition where the kidneys cannot retain fluid correctly. This is a different from diabetes mellitus, or “sugar diabetes,” what most people think of when they hear “diabetes”). The diabetes insipidus is felt to be related to damage to her hypothalamus, making three separate areas of her brain affected. Taking in all the symptoms, House diagnoses the patient with spongiform encephalitis (more commonly called “spongiform encephalopathy.” It’s a rare type of infectious brain disease — the best known are Creutzfeldt-Jakob disease (CJD) and bovine spongiform encephalopathy (BSE), i.e “mad cow disease”).
House wants to perform brain surgery to remove the damaged tissue. Sidney is for it, but her husband is against it. The husband threatens a lawsuit to block the surgery. As the argument rages, House looks at the vitals sign monitor and tells them that it’s too late. The extreme variation in heart rate means that the spongiform encephalopathy has invaded her brainstem and now it’s too late for surgery. All that remains is to implant a pacemaker to control her heart rate, and then give her radiation and chemotherapy in an attempt to buy her a few more weeks of life. A short time later, Taub arrives to tell House that when they implanted the pacemaker, they saw signs of a rapidly progressive cardiomyopathy — which doesn’t fit with the spongiform encephalopathy diagnosis. The team continues to have trouble stabilizing her heart and she experiences fast heart rates and low blood pressure. Endocarditis (a type of infection of the heart) is suggested as a diagnosis, though House favors tuberculosis. Both of these possible diagnoses hinge on the fact that her immune system has been suppressed by her extreme exercise habits. He orders her started on a tuberculosis drug regimen.
Sidney continues to deteriorate. Her oxygen saturation is dropping and her pulmonary edema has returned. The team rushes her…somewhere…wherever it’s convenient to have a crashing patient, I guess. In the dim blue lighting of the hall, House notices a faded tattoo on her ankle. She had clearly tried to have it removed, but only the top layers were taken off – the rest remained. It suddenly all clicks for House. The extreme running has affected her immune system, causing her to become allergic to the tattoo ink, and that’s what is causing all her symptoms. Some surgery to remove the tattoo in its entirety and she’ll be fine — physically, at least. Her memory remains absent.
I have few specific medical complaints about tonight’s show. I thought the medicine was sloppy, with none of the suggested diagnoses fitting well – but then the actual medicine was clearly secondary in this episode. As usual, major complaints are in red, minor complaints are in blue, and nit-picking ones in green:
Surgery for prion disease? Chemotherapy and radiation for prion disease? It’s not cancer; it’s a poorly understood infectious disease and none of these are appropriate treatments.
House first tries to convince us that her immune system has been suppressed from all her exercise – which is certainly a possibility. Then they turn around and state that her extreme exercise caused her to be allergic to something she has never been allergic before. In other words, it somehow gave her a heightened immune system. This is the opposite of what he had said a few minutes before, and farther from reality (remember that severe allergies are treated with immune suppression).
I notice the writers were being coy with which specific spongiform encephalopathy House thought the patient had. That way, they could borrow symptoms from several. Variant CJD seems the most likely, yet she has some symptoms that are closer to traditional CJD than vCJD.
Other than one episode of incontinence, she didn’t have any signs of diabetes insipidus.
There are frequently findings on the MRI with people with spongiform encephalopathy.
Amnesia almost always makes a good mystery, and this was no exception. I give the medical mystery an A-. The solution was clever, but didn’t make much sense as it contradicted earlier information. I give it a C. The medicine was sloppy and superficial. The superficiality I can forgive in an episode like this, but not the sloppiness: C-. The soap opera was the major part of this episode, particularly focusing on House and Nolan, House and Alvie, and the patient and her husband. It earns a solid A.
The review of the previous episode of House
A list of all prior House reviews
May 10th, 2010 at 11:12 pm
Looks to me like there is going to be a sexy House-Cuddy showdown.
May 10th, 2010 at 11:23 pm
NOW THATS WHAT I’M TALKING ABOUT!!!!
Did someone put something in the writer’s latte’s this week?? Seems like they FINALLY woke up.
Hands down this has been THE best episode since Ep 3.
I LOVED the camerawork that made the viewer question if what we were seeing was really ‘real’ or maybe just an alcohol induced fantasy..
Dr, nolan’s return was needed (and should have happened much earlier IMHO) & Alvie’s return was great to see him acting as maniac as always..
The POTW this time was at least an interesting medical mystery that wasn’t meant to provoke an emotional response… it was actually kind of fascinating to see it unfold….
I *ahem* DID predict way back in “open & Shut” that events were leading up to this and I am HAPPY to see the writers getting their script ideas from places other then the backs of children’s cereal boxes….
I’m going to re-watch this again to see if there’s anything I missed. It’s just that damn good and that’s something I thought I wouldn’t hear myself say after the first few episodes this season….
May 10th, 2010 at 11:38 pm
I was wondering since when we had any kind of treatment, even successful brain surgery, for prion disease.
Remember when House was solidly about the medicine? I thought the format was clever, but wanted more of that and less of the long soulful stares.
May 11th, 2010 at 12:19 am
More of the same, please. This episode was extremely refreshing since it didn’t have 15+ minutes of banter between all the doctors. That gets VERY TIRESOME.
May 11th, 2010 at 12:34 am
Again the medicine was just background light noise but that did not affect the episode one bit. The camera work the way it kept on switching between “real”, “telling a story”, “making up story”, “fantasy” – all good. Suddenly remembered the episode from season 2 “The mistake” where they kept on switching versions of what actually happened – it was the first time they did it – that is a great way to make an episode and the team of House has been perfecting it for years now. Actually it started earlier with “Three stories” – how could have I forgotten the one episode that wan an Amy! Anyway bravo – I am itching to see the end – the ending of this one actually promises a lot! And the way House brushed aside D-r Nolan – that was so House-like so season one House – I thought that guy died – strong, self-assured, confident in his own infallibility, ready to fight for his own, ready to go all the way to find the answer. A week just one week but what a long time that would be. OK I’ll comment the medicine for a while just to calm my enthusiasm:
1. Complex partial seizures are usually accompanied by at least SOME loss of consciousness: that patient was completely lucid when she fell down and wet her pants. My guess (while I was watching) was sudden paralysis or numbness cause by peripheral neuropathy – CPS came out of nowhere.
2. If 3 different areas of the brain are affected by prions, that means disseminated or advanced case – MRI would be much more different than “small blur” or whatever House said. And neurological symptoms would be piling – in fact I even doubt the woman would be able to talk at that point.
3. While athletes tend to have decreased white count (it is not a rule just a possibility), their immune systems are usually stronger than those of non-athletes – that is a medical fact proven by experience – and I suppose at least some of you guys have heard the phrase “running for health”? I myself am a regular runner – 5-10 km 2-3 times a week. I started running very late in my life – when I was 19 – and I did started mostly because I felt ashamed when I heard that an overweight colleague of mine can circle the Olympic rowing channel in my home town while I would have crashed spitting my lungs after 300 meters. In my childhood I was extremely fragile – had a pneumonia when I was 10 and than bronchitis almost every year after that. I was sickly and unable to even walk a long distance without starting to caught and sweat. A slight breeze on my back and I was sneezing already. Now I feel great – and I haven’t had a sniffles for 4 or 5 years in a row now. But anyway my point being is that to suggest that running can reactivate TB (where was this woman born anyway – Goulag?) or ruin your immune system is ridiculous. May be it could activate an allergic reaction – but IMO that is still reaching too far. I have read researches that Yoga, Thai-Chi and regular balanced sports regime can suppress outbreaks of diseases like psoriasis or arthritis – basically any mild autoimmune disease that is otherwise triggered by stress so sport making you sick? Unlikely. You can get joint pain and you could need joint replacement at some point if you overdo it but allergic reaction? Unlikely.
4. It is the 4th or 5th time they try to push the idea that an allergy can cause variable systemic reactions and even endanger life. Unfortunately I am not sure if this is even possible in real life – or let me rephrase it – I know that it can do that but a chronic allergy causing vascular inflammation and systemic reaction of that magnitude? I would be really thankful if our host here gives us his opinion on “allergic vasculatis” or whatever the idea is that the authors of House love so much. Could “slow” allergies lead to something that big that fast?
Ta ta from me and I’ll probably be here next week for the shocking finale!!!
May 11th, 2010 at 1:09 am
Funny, I was expecting to see minor complaining about another medicine-light episode.
The way the story was told in tonight’s episode was kind of meta-referential; the pataphysical (look it up) way what was seemingly happening in the present melded with recalled events immediately reminded me of “Three Stories,” “No Reason,” “The Mistake,” and probably other episodes I’m forgetting. It meshed with the theme of worries over House’s past.
Tonight certainly opened a lot of doors for season seven. And that makes me very happy :) Though isn’t it about time to get some new fellows? I’m sick of Foreman, I’m sick of Thirteen (Olivia Wilde is a total babe, but the character got stale a long time ago), I’m REALLY sick of “The Continuing Saga of Taub’s Crappy Marriage.” I guess Chase can stay. I seem to remember when Foreman, Chase, and Cameron were first written out that people were crying foul that they were in a fellowship for 3 years when it should have been only 2 if the show was as realistic as it purported to be. This’d be 3 now for Taub and Thirteen.
May 11th, 2010 at 2:06 am
It seems that they may be hinting a return to vicodin, or signs of worsening alcoholism. either way the show will be interesting.
one thing though, they did a scan to find that white/gray matter differentiation was damaged by the prions. wouldn’t it show that it was progressive too?
May 11th, 2010 at 4:22 am
House’s alcoholism/addiction causing problems for women is not new….
After all, it was Amber that House called when he was too drunk to drive his motorcycle home and the bartender took his keys…they took the bus instead and Amber died as a direct result…
I predict that there will be a similar type of crisis moment for House and Cuddy next week….
Totally Off Topic:
Next week is being touted as the Season Finale but according to Scott this is only episode 20…. I thought that a full season is 22 episodes not 21 so where’d we lose an ep?
May 11th, 2010 at 5:00 am
@Hugh L. – The 2-hour season premier was considered 2 episodes by most everyone except this blog. Episode 1 was “Broken Part 1″ and Episode 2 was “Broken Part 2″. So this week was Episode 21 by most accountings. See http://en.wikipedia.org/wiki/List_of_House_episodes
May 11th, 2010 at 5:24 am
The episode was excellent, and is probably my 3rd favorite behind the season premiere and the dibala episode, from this season.
I wish House hadn’t left Dr. Nolan in that way though. It actually left me feeling personally upset that he left, because Dr. Nolan was helping him, even if he didn’t realize it. I just hope he doesn’t return to vicodin, because it definitely made for a more interesting character when he wasn’t popping pills constantly.
May 11th, 2010 at 5:48 am
It was great having House interact directly with the patient. Esp. the Aha moment, which did not come from somewhere completely unrelated to the patient, but from actually looking at her.
I am disgusted with the medicine as analyzed by Scott. It didn’t make a lot of sense to me as I watched, and now it makes even less. At least they didn’t operate to remove the spongiform encephal-thing and and her memories, instead of her tattoo.
So House would like to have his own memories removed?
May 11th, 2010 at 7:00 am
The best episode since the 1st one this season. Finally the surreal touch and the cool playing with time and space and thoughts and insights. Bravo!
May 11th, 2010 at 7:29 am
“Next week is being touted as the Season Finale but according to Scott this is only episode 20…. I thought that a full season is 22 episodes not 21 so where’d we lose an ep?”
This is episode 21. “Broken” counts as episodes 1 *and* 2
May 11th, 2010 at 8:29 am
This episode reminded me of the finale of M*A*S*H – the whole amnesia thing, the staging between memory/reality…and using “Sidney” as a character name (Hawkeye’s shrink was named Sidney). Does anyone else think there’s a connection? Or do I need to see Dr. Nolan?
I liked this episode better overall than I’ve liked most recent ones.
May 11th, 2010 at 10:20 am
Very watchable episode, though the medicine was so bad that even I, usually less bothered by those things, found that whole part a bit of a mess.
It’s also problematic how people who never had allergies before suddenly get these life-threatening allergies first time out. It’s happened on other shows as well. I’m sure it happens, but this has become a repetitive solution. (Te nun with the copper allergy, the actor with the quinine allergy, the girl with the allergy to the boyfriend’s father’s sperm…and I’m sure there are more.)
It’s nice to see the writers turn the House character around so that he now uses his sneakiness and sharp mind for good. A well-thought-out evolution of the character, even though one they probably can’t sustain for too long.
Disturbing, though, this idea that Nolan could promise to make House happy. That to me sounds like the sort of promise a therapist would not and should not make. Therapy can help people live their lives more fully and create more happy moments, but a promise of happiness?
May 11th, 2010 at 10:52 am
Two quick notes:
1) I thought I remembered hearing something about putting the patient through UV lighting (to disinfect her/the doctors?) towards the end, which is how her tattoo became visible. Am I mistaken? Would that explain it?
2) How accurate was the depiction of amnesia in this episode?
May 11th, 2010 at 12:03 pm
@PSU My thought exactly. It was like the last episode of M*A*S*H which I guess in some ways lessened it for me. Overall an excellent episode though. Also highly reminiscent of “the Mistake” from season 2 but with a much darker flavor.
@TED, I think the blue lighting was the UV lights that House ordered the patient under when he thought it was TB. There are certainly things that glow like that under UV and it is a somewhat popular method to tattoo with pigments that only light up under UV allowing people to show off extreme tattoo’s at raves but pass as normal in society.
May 11th, 2010 at 12:09 pm
season four didn’t have 22 episodes, but that was because of the writer’s strike.
Now i’m going to be honest i thought this episode’s medicine was at times ridiculous and the end ruined it. is it a progressive prion disease or a allergic reaction? somebody needed to make up his or her mind.
hilson: i saw this coming when sam was introduced.
May 11th, 2010 at 12:11 pm
No, you are correct, UV-rays can kill some micro-organisms. But I wouldn’t think that is the same mechanism that showed the tatoo.
May 11th, 2010 at 12:34 pm
Particularly good episode IMO. Great to see Dr. Nolan again.
Medical, sort of: When House told the judge that a DNA test proved that Alvy’s mother was really his mother, I started to scoff because the test would take much longer than that. But of course House was lying.
May 11th, 2010 at 1:52 pm
I was SO looking forward to this episode! Unfortunately, House was preempted here in Tulsa for live storm coverage. :-(
May 11th, 2010 at 2:04 pm
Pretty obvious Dr. Nolan hit a nerve there at the end when he brought up Cuddy. House has been able to bring himself to face almost everything else in therapy, but he still walks out when Cuddy is mentioned. Wonder who’s going to figure prominently in next week’s season finale?
May 11th, 2010 at 3:14 pm
I, too, liked the way this episode was played out; this type of format is always interesting. However, I have two issues with the actual story:
1) Why is Dr. Nolan ignoring the fact that his patient has traded one addiction for another? People in recovery are not supposed to drink; alcohol affects the same nerve receptors as opiates. Even Wilson and the “kids” continue to enable House and his escalating alcoholism. As for the Cuddy issue, House needs to address all of his addictions and learn to stand on his own two feet before he enters into a relationship with a woman, and, clearly, he’s a long way from that.
2) This episode was co-written by David Foster, who is an MD (Internal Medicine). Dr. Foster was a medical consultant for this show back in the day and is now one of its producers as well. I often wonder, with as “sloppy” as the medicine has been on this show of late, if the good doctor hasn’t gone completely “Hollywood.” Reference http://www.housemd-guide.com/showinfo/davidfoster.php.
May 11th, 2010 at 4:10 pm
ADEM is a more likely differential for what appears to be an acute onset of demyelination than MS. I’m no expert on immunology, but despite the exercise-induced immunodeficiency occasionally observed in elite athletes, it also seems possible that all that perfusion during exercise could introduce all sorts of epitopes that collectively screw up the B-cell clonal selection process and induce a hypersensitive immune response
May 11th, 2010 at 4:40 pm
MedMavRx: Thanks for addressing the addiction “elephant in the livingroom”. I am no expert on addictions myself but I have been wondering how any of the MDs on this show can sleep at night knowing that House is substituting one drug for another and all of them are enabling him. I am also wondering, what about that bruise on House’s arm? Are there more? Why was House so late to his appointment? Hopefully, these will all be addressed by the last episode.
May 11th, 2010 at 5:58 pm
From the link that MedMavRx provided:
“A year ago, Dr. David Foster was working in two very different worlds: treating patients at an inner-city clinic in Boston, then periodically flying across the country to help plot the medical mysteries that arise each week on Fox’s ‘House.’
“His commute came to an end last March, after ‘House’ creator David Shore added the Harvard Medical School graduate to the show’s writing staff and Foster, who’d worked as a technical consultant in television for the past 10 years, decided it was time to jump into show business with both feet…. ”
Guess he decided that the spotlight of Hollywood was far more glamorous then any type of factual realism…
It’s ironic how quickly people forget their roots and where they came from whenever they get a little fame or recognition…
May 11th, 2010 at 11:52 pm
I wanted to put a completely different question on the table but I was hesitating because it was a subplot albeit important. This episode was dealing with that however so I’ll scratch the itch: Could a family consultant or a psych who is reading this blog (there are those types here I know!) tell us what is the success rate of people trying to re-mary their divorced wife? I’m not even talking ex-first wife or people with baggage and history like Wilson, I’m just saying – your ex? What are the odds? I mean the issues are still there you divorced that person for a reason (bigger than milk on the fridge door!) so WTF? I mean it was fun watching but Wilson is almost proposing – is it really possible to be so happy in that situation? It is going to blow over eventually right? May be I am still just bitching about Amber again: but come on – if you take ex number one two and three you still make lees than half an Amber (we’ve seen one and two so we can safely assume 3 is not so different). To trade CB for that? She was the freaking love of his life and to settle for that? Am I the only one who thinks this romance is forced and unbelievable? Fun to watch but annoying?
May 12th, 2010 at 6:55 am
I enjoyed this week’s episode. (I fell asleep last week during House–not a good sign.)
Dr. Nolan and Alvie — not only some great acting moments with House, but it tells us so much about our main character when we see him interact outside of the main group.
House and Alvie doing illegal favors for each other–their version of friendship. It was very touching in its own twisted way.
Wilson’s relationship? Well, I think it is there to put House in a situation where his inability to sustain a relationship is highlighted. With Wilson and Cuddy in relationships, his lack of deep personal connections is highlighted. House delights in the dissolution of his trio of fellows’ relationships and it sustains his ability to be comfortable with his situation. If everyone else is miserable it is ok for him to be miserable also. House’s comfort level with himself is threatened when Wilson and Cuddy move to something he can’t do.
Did you see this article about how House and Colbert keep photos of each other on their sets?
http://news.yahoo.com/s/ap/20100512/ap_en_tv/us_tv_colbert_and_house
May 12th, 2010 at 7:07 am
Dr Bulgaria > Elizabeth Taylor and Richard Burton? ;)
May 12th, 2010 at 9:03 am
@Mathilde: I thought those guys divorsed AGAIN? I’ll chek it out :)
May 12th, 2010 at 10:14 am
I liked the way this was done. It reminded me a lot of “The Mistake,” from season 2.
Also: Alvie is hilarious.
May 12th, 2010 at 1:01 pm
“Dr. Nolan was helping him, even if he didn’t realize it.”
@ Akshay
I found the Dr. Nolan episode to be very moving. This is often the way it is with psychiatric patients. Even when they say they want to change, they have a lot invested in being the way they are, staying the way they are, and they do not want to see that in order for things to be different THEY have to change something themselves.
Also getting mad at the shrink, blaming the shrink. Did Nolan really promise he could make House happy? That’s pretty pie-in-the-sky. Were those really the words he used?
I think I understand how House feels and that, more than anything I’ve seen lately, makes me want to see what happens in Season 7
May 12th, 2010 at 4:17 pm
The medicine definitely came across as ridiculous, even to a non-doctor. They can’t tell the difference between an allergy and mad cow? And how likely is an allergic reaction to cause total amnesia?
May 12th, 2010 at 4:17 pm
The one thing I found strange is that Dr. Nolan seemed to be playing with House. He was teasing him, toying with him, poking vulnerable spots, and when House would begin opening up or get on a roll dialogue-wise, Nolan would completely change the subject or cause him to shut down with more teasing and toying.
That whole “If-you’re-not-going-to-talk-then-I’ll-read-this-magazine” shtick felt very childish and not like a game one should play with a patient who clearly cannot openly ask someone for help; there are better ways to help ridiculously stubborn patients. That’s just one of many instances I didn’t like.
I wasn’t surprised House stormed out and expected it to happen much sooner.
Other than that, this episode was beautifully done; in a season with bad to “almost good” episodes, this one may be one of my favorites of the entire series. The only other thing I would have liked to seen is when they would play out the story that House was telling Nolan, I didn’t like how Nolan was watching the action. I would have liked it better if his gaze was 100% on House, and the story was playing around them. For example, when the wife kept rejecting the husband’s sincerity in the hospital bed, Nolan was watching the whole thing like a movie. I don’t know, it’s just like Nolan shouldn’t have been able to interact with the story, just with House who was telling him the story… but that’s just me and my vision of the story-telling-device.
May 12th, 2010 at 8:04 pm
@Onimusha – Nolan’s magazine stunt was especially egregious in its similarity to a similar “technique” employed by Robin Williams’s character on his uncooperative patient in Good Will Hunting.
Did not know until this episode that 1) House has been attending weekly therapy; 2) House still has his old apartment; or 3) Alvie was out of the psych ward. I suppose that (1) makes the most sense; however, why haven’t they portrayed his therapy sessions more regularly? The insight into House’s character is invaluable, so why leave it out? As for (2), however — why would House pay two rents?
May 12th, 2010 at 10:24 pm
The episode was reminiscent of Mistake and Three Stories in places, but those are two of my favorite episodes, so I’m okay with that. Also, yay for no Taub-the-Philanderer sideplot.
Alvy felt a little tacked on at first, but got much better from about the middle of the episode onward. It’s too bad he didn’t show up last episode or two episodes ago, because him showing up this week was a little TOO convenient.
May 13th, 2010 at 12:32 am
@ Patricidal Pat :
3.) At the end of ‘Broken’ as House is leaving Mayfield, Alvie is watching him leave from a window. Alvie went to to the nurse and asked for his meds (he was chronic about NOT taking them) and when asked why he said “I want to get better”, presumably because of House’s influence on him while they were ‘roomies’…The inference is he took his anti psychotics long enough to calm down to where he was deemed no longer a threat to himself or others and was discharged as a result… If memory serves, Alvie was in there like house, i.e self-admitted so once he could show enough progress he could be let out easier then if he were court ordered to be there..
1.) I was also annoyed that by the time ‘Brave Heart’ aired… House had had only 2 outpatient visits w/ Dr Nolan that we were made aware of… I griped back then that there’s no way House would be miraculously cured to the point where he no longer needed Dr. Nolan’s services…. I guess we were all supposed to ASSUME that House went to weekly sessions when he said this week to Dr. Nolan; ” for a year I’ve done EVERYTHING you’ve asked and everyone else is happy…”
2.)Back in ‘Known Unknowns’ when Wilson told House; “When you moved in, I promised your therapist I’d be here for you, presumably also meant that Wilson cold then keep an eye on House to insure that he stayed off the Narcotics until he got stronger…
House keeping his old place was because his living with Wilson was supposed to be a temporary arrangement at best, to help him get past the detox and in to a more stable place mentally in order to be able to cope with living alone again without a big risk of a relapse.
Then along came the bumps and twists on the road to House’s recovery throughout the season and it was just never the ‘right time’ to move back until now when living w/ Wilson is no longer an option.
May 13th, 2010 at 1:42 am
Did anyone else watch “Mercy” tonight? The nut-job, alcoholic, Iraqi war vet nurse got trapped in a collapsed building with two boys, one of whose arms she had to amputate in order to save him (and the arm which was later reattached – let’s hear it for happy endings). There were lots of falling beams, a fire, some smoke, a heroic rescue, etc., all of the drama you’d expect from such a premise. I wonder if we’re going to see a rerun of this scenario on “House” next week.
And for all of you “Huddy” cuddlers, rumor has it that Cuddy says 4 words to House that break his heart on the much-anticipated season finale. Guess you’ll all have to wait another agonizing year before that train wreck is consumated. Cheers!
May 13th, 2010 at 2:26 am
Note that it’s kind of a House tradition for the second-to-last episodes of each season to be somewhat ‘different’. I think both ‘Three Stories’ and the House-gets-shot ep had this place in the season.
Don’t recall any other experimental eps offhand, but do remember they exist.
May 13th, 2010 at 4:57 am
Dr Bulgaria > No, you’re right, I thought they divorced, and then there was another marriage and it worked, but it didn’t. :) So, to answer your question, I guess it never works. It just stands to reason, people divorce for a reason, I don’t see why this reason should disappear years later. People don’t change, remember? :)
May 13th, 2010 at 12:48 pm
@ Mathilde: Yeah “People don’t change!” 10x House. Jokes aside I do not think that it could ever work – a divorce is a divorce so to re-mary seems like trying to fix a broken mirror or trust :(
May 13th, 2010 at 3:20 pm
For whatever it’s worth, I do know a couple who remarried after a divorce. I met them after they remarried, so I don’t know the details of the divorce or how long they were divorced (or how long they were married the first time). But, I met them 14 years ago, and they’re still married and all seems to be well, so I guess it can happen. The guy told me that while they were divorced, he never dated because it thought it would be too hard on their kids to see him with other women or to even know that he was seeing other women. I’m sure that was part of it, but I suspect he must have never stopped being in love with her.
May 14th, 2010 at 10:31 am
Neuropathy? Anaphylaxis as a late effect of a tattoo? OK so it got into her system, but was this a believable reaction?
I’ve noticed especially lately, that they present the dx so late in the show that there’s no real time to go into it and make it believable. The final dx is treated almost like a throw-away line.
For example, rather than leaving an impression that this was in any way a likely reaction to a tattoo, especially to an old one, they could have made the point that the industry is largely unregulated and people can use virtually any substance to tattoo. Nowadays, reputable tattoo artists have hypoallergenic dyes available and there are relatively few reactions of any kind.
Or the tattoo could have been with red or green ink. They claim hypoallergenic forms of those colors don’t exist yet. Reds and greens are made using nickel, mercury, cobalt, and cadmium. Nickel is a very common allergy. I have one, myself. When I buy earrings, I need nickel-free.
So, again, there were ways they could have made it a little more believable, or at least saved grace by way of edification. The writers ought to at least Google these things before presenting them……
May 15th, 2010 at 1:50 am
Can’t believe there’re so many real doctors interested in such episode, though I do agree that House M.D. is indeed a very serious medical TV show.
Sincerely, the show’s getting a little bit boring lately as House is starting to act ‘unHousely’ lately. The original jerk has long gone, and I really am hoping that after his ‘break-up’ with Nolan that I feel like I am watching a teenage girl trying her best to resist the temptation of announcing to the whole wide world that she’s got a gay issue… Excuuuuuse me? Now that Nolan seems to be leaving this episode, things may be turning out interesting.
And I’m so glad at Alvie’s sudden show-up~ Thought I’d forgot about him~!
May 15th, 2010 at 3:26 pm
So….everyone who leaves Jersey winds up in Arizona on this show. Lydia and her family moved to Phoenix, Alvie is going to Phoenix, when Cameron and Chase “left” they were supposedly going to Phoenix.
Either there is something in the works re: a trip to Arizona or the writers need to realize that there are actually 50 states, not just 2.
May 16th, 2010 at 2:51 pm
i don’t why everybody enjoyed this episode, so boring like previous 19 episodes. Wake up script writers!
May 17th, 2010 at 12:37 pm
I greatly enjoyed this episode.
It had the same feel as 3 Stories, The Mistake, No Reason, and Wilson’s Heart–gives an “Eternal Sunshine of the Spotless Mind” feel and I thought it was stellar!
Certainly this show (although still my favorite) has moved away from the great medicine it was beforehand, I take great pride in knowing it is nowhere near as silly as a “medical drama” like Grey’s Anatomy.
I do think, though, that great shows like House need to end before they are cancelled. I think 1-2 more seasons is enough time to bring some sort of resolution for the viewer, and I hope they choose to have House make the right decision and end giving some confidence that House will be okay :) Maybe that’s immature and unrealistic but as a from-episode-1 fan, thats what I want :)
May 17th, 2010 at 8:06 pm
I really enjoyed this episode.
Great writing, good story progress, interesting patient. Other than the miscommunication and misunderstanding about the prion disease it was a solid episode.
Alvi was also good to see again, he really does play a fairly good manic depressive.
May 18th, 2010 at 2:21 pm
Was this the final episode of the season?
Thank you
May 18th, 2010 at 5:03 pm
WTF was that? like seriously?
“The ultra-marathon modified her immune system”
OH COME ON!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
Even by the longest, longest, longest of shots, vigorous exercise causes negligible (debunk?):
# Monocytosis
# NK increase
# Even more negligible eosinophilia & basophilia
# NO effect on T-cells, I repeat NO effect on T-cells.
Listed above is the effect of vigorous exercise on components of cell-mediated immunity (where the stated antigen resides), and in no way would that trigger an immune reaction with the magnitude shown in this episode, specially no T-cell activation = no polycolony (debunk?)
Also Chemo + irradiation for Prion? How was that even diagnosed? Antibiotics INTO the lungs? TB does not even fit in the first place! And 13’s brilliant diagnosis of diabetes insipidus by loss of bladder control.
Plot technique: random incomprehensible organ damage, then diagnose as autoimmune (since it has unlimited combinations).
Words could not express my disappointment.
May 19th, 2010 at 8:25 pm
Not a medical criticism, but a deportation hearing in a New Jersey state court? Unlike Arizona, being an illegal alien doesn’t contravene New Jersey law. Alvie’s hearing would have been held in an Immigration Court, which wouldn’t have a New Jersey state seal on the wall behind the judge.
May 19th, 2010 at 9:19 pm
The soap opera was pretty outstanding, especially for the way in which it was framed –soap opera is so hackneyed in itself that just soap opera has little chance of being any good, but as has already been noted the use of blended scenes and having the story come out in the therapy session put a new twist on it.
On the other hand, the idea that House has been in therapy for the past year is ludicrous. Not only has there been no mention of it, but his behavior quickly returned 100% to old patterns (with the relatively minor exception of actual drug use) after the episodes in which he had been committed. For several episodes now I’ve been asking why the writers bothered to have that storyline because he so clearly has had no change whatever. The silliest part of the episode was the character’s parting shot about the psychiatrist not having the answer. Other brilliant people living with pain do not automatically become embittered self-centered assholes, and we already know he was a self-centered asshole back in college. The “answer” –becoming a nicer/more social/caring human being–is one he has to do for himself.
May 19th, 2010 at 9:26 pm
Oh, btw…Scott, thanks for airing a bit of the idiocy used in this episode about prion diseases. Having just put together a synopsis of the history and current research a few months back, I couldn’t keep from the jaw drop reaction at the TV protrayal.
May 20th, 2010 at 3:11 am
2 Dr Bulgaria, in case you’re still watching the thread, I know 2 families who went through the divirce-remarriage, and both are still together. In both cases the “issues” were temporarily gone, then came back, but, I guess, being apart made both parties realize they’d rather have the “issues” than be separated.
May 20th, 2010 at 9:22 pm
Prion spongiform… encephalitis? Why don’t you just say “the common lukewarm” instead of “the common cold”?
May 21st, 2010 at 5:18 pm
what anoys me are scenes like the one where house concludes from an arrythmia that now also her brain stem is affected by the prion infection. arrythmias have like a thousand different causes. among them an infected brain stem is really not the first thing you would consider. and if so, you’d still make sure to exclude other, more likely causes, e.g. any structural alternations of the heart, before taking any further steps or changing your plan of therapy.
May 28th, 2010 at 9:48 pm
So, even though some of the medicine bugged me (life-saving treatment for prion disease? since when?), I think the show gets psych bonus points this episode for a few things, particularly the therapist having a different version of the conversation between Wilson and Cuddy and saying, “I have as much evidence for my version as you have for yours.” Pretty typical cognitive therapy approach… also the fact that therapy is not supposed to be “nurturing.”
@Onimusha
I don’t think it was “toying,” it was drawing boundaries; the focus of therapy is not to idly and aimlessly talk about whatever the patient feels like, but to figure out what’s going on that’s giving the patient problems and working with it. I would agree that the need for drawing boundaries at that point was not necessarily communicated in this episode. It’s believable and could have been appropriate since he’s been in therapy a year, but since us viewers haven’t seen this, Nolan comes off as a little bit of a jerk. Keep in mind that his job is not to amuse himself with patients, but to take a role, even when it’s adversarial, to help a patient function. Yes, it can take more than a year, given the number of years an adult like House has spent (dis)functioning the way he has been. Though the goals and process of therapy should be outlined early, especially with someone like House, it does seem believable he’d reach a point where he’s frustrated and walks out. It could have all been done better, but I was just happy that Nolan did more than say, “And how did that make you feel?” while taking notes the whole time.
Replacing opiates with alcohol is all-too-believable.
May 30th, 2010 at 5:58 pm
@MidMavRx, just because David Foster co-wrote did not mean he was calling the shots on the story. A series usually has several writers. The original writer may make an initial concept or pitch and then write two drafts but after that who knows who takes and runs with it. I know of a case of two writers for an episode of star trek who had their episodes mutilated beyond recognition.
I’m very certain other people than David Foster did some “enhancements” to the episode for story purposes.
June 10th, 2010 at 9:42 am
I’m surprised that you did not mention this, (then again, I am not a doctor myself, I might be totally wrong) but why did House stop Chase and Foreman while their patient was crashing. From what I understand, once a patient is in that state, time is of the essence when trying to save them. Why couldn’t he have just waited until she was in a stable state before checking out her leg. Also, I don’t think that a simple blue light would reveal an erased tattoo. You would need an ultraviolet light for that, and I don’t think that many hospitals leave those just lying around. (Again, I am not qualified to make any concrete statements as I have not had any formal medical training.)
I quite enjoy these reviews, by the way. Keep it up!
July 14th, 2010 at 7:33 pm
About therapy not making House happy — I’m working from memory here, but I seem to remember that Dr. Nolan specifically told House quite early that that was not the purpose of therapy.
Leave a Reply
Contact Me
About
Subscribe:
The Best Of...
Special Topics
Archives
Categories
Twitter
See Also
Comic Blogs
Medical/Science Blogs
Currently Reading
Arbitrarily Interesting Medical Condition
Syndrome
The Net:
Contents may have settled during shipping. Past results are no guarantee of future performance. No animals were harmed during the production of this product. Void where prohibited by law. All rights reserved. Not valid with other offers or specials. Professional driver on a closed track. Your financial institution may impose other fees. All models are over 18 years of age. Employees must wash hands before returning to work. Results not typical. Many suitcases look alike. 18% gratuity added to tables of six or more.
Do not taunt Happy Fun Ball.
© 2004-2012 Polite Dissent. Powered by WordPress