House – episode 8

January 25th, 2005

Filed under: Medicine, TV

Spoiler Alert! Spoiler Alert!

It was a decent episode of House tonight. The character moments were good and the medicine started out well, but then went rapidly downhill. The ultimate diagnosis was organophosphate poisoning from stolen pants. Organophosphates are always an interesting topic not just because they are present in many pesticides but because they are a potential chemical weapon.

This week, the team made the correct diagnosis in the first fifteen minutes but then spent the rest of the show trying to determine precisely which organophosphate was the culprit so that the specific antidote could be used. The problem is that while there are general treatments for organophosphate poisoning, there is not a unique treatment for each specific toxin. The show tried to explain it away as “experimental drugs used by the Army.” I hate it when medical shows start basing plots on experimental drugs; that’s when we go from the realm of plausible medicine to the realm of science fiction.

The idea that the military would have a unique antidote for each specific organophosphate is absurd. I’ve deployed to areas where we had to stock medications for organophosphate poisoning. Just the standard treatments of diazepam, 2-PAM and atropine take up a tremendous amount of space because you need multiple doses for each soldier present. Now multiply this by forty, because according to the show there are 40 different organophosphates — and just hope the enemy is nice enough to tell us which one they used, or didn’t develop one of their own.

I liked the character bits with Dr. House and Dr. Foreman, and thought the sex-starved 82 year-old lady was clever, but I hope this is the last episode we see built around “experimental medicine.”

15 Responses to “ House – episode 8 ”

  1. Bob
    January 26th, 2005 at 5:28 pm

    I’ve been watching the show for the past few weeks because I noticed Lisa Edelstein in the credits, but I’m finding her disappointingly underused, although it’s sometimes entertaining even when she’s not around.

    I don’t know if you’ve mentioned it before, but I’m kind of bugged by how often the plot hinges around a treatment which is a miracle cure if you have the condition in question, and fatal if you don’t. How common is that, really?

  2. Scott
    January 26th, 2005 at 7:28 pm

    I’ve yet to run across across a situation where one treatment is a death sentence and the other is a cure. Honestly, it’s common in unclear situations to try more than one treatment at the same time.

  3. chasdom
    January 26th, 2005 at 9:28 pm

    So I’m thinking about halfway through the episode: “So if I come in contact with a pesticide, and I get organosomething poisoning, and my doctor DOES NOT have a former professor with an experimental cure, I’m screwed?” Because it sure didn’t seem like they knew of any effective “general treatment,” as you say.

    I didn’t catch that the “experimental cure” was for the army. Why did some hack writer feel the need to give an offscreen character additional motivation to research a cure for a disease? Should have just left it an experimental cure. Unless he was working for some special Army Corps of Gardeners.

    Still, an enjoyable episode, particularly the Laurie-Epps parallels and the rotation-of-doctors-being-sent-to-the-patient’s-mother bit.

  4. medmusings
    January 26th, 2005 at 11:34 pm

    1.26.05 del.icio.us links
    » Interview: ‘A Deficiency Of Will And Ambition’: A Conversation With Donald Berwick, CEO Institute for Healthcare Improvement (IHI) — Galvin, 10.1377/hlthaff.w5.1 — Health Affairs / heathcare policy » Pro-Bloggers Association / blogger…

  5. Mazal
    December 5th, 2006 at 11:40 am

    The medicine, for the layman, seemed plausible. The logic of snake venom made sense when applied to organophosphate poisoning. What I particularly enjoyed about this episode: the “arrogant jerks who saved your life” line. House was incredibly audacious in this episode. The “kick off” line WAS insensitive. The point in this episode was to show a caretaker’s sense of right and wrong vs. a medical practioner’s sense of right and wrong. For that aspect alone, I believe this particular episode was successful.

  6. Anonymous
    January 15th, 2007 at 1:57 pm

    I worked for the US Army for two years doing advanced anticonvulsant and neuroprotectant research, and I can tell you that there are no “experimental drugs” from the Army for each individual nerve agent (the weaponized forms of organophosphates). Unless you want to count the recent advent of midazolam autoinjectors to replace the diazepam autoinjectors, but again those autoinjectors apply across the board, not to any specific agent.

  7. divis
    February 16th, 2007 at 1:38 am

    Of course, the story of the old lady was straight out of Oliver Sacks’ book
    (The Man Who Mistook His Wife For A Hat), right down to the “Cupid’s Disease”
    bit (that’s the name the 90-year old lady in Sacks’ book uses, as well as
    the title of the chapter where her case is discussed).

  8. unknown
    April 24th, 2007 at 4:52 pm

    Anather syndrome from Oliver Slack’s book is mentioned later on. House tells some med school students that a lady has Korsakav’s Syndrome, which is what the “lost mariener” had in chapter 2 of “The Man Who Mistook His Wife for a Hat”

  9. Jane
    April 6th, 2008 at 9:02 pm

    And the whole “poisoned pants” plot was straight out of a epidemiological mystery that got written up by Berton Rouche. (”The Dead Mosquitoes”, in _The Medical Detectives_)

  10. The Duke of Waltham
    June 17th, 2008 at 7:09 pm

    How well-known are those books, though? I assume that the screenwriters expected to basically get away with ripping off some stories because these would be relatively obscure.

    I agree with Mazal as far as the medicine is concerned—it does not look absurd to people not trained in medicine. Poetic licence, I suppose, to make for an interesting episode, but I hope it doesn’t happen too often.

    Not that I’d notice before coming here, hehe. Unless they really over-do it, that is.

  11. Bill
    November 25th, 2008 at 9:34 pm

    uh, it’s a television show…. supposed to be entertaining and the rest of the stuff is peripherals (sp?). I love the show, I’ve been watching it from the beginning… very entertaining even if the plot lines are not always credible. The dialogue between actors is what makes the show. I would let them be my doctors anytime! LOL

  12. roy
    September 9th, 2009 at 5:21 pm

    I read the first Berton Roueche book and virtually every story was similar to the first season of House. Great books.

  13. Kai
    October 25th, 2009 at 11:33 am

    Thank you for your posts, it’s first time I looked behind ‘House’. I’d just like to agree about this medicine fiction thing. I even think it’s dangerous, though I have seen even worse series. I still like House but it should be stated more clearly that these cases are purly fictional. (if they are)

  14. lennka
    January 26th, 2010 at 11:08 am

    Interesting…

    Ever read “The Man Who Mistook His Wife For A Hat” by the neuropsychiatrist Dr. Oliver Sacks? The book is a composition of his most interesting case reports. One of them deals with an 80-something year old woman whose syphilis (contracted in her early 20’s while she worked in a brothel) flared up again, causing neurological symptoms that exactly match those from this House episode. In fact, the two stories show such remarkable similarities (the patient was reluctant to accept treatment as she enjoyed the effects of her condition, and the statement “I like feeling sexy again!” is basically a direct quote) that I think the writers may have let themselves be “greatly inspired” by Dr. Sacks.

    P.S. Very interesting book for anyone interested in neurology.

  15. lennka
    January 26th, 2010 at 11:16 am

    And of course I didn’t read the other comments before posting… Sorry!

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