House — Episode 7 (Season 7): “A Pox On Our House”
The possibility of a smallpox infection was clever, and the medicine was mostly well-done on this week’s House, but the final diagnosis was contradictory and impossible
In 1793, a Dutch slave ship was purposefully sunk off the coast of Bermuda over fears that the cargo and crew were infected with smallpox. Two hundred and seventeen years later, Julies, a sixteen year-old diving on the wreck, brings an old glass jar to the surface. The jar breaks, lacerating her hand, exposing her to the contents of the jar: old scabs. Julie is eventually admitted to House’s service at Princeton-Plainsboro with symptoms of fever, vomiting, and bloodshot eyes. House suspects she has smallpox, so both she and her family are placed in isolation while tests are run. The rest of the team isn’t so sure she has smallpox, suggesting varicella (the virus that causes chicken pox and shingles) or measles as a possibility. Tests are run looking for the three diseases while the family is given smallpox vaccination.
The tests are all negative, but House continues to suspect Julie has smallpox. He hypothesizes that the pressure exposure from her scuba diving has driven the antibodies into her joints, so he has the team drain fluid from her joints to run more tests. While performing the tests, Taub notices a suspicious rash that looks like smallpox alongside Julie’s right knee. A close examination shows no hemorrhagic lesions (which would be a sign of hemorrhagic smallpox, a particularly nasty kind), but a petechial rash is in her right armpit that doesn’t fit the smallpox picture. To House, this new rash means that she does not have smallpox. Meanwhile, the Center for Disease Control (CDC) team this arrives to take over the case and lock down the hospital. The CDC arranges for DNA tests to be run that will confirm or dismiss smallpox once and for all, but it will take eighteen hours to get results. Chase finally arrives and suggests molluscum contagiosum as a possible culprit (sorry, doesn’t match the rash or explain the flu-like symptoms). House still believes it is not smallpox, but he needs proof and the CDC won’t allow him access to the patients. He manages to get a hold of a copy of the captain’s log from the slave ship and pays a Dutch internet stripper to translate it for him. According to the log, only the slaves got sick, not the crew. Given this information, the team proposes a differential diagnosis that includes sickle cell disease, vitamin D deficiency leading to immune suppression with subsequent infection with malaria or dengue fever, or scrofula (an older name tuberculosis infection of the lymph nodes in the neck). House wants to run a TB test, but knows the CDC won’t let him, so he has Foreman pretend he thinks it is meningococcus so he can run the test. As Foreman is trying to smooth talk the CDC doctor, Julie’s step-father develops a severe headache, red eyes, and a nosebleed. This is consistent with smallpox — but according to House it could also represent a brain bleed caused by the tuberculosis. M3 smooth talks the CDC doctors into running a head CT on dad to look for a bleed, but they notice a pustular rash on him and cancel the test since this is consistent with a worsening case of smallpox.
As the day goes on, both Julie and her step-father are worsening. There vital signs are worsening and the rash is spreading. M3 notices that Julie does not have the rash on her soles, while someone with smallpox should. Step-dad does have the rash on his soles — but he also has a history of kidney cancer. House now surmises that the step-father does not have smallpox, but instead disseminated vaccinia — an infection caused by the virus used in the smallpox vaccine (a virus similar to smallpox, but not actually smallpox). It has affected him so severely because his kidney cancer has returned and suppressed his immune system. As proof, House points to the bloody urine at his bedside as proof that his kidney failure (and yes, he said “kidney failure”) was caused by renal cancer and not smallpox. (House does acknowledge, and then promptly ignore, that this none of this explains Julie’s case). House enters the isolation room and injects the step-father with interferon, which should make him better, proving House right. Because he broke quarantine, House finds himself locked in with the patient, likely exposed to whatever the infection is. Unfortunately, the step-father doesn’t get better and actually gets worse. A couple of hours later, after a tearful talk with his wife and son, he dies. It seems we’re back to the diagnosis of smallpox. However, M3 is not ready to admit defeat yet. She has more of the captain’s log translated and discovers that the ship’s cat succumbed to the disease as well — which means it can’t be smallpox as that infects only humans. Hearing that the cat lost all its fur before dying leads her to suspect rickettsialpox, a bacterial disease transmitted by infected mites that live on mice. She has House check the step-father’s corpse for the tell-take eschar (scar) of rickettsialpox, and he finds one. A course of the antibiotic doxycycline and Julie should be as good as new.
As usual, major complaints are in red, minor complaints are in blue, and nit-picking ones in green:
The biggest problem with tonight’s episode is that there’s no way the step-father could have caught rickettsialpox. Even if you accept that the bacteria could live hundreds of years in a glass jar at the bottom of the ocean and could infect someone who got old scab tissue in their blood stream (which seems very questionable to me), Julie could not have passed it on to her step-father as it is not transmitted person to person. Rickettsial pox is only transmitted from the bite of a mite infected with a certain bacteria (and it is this bite that leaves the eschar.) In other words, even if you accept the increasingly ludicrous ideas that 1) Julie caught the infection from the old tissue in the jar, and 2) somehow passed it on to her step-father, even then he couldn’t have had the eschar that proved the case as he was never bitten by an infected mite.
Sigh. Once again, you don’t shock a flatline.
The time course is wrong for smallpox (not a surprise as they commonly shorten time courses on this show, but still worth mentioning). Julie would not have started shedding the virus until the rash appeared (at least ten days after exposure), so her step-father shouldn’t have started showing smallpox symptoms until ten or more days after that.
Again, bloody urine does not equal kidney failure. (House’s point about the color was that a brown color meant the bleeding was before the kidneys filtered the blood, whereas a bright red color meant that the bleeding occurred in the kidneys).
Interferon has been shown, at least in animal models, to treat vaccinia. But it is not a single shot treatment — just like last week it takes several doses to have an effect. It’s not the first line treatment for disseminated vaccinia either, VIG (varicella immune globulin) still is.
The characters were confusing vesicles and pustules. Smallpox has both, but the terms aren’t interchangeable.
What sort of TB test did House want to run? Was he planning on having Foreman place a PPD, which takes 48-72 hours to get a result?
Step-Dad has kidney cancer severe enough to cause immune deficiency, but no other symptoms (except maybe the bloody urine?)
I know Step-Dad was (allegedly) immune compromised, but that was still awfully fast for step-dad to die. First signs of infection to death in less than 18 hours?
The medical mystery was intriguing this week. I like the idea of a smallpox, and the potential route exposure was not impossible (Civil War era smallpox scabs were discovered in an envelope hidden in a book several years ago). I give it an A-. The final solution of rickettsialpox was, for reasons I outlined above, impossible. It score an F. The medicine was fairly well done throughout, though the team never got a good exam on the patient which would have answered a lot of questions (for a legitimate reason this week). I give the overall medical aspect a B-. The soap opera was better this week: more Wilson, better House/Cuddy, and M3 was actually an enjoyable character — if only she had been written this way last week. I give the soap opera a B.
The review of the previous episode of House
A list of all prior House reviews
November 15th, 2010 at 10:42 pm
I thought it was an OK episode with some memorable moments. It provided a nice minor variation on the formula – instead of one wild guess after another over what the disease was, the issue was a simpler one: Is it or is it not smallpox?
The prologue with the (computer generated) slave ship was very unsettling. Also unsettling was how House became convinced that he’d outsmarted himself, and was in danger of also becoming infected with smallpox, until M3 (of course) saves the day.
In a strange kind of way, I didn’t mind that CDC doctor. Of course he’s meant to be the stereotypical bureaucratic scold, but he came across as perfectly reasonable, based on what he was dealing with.
And didn’t Wilson’s young patient tear your heart out?
Don’t know how the family is going to react to the news that dear old Dad (or stepdad) died of a curable disease, or that it took his death to find out what the disease was.
And how many of us yelled at House: “You don’t shock a flatline!”? (Thanks, Dr. Scott.)
November 15th, 2010 at 10:42 pm
I’m still in the midst of watching and enjoying the medical mystery immensely. Overall, much better than House episodes lately; like the old House returned. nice subplot with Wilson and the Lambie.
November 15th, 2010 at 10:44 pm
Oh, right, Stepdad had kidney cancer, so even if he’d survived the R-pox …
November 15th, 2010 at 10:51 pm
Also, according to wikipedia, rickettsialpox is a mild self-limiting disease which has never killed anyone.
November 15th, 2010 at 10:57 pm
How familiar would all these doctors be with smallpox? I mean this seems like a time were they would have to dust off the old medical books since as they say no one has had small pox in 30+ years. Heck I’ve had doctors who knew nothing about parasites because we don’t get them in the US
November 15th, 2010 at 10:58 pm
Where was the 40+ year old dad from that he hadn’t been vaxed for smallpox?
November 15th, 2010 at 11:06 pm
Can you please explain the “you don’t shock a flatline” part? First time to your site.
November 15th, 2010 at 11:12 pm
I thought Rickettsialpox resolves within 14-21 days? No fatalities have been reported, so why did the father die?
November 15th, 2010 at 11:16 pm
I found tonight’s episode quite engaging. I suspected the medicine was total bunk – nice to see it was only partial bunk.
I continue to enjoy Masters. I’ll be a little bummed when tired old 13 comes back (haven’t been a fan of hers for a while now). The comparisons to Cameron are obvious and banal, but I don’t think she’s treading the same ground Cameron did. Masters is a true foil for House; Cameron never really was anything more than a bunny held to the saw.
And given that I read the comments after posting, I’d like to request that no one reveal what was in the preview trailer shown after the episode. Someone did last week, with the comment “it’s not a spoiler – it was aired after the episode.” Some of us (I can’t possibly be the only one) deliberately don’t watch those so as to not be spoiled at all coming in.\
If I *am* the only one, well, fine :p
November 15th, 2010 at 11:17 pm
@ Trevor – immunocompromised.
November 15th, 2010 at 11:17 pm
Is it because of his compromised immume system?
November 15th, 2010 at 11:17 pm
A small language nitpick. As a native Dutch language speaker myself, it is virtually impossible for a modern Dutch speaker (and she obviously was Dutch) to understand and translate the 18th century language. Unlike the English language the Dutch one has considerably changed over the last one hundred years and it is very unlike she could even read it.
November 15th, 2010 at 11:21 pm
(Disclaimer: I’m not a doctor so I’m pretty much talking out of my ass)
Jamie: Doesn’t the smallpox vaccine lose potency after a few years without a booster? If he was vaxed in the 60s and never got another shot it’s conceivable, right?
Just Some Dude: I believe defibulators (sp?) are meant for patients who are in v-fib i.e. an abnormal heart rhythm. If the heart has stopped completely the shock isn’t going to help.
November 15th, 2010 at 11:26 pm
It could have been better if the girl had some similar pox to smallpox (monkey, cow,… something that you only catch if you actually fornicated with the animal it’s named for)
A *really* bad vaccine reaction could explain the father’s illness. His timeline still seems to fast. A better immunocompromise could explain it but then they would have to have House wait until the girl’s DNA test came back negative.
November 15th, 2010 at 11:30 pm
@JSD – You never shock a flatline. To quote our good doctor here: “When the heart goes into asystole (a term for when it stops beating and has no electrical activity), the treatment is NOT defibrillation. To restart a non-beating heart, the recommended treatments are CPR, epinephrine, atropine, and transcutaneous pacing. Defibrillation does more harm than good.”
To be fair to the producers of House M.D., I think this particular medical myth goes back awhile in TV land… somebody at some point decided it was more exciting and dramatic to break out the paddles.
Yes, M3 (heh, nice one, Doc) was much more tolerable this episode. Who knows, we may even be sad when she leaves…
November 15th, 2010 at 11:32 pm
From interviews with experts about biological weapons, it sounds as if smallpox vaccination does not last forever. If this is true, the father’s vaccination from 30+ years ago might not have protected him (if the disease had actually been smallpox).
November 15th, 2010 at 11:38 pm
Chances are the theory of the show was that the slaves were infested with the mites, for some reason the they collected the scabs in an air tight bottle. The cold and darkness induced the mites to enter into a dormant state for two hundred years or so. Maybe there was enough scabs to enable the dormant mites to survive…. Yes it’s a huge stretch, but when you read of microbes being able to go dormant for thousands of years what’s a few hundred to the mighty mite.
November 15th, 2010 at 11:48 pm
IMHO, this is currently the Best Episode so far this season…
M3 Seems to be progressing, House seems to be back to his old ways, Wilson actually had some camera time for once!!! (OMGWTFBBQ!!!!) and everything just seems a little….too… perfect.
Methinks that we’re seeing the first beginnings of things coming a bit unraveled between H&C, something that the writers will exploit over the remainder of the season..
*I* predict that by the end of this season, “Huddy” as we’ve all come to affectionately know our beloved dynamic duo will be no more….
November 15th, 2010 at 11:55 pm
@Adamantyr the AHA just took atropine off the primary medications list for asystole, citing lack of empiric evidence.
Otherwise, I was rooting for monkeypox, considering the pattern of the lesions and the pathophysiologic and genetic similarities to smallpox. I also had an issue with the way Taub gave the smallpox vaccine, if I recall, we was using a standard syringe and hypodermic, I helped my father do post-eradication vaccinations in India when I was ten, and we used bifurcated needles dipped into a diluted vaccine solution. We jabbed the needle in a circular pattern on the arm. As far as I know, that hasn’t changed. In terms of the containment procedures used, PPTH would in no way have the proper facilities to handle a BSL 4 pathogen. The patient should have been transferred using a BSL 4 stretcher device to either Atlanta, or fort Detrick (USAMRIID) so that they could be treated in a level four hospital. Isolation precautions here were shoddy at best.
November 16th, 2010 at 12:25 am
As a 39 year old it’s plausible to me that the father had never been vaccinated. As I understand it the vaccinations were becoming less of a “must have” by the late 60s and by the time I was born (1971) were becoming ever more rare. I never received one. Also AFAIK they were never done on newborns.
So, ignoring the question of whether it would have been effective after so long, a 40+ guy that had never had a vaccination seems reasonable.
November 16th, 2010 at 12:27 am
Also yes, I was yelling “don’t shock the flatline”… Dr. Scott is seriously impacting my enjoyment of medical TV. :)
November 16th, 2010 at 12:47 am
According to what I have read the vaccine is only effective for 3-5 years. The vaccine currently in use is considered dangerous and is only used by deployed military, certain health care providers, or in the case of an outbreak.
I can understand why House would have been very nervous.
November 16th, 2010 at 1:26 am
Another interesting aspect to mention is that if it had in fact been Rickettsialpox (for whatever crazy impossible reason), tonight’s show would have in a way advanced an entirely new (and fictional, of course) epidemiological history for the disease. As I gather from the Wikipedia article on the bacterial pathogen, it was contained to the series of events between the 1940’s and 50’s in New York. So, the show would, in a way, have created a new origin myth for Rickettsialpox. Right?
November 16th, 2010 at 2:34 am
@Ernesto
Another interesting thing to pull from the wiki article on rickettsialpox is this –
Rickettsialpox is generally mild and resolves within 2-3 weeks if untreated. There are no known deaths resulting from the disease.
Of course that part isnt cited and I dont have the interest to actually look it up to see if its true…BUT
I suppose that the father could die since he was immunocompromised, (did they ever rule out he had kidney cancer?) but they also stated the daughter was teetering on the edge of death herself.
November 16th, 2010 at 6:37 am
Having Wilson there is always nice, but we need more House-Wilson interaction. Last week there was just that small scene right at the end, and if I’m not mistaken there was none whatsoever this week apart from a small scene at the very beginning. The banter between the two of them is what makes the show so hilarious for me
November 16th, 2010 at 6:52 am
Unfortunately, medically, this particular episode was just bad. My brain switched off half way through because I’m so tired, but instinctively, I knew stuff was wrong. And it was quite annoying.
Regarding the TB testing, did you consider that TB testing using Quantiferon Gold actually takes about 24 hours or less?
November 16th, 2010 at 7:25 am
Actually, there are lots of people who haven’t been vaccinated even among those born and brought up in the USA. If, for example, you had asthma or eczema as a child and it was never clear to your doctors that you weren’t allergic to eggs (in which the smallpox and flu vaccines are or used to be cultured, AIUI) no one would want to take the risk. I’m 56 and have never been vaccinated, and for many years I traveled with a letter from our family doctor explaining why it was contraindicated.
So, even though they didn’t explain it, it’s perfectly possible that he came into that sort of category.
wg
November 16th, 2010 at 7:31 am
ok cuddy should be used to ol’ house’s lying ways, even to her n spite of their ”relationship” so iam amused at her being mad at him. he is what he is.
they dont vaccinate anymore for smallpox. and so i was one of those 60’s kids who got one at like age 5. i think at age 55 it probably would have worn off by now if i was exposed to the virus, i could probably get the illness some how.
November 16th, 2010 at 7:55 am
I suspect the writers’ making M3 so much smarter than House was timed to reinforce his emotional vulnerability with Cuddy– he’s merely human after all. (So will this mean M3 gets the boot when H&C finally break up?)
November 16th, 2010 at 8:41 am
Two bits I thought were interesting:
House messed up by going into the quarantined area against advice and, for a bit, it seemed that he realized that he had really messed himself up. It is rare to see House really come up against himself being wrong and taking wrong actions and have to face the possible consequence.
House also has to come to some kind of place where he can admit he is wrong in his personal relationship with Cuddy.
So, it seems that perhaps that if House is to grow and to grow into this relationship he has to let go of some of his arrogance and let himself accept himself as a person who can have a different relationship with Cuddy and at work.
I love Amber and the character she plays. It is nice to see someone who has the oomph to take on House on a level playing field. Just part of that is that she is smart.
Wilson thinking about having a baby? Wonders never cease.
November 16th, 2010 at 8:42 am
Dunno how I feel about Masters, She’s more successful in breaking down House’s cynisism then Cameron, Wilson, Cuddy, Cole and Kutner have ever been. That’s serious Mary Sue territory. I hope he starts putting up a better fight soon. Wilson actually getting a kid would be great, means the writers are irreversibly committing to taking his character in a certain direction.
November 16th, 2010 at 8:58 am
The portion that bothered me the most throughout the episode was that i didn’t understand that if the Pox’ was contagious then why didn’t the son or mother have it??
Oddly the revelation of Rexy Pox’ made more sense since that meant that the dad was cut by the same bottle and was infected that way.
Although where his infection site scar showed up seemed pretty farfetched.
November 16th, 2010 at 9:19 am
M3 *Giggle* Love that nickname!
A few too many overtones of Euphoria and Lockdown. Though I would have loved to have seen THIS episode as a 2-parter like Euphoria–explore more of House’s working w/ M3, his “ohshit” fear when he realized he maybe made a mistake–him huddling over to the side was just so unlike him. Plus more of Wilson and Sam (I actually like her this season).
Why did the CDC come rushing down this time and not during Euphoria? (Guessing the smallpox). And why the lockdown of the hospital this time and not then?
Nitpicky but it seemed odd for Sam to say “Maybe I should get a puppy” when she lives w/ Wilson. But I loved his comeback *drool*
Why do I get the feeling they are phasing out Chase?
My fave ep of the season.
OT–I had a TB test recently, never heard it called a PPD until then and had to look it up LOL.
And now we know where RSL got the toy for his Youtube vids ;)
November 16th, 2010 at 9:33 am
To add–I was born in 1970 and do have a smallpox vaccine scar on my arm. (I won’t rant on about the theories of the connection between it and CFS which I have).
@Wendy, yeah my son is not vaxed, eczema at 2 weeks, asthma and anaphylactic to eggs (and dairy, nuts, shellfish). His pede said the same thing.
November 16th, 2010 at 10:14 am
Official Comment
Kalika,
Good point about Quantiferon Gold. It’s not readily available in our neck of the woods, so we tend to rely on the old standby of the PPD. Still, even with the newer test, the results would still return after the CDC smallpox test results were back.
November 16th, 2010 at 10:18 am
Official Comment
Smallpox immunity from vaccination wanes over time, so it’s not as effective at 10 years out as it was at 5 years as it was initially, but there is still some immunity remaining.
In the early 2000s, when I was in the Air Force, I was the doctor in charge of the smallpox vaccination program for deploying troops at our base (mainly because I was the only primary care doctor who had been immunized as a child…and had the time and rank to run the clinic). People who were re-vaccinated definitely had a more mild reaction than those getting vaccinated for the first time, even though it had been decades since their original vaccination.
November 16th, 2010 at 10:21 am
Official Comment
The smallpox vaccination carries some small but definite risks, more than most other vaccines. Thus, in the late 1960s/early 1970s, with smallpox in decline in the US, most state health departments decided to phase out giving the vaccine routinely.
According to my parents, when I was born in Virginia in 1970, smallpox was still a routine vaccination. However, when my sister was born in 1971, they had to specifically request that she receive it.
November 16th, 2010 at 10:22 am
Big pet peeve:
They are not speaking Dutch on the slave vessel but Afrikaans!
November 16th, 2010 at 10:23 am
@JB
I don’t think M3 is smarter than House, she almost killed a the guy last week and she caused panic to the family on this one
I’m not from the US so I always find it strange how in there people directly relate how smart a person is to how much knowledge they’ve accumulate, when those are two completely separate things, the ability to memorize the phone book doesn’t make you smart
it’s posible that the smartest person in the world is an 8 year old in some african rural village who never learnt to read because no one on the village knows
November 16th, 2010 at 11:44 am
what’s the most you ever lost on a coin toss house??
November 16th, 2010 at 12:09 pm
This episode was like the movie “The Game.” Every scene was hugely enjoyable, but at the end you’re left thinking that that didn’t make a G*dd*mn lick of sense.
November 16th, 2010 at 12:12 pm
PurnoDePurno, surely the slaves and the crew were speaking different languages?
November 16th, 2010 at 1:01 pm
Well there are things about htis episode that I liked a lot and things I just abhored…The mdeicine was one of the later but than again the medicine here was a setting for Huddy to work on their issues so I am not surprised it was mostly rubbish. The Huddy issue however was better handled and both House and Cuddy played well with him being the stubborn boyfriend (”I did nothing so wrong to deserve your silent treatment!”) and she being the angered scratching cat (” How Could you do that to me after all this!”). It was enjoable to wathc and House needs to realy focus and stop taking Cuddy for granted now otherwise it will all crash down really fast (yet somehow I do not thing that is the meltdown we are all waitng for – the potential for drama here is still too big!) And they started talking about it and that is a good thiig both for them and for the show. So let us wait nad see. Hopefully we’ll see more Lisa Edelstein covered with small chunks of sheet only (OK who is with me – L.E. IS THE MOST SMOKING 40 Years something chick on TV. To Quote the show – her pistons are like a Ferrari!). Now let us chew on the medicine since there is pleinty to work with here:
1. All the ideas that the team was trowing as na alternaticv for smallpox were abismal. Apart from the original other “poxes” measles and varicella the other ideas did not fit the symptoms at all: molluscum contagiosum (?!?) sickle cell disease (not an infection and hence is not transmitable – and the idea that a whole ship was full of “sicle cell people” is idiotic) malaria (does not presente with rashes of any kind and you need a moscito in that 200 years old jar to transmit it. :) dengue fever (ok this one might fit the symptoms barely but still not transmitable the way they suggested) and the most idiotic of them all TB: it takes time to develope and to present itself with rash severe headake high fever and bloody eyes but no lung involvement whatsoever is IDIOTIC to say the least. It also cannot kill a person in 24 hours so why the rush?!?
2. I have to give House a golden star for: blood in the urine equals kidney cancer. That is right – clear red blood in the urine does suggest kidney cancer especially if there is no pain (kidney stones might provoke bloody urine but it does not go unnoticed the patient is usually screaming from pain). And of course bloody urine does not mean kidney failure (I think we all know that now right? Let us move on children:)
3. If we accept that it was the cancer being back responsible for the dad immune status we have to also look for all the other screamer signs of cahexia (I am not sure how this is spelled in English so please excuse me and correct me) People with advanced cancer have: weigth loss, constant sweating and mild fever, oportunistic infections, skin leasions loss of apetite etc. All those would have been there if stepdad was that badly imunocompromised.
4. As many people mentioned riketsiapox is not lethal (I doubt even an imunocompromised person can die from that) Oh and BTW did all those miserable black people on the ship died in vain? They all had riketsiapox? Oh right this is actually impossible (just like transmiting it from a jar is :) Smallpox form a jar – plausible. Riketsiapox NOT! Sorry M3 (bravo Scott that is a good nickname. I am surprised House did not figure it out.
M3 is actually turning out a good foil for House however I doubt that the writers will keep on playinf her that way (yeah I did it honestly and it worked! Yey I was right and tyou are wrong!). She will crash and burn from her high perch and I actually cannot wait for this to happen. It will be in perfect tone with the show general motif!
I almost forgot Wilson and his sideplot (sigh). I did not like it and may be that was the first time I was not invested in SPL play. The reason for this is that the writers are still trying to jam Sinthya Watross in Ambers very big shoes and they are failing miserably. I cannot accept her as the love of his life I cannot even accept her as a mild and acceptable “good enought to take it” Sorry but I simply do not like her. Wilson needs a new Amber not a sorry excuse for her. And I am not happy they are going to try for a kid now – it would have been funny with Amber but is aufully boring with this chick.
November 16th, 2010 at 1:08 pm
[...] he couldn’t have had the eschar that proved the case as he was never bitten by an infected mite. (politedissent) Verb: compartmentalize Separate into isolated compartments or categorise Share and [...]
November 16th, 2010 at 1:19 pm
I didn’t see what language the CC said the slavers were speaking, be it Dutch or Afrikaans (a language related to Dutch)
The CC said the slaves were speaking Swahili, (An east african language, out of place since most slaves came from west africa….)
November 16th, 2010 at 2:02 pm
I do not understand why the producers of House don’t vet scripts with Scott and perhaps some of the frequent readers of this board. A simple non-disclosure agreement, give two weeks before shooting, and TONS of important discrepancies could be very simply avoided. The show might even be improved a bit :-)
Uncle Ron
November 16th, 2010 at 2:06 pm
Since the episode involved a mite-transmitted disease, some nitpicking seems appropriate:
1)The CDC doc tells the story of the last person to die of smallpox due to the disease getting into the air ducts, but doesn’t seem to say anything when House just strolls into the room, thereby releasing the air to the entire hospital and beyond, since the hospital isn’t air-tight.
2) Don’t isolation rooms need at least two doors with an airlock?
3) I got the impression that when the ship was sunk the entire crew perished. How did the captain and his log survive? Wouldn’t anybody willing to sink the ship also have killed the captain, even if he had escaped by small boat?
4) If you could get a copy of the log to the woman who translated, couldn’t you just use Google to translate?
5) Since the team was looking for something other than smallpox, why would they not be interested in all the “irrelevant stuff” like pets, what they ate and all the other things they look for with cases?
6) I think it’s been mentioned before, but isn’t the whole differential methodology backwards on the show? Seems to me that you should be looking at a bunch of possibilities, and narrowing it down as they are excluded, but they exclude everything that doesn’t have the exact symptoms, which presumes every ailment causes the exact same symptoms in every patient, which is contrary to the whole premise that they only get the zebras.
(Of course, it it’s not obvious, I’m not a doctor.)
November 16th, 2010 at 2:13 pm
Did he really shock a flatline?
House grabs the paddles when he sees this:
http://img101.imageshack.us/img101/2577/notflat.jpg (35min 07sec)
When he goes flat he correctly uses heart massage.
Or am I getting this wrong (medical newb :) )
November 16th, 2010 at 2:17 pm
It isn’t flat here either:
http://img607.imageshack.us/img607/149/notflat2.jpg
Looks like Ventricular fibrillation to me
November 16th, 2010 at 2:21 pm
Official Comment
EricInOregon:
The Captain handed the log to the medical inspector in the beginning of the episode, right before they started to throw slaves overboard.
November 16th, 2010 at 2:21 pm
uh…did house start cpr on a bed with no hard board below the patient?
November 16th, 2010 at 2:24 pm
OK, here’s a question. At the beginning of the show, House says to vaccinate the entire family because even if they’ve been exposed the vaccine will protect them somewhat. So how come no one vaccinates House as soon as he’s – they think – exposed? Assuming he was never vaccinated in the first place, which given his age isn’t *so* likely.
wg
November 16th, 2010 at 3:25 pm
I’m probably missing a lot here, so I’d be happy for somebody to explain to me why I’m wrong, but:
House went into the father’s room with no protective gear (and, as other people have already mentioned, exposing the rest of the hospital) while he was under the impression that they had given the dad smallpox by vaccinating him when he was immunocompromised. He then started to get scared when he thought he might be wrong and the dad might really have smallpox. What I don’t understand is what changed. The dad could have had smallpox by catching it from the girl, or he could have had smallpox by contracting it from the vaccination because he was immunocompromised. The end result is still that the dad had smallpox (though of course in reality he didn’t), and presumably this would be dangerous however he got it. So why isn’t House scared to go in there when he still thinks it’s smallpox caused by the vaccine? Is the vaccine-type smallpox non-contagious? Or am I just misinterpreting what happened in the episode?
November 16th, 2010 at 3:34 pm
The first thing that jumped out at me was this: if the jar was full of air, how did it stay at the bottom of the ocean all that time? In two hundred years, did it never have the chance to float to the surface, but it was readily available to a recreational diver?
Maybe I’m hopelessly detail-oriented, but I found that so annoying that all the rest of the show got demoted a bit. Honestly. Don’t these scripts have any reality checks?
November 16th, 2010 at 3:42 pm
The containment procedures depicted would never have been approved by a CDC doc for a Biosaftey Level 4 pathogen. It is more likely that the patient would have been transported to a BSL-4 care facility like USAMRIID’s or the CDC’s.
November 16th, 2010 at 3:44 pm
Oh yeah, and those were O2 tanks strapped to the isolation suits, not air tanks, another goof, as if an SCBA was used instead of a mini HEPA filter (which by the way should have been in use in the containment facility), it would have been plain air, not O2.
November 16th, 2010 at 3:51 pm
Yes, I wanted to say that as well….What I heard in the begin was FOR SURE not Dutch, and even if that really was some sort of 18th century Dutch, how someone who obvioulsy doesn’t have any specific education, could read a report from the 18th century?
November 16th, 2010 at 4:23 pm
Official Comment
Hannah:
Smallpox vaccination doesn’t actually use the smallpox virus, but instead a similar and much less dangerous virus known as vaccinia.
When House entered the step-dad’s room, he thought the man had a vaccinia infection — and as this is generally not dangerous to people with normal immune systems, he wasn’t worried. However, when it became more likely that the step-dad had smallpox and not vaccinia, House became more concerned because smallpox is nasty to everyone.
November 16th, 2010 at 5:01 pm
2 things struck me in this episode.
1. The coldest woman on the planet.
Her daughter might be dying, her husband is actually dying, she might be infected -and she keeps a perfectly calm face with makeup throughout an entire ordeal, only struggling to squeeze a couple of tears when the man is dead.
2. Ok, her husband is dying, her daughter might be dying, she might be infected and House tells her “Don’t worry”, i thought it was extreemely out of place.
But, what’s even stranger – is that she seems to take this “advice” and actually hardly worries at all. :)
Also, I thought the little girl with cancer was the cutest thing ever! And she was such a good actress!!!
November 16th, 2010 at 6:22 pm
@ Hannah: In addition (Scott is too polite to mention this), the writers have to show that House is not only an arrogant *ss, but he’s got the biggest pair of b*lls of anyone, even Cuddy. Those two traits are what makes him not-such-a-genius-after-all.
@ Dr. R: You called it last week – “not smallpox.” And you’re right about the PPE: He should have been wearing a HEPA mask, even though, like an idiot, he’d already exposed himself.
November 16th, 2010 at 7:03 pm
@doa766: When you say that it is possible that the smartest person in the world is an 8 year old illiterate in an African rural village, I have to suspect that you do not understand the basis for intelligence. For example, could the smartest person have been raised by wild animals and have no language as well? I suspect you may at least play with the idea that the answer is yes, but… Science has shown that the answer to that is absolutely “no, that’s not possible”. A person who does not have language is missing a giant tool that humans use to think. His mind has not been trained to think.
Reading and writing are other tools. And maybe you’re thinking about famous people who didn’t learn to read and write until later in their lives, but those people still understood the concept of reading and writing. There’s a real and perhaps unfortunate distinction there between those situations where they have been exposed all their lives and the situation where somebody hasn’t.
Reasonably, the idea that the smartest person lives in a society where there is no concept of written language is absolutely and profoundly absurd to the point that it is indistinguishable from an impossibility. It doesn’t seem fair, but it’s the truth.
November 16th, 2010 at 7:17 pm
Please, can someone explain to me, how the biohazard suit works? House has thick gloves, he is afraid to come close to the body, but when he jump on the patient, you can see his shoes and socks. Isn’t it strange or am I missing something?
November 16th, 2010 at 7:22 pm
Awesome episode, the child trowing her plush to wilson was funny. Also anyone else thinks Master is freaking cute?
November 16th, 2010 at 7:29 pm
I’m surprised it took them 7 years to come up with the mandatory smallpox episode (all hospital shows have one).
I also laughed at the idea that less than 18 hours from sowing symptoms to death (does a disease even exists that works that fast?)
November 16th, 2010 at 7:42 pm
Not only am I not a doctor, I do not even play one on TV. So I may be way off-base, but at least twice – during Dad-in-trouble and then Dad-is-dead to scrub with bleach – nondoctors, presumably male nurses, entered with just scrubs: huh?
Well, I am not sure if someone on the show put in some thought, but M3 was more believable this week. Last week I was annoyed by the oft-used “geniuses always have eidetic memory and use it to show off” stuff and other limitations of the character I suspect were symptomatic of the director having mild flu or otherwise not up to par. And this week House seemed more normal (well, for the character) as well.
November 16th, 2010 at 7:59 pm
3M at one point suggests the slave ship’s drinking water as a source for the disease, or it was mentioned as means to find it why the crew didn’t get sick vs. the “cargo.” It’s worth pointing out they didn’t exactly have bottled water on on-board water filtration and cleaning systems on old wooden sailing ships. Water also is tough to keep around as it’s not the most shelf-stable stuff in the world when it hasn’t been cleaned or treated. Ships back then carried rum and other alcoholic beverages to drink. What the slaves would’ve drank I’m not sure -as I doubt the rum would’ve been “wasted” on them. Possibly the slaved would’ve drank rain water coming in from the air vents/grates in the ceiling and, obviously, rain is about as pure and clean as you can get for drinking water.
November 16th, 2010 at 9:16 pm
@NotEng: Most biosaftey suits are worn with thick rubber boots with the pant legs tucked inside, and tape covering the junction. The one I used when I worked in a BSL-4 lab as a cardiology consultant looked like this:http://www.ilcdover.com/products/protective_suits/protectivesuits.htm though ours had an air hose that connected on the side of the suit.
November 16th, 2010 at 9:28 pm
House certainly would have been immunized when he was young; he was born in 1959 (evidentally House’s DOB is the same as Laurie’s), when smallpox immunization was routine. Also, wouldn’t they have immunized the medical staff when they did the patients?
November 16th, 2010 at 9:54 pm
@Nybbler: The vaccine does wear off, so an immunization then would likely be inactive. And yes, they should have vaccinated all staff interacting with the patients. (The CDC people were already vaccinated)
November 16th, 2010 at 9:56 pm
Official Comment
polacola:
Bacterial meningitis can kill very fast — less than eighteen hours in some cases.
November 16th, 2010 at 10:15 pm
It had to be rpox. If it’s not rpox, then there’s no M^3 aha moment with the cat. Without the cat the log becomes irrelevant. Without the log, there’s no need for the Internet stripper. Without the stripper, there’s no “OMG, that House is so outrageous!” scene.
@mojo: There are plenty of dyslexic people with advanced degrees who can’t read or write. There’s no reason a non reading person couldn’t be exceptionally brilliant. Neither Lennon nor Mcartney could read or write music.
November 16th, 2010 at 10:33 pm
@ Scott and polacola: When I was working in Tacoma in the late 90’s, I had a patient come in with a mild headache and stiff neck at 6:30 AM, and died at 8:00 PM from bacterial meningitis. So yes, 18 hours is somewhat believable.
November 16th, 2010 at 10:43 pm
Not a doctor, but shouldn’t House’s suit actually, you know, cover his feet. When he’s giving CPR, you can see up his trouser leg.
Plus, why would the crew get fresh drinking water? they probably all drank the same foetid water that had been in a cask for weeks.
Plus why would the captain not have a pet?
November 16th, 2010 at 10:53 pm
@Will: see my comment above one House’s feet
November 16th, 2010 at 11:17 pm
I guess they do shocking flatlines for dramatic value (maybe you’re going to put that into serious account), ignoring every literal fact about it.
But the Wilson half on this episode was actually pretty good (for that part alone, I give it a B+). Come on, how many of us haven’t seen a kid going through some operation without his or her teddy bear or stuffed animal?
November 17th, 2010 at 12:29 am
One very big nitpick that I am not sure is correct but I am trowing it in because I forgot about it and it bugs me greatly: Vaccination in general works in two possible ways (we discussed it in an earlier review and D-r Scott actually expalined it pretty well but I’ll make a biref recap for those who forgot/not read it):
1. Active immunity – the vaccine contains weakened or modified or dead version of the virus/bacteria and when a person reseives it he produces anthibodies that protect him.
2. Passive immunity (that is the one that a mother gives to the newborn with breast milk!) but is used medically as well: the ‘vaccine”actually contains ready antibodies that directly protect the person vaccinated.
Now the second method is usually used for “fast”vaccination so to speak – when the person is already exposed and needs protection. It takes minutes/hours to take effect.The first methode is used routhinely when a danger for exposion exists (let us say if you are a medical worker and need protection from hepathitis because of the increased risk of exposure)
You see the probleme we have here at House? Why would they use a vaccine containig the danger (or an analog) to stimulate the immune systheme when it is already stimulated by the real stuff. If a person has been exposed to the virus in question his immune systhem does not need another virus to start working – it is either working already or is useless to bgin with. They should use anthibodies to treat not vaccine to protect. They should use the second type of ‘vaccination”.
My only concern here is that I know very little about smallpox in general so may be I am wrong. Whoever knows more please enlighten us all :)
November 17th, 2010 at 12:30 am
And oh yes the main problem with vaccination with dead viruses is that it takes at least a couple of days for the body to actually produce anthibodies. Right?
November 17th, 2010 at 12:46 am
Official Comment
Giving a smallpox vaccination to someone within 3-4 days of exposure to smallpox will decrease the severity of the disease (bear in mind this is well before the patient would show any symptoms). Giving it after four days is still felt to help, though the data is lacking.
November 17th, 2010 at 2:16 am
@ Dr. Bulgaria: You know, buddy, you’re pretty smart for a guy whose practice is limited to that part of the body found between the nose and the chin. What’s the story in your part of the world: when did your people stop vaccinating for smallpox?
I was born in California in 1959 and was not vaccinated for smallpox, and I’m fairly certain that my parents loved me. From the little research I’ve done on the subject, after 1958 it was no longer mandatory in some parts of the world because the possibility of infection was slim-to-none.
In addition, viruses are extremely fragile and must have a host organism to survive and thrive. Viruses die very quickly when exposed to the environment; case in point: HIV. The whole premise that a smallpox virus could have survived 200 years at the bottom of a cold ocean with no nutritional source is ludicrous.
Whatever happened to pitching “lupus” as a plausible differential? I miss those days…
November 17th, 2010 at 2:25 am
Quoting Headacheslayer “to add–I was born in 1970 and do have a smallpox vaccine scar on my arm. (I won’t rant on about the theories of the connection between it and CFS which I have).
I just have to laugh, there were fears of vaccinating children because of the fear of Autism from those vaccines.
If you have really been following up you would have fond that the evidence was faked. http://www.parentdish.com/2009/02/11/doctor-who-linked-autism-and-vaccines-faked-data/
November 17th, 2010 at 2:35 am
I could be wrong here, but I don’t think viruses need a “nutritional supply” in order to survive. Aren’t they (and bacteria) routinely frozen until further use? However, viruses DO need cellular material in order to multiply.
November 17th, 2010 at 4:00 am
@MedMavRx You made me smile :) Dental doctors here are pretty smart medical wise because we cover medicine while we studdy “that small area between the nose and the chin”. However: A. That small area is pretty complex and not that easy to learn and B. Don’t dental doctors all around the world studdy medicine routinely as well? Sure we learn less details but we cover everything basic-wise :) (To be honest I have no idea what dental doctors studdy outside of Bulgaria. Feel free to impart some knowledge :) Also I am a brain type “facts curator” wich means that I tend to remember “useless” facts for life. I guess that makes me some kind of lesser savant on medicine. sort of like House beta or House SuperLite :):):)
November 17th, 2010 at 4:01 am
@ D-r Scott Did they give small pox vaccination to the daughter as well? It seems like a waist considering she IS showing symptoms?!? To dad mom and bro OK but to her?!?
November 17th, 2010 at 4:30 am
Minor nitpick, but it seemed to me that the lesions on the girl’s and dad’s bodies didn’t seem like smallpox lesions in terms of size and density on the body.
Of course, all I’ve seen are pictures…
November 17th, 2010 at 6:51 am
Thanks Scott!
I watch the show with no medical knowledge whatsoever so it’s wonderful to be able to come on here and find out the facts behind the cases.
I do, however, know my sitcoms/dramas, and I was disappointed to see House again copying storylines almost directly from other shows: smallpox (ER) and little cancer girl missing her stuffed toy (Scrubs). And I absolutely hate Masters. The soap opera element of this show is going downhill, in my opinion.
November 17th, 2010 at 6:56 am
im just curious is the smallpox vaccine a “live” vaccine? is that why they thought he contracted vaccinia? im just a first year nursing student so we havent got into human pathopyshiology yet.
November 17th, 2010 at 7:46 am
Since you have so much knowlege about these inaccuranncye maybe some-one should create a foundation for accurate depiction of medice in (for a lack of a better thought word) filmograpy (or anything videoiee)
this way the director and writer and (sayers if there is such thing! in filming) can consult and find out from the viewing public like Scot,
this can lead to better production of videos and movies
and remember prevention is better than cure,
so better ask before and consult, when createing an inaccurate house episode or gray’s anatomy apisode, or batman virus or (a super drug to make you healthy, wealthy, and inaccurate!) :D :) :))
just though i’d put it there:))
November 17th, 2010 at 8:32 am
I for one loved the episode. House is still the best thing on television. :)
November 17th, 2010 at 9:20 am
D-r Bulgaria: The most common type of active immunity injection given after exposure would probably be the rabies vaccine.
November 17th, 2010 at 9:35 am
M3? I don’t get the reference. I first thought maybe M, from the James Bond series. She was a bit ethical, ok well maybe not really, but more than Bond. :P
Please explain, anyone?
November 17th, 2010 at 9:49 am
Official Comment
It’s nothing that clever. Master’s initials are MMM, hence M3 (and, conveniently, M3 is also an abbreviation used for third-year medical students).
November 17th, 2010 at 9:52 am
M3 stands for Martha M. Masters, played by Amber Tamblyn. I hope they keep her on. This actress can do more with a silence than most can do with a page of dialogue. See Joan of Arcadia and the late lamented Unusuals.
November 17th, 2010 at 11:05 am
1. Why was House wearing sneakers with a hazmat suit?
2. Why has the CDC guy refused to give interferon to the dad? House has convinced him that it might be a cancer, but the CDC guy refused on the grounds of quarantine restrictions. Surely the person already in the quarantined area wearing a suit can make a single injection, right?
November 17th, 2010 at 11:12 am
“*I* predict that by the end of this season, “Huddy” as we’ve all come to affectionately know our beloved dynamic duo will be no more….”
Let’s hope so. This season is better than last imo, but ‘Huddy’ is a dud – no sexual tension anymore. That’s boring.
November 17th, 2010 at 11:18 am
Great episode, Great review.
November 17th, 2010 at 11:34 am
Thanks for the review Scott, however one nitpicking comment on it: As an avid reader of your reviews I also thought house was shocking a flatline, but as Pcuser already pointed out: he really wasn’t. The sound suggests it was a flatline (but that might also be just an error beep), but the screen clearly shows something differerent (ventricular tachycardia?) right before he shocks her. When he sees the dad is flatlining he immediately starts CPR, so I think he actually did everything right! Or am I missing something?
Another point: I think purnodepurno (genius nickname by the way, only younger Dutch people will get it :p) was wrong. Being Dutch the use of Dutch in American series is also one of my terrible pet peeves and the actually got it quite right. The slaves were speaking a different language (probably Swahili as Mark pointed out), the guy in charge of the slaves was speaking Afrikaans (which is a kind of mixture of English and Dutch spoken in South-Africa), while the Doctor was speaking Dutch (the accent sounded like the South of the Netherlands or Belgium, while a doctor from that time would’ve probably been speaking common dutch but we’re getting into extreme nitpicking here), so that’s actually historically quite possible.
I’m really happy that they got the stripper right though… that sounds weird. Seems like they got someone who actually speaks Dutch natively, since she pronounced the G’s right in Dutch words. This is something which almost every show that I’ve seen use Dutch gets wrong, the pronunciation of those two letters is totally different in Dutch. However, there was a funny discrepancy between her pronunciation of English and the weird grammar errors she made. Quite a lot of Dutch people (especially older people) pronounce English really badly, they speak english words the way you would speak the same word in Dutch, which sounds absolutely terrible. Someone who is able to speak English that well would certainly make no grammar mistakes like that, they were very clearly scripted. Overall they got everything (language-wise) quite right though, credits for that! (By the way, I know none of this matters at all, but I found it funny to write down, maybe it will educate someone slightly ;) )
November 17th, 2010 at 11:47 am
So the daughter and father both got cut by the bottle and so were the only ones to show symptoms of R’Pox. The only reason the dad died was he had the Vaccinia infection in conjunction with the R’Pox. Ok, now I get :p
November 17th, 2010 at 12:11 pm
Scott, thanks for your wonderful reviews about one of my favourite shows!
Couple comments on this episode: There are bacteria which have the defensive ability to reduce themselves to inert spores; during this phase, they can last indefinitely without nutrients, water or even air (there are claims that scientists have reanimated bacterial spores recovered from 25-40 million year old amber). I have no idea if the rikketsialpox bacterium can perform this trick, but it is at least remotely possible that a glass jar recovered from a wreck might contain bacterial spores of some kind.
Smallpox, on the other hand, is a virus; the only way to preserve it outside a live host is to deliberately freeze-dry the virus. So the premise that anyone could get it in the way suggested by the show is implausible all the way through.
November 17th, 2010 at 12:27 pm
Just to add another small language-related nitpick. As pointed out above, the guy in charge of the slaves was speaking Afrikaans. However, Afrikaans has only really been around since the beginning of the 20th century.
November 17th, 2010 at 12:59 pm
QUESTION: at some point forman says that viruses can survive contact with water. Is that true, and why? if anyone could answer that i’d be really greatfull…
November 17th, 2010 at 1:03 pm
***** sorry***** i meant GRATEFUL
November 17th, 2010 at 1:33 pm
DIE, HUDDY, DIE!!!!
Why don’t the writers/creators just start inventing diseases and syndromes for House & Team to diagnose and treat? It would be easier to accept the bizarre medicine they sometimes practice if you already knew that what they were working on wasn’t even a real condition.
I’m shocked at myself – I really LIKED 3M this week! Hated her last week. Don’t care if she stays or goes, though.
No, Wilson’s little patient did not tear my heart out. My heart is made of cold, hard granite and that storyline just bored me. Actually, I ended up FFW’ding through most of her scenes. I’m completely indifferent to Sam’s and Wilson’s relationship B-storyline. I don’t care whether Sam stays or goes, either.
November 17th, 2010 at 4:44 pm
Before posting a question, you might want to read through my little summary of answers to the most common questions about this episode:
It is unlikely that a vaccination given pre-eradication would still be effective. To all of those questioning whether smallpox could survive in the jar: It is theoretically plausible, in fact,In March 2004 smallpox scabs were found tucked inside an envelope in a book on Civil War medicine in Santa Fe, New Mexico. The envelope was labeled as containing scabs from a vaccination and gave scientists at the Centers for Disease Control and Prevention an opportunity to study the history of smallpox vaccination in the US. The R-pox bacterium does not form spores though AFAIK. Again, house should have been wearing a chemiturion type or Racal type suit, the ones they had didn’t look like level four material. But if they were, he should have been wearing rubber boots taped to his pants. However, the fact that they had to pass the suit through the slot to him after the fact might explain the lack of boots. @ me, yes, the smallpox vaccine is a live analogue virus. @wildhousefan: viruses can survive contact with water for the same reason you and I can, they aren’t water soluble, and H2O has no effect on their genetic material (whether ssRNA, SSDNA, dsRNA, or dsDNA. it dosen’t matter) I believe that this has been said before, but giving the smallpox vaccine to a person who has already been infected can lessen the severity of the symptoms.
@Heather: I would tend to agree that the pattern of the lesions is not dense enough, but there have been specific cases where there are very few lesions. However, on face value, I would say that the pattern of the lesions would be a bit more indicative of monkeypox, a closely related virus that is somewhat less virulent. However, with their “diagnosis” of R-pox, the diffuse lesions do somewhat fit.
November 17th, 2010 at 5:12 pm
I was reading a bit about Rpox, but it does seem to suggest its not exactly a fatal disease. The show seemed to make it out to be just like the plague. Was this just another example of the show’s usual exaggeration?
November 17th, 2010 at 7:13 pm
Oh, come on. M3 only appeared to be smart because House and his cohorts contracted a severe case of plot induced stupidity this episode. Sitting on their collecitve bottoms while waiting for House to die? Yeah, that’s totally them. After all, no amount of thinking that they didn’t do would save anybody, right? It’s not like it’s their job or anything.
Actually, no one whose initials weren’t alliterative seemed to think normally, or at all, really. I guess the Plot demands Masters to be smarter than anyone in ten mile radius. It’s like she has an intelligence draining aura around her. She’s a vampire. A spotlight-stealing beloved-by-writers IQ vampire.
You guessed it, I don’t like her.
Also, I feel the Wilson could’ve at least knocked when his best friend was dying of a horrible disease. Seems like he was affected by the aura as well. Strangely, his wife appears to be immune – perhaps they could make a vaccine for the rest of the cast.
November 17th, 2010 at 7:56 pm
@ me: the vaccine which is used for smallpox is called vaccinia. It is a heat-killed virus. Essentially, the virus is heated so that it is no longer virulent and cannot reproduce. However, the body will still recognise the molecular structure of the virus and develops an immune response against it.
I think that in immunocompromised individuals, their immune system cannot fight the virus as effectively and hence they show symptoms – but i’m pretty sure its not to the extent as the dad has. Feel free to correct me on that one though
Just a side note: my immunology lecturer said that based on the current protocols and regulations today, vaccinia would never make it through to be a vaccine against smallpox
November 17th, 2010 at 8:17 pm
House sucks now, really. There was a time where people who didn’t know much about medicine, like me, would just believe any diagnosis on this show because they would mostly make sense. But it’s reached a point now where without even having a college edutacion it’s just SO GODDAMN obvious where the diagnosis fail and fail.
“it’s smallpox. it’s not. it is. it’s really not, it’s somethingsomethingpox” Oh yeah. Right.
November 17th, 2010 at 8:41 pm
M3 seems way too much like the latest pseudo-Cameron. I prefer the well-written character who was incapable of lying, as opposed to too pseudointellectual to do it. The writers really need to stop trying to write geniuses (besides House, obviously).
Otherwise, I’m with you on the soap opera elements, and as usual distressed by how bad the medicine’s gotten.
November 17th, 2010 at 9:45 pm
Couple more questions:
Why wouldn’t the suit have air-scrubbers/carbon filters to replenish the air supply?
There was a little door-thingie through which Cuddy passed House the suit (also this same isolation room was used in the third-season two parter dealing with Forman contracting Naegleria. (Euphoria Parts 1/2) Anyway, it seemed this door was a weak point for the isolation. The CDC doctor tells a story of how some of the virus got into the air vents at CDC HQ causing a death. This little lock has no visible means of evacuating the air inside it. So, the person in isolation would open it, the “contaminated air” would get in it. Then the person in the hall would open the box and now the contaminated air would get out into the hospital.
Oops.
November 17th, 2010 at 10:08 pm
enjoyed this episode more than most. 3M iproved tremendously as a true foil for House, though she still never strikes me as being all that brilliant. The medicine, inaccurate as it was (as though I would know), made sense….it followed a line ot reasoning, and I’ve always like that bit of intellectual challenge in House. The diagnostic process as been so wild of late, with so many things thrown in out of nowhere, that instead of feeling intellectually challenged. Liked having a medical subplot again; those have been missing of late.
It’s still lacking the wit that was so sharp in those early years, and I don’t know why the writers seem to be having so much trouble bringing it back. For a moment at the end of the show, I thought, oh, that might be the end of Huddy, how said…..and then thought, oh, that might be the end of Huddy, thank heaven. There’s been no real point to that relationship. All the great things that made up their relationship before they slept together is gone.
November 18th, 2010 at 2:53 am
hi ALPs36 thanks for the response. i am finding i am quite curious about vaccinations lately as i am an immunocompromised person due to being on biologic immunomodulaters for an autoimmune condition, ever since i started that medication i have been told i am unable to have live vaccines. i havent really looked into the reasoning behind that so if someone can answer that that would be great. i am really looking forward to doing pathopyshiology next year then i might have a better understanding of the diseases mentioned.
p.s i have missed a few episodes so thats the first i have seen of M3, i know its a show but wow she seems really young to be a dr and what has happened to 13?
November 18th, 2010 at 3:46 am
@Mojo Jojo
While you are right that the claim about an 8 y.o. African boy being the most intelligent in the world is absurd, you are wrong about the reasons: The true reasons are that the human brain is far from complete in its development at that age, that he would stand a disproportionate risk of malnutrition (and possibly other limiting environmental factors), and that he would belong to a group of people which (for whatever reason) tends to test poorly on tests with a high g-loading.
(A much better bet would be an 18 y.o. New York Ashkenazi.)
If we first look at IQ/g or “raw” thinking ability in some form, language is of a very secondary importance. Indeed, I have myself more or less stopped thinking in language, except when I am forced to do so in order to communicate with others. (Telepathy is nice in theory, but does not actually work…) Indeed, language slows down thinking—often quite considerably. It can further impose limits to thinking by making it harder to get around a lack of pre-existing words or concepts.
In a bigger picture, intelligence is more than IQ (and the definition varies from source to source); however, additional factors that are actually useful can include knowledge, training in methods of thinking and problem solving, experiences gathered, …, but not actually language skills. Language is a useful tool for gaining (and spreading) knowledge of various kinds, but it does not, in it self, actually have a positive effect on intelligence.
November 18th, 2010 at 8:53 am
“Me: Re: 13, Olivia Wilde is shooting a movie so the producers gave her time off. In the story we don’t know exactly what she’s doing other than she left.
3M’s age has been said to be “effectively” the same age as 13 and, indeed, the actress is about the same age as Olivia Wilde. 3M is a child prodigy who graduated High School at 15, has gotten masters degrees in physics and math and is now in medical school so she’s “behind the curve” in where she should be at this point had she gone for being a doctor right out of high school. She’s only a third-year medical student.
November 18th, 2010 at 9:17 am
@ALPs36: Check your textbook, Vaccinia is used as a live virus.
November 18th, 2010 at 12:13 pm
@ Michael Eriksson
First off, “I have myself more or less stopped thinking in language…” — what?
Secondly, language seems to have some sort of effect on intelligence– consider feral children: they aren’t exposed to any language in their youngest years and never make up that gap if they aren’t found before that critical window closes. It’s something separate from the sheer neglect or malnutrition or isolation. That’s hardly comparable to an oral culture, of course, but there does seem to be some impact.
November 18th, 2010 at 2:00 pm
@Michael Eriksson: I suggest that you do further research. Even if you are able to think in some advanced way that requires no language now, and it is inarguably superior to using language, you still have passed through the thinking using language step.
There are some deaf people who grew up without language and they were subjected to a test where something was put into a room and the room had one blue wall. Later, they couldn’t remember the location of the object, and researchers thought it was likely because language introduces concepts like “the bottom left of the blue wall”, and these types of thoughts are nearly unimaginable to a person without any language. Once they were taught a language, the task became simple.
November 18th, 2010 at 5:00 pm
The Rickettsiapox is self limiting and not deadly.
November 18th, 2010 at 5:56 pm
@me: I am not medically trained, but a short use of my reasoning and the first hit on google confirmed: live vaccination contain a weakened form of a virus that is still active, hence able to duplicate. In an immunocompromised person, that means a serious risk of getting the full blown infection which they are vaccinated against, because the immune system might not be able to fight even the weakend virus. check for example http://www.medscape.com/viewarticle/421487_6 .
@d-r bulgaria: in germany at least, medical training for dentists covers the same 5 year university and practical training every doctor needs to fulfill, after that, there is an additional 2-3 year training in the respective specialties.
@elam: to your feral kids point: I’m not sure if I follow your argument. As I’m sure is obvious I’m not a native speaker. I understand you as follows: feral children never make up the gap in language or communicative abilities when not found bevor a critical window. That is correct, but to draw a conclusion to intelligence from there is absolutely incorrect. Language is an ability which is anchored in our genetics and our ability to aquire language is on a quite strict time-course. For example, infants can still discriminate all existent phonemes, but at some point, as we get experts in our language, that ability diminishes. That is one of the reasons way it is so damn hard for chinese and english people to speak the respective language correctly (accent-free)- the languages don’t share all phonemes. So for the english person, two chinese words may sound 100% alike, whereas for the chinese, one phoneme is clearly different.
There are several other language-related phenomena in children which disappear over time. That explains why a person who didn’t acquire a language in that critical period will never close the gap and has nothing to do with intelligence.
On intelligence in general, it’s a difficult discussion since the concept is less than clear. I forgot who, but someone brought it to the cynical point: intelligence is what intelligence tests measure. Other that that, in your discussion it might be fruitful to distinguish fluid and cristalline intelligence – one which more or less equals the g-factor and comprises things like ability to reason, solve problems, think logically etc, and one which accumulates over the life span.
I tend to agree that knowledge is far from being the same as intelligence. On the other hand, intelligence is also defined as being the thing which determines how easily one acquires and stores knowledge. that is why some intelligence tests include questions concerning general knowledge. so, if a person is able to quickly and effectively gain vast amounts of knowledge and apply it, that is a pretty good indicator of high intelligence.
One last thing, concerning the metaphor of the chlid which never gets an education: our brain is enormously plastic (hope this is the correct term in english) – meaning education and ability to adopt intelligence related capabilities has quite an impact on intelligence. So someone who does not have the opportunity to engage in reasoning, learning etc will very probably not be the smartest person on earth. But of course, to train those abilities, language is an essential tool.
Excuse my escalating post :)
November 18th, 2010 at 10:05 pm
Is “The Next Three Days” the movie Olivia Wilde left for? It doesn’t seem like she has a particularly big role in that (I’ve seen lots and lots of Russell Crowe, Liam Neeson, and Elizabeth Banks in the trailers, though Wilde’s is usually the fourth name given in the cast with them)
November 18th, 2010 at 11:41 pm
Official Comment
Wilde left for Cowboys & Aliens — a movie also starring, among others, Sam Rockwell, Daniel Craig, and Harrison Ford.
November 19th, 2010 at 2:23 am
@elam
Yes: More or less all thinking can be done without language.
Feral children are poorly investigated, so it is hard to say anything with certainity. The main problem in my impression, however, is just that they have problems developing language skills—an effect reasonably compatible with many theories on language development.
Even if they do have a limited development in more general intellectual areas, this could also, possibly, be explained by lack of appropriate stimulation of other kinds. (Further, I have no objections to language’s role as a means of communicating various kinds of knowledge. It is a claimed direct effect that I am critical of. The effect of language, however, would be the stronger the more we speak of knowledge and the weaker the more we speak of g.)
@Mojo Jojo
Even if I have passed through a language stage in one area, it does not follow that this stage was necessary. Further, there are areas where I have not passed through such a stage. Examples include playing soccer (as a child, some oral instruction needed), solving differential equations (as a teen, some textual instruction needed), and doing sudoku puzzles (in my late 20s, no instruction needed).
Concerning deaf people: The problem here is a lack of concept, not a lack of language. (And, again, I do not deny that language can be a valuable tool to e.g. communicate concepts.) Similarly, there are things that I remember or not remember depending on whether I have developed a concept for it (without necessarily having a corresponding word—language is not necessary to invent concepts).
November 19th, 2010 at 8:14 am
@Steven R
That parentdish article makes some good points: that there is no link between the MMR vaccine and autism, and that the scare had terrible repercussions in the UK (not just “England”)
However, I disagree with demonising Andrew Wakefield, and laying the entire blame at his feet. I’m not saying he’s blameless, but the whole sad story cannot be entirely blamed on him.
Dr Ben Goldacre points out that Dr Wakefield’s paper “never supported the conclusions ascribed to it,” that it was lazy, ill-informed, scaremongering journalists who whipped up the scare story, then pinned all the blame on the Wakefield. Furthermore, he says:
“It is madness to imagine that one single man can create a 10-year scare story. It is also dangerous to imply – even in passing – that academics should be policed not to speak their minds, no matter how poorly evidenced their claims. Individuals like Wakefield must be free to have bad ideas. The media created the MMR hoax, and they maintained it diligently for 10 years. Their failure to recognise that fact demonstrates that they have learned nothing, and until they do, journalists and editors will continue to perpetrate the very same crimes, repeatedly, with increasingly grave consequences.”
Full article, and many more, available here: http://www.badscience.net/2008/08/the-medias-mmr-hoax/