House — Episode 21 (Season 7): “The Fix”
Another relatively uninteresting episode of House, despite having two patients.
Wendy Lee, a weapons designer, suffers a tonic-clonic seizure in the middle of a weapons demonstration and is admitted to House’s team. According to House, her initial differential diagnosis consists of a brain tumor or a brain bleed, so Foreman orders an MRI.
The MRI is normal, and the team learns that Lee has a vindictive ex-boyfriend and may be a victim of poisoning, but her toxin screens were negative. Chase wants to start her on activated charcoal, just to be on the safe side. The team searches both Lee’s and her ex-boyfriend’s house. The search of Lee’s house turns up a crate of empty liquor bottles, so the team now suspects she may be an alcoholic, which she denies. They start her on Valium to assist with alcohol withdrawal. Next she develops severe stabbing abdominal pain that requires morphine for relief. Foreman takes this as a sign of acute pancreatitis, which can be related to alcohol use. Thirteen thinks Lee has a stress-related condition, and Chase thinks she has pyelonephritis, a kidney infection.
Lee has another seizure and the tests have all been normal, so the team is back to square one. Chase posits that the CT scan and ultrasound show some inflammation around the kidney, so suggests that Lee may have an obstructing kidney stone or a perinephric abscess. Taub thinks she is having neurological symptoms secondary to a urinary tract infection, so starts her on ampicillin and an aminoglycoside antibiotic.
Lee takes a turn for the worse, developing ventricular tachycardia and then a heart attack. Surgery is performed to place an AICD (automatic implantable cardioverter defibrillator), but during surgery, Lee is noted to have both rectal and vaginal bleeding. The differential diagnosis now consists of a surgical error, a blood clotting disorder, or toxin exposure. Foreman goes further and lists cancer, sepsis, trauma, liver disease, and hemorrhagic fever as possibilities as well. Lee then develops bleeding gums, leading to a new differential of candidiasis (a severe yeast infection) or acute myelogenous leukemia (AML). The team ultimately decides she has AML caused by radiation exposure, most likely from her work. They place her in isolation and ready a bone marrow transplant. It is then that her swollen genitals are noticed. Once again, this changes the differential. Chase and Thirteen confront her boyfriend who eventually admits that due to her infidelity, he has been poisoning her with Spanish Fly (a very irritating chemical that can be — allegedly — used as an aphrodisiac, but there is a thin line between useful dose and toxic dose).
Meanwhile, House has lost a bet over a boxing match to Wilson. Unwilling to concede defeat, he thinks that his fighter either threw the match, or has something medically wrong with him. Initially House suspects an abnormal heart rhythm like Wolff-Parkinson-White (WPW), but the tests are negative. Next he thinks the boxer has sympathetic overdrive, but is proven wrong. Then he suspects water intoxication relating to a kidney disorder, but his tests again show he is wrong. Finally he proves that the boxer has a glomus tumor, which caused him to pass out shortly after it was pressed.
As usual, major complaints are in red, modest complaints are in blue, and nit-picking ones in green:
Taub stalks out when Foreman starts listing all the things that could cause Lee’s condition, implying that is the wrong way of going about treating the patient. Apparently Taub (and the writers) are unfamiliar with the true concept of differential diagnosis, because that is just what Foreman is doing – listing all the possible causes – the differential diagnoses, if you will – of Lee’s condition.
Taub stating he’ll treat the symptoms sounds good in practice, but is problematic in reality without knowing the underlying cause. For example: the patient’s seizures. If they are classic grand mal seizures, then that’s one treatment. Alcohol withdrawal seizures uses a different treatment. Or maybe it’s eclampsia – she could be pregnant – and those seizure require still another different treatment.
Activated charcoal won’t do any good once the poison has passed from the gastrointestinal tract, which would have been the case when Chase suggested using it. (Of course, Chase may have ended up being right to suggest using it, since Cesar must have still been poisoning her in the hospital — but as far as the team knew at the time, any poison exposure would have been hours, if not days, before.)
The tests show no urinary or kidney infections, so the very next thing Taub claims Lee has a urinary infection.
The ultrasound and CT scan which showed the inflammation around the kidney probably would have shown the kidney stone too, or at least signs of urinary obstruction. They should also have shown a perinephric abscess.
A quick and simple blood test will show pancreatitis.
I’m willing to bet that the research scientists have a better way of getting experimental drug “CS-804″ into suspension, and that heating the drug like that may very well ruin it.
This week’s medical mystery was rather pedestrian. There haven’t been any cases that started interestingly for several episode now. The boxer was a little more interesting, but that was mainly for the potential House/Wilson conflict. The medical mystery gets a C . The final solution fits, assuming Cesar kept poisoning her while she was in the hospital. The boxing solution was more of a stretch. I give them a B-. The medicine, in both cases, was very sloppy and demonstrated beyond a reasonable doubt that the writers have no idea what a differential diagnosis actually is: D. Another C. The soap opera was barely there and fairly week and deserves only a C.
The review of the previous episode of House
A list of all prior House reviews
May 9th, 2011 at 11:05 pm
Thanks, Scott. I thought a powder form was a rather odd choice for an experimental drug.
Next week, aside from the obvious tumors, we get to see IV antibiotic treatment of House’s cellulitis. I have yet to see an IV drug user, of any sort, that does NOT have at least a mild cellulitis.
There’s another “Law” in there somewhere.
May 9th, 2011 at 11:58 pm
Okay, the guy who was taping her picture to the target was Glenn, right, the same one that Cesar called a psycho-ex, and who he was referring to before. The guy with the picture seemed quite sure that she was his ex.
But later 13 explains that Cesar “found out about Glenn,” which suggests that she was with Cesar first. This would make sense if she was dating Cesar, started dating Glenn, and then broke up with Glenn. But that doesn’t make sense, because Thirteen reports that Cesar said he shouldn’t be surprised because he started going out with her when she was with Anthony.
Huh? I think the writers mixed up Glenn and Anthony.
May 9th, 2011 at 11:59 pm
The “research scientist” scenes make me finally empathize with what Scott must feel about the shoddy medical scenes.
May 10th, 2011 at 12:30 am
Bad medicine notwithstanding… yeah this was a pedestrian episode, but this one spoke to me because I have a condition (essential tremor) for which I would give _anything_ for a magical cure. This is the first time in quite a while where I’ve said “yeah, I get why he’s doing that” for House’s behavior. As a result of that I enjoyed that HIS drama boiled around what he wasn’t doing rather than what he was.
May 10th, 2011 at 1:06 am
The delivery system for the experimental drug was obviously concocted so that the previews would make it look like House was using heroine. It was also way too convenient that the researcher left the cabinet open with another doctor in the room who would 1) potentially benefit from the drug, 2) has a history of, and a reputation for, doing suicidally insane things to lessen his pain and 3) has no other reason for being there. The guy has to know House or he wouldn’t let him in at all, and if he does know him leaving him alone is the last thing he would do. Also, he has to have some kind of inventory of the drug and has to have noticed that some is missing. I realize his trials only involve rats but he would have to have pretty thorough documentation to get past the rat phase. The whole thing is way too contrived. The thing I used to like about this show is that the writers rarely underestimated the viewers this much, or at least the ones who didn’t have a medical background.
By the way, didn’t House get married recently? Too inconvenient a plot point to follow through on? I almost hope that they end this season by having House wake up from a dream (or a Vicoden binge). Sure it’s been done before but at least then we can all just pretend this season, or at least the second half of it, didn’t happen!
May 10th, 2011 at 5:17 am
Worst drug trial ever.
I have to say, I was hoping that House had accidentally been injecting himself with placebo.
May 10th, 2011 at 5:38 am
The episode seemed a bit silly to me, and I am not even a doctor!
What I found most hard to believe was the lack of any real focus on anything; it wasn’t focused on medicine, or on characters. Was really dull overall. No real tension in the episode at all.
BTW, I enjoy ur reviews :)
May 10th, 2011 at 6:37 am
Wilson’s dancing was the highlight of the episode for me. More of that acting up please.
May 10th, 2011 at 7:03 am
An AICD is implanted under local anesthetic through a small slit in the upper chest right below the collar bone. What kind of surgical error could occur that would cause vaginal bleeding?
Doesn’t spanish fly cause intense urinary irritation? You’d think that she’d already be being treated for a UTI.
The boxer case alone would have been more interesting if fully developed.
May 10th, 2011 at 7:18 am
Medical mystery(s) this week were mundane (a seizure, a collapse?), and the medicine pretty much went downhill after that. I’ll just trow in a couple of things that irritated me but I seriously thing there were to many to mention each one separately:
A) The boxer
- Water toxicity was idiotic idea – if the guy had kidney problems of that type he would have said: “I cannot pee” D-r Scott mentioned repeatedly that the first 4 major questions every doctor asks are: Problems 1.eating 2. poo and wee 3.sleeping 4.with pain . Question two would have revealed it all. But then again when did we see House take a proper history :)?
- If the said tumor did have said effect I doubt the guy would just drop – he would feel some of the shock/electricity thing House mentioned. All in all symptoms rarely present like this – bang you are down. You feel dizzy you stumble left and right (other people asking you are U all right :).
- sympatetic overdrive is also a stupid idea. The guy would be down on the floor two minutes into the fight not 4-5 rounds. He would be down before he is punched (probably)
B) The final diagnosis made perfect sense. The differentials they were trowing were idiotic to say the least. Here are some of the gems:
- Pancreatites (normal blood work)
- Radiation poisoning (same as above plus her intestines were fine at first. Guts are the first thing to go if you have RP) Oh yes her hair was not falling and her skin was perfect and smooth :)
- Infection (all the types they mentioned – pyelonefritis, kidney abscess (actually perinephral abscess but all in all abscess), hemoragic fever, all of those would show on the blood work. Also she was not feverish and she was not vomiting (except blood :)
- Problems with the gums of that type would point me towards leukemia as well. Candidosis was stupid idea – you need months of untreated infection in the mouth to get there. Patient was fine at first.. I would also consider HIV as cause for immuno compromised mouth (The main problem with all those things is that they take time to develop. I am fairly sure your gums can’t get that way overnight – no disease covers that symptom. If we assume it was the radiation or the poison – well she would die before her gums look like this)
The soap opera was supposed to be intense and intriguing but it failed on both fronts. Sure Wilson House and 13 interactions was fun to watch but the writers are obviously pointing us toward the finalle and trying to bring drama in (Ohhh experimental drug will kill House!) but I did not feel the drama. Sorry. May be it was because the whole drug can grow muscle medicine felt like… sucked out of the fingertips. It is not in the spirit of House to throw fantasy into medicine and then sell it. Crazy unbelievable medicine – yes fantastic impossible for now medicine – no. My grades would be C for the mystery (both), D for the medicine (make that D- for the Young Guns case), C for the solution (C- for the boxer, B- for the girl). And a dissapointing C- for the soap. We have to gather our strengh guys – we are almost at the finish line. Would the show be renewed for one more season? Or is House about to die dramatically? (and literally?!?) We’ll wait and see.
May 10th, 2011 at 7:23 am
I was hoping House would drop three Vicodin and immediately seize due to a drug interaction with CS-whatsit. Is it bad when you hope the star keels over?
May 10th, 2011 at 8:59 am
I thought the gums were a sign of hydrofluoric acid poisoning. Deep burns that are slow to develop and initially painless accompanied by heart failure. It’s a chemical that could be found in a research lab. A lot easier to get than real spanish fly.
May 10th, 2011 at 9:07 am
Medicine aside, this was some lousy writing and directing.
1. A military weapons facility has no EMTs or medical personal of any kind requiring the guy to yell for 911?!
2. House threw away the leg strap with the drugs, then when he feels better, tests the leg strap BUT later reveals the drugs are STILL in the trash?!
Was this script punched up last minute? I’m bitter.
May 10th, 2011 at 9:17 am
I thought the soap, lurking in the background, was actually pretty good. For one thing, Wilson implied that the boxing bet and the chicken contest a couple of episodes ago (which was ripped off from Social Network) are his attempts to distract House from his Cuddy-related misery. And Cuddy’s brief entree in this episode had her sacrificing the good of the patients/hospital to her fear of confronting House. She is getting ragged and bitchy in a way she was not before, I think. I enjoyed House’s interactions with the boxer, and the team’s interactions with each other and the patient. It was not a spectacular episode (except for the pseudo-junkie scenes) but the balance of suds and medicine was good.
I noticed a black spot on the back of the boxer’s neck early on, in the first gym scene I think. Would a tumor like that be visible? Or did they paint a target for House to hit when they shot the final boxer scene?
May 10th, 2011 at 9:31 am
My guess as a tie-in to the Wilson-House bet was that House was using steroids of some type for his leg and never suspected hard drug use like heroin. (I don’t watch the spoiler previews.)
I was also wondering how House knew he wasn’t getting a placebo with the same feeling as Ledasmom. Didn’t he learn anything from Foreman and 13? ;^)
And I agree with Colorado Dave about Wilson… he bad!
May 10th, 2011 at 11:01 am
In early stages of testing the control is simply labelled control (or whatever it literally is). You don’t start blind testing until much later when some kind of positive result is seen.
May 10th, 2011 at 11:09 am
I really wish they wouldn’t write the underlings as idiots whenever House isn’t around. I’m sure finding the reason when the reason is someone is poisoning you is difficult and not as interesting as heavy metal poisoning from gold, but they made Foreman et al seem completely useless and in need of House.
There have only been a few moments where someone other than House had the Eureka moment and I guess in episodes like this it would be nice to see the all-stars be something more than House’s lackey.
Also, I noticed they don’t use the “white board” much anymore, maybe that is why they lost the magic.
Thank god for Wilson, I think it’s time for him to hacksaw 3/4 through House’s cane again…. I’m sure he’ll need it after next week.
May 10th, 2011 at 11:32 am
A metal wheel chair in an MRI room, neat trick.
May 10th, 2011 at 11:50 am
So the poisoning was being done slowly via food or drink, in order to prolong her suffering??? Rather than all at once in a fit of rage? But the poisoner successfully impersonated a concerned lover as he’s torturing her?
Is it true that spanish fly is so unlikely to be detected, if he’d given her a single fatal dose they would have been stumped?
May 10th, 2011 at 12:04 pm
Can anyone tell me what happened at the very end of the episode? My DVR cut out right as the scientist started walking towards the cage.
May 10th, 2011 at 12:19 pm
@Maven
He sees that the rat is dead.
May 10th, 2011 at 1:34 pm
I felt really cheated by the “Oh surprise — it isn’t heroin House is shooting!” gimmick. (Does the researcher cook the drug in a spoon over a gas stove before giving it to the rats? Is this generally how experimental drugs are tested? I’m not a doctor, so granted I don’t know for sure — but for some reason, I doubt it.)
I was really looking forward to 13’s return, but I have found her nothing but annoying since she came back. Did she actually suggest that the patient was simply suffering from “guilt” about helping to develop advanced weapons? (Note to any good-hearted pacifist folks — exquisitely targeted precision weapons are a sign of a civilized people who want to limit collateral damage. It is a LOT cheaper to carpet-bomb than it is to spend millions/billions on a targeted weapon with a CEP that is measured in inches.)
Maybe Oliva Wilde insisted on more “creative control” over her character as a condition of coming back to the show? They should have let her go be a movie star. . .
May 10th, 2011 at 2:31 pm
What ever happened to the rat, “Steve McQueen”?
May 10th, 2011 at 3:19 pm
Another so-so episode but it left me wandering what’s going to happen with House, since that experimental drug killed the rat…
PS: All the experimental drug procedure was so unreal…even without knowing how are the correct procedures you just know that something was terribly wrong…
May 10th, 2011 at 3:35 pm
So they renewed for an eighth season. I guess we get one more year of the House deathwatch.
May 10th, 2011 at 3:43 pm
Re “House isn’t really shooting up heroin,” I thought he was using heroin at the beginning, then switched to the experimental drug. Why else would he be talking to the research scientist as if it were his first visit to the lab? And did he cook the experimental drug too? I thought he only cooked the drug at the beginning of the show.
I deleted the episode from my DVR so I can’t check these things.
May 10th, 2011 at 3:58 pm
They haven’t renewed yet. I REALLY hope this is the idiocy that finally kills him.
May 10th, 2011 at 4:13 pm
Official Comment
Dr. R is right, House was renewed for an eighth season today.
May 10th, 2011 at 5:41 pm
I’m still reeling from “engorged genitals” and “I smell vaginal bleeding.” The last time I heard a line like that on TV, it was spoken by Marmaduke.
Ruh-roh!
May 10th, 2011 at 5:48 pm
I’m willing to give the benefit of the doubt with the mainlining of the drug, we never saw the researcher doing it – this is just House’s method of choice with a hypo in his kitchen.
And as Foreman started listing out possible causes, I thought FINALLY a real differential and then I literally laughed out loud as Taub walked out.
I know he’s a plastic surgeon by training, but surely he knows how this department is *supposed* to work by now.
Also I’m surprised House jumped to such zebras on the boxer when a more realistic and simple explanation for him winning his first 20 fights and then suddenly losing 6 in a row — drugs?
He finds the boxer depressed, friendless, and most importantly the symptom that set it all off: ANISOCORIA, which is often indicative of drugs.
But noooo must be a rare congenital mutation.
May 10th, 2011 at 6:38 pm
Thirteen’s talking about karma in regards to to the patient bothered me. If she was sick because of her work, who was Thirteen in a previous life? Hitler? Stalin?
May 10th, 2011 at 7:20 pm
I was also wondering how House knew he wasn’t getting a placebo with the same feeling as Ledasmom. Didn’t he learn anything from Foreman and 13? ;^)
Placebo? For a rat?
NAD, so I was able to really enjoyed the patients’ link-in with House’s pathology. No great recommendation, perhaps, but it worked for me (first time the post-Cuddy development really has), and I’m looking forward to where this is going. Wilson’s theory about getting House back to doing stupid but typical House-business was applicable to the show, IMO. First time I’ve really thought, ‘Yeah, Season 8 – bring it on!’
May 10th, 2011 at 7:31 pm
@Biff
AFAIR it was reported that the rat actor playing “Steve McQueen” just died and for this reason they are not interested in reviving the character with a different rat.
But it was a few years ago.
May 10th, 2011 at 7:50 pm
@someone: Its a good thing he IS dead; otherwise, he’d be facing a salary cut like the rest of the supporting cast.
May 10th, 2011 at 8:55 pm
This was a mediocre episode, but one scene caught my eye. About 11 minutes in there is a power walking scene, quite extended, with the 4 young doctors walking through several halls and turning two or three corners. During this scene 13 occupies House’s usual position, in the center (with Taub squeezed to the rear and saying nothing), and she is also running the conversation. Although Foreman is the senior junior guy, 13 seems to be the real power center of their group, at least based on body language.
May 10th, 2011 at 10:20 pm
I watched because I heard there would be Wilson. That was the best part. Everything else left me dumbfounded because the starting premise did not make sense. US Defense funded weapons design is top secret. The designer would not engage in unnecessary conversation with anyone about the nature of her work. The other thing I have grown to hate is the idea that qualified spend their time whining about their boss who refuses to do his job. What the hell happened to House the medical mystery drama?
May 10th, 2011 at 10:39 pm
A jilted lover using Cantharidin is almost a Cliche’….
And how did Thirteen know House wasn’t using heroin?
May 10th, 2011 at 11:27 pm
By coincidence I watched a repeat of “The Softer Side” this morning that had all the staff thinking House was using heroine (when he was trying out Methadone); and Foreteen pretend to be broken-up (to avoid a feared House reprisal) and 13 says something to Taub about him not knowing what it’s like living with Foreman.
May 10th, 2011 at 11:27 pm
Doh! “heroin”
May 11th, 2011 at 12:07 am
Is there any reason why the Spanish Fly didn’t show up on the tox screen? If there is, I missed it.
May 11th, 2011 at 1:57 am
I suppose after 7 years such details as “improper defibrillator technique”, “inappropriate time to use defibrillator”, and “no eye protection in surgery” are no longer medial mistakes, they are just part of the show (ianad).
The show is badly in need of something crazy happening, otherwise I have no idea how it will last another year.
May 11th, 2011 at 2:44 am
I’m with @zimbabwe….I’ve had chronic daily headaches and complex migraine disease for 6 1/2 years now (nevermind my other chronic illness/pain for 16 years). I’m ready to have them cut my head open and poke around my brain. ANYTHING to make the pain stop for good.
It’s like House said in Euphoria–Pain makes us make bad decisions, fear of pain is almost as big a motivator.
YAY! Wilson! RSL seemed to be in a much better mood this ep. Maybe his stint away gave him a much-needed breather.
I *love* 13’s new badass attitude. I keep thinking of a 13/House ship.
YAY! SEASON 8!
But yeah, the medicine sucked.
May 11th, 2011 at 5:45 am
Linda Park, the scientist, was an actress on the Star Trek series Enterprise.
Although it took them forever, the Team figured one out for themselves so I will give them a single point for that.
House has again taken being an idiot to a new level. I am happy to read that the series has been renewed. I still enjoy watching it. Perhaps having to trim some costs will make them focus on the story more than the flash.
May 11th, 2011 at 7:04 am
A lot of commenters on this blog like to assert that the quality of the show is declining over time. Has anyone ever attempted to quantify this by plotting Scott’s episode ratings? i.e. Was the average rating in season 2 (for instance) higher than it is now?
May 11th, 2011 at 8:04 am
Am I the only one who noticed House’s wife has gone missing?
May 11th, 2011 at 9:56 am
@ Tom
House explained that his wife took off in the episode where he picked up Thirteen.
May 11th, 2011 at 12:59 pm
An extremely hit-and-miss episode, with a lot more misses than hits.
May 11th, 2011 at 1:50 pm
@juan: He’d have to decide first =)
See above:
“The medicine, in both cases, was very sloppy and demonstrated beyond a reasonable doubt that the writers have no idea what a differential diagnosis actually is: D. Another C.” – so what is it, C or D? =) not that it’s that important.
And personally I’m still desperately hoping for the whole season to be nothing more than a total hallucination or wild dream, because it really lacks much compared to even season 6. I hope next year will be more exciting… I miss the crazy good finals from the seasons 2 – 5 so much.
May 11th, 2011 at 2:28 pm
@Hibbleton : Very good point mentioning the hydrofluoric acid poisoning. The gums would look exactly as you said. I completely forgot the damage that fluor can do to the gums in such cases. The only major problem with that idea would be timing – she developed the problematic mouth 3 days after her admission. Hydrofluoric acid poisoning would present about 24hours after admission (tops and that would be stretching it actually. Make that 12 hours). And it is not painless; no, no, no :(. Sure it starts painless but once the bone is exposed it is PAINFULL. She would be screaming in pain if she had developed ulcers like this. And she would also die :( about 24 -48 hours after admission. Severe fluoride poisoning is incurable…
May 11th, 2011 at 2:39 pm
@Horsefly, you wrote: “Placebo? For a rat?”
Yes, and it’s not because the rat needs to be blind to whether s/he is in the control group or the treatment group. There are two reasons for random assignment to treatment or control:
1) Without a control group there is no way of telling whether the rat would have had those observed changes across time anyway, in the absence of an effective treatment.
2) Even in rat studies, the people administering the “medication” to the rats would be using coded doses. Many studies have been conducted to determine whether researchers will behave differently if they know that someone (even a rat!) is getting a treatment or a placebo. This is called the experimenter expectancy bias. In one study researchers randomly assigned students to taking care of a lab rat that they were told was either bright or kinda stupid. The students weren’t told that they were the actual subjects of the study. The students treated the supposedly smart rats better and the dumb rats worse, so at the end of the study, the supposedly smart rats performed better than the dumb rats. (Rosenthal & Fode, 1963)
May 11th, 2011 at 3:18 pm
mmmmm…. HOSHI! I hate Hoshi.
May 11th, 2011 at 7:20 pm
Oh, puh-leeze! Everyone knows that “Enterprise” was just “Star Trek Lite.” The only cool person on that show was Connor Trineer who went on to play an awesome wraith in SGA.
May 12th, 2011 at 12:02 pm
@juan, I had a slow day at work, so yes, I’ve analyzed our reviewer’s ratings for all the episodes reviewed to date.
– The red, blue and green nitpicks didn’t appear until the beginning of Season 5, so they could not be used to compare seasons.
– Four grades (medical mystery, solution, medical overall, soap) have been provided for most episodes. To facilitate the analysis, the letter grades were converted to numbers. Specifically, A+ = 12 points, A = 11, A- = 10 … down to F = 0 (there were no F+ or F- ratings).
The episodes can be compared across seasons to see if there has been a change in what is typical, middle, or average for the four ratings. The middle score is the median, and it’s usually an actual score, so it’s easier to interpret here and uninfluenced by extremes (a random F or A+ that might not be typical).
For medical mystery, Season 4 got the highest median rating of 8.5, which is between a B and a B+. The worst season for medical mystery: So far, it’s this season, with a median rating = 7 (B-).
For the solution, Seasons 1 and 2 had the highest median = 9 (B+). The worst season for the solution: So far, it’s this season, with a median rating = 4 (C-).
For medicine overall, Season 2 was rated highest, with a median = 8 (B). All other seasons were rated with medians = 5 (C).
For the soap, Season 4 was rated highest, with a median = 9.5 (between B+ and A-). This season had the lowest median rating = 8 (B).
Therefore, using three of the four kinds of ratings, this season is coming out as the worst (in terms of medians).
Two other things:
– Another way to measure quality is consistency. The mystery and solution ratings for this season were more variable than any other season.
– This analysis assumes the rater has been reliable and has not changed across the seven seasons. He is not a perfect measuring tool, so the differences could be attributed to him.
Whether there is a statistically significant difference among these medians (or means, which I also could compare) has not been determined. I could run the analysis, but I have a meeting now.
I wonder if I could get this published … ;-)
May 12th, 2011 at 12:54 pm
Elle, I hope you have a great job!
This episode left me terribly confused at many turns. How, all of a sudden, did all of the Cottages suddenly forget how to do a differential? Where’s the whiteboard? I guess I’m glad that the medicine confounded others as well.
Wilson’s dance nearly made up for this mess. I kinda want to know whether it was scripted.
I’m still not understanding why the new, dumbed-down House would cook the powder. If I missed an explanation above, could someone please point it out? Thanks.
As always, Scott, bang-up job.
May 12th, 2011 at 2:59 pm
Wow, Elle! Thanks for the analysis! And thanks to Scott for the helpful episode analysis as well.
I actually enjoyed the plot more than most people here did, even though the ending reminded me of “Flowers for Algernon.” I’m looking forward to seeing where they take this storyline. (Obviously, they can’t let House die, since they just renewed for Season 8.)
May 12th, 2011 at 3:12 pm
Elle: Do you, by chance, happen to remember the episodes with the best and worst scores? And if any episodes got an A for Medicine?
May 12th, 2011 at 3:43 pm
@Dr. R, taking your second question first, only one episode got an A for medicine overall: Clueless, Season 2, episode 15. The following episodes received an A- for medicine overall (in parentheses, the first number is the season, and the second number is the episode number):
Role Model (1-17), Acceptance (2-1), Fools For Love (3-5), Guardian Angels (4-4), Whatever It Takes (4-6), and Don’t Ever Change (4-12).
As for your first question: best and worst scores on which rating?
May 12th, 2011 at 4:30 pm
Another lull at work and back to Dr. R’s first question. Again, the numbers in parentheses are (Season #-Episode#).
Ratings of the medical mystery — There were 14 episodes earning an A for the mystery (too many to list). The lowest rating given for the mystery was a D, given to four episodes: Human Error (3-24), Two Stories (7-13), Painless (5-12), Office Politics (7-6).
Ratings of the solution — Ten episodes earned the top rating of an A for the solution (too many to list). Two episodes earned an F for the solution: A Pox On Our House (7-7) and Love Hurts (1-20).
Soap ratings — The top rating was an A+ : Babies and Bathwater (1-18). There were 34 episodes earning an A for the soap (too many to list). No soap earned less than a C-.
Combining the numeric versions of the ratings for mystery, solution, medicine overall and soap — The problem with adding the scores is that comparable results will be available only for the subset of episodes that had grades for all four of these elements. There were 26 episodes on which at least one rating was not given. That leaves out most of Season 1, because only one in the first nine episodes had ratings, and soap ratings appeared only once in the first 15 episodes.
For the 129 episodes with four ratings available, we can add up the numeric versions of the grades to create one total score. The two episodes with the top total scores were Humpty Dumpty (2-3) and Euphoria, Part 2 (2-21). These episodes had total scores of 40, which is an average of A-. The two episodes with the lowest total scores were Human Error (3-24) and Two Stories (7-13); these episodes had total scores = 10, which translates to an average rating between a D and a D+. I wonder if these results match our reviewer’s gestalt feeling about the best and worst episodes.
@sonny, yes, I have a good job. :D
@Cliff, I had the same question re “…what a differential diagnosis is: D. Another C.” I put D in my analysis, knowing I was making a judgment call.
May 12th, 2011 at 6:18 pm
Mmmm… I’m afraid I keep on watching this show more for what it was than for what it is now. Anyone noticed how the CGI almost disappeared? How long since the last time we saw some POTW’s bloodstream, kidneys, whatever, over House (or Foreman, or whoever) explaining what was wrong with him/her? It’s like they care less, cut corners, or both. Anyway, moderately happy about the 8th season renewal. Maybe they’ll wrap it up with some dignity. (Fingers crossed…)
May 12th, 2011 at 10:02 pm
Thank you so much Elle. Now I know which episodes to avoid re-watching!
@Scott: What do you think of Elle’s analyses?
May 13th, 2011 at 1:53 am
I wish the series ended with Amber.
Afterwards everything is downhill (excepting the psych ward arc)
May 13th, 2011 at 7:59 am
“House”’s upcoming eighth season (Fox has renewed it) will probably be its last. This is coming right from the “House”’s mouth himself, whose contract is up, and says he wants to concentrate on music. More from the New York Post here:
http://www.nypost.com/p/entertainment/tv/house_hold_5ueiWGvEZp4khaPq7CKgFP
May 13th, 2011 at 9:36 am
Thanks Elle! For a long time now I’d been meaning to take a shot at doing that analysis but never found the right combination of motivation + time. Good work!
May 13th, 2011 at 12:41 pm
Always meant to ask about it, might as well do it now. Do Doctors in USA really break into houses of their patients (or relatives) ?? And is it legal ?
May 13th, 2011 at 2:58 pm
@Dana: Doctors don’t do it and it’s not legal.
TV Doctor House believes that asking for permission to search their homes will enable patients to have friends or relatives hide drugs, sexual proclivities, diaries and other important clues for fear of embarrassment. I suppose that the team believes that if caught they will tell police that they have permission from the patient who, btw, has lost his keys.
@D-r B. Thanks for filling in the details. Hydrofluor poisoning is way too gruesome even for House.
May 13th, 2011 at 3:01 pm
@Dana: No, doctors do not break into their patient’s houses, and, yes, it is illegal.
May 14th, 2011 at 11:31 am
@Hibbleton, Why would researchers give the rats in the control group a substance other than the drug? Are they worried that the rats will experience a placebo effect?
May 14th, 2011 at 6:44 pm
Thanks Elle, both for the enlightenment re placebos and rats, and the awesome statistical analysis. I am glad you have a good job, and bet you excel at it! (Not that anyone should care but me, but … I have a crap job and suck at it. Which may explain why I still enjoyed the ep and am looking forward to Season 8.)
Laurie is pulling the plug to concentrate on ‘his’ music? Wish I was ROFL, but alas no … Still. I am pleased to think they have a hiatus between seasons to concentrate on a fitting end, whether it is ‘and they all lived happily ever after’ or an opposite but hopefully satisfying closure. I’m glad to see Laurie says he feels the same [Sorry, couldn't paste the quote. It's in the article above, 12th para: http://www.nypost.com/p/entertainment/tv/house_hold_5ueiWGvEZp4khaPq7CKgFP ] (Should 13 begin her decline in earnest? Or should it be left to our imaginations?)
On that note, I reiterate appreciation for this great resource. Thank you, Scott!
May 14th, 2011 at 11:55 pm
http://www.politedissent.com/archives/7383#comment-1045531
May 15th, 2011 at 2:12 am
Seriously? Another ‘poisoning’ case again? Remember the ‘gold’ case…
May 15th, 2011 at 5:36 am
Not interesting.Maybe they have nothing to show.
May 15th, 2011 at 10:24 am
@Eppur Si:
Quoting Elle above
“1) Without a control group there is no way of telling whether the rat would have had those observed changes across time anyway . . .”
For example, when I worked for a testing lab in the eighties, the bio division would test cosmetics by smearing it in the eyes of a group of white rabbits. There would also be a control group which were smeared with a substance that was known not to cause a reaction in the rabbits. That way, when the rabbits went blind you wouldn’t have to question whether it was because the equipment was not sterilized properly or the tech had dirty hands or the rabbits themselves were contaminated with an eye disease.
This doesn’t necessarily mean blind testing (where the tester doesn’t know which substance is which). That could could come later and would also use a control (the added expense of blind testing wouldn’t be done if initial testing were a failure).
May 15th, 2011 at 1:53 pm
@Elle: thank you so much for your analysis.
I miss the mistery and tension in the series. I miss the episodes that really grasped my attention and moved my emotions, to the point of making me clench my knuckles and cry silently with tears, such as the one with the homeless woman who died of rabies (oh the moment the reason behind her mental collapse was reaveled… and the moment the disease was identyfied…).
I would have been fine with the increased focus on the relationships between characters and their inner life in general, I wold have been satisfied with the soap part, as long as I hadn’t interfered with the medical mysteries and the patient-of- the-week’s drama. Now I cannot “bond” with the POTWs anymore and I feel that the team are indifferent as to solving the medical puzzle and saving the POTW or not.
Sorry to say, I am really really afraid that the incoming 8. season is going to be a diseaster.
May 15th, 2011 at 2:29 pm
You might want to change the “Spanish Fly”-Wikipedia link from the “emerald-green beetle in the family Meloidae” to Cantharidin :-)
May 15th, 2011 at 3:55 pm
I’m unclear on how House deduced that Carli was bulimic from the cuts on her leg. Ok, the cuts would suggest masochism, but since when are bulimics masochistic? If someone is hypersensitive about their appearance, why would they be cutting themselves up??
May 15th, 2011 at 11:42 pm
@Andrew: I think the suggestion is that cutters also have eating disorders. I know I’ve read a few articles on the subject, but I’m no expert. Can anyone else out there weigh in on the issue?
May 15th, 2011 at 11:45 pm
Also, it has less, if anything, to do with masochism, and more to do with self-image (physical and emotional) and control issues. Again, I’m sure we have other posters on this site who can give you more, and more accurate, information. It is a very interesting topic…
May 16th, 2011 at 12:24 am
If Hugh Laurie doesn’t come back for season 9 I’m sure they’ll find someone else, like Robert Sean Leonard or Omar Epps to fill his role.
May 16th, 2011 at 4:13 pm
@Henry
hahahahahahahahahahaha do you really blieve that? the show is called HOUSE for a reason.
May 16th, 2011 at 6:12 pm
ParaMedIV: “Cutters” are, in general, psychologically unstable people, and there have been some studies linking this behavior with further masochistic behaviors. Anorexia Nervosa was the more commonly noted of the two eating disorders, but Bulimia Nervosa was also seen
May 16th, 2011 at 8:34 pm
Spin off. and didn’t say I’d watch it. Just most likley.
May 17th, 2011 at 7:28 am
I actually enjoyed this episode of House – a big surprise. The boxer storyline seemed the first genuine mystery for a long time – the first time someone hasnt collapsed at the start and gone through a whole range of mouth bleed/heart attack nonsense. For the first time “could House be wrong” was the question…….even if we know the writers would never allow it. The dance was fun.
Onto accuracy, I boxed for 8 years, and still train most days. House proves as ignorant as he prob is at the medicine. Speed always beats power is NOT in the least bit accurate. Nor is seeing a guy get KO from a “light” punch any reason to think there is something medically wrong.
That aside I thought it was quite engaging. The woman being posioned was irrelevant, but that was ok, those have become the incredibly dull parts of House. The cardboard team characters are a letdown, and 13 is so dull I just hope half the cast get nuked somehow…………
I did see they have renewed House for another season. Mixed feelings as its never nice to hear a show you watch get pulled, but to be honest I’d like the thing to end before it gets worse…………
May 17th, 2011 at 9:28 pm
Wouldn’t her genitals have been swollen when she was admitted? In a lot of episodes, it seems like they just never gave the patient a complete physical exam.
December 19th, 2011 at 4:47 am
Just in case some archaeologist comes across this web site, maybe he can answer a question about the thing that bothered me about this episode. If House is using an experimental drug that promotes muscle growth, and he wants to regrow muscle tissue in his leg, why is he injecting the drug in his arm?
Regarding the question about why he prepares the drug in the way he does, as a person trained in chemistry, I could believe that the experimental drug was purified as the HCl salt, and he is removing the HCl to get the pharmaceutically active free base (hence the term “freebasing”).
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