House — Episode 3 (Season 8): “Charity Case”
An average, at best, episode of House tonight. You’ll notice I throw around that phrase a lot tonight: “Average, at best.”
Benjamin, a once rich man who now gives all of his money away, collapses after leaving a million dollar donation to a job skills clinic. He is admitted to House’s team, mostly, House admits, because he is rich. Park is unimpressed with the case and feels Benjamin was just dehydrated. She is even more unimpressed when Dr. Adams, the doctor House got fired from the prison clinic, joins the team. Adams suggests cardiomyopathy as a possible cause. An echocardiogram is checked and it shows nothing wrong with the heart. Along the way, a head CT is checked to rule out a subdural hemorrhage, though it was never mentioned in the differential (pay attention, this will become important later). Park suspects Benjamin’s extreme altruism is a symptom of neurological disease, but Adams disagrees. An electromyogram is tested (because apparently muscle tone goes along with charitable impulses), but it is also normal. Just as he is ready to be discharged, Benjamin complains of feeling “funny” and develops tachycardia (an unnaturally rapid heart rate) that is corrected with the administration of adenosine.
The differential diagnosis now consists of long QT syndrome (an inherited heart condition that can lead to life-threatening arrhythmias) and Whipple’s disease (an intestinal malabsorption syndrome). While undergoing another cardiac test, Benjamin develops severe hand tremors (ridiculously severe — I thought he was having a tonic-clonic seizure. And, though mentioned repeatedly, these tremors were never seen again.) With symptoms of arrhythmia, fainting, muscle tremors and (possibly) mental status changes, the differential diagnosis now consists of drug abuse, polyarteritis nodosa, or echovirus infection. The latter seems the most likely, so Benjamin is started on pleconaril, an antiviral active against echoviruses.
House thinks Benjamin is cured, but then he hears that his patient has volunteered to donate a kidney to one of Wilson’s patients. To House, this means that Benjamin’s condition has not improved and it must not have been echovirus. Whipple’s disease now seems the most likely cause, but all the tests including EGD and DNA testing are negative.
With no proof of anything seriously wrong, Benjamin is wheeled into surgery, but his heart rate spikes and blood pressure drops so the surgery is called off. The team now considers a spider-bite (no specific spider species is mentioned) or LCDD (light chain deposition disease), and Adams wants him started on blood thinners for the tachycardia. Foreman shows up and accuses House of doping the patient with some drug to cause his symptoms, but House denies it — to Foreman, anyway — he admits it to the rest of the team.
Back to the symptoms of arrhythmia, tremor, and mental changes, the team now suggests Graves disease, or some other form of “thyroid disease,” Coxsackie B virus or porphyria. (Why weren’t these mentioned in the original differential diagnoses for the same symptoms? They should have been.) The patient is started on hematin to treat the presumed porphyria. Meanwhile, House has his Eureka! moment of the week when discussing the case with Wilson. It seems Benjamin has Plummer’s Disease — a single thyroid nodule that has managed to pump out enough thyroid hormone to cause behavioral symptoms and syncope, but yet remain undetectable in thyroid tests. Benjamin’s condition worsened when he received iodine based contrast for the head CT, which caused thyrotoxicosis (high levels of thyroid hormones in the blood causing hyperthyroid symptoms). After surgical removal of the nodule, Benjamin is back to normal, losing most, if not all, of his altruistic feelings along the way.
I already mentioned some of my concerns above: the miraculous untestable thyroid nodule that causes personality changes, the poorly explained need for EMG testing , and the only mentioned after-the-fact need for a head CT though it was useful for nothing on the differential diagnosis. Here are a handful more (as usual, major complaints are in red, modest complaints are in blue, and nit-picking ones in green):
In referring to the diagnosis of Whipple’s disease at one point, Adams states that it should have improved since the patient had already been on antibiotics.
No, the patient was on an antiviral, not an antibiotic (which is antibacterial). Frankly, that’s a mistake a first year medical student wouldn’t make.
Even if she had been right, Whipple’s takes a year of antibiotics to treat. Do you really think a day or two is going to make that much difference?
I know I’ve mentioned it before, but this episode really highlighted how poorly this show actually understands what a differential diagnosis is, despite it being a major part of every episode. When creating a differential diagnosis, you list every possible diagnosis that could explain the patient’s symptoms, then you run tests or elucidate a better history so the long list can be narrowed down to a shorter one and then finally to the correct diagnosis. If you’re introducing entirely new diagnoses for the same symptoms, then you’re doing it wrong.
Tachycardia simply means an elevated heart rate. There are many causes of tachycardia, but it seems that Benjamin has SVT, since it responds to adenosine. This is not a rhythm that requires blood thinners.
Whipple’s disease is one of the main diagnoses? Really? Where’s the abdominal and bowel symptoms you’d expect? In other words, throw out all the half-dozen expected symptoms and shoe horn in several one-in-a-million-cases symptoms. I know this happens every week on House, but this episode was particularly egregious.
Repeat with spider-bite, echovirus, polyarteritis, porphyria, and most of the other diagnoses mentioned this week.
This week’s medical mystery was nothing special. In the 100+ episodes of House, how many times has collapse been the initial mystery? A dozen? Two dozen? I know they lampshaded it, but that still doesn’t change the fact that the mystery was average, at best: C-. The final solution was quite a stretch requiring several unlikely coincidences: a nodule strong enough to cause personality changes, but not be detectable? check! An unneeded test that fits no suggested diagnosis that worsened the symptoms? check! The final diagnosis earns another C-. The medicine this week was poor. Zebras were chased left and right while ignoring more likely more common diagnoses. I give it a D. The soap opera had some good moments this week, but for most of the show was barely above average with a B-.
The review of the previous episode of House
A list of all prior House reviews
October 17th, 2011 at 11:05 pm
Good to see Wentworth Miller again, I think he’s an underrated actor and enjoy seeing him whenever I can.
I cant remember when I laughed as much as I did when watching the interaction between “New Girl” and “Newer girl”. The banter was light and yes, even a little bit playful in a non cruel way… Dont know (yet) if that’s just chemistry ‘rween the characters or clever writing by the producers, only time will tell but they definitely seem to be slowly moving in the right direction if either or both of them stick around for a while.
Now Wilson’s 2 faced tournaround regarding the POTW’s decision to donate a Kidney and accepting his ‘gifts’ seems totally out of character. At his core he’s just to *goody goody* to compromise his ethics, especially to someone like House who is the anthesis to everything Wilson beleives in and stands for.
If POTW is indeed sick, no gift should be accepted from him and ultimately the right decision was made, at the unfortunate cost of a life but t the end of the day, Wilson should be mortified that he even considered doing something uncharacteristic for him.
Wilson is just not beleivable when he’s asked to choose between a patient and “whats right” he comes off as forced when faced with a moral dilemna. We’ve seen it before but this is the first time in a while (iirc) that he’s been willing to enertain the thought about stooping to House’s level.
Was it me or dod Foreman look SO out of his league tring to be Cuddy that he was
House’s clinic diagosis of the kid with the “rosey palms” was classic House.. The mortified look on Moms face when she finds out her kid’s allergic to her lotion… :D
House LOVES his new partner in crime and messing with both 13 AND Park feeds his need to no end.
“Nothing is ever over” House says as he fires Remy to she will go and be happy and not feel obligated to stick around….
Olivia Wilde’s swansong is bittersweet….PPTH will be that much more empty without her around as she’s been an intregal part of the show for the last several years.
So who says good bye next week… Taub? Chase? the writing staff? (oh wait, they really left 3 seasons ago but shhhhh it’s our secret) Maybe cuddy re-appears to say good bye to House?
October 17th, 2011 at 11:21 pm
Lol I think I need to learn to use a spellcheck.
It’s finally hitting home and we’re now getting the sense that there’s no turning back that this really IS the last year…
Things have been changing (or have already changed) and while familliar in an eerie way, actually showcase the differences between old and new, similar yet different..
Take this and apply it to any situation this season so far and you can’t help but see the writers are deliberately making us move on…
October 17th, 2011 at 11:56 pm
The few good concepts in this week’s drama/comedy (i.e. between Park and Adams) were squandered by uninspiring dialogue and acting. House, Wilson and Thirteen turned a mediocre episode into an average one, but this was definitely not worthy of House’s last season or Thirteen’s farewell.
The new team members don’t hold a candle to Thirteen, Taub, or even Chase. How long is Park going to last? There just doesn’t seem to be much to her character – she resolved her family issues last episode, and this week’s “I don’t accept charity” schtick was just filler. The same goes for Adams. Unless she’s hiding some serious personal issues, she serves no purpose besides eye candy – which isn’t all bad, but still…
House needs some more (interesting) team members.
October 18th, 2011 at 12:00 am
I presumed the ‘unnecessary tests’ were because House believed there was originally nothing actually wrong with the patient and so House was trying to find anything he could blame the collapse on and so appear to be getting funding. Of course I suspect House was doing just that .. trying to appear to get funding while not actually getting any.
October 18th, 2011 at 12:04 am
This “average, at best” episode (loved the title) did have its moments. I had to laugh when Thirteen tested the patient by saying she needed a kidney too, only to have the guy volunteer to give up both his kidneys and go on dialysis for the rest of his foreshortened life, after which he would be able to donate all his other organs as well, prompting Thirteen’s less-than-scientific-sounding diagnosis: “This guy is kuh-razy!”
Sorry to see Olivia Wilde’s Thirteen go.
Got caught up in Wilson’s dilemma, which would have been even more acute (to us) if we’d been introduced to the patient with renal failure.
The new season still has an unsettled air to it — which I think is terrific.
October 18th, 2011 at 12:10 am
Would a patient donating a kidney really be lying on his back for the surgery. IMNAD, but if memory serves, the kidneys are in the back – shouldn’t he be on his stomach or side? I also thought Adams ultrasound technique was particularly bad. She was running that thing over his chest like it was a vibrating massager and I don’t think she looked at the screen once. I’ve had a few ultrasound’s and the tech almost never looks up from the screen. Perhaps her technique is sloppy because doctors don’t generally perform ultrasounds? Honestly, I was impressed she remembered to apply the gel!
As a side note, I think this was the first surgery (almost) performed by someone other than Chase in several years! I also particularly enjoyed the clinic scene- they were often the highlight of an episode for me.
October 18th, 2011 at 12:29 am
Dr. Scott, Dr. R, Dr. Bulgaria and all of you various and sundry physicians and health care providers: I am very curious to read what you think about this:
http://www.wired.com/underwire/2011/10/tv-fact-checking-house/
October 18th, 2011 at 12:31 am
If that URL doesn’t work, try this one:
http://www.wired.com/underwire/tag/hugh-laurie/
October 18th, 2011 at 1:25 am
Scott,
I was just curious about the end of the episode, after the patient had the thyroid surgery. Shouldn’t the bandage on his neck have been placed somewhere else? Like…at the base of his throat where the thyroid gland actually is? It seemed in a weird place.
Maybe I’m just being too nitpicky ;)
October 18th, 2011 at 2:41 am
All of the non sequiturs — and the increasing rate at which they occur — can be explained if we assume that they are heading toward a “Newhart” style finale in which either (a) everything that has happened since the third season is something that House has dreamed while in a coma after being shot (possibly with a “Jacob’s Ladder” type ending in which he dies) or (b) he wakes up and we find out that the entire series has been a very strange dream that Bertie Wooster has been having, and the final episode ends with Jeeves (Stephen Fry) administering some of his infallible cure for a hangover.
October 18th, 2011 at 3:52 am
Ahh, Wentworth Miller. I think I’d go straight for him.
Park seems to be becoming House’s primary new partner in crime. Maybe Wilson doesn’t hate him, but they’re sure not BFF like they used to be. Park is pretty well on the same page with House in terms of beliefs and motivations, something we haven’t often seen. But god, most of her dialogue just sounds awkward and wrong coming out of Charlyne Yi’s mouth – “do you want me to put these on while you masturbate?” Uhh, that made me cringe so hard.
So that’s it for Thirteen. As happy an ending as she could realistically have. House firing her may have been the most caring thing he’s ever done. I wonder if she might come back for a one-off like Cameron did (wonder the same about Cuddy).
And are they just not having a title sequence at all this season?
October 18th, 2011 at 4:56 am
Wahhhhh I’m going to miss 13 :*(
I love that they are going back to some “oldschool” House (the CGI, the hysterical clinic cases).
But I have to agree, this episode was very meh in the world of House.
I will offer this however–my sister was tested every which way possible and told her thyroid was normal when she experienced obvious thyroid issues in college. When she finally developed a goiter and diagnosed with thyroid cancer, they realized the tests had been wrong. So it *can* happen.
That does seem odd about the bandage placement, because I know where her scar is–I know they have to be careful due to vocal chords. But hers is at the front of the throat not the side.
Shout outs:
Wilson!
13!
Girl on girl! um did I say that out loud? *blush*
October 18th, 2011 at 8:17 am
@Alexandra, they probably need to set up a new one that doesn’t have Lisa Edelstein’s or Olivia Wilde’s names.
Honestly, I loved this episode. Sara Hess is one of the better writers the show has and can be relied on to crank out something nice. I’m glad Thirteen went out here; her last big episode, The Dig, left a lot to be desired beyond the ending. Charity Case was a lot better than the first two this season.
October 18th, 2011 at 9:17 am
“While undergoing another cardiac test, Benjamin develops severe hand tremors (ridiculously severe — I thought he was having a tonic-clonic seizure.”
Lol…i dint realize they were “tremors” until it was said so…hyperthyroidism usually causes physiologic tremors that are barely visible but in severe cases ‘Enhanced physiologic tremors’ may probably look like that?
But then a solitary adenoma can cause THAT? unlikely i guess..
October 18th, 2011 at 9:32 am
Medicine aside…this was one of my favorite episodes. I very much enjoy discussions of philosophy and ethics. Plus I suffer from many of the same psychological hangups as the new Asian doctor.
October 18th, 2011 at 10:50 am
If Wilson is the head of Oncology, why is he treating renal patients?
I’m still not buying Foreman as the Dean of Medicine. Is this the only job they could find for Omar Epps? Why not just leave him out like Taub and Chase? Bringing back Cameron to fill in for Cuddy would be more believable because she did it before.
I thought they would have had her Huntingtons kick in and House would have killed her like he promised and ended up in jail to end the series.
October 18th, 2011 at 11:34 am
well…the girl who acturally had Huntingtons had just been “kicked out”.
October 18th, 2011 at 11:43 am
“Do you want me to wear them while you masturbate?”
Representative line of humor.
I hope 13 isn’t gone. She at least has a little bit of depth to her character.
October 18th, 2011 at 11:49 am
Balok – Love the Bertie Wooster idea. That might be absolutely the best thing they could do at this point.
October 18th, 2011 at 11:50 am
I didn’t watch, but I love reading this discussion… guess I’m hoping the show will stop its downward slide, but that doesn’t seem to be happening. Regarding Scott’s comment –
Foreman shows up and accuses House of doping the patient with some drug to cause his symptoms, but House denies it -
I certainly hope Foreman was not all self-righteous about it since he did that exact thing in the episode Moving the Chains…. a guy wants to delay treatment so he can go to his pro-football “audition”, but Foreman doses him so he’ll think he needs immediate treatment.
I personally think writers should have to watch prior episodes before they’re allowed to put so much as a comma into a script. Beginning in season 6, and perhaps a little earlier, there started to be evidence that made it painfully clear the writers didn’t know what the characters had done/been like in the past. Example: in the episode where Foreman is (once again) in charge and he, Chase and Cameron are treating an African dictator, Cameron is hestitant about helping because he’s a mass murderer. Foreman chastises her, saying she didn’t have a problem with treating a guy on death row. Wrong. Cameron had a whole lot of trouble with treating that guy, especially since she felt there was a more “deserving” patient the team should be treating instead.
I assume the writers are getting paid good money. The least they could do is spend a little time watching episodes from prior seasons so they know a little about the characters about whom they are writing!
October 18th, 2011 at 12:14 pm
All three episodes this year have been flat, ill-paced, and thoroughly unsatisfactory. Consider the abrupt way in which House tumbled to the solution while sitting with Wilson: much less punchy than similar realizations in past episodes. Character moments are mostly unmotivated, with a few exceptions. Ratings are going to fall through the floor. This is how a successful series overstays its welcome and comes to an end. RIP.
October 18th, 2011 at 12:43 pm
This season is so bad so far, I’m starting to feel bad for Hugh Laurie.
October 18th, 2011 at 1:03 pm
“Shouldn’t the bandage on [the patient's] neck have been placed somewhere else? Like…at the base of his throat where the thyroid gland actually is?”
A friend recently had his thyroid removed, and sent me a photo. The bandage goes across the base of his throat. If he were standing and wearing a necklace that is a bit looser than a choker, it would cover the bandage.
The clinic patient reminded me of a friend who had an annoying rash on his hands. He got hypoallergenic hand lotion, wore gloves to wash dishes, etc., but nothing helped. Then he ran out of the shampoo he used every morning, used another brand, and his hands felt better. His scalp never had a problem, but changing shampoo fixed the rash on his hands.
October 18th, 2011 at 1:09 pm
Sad to see this if this 13 farewell, Charlie Angels does make a good soap.
Great to see Wentworth Miller. So House didn’t get the funding, I wonders his “department” could not stick. The new girl “Park” does offers some more medical points, …
October 18th, 2011 at 4:12 pm
The writers seem so hard to be trying to do what many of the commenters here, myself included, have been suggesting for at least two years–getting back to some of the elements that worked well in the past. They’re working in subplots about offbeat clinic patients (OK, I still didn’t get why the kid was putting his mother’s lotion on his hands); staff members pulling off layered practical jokes on each other; and trying for a lighter feel. (I particularly appreciated Thirteen going off on a happy note; last year or the one before, this would have been such a predictable soap-opera moment.)
It didnt work all that wonderfully well, though, except for the nice moment at the end when Park mischievously turns around and grins because she got her car repairs paid for. The past couple of years, they threw Cuddy’s tough, funny character off the train; this year, they seem inclined to do the same to Wilson. Everyone’s acting, except for the actress playing Park, seems flat and without conviction or energy. The humor is nothing special; this used to be such a wickedly funny show.
I hope that once the original magic was lost, it wasn’t lost forever. Maybe the problem is just that it’s hard to forget three years of overwrought soap opera and dull scripts.
October 18th, 2011 at 4:25 pm
I used to like this show. Not I only watch it to read these reviews. Something is wrong here…
October 18th, 2011 at 4:27 pm
Oh, and feel compelled to add….What on earth has happened to Omar Epps’ acting in the past two episodes? He’s about on par with a high-school actor. As he appears in House’s office, it felt like I was practically reading a script. “Enter: Foreman.” He doesn’t seem of a piece with the actors he’s onscreen with. He comes on, delivers an unconvincing speech with no particular personality and is gone.
October 18th, 2011 at 5:42 pm
@Mary T – That’s always bugged me about “The Tyrant,” too. Whenever I watch the episode the I really have to keep myself from shouting “YES SHE DID!” at the screen.
October 18th, 2011 at 6:05 pm
MedMavRx: I’ve actually met Sotos (it was a few years back at a cardiology conference), and have his book. He’s a great physician, and an interesting person to talk to. Apparently, about 90% of things Scott and the rest of us complain about are either items he missed, items added in later or for dramatic effect, or simply to speed up the episode. His personal favorite episode (at least when I spoke to him two years ago) was Humpty Dumpty.
October 18th, 2011 at 6:48 pm
@ lisa:
” (OK, I still didn’t get why the kid was putting his mother’s lotion on his hands)”
Clinic kid was allergic to the lotion because he was puttling the lotion on his hands and ‘polishing’ something…. Why else do you think House gave him the lube to use instead?
October 18th, 2011 at 8:36 pm
I know this site is about medical review, but since I am just a layman, I only have a comment about the soap element.
Am I correct to read that the sub-plot about gifts between Adams and Park is that House noticed the tug-of-war between them quite early, and then manipulated BOTH of them to get his, not Park’s, car fixed? If that’s correct, I think it’s brilliant and the soap for this episode deserves more than B-.
October 18th, 2011 at 8:50 pm
@ Ming:
Correct! House played Adams need to understand the “why” off of Parks abhorance of accepting praise/gifts…
The more Adams pushed Park by giving her extreme gifts to try and understand WHY she was so reluctant to receive them, the more pronounced Park’s negative reaction was to them.
Classic House playing both ends against the middle to enjoy the “fruits of his labor”.
October 18th, 2011 at 8:59 pm
@Melly: The patient is positioned for kidney surgery after he passes out. The surgery is done through the side towards the belly. The actual cut depends on the surgeon.
@Lisa: That’s cute :)
October 18th, 2011 at 9:34 pm
I hate to exaplain a joke but seems quite a few viewer didn’t get the clinic lines so here it goes:
the child was masturbating with his mother’s lotion. triggered by his sighting some nude woman in neighbor’s pool. the best part of the joke is not House giving him lube, but his exit line:
“sorry, too late for your eyesight.”
this is classic House venom, regarding to the popular adolescent myth that “masturbating will make you blind” . And the boy does wear glasses.
House is also quite irresponsible as a clinic doctor not to check the boy’s genital for possible allergy. it could be worse than in the palm, hidden by patient’s shame and need careful treatment.
and @ Ming: your are right, it’s House’ car get fixed.
October 18th, 2011 at 10:36 pm
Dr. R: Ah, yes: Humpty Dumpty and activated protein-C.
House is to “medicine” what Dennis Miller is to “comedy.” ….. I can’t finish this wise simile because I cannot think of a medical equivalent for “hyperbole.” But I think you get my point.
Dr. Sotos stated that the writers of House “got it” faster than some of his medical students. Someone who posted on another site queried: At what point does the “real medicine” get skewed into the “reel medicine?” Dr. Sotos really can’t be happy with the finished product on average, can he?
October 18th, 2011 at 10:40 pm
Remember when we actually cared about second bananas? As in, for instance, the ep when Chase says goodbye to his dying Dad (and only House knew he was dying, and eventually Chase ended killing a patient because of that), or the two-parter with Foreman in quarantine, or even Cameron and her schoolgirl crush on House? Not only Park or Prison Doc, but no one really can hold a candle to the original team in their early, well-written days. Neither Thirteen with her Huntington, nor Taub with his philandering or Kutner with his nerdiness. I’m afraid this show has jumped the shark years ago, but Mr. Laurie’s talent still keeps it watchable.
And I really hope House has provided Thirteen with a cell number or email address to contact him in case she needs him to kill her as he promised last year… :)
October 18th, 2011 at 10:53 pm
Epic B: It wold seem to be that way, considering that no responsible MD would defib asystole, or allow it to be portrayed if it were within his control. (Something rarely seen on House, but it’s there). Apparently Scott and I aren’t along in our experience of physical pain when we see House et. al out there defibing asystole!
October 19th, 2011 at 1:16 am
@C6H12O6 House saw the boy squirming on the table–he KNOWS he has an allergic reaction on his “bits” But yeah some cortisone cream would have been just as helpful as the lube ;)
I did a quick search online–does anyone think Olivia Wilde might be pregnant? Don’t get me wrong, she looked AMAZING (yes I’m like 13, I do it both ways LOL). But her hips looked wider, and her baggy clothes seemed to hide her stomach. I already deleted it from my DVR but will try to catch it On Demand.
I hate, hate, hate that she’s gone. And as much as I fanatically adore Omar Epps/Foreman, he did seem off his game in this ep. I *love* that he’s DoM.
Wilson looks tired. Is RSL moonlighting on the stage again?
And I forgot to mention–THANK GOD House cut his hair! *cheers*
I’d love to see Park come in next ep–after House’s snarky remark–with a personal makeover. She looks younger than M3 ever did.
October 19th, 2011 at 7:28 am
Did anyone catch that this episode closely follows a real case described in the New Yorker? http://www.newyorker.com/archive/2004/08/02/040802fa_fact_parker
October 19th, 2011 at 11:40 am
Mary T:
“she didn’t have a problem with treating a guy on death row. Wrong. Cameron had a whole lot of trouble with treating that guy”
I just rewatched that episode…she didn’t have a whole lot of trouble treating that guy. Her only complaint was that House wouldn’t take the terminal cancer patient, who turned out to be, well, terminal.
October 19th, 2011 at 12:06 pm
thanks, Ming and others. I was watching a not-so-great computer screening and missed some of the lines, didn’t realize he was giving the kid lubricant. Nice to know that missing a couple of lines in House is starting to matter again!
October 19th, 2011 at 1:29 pm
First of all: Yippppeaaaaaahhhh! An episode that did 3 things I dream of for so long:
13 is gone!
Clinic is back (it’s too late for your eyesight! Genius! Wiff of tha classy old days! Clinic evil House we all love!) If I do have to say what actually won me over to watching House at the first place, do you remember this: “…but not to worry because for most you this job could be done by a monkey with a bottle of Motrin”
And last but by no means least: House is manipulating the hell out of everyone around him and nobody could stop him: not Wilson, not Fuddy (see what I did there?:)) not even Ms smartypants 13. I actually enjoyed 13’s presence in this episode a lot – probably because I knew this is her last episode, but also because she was looking a lot sillier, predictable and yet smart and on-par with House while they brain-dueled. She is in love she just wants to be happy good bye, oh god I love the way you scratch that itch :):) funny funny funny.
I do believe the writers and the producers are delivering the goods they promised us – going back to basics. Let us hope that we will see more clinic stuff, we will see House outsmart the Dean to get what he wants (remember the times when Cuddy was nothing more but a deep cleavage nuisance in the hospital?God I enjoyed the boob jokes House kept flinging around at least twice per episode) Of course Foreman is a lousyy substitute for Cuddy of old but at least he stays on the show and gets to be more boring than ever. Hopefully when Chase and Taub come back we will see some more good old fashion fun (I wonder how exactly is Taub juggling two babies and two wifes?) And how long do you think it will take Chase to get into the pants of the new sexy-slutty d-r Adams? Let us hope not 3 seasons like he needed for Cameron (oh wait she did him in season 2)
The medicine: I cannot think of adding something to what D-r Scott has already said. I do disagree with his severe judgment though: most of the mistakes were actually also good old fashion House blurbs: like widening the differential when new symptoms come along instead of narrowing it down. I say medical mystery B- (What exactly caused this guy to faint? I’ll have to wildly assume a bout of SVT? Patients with tachicardia appear a bit more agitated though: Wentworth looked lethargic throughout the whole episode episode) I am not actually sure if Plummers disease could cause loss of consciousness; may be a syncope but not a complete loss of consciousness….Medicine B- (nothing so bad except the flinging of diagnoses with no real basis for them), solution B- (as I (and our host) said the solution does fit the symptoms but only barely) and solid A for the soap. House and Wilson were at their best Foreman was as boring as ever, 13 was as amusing as we could expect, and the new girls were actually fresh funny and semi sexy (one was sexy the other was ummmmmm, spoiling the Charlies Angels fantasy.
October 19th, 2011 at 1:43 pm
@MedMavRx:
What this dude Sotos is saying in this article actually makes a lot of sense. He is not writing the scripts – he is just checking them for medical accuracy. Key point here is medical. He says it himself: The writers asks me: “Let us connect symptom A with organ B” I ponder on it for a while and give him an idea. He incorporates it in the script and keeps on writing. He handles me the script and I make sure that the said connection exists. I thick it OK and they start shooting. Nobody is asking the medical consultant to come up with the idea or develop it medically. Nobody is expecting him to check the episode for continuity, or to check the final product (after filming is done) for missing parts. Do not forget that after the writers do their job the produser have to cut it to size and then the director have to chage it to his taste while shooting. The end result? A product that is good for watching but has about as much real medicine in it as Whiskey has grain seeds floating inside. So that is my explanation. If you take this episode for example and the main problem that D-r Scott pointed out: That if the original symptoms could be explained by diseases A, B and C, than you cannot simply say 20 minutes later: Oh yeah those could be explained by diseases D, E and F too. Why is this happening? Because the writers are actually trying to do the reverse of DDxing: they are coming up with ideas to test for, and then thinking what kind of symptoms the patient should have to be suspicious for those. Medicine is complicated by itself, trying to reverse invent it without medical education leads to the results we see. I do have to note that Brian Singer himself said that when the show originally started it was more focused on medicine (hence the more accurate medicine from the early seasons, and the higher grades we gave) Later as the viewers opinions started to weigh in he switched the focus on char development: and Voila: lazy crappy medicine :).
October 19th, 2011 at 1:47 pm
Almost forgot: “the patient was on antibiotics” – straight F for that one giant mistake that downgrades the medical aspect to C or even D. Antibiotics and antivirals are two things that are so different that even average guys on the streets this days know the difference between viruses bacteria and the treatment required for each of those.
October 19th, 2011 at 2:17 pm
Farewell, 13. We’ll never forget you. :)
October 20th, 2011 at 4:00 am
Hi everybody!
I’m a french fan of House, and also a big fan ou Scoot’s reviews, and I have a question on something that always bugs me in american medical dramas:
Do Doctors really discuss their patients lifestyles such as who they are dating, what they do with their money, what they believe in and so on? In this particular episode, the charity/philanthropy was a part of the condition and the diagnosis, and it’s sure often the case in House, but still! I understand easily the drama dimension (one of the character is always concerned directly by the patient beliefs, in this episode the “offer without asking anything in return” thing) , but is that the same “in real life”?
October 20th, 2011 at 4:12 am
“..’Cause nobody is unhappy in Greece”.
That hurt in a very funny way.
(by now you must have deduced I’m greek. And still living in Greece :p)
Reading your review of the episode I have to admit it is nice that I’m not a doctor. Such blatant mistakes, omissions etc would frustrate me.
On the other hand the show is beginning to be very “soapy” and I hope they’ll change that in the course of the season.
And I would really like to see the team change into at least a decent percentage of a previous “roster”…
October 20th, 2011 at 1:44 pm
Bruno: Sometimes. It’s mostly the nurses that do that kind of thing though in my experience.
October 20th, 2011 at 2:09 pm
Ok – so the medicine may not have been 100% accurate, but the philosophical questions posed were intriguing enough to forgive that.
Personally, I think Olivia Wilde was one of the best actors on the show. Sad to see her go, but it was a great episode – the writing, direction, acting, even the music. A Big Star cover by The Wellspring? Good taste – http://www.youtube.com/watch?v=p7tY8LF6W2k
Well done, House! Good luck to Olivia in her movie career…
October 20th, 2011 at 5:52 pm
I generally use DVR for most of the prime time shows I watch. In the past, I would often watch House more than once to make sure I got it all. Not this season. I watch, delete, and forget about it. It’s OK, but nothing special anymore. I think the writers are trying too hard to make the secondary characters seem more interesting than they actually are. The line about “masturbation” just did not seem realistic coming from Yi, at least IMO.
Some of you might be interested in this article from the NY Times which discusses the changes made in several shows this year, including House.
http://www.nytimes.com/2011/10/20/arts/television/for-csi-house-law-order-svu-risky-transitions.html?_r=1
October 21st, 2011 at 1:28 am
Adams: ’… Echo virus’
House: ’Virus… virus… virus… virus.’
Just in case you missed it.
October 21st, 2011 at 1:46 am
@RAK: Great link.
The NY Times calls House “The wackiest network series in prime time.” I don’t think they’re talking about the medicine. :-)
October 21st, 2011 at 6:10 am
A PCR takes 4+ hours to do. Not 30 seconds.
October 21st, 2011 at 11:46 am
@Headache Slayer – OW admitted to “self medicating” with food after her divorce. I would guess she’s just gained weight and does not actually have a “bun in the oven.”
October 21st, 2011 at 2:52 pm
@Estarian: When he said that line, I did think he’d add “except the greeks” to it :p
October 22nd, 2011 at 5:04 am
Actually this case of extreme altruism existed and I read it in my textbook of abnormal psychology as a case study.
The famous case of Zell Kravinsky (donating all his fortune around 45 millions, donating one kidney, and wishing to donate lobe of his lung, liver and bone marrow, etc…), the question is still not answered: Is he extremely generous or is he mentally ill?
October 23rd, 2011 at 10:30 am
Am I the only one who absolutely can’t stand Park?
And finds her character very strange and contradictory?
If we need an “awkward young girl” – I’ll take M3 back any day!!!
At least, she had integrity in her character, she felt “real”.
And with Park they seem to be going for “wild horse” where writers just trying to see how many different character traits and quirks they can apply to her.
But she’s not pulling it off – neither with the way she looks, nor with her delivery and her voice.
Is she gonna stay the whole season? Meeeeh.
Foreman as Dean – is awful, but at least there’s not enough of him.
Wilson – what a disappointment! Writers don’t care about any continuity of character at all??? I’d never expect Wilson playing fast and loose with ethics like that.
And why no comment on how unusual it is that someone who is willing to donate kidneys to specific people can actually be a match to them?
He seemed to be a match to that lady and no comment about how rare it is to get a match?
Then him offering a kidney to 13 and no one mentions that there’s possibility of not being a match?
As they say – he’s mental, but he’s not illogical.
Adams so far is fine for me, I think she’s an ok replacement for 13. At least, she’s not annoying. And she dresses well.
The episode felt very “uneven”.
I don’t know anything about medicine and even to me it all seemed like a bunch of BS.
But there were lots of funny one-liners and some solid acting from House, he reminded me of his old self from season 2.
October 23rd, 2011 at 4:53 pm
They actually stole the 1 in 4,000 line from Kravinsky as well. Look him up on Wikipedia, it’s quite interesting
October 24th, 2011 at 3:39 am
How did we all miss it? Both D-r Scott, me and the others here who comment on the medicine missed such an obvious medical blunder – the guy can’t just give away kidneys to whomever he wants – he needs to be a match to donate. Hey take my kidney – NO, No, nooooo…. Big downgrade to medicine for that. It was needed for the storyline though…
October 24th, 2011 at 8:59 am
D-r Bulgaria: I was wondering about that, but I assumed that they had matched them. Though after rewatching the episode, it looks like they didn’t mention it, so I assume major medical mistake. I would lower the medicine grade to D- or F.
October 24th, 2011 at 2:00 pm
No mistake. Wilson was really excited because he was a match and a willing donor. There is nothing explicit that would indicate he wasn’t a match, therefore we must assume the show is skipping the redundant steps and showing what matters.
About thirteen was just testing the guy, the patient reacted because of his pathology. He could have said, take my brain as well. The whole point is that the guy isn’t thinking rationally.
October 25th, 2011 at 5:14 pm
I still think Wilson should have mentioned – how lucky it was that the match donor appeared at the “11th hour”.
Coz I don’t think it happens very often and it’s a miracle in itself – someone wants to give a kidney to a person who is gonna die in a few hours and this person is a match!
But just skipping “match talk” alltogether was a bit weird even if we were to imply it happening “behind the scenes”
The writing wasn’t consistent enough.
October 25th, 2011 at 6:10 pm
I am catching up with this episode. I can’t seem to stay awake to watch at 9 pm and have to watch on the 8 day delay.
One thing I enjoy is seeing the character of House in new situations and that still works for me. House problem solving in an airport, in an airplane, in a hospital, in a jail and so on. In some ways it is more in interesting to see what he gets up to in a new situation.
The question for me is whether House can ever problem solve himself before the show runs its course. I would like some kind of resolution even if it is the image of House and Wilson taking off around the globe and solving medical mysteries along the way.
I did enjoy House giving himself a haircut as someone mentioned. It was a good scene.
October 25th, 2011 at 9:01 pm
I too agree that Park’s character is just an unsavory one at this point. I can somewhat tolerate her grating, muted, squeaky voice, but the dichotomy of her character is jarring.
First she is terrified to let her parents know that she defended herself from a superior who was sexually harassing her, then next week she is a completely arrogant, prideful person who won’t accept small gifts without making a huge deal of it. I also saw signs of a mini-House inside her, since she was convinced the altruism was a symptom from the get-go. Usually it’s just House that thinks that way =/
October 26th, 2011 at 3:10 pm
Thank you Michael!
Yes, dichotomy!
And many contradictions within her character!
And her line about shoes and masturbation, man, I wanted to punch her! ))))
And her turning out to be a bit divious like a mini-House, I agree – that’s just wrong, I think only House can pull off this evil genios thing!
October 26th, 2011 at 3:13 pm
Yeap Park… I was not sure if she is a one episoder or a new stayer…. To be honest I like her. She looks a bit like House, however not just like House…. More like she is like him because she is a “loon”. She is messed up in many, MANY ways. A lot to explore (and hopefully have fun with here). Adams on the other hand is a lot more straight forward (or gives that impression) – she has a hint of the older Chase (who was bored of the work and annoyed of the patients and enjoyed only the fun parts – like quipping racist/fat/religion jokes or whatever jokes he can think of the POW.) Rich and bored – that was Chase, now it’s Addams. She does look better in high heels though. And as House said: she is sending signs that she is an evil genius – which means she’ll fit right in. Speaking of Chase I am proposing a online poll: Let us all give predicitons how much episodes he will need to get into Adams’s pants? I’m betting on One or Zero.
October 27th, 2011 at 12:42 am
Aw, c’mon, people. I LIKE Dr. Park. I think in the end she’ll turn out to be the only person that House can’t outsmart, outwit or outfox. And she’s cute as a button. Give her a chance.
October 30th, 2011 at 1:15 am
The first thing that occurred to me with Mr. Charity case was that he had a monster case of OCPD. Obsessive Compulsive Personality Disorder (not Obsessive Compulsive Disorder). The difference between OCD and OCPD is that with OCD the symptoms are ego-dystonic, and the patient feels miserable unless he gives in to the compulsions, whereas with OCPD, your obsessions and compulsions make you feel great. Alas, OCPD is relatively intractable, given that it’s a character disorder,and would take ten years of CBT once the guy figured out he had a problem (which he won’t, it doesn’t get much worse than sacrificing the well-being of your wife and children on the altar of your obsessions, and losing them all as a result).
It would have been interesting to have a psychiatrist be brought in, mistake it for OCD, administer SSRIs (which would have made his symptoms worse, and maybe given him a nice layer of mania), then try Lamictal and Risperdal and/or Seroquel (which are better choices for OCD) and, while waiting for them to work have his ex-wife show up and turn out to have an obvious character disorder, herself. (People with character disorders tend to attract other people with character disorder, which is why the guy who is telling you on the first date that his ex-wife is a borderline is a narcissist). Also, how is this episode not a rip-off of the one with the big bear of a guy who was “too nice,” and it was a symptom? They need not repeat themselves. Last season it was the writer who imagined her dead son and tried to kill herself out of guilt for letting him drive the car, and a couple seasons before that it was the homeless artist who killed her husband and child in a car accident and went crazy as a result.
On the plus side, I like Dr. Park…I think she’s interesting and would love to see her parents be brought in as secondary characters. Dr. Park has personality, and it’s consistent with her character that she couldn’t stand up to her parents, but she could to a colleague. You don’t have to be neurotic to think it’s just icky and a boundary violation that a colleague you just met that you are not friends with just up and chooses a pair of shoes for you and gives them to you as a gift. I would worry about Mrs. Buy One Get One Free following me home, next. Single White Female, much? And how many people would be okay with someone handing them two dollars as a gift. I mean, really?
I really do feel bad about the medicine, though. Everyone puts up with House because he’s supposedly a medical genius, but how many of his patients come in with a tickle in the back of their throat and end up on dialysis for the rest of their lives due to House’s incorrect differentials that he arrives at without testing, and not due to the actual disease the patient turns out to have in the first place? That is the least realistic part of this show, even when we get past the fact that House still has a liver even though he eats Vicodin like candy and drinks at the same time.
I think that this season the actual show is reviving itself — I actually look forward to watching it again, instead of being drawn to the train wreck it was turning into. I think Foreman is tedious, and I wish that Park would get a better hairstyle. I would love to see the interplay of Taub and Park, and I think they need to make boring Dr. Prison Doctor go away — she was a lot more interesting when she was slipping Vicodins to House in the prison.
Now please don’t bring Tritter back, that story arc was a big yawn — everyone knows that IRL House would be peeing in a cup for the rest of his natural life, and it would have been a greater arc if some other criminal Tritter had ruined before arresting him had blown Tritter’s head off at front of House’s hospital.
The medicine — could they PUH-leeeeze get that back on track?
October 30th, 2011 at 1:23 am
Also, House did change a little — since when does House consider the well-being of others, even his friends, before his own? He wanted 13 back, but recognized that family was more important than anything, and so he forced her back into the arms of her girlfriend, and Greece . Thirteen was willing to circumvent Foreman and approach the patient and get him to offer to donate his still-beating heart to her, and his eyeballs, while he was still conscious, so he could read her a bedtime story. He’s got a guaranteed accomplice in her, but he lets her go so that she can be happy. It’s not a coincidence that this scene takes place after Mr. Charity states his intention to get his family back.
I still thought it would have been better for the show to try psychiatric differentials sometimes — especially where, as here, there are psychiatric symptoms.
October 30th, 2011 at 8:11 am
@lewfalo,
I’m with you. This was a classic episode of House — the kind of episode where you don’t care that the medicine was all wrong because the medicine is besides the point. The ethical dilemmas, the Housian certainty that altruism is a symptom, and the twists and turns in the mind games House plays with his staff are the elements of House at its best.
February 7th, 2012 at 3:40 pm
I realize this is very late in the game, but I am only just getting back into House now after slowly losing interest in season 6 and am just catching up on season 8 now.
Regarding the kid flogging his dog with mommy’s hand lotion, I have one major question:
Why on earth does have have equal discolouration on BOTH hands? Does the kid spank it with both hands??
That really threw me off and sent my mind places it didn’t want to go. :( I mean is he alternating hands on different sessions? or is he John Holmes Jr.?
That aside, I really liked the direction of the first two episodes, although I really would have liked to see House in prison for a couple of more episodes. I really like Dr. Park and I understand she sticks around. I think she plays an excellent partner-in-crime with House. She may not have the intensity of Amber, but she just started.
Off to Ep. 4 now to see how she grows, if at all.
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