House - Episode 10 (Season Three): “Merry Little Christmas”
This episode was mostly about House, Wilson, and Vicodin, but they did manage to squeeze in some medicine as well. The mystery was fair, the solution clever, but the medicine — even though they ordered less tests than usal — still had too many errors. Here is this week’s review of House (with spoilers, of course):
Abigail is a 15 year-old dwarf with cartilage hair hypoplasia dwarfism (CHH). She was recently in the hospital for a collapsed lung and is now following up in Dr. Cuddy’s clinic. House convinces Cuddy to admit Abigail to the hospital to find out what’s really wrong with her. He presents her case to his team, at this time noting that she also has anemia. Cameron points out that individuals with CHH dwarfism have compromised immune systems and the PPD (tuberculosis test) that Dr. Cuddy placed may not be reliable. A gallium scan is ordered to look for infection. The scan shows no infection, but House notes that the liver is the darkest area of the scan, which makes him suspicious that something is wrong with her liver. He wants an ultrasound of the liver, but at this point, Cuddy intervenes. She removes House from the case until he accepts Tritter’s plea bargain and she takes over as lead physician. She orders a lung MRI to look for lung cancer, but it is negative. As the scan is finishing, Abigail develops a bad coughing spell and begins to cough up blood (hemoptysis). A further work-up reveals variceal bleeding (enlarged easily bleeding blood vessels in the esophagus related to liver problems) and liver failure. The diagnosis at this time includes schistosomiasis (a parasitic infection of the liver), cirrhosis, hepatitis, hepatoma (liver cancer), Budd-Chiari syndrome (an obstructing clot of the hepatic vein), and drug or alcohol abuse.
A liver biopsy shows sclerosing cholangitis. Surreptitiously, House tells Foreman that he believes Abigail has a condition that will affect her whole body, starting with the pancreas. Foreman order an alpha-1 antitrypsin level, but it is normal (This is good thinking on Foreman’s part, sort of; an antitrypsin deficiency can lead to lung and liver disease, so that part is right — but it really has nothing to do with the pancreas). Cuddy discounts House’s theory about the pancreas and orders an ERCP. Just before the test is to begin, Wilson and Foreman realize that Abigail in unconscious. They detect fruity breath and diagnose her with diabetic ketoacidosis. Her pancreas has failed leading to diabetes; House was right.
At this point, the differential includes Langerhans Cell Histiocytosis, cystic fibrosis, Hodgkin’s Lymphoma, and lupus. A lumbar puncture is obtained to look for signs of Hodgkin’s and antibody levels are drawn to look at autoimmune diseases. Cameron visits House who deduces that Abigail has Still’s Disease (better known as Juvenile Rheumatoid Arthritis) — a particularly nasty autoimmune disease. She is started on steroids, methotrexate, and cyclosporin. Sadly, she starts bleeding from her mouth and ears. A head CT is normal. Wilson suspects she has leukemia and wants to perform a bone marrow biopsy but Cameron feels that it is still an autoimmune disorder, as Abigail did initially improve on therapy.
House examines an x-ray of Abigail’s leg to make the diagnosis. The growth plates on her bones are normal, suggesting that she does not have CHH. Instead, she has growth hormone deficiency caused by a pituitary tumor caused by Langerhans Cell Histiocytosis (and Chase was right again).
I thought the idea of Abigail not really being a genetic dwarf was particularly clever, unfortunately the route (and medical care) they used to get there was poor. In several cases, the timing was off. Gallium scans take 2 to 3 days to complete (it takes gallium a while to build up in the tissues), and diabetic ketoacidosis would not kick in that quickly unless the team inexcusably missed some earlier abnormal labs. Neither of Abigail’s diagnoses really fit her case. Look at the signs and symptoms of Still’s Disease and Langerhans cell histiocytosis. Few of them are even close to her symptoms, and nothing explains her lung collapse and liver failure — her main complaints. Finally, people with short limb dwarfism (of which CHH is one) have a different body build than people with growth hormone deficiency; someone should have caught that sooner. I was also a little disappointed that they presented such a rosy ending (or close, anyway), apparently forgetting that poor Abigail still has liver failure, pancreatic failure, and diabetes. She has a rough road ahead.
The soap opera/personal relationship aspect of the episode was good again this week, with several good scenes involving House and Wilson, House and Cuddy, and then House and Foreman and Cameron. I’m still not sure how much of House’s actions are signs of addiction, or are signs of an obnoxious person with pseudoaddiction. I’m certainly no lawyer or policeman, but I was confused why Tritter was offering the deal. Isn’t that what lawyers are for? Sure, he mentioned the DA, but at this point House hasn’t been arrested or even indicted.
This episode earns a B for the mystery and an A for the solution. The medicine, however, was only average (for House at least) and deserves a C. The soap opera was good, but not as good as last week’s and earns an A-.
The previous House review
A list of all prior House reviews
Grand Rounds, the weekly collection of the best medical blogging on the ‘net, is held this week at Anxiety, Addiction and Depression Treatments
December 12th, 2006 at 11:03 pm
Yeah, the Tritter arc is quite obnoxious in regards to due process…I was wondering how he gained access to the pharmacy log book so quickly.
*sigh* I wish the writers would focus on fleshing out the non-house characters, rather than continue to try & get House to jump through the same hoop every week, albiet a hoop with a new paint job. We still don’t have any idea why Chase’s finances are in such dire straights for example. Wilson’s characterization has been lackluster at best this season, after last season’s excelent job in that regard.
December 12th, 2006 at 11:18 pm
I think the legal term that you’re looking for is ‘endited’ (but I’m not sure, my dictionary is being a dick and not loading) but I agree with you that it was confusing that Tritter was the one offering a deal - even on the most awful of lawyer TV shows, it’s always the DA that cuts the deal.
December 12th, 2006 at 11:40 pm
Ellen: No, it’s definitely “indicted”, though it’s pronounced “in-dite-ed”. See here.
December 13th, 2006 at 12:02 am
Dudes, chase is the man now.
Hes better than House, F*** House.
December 13th, 2006 at 12:05 am
Did anyone else find it a little odd that Wilson just walked out of House’s living room in disgust after finding him semi-conscious on the floor with an obvious overdose? I know Wilson has taken a beating from House (not that he hasn’t deserved at least some of it), but, really, when you find someone in that state, don’t you call 911? And why the heck has NO ONE suggested that House needs to be in a pain management program, maybe including narcotic analgesics along with other treatments? And wouldn’t a doctor know better than to take extremely high doses of Vicodin, given the liver-damaging properties of acetaminophen? Silly questions for HollywoodLand, perhaps.
December 13th, 2006 at 12:25 am
Wow, my brother’s rare disease is finally the House DOTW! Does he get a prize?
December 13th, 2006 at 12:56 am
I find it terribly ironic that from last time’s episode, how it’s “never lupus” which is true in this case.
December 13th, 2006 at 3:49 am
It’s interesting that just as you’d think Tritter was actually doing this for compassionate reasons (all this muck to get House into rehab???), it slaps down again. Although it sure pisses me off.
Honestly, I don’t even know what to say about the deal. The fact that it would be Wilson brokering it already threw me off way more than Tritter seemingly to be the one offering it.
But it’s weird that finally someone addressed the fact that House was off the Vico after the ketamine (for less time than others thought, but he was off for a bit), and acted perfectly fine. Ketamine wouldn’t dull the physical effects of opiate withdrawal, right?
December 13th, 2006 at 6:54 am
I agree with Nick.
The Tritter arc is nothing short of annoying. No one wants to see House get embarrassed by some above-the-law “SuperGod” cop out for revenge. And the “scenes from the next house, in a few months when we feel like airing new episodes again” didn’t look that enticing. The cases might be interesting, but this Tritter thing needs to END.
Scott: It’s honestly pretty sad when a doctor with no criminal medical training is spotting obvious flaws in a show’s legal logic. Yes, the “deal” was pure rubbish, plain and simple. No DA would ever suggest such a ridiculous deal, and even then there’s no guarantee the judge would accept such a plea/deal arrangement, *especially* if he believed the doctor in question was a true-to-life drug addict. Basically House would be depending on the DA to fight for him in court if the judge even sniffled at the deal. And then guess what? You pleaded guilty!
Scott: While it’s true that the various types of dwarfism have different features, I don’t think you can safely say “someone should have noticed it” — it really didn’t seem on-topic until right towards the end. Plus, give the severity of her other symptoms, I don’t think her type of dwarfism would be foremost in their minds. It also didn’t seem like any of the team had much prior experience with dwarfs, which would also explain things.
Offtopic - did anyone notice the jab at House on NCIS? It was one I’m sure Scott would thoroughly appreciate ;)
December 13th, 2006 at 9:12 am
One minor point that bothered me. They explained to the patient that “gallium is a radioactive isotope”. That’s incorrect. Gallium, in its most abundant isotopes Ga69 & Ga71, is not radioactive. There are numerous radioisotopes of Gallium, at least one of which (Ga67) is used in nuclear medicine imaging, but from they way they stated it, many people out there who saw the show and don’t know any better now probably think all Gallium is radioactive. I know they’re talking to a kid, but they still should have referred to what they were using as a radioactive isotope of Gallium. “This is a radioactive isotope of gallium…”
You may as well refer to carbon as a radioactive isotope when doing carbon dating by stating, “Carbon is a radioactive isotope”
December 13th, 2006 at 9:21 am
Thanks for the update. I was confused on a couple of points and had a couple of comments:
1) Did House try to kill himself? It looks like he knew he was overdosing and taking alcohol. If he was trying to kill himself wouldn’t Wilson have called the ambulance?
2) I noticed the difference in the interaction between Chase and the others in this episode. Do you think this will continue?
3) The storylines involving non-medical topics are horrible. The hospital administrator from seasons past and now Tritter. Sure, they are good for a small diversion, but this whole season arc thing is a bad move.
4) The girl’s mother asked if House was high. Why don’t they ever follow-up on *those* complaints?
Looking forward to January, and thanks for breaking it down!
December 13th, 2006 at 9:35 am
While I see that House will be due in court the next half of this season (I personally would prefer a cross-over with Boston Legal, but alas — this isn’t a David E. Kelley show), there are many arguments to be made about Tritter’s own unethical mishaps. House should have hired a lawyer sooner and force Tritter to obtain proper documentation for everything he’s done to this point. As far as I know, it’s fairly difficult for police officers to suspend bank accounts at their will, go through medical records (even with the hospital giving consent, there are probably legal privacy issues that Tritter probably hasn’t been very compliant with).
Of course, Tritter does suffer from Jack Bauer syndrome (… and I do love 24, so I’m saying this in the most positive light) — we don’t see Tritter taking the mundane legal steps in order to fully investigate House, but it certainly would quash the notion of Tritter being some deus ex machina element that can jump over legal leaps and bounds. House needs a lawyer… he knows it, yet ignores it. Stacy, where are you?
Again, I’d personally like to see James Spader and William Shatner come in and blackmail Tritter for his abuse of police authority. I’ll close out by saying two words… Denny Crane.
December 13th, 2006 at 9:43 am
Tritter may have been lying about the DA sanctioning the deal. Generally, Tritter would have to refer the case to the DA for prosecution before the DA would get involved. With Wilson waffling, and none of the YGs cooperating, Tritter may have felt that bluffing House into rehab would be his best chance for victory. However, even if the DA has sanctioned the deal, there’s nothing terribly unusual about Tritter making the offer, especially if the DA would rather avoid prosecution. Once an indictment is handed down, the DA generally has to proceed or else the indictment may be dismissed with prejudice, i.e., without leave to re-indict later. So if House were to reject the deal, then the DA would have to consider prosecution, the first step of which would be indictment. What I find unrealistic is that no one seems to have an attorney working for them on a consistent basis.
December 13th, 2006 at 9:48 am
Some thoughts/questions.
Isn’t Tylenol w/ Codeine a narcotic and against clinic #2 new patient guidelines? (Admitedly much less abuse-able than Vicodin)
Wilson rolled House onto his back and left him. Isn’t that the absolute worst thing to do to someone OD’ing? Just incase there is more vomit inside?
What was the drug mentioned for House’s pain that he pu-pu’ed as being for nerve pain?
I agree that people should have noticed that they weren’t the same type of dwarf. They didn’t look it to me. (casting coincidence?) The daughter was far longer in limb and shorter in torso than the mom.
I also think that House had a chance with the mom right up until she saw he was stoned.
December 13th, 2006 at 9:52 am
One more thing. As for Wilson brokering the deal, I figured that was one of his 30 pieces of silver, House gets help not jail and stays a doctor.
And perhaps Tritter is still waiting for House to remove the thermometer. At least he acts like it.
December 13th, 2006 at 10:24 am
I’m finding it harder and harder to believe that Cuddy is the hospital administrator: she’s doing a crappy job of reining in House, and appears to be a poor MD as well. It’s a pity, because for me she’s the most sympathetic character on the show.
It wouldn’t surprise me if Chase left. I think he’s had enough of House, both academically and personally. But he probably won’t, because I don’t think the writers have that much imagination.
December 13th, 2006 at 10:28 am
Official Comment
Personally, I’m not sure that House overdosed as much as he “overindulged.” Either way, rolling him on his back was not a good thing to do.
Tylenol with Codeine does indeed contain a narcotic. It may not be as potent as Vicodin, but sure is still addictive.
In the beginning of the show they mentioned Tramadol (brand name: Ultram) and Gabapentin (brand name: Neurontin), and then the Gabapentin was mentioned a second time as well. Tramadol is a pain killer. It’s a unique class of drugs and is not a narcotic. However, it shares enough characteristics with them that I am weary of prescribing it to anyone where addiction is an issue. Gabapentin was originally developed as a seizure drug, but it hasbeen found to work well in chronic pain patients. It’s not entirely clear how it works; I tell patients that it “lowers the sensitivity of the pain carrying nerves” and it seems to work well, though it’s not a pain killer per se.
I meant to say something about this in the main post, but I forgot: I was disappointed when Cuddy referred to House as her “best doctor” when clearly he’s not. He may be her smartest doctor, or her most brilliant doctor, but he’s not the best. Being a good doctor requiresd more than smarts, it requires sensitivity, compassion, and an ability to relate with patients. House is lacking in many of these areas. Wilson is a much better doctor than House. And let’s not even go into all the money he costs the hospital…
December 13th, 2006 at 10:30 am
Loved the scene with Wilson walking out on the OD’d House… so much strength in that one minute!
Seems my predictions about Wilson’s motives turned out to be pretty much true. (See last episode’s comments)
Nice interaction between Abigale’s mother and House on this episode. Other than that the House/Wilson moment I mentioned, the visit from Cameron and Hugh Laurie’s acting in that scene really stood out. Brilliant.
I agree with Scott that the drama did not quite reach last episode’s peak, but it was still brilliant TV drama. I’d give it an A- as well.
Regards,
MikeB
December 13th, 2006 at 11:05 am
I find it intresting that nobody has noticed that the reason House passed out was probably that he was taking Oxycontin rather than Vicodin, and possibly failed to realize that his body was used to Vic, but not to Oxy, so when he took the size dose he was used to, it had a much stronger effect. (Is this a possible error for a doctor to make?)
I think the whole Tritter sequence is the writers’ attempt to take on the current ‘crackdown’ on doctors presecribing pain medication. (For some reason, Fox’ entertainment section has always been at almost the opposite end of the spectrum from their news division. Cases in point, IN LIVING COLOR, THE SIMPSONS, VANISHED, and now HOUSE.) I am enjoying it very much, and wondering how they will end it. “Saving” Tritter is too trite, and having HOUSE off Vicodin permanently would be a mistake.
As for the ’seizure of assets,’ sadly this is not mythical. It can be done fairly easily in supposed cases of drug trafficking — and long before the case comes to court. It usually requires a DA to sign off on it, and is more common in federal cases, while Tritter is obviously a NJ cop. (State or local? I remember from my growing up in NJ that the state cops weren’t very prominent or powerful.)
I am surprised though, that Cuddy has not communicated with Tritter’s superiors. Hospitals have enough wait that she’d be listened to, but I suppose that Tritter is being used as a personification of ‘authority’ and ‘the Government,’ which, sadly, does act that way too frequently.
December 13th, 2006 at 12:23 pm
Reagrding the legal aspects of the Tritter subplot:
1) It is a little strange that Tritter brokers the plea bargaining and such, but not unique. A DA would have to make the decision to offer a plea deal and such, but DA’s just aren’t (as a rule) heavily involved in the investigation of cases, at least not until it looks as if a case is going to indictment and trial, and often not even then. Sometimes investigators are so relied upon by DAs that in essence they really are the ones prosecuting the case, particularly when the investigator takes a greater-than-usual interest in the case, as Tritter clearly has. Incidentally, plea deals are often offered before arrest or indictment.
2) Previous commenter is right: a judge would have to actually accept the plea bargain. However, House would not necessarily be screwed just because the judge refused to take it. In such a situation, House would almost certainly be allowed to withdraw his guilty plea (assuming his strangely absent lawyer was even reasonably competent).
3) Yeah, Tritter’s near omnipotent access to to everyone’s bank account, cars, records, and so forth strains credibility. Tritter and his employing authority would potentially be subject to civil claims for abuse of process, amongst other possibilities. Of course, law enforcement generally have various types of immunity practically leaking from their pores…fraid I am not an expert on New Jersey law in that regard.
4) It really bothered me that Wilson just left House laying on the floor too, particularly after Wilson had made overtures to House to spend Christmas with him and then been worried enough about House to call him multiple time and then come over to find out if he was ok. Clearly, House was not ok. A cry for help on House’s part could not have been clearer, and Wilson should have known that. Why abandon him in disgust at that of all times?
5) House had to be aware of the dangers of taking large doses of narcotics and whiskey (though I applaud his taste…Maker’s Mark is bottled bloody gold), and this in combination with his actually having called his mother whilst ingesting suggests to me the very real possibility that he was half-heartedly attempting suicide. (I say half-heartedly because I suspect if House really set his mind to suicide I suspect he would be very effective at it.) They have hinted strongly that much if not all of House’s pain problem is psychosomatic and related to the internalized guilt he feels over how badly he treats the people around him. Combine that with detox, the spectre of jail and the end of his career (the only thing he really has apart from playing the piano), and his general loneliness and probable depression at this point, and well…yeah, the boy needs help badly, so badly that at the end even he had to admit it.
December 13th, 2006 at 1:38 pm
As someone who knows nothing about medicine I just assumed that House was on the floor because of alcohol and thats why Wilson just left rather than help.
December 13th, 2006 at 1:56 pm
Thank goodness, they have shown the true meaning of Christmas —to defeat the mean ole Grinch (who is an omniscient ass, but we love anyway), use a self-righteous nazi (Tritter) to usurp the legal system and get his way via extortion, bribery, and a single-minded obsession with the only doctor at the hospital who knows what is going on in medicine.
If they wanted to give kids a life-lesson, it is this: if you are a doctor, with a pill problem, (debatable or not), don’t ever talk mean to a policeman or he will make it his life’s work to bring you down (for your own good, of course) at the expense of all his other cases.
December 13th, 2006 at 2:03 pm
“4) It really bothered me that Wilson just left House laying on the floor too, particularly after Wilson had made overtures to House to spend Christmas with him and then been worried enough about House to call him multiple time and then come over to find out if he was ok. Clearly, House was not ok. A cry for help on House’s part could not have been clearer, and Wilson should have known that. Why abandon him in disgust at that of all times?”
Exactly! When I saw that scene, I yelled at the tv “Weren’t you coming over to make sure he wasn’t dead?” The writing for Wilson has been very inconsistent. This was the guy who just drove to Atlantic City, and covered for House so he could help a guy commit suicide (still illegal in this country, morally up in the air), who turns around and sells him out to the feds for taking pain pills that are probably just for pain(the legality and morality of which are both up in the air).
December 13th, 2006 at 2:33 pm
Prediction (having seen no more of the show than any of you): Tritter will turn out to be in recovery himself, and will become House’s AA or NA sponsor. They will run into each other when the short bus takes House from rehab to his first meeting. Hilarity ensues.
Re Wilson leaving House passed out: He could have notice the vomit and presumed that a) House’s stomach was empty and b) he’d puked up enough of the booze and Oxy to no longer be in danger of acute poisoning.
December 13th, 2006 at 2:37 pm
Michael,
I disagree with you regarding the judge’s role in this particular case, although, admitedly, I don’t know the specifics of NJ law. In my state, what Tritter has offered would be called a diversion agreement rather than a plea bargain. There are two relevant differences: (1) a judge does not review a diversion agreement, and (2) a diversion does not involve a conviction, whereas a plea bargain does. Because the deal has been framed as being so favorable to House, I assume it does not involve a conviction and therefore is not a plea bargain.
December 13th, 2006 at 3:33 pm
I agree with Steve. Why isn’t House in pain management? Why isn’t he under the care of a Physiatrist? Why wasn’t he on a long acting Morphine like Avinza or Kadian and only using theVicodin for breakthrough?
Prup–Was that bottle filled with oxycontin or oxycodone? If it was the later there shouldn’t have been such a difference. With the first the size of the pills are quite different and I can’t imagine a Doctor not accounting for the difference between a long acting and short acting med even high.
More likely alcohol interaction.
Why didn’t any of his colleagues suggest Subuxone since he was so clearly way into withdrawal? He would have gotten some relief and they could have coaxed him into detox.
Lastly, I really have issues with how they are treating this whole subject. As someone who has RSD/CRPS and TOS I feel the whole issue of physical dependence versus addiction is being made black or white. Making him reject Gabapenten makes him sound like he is rejecting help. House
is smart enough to know that Neurontin will turn him into a zombie and unable to function; and the kind of pain he is dealing with Ultram won’t touch. That whole scene was ludicrous.
When you are in that kind of pain you cannot function. An Opiate makes you able to function and returns your life to some normality without destroying your liver or kidneys. Opiates can be used appropriately and responsibly and they are sometimes are the best option. House may have been using vicodin inappropriately; but, that is not to say there is no place for their use in his case and other cases.
Maybe they were treating his pill popping too comedically, but the pendulum has swung too much in the opposite direction. There are people for whom this may be the best option. This just feeds into a growing amount of patients afraid to take these meds and Doctors fearful to prescribe; As well as pharmacys fearful to fill the scripts no matter how legitimate.
Give House a narcotic holiday by way of Subuxone and Subutex and then find a pain baseline and treat him appropriately.
One other thing; Did they dismiss the Ketamine solution too quickly? Does it get rid of all the pain permanently or just put you in remission? Don’t you still have to get periodic shorter infusions to keep that sympathetic nervous system rebooted? Don’t they still need some pain
meds–just less in some cases?
December 13th, 2006 at 3:39 pm
>
The writers (and House and even Cuddy) seem to be very prejudiced in terms of patients that can potentially be cured being more valuable medically than the dying. It’s really kind of sick logic. And House treats about one patient per week versus Wilson’s presumably numerous patients.
December 13th, 2006 at 4:20 pm
>>>As for the ’seizure of assets,’ sadly this is not mythical. It can be done fairly easily in supposed cases of drug trafficking — and long before the case comes to court. It usually requires a DA to sign off on it, and is more common in federal cases, while Tritter is obviously a NJ cop. (State or local? I remember from my growing up in NJ that the state cops weren’t very prominent or powerful.)
That’s only in Trafficking, the only person who could be reasonably suspected of trafficking is Wilson, but they have no reasonable suspicion that money is involved, hence I would think no trafficking. At best, they could have frozen Wilson’s assets, but again, there is no money connection. There is no basis for suspecting the young guns of trafficking, and therefore no justifiable reason to freeze their assets.
December 13th, 2006 at 4:26 pm
Gary,
You are right about the diversion thing, and I gratefully accept the correction. However, it is somewhat more complicated than that. When I clerked for a judge in Alabama, the basic diversion process was something along these lines: an indictment and case would be open against the defendant, but the defendant would be offered diversion by the DA. The judge who had the case, upon being informed of this fact, would place the case on an administrative docket (i.e., limbo) until either the diversion was successfully completed (and then the case would be nolle prossed by the DA and dismissed, though the judge still had to formally sign off on that….in practice that was as simple as sending him a form which he or she would sign in every case) or else was not successfully completed, and the case would become active again.
Interestingly, my circuit phased in a drug court program about the time I left the judge’s chambers. That was a bit more formal than the old diversion process: upon acceptance into the drug court program (at the DA’s discretion) the defendant would have to enter a conditional guilty plea and then go into the rehab program. Again, if the defendant successfully completed it, the case would be dismissed. If the defendant did not successfully complete rehab…the guilty plea would stand and the defendant would be sentenced accordingly.
Oh, I wanted to say one more thing about the seizure aspect of Tritter’s actions in light of Prup’s comments above: certainly, law enforcement has much broader seizure powers than most people realize, and there need not be a conviction (and therefore the adjudication of guilt beyond a reasonable doubt) to do so, it’s a quasi-civil proceeding and therfore subject to a preponderance of the evidence standard. This is not carte blance however, and while we could debate whether Tritter had enough evidence or probable cause to mess around with House himself (not really clear), as nearly as I can tell there was not even remotely enough evidence to go after Wilson or the Young Guns. Wilson said he wrote the Vicodin prescriptions for House, and to the extent the YG’s might have prescribed House narcotics in the past, I am sure they would (or did) admit the same. It seems simply ludicrous that, without evidence of a broader conspiracy to traffic (of which Tritter has zero), any cop could just go in and seize the assest of four or five doctors (and suspend Wilson’s privileges) just because he wants to pressure another one. On that theory, Tritter could just shut down the entire hospital if he wanted to, because anyone could have written House a scrip or be in on the trafficing conspiracy.
All of this would be very ripe picking for a competent lawyer to challenge Tritter, and in fact, the hospital itself probably would do so under those circumstances. Still, if the show got all into that, it would go from being a medical drama to a legal drama. And then, I would get *really* nitpicky. ;-)
December 13th, 2006 at 4:53 pm
I’m still confused…did they EVER explain why she started bleeding, or did I just miss it?
December 13th, 2006 at 5:07 pm
Official Comment
The initial mouth bleeding was from the esophageal varices, plus the liver failure. Since the liver makes the body’s clotting factors, liver disease can lead to poorer clotting and easier bleeding.
The second bleeding was implied to be from the fact that Langerhans wasn’t being treated, just the autoimmune aspect. Of course, combine that with immunosuppresant medications that can affect bleeding and liver failue and bleeding would be common. Still, they could have done a better job of explaining it.
December 13th, 2006 at 6:26 pm
The scene where Cameron got mad at Wilson for making the deal really got to me. House steals Wilson’s pad and forges his signature, but somehow Wilson is honor-bound to cover it up? Really, it seems that House betrayed Wilson, not the other way around. Turning in House benefits Wilson, so it’s morally reprehensible. Don’t bother pointing out that keeping Wilson silent and destroying his career benefits House, because that’s completely different.
I really liked this plot arch when they introduced it a few episodes ago. It seemed like they were going to show that House really is human and isn’t right all of the time. This episode is the first step in undoing all of that. In the end House will get off without accepting responsibility for anything, Wilson will be the pariah for not following House blindly, and Tritter will go home with his tail between his legs.
December 13th, 2006 at 6:53 pm
The reason for Wilson leaving House flat on his back is more readily understood if you get a closer look at the medicine bottle House is holding. It’s easily seen that it’s Oxcodone, but not so easily seen that it is a bottle of Oxycodone that Wilson prescribed to one of his own patients (both named near the top of the label). House either forged another prescription or stole the bottle. Either way, Wilson is disgusted at his friend.
December 13th, 2006 at 8:38 pm
Sariel,
Point taken, but…House had already earlier in the episode tried to steal the same patient’s narcotics right in front of Wilson. And it is Wilson (amongst others) who is contending that House has a problem and needs rehab, and basically forced the issue on him by negotiating with Tritter in the first place. It was also Wilson, again, who wanted House to spend Christmas with him, called him multiple times to check on him, then apparently rushed over to House’s place worried that he was not ok. Which he wasn’t. Given all of this, can Wilson really be surprised that House stole the scrip? Isn’t this exactly in the nature of ther problem Wilson is trying to make him address?
The point is that House has often (more or less in his right mind) done or said awful things to Wilson whch would have fully justified Wilson never even speaking to House again. But Wilson finds House more or less out of his mind on alcohol and narcotics, clearly hitting bottom and at the end of his rope, possibly suicidal, and certainly in a hazardous situation…and then decides House is an ass and leaves him to it? I just thnk it would have been at least a little bit more in character for Wilson to have at least made sure House was not in any immediate peril before huffing off disgustedly.
December 14th, 2006 at 12:05 am
Anþony- Not turning in House benefits a lot more than just House. Why, in this very episode we see a small growth hormone deprived girl who Wilson hurt by turning in House. See, that’s what Tritter wants to do here, in the end, he wants to end one life per week, 22-26 lives per year.
And based on the previews for the next couple of episodes, Tritter is not going off with his tail between his legs, and House IS accepting responsibility for things he’s done by going to rehab and even apologizing to Tritter.
And, quite frankly, I don’t see the point of this arc: House is a doctor, and demonstrated when he went to the clinic that he knew enough about the other pain killers to know they were inefficient, and most of all when he had no pain he took no pain medicine. If he were truly addicted to Vicodin, could he really drop it cold turkey for 3 months when he had no pain? I’m not sure I believe he could.
December 14th, 2006 at 5:26 am
Zach, the arc is to help build House’s characterization. Except…he’s had characterization. This isn’t adding anything. The need to shift focus on the supporting cast more, and how House reacts to them, rather than focus on House, and how the supporting cast react to him. But what do I know, I’m not some big-shot Hollywood writer.
I will say, most obnoxious thing in the episode? The Menorah christmas tree ornament.
December 14th, 2006 at 6:34 am
Gary, Michael:
The deal was stated as “2 months rehab *in exchange for a guilty plea*” — I think that is basically a plea bargain defined.
December 14th, 2006 at 9:41 am
I’m not at all surprised that House isn’t in any kind of program. Doctors and other health care professionals are notorious for self-medicating and self-treating. House’s character makes it even more unlikely for him to submit to anybody else for treatment, especially after the way his leg was botched up. If he indeed agrees to go into treatment that would be a major turning point in his character.
December 14th, 2006 at 10:37 am
Just my two cents’ worth..I think the fact that Wilson left House on the floor fully aware that he might be in great danger was a brilliant move on the show’s creators’ part. For me, it made Wilson more human, less “angelic” so to speak. House have pushed Wilson’s buttons long enough, maybe it was a payback time. Very understandable, really ..
December 14th, 2006 at 10:57 am
I guess this is slightly off-topic, but…
I don’t understand the claim that Wilson is somehow a better doctor than House. I guess this follows from the definition of a good doctor (Scott says: compassion, ability to relate to patients…). But does Wilson’s personality traits make him a better *doctor* or *person*? If you were in a life and death medical situation, are you going to want a compassionate doctor? Or an arrogant prick who is more likely than anyone else to save your life? I think the choice is clear.
It’s not a big deal, just that I don’t get how anyone can argue against Cuddy when she calls House her best doctor. Heck, even Wilson eventually backs down telling Tritter “He [House] saves lives.”
December 14th, 2006 at 11:07 am
19 Years Clean:
Congratulations are in order, I suspect. Good for you!
December 14th, 2006 at 11:24 am
As a music lover I really enjoyed the intro’s use of Louis Armstrong’s “Is that you, Santa Claus?”. I really enjoyed the whole episode, in spite of the nits that are being picked to death here. Anyone who’s been awake in post 9/11 Bushland should be unsurprized by the discretionary power of law enforcement today. Anyone familiar with “Chrismon” tree ornaments shouldn’t object to Hannukah getting equal time. I’m surprized they didn’t have Muslim and Qwanzaa ornaments as well. The writing is nearly back up to last year’s standard, at least for dialogue. I love the rapid repartee with each character packing multiple meanings into every serve and volley. I love Hugh Laurie’s virtuoso portrayal of tormented genius and his dead perfect American accent. How could he fail to win the heart of every female in eye, ear, nose, and throat-shot?
December 14th, 2006 at 12:38 pm
X,
The point that Gary and I were discussing is that it could be one of a number of specific arrangements which are commonly shorthanded as ‘plea bargain’ but in fact differ from place to place in one or more material respects, the most important of which is whether a conviction for the underlying crime results. For example, in the ‘drug court’ scenario I outlined above in post 29, the defendant actually pleads guilty, but no conviction ultimately results. The same is generally true of diversion programs where they are an option.
You are putting the emphasis on the wrong term in “plea bargain.” Bargaining, and not making a plea, is the unique component. This is obvious when one considers that the defendant can plea whatever he or she wants whether the DA likes it or not, but certainly cannot bargain without the DA’s involvement.
In fact, the essence of plea bargaining in the technical sense is either pleading guilty to a lesser included or related offense in aid of obtaining a lower sentence than would strictly be mandated, dropping one or more counts in a multi-count indictment in aid of obtaining a lower sentence than one would get for conviction on all of them (US Attorneys practically do this for a living, which is also why they throw every conceivable charge into the indictment that they think they can get away with), or more simply, just bargaining a lower sentence in exchange for the guilty plea in places where such sentencing is largely discretionary.
Drug court or diversion programs (where they are in use) are generally at the option of the DA and, strictly speaking, fall outside of the judge’s sentencing authority. In other words, there is an extra layer of bargaining: the DA can refuse admission to the program and the defendant must either then make a ‘classic’ plea bargain (which will involve a prison sentence of some sort, whether suspended or not), or go to trial and take his or her chances with a jury.
The very fact that the offer made to House was 2 months in rehab indicates to me that the deal offered by Tritter was not a ‘classic’ plea bargain for the simple reason that in most states I am aware of (and certainly in the one in which I am licensed to practice law), there is no legal authority for a judge to sentence a defendant to “two months in rehab” just because it would be a nice thing to do. Rather, the judge is constrained to follow whatever the relevant sentencing laws for that state are. In other words, if the law says that conviction for crime A (forging prescriptions if you like) results in a sentence of of 3 to 5 years, the judge cannot just decide that the defendant really deserves a shot at rehab…once the conviction is in, the judge MUST sentence the defendant to a minimum of 3 years in prison but no more than 5 years.
Therefore, unless there is a law in NJ that states (in one way or another) that one of the available sentences for the crimes with which House is charged is 2 months in rehab, the deal offered House must be some sort of program run through the DA’s office which allows the DA to send people to rehab, after which (if the defendant successfully finishes rehab) the DA will decline to prosecute and the case will be dropped. The whole point of such a program is generally for a defendant (usually a first time drug offender) to avoid an actual conviction and the consequences of the same.
As I stated earlier, these arrangemets are commonly all discussed under the rubric of ‘plea bargain,’ but there are important distinctions between them.
December 14th, 2006 at 3:40 pm
Joe…that’s the problem, they don’t deserve equal time, and didn’t receive equal time. Please keep in mind, I’m coming at this as a Jew. The orniment was thrown in as a Politically correct way to aknowledge Jews. If they want to give equal time, rather than focus on Channukah, a VERY minor holiday that has been blown WAY out of proportion by the US media, I’d rather that in eaither fall they mention Rosh Hashana/Yom Kippur, or in Spring have them mention Passover, both more substantial holidays that more adversly affect Jews. Granted, people don’t decorate for those holidays, but a simple, “Hey, where’s Wilson today?” “He took it off, Yom Kippur” or “Hey Wilson, how about a sandwich?” “Can’t, Passover” would be awesome.
It’s a personal peeve of mine that Hanukah gets all the limelight is all….
sorry about ranting..
December 14th, 2006 at 11:48 pm
“Or an arrogant prick who is more likely than anyone else to save your life? I think the choice is clear.”
“Which would you prefer: A doctor who holds your hand while you die, or a doctor who ignores you while you get better? . . . I guess it would particularly suck to have a doctor who ignores you while you die.”-House
I’d go for House over Wilson any day.
December 15th, 2006 at 12:05 am
I’ve been viewing “A Bit of Fry and Laurie” and my “House” dvds and am repeatedly amazed by the seemingly effortless manner with which Hugh Laurie is able to switch from comedy to heart wrenching drama that is dead-on accurate in his portrayal of a person suffering withdrawal from opiates as well as what must be searing neuropathic pain. As I tick through the diagnostic criteria, I am still not sure as to whether House has “pseudoaddiction” (insufficiently treated pain that prompts drug seeking behavior that looks like substance abuse) or not. I don’t understand why Cuddy doesn’t force him to see a pain specialist who could prescribe something more effecive for House, like a Fentanyl Patch that would address his pain and also prevent the opiate withdrawal and thus keep him functional. During the “overdose” scene, it looked to me as if he was trying to choose the combination of pills and booze that would give him a nights sleep, rather than kill himself and we need to remember that he is portraying a medical genious who should have a good idea of what that dose would be for himself. However Wilson had NO way of knowing what House had done to himself when he found his friend down, and I was horrified that he didnt even call 911. Well enough of my ranting for the moment. Thanks for this great web site Scott .
December 15th, 2006 at 5:33 am
spanish fly
December 15th, 2006 at 8:08 am
@Rob G
How if you get some illness that can’t be cured? Like, I dunno, cancer in its terminal stages?
December 15th, 2006 at 8:18 am
Benmast: Well, then, I guess the choice is would you rather have a fatal disease that you can’t cure, or a potentially-fatal disease that may or may not be incurable but no one can diagnose it? ‘Cause that’s what House does right: He diagnoses diseases that no one else can. He has had at least two incurable patients that I can recall, but the important thing is that he found out what they were suffering from so they could get their lives in order.
December 15th, 2006 at 11:15 am
>The writers (and House and even Cuddy) seem to be very prejudiced in terms of
>patients that can potentially be cured being more valuable medically than the
>dying. It’s really kind of sick logic. And House treats about one patient per
>week versus Wilson’s presumably numerous patients.
Nonsense, no one said that, although you might claim Wilson implied it when he offered himself in exchange for House (when he told Tritter “Better me [in jail] than him”).
With Wilson+House+Cuddy, Wilson’s patients get care while House cures those with difficult diseases. With Wilson+Cuddy alone, they can’t solve the tough cases and Wilson’s patients still get care. Wilson+House+Cuddy is clearly the best option. What’s the problem here?
December 15th, 2006 at 11:35 am
What bothers me is this: According to the writers of this show, House has only shown real radical and dangerous behaviour when he’s off his meds. So where is the sentiment coming from that House is a danger to others, and he might one day kill someone?? Tritter talks like someone who has never seen the show :-), so I understand that part, but why are Cuddy and Wilson going with this flow?
Inconsistent, to say the least. Wilson ready to threaten House with jail and suspension of license, but why? House - high on vicodin - killed a few patients recently in some mystery episode I haven’t seen?
December 15th, 2006 at 5:03 pm
Ok I have not read all of these post so if I am reposting something..I am sorry. Here is my thoughts of Tritter. It is a load of crap. Why would he offer a deal and then take it away for recieving no evidence. One moment he is fine with House getting off clean and the next he wants him to loose his ablility to practice medicine. It makes no sense.
The drug that House took to overdose. I read about that drug and I am pretty sure that if you over dose on it, you pretty much die. There is no being a-ok a couple hours laters like the show made it seems like.
Why would they want House to stop taking pills. He does his job when he is not in pain. He doesn’t do he job when he is in pain…more people live when he has his pills but some might die when he doesn’t have his pills…I’m glad that House can do that math.
December 15th, 2006 at 6:23 pm
My thoughts on the point of *best* doctor. I have to agree with the stance that House can be considered the best doctor, though not the best person. Looking at all the stuff Scott listed earlier, though, House’s a pretty okay doctor. He’s not the kind of doctor that does it by the book, but he DOES connect and relate to patients- this episode is a prime example with the ending bit where he had to convince the mother to tell her daughter to take Growth Hormone. He’s rarely compassionate at face, but, like Cuddy said recently, he doesn’t obliterate self-esteem needlessly, he does it to get the patient to do the smart thing, despite the difficulty in that.
As for other stuff, I’m no doctor, lawyer, cop, whatever, and thus, I don’t really care about the inaccurcies unless it gets to the point where it’s painfully obvious they haven’t done their homework to someone outside these fields. If House cures Cancer with Penicillin, or something, then I’ll have to stop watching. Until then, suspension of disbelief and artistic license FTW!
^__-.
That said, I don’t really like the Tritter arc, but see the neccesity in it…a bit. The writers probably chose not to focus on the secondary characters because if they’re developed too fast they’ll run out of show. So developing them slower as an aside to House’s character evolving keeps them writing and making money. However, I’m with whoever said House is jumping through the same hoop with a shiny new paint job- the start of this season had a lot of promise. But then he grabbed his cane again, and instead of focusing on his return to that piece of sandpapered wood, they went off with this Tritter arc, which probably would’ve made more sense if they’d thought about it back around the episode “Detox” instead of tossing it in in this season.
Nonetheless, I think most people who watch still like it. It’s still by far my favorite show! (way better than Grey’s Anatomy!)
December 16th, 2006 at 7:04 pm
I think the best solution is to have Chase get into some argument with Tritter and then kill him. That would let this whole going to jail thing disappear, since this seems to be a personal vendetta of Tritter.
December 16th, 2006 at 7:10 pm
Jordan: That’s basically how I was hoping this episode would end, personally. I imagined House would take the deal, and then Wilson would explain how the deal was basically to make House no longer a suspect in Tritter’s murder right before Wilson kills him.
December 16th, 2006 at 7:43 pm
Nope. It would have been Cuddy. She would kill Tritter to save her hospital and doctors. And then she would tell House: “The only reason I wanted you off the Vicodin is so you could give me a clean sperm sample.”
December 17th, 2006 at 8:19 am
I’m glad to see that someone else thinks Tritter is off base, if not a half a bubble off. Don’t get me wrong, David Morse is as good as it gets for the character but the writers need some legal researching. A cop doesn’t just get a warrant for medical, treatment or pharmacy records. Cuddy would have had to get served with a warrant, whi in turn would have gotten the hospital’s attorney, who would have filed a motion to squash based on doctor patient privilege. The records would have been confiscated and not left in the hopsital so anyone could change entries or simply take the files - chain of custody issues. No DA would offer a deal and yank it out because of swiping a “script”. Credibility would prevent any other attorney from agreeing to deal in the future. Besides, Tritter has House on forging signatures which is one step from stealing a script. Wilson on the other hand needs some major help in ethics, especially leaving House alone after the latter used drugs and booze. A 911 call was in order, no demanded. If something had happened to House, say for instance death, coma, etc. Wilson would have really been in a trick bag along with Tritter. Imagine neglect homicide charges for both because they’re acting in concert. Tritter pushing without any legal leg to stand on and Wilson telling Tritter about the stolen pills. Medically speaking I don’t know the terms, etiology or any other such items. Drama wise the series is excellent but the writing needs CPR.
December 17th, 2006 at 3:44 pm
I hate it when you guys keep referring to scenes from the Fox previews. Not everyone here watches them, you know … Some don’t even watch Fox … So please keep the future spoilers to yourselves. Thanks, and Merry Xmas.
December 17th, 2006 at 5:41 pm
House is a Diagnostician, right? How do you even beomce one of those. After recently starting to watch House, he makes me what to be one. Do you just become a doctor and get put in that position or is it something you go to college for? I would really enjoy to know.
December 17th, 2006 at 11:49 pm
Long time lurker, first time poster.
I won’t go into the reasons why the Tritter arc is a load of deus ex machina that has no place on this show, as they’ve been well elaborated already.
The way I’d like for this to end is, honestly, to go with the idea of Tritter getting sick and being admitted and having his life hang in the balance…
…And he dies while House is in withdrawl.
Cuddy realizes that taking House off his pain meds doesn’t help anyone, Wilson realizes that he’s not the same sort of doctor that House is, the Young Guns (who try to diagnose Tritter without House, which could give Chase a time to shine) realize they still have a lot to learn, and House is back to being the House we all know and love. “Yep, it was just a matter of knowing the secret of all TV shows: at the end of the episode, everything’s always right back to normal.”
As far as what makes the “best” doctor, I remember a poll conducted a couple years ago where people ranked their most desired traits in a doctor, and “bedside manner” was #1 ahead of “medical ability.”
December 18th, 2006 at 3:24 am
Honestly, who would put bedside manner ahead of medical ability? Do you have a link to that?
I mean, perhaps it’s because I’m extremely sarcastic in person and can absorb unlimited amounts of verbal abuse, but as I stated above, I’d LOVE to have House as my doctor (aside from the impending medical bills of all the tests). Frankly, I don’t give a damn what they say to me or how they say it - I can take it. I just want the best guy out there to make sure I’m cured.
Then again, I also fear death more than public speaking; so I’m a proven anomaly.
December 18th, 2006 at 1:56 pm
I don’t have a link, IIRC I read it in Reader’s Digest (an appropriate amount of salt taken here). Still, I can see the reasoning behind it. Most people don’t see a doctor because of lupus (It’s never lupus, right?) or other major House-like problems, but just for minor things. They go to the doctor because they have a cold, or a sore joint, and they want to feel better. A doctor who is polite and soft-spoken and eternally optimistic, even without giving any treatment, can make people feel better and let the body’s natural recovery process do its work.
Granted, I don’t fall into this category either; my last doctor was a quack and no amount of politeness could make up for it.
December 18th, 2006 at 5:23 pm
Granted, I’d also generally prefer a nice doctor over a mean one (although House would be kinda fun).
But ‘Medical ability’ is so danged important. But it is true - the average doctor visit is just a checkup.
(Then again, having a bored and skilled doctor would mean stuff like checkups would go by fast; we all hate the waiting room).
December 19th, 2006 at 9:01 pm
I always wondered if the hospital and Cutty keeps House there because of the mistakes that were made that left him in pain…..imagine being a patient in the hospital that couldn’t even get a diagnosis right on their own doctor? I gather that would cost much more over time than keeping House in house…….just a thought…….
Air Force Pathologist
December 20th, 2006 at 5:12 am
For those of us you could have been doctors and, para phrasing House, should have knuckled down in school, the third season has been a bit of an oddity. the first 2 seasons always had a sub plot within each episode that causes the secondary character to grow. Now its seems that House now is the one who has to grow, albeit slowly. This is not a good thing as House great as the angry misanthrope.
December 25th, 2006 at 1:32 pm
This debate about the value of a good bedside manner compared to “medical ability” misses the point of House, I think. In practically every episode House cuts through the patronizing and lying by being candid and sometimes brutally honest to the patient about what’s happening. Said patients often initially react with shock to his approach, but almost always end up reacting positively to his honesty and candor. It may be that we all believe we, personally, want a hand-holder. But the writers are suggesting that, in fact, what patients respond to is the truth and to someone who appears to be acting purely with their best interests — as compared to their “feelings” — in mind. Think of it as a child’s response to a father who acts with wisdom and strength compared to one who overlooks every indiscretion. Respect flows to the former, not the latter.
If you want to disagree that his approach would result in such respect in “the real world,” fine. But since, in the world of the show, it clearly does, and since his patients inevitably survive and respond to his attitude (the dwarf in this episode most notably, perhaps), I don’t see that there’s any real basis for debate. House DOES save lives, and DOES generate respect and gratitude from his patients. Thus, he has — in the world of this show, again, at least — both the “bedside manner” (albeit a nontraditional one) and “medical ability.”
In my opinion, at least, that’s the whole point of the character and the show. A nontraditional doctor who detsroys himself while saving others. To argue that House *doesn’t* succeed in connecting with patients emotionally seems to ignore what’s actually happening on the TV!
December 26th, 2006 at 10:53 pm
Hello everybody :)
I’m following discussions and reviews about House. I had seen first two season adapted in italian, and liked them very much. In this 3rd season the medicine aspect seem less accurate than before; it’s like the show had lost his special hospital scent… and now it’s smelling like a damn soap-opera. Don’t know if it depends on me (and my poor english), because I’m actually watching it in american-english and not in italian… or depends on writers who haven’t any damned ideas about the episodes to come…
Just hope Stacey will come back to help House…
Tritter will get jailed… then he tries to kill himself with poison… and House save his life thanks to a rectoscopy :D Tritter then thankful but humiliated disappear for ever.
December 27th, 2006 at 2:27 pm
I have to agree that because House isn’t compassionate or fits the stereotypical mold of society doesn’t mean that Wilson is a better doctor. While those traits are admirable in Wilson, it doesn’t solve medical problems.
December 27th, 2006 at 4:29 pm
Add me to the list of people increasingly frustrated and tired of this Tritter story arc. It’s completely unrealistic (no way in the world could Tritter get court orders to close accounts and inhibit the legitimate workings of the hospital as he has), and, more importantly, increasingly boring and annoying. All right already! We get it! House pissed off the wrong guy! Either have House learn his lesson or Tritter get his come-uppance, *soon*.
(Not to mention I keep waiting for the inevitable conversation between Tritter and Cutty where she points out that the trade-off for keeping House out of the hospital is having patients die who would otherwise be saved. Why nobody has pointed this out to Tritter is beyond me . . .)
December 30th, 2006 at 3:35 am
I did love this show, but I’m really not sure I can watch it any more. They are so far off base with the chronic pain thing, that I just wince watching them misrepresent the whole issue of painkillers, pain management etc. And it’s probably doing a lot of harm to chronic pain sufferers who are probably getting more crap than usual about being “addicts” or “junkies”.
It’s not like they’ve even mentioned long-acting meds like fentanyl, MSContin, Oxycontin etc and then dismissed them for some weird reason.
Whether or not there’s some underlying psychological reasons contributing to it all, he still has a legit reason for proper pain medication. And the pseudo-addictive behaviour he’s exhibiting (eg hording) makes perfect sense in his situation.
I can understand them getting some things wrong just for the sake of keeping the show moving (eg how quickly they get tests done, that they do most of them rather than a lab etc), but basic stuff like this throws all credibility out the window.
I don’t know enough about the law stuff to comment on it, but it seems as though the legal script advisors went to the same crappy school for law as the medical advisors did.
December 30th, 2006 at 5:56 pm
I’ve just started watching House the past 2 months or so. Saw “Merry Little Christmas” when it aired, now I’m catching up with earlier episodes that are coming into re-runs. I can’t help thinking that House’ extreme actions leading up to this point have to do with resentment toward Cuddy and Wilson for trying to “manage” him over his intuitive diagnosis of the vegetative guy with Addison’s. Wilson and Cuddy are now getting the exact kind of House they feared — single-minded, selfish, thoughtless, (brilliant) but without perspective. House is fulfilling his colleagues’ worst images of himself.
December 31st, 2006 at 8:00 pm
As much as I enjoy watching the show and as brilliant as House is, I must disagree with those who maintain that he is the best doctor. He may be brilliant, but he is rude, disrespectful, crude, and unprofessional. He isn’t “brutally honest”. He is just brutal. These are people, hurting and worried. He is compelling to watch but I think that has more to do with Hugh Laurie consummate abilities rather than the idea of House. I have had doctors who are technically brilliant (have Ulcerative colitis) and yet were unwilling to answer questions or tolerate a communication with the patient. There is no reason why brilliant doctors cannot show or be asked to show or be expected to show compassion, patience, and respect. It is sad that we have this idea that not only do brilliant people have personality problems, but that society/patients must tolerate and even approve of these defects because of the brilliance. The best doctors are those that keep up with the research (and thus have the info to be brilliant), have a clear respect for what they do and for whom they do it, and have good people skills. Those are the best. If I had to choose, of course we would choose the technically brilliant, but why are these two traits, brilliance and compassion, considered mutually exclusive?
I am also frustrated with the pattern card patients and storyline. The “relative/friend/spouse who has lied about cheating/past events/medical history who, while shocked at House, never seems to rise to the level of furious or indignant at his comments and turn into his slavish adoring fans because he solves the problem after subjecting the patient to snap judgement treatment that always fail” House is always so confident in his first two/three diagnoses, which always fail. The dwarfism storyline was refreshing simply because the mom wasn’t deceptive! And tritter is somewhat refreshing (although yes, unrealistic) because House was rude and essentially assaulted him and he didn’t take it. House is a bully and the early shows with Tritter I was actually happy that someone was standing up to him.
And yet, this is still the best medical mystery show. Testament to Hugh Laurie’s abilities and the fact that I learn so much from this website that I still watch it.
IMHO :-)
Zoe
January 2nd, 2007 at 8:18 pm
Tritter and House are pretty much the same people. Both are bullies and both are going to go as far as they can. Tritter isn’t going to stop until he stops House and House won’t stop until he wins.
Why wouldn’t House keep going back to his first 2/3 diagnoses, he said them for a reason. I would want to back up my diagnoses until I knew that they could not be true without a shadow of a doubt.
House doesn’t have to be nice to his patients. It’s not his job to be nice, it is his job to find what is wrong and treat it. Being nice is optional thing. I seriously doubt that patients would be angry at a doctor or complain about him if he just saved their life.
January 3rd, 2007 at 12:55 pm
Zoe:
No-one says that being nice and brilliant are mutually exclusive. Rather, the claim is that if you have 2 doctors, one nice and pretty clever, the other a jerk but insanely, mind-bogglingly, ridiculously clever, you’re going to go with the latter when it’s a matter of life and death. This alone makes him a “better” doctor, for some definition of the word better. The definition I’m going by is one who can save lives. Of course, you may disagree. :-)
January 4th, 2007 at 8:43 pm
I was sure Tritter is an alter ego of House - and in 3×10 there’s a little gem supporting my hypothesis. Watch first 20 seconds (or so). Louis A. is singing X-mas song. Theline “Is that you, Santa Claus?” returns twice. Just watch what is then shown. It means probably nothing, but I like flavours like that.
January 6th, 2007 at 7:01 am
Going through all these posts I find that I have no clue when it comes to the medical or legal aspect of the show. But the drama part of it I really understand. I’ve seen a few people hint at the whole Tritter vs. House thing is getting a little old. Personally I don’t like plot arcs. I’ve seen Star Trek ruined by it. Just take Shakespeare for example. (you don’t have to get him, but follow me here) He based all of his plays on a very good concept that has been copied by many sucessful shows (Star Trek one of them… forgive me) In Shakespear, all the events take place within five acts. THese plays were intended to be fairly short, say an hour or so. All the events and the climax had to take place within that short time span. When TV writers go into long elaborate plot arcs, you tend to lose the focus. Like, the episodes where there is one problem (or more whatever!) that are all solved within the hour are excellent. Its just enough drama/excitment or whatever else you get from it. But like, after a few episodes of the same story line, no matter how much you develop it, just does’t fly right with me. Like, I’m starting to forget the real reason this Robo-cop is after House (yes yes the thermometer!) But really, how far are they going to take this. At this point I don’t know what they are trying to show us. Is it House’s humanity/humility or is it the all powerful institution out to crush what it sees as corruption?
I just want to see this plot end. We all hate Tritter, but I want more of the miserable Dr. House saving the world. A drama in Five commercial breaks! Shakespear will be rolling over in his grave, but it works!
January 6th, 2007 at 4:55 pm
I must say, I thought the Vogler arch was annoying — but that was before they gave us the Tritter arc. Vogler’s actions and the reactions were at least believable, but here neither is. The police stuff is absolute crap (that is more Gestapo than even US police proceedure), and it seems (among other things) more than unlikely that a whole hospital would let a pain patient not only go cold turkey, but without pain management, too. Other stuff might help less, but it is rather unlikely that nothing helps at all. Not to mention that a “reasonable” dose was stopped cold turkey, too. And of course, it is utterly unbelievable that there are no lawers for House and the hospital, either.
So does anyone know how much longer we have to suffer through this crap? First, IMDB said David Morse was in 4 episodes, now it is 6 — and does not look like it was the last one, either. Because if it is many more, I am inclined to skip a few …
January 9th, 2007 at 11:23 am
Let’s all hope that the plot develops away from Tritter (here, here to all the negative comments about him!) and to the substance use issue. Whether or not we think house is drug dependent/addicted et al, the underlying issue of human suffering, pain management, life coping, etc is one that every human can understand. And heck, House vulnerable, in pain, and out of control as we last saw him in the Christmas episode is very compelling TV. I hope that the next episodes will find House (and us) exploring the deeper psychological and spiritual aspects of House’s life that will most certainly come out in his upcoming stint at a treatment facility. Let’s also hope that we don’t have to endure protracted minutes and episodes of House’s legal problems associated with Det. Too-Gung-Ho Tritter! Bring it on tonight!
January 9th, 2007 at 1:42 pm
It seems House is alone, much more alone than he was before Tritter Cra…Arch.
So, it’s time to stregthen his “friendship” with Cameron…
…or Stacey will come back to help him?
Or least but not last, will he be doing is job, ignoring all the medical crew?
One thing is sure, I want the belivable episodes BACK! And i Want them now!.
January 9th, 2007 at 7:48 pm
Thanks for these reviews. Read every one of them, and found myself liking the series more because there’s such excellent critique available. (Started watching the show because I like Hugh Laurie.) Now, I just _have_ to check this site after each new episode.
Thanks, also, for not having ads by google or whatever all over your blog. Muchly appreciated.
January 9th, 2007 at 8:03 pm
Zoe (item 72),
The Brilliant and Nice personality traits aren’t mutually exclusive, IMO, just not a likely combination. Most intelligent people (especially hyper-intelligent people) don’t have the time to deal with the banalities of the average person. Consider how bright the average person is… and now remember that half the population is _worse_. Now consider being brilliant, working on intricate problems… and being constantly interrupted with inanities.
Can House be Brilliant and Nice? Certainly, but in small doses, because if he focused on his people skills, his analytical abilities would have to suffer for it, and then he’d be just another doctor. Would that really make for compelling TV, Hugh Laurie notwithstanding?
IMHO, too.
PS: 79 responses?!!! Wow.
January 12th, 2007 at 4:13 am
So Cameron finds out that House cut himself to release endorphins to numb pain. There are better ways to generate endorpins. There’s chocholate and sexual activity. Now I haven’t noticed much of a pick-me-up from chocholate, but….um…self-induced sexual pleasure works pretty well. Why didn’t he do that instead of cutting himself?
January 27th, 2007 at 12:54 pm
One tiny thing that you did miss and I am not sure if anyone else mentioned is House’s growth hormone replacement therapy imitation. House kneels down on one leg, pretends to put a pill in his mouth and then stands back up. Sorry writers but take it from a women whose son is hypopituitary….growth hormone is given by injection and not in pill form. How I wish House’s depiction was true!
Terri
March 17th, 2007 at 12:56 pm
Justin, I think, said that what the bottle was labelled for would kill him if he overdosed on it. I live where Chase comes from (we aren’t up to this episode), and my sister doesn’t let me watchthe episodes she downloads, but it sounds like the contents were a placebo. Has Cuddy given the pharmacy standing orders about House?
April 26th, 2007 at 12:51 am
Each person may have their opinion about what makes a better doctor - but the fact is that the majority of cases where doctors are sued by their patients are due to communication issues - and House would have been sued so much in real life that there is no way the hospital wouldn’t have hung him out to dry by now. I wouldn’t mind being a brillant genius doctor like house - but I’d rather be a good doctor who doesnt get sued every week.
April 26th, 2007 at 5:07 am
They seem pretty ready to lay into Wilson because of his part in the deal (I’ll step aside from the legal-or-not-ness). But, really - the offer probably is good for House (two months’ rehab versus who-knows-how-long in gaol). That playing a part in it gets Wilson his stuff back is what they call a bank shot. Not helping himself is by no means a way to help House even more.
July 18th, 2007 at 12:23 pm
I think a better reason for Tritter offering the deal is the fact that Tritter is a control-obsessed, sadistic bully. He wants to tempt House with the deal, just so that it can be taken away from him.
I think people give Tritter too much credit, thinking that he’s “just like House,” tough, rude, and good at his job. Tritter is the exact opposite of House. He is hateful, a bully and a sadist who gets off on hurting and controlling people. He cares nothing about justice or law, or what is right, except when the law can serve to help him ruin the lives of the people he’s chosen to hurt.
If House was like Tritter, he would go around giving people lumbar punctures for fun, or performing procedures without anesthetic to get off on the pain he’s causing, and then strut around saying he’s a doctor, and can come up with medical reasons that no one can challenge..
Take House off Vicodin, remove any shred of humanity, and multiply the more evil end of the result by ten. THat’s Tritter.
Besides, House is a good doctor. Tritter is an incompetent and corrupt cop. I bet the guy has pages and pages of excessive force complaints that are hushed up or intimidated away.
House is rude. Tritter is evil. That’s a bigger difference than a lot of people would like to think.
July 31st, 2007 at 12:23 am
I thought that this was an excellent episode; the appearance of Hugh Laurie detoxing off his medicine was gut wrenching, and I managed to genuinely feel sorry for him, not even long after being disgusted at how he treated Cuddy and Wilson and Chase.
One thing that has become apparent that I don’t like so much is the regard that Cuddy and now W