House - Episode 17 (Season 3): “Fetal Position”
Another episode of House where diagnosis after diagnosis is discovered, but the whole was ultimately less than the sum of its parts. Frankly, I found the medicine in this episode to be weak and confusing, and the melodrama too schmaltzy for my taste.
Emma is a 41 year-old photographer who happens to be 21 weeks pregnant. At a photo shoot, she suffers a stroke. Luckily, she recognizes the signs and has an ambulance called. She is admitted to the hospital under the care of her physician. Even though her doctor is ready to discharge Emma, Cuddy asks House to examine her. He notes a pronator drift (a sign of muscle weakness or upper motor neuron disease), weakness in some of the mouth muscles, as well as some microaneurysms in her retinas (generally a sign of diabetic retinopathy). He also notes a copious amount of blood in her urine. Her discharge is canceled and many tests are ordered.
A urinalysis reveals protein and blood in the urine. Blood studies show an elevated creatinine, suggesting that Emma has developed kidney failure. An ultrasound of the kidneys is normal. Her blood pressure is good and there are no signs of pre-eclampsia (Also known as “toxemia of pregnancy”. Classic signs are high blood pressure, water retention, and protein in the urine). An echocardiogram is also normal. Despite this, House is suspicious that the problem is her heart. Her medical records show evidence of past Strep throats, and he suspects she must have gone on to develop rheumatic heart disease, specifically mitral valve stenosis, as a consequence of the Strep infections. A heart MRI does reveal a slightly calcified mitral valve. This is opened up with a balloon, but her kidneys do not improve (and frankly, why should they? A slightly stenotic mitral valve has no effect on the kidneys, unless the valve threw a clot to the kidneys, in which case the damage has already been done).
The differential diagnosis now includes pre-eclampsia, hypoperfusion (blood is going to the fetus preferentially instead of the mother), infection, HUS/TTP (hemolytic uremic syndrome/thrombotic thrombocytopenic purpura — diseases of the capillaries that can affect the kidneys), or a cholesterol embolus (a clump of cholesterol that breaks off the wall of a large vessel and proceeds to block off a small vessel), but tests for these are all normal. House believes that Emma has a rare condition known Maternal Mirror Syndrome (also called Ballantine Syndrome, or Maternal Hydrops). This is a maternal condition caused by an abnormality in the fetus (hence the term “mirror.”) House’s next step is to find the fetal abnormality. To get a good image of the fetus, House uses a paralytic agent to temporarily paralyze it while an MRI is obtained. The heart looks good, but the bladder is greatly enlarged, crushing the lungs. This bladder is enlarged because of a urinary obstruction. A stent is placed into the fetal bladder to relieve the obstruction. The surgery seems to go well, but now Emma is complaining of right upper quadrant pain (the location of the liver) and her sclera are icteric (the whites of her eyes are yellow), both signs of jaundice. Sure enough, lab tests show that she’s gone into liver failure.
House believes the only way to save Emma’s life is to terminate the pregnancy, but she refuses. Cuddy takes over the case. She slams Emma with high doses of steroids in an attempt to mature the fetal lungs. She suspects the liver failure may be unrelated to the Mirror Syndrome. This leaves a differential diagnoses of acute fatty liver of pregnancy, viral hepatitis, and HELPP (Hemolysis, Elevated Liver enzymes, Low Platelets) Syndrome. Cuddy wants a liver biopsy performed, but due to the risk of bleeding from low platelets, they’ll have to sample the liver from within the venous system itself.
The liver biopsy results are normal, but the procedure induced pre-term labor. Emma is given tocolytics to stop the contractions. Cuddy is now convinced that the Mirror Syndrome is the cause of everything and the problem must remain in the one area they haven’t been able to get a good look at: the fetus’s lungs — but because they are so underdeveloped, there’s no way to get a good look. Cuddy gives more steroids to Emma even though she is warned she could cause pulmonary edema — and (of course) she does. Emma is intubated and placed on a respirator and Cuddy keeps giving her steroids. Her plan works, the lungs open up enough that a scan shows that there is some sort of malformation there.
The only way to diagnose and treat for sure is to perform open surgery on the fetus. The surgery is rough, and Emma slips into ventricular fibrillation during the procedure. House wants to cut the umbilical cord (and kill the fetus) to save Emma, but Cuddy is able to shock her back into a normal rhythm and the surgery continues. The surgeon notes that the baby has CCAM (Congenital Cystic Adenomatoid Malformation) and he will be able to remove the lesions. With the baby’s lungs treated, Emma’s symptoms resolve and we learn in a closing scene that she delivered a healthy baby.
Let me state up front that I am no expert in maternal/fetal medicine and high-risk obstetrics. That being said, I still had some significant problems with the medicine in this episode. To save time (and my typing fingers and your eyeballs), I’ll just mention what I thought were the four biggest problems (I’ll leave the rest, including the surgery scene, up to everyone else — though if you have specific questions, I’ll do my best to answer them):
1. Why didn’t the mitral valve problem show up on echocardiogram? And if the mitral valve did cause the stroke, it’s because there would have been a clot or vegetation growing on it, which would have shown up on the echocardiogram. And if there was a clot, the last thing you would want to do is force the valve open.
2. Speaking of stroke, I’m not clear on what caused the stroke that set off the whole chain of events. I can find no connection between strokes and Mirror Syndrome. There has been one recorded case of a seizure and Mirror Syndrome, but that’s the closest I could find. Nor can I find any connection between blood in the urine and Mirror Syndrome. Protein in the urine – yes. Blood – no. And what was with eye exam showing diabetic retinopathy?
3. Mirror Syndrome occurs when there is fetal hydrops (a serious condition of severe edema in the fetus — which this fetus did not have), and the mother develops pre-eclampsia like symptoms including edema, liver problems, high blood pressure and proteinuria. There are also other key findings including anemia and elevated uric acid that were never mentioned. Mirror Syndrome can be caused by all the fetal conditions mentioned in the episode, but there is significant debate over whether surgery is good treatment. One reference I read went so far as to state that Mirror Syndrome was a contraindication for surgery (that is, a reason not to do it) because removing the lesions in the fetal lung did not help the mother at all.
As far as this episode goes, Emma had some symptoms of Mirror Syndrome, but was missing common ones, and had other symptoms that didn’t match (blood in the urine, stroke). Her baby had CCAM, which has been known to cause Mirror Syndrome, but did not show the fetal or placental edema seen with the condition. Surgery may not have been the best choice.
4. Mature lungs produce a chemical known as surfactant. Surfactant helps with the surface tension within the lung and keeps it from collapsing. Premature babies who are born without the ability to make surfactant can develop severe lung problems including respiratory distress syndrome. A dose or two of corticosteroids given 1-7 days before delivery will help the lungs create surfactant. Steroids do not otherwise help the lungs mature. Giving repeated doses of corticosteroids to a woman who is only 21 weeks pregnant (a long way from needing surfactant) will accomplish nothing useful.
I give this episode a B for the mystery, because it was intriguing; and another B for the solution, because it did ultimately fit. Unfortunately all the medicine in between was sub-par and earns a weak D. The soap opera had some good moments, but seemed to waste a lot of potential, so it also earns a B.
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April 4th, 2007 at 12:15 am
The fluid did not pop out when the uterus was cut open. Is that true? I thought the uterus is filled with water.
April 4th, 2007 at 12:18 am
I always love reading your reviews post-House, and in fact find myself pressing “refresh” every five minutes after 10:00pm or so, just to see. It’s fascinating to discover which parts of the TV-medicine are “good” and which are “bad”, especially since sometimes the “oh come on!” stuff is real, and the normal-looking stuff is apparently not. :)
I did a little research between the time House ended and the time your post went up, and found this photo and story of an actual fetal hand touching a surgeon’s hand:
http://michaelclancy.com/
Apparently that’s what this episode, and a recent Scrubs, were alluding to. I would have thought that was the biggest “oh come on!” moment, but apparently it’s possible (even if some sites take a more cynical view of the Clancy photo.)
April 4th, 2007 at 12:21 am
Official Comment
The amniotic fluid within the uterus is contained within the amniotic sac. As long as the sac isn’t cut open, there shouldn’t be any gushing of fluid.
When a pregnant woman’s “water breaks”, this is the amniotic sac rupturing, and signals imminent labor (usually). In cases where labor is not progressing well, the sac can be purposefully ruptured in the hopes of stimulating labor.
April 4th, 2007 at 1:02 am
I was rooting for Dr. Lisa Cuddy for much of the episode, but after a while, I became perplexed by what I saw as her recklessness. OK, she ultimately saved both mother and baby, but the way she got there seemed very suspect - House was right, she’d lost her objectivity. And the way she used House’s methods - or what she perceived as House’s methods - to rationalize her approach perturbed me. But of course, it all turned out well in the end, so everything’s fine. (Huh?)
April 4th, 2007 at 1:02 am
I seriously wonder what will happen to the series now that Cuddy has a new respect for what House does. It’s probably harmless, but will the writers use this as an excuse to let House get away with more stuff? Guess we’ll have to watch to find out.
I was also amused that they turned to Wilson while Cuddy was apparently going on tilt; in fact, I was amused by the role reversal in this ep.
I’m not sure how reasonable terminating the baby was, but I’d still like to say something. There’s no reason just to give up on parenthood if you have problems carrying a child and really want a family. I mean she could have secured her health and adopted a child. Maybe I’m entirely heartless, but I’m surprised no one ever mentions adoption anymore, which is a bit saddening. Even for soap opera purposes that’s a persuasive argument to make, rather than simply saying “terminate or die.” It would have identified with the character’s feelings better, I hope.
April 4th, 2007 at 1:10 am
I’m a political science student, and my first observation was how quickly House dropped his efforts to convince the mother to terminate. I’d like to think that a doctor will advocate what he/she thinks best for the health of the patient. Granted, I’m far less emotionally vulnerable than an aspiring single mother in her forties, but I’d think House would have been a bit more vocal and (in his particular case) graphic in his efforts to convince the mother to terminate. How accurate was this? I’m sure it varies by state, as do abortion laws in those states, so this may not even be a valid question.
April 4th, 2007 at 2:59 am
Hey, a first-year med student here. I thought I’d try my hand at a diagnosis tonight.
Before they came up with Mirror syndrome, I was rooting for Budd-Chiari syndrome.
My differential diagnosis went something like this:
Since this is a TV show, they’ll pick something totally random and rare. It needs to have a cool name and involve as many different organs as possible. Hyperestrogenism is a hypercoagulable state. This could cause clots to form and cause strokes and a blockage of the hepatic vein. The hepatic vein blockage could be asymptomatic at first. Blood would back up in the portal venous system and jaundice would result. Weird splanchnic vasoconstriction would have fetal abnormalities and possible kidney involvement with the hepatorenal syndrome. Acute tubular necrosis could cause protein and blood to show up in the urine. It’s all a stretch, but “House” always is.
My fun diagnosis was shattered when the transjugular procedure was clean. Drat! Besides, my diagnosis neglected to consider the ethical and curable issues. A “House” treatment always has to be controversial, dangerous, totally unethical and it needs to have a miraculous recovery at the very last second.
I didn’t know enough about fetal development, so I just went along for the ride after that.
I liked all the drama in this episode. I thought that there were a bunch of very interesting role reversals… House/Cutty, Chase/Cameron, Cutty/Wilson. The way House stared at his hand at the end of the episode makes me think that there’s potential for him to want a baby with Cutty! Haha! That would eat away at Cameron even more and in turn break poor Chase’s heart.
April 4th, 2007 at 3:01 am
I was sort of disappointed by the outcome of the episode. Yes, both mother and fetus (OK, baby) survived, but it seemed like dumb luck. If Cuddy had really come out of this with an appreciation of what House does, she would have recognized the utility of rational decision-making. A good outcome doesn’t justify what she did. Yes, it’s a fictional series, but come on, in real life, all that does is encourage more reckless behavior. That should have been examined a bit more closely by the episode, but it was all swept away by the feel-good ending. House was right–the 9.8 difference doesn’t go away just because one mother and child survived. Anecdotal evidence is lousy that way.
By the way, who is developing the photographs she’s taking? Or are they digital–did anyone notice the model of the camera?
April 4th, 2007 at 3:10 am
I just wanted to point out that the Michael Clancy picture mentioned above, or the “samuel” baby picture as it’s also known, does not depict what the photographer says it does. According to interviews with the surgeon himself, the baby’s arm had popped out of the uterus after the surgery was completed and he was guiding it back in with his finger when the picture was snapped.
The baby did not “reach out and grab his finger” as the photographer would have you believe. The baby was in fact anesthetized for the surgery.
Clancy actually tells you right on his page his job is to “tell stories through his pictures” and that is apparently what he’s doing with this one, and probably for quite a bit of notoriety and cash.
April 4th, 2007 at 5:18 am
“By the way, who is developing the photographs she’s taking? Or are they digital–did anyone notice the model of the camera?”
From what I could tell, the camera was digital; though I do seem to remember Cameron packing up a box of film, but that might have just been photo-printing paper.
I’m still kind of indecisive on whether I liked this episode or not. It seemed to go to lots of subjects in an episode, and it left me feeling like I couldn’t get a hold of it. Maybe I’m just focusing too much on the little developmental moments. Anyway, it was at least average, but more likely it was slightly better overall. Episodes now seem to take a few days sitting with me before I get a good judge of them.
April 4th, 2007 at 6:58 am
I noticed a discrepancy when they said her platelets were too low to do a liver biopsy, but they did three more surgeries. Wouldn’t she have bled out during all of them?
April 4th, 2007 at 7:28 am
Now, in the worst tradition of Television, House has become maudlin. A baby’s little hand reaching out of the womb to clutch House’s finger? Please.
As for Cutty’s character, she has been very badly used this season. Why don’t the writers just have House and Cutty screw and get it over with? Instead, she’s been turned from a respected hospital administrator into a reckless, hormone-driven (I might go so far as to diagnose some mental disorder) mommy-dearest. And she used to be the most sympathetic character on the show.
This has become a good show to watch while doing something more useful, like balancing your checkbook, or separating the whites and colors before washing the clothes. It doesn’t demand or deserve your full attention.
April 4th, 2007 at 7:31 am
By the way, good article on House and other MD shows over at http://www.salon.com today.
April 4th, 2007 at 8:00 am
( delurk )
Regarding the fetal hand holding:
Snopes on that exact picture
Love the reviews. :)
( /delurk )
April 4th, 2007 at 8:03 am
Re: By the way, who is developing the photographs she’s taking? Or are they digital–did anyone notice the model of the camera?
I wondered that, too. Even if the pictures were digital, they were edited on a computer. I think a professional photographer like Emma would have preferred to develop or edit her own pictures, whether in a darkroom or on a computer. I’m not very familiar with high-end digital cameras, but Emma’s camera looked too big and blocky to be a digital to me. I suppose we could say she was having one of her assistants pick up the film (or the memory card) and do the developing (or editing), but I still see a minor plot hole.
I was a little disappointed in this episode. I read a spoiler for it a while back, and the story sounded considerably more promising than it turned out, IMO. Cuddy’s loss of professional perspective–a major plot point–seemed a little overdone and all the different medical diagnoses were overwhelming, at least for me.
Parts I did like: The interaction between Chase and Cameron revolving around their pictures, the flash-forward at the end when Emma is hanging the matted pictures on her wall, and I admit I loved the part where the baby grasped House’s finger.
I also liked the way House and Cuddy’s role-reversal was pictured first by him sitting at her desk, “You can’t be me. Not enough cleavage” and later by Cuddy pacing in House’s office and fiddling with the ball on his desk. I thought that was a neat little visual bit of storytelling.
Not my favorite episode, but not all bad either.
April 4th, 2007 at 8:34 am
Official Comment
Buddwing, Keith, and Brian:
You all make excellent points about Cuddy’s recklessness. This the exact behavior she was trying to discourage in House when she lied to him about curing the patient in the first episode of the season.
Mary:
Good catch. To be fair, I don’t see any reason they couldn’t transfuse a couple of units of
FFPplatelets before the surgery (or procedures, for that matter).April 4th, 2007 at 9:59 am
I knew the baby holding House’s finger was fake and thought it was another cheap gimmick in a mediocre episode. Even someone not familiar with the urban legend would have caught on that the baby was anaesthetized and couldn’t have grasped anything.
Reprising her role in Humpty Dumpty, Cuddy was as reckless as House (which makes her hypocritical for trying to curb his) but the difference is that House’s recklessness is based on playing the numbers and and a clinical grasp of medical facts. As House pointed out, Cuddy’s recklessness came out of her personal identification with the patient, which is bad medical practic. Happy endings make the audience feel good but I’m not convinced she deserved to be rewarded for that.
It was a nice visual when Cuddy was playing with House’s ball in his office and dropped it. Dare I think it a deliberate comparison to Cameron in Que Sera Sera, who could handle it and who I think is overall a better doctor? Going by the quality of this episode, probably not.
April 4th, 2007 at 11:36 am
Re the camera: it looks very much like a Canon EOS 1d - a professional digital camera. Not sure if it’s the latest model though. It is best seen when Cameron is packing the bag at the end.
Great reviews!
April 4th, 2007 at 12:43 pm
Can the readers here help someone who’s DVR _died_ seven minutes before the end of the episode…What in the world was all House’s talk about taking a vacation about??
April 4th, 2007 at 2:00 pm
I didn’t see House’s fascination with the fetal hand being a major change moment for him as many others seem to. Rather, I thought it was pefectly in character. He was fascinated because it was neat, cool, different and interesting. It engaged his mind. I also didn’t see his shift in terminology from fetus to baby as particularly bothersome. He kept using “fetus” because it’s the medically correct term but also because he was trying to help Emma come to grips with the fact that it was killing her and termination was the best course of action. After the problem was corrected and it was likely both would survive to term, he could throw her a bone, and since he fundamentally liked her, there was no harm in it. On some boards, this episode is being lambasted from both pro and anti-abortion sides as political theater to advance one view or another, but I don’t see it.
April 4th, 2007 at 2:00 pm
The camera is a Canon 1d of some variety - digital, and you see a mini photo printer on her desk, which goes a way to explaining how the pictures got there!
April 4th, 2007 at 4:34 pm
> What in the world was all House’s talk about taking a vacation about?
Just House screwing with his colleagues. It’s revealed at the end that he’s just going to spend his vacation watching TV (although the teaser for the next episode is the standard infectious disease + airplane trip plotline so well-lampooned by Airplane! so who knows if he actually goes on vacation). Cuddy bought him tickets to Vancouver, but he tears them up in one of those scenes without dialogue set to music. All in all, it’s a heavy-handed approach to reiterating that House is ultimately a tragic character that doesn’t really fit in an episode that’s centered on Cuddy’s character. (The subplot was also confusing to me and with such few payoffs.)
April 4th, 2007 at 6:19 pm
Um, FFP=fresh frozen PLASMA, not platelets. Of course that would be helpful too if her liver is not working.
I’m usually able to ignore the blatantly incorrect medicine in favor of the soap opera. But not this week. I really wish the writers hadn’t ever started the Chase/Cameron thing. It makes NO sense, except that Jesse and Jennifer are together in real life. Chase and Cameron have nothing in common, and before they slept together they didn’t even seem to like each other much. Now Chase is “glowing” over Cameron’s picture? I just don’t buy it.
And then there was the medical content - as an OB/GYN, I could not ignore their criminal obstetrics! Don’t they supposedly have people with medical degrees vetting this writing? The steroids-magically-plumping-up-the-lungs thing was just ridiculous, as Scott said. OBs stopped using terbutaline pumps about a million years ago for tocolysis. They *never* would have done the CCAM surgery in this situation. I have known stable, completely healthy patients get turned down for this very surgery in real life.
On the bright side, they were foreshadowing a great House and Cuddy try to have a baby storyline, and the plane episode should be pretty fun.
April 4th, 2007 at 7:15 pm
Scott,
Just a tease. Hope you don’t try transfusing your patients with fresh frozen platelets. Platelets are awfully finicky little buggers who like platelet rockers and ambient temperatures, and I can’t imagine what freezing them would do. It probably wouldn’t do the patient much good:)
April 4th, 2007 at 7:30 pm
Official Comment
Yep, you’re right, for some reason I always think the P on FFP stands for platelets instead of plasma (which is why I always double check when ordering). I should have said platelet transfusion, not FFP transfusion.
April 4th, 2007 at 7:58 pm
As always, I greatly appreciated your review. Thank you for faithfully posting your thoughts about House each week, it’s a true eye opener for non-medical folks like me.
I was wondering how it’s possible to shock the mother while not adversely affecting the baby. In my non-medical logic I would assume that the electroshock would disrupt the rhythm of the baby’s heart that would in turn fail.
Clearly it’s medically possible, otherwise you (or someone else here) would have commented. So forgive my ignorant question, I just wondered how this works.
April 4th, 2007 at 8:04 pm
As I watched the episode last night, I couldn’t help but wonder. After everything that the mother and the baby went through, could she really carry to term with a perfectly healthy baby or was that just BS?
April 4th, 2007 at 11:30 pm
This episode, by the way, was re-run during the current (fourth) season, on Tuesday, April 3, 2007.
As far as I’m aware, nobody has ever mentioned, here or elsewhere, that many nurses have a major problem with House MD, and with ER: Doctors are always showed doing things that nurses or technicians would actually do. Both of these types of highly-trained and essential health care professional are rarely characters in hospital TV series, even the ones that otherwise are fairly authentic. Nurses are occasionally glimpsed in the background. Technicians are almost totally invisible. My nurse friends say the only TV series that ever showed nurses doing the things they really do, serving as the primary patient care providers around the clock, was one called China Beach, back in the 1980s and 90s. An original and effective series could (and I think should) be produced, showing the things that happen, say, in a critical care unit, perhaps cardiac or neurological. The relationships between the nurses, and with physicians, administrators and patients’ families in that kind of pressure-cooker environment would furnish one fascinating story line after another. It would be a major boost for recruiting nursing students, too. Anybody want to collaborate on one?
April 5th, 2007 at 1:53 am
Lioness, once the baby develops a heart, it beats on its own. Using a defib on the mom should be fine.
April 5th, 2007 at 2:38 am
Hey, I acknowledged that some sites take a more cynical view of the Clancy photo. :) But frankly, as a photographer myself (I run a studio in Michigan), I tend to take the word of the photographer over the Snopes teens. And remember — the photographer himself does NOT say any of the weird “it changed my life” stuff that the email forward had (which Snopes is debunking.)
April 5th, 2007 at 3:24 am
John: I’m not sure what you mean by “the Snopes teens”. Snopes.com is run by David and Barbara Mikkelson, who are both in their 40s and have been running the site since 1995. I have absolutely no information or opinion on the photo in question, but I do tend to trust the Snopes staff more than your average teens.
I liked this episode, with the assorted role reversals. I’m not sure what the whole vacation subplot was for, though. Maybe House’s weird way of trying to get at Cameron, but it came to nothing in the end.
April 5th, 2007 at 6:46 am
I think this episode goes rather abstractly about the worth of a human life and where should one draw the line at calling a baby sub-human. The bad medicine, especially the pumping up the baby’s lungs with corticosteroids; are all just plot devices for this episode’s writers to bring out the points (I felt that the dialogues were modeled with such objectives in mind).
As a medical student, I enjoyed this episode immensely (in spite of its flaws). I’m watching it for the drama and for Hugh Laurie, not so much to learn (I do that (learn) when I read Scott’s site).
I was kind of surprised that House didn’t do more to try to get the abortion done. He seems pretty relatively uninterested in saving Emma. I’ll definitely agree that Chase’s ‘glowing’ at a picture of Cameron was definitely out of character.
April 5th, 2007 at 10:15 am
Chase’s “glowing” is a very serious symptom. :-)
He’s obviously fallen in love with Cameron, but is afraid to admit it to anyone, especially to her.
His comment to Foreman about the relationship was typical male BS.
Some might not like the direction that this story line is taking, but Chase “glowing” is not at all out of character for someone who has fallen in love.
April 5th, 2007 at 10:32 am
Well maybe the medicine was no good on this episode but to the layman it was one of the most medically compelling shows House has done, IMO.
And I loved how House’s refusal to call the fetus a baby changed when that little hand grabbed his finger. Definite series highlight for me.
April 5th, 2007 at 11:26 am
The whole episode was troubling and, in my opinion, poorly written. First, Chase and Cameron: My only hope is that it’ll turn out that Chase is right, and that Cameron really is doing this as an attempt to make House jealous.
Second, House’s switch from “fetus” to “baby” terminology. For one thing, there’s the dubious politics of it — as if only those who don’t *understand* use the word “fetus”. For another, has House *really* never experienced a fetus before (either while performing or observing abortions or other procedures like the one in this episode)? This from the master doctor who knows all?
Third, Cuddy “beating” House. Throughout the episode, Cuddy makes the bold decisions while House’s recommendations are shown to be wrong over and over (I know, statistically he was right, but face it, in this episode Cuddy “won”). I thought the show was supposed to be about a superior doctor who is unique and difficult. Now it turns out that Cuddy’s actually — in this episode, at least — a better doctor? I would have had *way* more respect for the episode if either the fetus/baby, or the mother, or both, died. They could have had ramifications from that going on for a long time. This outcome, however, seems backwards and inconsistent with their characters — isn’t it usually Cuddy who reins in House’s attempts at extreme (though inevitably successful) measures?
Finally, House’s vacation: If House wasn’t really going to go on vacation, why was he in the hyperbaric chamber? Furthermore, the act of ripping up the first class ticket is shockingly disrespectful. Those things are expensive, *even* on a doctor’s salary, and not to, I don’t know, turn it down, give it away, save it for use on another flight another time . . . I know House is a jerk, but this seems pointless. (I guess, in reality, he did it so we would realize he wasn’t really going to go on vacation after all. But there have to be other ways of showing that).
One last note. I wish I had any confidence that they would address or continue some of these story lines. But I too was shocked that the conclusion of the episode before this one was not ever mentioned (DID House go into the bar? DID he really want to go to Boston JUST for the “high” of the experimental drug?). What’s the point of raising these questions if they’re just going to ignore them?
April 5th, 2007 at 11:30 am
“Doctors are always showed doing things that nurses or technicians would actually do. Both of these types of highly-trained and essential health care professional are rarely characters in hospital TV series, even the ones that otherwise are fairly authentic.”
Actually, Scott has addressed that issue several times in earlier reviews, and has pointed out that House’s team consistently performs procedures that would be done by nurses or technicians in real life. That’s another piece of ground, like some of House’s surgical antics, that’s been gone over too often to be worth mentioning. Those of us who choose to continue to follow the series just accept is one the show’s flaws and move on, although you certainly make a valid point.
I think your idea of a TV series focussing on all aspects of medical care instead of just doctors is excellent. I would love to see that happen.
Thanks for mentioning China Beach. I remember that as an excellent show. I don’t know how accurate the medicine was because I didn’t have the internet in those days, but the characters and the writing were very compelling.
April 5th, 2007 at 1:07 pm
I’d be interested to see some medical commentary on the Canadian series ReGenesis. The main character very much reminds me of House, and the medical plotlines involve cutting-edge biotech and stuff like that. The third season has just started airing and is available through the usual other sources.
April 5th, 2007 at 1:18 pm
A lot of debate is going around about nurses not being in House or E.R. Now, I don’t, nor did I ever, watch E.R., but I know in House MD, they definitely acknowledged the fact that they don’t use nurses. They did it very early on - maybe in the very first episode.
I believe it was Omar Epps that said, in response to someone asking why he was doing all the tests, “My boss doesn’t trust nurses.”
Now I’m not saying it’s right to put nurses on the backburned, but doesn’t it seem like a very House thing to do? So I really can’t argue with the lack of nurses on this show.
If you want to see nurses making a difference, watch Scrubs. Also a fantastic show. More realistic medically and in terms of how an actual hospital operates; but no character will ever beat House, in my opinion.
April 5th, 2007 at 6:07 pm
I didn’t like this episode for a number of reasons:
Cuddy’s behavior was totally out of character except for the advice she gave to Cameron.
Foreman is very intelligent.(He is the young gun that comes closest to being the type of diagnostician that House is, but without recklessness and crankiness.) He should have suspected that Cameron and Chase was fooling around.
There was no continuation of the previous episodes secondary storyline of House having “romantic” feelings/thoughts of Cuddy.
House’s on/off vacation was pointless and made no sense.
Television rarely realistically portrays people in the medical field.
April 5th, 2007 at 7:14 pm
A few comments.
First of all, I think Don is right: Chase is absolutely acting in character for someone who’s fallen in love with Cameron. His admiring Cameron’s photo, his comments to Foreman, his coyness when Cameron sees the photo of him–all of these are entirely consistent with that. It’ll only be disappointing if it turns out to be untrue, because characterization should be honest.
Wertrew: House’s point still stands–just because she was successful doesn’t make her right. The episode made that point and was right to do so. The disappointing thing was that House had no rejoinder. If it had been the House I’ve come to know and half-admire-half-despise (but wholly enjoy watching), he would have pressed her about the next such decision, and the next, and the next. They’re doctors, not patients, so they have to deal with oodles and oodles of life-and-death situations, and they ought to be playing the percentages. But I’m preaching to the choir.
I don’t think that ripping up the ticket was disrespectful (unless he plans on revealing, directly or indirectly, that he didn’t use it–then it’s disrespectful), merely very wasteful. It’s unclear whether or not he planned to watch TV on his vacation from the start, or whether he just led himself to that conclusion. I’m inclined to think it’s the latter–that he eventually decided that there’s no place like home–but there’s no surefire reason that’s necessarily so.
By the way, I like the palindrome.
shadytrees: The plane trip they’re on is allegedly for a return from a conference in Singapore, so no vacation.
Roland: I’ll have to go back to the tape to be sure, but I seem to remember some sentimental music playing over the 15 seconds or so that House spaces out on the hand, suggesting that he really was feeling paternal for a moment. I have no specific problem with that, myself, but I did dislike that someone else, not he himself, snapped him out of it. This is reinforced by him using “baby” instead of “fetus” in the denouement. I thought it was out of character. He has always struck me as a guy who not only is unsentimental, but hates sentiment. Someone merely unsentimental might have a sentimental moment every now and then, but someone who hates sentiment as House does, who’s as witty as he is, should have been able to come back with a riposte–and at Groucho Marx warpspeed, to boot.
John: I might conceivably take the word of a photographer over the Snopes folks, if there were reason to do so (I have none either way), but I certainly do not take it over the word of the surgeon. Generally, I find the Snopes folks pretty trustworthy, even in my own field of expertise.
Cheryl: I think Foreman did suspect, but didn’t go any further than that. Throughout the series, he has acted the most professionally of the three of them–not through any abundance of moral fiber or anything like that, but simply in defense of his job. He’s not likely to decide for sure without ironclad evidence, or to act on it at risk to his job.
As for Cuddy, she was wrong over and over again, but I can’t tell whether that’s in character or not, since she’s portrayed as a good administrator but a mediocre doctor (whether that’s accurate characterization or just a disproportionate amount of the bad medicine writing Scott’s always citing falling unluckily in her abundant lap, I don’t know), and she’s primarily a doctor in this episode. But she does feel irrational attachments to people. She wouldn’t have kicked a hundred million dollars out of bed in favor of House if she didn’t. She makes bad decisions for sentimental reasons, and so far, she’s been pretty lucky–they tend to work out well.
That reminds me–Keith: I’m pretty sure it’s Cuddy, not Cutty.
Thanks to all those who identified the camera. Still a little bemused that she was able to edit/print in the hospital, but I guess it’s not totally crazy.
April 5th, 2007 at 8:34 pm
As far as Chase and his ‘glow’ are concerned anyone who has been paying attention would know that he has had a ‘thing’ for Cameron ever since Ocam’s Razor…way back in Season 1. That he has fallen in love with her is not out of character at all. I don’t mind the Chase/Cam hook up. Anything to keep House and Cameron apart is fine with me.
House doesn’t trust nurses and he doesn’t trust test results done by anyone else but his team. That also allows an easy out for the Producers of the show to not have to pay actors to play these parts. It all comes down to money.
April 6th, 2007 at 12:51 am
binky: Occam’s Razor was–let’s see, according to Scott’s list, it was the third episode of the series. Was that the, ahem, “multiple” speech? You might be right about Chase there, but in my opinion, it’s early enough that it seems more likely to me that he just thought she was hot, whereas now, in the third season, he’s probably fallen in love with her, rather than her looks. (Personally, I’m of two minds about Jennifer Morrison. Sometimes she does look hot–other times, she just looks mousy. I wonder if that’s intentional.)
Regarding the test taking, I’m not certain it’s money. Hugh Laurie is being paid an obscene amount of money per episode, and I doubt that a couple of more bit roles at scale would cost the producers much more, relatively speaking. I just think they’d rather have familiar characters do the tests, and more importantly, react to them confirming House’s suspicions. :) But again, you might be right.
April 6th, 2007 at 2:47 am
In season 1, Cuddy didn’t “kick a hundred million dollars out of bed in favor of House” because of a irrational attachment. She voted to keep House because she knew Vogler would continue to hold that money over the board. Vogler would continue to demand that the hospital’s doctors to publicly endorse the pharmaceutical companies’ drugs. She knew the demands wouldn’t stop there.
What I consider an example of her “irrational attachment” to House is when earlier this season Cuddy gave false testimony in court to save House.
April 6th, 2007 at 11:59 am
Apologies if this comes up twice. I thought I posted it, but I might have forgotten to.
Cheryl: I think you’re right about that example–I did exaggerate it. That being said, she does form irrational attachments, and it adversely affects her capacity as a doctor. At least, that’s the way she’s portrayed.
April 6th, 2007 at 9:20 pm
Brian: The problem, for me, was the absolute role-reversal in this episode. I’m not as good at remembering episode names as some on here, but there was one fairly recently in which House’s guess turned out to be correct in the instant case but Cuddy (at Wilson’s urging) refused to tell him lest he follow such impulses in the future with negative consequences. I mean, they made the point over and over in that episode (the story line actually lasted over two or three episodes) that allowing doctors to pursue their “instincts” at massive and unjustifiable risk was unprofessional at best, and probably malpractice. But here Cuddy does *exactly* that, and House is put in the position of criticizing her.
Obviously, there are some distinctions between the two story lines. But, in my opinion, they’re irrelevant here. Fact is, House is *famous* for pursuing his instincts, odds be damned. And Cuddy, we’ve been told, is an excellent administrator exactly *because* she’s responsible and generally follows proper procedure. The tension between these two, then, is what (in my opinion) makes the team so successful — she forbids him from pursuing his most egregious instincts, and he forces her to recognize when protocols are counter-productive.
Once that tension is destroyed, you don’t have anything approaching a real hospital. You have mad scientists doing whatever they want in pursuit of their own moral and medical interests.
Also, I agreed with Cuddy’s rejection of a hundred million dollars in that previous episode — in fact, what was profoundly unrealistic were the other doctors’ willingness to accept it. Adminstrators obviously want and need money, but you can’t set the precedent of allowing the donors to run the hospital as their own fiefdoms. She made a sacrifice — but administrators have to weigh costs and make sacrifices, both financial and otherwise, almost every day. This was a reasonable one.
(Not to mention very few professionals like being treated as whores — there may be ways to coax them to desired behavior, but they’ll generally resist attempts to buy them outright).
April 6th, 2007 at 9:46 pm
Wertrew: The reversal of roles was because of Cuddy’s personal identification with the mother. This happened, what, once during the entire show?
I don’t think the hospital is going to break down now..
But I do think a more realistic ending would’ve been more fitting.
By the way, could it be that House has decided to pretend to be going out of country on vacation so people won’t bother him, when he - tried to rehabilitate himself, off the Vicodine? That’s the impression I got when I saw him sit in front of the TV.
April 6th, 2007 at 10:04 pm
First time writer, pretty longtime (season 2) lurker:
Thank you Josh and Nick for your comments.
This is not a political site I know, but I was for the first time, loving this show as I do, made furious at the absolute avoidal of certain issues: “My dear, it looks like you are going to die due to a foetus that is probably killing you and too young to live.” “I won’t abort, I won’t I won’t I won’t.” ”
How’s this for some script: “Adoption is an option. You have travelled a great deal. Photographed children needing a home. You have tremendous empathy shown in your photos.”
Adoption. Adoption. Where was it mentioned??? One of my most loved cousins is adopted! She is my family!
Before anyone flames me, I spent a year of my life jabbing myself with needles to try to get pregnant, like the character. I cannot thank the anonymous donors enough — it is a true gift, and yes I wanted it so much and cried one hell of a lot as I poked my bruises and ranted at my monthly visitor. But after a year of unsuccessful hell, I realized that adoption is often the only answer. For me for sure (unless I do a soapy thing like marry a widower with kids — Scott, would I get a B for the soap quotient? :-). Our society focuses so much on “natural” parenthood, birth is the only thing that makes a woman a woman etc.
Forgive me if this is not being particularly coherent, but I think that the nature of this episode would have been well served (and I’ve actually known a couple of soapy tv writers) to address those initial issues more, and yes, then get to the decision of the mother to do ALL she could do to keep her pregnancy. That is of course her choice, and good theatre.
This show is called HOUSE. He would have railed more about adoption, and indeed being a huge crank he would have ranted more about stupid court cases and unmedically knowledgable legislation about late-term abortion and lifetime damage done due to being a premie, and more. He’s House!
And I think he was weirdly pushed off much of the canvas until the clutchy foetus hand (cue the weeping), and his handy ‘remembering rubbing’ the little hand moment before his television after ripping up the tickets. Out of character, which means they are hoping to change his character. Changing a character is completely fine, except this major change was way too soon for the House we have known. Bad script writing. And it makes me worry…
And of course, nowadays actual real paper tickets cost _extra_ — it is all e-ticket. We should have seen House calling in the cancellation and getting the refund applied to HIS credit card! After saving the day, with a bit of a look on his face…
My rant is ended with this. I know fully this is a tv show. One I enjoy hugely usually. I just think that certain aspects of this particular episode really betrayed the character of House, and of the show. I do hope this is not an indication of future oddness.
Final ending: Thank you Scott — this is a wonderful website.
April 7th, 2007 at 7:57 am
For crying out loud! This episode was absolutely anti-abortion!! How the hell can a 21 weeks old fetus grab a finger?! That’s ridiculous, even preposterous! Looks like they thought: House is a skeptical arrogant atheist, so let’s teach him a lesson. “Oh come on!”
April 7th, 2007 at 9:45 am
I don’t know that Hugh gets a ‘huge’ amount of money. I just read an article about casting directors spreading their nets abroad to the UK because the actors are willing to work for less money than the US actors.
However since the show has become a hit Hugh might be making the big bucks now but I don’t think he was in the begining.
April 7th, 2007 at 1:39 pm
binky: Hugh Laurie is no longer your typical U.K. actor. As of the second season, he was making $300,000 per episode–that’s a tidy 7 million plus for the season. To me, that’s huge. More than enough to absorb an array of extras in the margin. Even in the first season, he was estimated to be making about a million for the entire season. Not huge, perhaps, but still pretty large. Having a day of extras (probably all you would need for the minute or so of lab technologist screen time) per episode would cost a small fraction of that. Current SAG scale rates are about $750 per day, I think. It’s on the Web somewhere.
Again, I’m not saying cost isn’t a factor; it just doesn’t sound like a significant factor. I just read–it might have been on one of the episodes here–how the producers of the show said that they went against the wishes of the medical advisor, who thought the lack of nurses/technologists was unrealistic; the producers said the audience wanted to see the stars do the tests, not extras.
April 7th, 2007 at 1:43 pm
Tiago: It’s possible that what they wanted to do was to raise the spectre of House having paternal feelings. I agree that it was done in a heavy-handed and obtuse fashion.
I would also make a distinction between atheism and pro-choice. I know plenty of religious folks who are pro-choice (or pro-abortion, if you like), and I also know a smaller number of atheists who are pro-life (or anti-abortion, if you prefer). To be sure, House is more than merely an atheist; he’s actively anti-religion. “House vs God” made it clear that he considered religious feeling–even sincere religious feeling–a weakness, and he disliked people who fostered such feelings.
April 7th, 2007 at 2:10 pm
Yeah, Cuddy identified with the patient, in the process happily risking her (the patient’s) death. I know that’s the explanation the writers gave us; I’m just wondering how this character can possibly be trusted with running a hospital if she’s so prone to reckless, unjustified, and harmful impulses. House can act as he does because he has Cuddy pulling back on the reins as necessary. But who’s there to pull back on Cuddy’s reins? In my opinion this episode slipped slightly into farce, almost — a hospital where doctors play bizarre and probably tortious games with their patients’ lives and treatment, out of personal emotional instincts.
(And advance, Scott’s summary above itself describes *six* acts of Cuddy’s in which her obsessive desire to save the patient’s baby led her to overrule House or regular protocol. You may count differently, but it’s still more than one any way you cut it).
April 7th, 2007 at 5:44 pm
The only, only part of this episode that I thoroughly enjoyed was the song at the end by Lucinda Williams, “are you alright” which I believed referred to his relationship with Wilson. I was very disappointed with what they have been doing with Cuddy’s character. She seemd to have gone batshit crazy. Totally unexpected for a hospital administrator. Many of you have brought the fact that there don’t seem to be any nurses or techs around to perform procedures that they would normally perform in world of REAL HOSPITALS. Personally, I would never watch a show about nurses or techs. They don’t interest me. However, I think one of the major flaws of House is that we NEVER see any fallout for the core characters behavior in the broader context, i.e. what were the nurses thinking who came to assist Cuddy after she told Wilson to help or get out. What about the surgeons who assisted Cuddy and House with the open fetal surgery? Why was CUddy resuscitating the patient? Will there be any consequences for Cuddy? Like Chase said Cuddy is suppose to rein in the craziness and now she’s acting crazy. Now, the writers have managed to make me dislike Cuddy almost as much as I dislike Cameron and I really hate Cameron. I realize the whole Cuddy thing was part of the set-up for the Cuddy baby arc. My prediction is she’s going to sleep with House in Asia and then come back and fall into a relationship with Wilson and we’ll be left guessing (episode 3.24) which one’s the daddy. The soap is okay but I hope they get back to classic House, when the medical mysteries were much better than the soap.
April 8th, 2007 at 3:54 am
Another lurker here, thoroughly enjoying your reviews.
I have to agree with most of the contributors here in that Cuddy’s character is losing a lot of its charm. The latest episodes all feel jumbled, chaotic and altogether too far out of the realm of real medicine. Even as a med student with an interest into the rare and abnormal, some of the diagnoses and treatments lately have really begun to bug me.
I used to watch House for the medicine, and sit in with my girlfriend to watch Grey’s Anatomy for the drama. Lately, House seems to focus on the drama as well, and the writers are doing a shitty job at it. I can barely manage to fit the “new” Cameron in with the old one, and Foreman just doesn’t get much development after his near-death experience. Chase has become a second-hand gigolo who always seems ready to burst into tears at a moment’s notice. Cuddy, well, you don’t have to be a rocket scientist to see she’s being set up for a romantic arc (I’m still waiting for Stacey to return, making a real muck of the soap opera part). The only character I can still appreciate is Wilson, and face it, he’s just the voice of reason occasionally popping up to remind the other characters not to have sex in the hallways.
What I’m trying to say is, House is beginning to feel more and more like “Sex and the Clinic” and less and less like “Good Medicine and Mystery”. Which is a shame, really. Maybe it’s time to take the Season 1 box set from the shelf and watch those episodes again, waiting for better scripts. Because character development is one thing, and going down the catheter without so much style as a helicobacter pylori is another.
April 9th, 2007 at 2:52 am
My first time on the site. I noticed one point that no one mentions in my reading over the comments on House’s reactions and the switch from saying fetus to baby at the end of the ep. In previous episodes I think it has been made clear that House’s attitude and behaviors are defence mechanisms. Although he goes through the motions, we know that, to him, people aren’t just a necessary evil required for him to have puzzles to entertain himself with.
I would have to re-watch the episode to be sure, but I think the vacation talk starts right when Cuddy takes over the case. By his actions he is basically saying 1.)”Well, I guess you don’t need me around for this.” and 2.)” I don’t want to be around for how this is going to play out.” But at the same time, he drags out the leaving process to make sure he is there in case he is needed.
House switches terminology at the end of the episode because the termination issue is off the table, and also as a way of communicating to the patient that he isn’t some unfeeling monster. With his next statement (as he leaves) he makes sure that she gives him no credit for preserving her pregnancy. His priority was making sure she got better even if hers were different.
Taring up the ticket was just heavy handed writing. I agree that house would have just never used the ticket, or cashed it in(depending on the mood). If this script had been an assignment for script writing class, that is one of the items the instructor would have counted off for.
April 9th, 2007 at 1:43 pm
John: I’m pretty sure someone mentioned the “fetus”-”baby” shift. I even thought it got a little mini-discussion. It’s a lot of messages to go through, though. Maybe I saw it on some other site, though this is the only one I frequent.
My impression was that he was supposed to have switched to “baby” as a result of that Touching Paternal Moment with the Fetal Hand. That was heavy-handed, if you like. It was nice that he made sure he got no credit for saving her child, though. I’d forgotten about that.
April 9th, 2007 at 5:08 pm
I would have thought Dr. House to be above all, honest, yet he refers to the fetus as “a tumor” and “a parasite”, neither of which is a scientifically valid or medically accurate description of the facts. Somebody’s politics got ahead of their objectivity, I think.
April 9th, 2007 at 6:18 pm
MacQuarrie:
Actually, dictionary.com defines parasite as “an organism that lives on or in an organism of another species, known as the host, from the body of which it obtains nutriment.” (Miriam-Webster contains a similar definition). Obviously, then, while House isn’t 100% accurate (in that the fetus is not another species), he’s essentially correct in describing the fetus as a “parasite” — an entity that is dependent on nutrients it receives from another. He’s made that point in previous episodes as well.
But note also that he’s not making any “political” (in your terminology) point about whether or not the fetus is a “life” or deserving of special attention. He’s using purely descriptive language. We are free to place our own value judgments on that terminology (the fact that we generally place a negative meaning on the word “parasite”, for instance, doesn’t mean the word itself is negative). In other words, House *is*, as is his style, being brutally, painfully honest.
By the way, I see no basis for your accusation that “somebody’s” politics drove the writing on this issue — which seems to me to imply that “somebody’s” opinions aren’t deeply-held or sincere (as yours, no doubt, are), but are instead partisan and unreasonable. Even if “somebody” was doing what you accuse him/her of doing, he/she would presumably claim that his/her position *was* “objective” while yours wasn’t. If you want to disagree that a fetus is a “parasite”, that’s fine — but why assume that “somebody” is being insincere instead of simply mistaken or wrong?
I think the writers of House have always done a really good job at showing both sides of this particular issue, and have never shyed away from the painful truths on both sides. In this very episode, one doctor (House) seems to feel that the fetus should be sacrificed to save the mother, and both a patient (the mother) and another doctor (Cuddy) asserting exactly the opposite. I for one love that the writers don’t sugar-coat the issue by claiming that it’s an easy one or that all “intelligent” people agree.
April 9th, 2007 at 11:16 pm
You trust the photographer’s opinion over snopes? You do realize the photographer is trying to sell his work. This touching and life affirming story makes a lot better “sell” then the real life story. Snopes makes logical sense whereas the photographer’s does not. Makes good TV though :)
April 10th, 2007 at 11:28 am
Wertrew,
You say, “he’s essentially correct in describing the fetus as a “parasite” — an entity that is dependent on nutrients it receives from another. He’s made that point in previous episodes as well.”
It is unprofessional to do this because of the nasty connotation to “parasite”; this could be ascribed to all unborns as well. If my OB had said this to me or any mother, we’d be rightly upset! I “feel” very acutely my babies taking from my body whenever I’ve been pregnant, which I have been five times. Low energy and leg cramps, for example, tell me that I’m losing vitamins; but I can honestly say, I never thought of my baby as a parasite, even though I knew it was their fault. If someone were to have said this, it would have been about as delicately taken as being hit in the head with a hammer.
Snopes: This whole thing is painful. The story gets out, Snopes debunked, bloggers debunk Snopes… It’s just a picture of a fetal baby and doctor holding hands (or finger)!
April 10th, 2007 at 3:08 pm
The point is, both “parasite” and “tumor” are emotionally-loaded words with extremely negative connotations, and neither one applies. I’ve never seen Dr. House be deliberately untruthful about a medical fact before, and I believe it was out of character for him to be so blatantly so in this case.
April 10th, 2007 at 10:40 pm
Unprofessional and nasty are the usual methods that House uses episode to episode. Just because people are emotionally sensitive doesn’t mean House is going to beat around the bush; if previous episodes have taught us anything, it’s that he’s more likely to be brazenly unprofessional and nasty when a patient is emotionally sensitive. The term “parasite” is accurate, has been used by House before to describe a fetus, and fits his character well (I’m not sure about ‘tumor’, but I trust that it’s probably just as medically accurate). Now quit crying tears of blood because House was insensitive. If you don’t like insensitive people, stop watching House.
April 11th, 2007 at 12:17 am
I suspect even House would not call just any fetus a parasite to its mother-to-be, even if it is, to a certain extent, applicable. However, when (a) the fetus is drawing so much from the mother as to risk her life, and (b) the fetus is most likely going to die even if the mother is sacrificed, I think it’s reasonable, if insensitive, to drive those points home by using the term “parasite.” It certainly doesn’t seem out of character for House.
April 12th, 2007 at 4:04 pm
As an intern, using those terms to describe a fetus to the mother can get you fired.
As a resident, I suppose you’d get a good whacking, even a suspension. More likely a review, and most certainly a stern talking to.
As a department head, especially one as lucrative and renowned as the character House, there’s really not a lot anybody save the mother herself can do. She can of course sue for emotional trauma, and House being situated in the U.S., have a good chance of wringing some money out of the issue.
But with a TV show, that’s also beside the point.
I personally didn’t like the episode very much. Ever since the Tritter story arc, the series feels somewhat off. I hope the writers get back on track in Season 4, since I’ve pretty much given up on them finding their par again in the remaining Season 3 episodes..
April 15th, 2007 at 12:55 am
A big issue I had with this episode was the fact that the fetus seemed to be grasping House’s hand during the surgery. (Maybe this has been brought up?) I mean, wasn’t the mother (and therefore the fetus) sedated for surgery? How would it be able to do that at only 21 weeks old? Yeesh.
I also generally dislike it when any show preaches at me, and this one seemed really pro-life. House played the mean ol’ anti-baby man (with exaggerated cruelty in his terminology, as I see has been mentioned), the mother was the pillar of moral strength, and Cuddy was suddenly morphed from a strong and practical woman to an emotionally biased wreck.
I can solve the mystery of your 2nd problem, though. Blood makes for more drama versus protein, of course!
April 15th, 2007 at 3:47 pm
How do I find out the name and recording artist for a song played in this episode? I wrote down one line of the lyrics “Are you all right?” but so far can’t even find out who wrote or who sang it. Thanks for any guidance.
May 4th, 2007 at 6:30 pm
Shoud be HELLP and not HELPP:
Hemolysis, Elevated Liver enzymes, Low Platelets Syndrome.
June 28th, 2007 at 11:33 pm
This episode was awesome. Tyson Ridder rocks!! I love HOUSE!!!!!
July 12th, 2007 at 6:02 pm
I thought the holiday sideplot made no sense too; why waste time/money calling premium-rate airline companies or sleeping in a pressure chamber. Incidently, on the adoption issue, while definitely hideously undermentioned in TV, it wouldn’t have been appropriate in this case; the woman was perfectly able to look after the child, but she wasn’t healthy enough for it to come to term, or even just become viable - as a result, the foetus would have died no matter what - abortion, forced labour or simply keeping it inside. Still, it had some of the best lines yet (”I wouldn’t advise her to buy any green bananas”, “lots of angry Germans going nowhere”).
September 24th, 2007 at 4:56 pm
Brian Tung Says:
“. . .He has always struck me as a guy who not only is unsentimental, but hates sentiment. Someone merely unsentimental might have a sentimental moment every now and then, but someone who hates sentiment as House does, who’s as witty as he is, should have been able to come back with a riposte–and at Groucho Marx warpspeed, to boot. . .”
This is a shrewd assessment of House’s character. So shrewd that it’s is exactly what happened. After being momentarily non-plussed by the anesthetised fetus grabbing his finger, House said “Damn. I meant to TIVO ‘Alien.’ ” (Or words to that exact effect.)
October 1st, 2007 at 7:56 am
My theory on the fetus/baby shift:
From the beginning, House didn’t like to see patients directly. Wilson’s explanation was that it made them real, and therefore made him care.
When the tiny hand touched his finger, he undoubtedly found it interesting, perhaps even moving. He was still willing to rip it from Emma’s womb two seconds later to save her, though.
Perhaps his contact with the fetus made it become his “patient,” or at least an acceptable part of his patient, but only after it was no longer killing her.
When remembering the touch later, once can almost hear Mr. Spock saying, “Fascinating.”
I don’t think it’s out of character at all for House to “have a moment.” Neither is hiding in his apartment for a week while pretending to be on vacation. Some of my best vacations were spent in front of my TV with the answering machine on.
December 25th, 2007 at 12:20 am
It was incredibly moving, time seemed to stand still as House experienced a miracle unique to a medical person. Was there demonstrable female prejudice in this story in favor of protecting the foetus? Darn right, and maybe these primal instincts sometimes come in handy. House absolutely made the logically correct judgement, and Cuddy took the right action. Beautiful reenactment of the eternal necessity of yang/yin.
Jungianly speaking.
April 26th, 2008 at 4:55 pm
Why does House tell the photographer that he is scheduling a D and C? At 21 weeks gestation, isn’t it a D and E????
Found in the dialysis scene
May 18th, 2008 at 11:22 pm
I thought it was very good patient advocacy by cuddy. the risks she took were within the patient’s accordances. the patient wanted to have her baby survive or die with it.
May 18th, 2008 at 11:25 pm
check out the noobie nurse hyperventilating the patient. owch.
May 28th, 2008 at 3:03 am
–House is a skeptical arrogant atheist, so let’s teach him a lesson. “Oh come on!”–
I completely agree with your statement, Tiago. Every time it is mentioned that House or someone else is not theistic the show’s producers also want to counter it in some way -such as with the fetus touching House so in turn he calls it a baby and not a parasite, or someone questioning so-and-so person of being atheist such as in the episode Damned If You Do:
Cameron: I don’t believe in God.
Foreman: You’re not even a little agnostic?
Side note: Foreman obviously doesn’t know the meaning of agnostic. It’s not an alternative to atheism. Atheist: Has lack of believe (in deities). Agnostic: Has lack of knowledge. Cameron could also be agnostic.
June 13th, 2008 at 2:31 am
hey! i do not know if someone will actually read this but if it happens… has anyone noticed that on the second 34′52” of the episode, when house shows the echo of the baby to emma in order to make her accept the surgery, the baby actually makes the “ok” sign with his hand while scratching his nose with the pinkie finger? i just thought that was very curious… well, anyway… love house, love the site and my regards to all of you
see ya
June 16th, 2008 at 4:04 pm
“Agnostic” does NOT mean “having a lack of knowledge”. In a religious context, it’s a position of not believing knowledge can be obtained. The difference is huge.
Of course, Cameron may perfectly well be both atheist and agnostic (especially as she’s smart and seems to have thought about it).
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