House - Episode 4 (Season 4): “Guardian Angels”
An enoyable and quick-mving episode of House, albeit one without much medicine in it. The mystery was intriguing, the solution logical, and the soap opera progressed well. Spoilers below!
Irene is a 24 year old Ukrainian immigrant who works as a funeral home cosmetologist. At work one night, she hallucinates that she is attacked and raped by two dead men. She starts screaming and her boss rushes in to find her in a full tonic-clonic seizure on the floor. She is admitted to the hospital and House and his team take over the case.
The initial differential diagnosis includes a temporal lobe tumor (but the CT was normal), toxic chemical exposure, or STD (which was dropped and never mentioned again). House sends part of his team to investigate the funeral home and Irene’s apartment; the rest he has run an MRI, EEG, LP (lumbar puncture, i.e. spinal tap), and a generic “blood panel.” The studies are all negative. The search of Irene’s apartment reveals little besides a plethora of organic foods. The funeral home search turns up no smoking guns, but Mormon Guy is suspicious of ethanol toxicity from the embalming fluid (which was already ruled out in the ER), and Old Guy points out that a recent cadaver at the funeral home died of something that sounds suspiciously like Mad Cow Disease (which they identify as Creutzfeldt-Jakob Disease). House sends the team to disinter the body of the suspicious cadaver and run tests on its brain — tests that end up being negative.
Irene is insistent on going home and the team is ready to release her when they realize that she has been carrying on a conversation with her dead mother. Old Guy points out that this is both a hallucination (talking to someone who isn’t there) and a delusion (believing her mother is alive when she died 20 years before). Plastic Surgeon suggests carbon monoxide poisoning while Old Guy believes that she may have an inherited disease of some sort. Irene’s mother died young, at age 25, and he suspects Irene may have the same disease, whatever it may have been. House tells the team to run tests for every hereditary disease, starting with Amyloidosis and continuing through to “Zamyloidosis.”
Around this time, Dr. 13 and Amber discover that Irene is seeing not just her mother, but other dead people as well, including a wheelchair bound man with a dead dog (Stark? From the previous episode?). When House talks to Irene, she tells him she sees his grandfather Walter. After hearing this, House leaves the room in a hurry, but he confesses to Wilson that it was all a ploy to make Irene think he believed her –– House actually has no grandfather Walter. He returns to the room and — through Irene — elicits some history from her mother to narrow down the cause of her premature death. Her mother was tired, unsteady on her feet, had a tremor, and walked bent over. From these symptoms House deduces that Irene’s mother died of Parkinson’s Disease. It matches Irene’s symptoms as well, so he starts her on L-dopa and Bromocriptine.
Irene now hallucinates that Dr. 13 and Kumar are stabbing her. When Dr. 13 tells her it was a dream, Irene points out that her arm is bleeding as if she had been stabbed. These new symptoms lead the team to consider retinal vasculitis and acute intermittent porphyria. Tests for both are run while she is started on corticosteroids, the treatment for vasculitis. While undergoing a retinal test, Irene starts complaining of abdominal pain and begins to vomit blood. The next thing we know she is in surgery with Chase (and since when was he a surgeon?) who finds an enlarged spleen and a necrotic liver. Old Guy still believes she has a vascular disease of some sort, so a visceral angiogram is ordered. As the test is proceeding, Irene begins to grope Mormon Guy and has convulsions, delirium, and hypersalivation. During this discussion, House continues to poke fun at Mormon Guy who finally has enough, and punches him. One of House’s comments rings a bell with Amber and she realizes that Irene is suffering from Ergot poisoning. Ergotism is caused by Claviceps purpurea, a mold which grows on rye grain (Irene’s organic food). Its symptoms include hallucinations, seizures, constriction of blood vessels, headaches, nausea, vomiting, and dry gangrene. It is thought by some to be the underlying cause of the infamous Salem Witch Trials. After treatment, Irene’s symptoms resolve and she bids a tearful farewell to her dead (again) mother.
The medicine, although there wasn’t much of it, was decent this episode. Not much time was spent on preliminaries and the obscure diagnoses came quickly. The writers were stretching on quite a few of the ergot-related symptoms (like the almost-stigmata, where did those come from?) and ergotism usually has a distinctly different presentation than Irene, but when has anything on House presented normally? Irene’s normal MRI, EEG, LP, and blood tests rule out most of the other causes besides a toxin of some sort — just what it ended up to be.
Also, Mad Cow is new variant Creutzfeldt-Jakob Disease, not classic CJD.
The medical mystery was interesting, though most of the symptoms were vague and added as afterthoughts (”By the way, she has focal weakness and urinary retention, we just didn’t feel like mentioning it earlier.”) — I give it a B+. The medicine was a little more focused than recent episodes, but still seemed more show than substance — it earns a B-. The solution was logical and actually fit most of the symptoms and earns an A-. The soap opera could have used more Wilson, but otherwise was strong, especially the last Cuddy and Foreman bit. It also earns a B+.
The previous House review
A list of all prior House reviews
October 23rd, 2007 at 10:55 pm
Great episode. It’ll be interesting to see how the applicants pan out. Season 4 is the strongest season so far, in my opinion.
October 23rd, 2007 at 10:58 pm
I love your reviews, thank you so much for writing them!
Wouldn’t the team have been more cautious about handling samples they believed had C-J disease? I have friends who are med techs and the idea of touching such things freaks them out even in controlled laboratory settings.
October 23rd, 2007 at 11:01 pm
Damn my House Challenge choices. I was overly-specific on vasculitis (Churg-Strauss) and probably cost myself 5 points!
October 23rd, 2007 at 11:27 pm
Thought this a particularly good ep. Not being a doctor, I don’t have as much to go on, but this season is shaping up well, IMO. We’ve seen a lot more range from House, and a lot less trumped up drama.
Can’t wait for Amber to get dumped. About halfway through the episode, I figured that -she- had told the patient about #13 ‘killing’ the previous patient, in order to get in #13’s head. Talk about trust issues. When you can’t even trust a character on a TV show……
October 23rd, 2007 at 11:29 pm
My first thought was the embalming fluids followed a B12 deficiency. When they focused on the mother and the milk I was thinking Strontium poisoning from Chernobyl.
When they said Ergot, I went Doh!.
One of the best ones in a while. I really love the new format.
As for Chase being a surgeon IIRC he has been head of the surgery department since episode 4.2.
October 23rd, 2007 at 11:38 pm
how did Irene find out about the wheel chair guy and his dog?
October 23rd, 2007 at 11:58 pm
vb, as Rich said above, Irene was told about the wheelchair guy and dog by Amber. Amber all but admitted it at the end when she got her rose/peony.
October 24th, 2007 at 12:02 am
Also, they talked about Wheelchair Guy during the prep for her MRI.
They did the reveals well in this episode. I called the mother being a hallucination, and then the Parkinson’s diagnosis, about thirty seconds before the doctors did, which is probably what they were going for. Like the self-medicating bit too - the other side of the cyclist’s self-treatment through blatant cheating in season 2.
I mourn the loss of Ridiculously Old Fraud. Why couldn’t it be Random White Frat Guy? He doesn’t even have a personality. Or lines. Just bad facial hair.
(Also, Chase as head of surgery? He just said “surgical staff.”)
October 24th, 2007 at 12:07 am
My problem with the ergotism diagnosis - the symptoms were perfect, but ergotism comes in epidemics. The fungus grows on the grain while on the stalk, not on flour or baked goods, so any product made from the grain is going to be tainted. Unless Irene is the only person in the entire area buying that brand/from that distributor, or the food they makes is distrubuted variably instead of in batches, there should have been multiple cases of ergotism.
October 24th, 2007 at 12:08 am
I began the season hating Amber, but she’s definitely started to grow on me. Pretty good character.
October 24th, 2007 at 12:12 am
I just love the fact that Cuddy showed some cajones in this episode. Sure it was at Foreman, not House, but cajones nonetheless. Especially since I always thought Foreman was the most holier-than-thou of the three and needed to be taken a peg down.
Unfortunately this means that he’s basically crawling back to PPTH, which is what I had hoped the writers would avoid.
I’m starting to wonder if that other white guy (the non-plastic surgeon guy) is just gonna sneak through and make it because House forgot to fire him. I’m not seeing any value added from his presence, from a medical or television perspective.
Got to ask though: as a doctor, do you think that someone can accumulate enough book smarts to actually know as much medicine as Bosley?
October 24th, 2007 at 12:18 am
Outstanding episode; this is turning out to be one great season!
I do have a question about the old team though. As mentioned in the comments above, Chase is now part of the surgical dept. We know that he’s been with House’s diagnostic team for 3+ years now and isn’t much older than 30, and he has a specialization as an Intensivist. So between college, med school, intern/residency in Intensive Care, and then the PPTH Diagostics Dept. - when did he have time to learn a surgical subspeciality? Can doctors just “switch over”? I’d really like to know how this might work in the real world, or if this is another TV-fantasy (like the Young Guns, old or new, running every test themselves… or the idea that any real hospital would even have a Diagnostics department in the first place).
Also, what exactly is Foreman’s “new” job entail? Did anyone catch what he was actually being asked to do? He’s not above House but he is not rejoining the team, either.
October 24th, 2007 at 12:30 am
SquishyCat: It’s possible that she gets her food long-distance. I know a couple of people who buy specialty foods, particularly grains, online (thanks to celiac disease), and if they started shipping tainted food you’d see an “outbreak” of poisoning distributed sparsely across the continental United States.
October 24th, 2007 at 12:32 am
Official Comment
SquishyCat:
That’s a very good point.
Kelvin:
You can accumulate a great deal of book learning from the classroom years (the first two years) of medical school. Most of the hands on patient care (and in my opinion, the bulk of the real learning) comes in the clinic years (the last two years) and the residency that follows.
McDee:
That’s my point exactly. Chase was an intensivist, a specialty which takes 4 or 5 years (3 years Internal Medicine residency + 1-2 years Fellowship); Surgery takes a minimum of 5 years (that would be 5 additional years). How did he squeeze in a surgical residency over the summer?
October 24th, 2007 at 12:45 am
David: Yeah, that could do it. I just wish somebody had bothered to mention it on the show. If I knew somebody in the area had ergot poisoning, I’d start asking where they shopped.
October 24th, 2007 at 1:05 am
That sucks that bosley is gone, but you didn’t really answer the guys question of whether it is possible to learn all that without med school.
October 24th, 2007 at 1:23 am
When Taub mentioned that a test could only be done during an attack, was that true? I remember a situation where they claimed that (Stacy’s husband’s AIP), but it isn’t so.
http://astro.isi.edu/misc/HouseGrades.xls
October 24th, 2007 at 1:48 am
Yeah, I was sorry to see Bosley go as well. (I’m not sure I get the reference that House was using when calling him that… after the football player?) But the episode actually did a pretty good job of illustrating why he couldn’t stay… he and House thought the same, and his lack of practical experience would eventually trip him up. Who knows, though, maybe we’ll see him return, just not on the diagnostics team.
I rather figured Foreman would end up with a tainted resume after last episode’s events… I’m sure such things happen in real life as well. I’m curious, how would a doctor normally deal with such things? I suppose he could always try and pursue an academic career, or switch specialties to something where life-or-death choices are far less common, or just relocate elsewhere in the country.
October 24th, 2007 at 2:13 am
Thanks for the reviews, they really add to the episodes. I hope the writers will handle well the return of Foreman and not simply keep the old formula. I’m guessing we’ll see some additional confrontation with House and the recruits having to take side.
I still don’t understand why a Creutzfeldt-Jakob diagnosis could have been linked to the cadaver she worked with and that the recruits subsequently had to dig up. How could it have been transmitted from the cadaver to the patient? Unless she had the nasty habit of feeding on his brain.
October 24th, 2007 at 2:17 am
Yeah, I was sorry to see Bosley go as well. (I’m not sure I get the reference that House was using when calling him that… after the football player?)
Er, no. Try the David Doyle character on “Charlie’s Angels” (why do you suppose House kept calling the young guns “angels”?).
And no, I was never a fan of “Charlie’s Angels.”
October 24th, 2007 at 2:51 am
Thanks for the reply & reviews, Scott! You have to keep these coming; they’re a must after each show.
Regarding Bosley/Henry/Old Fraud - who I loved BTW and it’s a shame to see him go - I had no problems believing that a guy who spent 30+ years in a top learning institution would be a walking encyclopedia of medical knowledge. I’ve seen people buy those “crash course” books in fields such as marketing (which has as many subspecialities as medicine it seems) and rise to prominence in under a year. Just don’t let the guy do any invasive procedures. :)
Keep in mind that House never wanted a team to begin with: his teams are not based on who the best “diagnosticians” are, but which personalities provide the best sounding boards to HIS personality. Some people hire idiots so they look good. Some people hire qualified staff so they can macromanage. House needs to hire people who complement his quirks and do some crazy things in the name of curing the patient and solving the mystery - i.e. grave digging, breaking and entering. Bosley/Henry/ROF might be the best Diagnostician in the group, but House doesn’t need that. House is God, remember? He is the Lord of All Doctors. Or something.
And to take this one step further… Bosley doesn’t bring in any significant viewership demographics (sorry). It doesn’t benefit the producers to sign him. In fact, you can predict who the finalists are based solely on a producing/marketing level. Then you can go confirm it (the “new team” was signed a few weeks ago, reported in Variety and other H’Wood trades).
ps - About Foreman, what I’m hoping for is that he ends up as House’s “backup QB”… you know, whenever House has to go to prison or Singapore or sticks a knife in a wall socket… and then Wilson/Cuddy end up taking over and screwing it all up, because they aren’t Diagnostic Gods. Or something. It’d be nice to see Foreman fill in that way, since House seems to go on a few adventures each season.
October 24th, 2007 at 3:34 am
I’m sorry to see Bosley go also. I hope we get to see him in later episodes hanging out with Wilson and House. It’s about time House had another friend.
I think Amber is huge B**** playing with 13s head. She’s too “the end justifies the means” to me. I see her butting heads with Foreman.
Also… I think Adam is too young to remember Charlie’s Angels and didn’t see any of the remakes. That’s why he didn’t get the Bosley reference.
October 24th, 2007 at 7:32 am
Wouldn’t an LSD-like drug cause you to see sounds like it did in the episode of House where he took it to stop a migraine, or at least not constantly have the same visual/auditory delusions? Not a medical person, just curious.
October 24th, 2007 at 7:33 am
The show is all over the map this season…none of the changes make any sense at all, and they are obviously just there so they don’t have to eliminate the three original doctors. House has lost any appearance of humanity and is just a shock-machine - why anyone would put up with him is a mystery.
OK, I admit - the Foreman story makes sense. What happened to him is what would have happened to House, in a real world, in season 1: namely, that he gets fired for being a loose cannon. Why Cuddy treats House any differently is beyond me. House’s entire career at this point should be taken up defending himself against lawsuits: harassment, racism, and malpractice.
And grave-robbing? What is this, the late 19th century? I’d like to meet one doctor who would risk his entire career like that for any reason. If caught, he’d no longer be a doctor; only “that grave-robbing guy.”
Sorry, the show is leaving me cold on so many fronts. Some of the quotes were alright. “I hate 13!”
I’ll miss the old guy because he was the only genuinely interesting new character, with understandable motivations. He and House obviously bonded, and if there’s one thing this show desperately needs, it’s some human feeling in its protagonist.
October 24th, 2007 at 7:34 am
I particularly enjoyed the House and Cameron bit. It’s interesting to see how he deals with his old fellows. Is it just me or is Cameron becoming Wilson 2.0? I wonder if that’s just for this episode or if it’s going to be a recurring theme.
October 24th, 2007 at 8:42 am
I thought in this episode, more than the others, Cameron’s personality was noticebly different. Hair coloring poisoning beginning to take effect?
October 24th, 2007 at 9:11 am
I was really disappointed in seely Bosley go. From reading the comments here and on IMDB, it seems like
Bosley was the most liked new person. I like that he’s old & he actually looks like a doctor.
Kal Peen, 13, and the Plastic Surgeon does nothing for me at all. They have a hard time convincing me
they’re doctors and their acting isn’t done really well either. I really hope those 3 new “signed” doctors
will only be there for some episodes. I don’t want to see them over the long-run
October 24th, 2007 at 9:12 am
I sort of like the personality of new Cameron, but like her brown hair better.
She seems more able to talk back to House instead of crushing on him.
October 24th, 2007 at 10:11 am
I really liked the irony of the whole thing caused by non-genemoded (I refuse to use the “organic” terminology because its idiotic) food. Stuff like this doesn’t happen when you actually have to appeal to industry standards when it comes to genemoded food that has to be checked by various healthcare institutes/government bodies/etc. As opposed to non-genemoded food, which sometimes worms its way around those by marketing.
I can see why Bosley is gone though. I find it kind of sad that such a dedicated man to medicine never got an actual medical degree. The fact that House can’t use him because the two think so much alike is a big compliment.
I really liked the episode. It was sheer brilliance and the fact that it was medically reasonable makes it all that much better.
October 24th, 2007 at 10:19 am
Ok, Scott or anyone that can answer. What is the difference between Creutzfeldt-Jakob Disease and Mad Cow Disease? Is Mad Cow just a mutation of Creutzfeldt-Jakob Disease or something different all together?
October 24th, 2007 at 10:37 am
I liked this episode, although I’m sorry to see Old Fraud go. As a layperson, I found the medicine much easier to follow than in the previous episodes this season. I am intrigued by the fact that the Mormon doctor is a singe dad. As far as I can recall, he is the first regular on the show to have children, and I wonder how they’re going to play that. Last, is it my imagination, or is House attracted to Dr. 13?
October 24th, 2007 at 10:44 am
Mad Cow Disease. I took a wild guess that they would include that in an episode just last week. Although I was sure it wouldnt be the end diagnosis cos there would be no way they’d show an outbreak of Mad Cow Disease in America, no way they gonna scare ppl like that - some people might take it for real…
And what was that about bosley? I looked through the whole ep again not more than twice did he and house actually predict each others suggestions. Most of the time bosley suggested something and house just agreed cos he understood. Didnt mean that House could’ve come up with it. Damnit, that cut throat chick should be fired or that guy who did nothing. Shame, the old guy was like half the team.
October 24th, 2007 at 12:11 pm
Re:Chase
In Australia, the ICU training program can be entered via either an internal medicine residency or a surgical residency. In fact, in med school, ICU was considered my surgical elective. So it’s quite possible that Chase did a surgical residency then focused in on ICU training in Oz, before joining House’s team. Which is why he could go back to doing surgical stuff when he left “diagnostic medicine”.
October 24th, 2007 at 12:46 pm
Gonna miss Dr. Oldguywhosnotevenadoctor
October 24th, 2007 at 1:14 pm
Nice episode! The medicine made sense to this layman; ergotism was something few doctors would see in this day and age, setting up the mis-diagnoses nicely. I also hated to see Bosley left out in the “rose ceremony”, though his exit lines were some of the best and most graceful I’ve heard on the show lately. I’m hoping we haven’t seen the last of Bosley; I think he adds much more texture to the show than anyone else in the “new bunch”. His status as a non-doctor with medical knowledge nearly the equal of House’s could make for some very interesting ethical dilemmas around the hospital, particularly when Cuddy found out that House was drawing him into cases. Or patients, for that matter. I like NONE of the other newbies. Irene and Amber in particular are irritating; the roles are too floridly written for the actresses who are playing them. Neither has the chops or the personality needed; they’re too generic.
I would not be surprised if House’s old team was re-formed by the end of this season; it would be just like the old misogynist to stir things up this much simply to see what happened.
October 24th, 2007 at 2:42 pm
Wow, Bosley was the only one I actually liked. Argh, Foreman, I thought I was rid of you….
This episode was pretty good, definitely had that spooky factor to it. Though, it would have been a lot better if “Walter” really was House’s granddad. Too bad it wouldn’t make any sense.
October 24th, 2007 at 3:38 pm
I too liked “Ridiculously Old Fraud”’s exit lines, and hope he’s not gone for good–in fact, didn’t he get that nickname when House told him earlier, “I think I’m going to miss you most, ridiculously old fraud”?
Also liked Wilson’s line, “You’re feeling pretty pleased with yourself right now, aren’t you?”
October 24th, 2007 at 4:02 pm
I thought this episode was cluttered. Having all the fellows seemed like a great idea early on — many moving parts, contrasting personalities, all giving House a broad canvas to play his games. But (for me at least) it hasn’t really worked, and worse it has lessened what I enjoyed most about the show, the twisting/bending of relationships between a compact cast of characters. I’m def not a television writer, but it seems to me there are too many players on the stage to try maintain the same levels of intrigue as previous seasons. Everything feels thin.
I know that the herd is growing smaller and soon the team will be chosen, but I hate the feeling I’m waiting for the writers to stop with all the high-paced back and forth (required by the current set up) to really dig in and let the season grow.
Would be very interested if others agree/disagree. This is the first show I’ve watched regularly in years!
October 24th, 2007 at 5:14 pm
re: cluttered.
This season, more than once I’ve looked at my watch expecting the show to be farther along than it is.
I don’t think that’s bad. Ultimately, it seems this show is about putting House in odd situations and exploring how he reacts to them. As such, watching this season has been a blast. The Survivor council with the bunsen burners and the carnations (I don’t think they were peonies -or- roses) were classic House responses to chaos of his own making. I like it.
Like the Tritter story arc, or the Vogler story arc, ultimately the reality show story arc will have to end, but unlike both of those story arcs, this arc is bringing out a far more playful side of House.
In the mean time, enjoy it, IMO. Especially superb theme compilations like “guardian angels” (Charlie’s Angels references, Irene’s mother as ‘guardian angel’, “Big Love” as guardian angel for an apparent foundling child–’I don’t know who the mother is’, and of course, Cameron as “Big Love”’s ‘guardian angel’).
October 24th, 2007 at 5:16 pm
I think some of the comments here are unfair to the new, emerging characters this season. I like all of them, with the possible exception of the bland white guy with an incipient beard, who hasn’t shown much personality yet. (I just looked him up at imdb.com; his name is Brennan in the series.) I think 13 is dynamite, both as a character and as an actress. Anyway, my advice is, give the writers a shot at winning you over to their choices for continuing team members. The great challenge to the writers will be to find enough interesting material for the larger cast, with the earlier team still present along with the new team. We already see this cutting important characters’ exposure (Wilson was nearly absent from this episode, for example). I hope that after the team gets winnowed down, there will indeed turn out to be enough meat to go around.
October 24th, 2007 at 5:44 pm
George: I agree–I find most of the new characters reasonably engaging except for Boring White Frat Guy…uhh, Brennan, lovely name. I’m hoping Thirteen doesn’t end up too close to Cameron in temperament. Looking forward to the new opening sequence when they stabilize on the new cast.
October 24th, 2007 at 6:35 pm
House Lite!!! Classic House?! Great Cuddy lines to Foreman!!! I agree with Matt- I haven’t watched any TV show on a regular basis in years. I also see Georges point about giving these guys a chance- I bet that if this was the first season we would be down on Cameron as ‘underdeveloped’ and Foreman as ‘forced’. I think this episode was the turning point- now all of the original 3 are back. Let’s give David Shore and Co. a chance to make it work………….
October 24th, 2007 at 8:06 pm
Was I the only one who had a problem w/ the “Reticular Vasculitis” diagnosis? The patient wasn’t just seeing things, she was HEARING them. And Justin, C-J disease IS Mad Cow, AKA Bovine Spongiopathy.
October 24th, 2007 at 9:17 pm
Ok, I have a medical question. Maybe I should just google it, but–someone here can probably answer it. Irene’s mother died at the age of 25, when Irene was 4. When they try to diagnose her by interviewing the hallucination, House decides the mother had Parkinson’s, and that Irene may have it too. Could the mother have died so young, 4 years after giving birth to a child, of Parkinson’s? Or are we to assume she died of falling in the bathroom and hitting her head?
October 24th, 2007 at 9:19 pm
I think Dr 13 is absolutely the best.
As for Chase, he’s Australia and Anna has answered that beautifully here:
http://politedissent.com/archives/1783#comment-190126
I thought the medicine was a bit under shadowed by the drama but that’s OK because we’ve had 3 seasons of non-stop medical drama and I wasn’t so fond of that detective plot twist.
I want to see Tracey back though :D She seemed to hold off on House well enough. She reminds me of the character Shirley Schmidt from Boston Legal.
I hope that if Foreman comes back, he comes back more competent and confident. I think he’s the only one that could rival house in terms of diagnostics…someone needs to give House a run for his money :P
More Wilson was needed this ep for sure. He’s really come into something…and I’m not sure how to react to Chase/Cameron’s personality bypass just yet.
And I’m sorry Old Fraud had to go. I still don’t like Amber. Sure she was useful this ep but we’ll see. I like the Mormon Daddy for some reason though :D
October 24th, 2007 at 9:58 pm
[…] A woman has hallucinations and House has the team working on it. Girl ends up having eaten mouldy organic bread leading to Ergot poisoning! Caused by a hallucinogenic fungus growing on rye-bread. Better medical review here […]
October 25th, 2007 at 2:42 am
In the opening, Cameron and House drink from the same straw. How intimate.
In the ending, House to ‘Bosley’; “If you want to hang out…” ‘Bosley’; “Yeah, I know, call Wilson.” Old Fart will be back. And previously, didn’t House eliminate Old Fart as a possible canidate and offer to make him aministrative assistant (without any funds in the budget)? Love this site!
October 25th, 2007 at 3:40 am
Hmmm.
They let go of ‘Bosley’, who is very House-like and everyone seems to like him.
They’re bringing back Foreman, who can’t stand working with House.
Perhaps they’re planning on bringing these two together as a team.
October 25th, 2007 at 8:04 am
Wouldn’t the fact that the women was essentially taking hallucinogens showed up on some blood, urine panel? I mean House does drug-tests allot,and doesn’t take it that his patients admitted none.
October 25th, 2007 at 8:08 am
Oh, and I think that Dr.13 likes House, not sure if House likes 13 though. She smiles at his bad jokes and doesn’t take issues with him.
October 25th, 2007 at 8:36 am
Official Comment
Routine blood and urine drug tests only look for certain classes of compounds: opiates, cocaine, benzodiazepenes, etc. Ergotamine is not one of the compounds that is tested.
October 25th, 2007 at 11:45 am
Stranger: Might that not have something to do with House keeping her on even though she didn’t make sure (and didn’t delegate someone to make sure) that Stark took his meds? Even if that wasn’t her mistake to make, she still thinks it was her mistake to make, and I think she might simply be grateful for that and/or believes she’s used up her quota for screw-ups.
October 25th, 2007 at 3:07 pm
did not see it:::
“The search of Irene’s apartment reveals little besides a plethora of organic foods. The funeral home search turns up no
smoking guns,”
October 25th, 2007 at 7:04 pm
“Wouldn’t an LSD-like drug cause you to see sounds like it did in the episode of House where he took it to stop a migraine, or at least not constantly have the same visual/auditory delusions? Not a medical person, just curious.”
The key word being “LSD-like.” Ergot doesn’t contain LSD, but rather ergotamine, from which lysergic acid can be synthesized and then you have the precurser to the fun stuff - lysergic acid diethylamide.
Hope I haven’t just tossed technical details at you: basically, they are two different chemicals.
October 25th, 2007 at 7:05 pm
I thought if you’re in a hospital for awhile, you’ll stop showing sypmtoms of the food you normally eat, because you’re not eating it anymore…you’re eating the hospital food. I know that was in the episode where the two boys got affected with the same illness and shared nothing, so it was a big mystery and Cameran thought it was the mothers’ spaghetti sauce and House said “If it was the sauce, he would have gotten better just eating the hospital food.”
The b!tch woman playing that nasty trick on the other girl (for no reason that I can see) was just dumb.
House has jumped-the-shark. It has gotten so bad that it’s almost unbearable, in my opinion. They’ve warped House, now they’re taking away from Wilson’s airtime because they have the old-guns in the episodes. UGH!
Bye bye House. I’m off to watch The Office - a show that’s getting better with each season rather than worse.
Bye gang! It’s been fun.
October 26th, 2007 at 10:54 am
I figured the “old fraud” was a gonner when I jumped ahead to preview the upcoming
episodes on the House website…didn’t see his name mentioned in the cast lineup.
How’s that for an unintentional spoiler warning?
I agree, and the popular consensus appears to be that most felt a loss
by removing this character.
I beg to differ with a previous mention
in regards to viewer “demographics”, in that although the general target audience
may be in the range of 18 - 35, the average age of veiwership is steadily on the
rise with the average age for this time slot, slowly moving towards the 35 - 50 age
group.
Keeping a character of this age and of personality kind of added a touch of
warmth and stability in stark contrast to the other characters thus far,
including the new ones added this season. I thought that there was room for
a lot of potential here with “old fraud” not only to himself, but the endless
possibilities that could have allowed his interaction with virtually anyone
on the show, regular cast and guest stars alike through upcoming episodes.
Also, it’s nice to see a show with a mixture of age groups for a change and
granted, being 48 years old, I can relate just as well to someone of his
age just as easy as I am to House, Wilson and Cuddy as late 30’s - early 40’s
characters.
As a fan of the “St. Elsewhere” series which ran in the early to mid 80’s,
I found ALL of the characters interesting and I firmly believe that this
approach to television provided for a much wider audience, simply because they
enlisted the talents on a regular basis of those over the age of 40.
Also, back then as today, a healthy portion was dedicated to the intimate and
romantic aspects of the interacting characters, to the degree where they
even focused an episode or two on the sexual dalliances of some of the
older characters (Dr, Craigs wife’s romp with another middle aged doctor…
Randy Cox?)…so it wasn’t all about just the younger guns, but proved, as in real
life, romance and passion isn’t just an 18-35 demographic phenomena.
Don’t get me wrong, I’ve nothing against youth…I hang onto it dearly
every day as it slowly slips away,haha. However I just think that House was
onto something by incorporating a regular character older than most that
would end up in a series like ER for example. I also have to congratulate
the writers of this show for not letting the romantic, “when all else fails,
throw in a steamy romance/relationship to stoke the embers” kind of attitude
take over the story lines like a lot of the other programs have done in past
and continue to do today.
I hope that they find it in their hearts to consider “old frauds” return
in some way, even if it’s the occasional episode.
Other than that, Hugh Laurie is a talent to be reckoned with. The show still has
my interest and I trust the writers will keep their collective wits about
themselves to do what’s right in keeping the show alive and healthy (no pun intended).
Thanks
Jazz
October 26th, 2007 at 11:02 am
Big problem that I had with the episode was with Irene’s hallucination of her mother. Her mom died at 25 when Irene was 4, correct? The last image Irene would have had of her mother would have appeared much younger. Furthermore, if Irene is 24 now, that would have made her mother a mere 45 presently. I suppose, however, that having her appear much older was part of the dramatics of the show - would have been a dead giveaway if she called a 25-year-old woman “mother”. I also had other complaints with the way her hallucinations/delusions were presenting, but to dwell too much on them is futile - it is only TV afterall…
October 26th, 2007 at 11:52 am
Yeah, I’m not sure how impressed I am with House anymore. I only got into it by watching season 1 earlier this year, so I’ve had the advantage of being able to watch three years of House in just a few months and now jump directly into season 4.
His character has changed to the point where it’s completely unrealistic and bordering on unbearable. Back when he started he was outspoken, Machiavellian, very pragmatic, blunt but not outrageous. He was insensitive only because he valued truth over feelings and diplomacy. And we tolerated it all because, well, being that frank is refreshing and funny, and he was a very good doctor. The hospital (Cuddy) tolerated him because he saved lives.
Now, the writers have been evolving that character over the years to be MORE dramatic, MORE rude, MORE outrageous, we have House the torturous, deliberately insensitive old coot who purposefully goes out of his way to try to hurt others just so he can push their buttons (it’s not even just to prove his points anymore). And he’s not even the one doing any of the work anymore, he’s just in the background telling people what to do, always smugly withholding details or theories, just to see what happens so he can say “Aha, I was right, I told you so.”
With SO many major characters sharing screen time, no single thing is even holding the show together anymore.
The “breaking into the patient’s house to find evidence” got old pretty quickly, especially when I realized how often they do it illegally. (I could see “give us your keys please, we’re going to go to your house”, but no…) Even the writers have become so accustomed to it that they forget that patients aren’t supposed to know about it. Remember last season when they found the blood-stained shirt in the vent under the little girl’s bed, in the episode about the testosterone cream? They accuse the father of touching his daughter, and when he denies it, they yank out the bloody shirt like a piece of forensic evidence on CSI and say “we found THIS!” and the father quickly explains it away. Wouldn’t your first reaction be “Wait, how did you find that?” followed by being real mad when you realized they broke into your house?
It’s just no longer believable. I’ll keep watching, but the suspension of disbelief disappeared somewhere partway through season 3.
October 26th, 2007 at 12:13 pm
I’ll miss old fraud too. I think (personality-wise) that he would have been the most interesting new member of the team. For one - he’s the closest thing House would have to a “peer” so it would have been neat to see how he acted with someone who he didn’t feel completely superior to(though I’m sure, still superior to) not to mention that they actually seemed to get along on a personal level. The reasons they made for ousting Old Fraud made sense at least - but I think I’d keep someone who was too much like me over Blandy mc’boring, Ruthless bitch or Big love - none of whom add much imo. (though good on Big Love for the punching!)
October 26th, 2007 at 3:08 pm
I really liked the episode, though at this point you’ve all discussed just about everything in the episode. So instead, I’ll comment on the one thing nobody’s mentioned: the Mormon guy’s prayer was nothing like a real Mormon prayer. If it was intended to be a blessing (which we Mormon’s also do) then it was even more off base. Not that he’s been a very plausible Mormon in other things, but the prayer was so wacky it actually made my wife and I laugh.
October 26th, 2007 at 6:31 pm
What bugged me about this episode is the inconsistency in the value of studying under House. All the newcomers are desperate to become House’s new Young Guns, but we see from Foreman’s interviews that having studied under House gets you blackballed. You’d think word would get around.
October 26th, 2007 at 8:14 pm
Foreman wasn’t fired and blackballed because of his association with House. He couldn’t get another job because he disobeyed a direct order from the hospital administrator. He was explicitly told the radiation treatment was off the table, and he did it anyway. The fact he saved the patient’s life is, from the bureaucratic standpoint of a hospital administration, irrelevant.
And unfortunately for Foreman, that combined with his known association with Dr. House, meant he now had a rather anarchic image. The only way he could probably escape it would be to relocate somewhere else, far away, where House’s name and rep were more legend than well known. His old boss in California would probably hire him. But that’s not the kind of work Foreman wants.
October 27th, 2007 at 2:20 am
Old Fraud was the best.
October 27th, 2007 at 9:16 am
I thought Creutzfeldt-Jakob disease had an incubation period of years, even decades, after exposure before symptoms presented. So why would House or the others believe that her contact with the corpse would cause all her symptoms the same day (I guess because grave-robbing is quite showy)?
Ah, I mourn the loss of Old Guy.
October 27th, 2007 at 2:09 pm
I liked this episode a lot. The new fellows, albeit not yet very interesting as characters, are getting a lot more fun banter in and developing personalities.
Ridiculously Old Fraud/Henry/Bosley:
I loved him. He was probably my favourite of the new fellows. But I thought this was an incredibly good way to see him off the show. He leaves with House’s respect and his dignity intact. Besides, he had a great time working for House, and got a chance, for a short little while, to live his dream of being a doctor.
I’m warming up to Amber on the grounds that she hates 13 as much as I do. Like, what’s to like about 13? That she’s a pretty, “mysterious” white girl? Forget it. Kumar and Plastic Surgeon are fun- I loved their “why does he get to be Bosley?” routine. Grumpy is boring as ever, but that doesn’t matter, because he’s obviously the next to go. Big Love getting groped and then punching House were cool, but not nearly as cool as when House punched Chase for correctly diagnosing porphyria (in the episode where it actually WAS porphyria).
Chase in sugery:
Absolutely ridiculous. I don’t see why the writers, if they wanted to just dump the old team in random jobs around the hospital, couldn’t have just put Chase in ICU or NICU. Both would have made sense for his specialty, would’ve been realistic given how valuable a bona-fide Australian intensivist could be to the hospital, and could still have kept him involved in the show- whenever a patient is hanging by a thread, Chase could be there to keep him/her alive until the diagnosis. It might also have been nice to see him moved to maybe some kind of pediatric/diagnostic position, given how much he likes kids. Surgery doesn’t make any sense for either the character, the soap opera or the hospital.
Foreman:
Whatever. I’m so completely bored with Foreman at this point. All I’m really getting out of his plot at this point is watching the guy learn some f&%@ing humility and stop strutting around like he’s the most righteous guy on Earth.
One problem I had with the medicine:
I don’t know anything about ergot, specifically, but LSD and psilocybin hallucinations are a lot more erratic than this, and have more noticeable behavioural change. People don’t sit around and calmly talk to the same imaginary person the whole time, especially not for days on end. She would’ve shown bizarre speech, emotions, distorted thought processes, things like that.
October 27th, 2007 at 2:38 pm
>“ ‘Wouldn’t an LSD-like drug cause you to see sounds like it did in the episode of House where he took it to stop a migraine, or at least not constantly have the same visual/auditory delusions? Not a medical person, just curious.’
The key word being “LSD-like.” Ergot doesn’t contain LSD, but rather ergotamine, from which lysergic acid can be synthesized and then you have the precurser to the fun stuff - lysergic acid diethylamide.”
“Seeing sounds” and other mixing of sensory input (tasting color, etc.) is called synesthesia. Taking LSD (and other powerful hallucinogens) can sometimes cause synesthesia, but it is not a solid “every time” effect of LSD or any hallucinogen.
October 27th, 2007 at 2:49 pm
Mattbear:
But a consistent, stable hallucination/delusion without any behavioural change (except for trying to grab a little Big Love) or distortion of thought would be extremely bizarre under the effects of ANY hallucinogen.
October 27th, 2007 at 5:38 pm
Cuddy puts up with House’s shit because she blames herself for destroying his leg. She won’t take House-like crap from anyone else.
If House has a crush on 13, he’s not the only one. She was radiant and heartbreakingly gorgeous in “Black Donnellys” too, as well as the only good reason to watch the show.
The grave-robbing scene DID remind me of the 1800s, and I was waiting for someone to mention that doctors used to do that all the time.
Getting very tired of House’s Mormon jabs. It’s not THAT much more absurd than anyone else who believes in god.
October 27th, 2007 at 9:13 pm
I really enjoyed how the hallucinations were handled– it was quite a while before we realized that her mother wasn’t actually in the room. I thought that was well-done. (Yeah, it’s been done before, but it was still done well here.)
I, too, will miss the Ridiculously Old Fraud Guy. And Manipulative Bitch gets on my nerves more and more as she goes on. And Mormon Guy is kind of bland too. I’m guessing we’ll end up with Mormon Guy, Manipulative Bitch, and 13, and that Annoying Plastic Surgeon will be next to go.
October 29th, 2007 at 3:10 pm
The trouble with dumping Amber (she’s the “backstabbing bitch,” right?) is that the other main female contend is just another vapid Pretty Woman with a Big Heart, like the one we almost got rid of at the end of last season. BB is interesting and would make a decent permanent addition to the cast.
October 31st, 2007 at 4:24 pm
It seemed that Irene was in the hospital for at least 3 days prior to the diagnosis… wouldn’t the hallucinations of ergotism have passed well before then? And they seemed too well formed, at least compared to LSD. I’d expect that ergotism to the degree able to cause such hallucinations would also present with a lot of delirium as well, which didn’t seem present?
October 31st, 2007 at 4:36 pm
It seems that a lot of attention has been paid overall to psychedelics… House using LSD to terminate a migraine, the use of psilocybin for cluster headaches, Wilson rolling joints (arguably; marijuana has been labeled by some as hallucinogenic but most folks differ on that) for a patient.
Not to mention House popping Vicodin as he does, which demonstrates that opiate addicts can be functional and that most of the harm from heroin, etc stems from the prohibition, not the substance itself.
Given the political climate and the “war on drugs” I’m shocked to find this on American television. I only discovered the series a few weeks ago and immediately (after watching season one online by way of piracy) purchased the box sets of the first three seasons. It’s almost (but not enough) to make me buy a television (threw mine out in 2001 and haven’t looked back). Thankfully Fox provides the current season episodes online (with a week of lag) so I can stay relatively current.
Hopefully the series prepares the public for a sane re-examination of Schedule I controlled substances for use as prescription medications. The Catch-22 that they are “by definition without medical utility” has made it very difficult to do controlled studies on them, yet millions have taken them illicitly and — once controlling for adulteration and dosage uncertainties resulting from the black market — have had relatively few adverse reactions. maps.org is doing some good work in this area, helping researchers navigate the bureaucratic hell of trying to get the proper licenses and permits to conduct such research.
October 31st, 2007 at 10:33 pm
As a linguist, I only have one qualm with the episode: why did Irina’s* mother speak in English. If she died back in Ukraine, when Irina was four, Irina should have no recollection of her speaking English, moreover, hearing Irina’s thick accent and occassional loss of words (English being an acquired language) one would think it would be more probable for the mother to speak in Ukrainian.
* - I am against the localization of names (excepting placenames), seeing as many people in my native Poland and generally in Eastern Europe are butchering their own. Try to write my name with “v” instead of a “w” and I will show you how your surname looks in Polish, German, Russian (in Cyrilic) and Chinese (Traditional and Classic).
November 3rd, 2007 at 12:40 am
The cutthroat bitch is still there! Shame!
November 7th, 2007 at 10:44 am
I remembering watching a documentary on how ergot was given in limited amounts to pregnant women long ago. Wouldn’t the effects start to wear off when she was removed from her home and put on controlled food in the hospital?
Also, the hallucinations seemed unrealistic. Shouldn’t she have had trouble concentrating on reality, had mild aphasia, mild psychosis and all the other conditions that typically effect people when they’re on hallucinogens?
November 24th, 2007 at 11:52 am
Just a summary:
as a german med I like this funny way of “CME” - continous medical education, and
especially this site to correct my probable misunterstandings not being a native speaker.
Go on!
January 30th, 2008 at 10:42 am
A geneticist’s nitpick: did I hear it right that House told them to check for *mitochondrial* diseases? Ah, yeah, right, that piece of DNA pased along only from the mother… with half of the autosomal genome. Mother and daughter could have shared any among the hundreds of autosomal dominant diseases, and not just those in mtDNA.
March 15th, 2008 at 7:25 pm
Iam dumbfounded about what happened to House’s diagnostic team?
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