House - Episode 4

Ethics and parenting were the themes this week, the former just hinted at while the latter was stated rather blatantly — especially in House’s overdone diatribe against antibiotics. The final diagnosis and the path to reach that decision all made good sense, and there was barely any random jumping from idea to idea this episode. The medicine seemed sound and logical (though I’ll happily admit that neonatology is not my specialty). I was surprised that they “forgot” that babies initially share their mother’ antibodies, since that was the “a-ha!” moment of the second episode.

Robert Sean Leonard’s character (oncologist Dr. Wilson) is growing on me, as is the previously-quiet Dr. Chase (James Spenser). This was a strong character episode for Dr. Cameron (Jennifer Morrison).

As an aside, we saw that not only do the Young Gun doctors run every test and procedure themselves (notice that they ran the MRI, ran the laboratory equipment and drew the blood), but Dr. House himself has the same compulsion (and where did he get credentials to do autopsies?).

Best line of the season so far! Dr. House to patient: Sometimes the best thank-you is never having to see you again.

19 Responses to “ House - Episode 4 ”

  1. I was wondering about the autopsy too. It seemed a bit specialized and away from what we’ve seen as his areas of expertise, but I wasn’t sure if I was just unaware of much doctors can multi-specialize.

  2. It’s not unusual for a specialist to sit in on an autopsy with the pathologist, but I don’t know of any situation where a non-pathologist actually does an autopsy (and I doubt the hospital would let him for medical-legal reasons).
    Maybe he is double boarded in infectious disease and pathology…?

  3. House has a double specialty in infectious disease and nephrology. He mentioned it in his cool speech in ‘Occam’s Razor’: “Hello sick people and their loved ones. In order to save time and avoid a lot of boring chit-chat later, my name is Dr. Gregory House, you can call me Greg. I’m one of three doctors staffing this clinic this morning. I am a bored certified diagnostician with a double specialty of infectious disease and nephrology. I am also the only doctor currently employed at this hospital who is forced to be here against his will.”

  4. Chase is played by Jesse Spencer, not James.

  5. I noticed when the team realized the babies were dying of a viral infection and they have to narrow down the list of ‘thousands’ of viral infections to a few 8 that would potentially affect the babies. In the list of viral infections that did not seem plausible, house (or i think one of the young ‘uns) suggests toxoplasmosis. Toxoplasmosis is a parasitic infection caused by Toxoplasma gondii that can be detected by stool examination (least invasive) or by antibody titres in the blood. It is not contagious, newborns can get it through the mother by zoonoses.

  6. And what about all these “antibiotic shut down the kidneys” thing? I don’t know much about healing babies but, I still don’t think this is true. It was not Amphoterecin B or gentamicyne…

  7. Wouldn’t be the first time on House that Antibodics were assumed to be shutting down the kidneys, it happened earlty in the prevous episode, Occtum’s Razor. It was later discovered it wasn’t the meds fault, but the fact that it can is enough to be considered. Note that no medical training here, just House, M.D. and Polite Dissent.

  8. Remember that part of the theme of House is to echo 19th century medicine, with the notion that House being a Holmesian character himself is going to handle all the autopsies himself. (Also see: Using maggots to clean away dead flesh, ludicrous drug use, etc.)

  9. what about their not considering a viral infection?? i think they jumped to the conclusion about the infection being bacterial

  10. Maybe the difference between top dogs in the sty and the rest of us is we let others do the important autopsies.

  11. house specializes in Infectious disease and Nephrology

  12. Quick question:
    At the end, when we see the old lady that was the disease vector, I made the comment that she should be held legally accountable for the death and endangerment of the newborns. As for what the charge would be, I think reckless endangerment at the minimum, manslaughter preferably. So, what are the rules for cases like these?

  13. I noted that dr House misspelt “coxsackie” in his listing of possible viruses which seems strange, as he is supposed to be a specialist in infectious diseases.

  14. Vancomycine is indeed known to be nephrotoxic..

  15. Re: the point on reckless endangerment or manslaughter, you would have to show (oddly enough) recklessness on the part of the accused. I am only passably familiar with English law, where the relevant requirement is laid down in R v. Cunningham (the accused has foreseen the possibility of harm and nonetheless gone on to take the risk); but it seems that the requirement in American law similarly requires a conscious taking of a risk regardless of the consequences, or one where the accused does not care about the consequences. In either circumstance, there is no way that the elderly lady would have met the test; she does not demonstrate foresight of the potential harm.

  16. That line actually read: Sometimes the best gift is the gift of never seeing you again.

  17. toxoplasma can indeed be trasmitted from mother to baby, which is one of the major complications for this parasytal infection.

  18. Great line indeed, that to the pregnant patient, and the whole sub-plot was quite hilarious. Another line: “The most successful marriages are based on lies; you’re off to a great start”. Nice moment the one with the tie as well; we hadn’t had a chance to see the students before (and I don’t remember seeing them afterwards, either).

    Question: has anyone found any parallels between “Maternity” and “Paternity” worth mentioning? The naming doesn’t seem like co-incidence. The basic common element so far seems to be the issue of a baby’s father’s identity, but there must be more. (Well, “must” is a strong word; people have a knack for noticing patterns where none exist. It’s one of the so-called “cognitive biases”.)

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