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House's Team

4.16 Wilson's Heart

Initial Symptoms: Woman with traffic accident injuries + elevated heart rate
Diagnosis: Amantadine poisoning (House) + influenza (Taub)

Contributions by Team
House (5): Idea to search apartment for toxins, idea for deep brain stimulation to retrieve memory, notices influenza rash, diagnosis for amantadine poisoning, knows that dialysis won't clear drug from blood
Cameron (N/A): Not in episode
Chase (1): Sees jaundice
Foreman (0): None
Kutner (1): Stops Thirteen from connecting wrong tube on patient
Taub (1): Suggests a toxin (lead, drugs) is causing heart trouble, diagnosis for influenza
Thirteen (0): None

Notes: This was a very hard episode to assign points for. I stuck to my method of working backwards from the correct diagnosis, which meant discarding a lot of things that would otherwise have counted for points or errors. The telling point here is that nothing would have saved the patient (Amber Volakis), so everything they did to her that could have potentially harmed her was irrelevant. I'm also calling influenza a separate diagnosis, although it didn't cause her fatal condition that they were diagnosing, because 1) it did cause at least one symptom and 2) knowing that she had the flu may have led them deduce that she had taken drugs for it and led them to the amantadine poisoning diagnosis without House's memory of seeing her taking the pills.
Wilson persuaded House to induce hypothermia and put Amber on bypass to avoid sending chemicals from her damaged heart to her brain. Everyone but House and Wilson acts as if this was a bad idea, so I'll assume it was. Again it didn't matter in the end, so no points were awarded or subtracted for it.
House and Foreman wanted to treat Amber for Rocky Mountain Spotted Fever before confirming the diagnosis, but Wilson prevented them from doing so. Foreman acts as if this is bad medicine, but it makes sense to this layperson. On Foreman's suggestion he and Cuddy later warm Amber up, but as Wilson feared the chemicals produced from her damaged heart do affect her brain. If Wilson hadn't stopped them then perhaps she would have suffered brain damage. For this reason I'm awarding Foreman an error for it, even if technically it would have been inducing brain damage in a dead woman.
Taub suggested "infection" but her influenza was not what caused her symptoms, so no points were awarded. Taub does get credit for a diagnosis for declaring her rash a symptom of influenza, however, as House later remembered that she did indeed have it.
I'm assuming that the flu pills which killed Amber was not in her apartment to find, that the only ones she had were on her and lost in the bus crash, so Kutner and Thirteen lose no points for not finding them in the apartment. I'm still awarding House a point for suggesting they search there, however.
Thirteen almost connected a wrong tube on the patient, but Kutner stopped her. Thirteen doesn't lose a point because she didn't actually hurt the patient, but I'm giving Kutner a point.
House asks everyone what the significance of sherry could be in his dream, and Kutner suggests it may stand for Sharrie's Bar. I considered awarding a point to Kutner but didn't, as the information gained didn't really advance the case and it wasn't exactly a medical suggestion anyway.
House has an idea to regain his memory by using deep brain stimulation. Cuddy rejects this by saying it's too dangerous, but Wilson later persuades him to do it. It's through the procedure that House remembers Amber taking amandatine and makes the diagnosis. Cuddy, however, turns out to be right about the procedure being dangerous.



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