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Update: Season 5, Episodes 1-6

I haven't been posting my analyses for Season 5 for two reasons. First, I haven't been able to find transcripts. Second, the medicine has gotten so confusing that sometimes I'm not even sure what the final diagnosis is. Here is a breakdown of diagnoses for the first six episodes of Season 5, but this doesn't include points. Sorry. I hope I can go back to analysis one day, but in the meantime I'm grateful to Scott at Polite Dissent for posting medical reviews of the show. What follows is pretty much cribbed from him, and the Fox recaps.

5.01 Dying Changes Everything
Initial Symptoms: Woman with hallucinations, abdominal pain, anemia, bradycardia, memory loss
Diagnosis: Ectopic pregnancy (House) + lepromatous leprosy (House)

Notes: How could the team have missed the ectopic pregnancy? Kutner should lose a point for that.
Foreman should lose a point for giving the patient chemotherapy which would have killed her if House hadn't diagnosed her infection in time.
Someone suggested she had an infection picked up while traveling, which was the case.

5.02 Not Cancer
Initial symptoms: Two patients who received organs from the same donor. Four other patients who received organs from this donor had died.
Diagnosis: Cancer stem cells from the donor (House)

Notes: The team was trying to save two patients. One died before the diagnosis was made, and one was saved.
I couldn't make any sense at all out of Kutner's intestinal perforation theory, and neither could the physician who writes the medical reviews.
At the beginning they said no blood is transmitted in a corneal transplant, so how did the cornea transplant receipient get the donor's cancer cells in her brain?

5.03 Adverse Events
Initial Symptoms: Man with visual agnosia
Diagnosis: Experimental drug interactions (House) + bezoar (House)

Notes: House deduced that the patient was in different experimental drug trials. I think he also figured out that the patient had a bezoar but I don't remember.
Taub earns a point for confirming from the patient's old paintings that the patient's symptoms are caused by drug interactions.

5.04 Birthmarks
Initial Symptoms: Woman with abdominal pain + vomiting blood
Diagnosis: Pins in patient's brain (House + Wilson)

Notes: I'm attributing the final diagnosis to both House and Wilson because House's diagnosis followed from Wilson's realization that the patient's parents tried to kill her when she was born.
I'm really uncertain about what caused the patient's symptoms here. At first House suggested that she had iron overload, but in the end it was all attributed to the pins in her brain. Was it one or the other? Or both? I think we're supposed to believe it was just the pins, that's how the Fox recap reads, but that shouldn't have caused all those symptoms.

5.05 Lucky Thirteen
Initial Symptoms: Woman with tonic clonic seizure, severe fatigue, history of retinal vein occlusion
Diagnosis: Sjogren's Syndrome (House)

Notes: I really had a problem with House's behaviour this episode. I thought he was torturing the patient for fun.
Why would the lung cysts have smooth muscle cells in them?

5.06 Joy
Initial Symptoms: Man with blackouts + hallucinations
Diagnosis: Familial Mediterranean Fever (House)

Notes: House deduced that the patient's daughter suffered the same illness as he did, so this case counts as two patients.
The symptoms don't match the diagnosis at all.
Cuddy met with a woman whose unborn baby she wanted to adopt. With Cameron's help she ended up diagnosing the unborn baby with underdeveloped lungs and the mother with placental abruption. This isn't part of the analysis because it wasn't House's team working on the case, but still worthy of note.



Anonymous Anonymous said...

Exactly! The episode with Familial Mediterranean Fever had me scratching my head for ages - I searched through A LOT of medical databases but found nothing that could even remotely suggest the "sleepwalking" symptom on the show - nothing about the disease seems to be neurologically related!

December 23, 2008 8:31 AM  
Anonymous Anonymous said...

As I understand it... Kutner suggested a genetic anomaly in the lining of the intestine that the granddaughter? could have inherited (a little far fetched?). I can't quite remember as I don't have the episode but as far as I can recall that genetic anomaly would have allowed whatever they had suspected to pass into the guys entire system.

Though I still do not understand how the corneal transplant got her what everyone else had... even though I watched the episode about 4 times after it aired to try and make sense of it.

Anyways :P Thank you so much for these reviews/recaps!

January 3, 2009 1:28 PM  
Anonymous Anonymous said...

My son has Familial Mediterranean Fever and had an attack in his brain. He had some strange neurological effects from it. He was smelling things that weren't supposed to smell like they did. He also had vision disturbances. I have not heard of the symptoms that was on House, but I know it can settle anywhere and causes severe pain.

March 4, 2009 6:45 PM  
Anonymous Anonymous said...

Familial Mediterranean Fever causes inflammation in various soft tissues around the body. If this swelling were to spread to the patient's brain stem both the sleepwalking and anhedonia are documented symptoms. The chances of both father and daughter suffering from not only undiagnosed FMV, but from an attack in the brain is extremely unlikely.

June 16, 2009 6:29 PM  
Anonymous Anonymous said...

I think whoever writes for House needs to be replaced with somebody that really knows something about medicine. I have Familial Mediterranean Fever; it is a recessive genetic disease. It is not a virus. Both my parents were carriers. I don't hallucinate and I am not anhedonic.

Since FMF is such a rare disease, and such a great mimic, it behooves me to know everything about it. I read all the medical literature and stay on top of all developments.

The symptoms on House had no relationship with real life. Yes, it is possible to have encephalitis or meningitis caused by FMF inflammation, but NOT on a long term basis. The attack would have been short and severe, the patient would have ended up in the hospital, (Nobody just walks around and works and goes to school with acute encephalitis, folks.) and on discharge would have been vastly improved whether the physicians were astute enough to diagnose FMF or whether the flare abated on its own. FMF flares are short and acute, not long-term and chronic.

The House episode did a great disservice to those of us who have this condition. I've been afraid to tell people I have FMF since it aired. Most attacks resemble a "hot" abdomen or pleurisy. Many of us have had unnecessary abdominal surgeries, including appendectomies, spleen removals, gallbladder surgery. The show could have been just as exciting if House had saved the daughter from an impending splenectomy...and a lot more realistic.

December 7, 2009 3:58 PM  

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