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House's Team

Season Four Summary

Thanks to the writers' strike there were only 16 episodes this season, half of which were dedicated to House's Survivor game. The second half of the season featured House's final motley team of three new Housepets, Hadley (Thirteen) the internist, the Kutner the rehabilitative and sports medicine specialist, and Taub the plastic surgeon. Foreman the neurologist rejoined the team as well and Chase and Cameron remained on the sidelines in Surgery and Emergency Medicine respectively, contributing only rarely.
House was away treating his own patient in Whatever It Takes, and Foreman diagnosed a patient in another hospital in 97 Seconds. These two cases were not covered here, and except for them there was one patient per episode.

Patients treated: 16
Lives saved: 14
The patient in Wilson's Heart died because her body was too damaged to survive, and the patient in 97 Seconds died because competition between the fellowship contestants interfered with his care.

House: 16 diagnoses + 33 credits - 1 error = 48 total
Kutner: 4 diagnoses + 10 credites - 1 error = 13 total
Thirteen: 2 diagnoses + 11 credits - 1 error = 12 total
Foreman: 1 diagnosis + 11 credits - 1 error = 11 total
Taub: 3 diagnoses + 6 credits = 9 total
Chase: 2 diagnoses + 3 credits = 5 total
Cameron: 2 credits - 1 error = 1 total

My conclusions: After four seasons, 96 patients have been treated by House and his pets and 82 lives were saved by them.
The new team started off better than the originals did, because they had to. After the first season they're all pretty equal to each other. Taub has less overall points, but he also gets less focus than the other characters.

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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.


4.15 House's Head

This review is a partial one only, and will be completed when/if a transcript becomes available.

Initial Symptoms: Man with injuries from traffic accident + leg paralysis
Diagnosis: Air embolism (House)

Contributions by Team
House (2): Diagnosis for air embolism, idea for removing it
Cameron (0): None
Chase (0): None
Foreman (0): None
Kutner (0): None
Taub (0): None
Thirteen (0): None

Notes: House begins the episode convinced that one of the passengers on a crashed bus is ill, and that person appears to be the bus driver. House diagnoses him only to realize that he's not the patient he was looking for. This review focuses on the bus driver's case, the medicine of which I found confusing but I did the best I could here.
Kudos to Thirteen (now given a name: Hadley) for performing the procedure on the patient, but I honestly can't remember the circumstances on how she came to be the only person in the room to do it. For now she won't receive a point, but this may change when I see the episode again.
To find the ill passenger, who is revealed to be Amber at the end, House has Chase hypnotize him. When Amber appears in House's hypnotic vision, however, Chase tells House to ignore her and therefore prevents House from realizing the truth. If I were awarding points for this part of the diagnosis Chase would get a point for knowing how to perform hypnosis (is there anything Chase can't do this season?) but would lose one for influencing House's recall during the procedure.
While I laughed out loud when Cuddy told House to go home and rest after discovering his skull was fractured and when Foreman the neurologist told Kutner to forget House's condition, again those aren't part of the differential here.


4.14 Living The Dream

Initial Symptoms: Man with loss of peripheral vision
Diagnosis: Allergic vasculitis (House) + allergy to quinine (House)

Contributions by Team
House (4): Notices patient has peripheral vision loss, sees patient is delirious, diagnosis for allergic vasculitis, diagnosis for allergy to quinine
Cameron (1): Idea to test thyroid with iodine uptake test
Chase (N/A): Not part of differential
Foreman (1): Notices patient is using his fingers in an odd way
Kutner (1): Sees that patient's kidneys aren't filtering iodine
Taub (0): None
Thirteen (0): None

Notes: I'm calling the vasculitis and the allergy two different diagnoses, because it was possible to diagnose one without diagnosing the other, so House gets credit for both.
I'm assuming that Foreman's suggestion about the patient having a neurological problem based on how he was holding his stethoscope was correct, since he did have other neurological symptoms.
Cameron makes suggestions for testing the patient for nerve entrapment when his foot becomes numb, and for testing his thyroid when Graves Diseases is suspected. By my method of working backwards from the correct diagnosis, these ideas would usually not receive credit. Cameron's idea for the iodine uptake test prevented House from destroying the patient's healthy thyroid, however, so I'm giving her credit for it.


4.13 No More Mister Nice Guy

This review is a partial one only, and will be completed when/if a transcript becomes available.

Initial Symptoms: Man with nystagmus + syncope + dysgeusia
Diagnosis: Chagas disease (Kutner)

Contributions by Team
House (1): Realizes patient's niceness is a neurological symptom
Cameron (0): None
Chase (0): None
Foreman (0): None
Kutner (2): Runs VDRL test, diagnosis for Chagas disease
Taub (0): None
Thirteen (1): Idea to perform bubble test to test for heart defect

Notes: Given that Cameron was working the ER without nurses, she can be forgiven for classifying a fainting patient as "low priority".
I'm assuming that all of the patient's symptoms were caused by Chagas disease, because chronic infection can cause heart and intestinal problems as well as the encephalitis that caused the neurological problems. Thirteen therefore gets credit for thinking of heart problems and proposing the bubble test, which when performed appears to have triggered Kutner's epiphany about Chagas disease. Kutner is awarded a point for running the VDRL test for neurosyphilis because Chagas disease also yields a false positive with this test; so do many other conditions, but that wasn't mentioned on the show.



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