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.
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.
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.
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.
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.
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.
Initial Symptoms: Woman with bloody urine + loss of bladder control Diagnosis: Nephroptosis (floating kidney) (House)
Contributions by Team House (2): Sees patient's symptoms set in when she's lying down, diagnosis for nephroptosis Cameron (N/A): Not in episode Chase (0): None Foreman (2): Suggests leg pain caused by pinched nerve, suggests pheochromocytoma and Addison's disease Kutner (0): None Taub (0): None Thirteen (1): Sees patient is bleeding internally
Notes: House receives an error for insisting that the patient's conversion to Hasidic Judaism was a symptom of altered mental status. If he hadn't done so, he would probably have gotten the diagnosis sooner. Foreman receives credit for suggesting pheochromocytoma and later Addison's disease, conditions concerning adrenaline production and adrenal glands, because the symptoms under consideration were caused by strain on the right adrenal gland on top of the floating kidney. Chase came up with an idea to trick the patient into surgery to find the source of her internal bleeding, but House later said that he wouldn't have been able to detect it because the patient would have been lying down. Since the surgery wouldn't have found the problem, Chase receives no credit for his idea.
Initial Symptoms: Woman with severe right flank pain Diagnosis: Fat emboli (Kutner) from a broken toe (House)
Contributions by Team House (5): Sees patient's lung is collapsing, tells patient how to re-inflate lung, idea to have mechanic test patient's urine, idea to relieve intercranial pressure, diagnosis for broken toe Cameron (N/A): Not part of differential Chase (N/A): Not in episode Foreman (2): Idea to test kidney function, talks mechanic through tests on patient Kutner (1): Diagnosis for fat emboli Taub (0): None Thirteen (0): None
Notes: I'm assuming that the enlargened and inflamed lymph nodes were irrelevant findings not caused by the fat emboli. House doesn't receive an error for not making the patient take her socks off during the physical exam because they were examining her lymph nodes, which doesn't require examination of the feet. Except for Foreman, the Housepets were not involved in this case until the very end.
Contributions by Team House (2): Realizes patient must have breast tissue somewhere in her body other than her chest, confirms diagnosis with Risperidone Cameron (N/A): Not part of differential Chase (0): None Foreman (1): Sees patient has osteopetrosis Kutner (0): None Taub (2): Diagnosis for breast cancer, diagnosis for paraneoplastic syndrome Thirteen (0): None
Notes: Taub's diagnosis was based upon the idea that the surgeon may have missed tissue when s/he removed the patient's breasts. House realized that the patient may have breast tissue somewhere else, and found it using a drug that causes breast tissue swelling.
Initial Symptoms: Man with bloody cough + drug use Diagnosis: Autoimmune reaction (Kutner) to measles (House)
Contributions by Team House (3): Realizes blood clotting resulted from patient's drug use, idea to look at masses around patient's heart with surgery, diagnosis for measles Cameron (0): None Chase (1): Sees enlargened lymph nodes Foreman (1): Realizes patient is hiding multiple nicotine patches Kutner (1): Diagnosis for immune system overreaction Taub (2): Sees patient has clotting problem, suggests infection Thirteen (2): Finds bad blood fragments, performs lumbar puncture Volakis (1): Realizes that patient has been having complex partial seizures
Notes: Volakis was fired at the end of the episode. House's final team is Foreman, Kutner, Taub and Thirteen. To be honest, the medicine in this episode was so confusing I'm not sure how to award points at all. What ended up being the cause of the bloody cough? Kutner was the first to suggest the patient's symptoms were caused by overstimulation of his immune system. House later realized that measles were causing the reaction. I'm not sure how his immune system could have been weak enough for him to get measles, then strong enough to overreact to it. Cameron receives an error for failing to realize that her patient had a serious illness. Volakis received an error for leaving the patient alone with an oxygen tank, allowing him to blow himself up with a cigarette. Thirteen received credit for performing the lumbar puncture because, in the real world, that should have showed the measles infection in the patient's brain.
Initial Symptoms: Man with cardiac arrest Diagnosis: Lupus (House) + blood transfusion error (Kutner)
Contributions by Team House (2): Realizes bleeding during MRI was caused by magnet ripping swallowed key out of patient's intestines, diagnosis for lupus Cameron (N/A): Not part of differential Chase (N/A): Not part of differential Cole (1): Sees fluid in lungs and bleeding in kidney and thigh Foreman (2): Sees immunoglobulin levels are low, stops House from irradiating patient Kutner (3): Finds bleeding around patient's heart, diagnosis for bad blood transfusion, sees kidneys are shutting down Taub (0): None Thirteen (0): None Volakis (0): None
Notes: It's unclear whether it was Taub, Volakis, Kutner or Thirteen who performed the ultrasound to find bleeding around the patient's heart when he lost consciousness. I've awarded credit to Kutner because he was the one who told House they did it, implying (but not proving) it was his idea. Kutner originally suggests "bad blood" and "tainted blood", which throughout the episode seems to imply receiving the wrong blood type as well as infected blood. House realizes the patient received the wrong blood type during his transfusion because lupus made his blood type test results erroneous. House tests the blood the patient was transfused with by injecting himself with it. I considered awarding him credit, but in the end decided this particular test wasn't necessary for the lupus diagnosis. Cole was fired at the end of the episode.
This review is a partial one only, and will be completed when the transcript becomes available.
Initial Symptoms: Boy with craniofacial deformity + ventricular fibrillation Diagnosis: Lyme disease (Thirteen)
Contributions by Team House (0): None Cameron (N/A): Not part of differential Chase (0): None Cole (0): None Foreman (0): None Kutner (0): None Taub (0): None Thirteen (2): Diagnosis for Lyme disease, stayed during surgery Volakis (0): None
Notes: Samira Terzi, the CIA doctor House met in the previous episode, was hired and fired in this episode without contributing anything to the differential. Cuddy told the team to get a CT scan. Thirteen was the first to suggest Lyme disease and then spotted the rash before the patient's surgery. At that point she simply suspected the patient was ill without realizing it was Lyme disease, so she was awarded two credits instead of one.
At the beginning of the episode House was whisked away by the CIA to treat an ill agent. Eventually House diagnosed him with selenium poisoning from eating too many Brazil nuts and returned to PPTH at the end of the episode. Back in Princeton, Foreman lead the Housepets. This analysis will cover their patient only.
Contributions by Team House (2): Diagnosis for thallium poisoning by Brennan Brennan (0): None (see notes) Cameron (0): None Chase (0): None Cole (0): None Foreman (2): Diagnosis for heat stroke, realizes patient doesn't have polio Kutner (0): None Taub (0): None Thirteen (0): None Volakis (0): None
Notes: Should I even bother pointing out that Brennan was in error for poisoning the patient with thallium and faking the positive polio test result? It doesn't matter, because Brennan is gone and hopefully in prison. The Housepets can be forgiven for not considering the possibility that someone in the hospital was poisoning their patient. House probably realized that the patient only had heat stroke when he accepted her as a patient.
Notes: Foreman rejoined the team in this episode. The condition House calls Giovannini Mirror Syndrome is real, but is one isolated case. Its discoverers called it environmental dependency syndrome. The real case was caused by brain damage, but in this episode it wasn't clear if the patient's illness caused it or if it was pre-existing. I've chosen to believe it was separate from his infection and therefore count it as a separate diagnosis. It was Brennan's idea to perform an ultrasound on the patient to look for abscesses. What was found was a lump of congealed blood that did not forward the diagnosis, however, so Brennan receives no credit. I wasn't sure whether to give House a credit for trying to find the patient's travel history by testing his antibodies. The antibodies showed that the patient had been to Ohio, and in the end they found out he was from Ohio so I did give House the credit. Kutner receives an error for not realizing that the patient had real memories. Foreman suggested a heart biopsy, but since it gave them no information he doesn't receive credit for it.
Initial Symptoms: Woman with grand mal seizure + hallucinations Diagnosis: Ergot poisoning (Volakis)
Contributions by Team House (2): Diagnoses patient's late mother with Parkinson's disease, realizes patient's illness isn't vascular Brennan (0): None Cameron (0): None Chase (1): Sees spleen is enlargened Cole (1): Sees liver is necrotic Dobson (3): Realizes patient is having delusions as well as hallucinations, idea to question play along with the patient's delusion to get family history, says blood supply to liver and spleen are being cut off Foreman (N/A): Not involved in the diagnosis Kutner (0): None Taub (0): None Thirteen (0): None Volakis (1): Diagnosis for ergotism
Notes: House didn't order anyone to search the patient's home or check her food, so how did Cole know that the patient only ate organic food? He didn't realize the significance of this, so I'm not awarding him points. House and Dobson thinking alike was a running theme in this episode, so theoretically Dobson's points are House's as well. House is given credit for his post mortem diagnosis of the patient's mother because eliminating genetic illnesses was part of the diagnostic process. I'm not sure if the visceral angiogram House ordered would have ruled out vasculitis or not, but since House realized this without the angiogram results anyway he doesn't receive extra credit. Some viewers felt that House realized the correct diagnosis moments before Volakis did. I didn't see evidence to prove that, so Volakis is given credit and not House. Dobson was fired at the end of this episode.
Initial Symptoms: Man with Spinal Muscular Atrophy (SMA) + fainting Diagnosis:Strongyloides (threadworms) (House + Thirteen)
Contributions by Team House (3): Diagnosis for Strongyloides, spots necrosis in cervical lymph node, realizes dog died from eating patient's medication Brennan (0): None Cameron (1): Idea for xenodiagnosis Chase (0): None Cole (0): None Desai (0): None Dobson (0): None Foreman (N/A): Not involved in the diagnosis Kutner (2): Suggests patient contracted disease in Thailand, idea to test stool Taub (1): Realizes patient's kidneys are failing Thirteen(4): Diagnosis for Strongyloides, says trouble swallowing was caused by SMA, realizes patient's lungs are filling with fluid, knows lung fluid should be bloody if patient has cancer Twin A (1): Idea to put patient on tilt table Twin B (0): None Volakis (0): None
Notes: House had already diagnosed the patient before Thirteen did. Thirteen received an error for not making sure the patient took his medication, though it's unclear why he didn't. The candidates were working in two teams throughout the first half of the episode. It's unclear whose idea it was to test the patient's stool, but I have to give it to someone so I gave it to Kutner. After only two weeks the worms shouldn't have been in the patient's stool, but it's where to start looking for parasites. Volakis is not getting credit for asking House's former fellows for help! The twins and Desai were fired at the end of the episode. In a different hospital, Foreman diagnoses a case of anaplastic large cell lymphoma and saves his patient - for which he is fired, ironically.
House begins this episode with 27 fellowship applicants, which he is narrowing down to two or three over a series of episodes. Starting now I am listing the nine that will be crucial for the following episodes and will cross them off as they are eliminated by House. Because I don't know if the original Housepets will rejoin the Department of Diagnostic Medicine, I will continue to list them as well. From now on I'll list them all in alphabetical order.
The nine prospective Housepets are: Travis Brennan (#37), epidemiologist nicknamed Grumpy Jeffery Cole (#18), geneticist nicknamed Big Love Jodi Desai (#32), veterinarian Henry Dobson (#26), not a doctor RemyHadley, called Thirteen (#13), internist (her name can be seen on Chase's betting slips in Mirror, Mirror) Lawrence Kutner (#6/9), rehabilitative and sports medicine specialist Chris Taub (#39), plastic surgeon Twins (#15A &15B), pediatric endocrinologists Amber Volakis (#24), interventional radiologist nicknamed Cutthroat Bitch
Initial Symptoms: Woman with synaesthesia Diagnoses: Von Hipple-Lindau disease (Chase) + pheochromacytoma (Chase)
Contributions by Team House (2): Idea to test patient's liver by stressing it, performs auscultatory percussion to detect masses in lungs Brennan (0):None Desai (0): None Cameron (0): None Chase (2): Diagnosis for Von Hipple-Lindau disease, diagnosis for pheochromacytoma Cole (0): None Dobson (0):None Foreman (N/A): Not in episode Kutner (2): Realizes patient is having a heart attack, suggests using alcohol to stress liver Taub (3): Notices elevated red blood count, talks patient out of chapel, idea to examine lungs as part of breast implant surgery Thirteen (2): Suggests "hormone overproduction" caused atrial flutter, idea to administer oxygen in stress test room for medical records falsification Twin A (0): None Twin B (0): None Volakis (1): Suggests patient has problem with her liver
Notes: At the end of the episode it is revealed that both Chase and Cameron are still at PPTH, Chase as a surgeon and Cameron as an attending in the Emergency department (I'm not sure which is more ridiculous). Foreman is running a diagnostic group in a different hospital. Pheochromacytomas are associated with some types of Von Hipple-Lindau disease. House started with 27 fellowship candidate in this episode, which were narrowed down to these nine by the end. Some have argued that during the surgery House did know the correct diagnoses before Chase revealed them. There's no way to be sure and I myself saw no proof of it, so I'm awarding these diagnoses to Chase.
Contributions by Team House (7): Diagnosis for serotonin syndrome from MAOI/Demerol interaction, diagnosis for delirium tremens from alcohol withdrawal, sees patient has internal bleeding, notices enlargened uterus, diagnosis for Warfarin/estrogen interaction, spots eosinophilic granuloma, diagnosis for mistaken identity Chase (N/A): Not in episode Cameron (N/A): Not in episode Foreman (N/A): Not in episode
Notes: House was working alone in this episode (hence the title) with no team and only Cuddy and a janitor helping him. Cuddy realized that the patient had pancreatitis, and made the diagnosis for cephalosporin allergy from the lump House spotted on the patient's arm.
Hello! I'm a simple fan who became interested in the professional dynamics of House's team. I'm not a fan of any particular Housepet, as I call them, so my reviews are as unbiased as I could make them. This was a surprisingly subjective task, however, so feel free to politely disagree with me.