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House Medbabble
Warning: very nitpicky post. I'm a PMS victim; I guess that's where this came from. It's all true, however. To my knowledge, anyway.
House is a great series for the slash and the angst, the snarky, biting sarcasm and the cute oncologists, but the medicine? The medicine's... weird. House just treated a pneumothorax by putting in a chest tube. What happened to the nifty long needle that gets jammed into the patient's chest and makes the lung pop? It's easier and faster than a chest tube, and it doesn't leave a scar. And House knew the guy had a pneumothorax because he explained it before putting in the chest tube - instead of just using the medical term and avoiding wasting time the guy he was treating might not have had - so he didn't put in the chest tube because he thought the guy was bleeding into his chest. He knew the nifty long needle would have done the job.
There's other things. Almost every tumor House diagnoses triggers an autoimmune reaction in the patient's body, with antibodies attacking healthy organs instead of the tumor cells. And each time he diagnoses this, he's very eager to point out that it's a) something that happens very rarely, and b) a terribly brilliant idea that just came to him. I get it, he's the rare-cases-guy, but after three seasons - meaning three years of diagnosing seemingly unexplicable cases - House might have put "tumor messing with immune system" on his routine list for the differential diagnosis.
Same as Lupus. Every time they do the differential diagnosis, Lupus pops up sooner or later. And obviously, testing for ANA is a good enough even though not perfect way to determine whether a person has Lupus or not. Now if they are a responsible hospital, which I assume they are, or they'd be kicked out of business, they do a routine blood screen on every patient that comes in. So, why doesn't House put the ANA test on his department's blood screens per default? It'd probably save him a whole carload of pacing back and forth in his office and bickering with his staff, and he wouldn't even have to write a note on the order form. He'd just filter out the Lupus cases from the beginning.
Then there's the thing about what's hypo- or hypertension, hypoglycaemia or brady- or tachykardia (I have not yet seen a case of hyperglycaemia in House, so I don't know whether they'd screw that up).
There's an episode in which House does some weird, incredibly risky test to find something out, and it involves lowering the patient's blood sugar. The monitor starts screaming at 45, and House stops the test at something like 35. Now maybe I'm weird that way, but I was walking and talking and having a pretty coherent conversation with my doctor at a glucose level of 18. The other day, I was perfectly lucid at 25. House's no saint, and he is certainly not someone who's afraid of risks. He wouldn't have stopped at 35.
They usually get the brady- or tachycardia right; in cases it's actually supposed to be brady- or tachycardia. However, in one episode Chase is concerned about a patient's alleged tachycardia at a heart rate of 104. A thin, skinny woman. Thin, skinny women often have high heart rates; don't ask me why, but they do, except when they're very much into sports, then they usually have pretty low heart rates. Either way, a heart rate of 104 is nothing to be very concerned about in an average adult.
The hypertension freaked me out in a season 3 episode, when they let a little kid have a BP of something like 180/110. I'm sure kids can get such a high BP, but I am also sure that at least Cameron would have been more concerned about that (House was doing his thing again, pushing the kids BP to skyrocket). Besides, they would have had to check for kidney damage, since the kid had been having these hypertensive episodes for some time. I admit, I'm not 100% sure they didn't do that, but I don't think I remember anything about it.
And they have psychic monitors. Those monitors show readings like "heart rate: 78, BP: 100/70", and suddenly they start screaming bloody murder, and then the readings drop. But only after one of the doctors shouted something about the patient crashing and calling a code. They should try and train those monitors, see whether they can extend their ability of premonition. They would have monitors that actually predict crashes and could do a prophylactic intubation and have the epi and the defibrillator already standing by.
Oh, and in one episode, they completely ignored the fact that eight minutes of resuscitation almost certainly causes brain damager. No, worse. They didn't ignore it and let Foreman brag on about it, until House did one of his magic tricks and diagnosed the kid, and voila! together with the inflamated encephalitis or whatever the brain damage disappeared as well. Nice.
I like House. I really do. But so totally not for the medicine...
House is a great series for the slash and the angst, the snarky, biting sarcasm and the cute oncologists, but the medicine? The medicine's... weird. House just treated a pneumothorax by putting in a chest tube. What happened to the nifty long needle that gets jammed into the patient's chest and makes the lung pop? It's easier and faster than a chest tube, and it doesn't leave a scar. And House knew the guy had a pneumothorax because he explained it before putting in the chest tube - instead of just using the medical term and avoiding wasting time the guy he was treating might not have had - so he didn't put in the chest tube because he thought the guy was bleeding into his chest. He knew the nifty long needle would have done the job.
There's other things. Almost every tumor House diagnoses triggers an autoimmune reaction in the patient's body, with antibodies attacking healthy organs instead of the tumor cells. And each time he diagnoses this, he's very eager to point out that it's a) something that happens very rarely, and b) a terribly brilliant idea that just came to him. I get it, he's the rare-cases-guy, but after three seasons - meaning three years of diagnosing seemingly unexplicable cases - House might have put "tumor messing with immune system" on his routine list for the differential diagnosis.
Same as Lupus. Every time they do the differential diagnosis, Lupus pops up sooner or later. And obviously, testing for ANA is a good enough even though not perfect way to determine whether a person has Lupus or not. Now if they are a responsible hospital, which I assume they are, or they'd be kicked out of business, they do a routine blood screen on every patient that comes in. So, why doesn't House put the ANA test on his department's blood screens per default? It'd probably save him a whole carload of pacing back and forth in his office and bickering with his staff, and he wouldn't even have to write a note on the order form. He'd just filter out the Lupus cases from the beginning.
Then there's the thing about what's hypo- or hypertension, hypoglycaemia or brady- or tachykardia (I have not yet seen a case of hyperglycaemia in House, so I don't know whether they'd screw that up).
There's an episode in which House does some weird, incredibly risky test to find something out, and it involves lowering the patient's blood sugar. The monitor starts screaming at 45, and House stops the test at something like 35. Now maybe I'm weird that way, but I was walking and talking and having a pretty coherent conversation with my doctor at a glucose level of 18. The other day, I was perfectly lucid at 25. House's no saint, and he is certainly not someone who's afraid of risks. He wouldn't have stopped at 35.
They usually get the brady- or tachycardia right; in cases it's actually supposed to be brady- or tachycardia. However, in one episode Chase is concerned about a patient's alleged tachycardia at a heart rate of 104. A thin, skinny woman. Thin, skinny women often have high heart rates; don't ask me why, but they do, except when they're very much into sports, then they usually have pretty low heart rates. Either way, a heart rate of 104 is nothing to be very concerned about in an average adult.
The hypertension freaked me out in a season 3 episode, when they let a little kid have a BP of something like 180/110. I'm sure kids can get such a high BP, but I am also sure that at least Cameron would have been more concerned about that (House was doing his thing again, pushing the kids BP to skyrocket). Besides, they would have had to check for kidney damage, since the kid had been having these hypertensive episodes for some time. I admit, I'm not 100% sure they didn't do that, but I don't think I remember anything about it.
And they have psychic monitors. Those monitors show readings like "heart rate: 78, BP: 100/70", and suddenly they start screaming bloody murder, and then the readings drop. But only after one of the doctors shouted something about the patient crashing and calling a code. They should try and train those monitors, see whether they can extend their ability of premonition. They would have monitors that actually predict crashes and could do a prophylactic intubation and have the epi and the defibrillator already standing by.
Oh, and in one episode, they completely ignored the fact that eight minutes of resuscitation almost certainly causes brain damager. No, worse. They didn't ignore it and let Foreman brag on about it, until House did one of his magic tricks and diagnosed the kid, and voila! together with the inflamated encephalitis or whatever the brain damage disappeared as well. Nice.
I like House. I really do. But so totally not for the medicine...