House

[bernard]

Posted by Barrett<script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2004,10,23,8,6,0), dfrm, tfrm, 0, 0, 0, 0)); </script> (Member # 67) on 23-11-2004 15:06<noscript>November 23, 2004 08:06 AM</noscript>:

Anybody who has been to one of my workshops can tell you that I honestly feel most therapists have the same problem-they don’t watch enough TV.

In an effort to rectify this I thought I might begin a regular feature here inspired by my new favorite program, “House” (Fox TV Tuesdays 8PM). I just watched the pilot episode and was immediately struck by the dialogue and dramatic tension. More importantly, the nature of this show lends itself to discussions of clinical life more readily than anything else I’ve ever seen-and I’ve seen a lot.

Gregory House M.D. is the head of diagnostic medicine at a large hospital. No tie, a six-day-old beard, a permanent, painful limp reduced with a simple wooden cane and a persistent black mood define this man and match the caustic wit and sarcastic asides that form most of his dialogue. Despite his open hostility toward the administration and any aspect of mundane practice (“Your billings are practically nonexistent!” says his long-suffering boss), his clinical reasoning skills are so good that he remains in his job and is given a team of bright young physicians to order around.

In the first episode House is talked into considering the case of a young woman whose seizure disorder remains undiagnosed. The show then revolves around House’s reasoning and actions in an effort to discover the underlying source of the seizures and offer her a cure.

House speaks to his staff in much the same way he does his patients, never hesitating to call them morons or idiots. However, late in the show he refers to himself “a jerk,” demonstrating that he’s aware of his own failings as a human being though he has little doubt about his own intellectual or observational skills. When asked “Shouldn’t we talk to the patient before we start diagnosing?” he quickly says, “Everybody lies,” and then “If we don’t talk to them they can’t lie to us-and we can’t lie to them.” I’ve not said this to my classes specifically but I point out that history taking is full of inaccuracy because of its dependence on memory (See “History and Imagination” on my site). I suggest that this is just a human failing but House, being who he is, characterizes it otherwise. In other words, he makes me feel a little better about my own impatience with others-mainly because he’s worse.

Twice while sifting through the data and findings House arrives at a conclusion that cannot be confirmed given what is known. “How can you prove that?” he’s asked. “I’ll prove it by treating it, and if that doesn’t work, we’ll know something else” he says, and he’s right. This sort of approach is characterized as irresponsible by others but I think it’s common in internal medicine. I know many therapists would object to it but it’s something I think we should often consider in order to speed up care. At another point while fighting for his unique idea regarding the problem he argues, “It fits-it explains everything.” This is abductive reasoning (See Discovery and Abduction on my site).

There’s more. House’s obsession with cable TV, especially the soap opera “General Hospital,” his penchant for tabloid newspapers (“doing research,” he calls it), his willingness to sit and wait for the patient to reveal more about their condition by growing worse in a certain way (when his colleague objects to the lack of care he says, “Well, I got nothin’. I especially liked this line) and his management of his own pain by continuously gulping pain pills, dry and in public. What’s not to like about this guy?

The second episode is on tonight and I’m hoping what I’ve written here along with that will generate some discussion. If it does I will have accomplished two things. First, the therapy community will learn a bit more about diagnostic reasoning, and, second, it will begin to watch more TV.

I can only hope.
<hr> Posted by Luke R (Member # 3561) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2004,10,23,16,45,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 23-11-2004 23:45<noscript>November 23, 2004 04:45 PM</noscript>:

Barrett,
I work for an old osteopath who is exactly like Dr House. Patients don't seem to care that he is such a cynical, sarcastic old grump because he just so good. His verbal history taking consists of "Where does it hurt? What does it feel like? How did it start?". The rest he does with his hands. He often tells patients that he's a 'crap osteopath' and he is wasting their time, but when he puts his hands on you, you know this isn't true.

I'll probably have to wait about 3 years for this program to reach Australia, and I'll have to buy a TV too. Can't wait to hear about the second episode.

Luke
<hr> Posted by dorko2 (Member # 2346) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2004,10,23,22,16,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 24-11-2004 05:16<noscript>November 23, 2004 10:16 PM</noscript>:

Pops-

Enjoy it while it lasts. This show is going to FLOP.

Still keepin' it real here in Missouri. Trying to watch my prescribed dose of television every night.

-Alex
<hr> Posted by Jon Newman (Member # 3148) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2004,10,23,23,0,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 24-11-2004 06:00<noscript>November 23, 2004 11:00 PM</noscript>:

Hi Alex,

Speaking of flops, there was an extremely short lived show (I believe on Fox) that had, as its main character, a fellow who was raised in a cardboard box with a small window cut out of it through which he could see a TV. The TV ran all the time and the boy did not really have much personal contact. The show picks up with this guy as an adult. He grew up to be a bit strange but possessed a profound understanding of human nature. To make the show interesting (apparently not interesting enough) the character blurred the line between good and evil, or less dramatically right and wrong, but it seemed that at the end of shows the correct thing always happened.

This show has the same quality of main character. So you may be right, it will flop. Not to mention that it asks people to pay attention beyond the normal show, another sign that it's doomed. Although if it was a cartoon it might fly; why is that?

Favorite line from the show was something along the line of (and in a sarcastic tone), "Feel free to disregard any symptoms that makes your job harder."

jon

By the way, good luck with your new pursuit.
<hr> Posted by Jon Newman (Member # 3148) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2004,10,24,8,6,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 24-11-2004 15:06<noscript>November 24, 2004 08:06 AM</noscript>:

More observations: The show caricaturizes the clinical reasoning process for everyone to see. The show illustrates that getting an authentic history is essential but often impossible without pushing people, sometimes uncomfortably, with objective evidence and logic. The show demonstrates unless this is done, inadequate/wrong treatment could be rendered. The show demonstrates that truth seeking is the goal (versus shaping reality to a 'truth'). The clinician must have a passion for understanding the truth.

Others can add their thoughts. Of course all the above is dramatized/idealized but this does not render the points made invalid.

As I think about it, I'll be suprised if the thread goes anywhere, it seems that few with access to watching the show participate regularly.

jon
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2004,10,24,8,28,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 24-11-2004 15:28<noscript>November 24, 2004 08:28 AM</noscript>:

Jon,

I remember this show and though I couldn’t think of the title last night I wakened this morning with the name “Prophet” in my head, and I’m pretty sure this is right. As with “House” it was the last name of the main character. I can still recall the final scene of the first episode. After a day full of conniving, scheming and remarkable success in business, Prophet is shown late at night, alone, curled up, content-and in a cardboard box. Brilliant. To me, anyway. While some might blame the TV watching for Prophet’s lack of a moral compass, I don’t agree. I think it was the cardboard. Think about it.

By the way, the line was “Feel free to exclude any symptom if it makes your job easier.” One of my favorites as well.

Alex’s prediction of failure for this show is fairly safe given the apparent thoughtfulness of the public. After all, it isn’t “Desperate Housewives.” However, while it’s still on we might see what we can learn from House’s demeanor and thought processes. I looked over my notes (yes, I actually took notes during the show though I’m not actually allowed to do this in the movie theater) and noticed a theme in the second episode-lies.

It begins with House “lying” on a treatment table hiding from a waiting room full of patients. He’s reading a tabloid, presumably full of lies. He finds his name has been forged to a letter allowing a complex case of brain dysfunction to be admitted to his service. He takes this lie in stride but explodes when he discovers the parents of the patient have neglected to report a head trauma suffered by their son. “Why bother (to tell the truth)? he says. On the verge of abandoning the patient, he notices a myoclonic jerk of the boy’s leg and is drawn to investigate the case further. I was reminded of Isaac Asimov’s observation: “The most exciting words in scientific discovery aren’t “Eureka-I’ve found it!” but rather, “That’s funny…”

The convoluted path toward the discovery of this patient’s essential diagnosis is littered with further deception. A young mother says she didn’t have her child vaccinated because, in her opinion, the drug companies are lying about the prevalence of childhood disease (you’ll notice this conversation plants the seed for House’s final diagnosis), another clinic patient lies about his reasons for seeking care so far from home and finds eventually that House defeats him simply because he is a better liar, the parents lie about their familial relationship to the patient and House lies in order to discover the truth. When confronted by the administrator he doesn’t deny it but rather asks her to weigh one lie against another and decide which was worse. In the first episode House says enigmatically, “The truth begins in lies,” and I’m beginning to see what he means.

I thought the end of the show rivaled that last scene in “Prophet.” We see House on the sidelines at his now recovered patient’s lacrosse game. As the boy makes his way toward a goal House is intently saying, “Wheels, wheels,” referring to the player’s legs as they race along. The goal is scored, the crowd cheers, House actually looks pleased-and then a distant view reveals House alone on the field, imagining the whole thing.

Anyone have an idea what’s going on here?

Alex,

I enjoyed seeing you here but look forward to your arrival at the airport tomorrow even more.

Dad
<hr> Posted by Jon Newman (Member # 3148) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2004,10,24,9,57,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 24-11-2004 16:57<noscript>November 24, 2004 09:57 AM</noscript>:

Hi Barrett,

Nice analysis; Ebert has nothing on you. I think if there is such a thing as high redefinition, you commit that when you encourage people to "watch" TV.

Alex I sometimes think I should send you a sympathy card.

Happy holiday.

jon
<hr> Posted by Jon Newman (Member # 3148) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2004,10,26,11,0,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 26-11-2004 18:00<noscript>November 26, 2004 11:00 AM</noscript>:

Barrett asks,

"Anyone have an idea what’s going on here?"

House is unable to actually run himself but this does not stop him from creatively running and this character is definitely a goal scorer in his own way.

I especially liked the overt focus on ideomotor expression as his imaginary runner was about to score. As you noted, the character actually seemed pleased, something we rarely see from the character.

What was it about being alone on the field that ended up leading him to being pleased? Why isn't he this way in other venues?

jon
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2004,10,26,12,35,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 26-11-2004 19:35<noscript>November 26, 2004 12:35 PM</noscript>:

Well, let's see who he saves next week.

House is a man who he teaches but his relationship to his students is, uh, fractious. Conversely,the young teacher in the first episode embraces and is embraced by them. The young athlete this past week runs when House can only limp.

Perhaps it's too obvious that the writers are working to complete this character vicariously through his patients, but it seems to work so far.
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2004,11,1,21,7,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 02-12-2004 04:07<noscript>December 01, 2004 09:07 PM</noscript>:

Another episode full of the kind of sarcasm and verbal terror only Gregory House M.D. seems allowed to deliver. I still like this show, though the reviewer on Slate.com agrees with my son that it is doomed and, in fact, should be. Check out this link http://slate.msn.com/id/2110251/

Despite that, I found plenty to reinforce my earlier ideas about the nature of House’s method and way of being in the world.

The episode concerns a young man suffering from a variety of symptoms that House agrees to see because his response to care is sufficiently “weird.” As usual, it is the challenge of odd symptomotology that intrigues him. He announces to a roomful of patients in the waiting room that his persistent use of Vicodan (not certain how to spell that) means that he “doesn’t have a pain management problem, just a pain problem.” I’m still trying to decipher this. It was interesting to watch him melt when a patient admits she “just doesn’t like being told what to do.” In response he displays an understanding and grants her wishes for care. Could this be empathy from its greatest enemy?

Then there’s what I’ve come to feel might be House’s ability to infect the minds of his colleagues, not by persuasion but simply because he’s worn down their ordinary defenses. His friend, another doctor who rages against his tendency to treat without the “proof” that tests might reveal says, “Screw the tests-do an exploratory laporoscopy and see what’s in there.” Sounds like House when he says, “Tests take time-treatment’s quicker.”

There’s more: “Do you want a doctor who holds your hand as you die or ignore you as you get better?” I mentioned this line to my class in Detroit today and got an audible gasp from a woman in the third row.

Maybe House is a bit much. But I still like the show.
<hr> Posted by Jon Newman (Member # 3148) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2004,11,1,21,51,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 02-12-2004 04:51<noscript>December 01, 2004 09:51 PM</noscript>:

Hi Barrett,

I've noted that the writers seem to enjoy punishing the patients. Those in walk-in are subjected to House's Vulcan presence.

The main patient of each show (in the two I've seen) have to have extremely painful procedures either for dx or tx and their suffering takes center stage.

In short, people uninterested in rational pursuit are made to feel uncomfortable. This is why I think the show is doomed as most who watch are likely to feel uncomfortable (next episode seems to promise this). I think Mr. Nulands critisim of needing to suspend disbelief is underestimating most people's abilities in this area.

Favorite line from the show: While one of House's patients is playing a video game House has given her, she is distracted by his conversation with one of his students. Imploring her to stick to her task, he states, "Don't look away, the space monkeys will be all over you."

jon

Speaking of shows that are doomed, I'll put in a shameless plug for my brother. He puts on a live stage version of "What's my line?". Their motto is: "No one gets voted off, no one wins a million dollars and no one has to eat a bug".

jon
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2004,11,8,21,51,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 09-12-2004 04:51<noscript>December 08, 2004 09:51 PM</noscript>:

Comfortably ensconced in the doctor’s lounge of the neonatal unit, our hero overhears two of his colleagues discussing the seemingly unrelated sudden illness of two infants and without knowing anything more than this House concludes that there a virulent and deadly infection spreading in the nursery. He browbeats his boss into acting before she’s satisfied it’s appropriate and, once she sees that he’s again accomplished an end run she says, “Happy now?” House responds as expected: “Nope-but I am interested.” Of course House is never happy.

This ability to see the whole of something once given just a tiny bit of it is typical of the best diagnosticians. According to one of my favorite contemporary philosophers, the poet David Whyte, “Our "imagination" is our ability to form an image out of something not yet fully formed around us. We must do this, we must move before we have all the facts. We put together a larger picture from small clues-we must have the courage to do this.” I like how he acknowledges the courage it takes to do this. Whatever else he may be, I feel House is courageous, and this is why he takes a chance on being wrong so often. Others suffer when he’s mistaken or inattentive and he knows this-he continues to try anyway.

There was an interesting exchange with the hospital’s lawyer that succinctly covered liability concerns and the craziness of modern medicine as we’ve come to know certain aspects of it.

This week’s favorite line: Grateful patient to House-“I gotta get you a gift or somethin’.”
House’s response-“Sometimes the best gift is the gift of never seeing you again.”

Well, it was my favorite anyway.
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2004,11,15,15,16,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 15-12-2004 22:16<noscript>December 15, 2004 03:16 PM</noscript>:

In this week’s episode House finds himself surrounded by issues regarding faith and personal philosophy. How these impact his clinical reasoning or the life and death issues his patients face from moment to moment haunts the dialogue throughout. As with virtually everything else, this is to his great consternation. I notice he punctuates his arrival at most meetings with people he doesn’t trust (the administrator and each patient) by swallowing a couple of Vicoden.

In the beginning he’s watching his only friend working studiously at some documentation and says, “We are condemned to useless labor…writing down what we already know to be read by nobody.” Wilson (the other doctor) reminds him that useless labor is the task reserved for Dante’s fourth circle of hell, thus introducing the religious theme that dominates the rest of the show. The seven deadly sins are alluded to a bit later.

Three nuns, one with a severe dermatitis, are waiting for House and he diagnosis the problem immediately as an allergic reaction to something previously tolerated quite well. Though the dish washing liquid he suspects is at fault turns out to be the wrong substance, it turns out that he’s precisely correct about the underlying illness. Realizing that takes a while however and, as usual, the treatment given for one problem after another helps until it almost kills the patient. I smiled when House first leaves the treatment room confident that he’s done precisely the right thing and says, “How do you solve a problem like dermatitis?” Perhaps his fascination for daytime TV and what it might reveal about people extends to musical theater as well. I’m just guessing.

True story. I couldn’t watch House last night so I taped it and watched it a lunchtime after walking Buckeye. She likes this show too. Anyway, my first patient this morning was new to me-a woman in her seventies leaning heavily on a red and white striped cane. I asked her if this was a seasonal affectation and she said not exactly, that in the summer she puts stars on it. I knew then that I was probably going to help this woman, no matter how god-awful her x-rays appeared. While watching him at lunch a couple of hours later I saw House eye a pile of candy canes in his office and then ask one of his young charges, “Are you mocking me?” (House also leans heavily on a cane) Of course, he gets the flushed response and stammered explanation he wants before he tells her “it’s a joke.” What do you suppose these amazingly coincidental occurrences mean? I mean about me and my practice, such as it is. Take your time, this may not be as obvious as it first appears.

Ultimately, House figures out what to do by discovering something about the patient she and her friends wish to hide, which is another common theme in this series. In this case it’s a tattoo-something permanently etched on the surface that reveals an inner self, or, at least, something about ourselves we wish or know to be true. This is why tattoos make more sense to me than botox injections.

I like symbolism but on this week’s show it is at times a little heavy handed. I mean come on, the copper cross within? Give me a break. Still there was one camera shot that intrigued me and that I don’t have a feeling for just yet. House is shown to carefully rest his trusty cane against the wall outside the room occupied by his patient just before they meet a final time. He walks in without it though unknown allergens are no longer an issue.

Why did he make this choice?
<hr> Posted by Jon Newman (Member # 3148) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2004,11,15,21,43,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 16-12-2004 04:43<noscript>December 15, 2004 09:43 PM</noscript>:

Favorite line: "Oh you people! Always with the protocols".

I don't have much to add to your other questions but perhaps Maria von Poppins would.

jon
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2004,11,16,13,29,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 16-12-2004 20:29<noscript>December 16, 2004 01:29 PM</noscript>:

Jon,

My favorite as well. Just had lunch with a family practice guy who hadn't heard of the show before but promises now to become a fan. Think one more viewer will be enough to save this show from cancellation?

Back to the show: Remember how I pointed out that each week House saves the life of someone who possesses a quality or personal attribute he quite obviously does not?

Right again! Not to gloat or anything.

I just hope the series doesn't become all about House's resurrection and/or the recovery of his humanity. When they did this for Sipowitz on NYPD Blue it nearly ruined the show.
<hr> Posted by Jon Newman (Member # 3148) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2004,11,16,13,54,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 16-12-2004 20:54<noscript>December 16, 2004 01:54 PM</noscript>:

The show is doomed. I doubt the same will happen to the new network show, "Medium" soon to air.

jon
<hr> Posted by Diane (Member # 1064) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2004,11,18,12,13,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 18-12-2004 19:13<noscript>December 18, 2004 12:13 PM</noscript>:

A line I found memorable was this:
Nun: (In chapel, after having caught House sitting alone in a pew playing his video game and exchanging some words about that..discussing the sick nun)
"She believes in things that aren't there."
House: (Snappy comeback) "Well I would have thought that was a job requirement."

Another:
House: "She says she has God inside her. I'd rather she had a tumor."
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2004,11,23,8,41,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 23-12-2004 15:41<noscript>December 23, 2004 08:41 AM</noscript>:

Well, it’s Wednesday night and you know what that means-another detailed and fascinating examination of House, the show touted by Fox as a “hit series.” I’m not sure anybody from the network is actually reading this thread.

Anyway, this week begins with our hero seated in the waiting area of the emergency room because, as he says, “I like these chairs.” He overhears another doctor tell a young man that his mother is an alcoholic. When the boy objects, House intervenes, “This guy’s a professional doctor-he plays golf and everything. I’m sure he did all kinds of tests before telling you your mom’s an alcoholic.”

With these few words House reveals a great deal of what he knows to be true about typical medical practice. Of course, House makes the same mistakes with some regularity and would probably be willing to admit that with a disclaimer; that his mistakes are made with the patient’s best interest in mind-or something along those lines.

The mother’s combined diagnoses of pulmonary embolism and schizophrenia at the age of 38 intrigues House and he launches into an intricate diatribe about Socrates (“an untreated schizophrenic”), Galen (“the Marcus Welby of ancient Greece”), Isaac Newton and chainsaw juggling. All interesting subjects, to me anyway, though he was wrong about that Greek thing. Galen worked for the Romans.

His young charges discuss his sudden interest in a patient with a seemingly ordinary problem and one makes the point that it’s the schizophrenic behavior that catches House’s attention, not the odd confluence of findings. “(Schizophrenics) aren’t boring,” he says.

The theme in this week’s show that caught my attention was “maturity.” The patient’s son is only 15 (though pretending to be older) but House treats him as an equal of sorts, calling him “doctor,” treating his notebook as if it were a legitimate medical record and offering him his beeper. Almost always, some of my current reading connects me to my current writing and today is no exception. “The Rapture of Maturity” by Charles Hayes talks at length of how the mature individual isn’t created simply by aging but by interest and curiosity. He quotes Marcus Aurelius (Galen’s boss, in fact): “Life is what thinking makes of it,” and emphasizes the tendency or willingness to simply contemplate as House is often seen doing. He points out that empathy is “just a feeling” and that it should take a back seat to compassion, which he sees as “a property of life that gains substance as a form of action.” We see no empathy from House, but he’s full of compassion.

There are a number of enigmatic lines and puns in this episode:

The patient’s son says, “I don’t want to be ‘housed!’”

“Mets” and “meds” are confused, and the Mets lose.

House says, “I like to walk.”

One other thing. This week I never once saw House take a pain pill. What’s up with that?
<hr> Posted by Eric Matheson (Member # 2368) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2004,11,23,9,17,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 23-12-2004 16:17<noscript>December 23, 2004 09:17 AM</noscript>:

Maybe House has been to see a good physio?? Hopefully one day he'll also learn how to hold his cane in the proper hand.
Finally caught the show myself this week. Enjoyed the scene with the seemingly protective mother and her daughter. Reminded me of a scene from the Titanic...
eric
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2004,11,29,6,45,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 29-12-2004 13:45<noscript>December 29, 2004 06:45 AM</noscript>:

Within the first two minutes of this week’s episode House spreads therapy’s most powerful and enduring meme by saying it to an audience of millions. It’s a saying first coined by Benjamin Franklin and passed along in a slightly altered form ever since. Perhaps the writers chose it for a specific reason this week, and maybe by the time I finish this writing I will have figured it out.

Familiar themes involving human behavior are evident this week once again. Deception, the power of interest and hidden motivations are woven into the dialogue supposedly focused on the reasoning behind another complex problem with diagnosis and treatment.

House says, “Diseases don’t have motives-doctors do (and) we all formulate questions based upon the answers we want to hear.” I like this-perhaps because it’s especially true of me. There’s further evidence that his colleagues are learning more about House’s eccentric modes of behavior and that they are learning to accept them. In the middle of an intense and fractious conversation about a critically ill patient’s treatment he leaves the room and flips a switch. Incredulous, one young physician asks, “Did he just turn on the TV?” Another more familiar with House’s ways says, “He needs to think.” This is also true of me.

I see House is popping pain pills again. In “Poor Richard’s Almanac,” published prior to the American Revolution, Franklin said somewhat more poetically something burned into the brain of many and, though typically untrue in a therapeutic context, it remains at the forefront of our lexicon and surely alters our care and the public’s expectations whenever physical therapy is perscribed.

Franklin said, “There is no gain…”

I’ll let you finish it.
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,0,26,20,7,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 27-01-2005 03:07<noscript>January 26, 2005 08:07 PM</noscript>:

Ah, Where to begin? This week a new episode aired (finally) that contained many of the old themes while introducing a new wrinkle or two. As usual, my radar for symbolism was set quite high-perhaps too high-but you be the judge.

We’re shown in the first scene several students taking an advanced placement calculus exam. I immediately wondered if this was a veiled reference to Isaac Newton, the man who invented the calculus (simultaneously, as it happens, along with Leibniz) and who, according to his biographers, spent 17 years lecturing to an empty room because nobody understood what he was talking about. A great image, don’t you think? For some reason I can relate. But I digress.

As is often the case on this show, things begin with a deceit, a lie. The two girls text messaging answers to each other are caught, thus raising the ire and suspicion of the teacher who briefly delays care for this week’s patient, another boy in the class who falls seriously ill.

For the first time the name of the hospital where House plies his trade is revealed; Princeton Plainsboro Teaching Hospital. Perhaps signifying the range of patients there, from Ivy League to “plain” folks-but maybe this is only a case of hypersensitive symbolism radar on my part.

One of the young doctors is then seen speaking to House about their new patient. House questions his motives for such an interest: Is he a friend? Does he have a good looking mother? When the young man denies any of this, House points out his interest lies in the problem, not the patient. Just like his mentor. This is a recurrent theme in this show, making it seem as if House is growing on his young charges. Perhaps “infecting them” would be a better way of putting it.

The rest of the show is true to form: patients respond to various treatments by suddenly seizing, new lies are discovered, the family interferes, House irritates, cracks wise and, in the end, saves another life after nearly screwing up fatally.

After being asked “What makes you so sure you’re right this time? (after a nearly disastrous mistake), House replies, “I think I’m right this time for the same reason as last time.”

I’m still thinking about that answer.
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,1,3,3,30,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 03-02-2005 10:30<noscript>February 03, 2005 03:30 AM</noscript>:

I tell my students that what they want to know about the deep model of the nervous system is available somewhere but, as the autodidact Charles Hayes reminds us, “An education isn’t something given to you; it is something you take. The tuition is your desire.” I find most a little short on funds.

This week House personally interacts repeatedly with a patient (definitely an unusual thing), a jazz trumpeter whose music he admires greatly, and who, having signed a DNR order, has decided to die because he hasn’t the lungs to play any longer. Of course, while trying to treat what he considers a misdiagnosis by another doctor; House violates this order, saves the artist’s life and briefly lands in court. He escapes prosecution using some well-timed deception and punctuating each exchange with his caustic wit.

Another great episode, even though I didn’t see even one seizure.

What I found most compelling this week was House’s speech about a visiting physician named Hamilton who “flew in from the west coast.” My symbolism detector pointed toward Margaret Hamilton, the actress who played The Wicked Witch of the West. She flew too. Well, maybe this doesn’t quite fit, but anybody reading this and looking for their daily Wizard of Oz fix just got it.

Anyway, House describes this competent but bland Hamilton as “not an idiot, but just a polite twit.” To House, this man’s absence of passion is abhorrent and, ultimately, of no help to his patient. Both of these men make mistakes-bad ones-but the man from the west coast just moves on with acceptance and an “ah shucks” attitude. “He sleeps better at night than I do,” says House, “but he shouldn’t.”

As another doctor says this week, “House doesn’t have a Messiah Complex. He doesn’t need to save the world. He has Rubick’s Complex; the need to solve the puzzle.”

And so in the final scene House and the musician leave the hospital together, both leaning heavily on a cane, each compelled to pursue the thing that grips them and which they cannot live without. “Thanks for sticking with the case,” says the trumpeter.

House answers with the absolute truth; “I can’t do anything else.”
<hr> Posted by Diane (Member # 1064) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,1,3,8,7,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 03-02-2005 15:07<noscript>February 03, 2005 08:07 AM</noscript>:

It was a good episode.

At least in this one House didn't have his underlings breaking into patients' homes to find out what was causing their problems, looking for pesticides, detergents etc.. they never seemed to get caught.

It was starting to happen too often and was becoming a distraction. It was a clutzy device in any case.. "the ends justify the means" meme wasn't just reinforced but bludgeoned the viewer.
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,1,7,6,13,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 07-02-2005 13:13<noscript>February 07, 2005 06:13 AM</noscript>:

Diane,

I believe they might have entered illegally once, maybe twice, but the other times there was a consent to search. This is an unusual way to approach diagnosis but I think you'd agree that House's passion for problem solving required it. He knows that what we say we do and how we say we live isn't concurrent with the truth for a number of reasons. The patient may lie, but the "house" is less likely to. Ironic, of course. And clever writing.

I noticed that Fox TV promoted this program twice during the Super Bowl. They must have some faith in its endurance. Good news.

For me anyway.
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,1,10,6,29,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 10-02-2005 13:29<noscript>February 10, 2005 06:29 AM</noscript>:

This week Dr. Wilson (House’s only friend) begins by referring to the patient as “Homeless” as if this were her name. The diagnostic team’s neurologist redefines the name as “crazy” and “no money.” He’s openly suspicious of her behavior and wary of being scammed for a few meals and a warm bed. Things begin to change a bit when in response to a question about whether or not she feels a painful pin prick she says, “Sure. I’m human.”

I was left this week with the sense that this show isn’t so much about the mysterious Gregory House whose behavior so often makes us wonder how he got to be so, well, brilliantly nasty (to put it nicely), but how well others around him suffer through life with such benign good will. Though irritating, his manner is more honestly authentic. Maybe this is why he succeeds as a clinician so often.

This week’s seizure showed up earlier than usual, and the muscle twitching and fever no one could possibly fake quickly confirm this patient’s truthfulness. The young neurologist becomes a fervent supporter and goes to great lengths to discover who she was before “Homeless” became her name. He again visits her domiciles, one a tarp covering some boxes and another an abandoned house that gives up her past and the underlying reason for her homelessness. The writers seem to know something many caregivers forget; the answer to the question “How did you get to be the way that you are?” typically lies in our life somewhere-and we often hide that from ourselves very effectively. To get to it, doors must be broken down.

There’s a great exchange between House and a couple of med students. He tells them “Treat everybody as if they have Korsakoff’s Syndrome. They all lie anyway.”

I must admit here that I made the diagnosis before it was revealed on the show. The woman’s sensitivity to light and fear of water brought the word “rabies” into my head and though I beat House to it by a few minutes I will concede that he didn’t have the advantage of being in the presence of the patient at all this week.

Maybe that’s why the patient died.
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,1,15,21,55,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 16-02-2005 04:55<noscript>February 15, 2005 09:55 PM</noscript>:

In the commercials promoting this week’s episode we were promised a dramatic examination of House’s addiction to Vicoden and things started out this way. A slight delay in the drug’s delivery to the pharmacy accentuates his already black mood and when challenged to go cold turkey he hesitates until offered less clinic work in return.

What I found interesting wasn’t the chemical consequences of withdrawal so much as the writer’s attitude toward the mechanical contributions to House’s leg pain. A “licensed masseuse” is introduced; non-English speaking and gorgeous, she provides him with very temporary relief. I’m sure the bodywork listserv will be buzzing about this tomorrow. It’s clear that if chemicals aren’t effective only “alternatives” are considered. For a show whose writers seem to understand so much about medicine you’d think they’ve have a physical therapy consultant in the wings.

If anyone there is reading this-I’m available. I only hope good looks aren’t one of the requirements. I can’t compete with that masseuse.

The most effective way House has of reducing his pain is a self-inflicted hand fracture that he uses a decorative pestle to acquire. You suppose the writers see the irony in using that chemical mixing device? Nah, probably not. Anyway, there’s a brief exchange about the gate theory of pain, so it isn’t a complete loss.

This week House’s young doctors dig up the patient’s yard and tear holes in his bedroom walls. It seems they’re getting even more aggressive in their search for the true cause of their patient’s trouble, and, as usual, they find the answers deep in the patient’s life-in their “house”-and the patient is saved.
<hr> Posted by Diane (Member # 1064) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,1,16,0,5,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 16-02-2005 07:05<noscript>February 16, 2005 12:05 AM</noscript>:

They were digging up the dead cat which set them on the path of the termites in the walls of the 'house'..

At least the 'pestle on the hand' manouver was accompanied by the explanation that the brain can only deal with one pain at a time.. even if the counter-irritation was extreme. More extreme was House walking in to contaminate and thereby prevent the liver transplant.

Something I've noticed, besides the lack of onsite PT, is that there seems to be no auxilary staff of any sort.. House autopsies the cat himself, the younger docs do their own lab tests, Dr. Cameron generally gets the portering duties. Oh well. It's TV.
<hr> Posted by hmgross (Member # 2350) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,1,16,17,35,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 17-02-2005 00:35<noscript>February 16, 2005 05:35 PM</noscript>:

I am really getting hooked on the show but couldn't help think how "fake" the OR seemed. Could it be any smaller? Maybe the production budget is limited but it seemed like a set on a SNL skit. Barrett, I am just relieved the masseuse didn't call herself a Physical Therapist (remember Frasier?)
<hr> Posted by S.Case (Member # 4115) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,1,16,17,49,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 17-02-2005 00:49<noscript>February 16, 2005 05:49 PM</noscript>:

I also think the pestle move was a little extreme, I mean he is a doctor, don't doctors value the use of their hands? I didn't really appreciate the masseuse either, but maybe that's because of the sexist nature of the scene. Besides, what's a masseuse doing in a hospital practicing Yoga in the hallway? I thought House was hallucinating at first.

Loved the bit where he dissected the cat himself, and spoiled the sterile field (speaks to that mischievious child in all of us). All I can say is "dude, use your cane in the left hand!" I wish they would get Barrett as a consultant on the show!
Sarah
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,1,16,19,29,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 17-02-2005 02:29<noscript>February 16, 2005 07:29 PM</noscript>:

Holly,

I see this as a program where things are represented or symbolized more than shown as they would actually exist. This doesn't bother me, it draws me in. I'm guessing that the director knows that I know this and gives me some credit.

Sarah,

Yes, the massage bit was markedly sexist and I was shocked! Shocked! (See "Casablanca")

Do you actually think that doctors value their hands more than, say, truck drivers?

The fact that House uses a cane is proof that there is a significant mechanical component to his discomfort, not that it is treatable beyond this, necessarily. Don't you suppose if the cane in the left hand relieved more of his pain House would have figured this out himself? He's using this device for weight bearing at a uniquely chosen angle and I would guess that he doesn't care what it looks like. I know I don't.
<hr> Posted by hmgross (Member # 2350) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,1,17,8,16,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 17-02-2005 15:16<noscript>February 17, 2005 08:16 AM</noscript>:

Barrett, I agree with you about the use of the cane. It "bothers" us because it doesn't look right, but in this case, it may be the best solution for him. My father-in-law suffered from severe RA and his biggest frustration when he was in the hospital was nurses and therapists telling him how to move, how to get out of bed and putting him in more pain. His body essentially "fused" in many areas and he was the one who figured out how to transfer, walk, etc in a manner that caused the least discomfort.
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,1,23,13,56,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 23-02-2005 20:56<noscript>February 23, 2005 01:56 PM</noscript>:

The show begins with a familiar theme this week-deception-this time with a baseball pitcher telling a lie to the camera before he breaks his arm throwing a pitch. The rest of the show revolves around diagnosing the origins of his unexpected osteopenia.

The writers seem to have ampted-up the lying this week, showing us how it not only retards accurate diagnosis but also destroys personal relationships and can be used physically to deceive a batter in baseball. Again, the pervasive deception is unavoidable and needs to be understood in that way. We must decipher it as justified or not. I think House gets this though those around him aren’t nearly as adept at using lies and, they find, he always catches them trying. My favorite line: while explaining to his boss why he lied to a patient, “I wanted to eliminate the placebo effect.”

A couple other things caught my eye/ear: The pro athlete gets special treatment because he’s bigger and stronger than others equally ill, and certainly more famous. I’ve never liked this though even House seems to do it. At least he admits it.

After having a bottle of urine poured down his pant leg while at bedside, House repeats a vow he seems to have forgotten in his starry-eyed care for the pitcher. He says “NEVER visit a patient!” I thought this was hilarious.

In the final scene House points to an aptly named monster truck and says, “The “Grave Digger” never disappoints.”

I’m sure he meant more than the truck.
<hr> Posted by S.Case (Member # 4115) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,1,23,18,6,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 24-02-2005 01:06<noscript>February 23, 2005 06:06 PM</noscript>:

I liked the scene where he diagnosed and treated everyone in the waiting room in less than 5 minutes. Why bother with the standard evaluation procedures, right? Geesh, that man is gifted! Did you notice he didn't pop any pills again this week?
Sarah
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,1,23,18,33,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 24-02-2005 01:33<noscript>February 23, 2005 06:33 PM</noscript>:

Sarah,

I was wondering if anyone else noticed this. However, House began to show us a little of his emotional pain this week.

In the Feb. 10 issue of The New York Review of Books there is an essay about a new collection of Sherlock Holmes stories. The author speaks of Conan Doyle being trained by a physician named Joe Bell, a legendary diagnostician in London. Not only were his observational skills and interpretive abilities acute, he attended to the patient's story in an unusual way:

"To succeed as a narrative diagnostician...you needed the feeling for story, both for the 'history' to be inferred from the signs and symptoms and for the way that story could be reconstructed, in therapeutic terms, for the good of the patient. Bell treated his patients, in part, by telling them their own stories, as if threading a coherent narrative were itself a kind of therapy."

Like Holmes, House is a detective, and, if you watch carefully, you'll see him tell every patient their own story. Perhaps not very gently, but truthfully.
<hr> Posted by Chris Adams (Member # 3013) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,1,23,20,8,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 24-02-2005 03:08<noscript>February 23, 2005 08:08 PM</noscript>:

Last night was the first night I've watched House. I was hooked in the first five minutes. Sarah, I too thoroughly enjoyed his 5 minute diagnosis session as well. The one that caught my eye (pun intended) was when he told the guy he was scraping/scratching his cornea!!! [IMG]smile.gif[/IMG]
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,2,15,2,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 02-03-2005 22:02<noscript>March 02, 2005 03:02 PM</noscript>:

I suppose it was just a matter of time before this show dealt on some level with father-son issues, and this was the week. As it happens, I have a shelf full of books dealing with that very subject and consider myself something of an expert. I’ve even had a few essays about this published here and there.

There is also in this episode an underlying theme of psychic phenomena and some clear understanding of how compelling such a thing can be. A Ouija board is featured in an early scene, the planchette driven about consciously by some boys bent on scaring another. Normally, this device is driven via an unconscious motivation (ideomotor activity). A little while later House identifies an unusual accent in a visitor and is told he has “a good ear.” As it turns out, House already is aware of the visitor’s background and “hot reads” him. This is a technique of supposed psychic divination that involves knowing something beforehand but not revealing that knowledge. “Cold reading” is a way of seeming to knowing something though you do not.

The father-son thing is so powerful and mysterious it conjures up a sense of the paranormal, and thus this fits very well into the episode.

A parallel story line of father-son conflict is played out between the patient and his father (from whom, it turns out, he acquires his disease) and this relationship involving one of the young physicians on the show. Not badly done, I thought, and real enough. Those of us who know about such things recognize that once the inevitable break in this relationship occurs there is a one way street between them-and it’s the son that must walk it. All the father can do is wait.

My favorite line: House is asked by his friend Wilson why he doesn’t simply talk to the father and son about their relationship and he replies, “If you want to know how two chemicals interact are you going to ask them? No. They’re going to lie through their lying little chemical teeth. Throw them into a beaker and apply heat.”

Perfectly true.
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,8,10,21,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 08-03-2005 17:21<noscript>March 08, 2005 10:21 AM</noscript>:

This seemed the best thread to send this link.

http://www.medicinenet.com/script/ma...ticlekey=46132

It was originally posted on the healthfraud listserv where some people say that acting lessons for doctors who can’t seem to display the requisite empathy would be appropriate and others disagree. House is mentioned immediately.

I was reminded of a line from Charles Hayes’ “The Rapture of Maturity.” “Simply put, compassion equals caring…empathy is only a feeling. Compassion gains substance as a form of action.”

Any thoughts before the show tonight?
<hr> Posted by Jon Newman (Member # 3148) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,8,18,5,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 09-03-2005 01:05<noscript>March 08, 2005 06:05 PM</noscript>:

Hi Barrett,

I enjoyed the link and your commentary. House has one and doesn't pretend to have the other. I can't say the same for myself.

I found it interesting that "Hamilton", in the link you provided (without brevity?) used horses to train nonverbal communication. How clever.

jon
<hr> Posted by S.Case (Member # 4115) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,8,19,38,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 09-03-2005 02:38<noscript>March 08, 2005 07:38 PM</noscript>:

I think that Dr. Phil would say feelings follow actions. Feelings are fleeting and unreliable, but actions are what build character and integrity. Unfortunately, I don't think one can teach empathy to someone else. Compassion can be developed I think, through acting compassionately.

I thought the use of horses was interesting also. Horses are very social animals and they communicate through body language almost exclusively. Nonverbal communication is more important than verbal in whether your message is received.

Sarah
<hr> Posted by hmgross (Member # 2350) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,9,10,51,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 09-03-2005 17:51<noscript>March 09, 2005 10:51 AM</noscript>:

Boy there seemed to be a lot of stuff going on in last night's episode. Can't wait to hear your take on things, Barrett! I miss bouncing off ideas with co-workers (I am all alone here). Do you feel it would be helpful in a PT department if you had one therapist offer insight without actually seeing/talking to the patient. I realize we do this at times, but I mean more of the "sit down and hash-it-out" like on House. I like the idea. I have found myself at times getting bogged down with all the details and not backing up sometimes and looking at the "whole picture". I guess that is why I spend more time reading the various posts and don't post much (also a time factor--I should be doing my billing right now on this computer)!
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,9,13,18,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 09-03-2005 20:18<noscript>March 09, 2005 01:18 PM</noscript>:

Holly,

This episode was a repeat. I commented on it earlier in this thread. The post is dated December 1.

I tend not to talk to other PTs. I will admit that when I run into someone I had done this with in the past they never tell me that I've been missed.

I wonder why that is?
<hr> Posted by hmgross (Member # 2350) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,9,15,41,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 09-03-2005 22:41<noscript>March 09, 2005 03:41 PM</noscript>:

Yes, just checked back to the Dec. 1 post. Of course now my secret is out. I started watching House because it comes on after American Idol.
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,14,6,24,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 14-03-2005 13:24<noscript>March 14, 2005 06:24 AM</noscript>:

If anyone here subscribes to Salon.com you'll find a review of "House" there today in the TV commentary, "I Like To Watch."

I agree with the author's assessment with the exception of her description of Dr. House as a sociopath. I just finished reading the new book by Harvard psychologist Martha Stout "The Sociopath Next Door" and am now an expert on this condition. It's clear that Stout is not describing House when she identifies the criteria for diagnosis.

However, she does a wonderful job of describing a number of people I have known or currently know. A hard statistic she cites as conservative indicates that sociopaths comprise 4% of the population in this culture. This means that every class I teach probably has at least one in it. Now I know how to understand and describe the one in there who disagrees with me (ha,ha).

Seriously, this is a wonderful (and terrifying) book and everybody should read it.
<hr> Posted by S.Case (Member # 4115) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,16,20,19,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 17-03-2005 03:19<noscript>March 16, 2005 08:19 PM</noscript>:

Holly,

I too, am guilty of watching American Idol (maybe we should form a support group).....hi, my name is Sarah and I am a non-adolescent American Idol fan.

Just saw House on tape (too tired to stay up). I liked the added tension of the new chairman and the politics that ensued with his arrival. Very surprised that Chase narked on Dr. House. But Chase's relationship with his father might have something to do with his distrust of authority.

Loved the exploration of the ethical grey area between patient advocation and following the "rules". As a PT, I don't face those types of life or death situations, but I have been known to duplicate copyrighted material for patient use (gasp!)

Barrett, looking forward to reading your take on this week's show.
Sarah
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,16,20,34,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 17-03-2005 03:34<noscript>March 16, 2005 08:34 PM</noscript>:

Sarah,

I was in San Diego yesterday and managed to fall asleep at 7PM local time, waking at 12:30 AM, long past the show. Obviously, I'm a wild man on the road.

In any case, disection of this week's episode is up to you guys. Please go for it. Here's a hint: Use an obscure literary metaphor almost no one elese is likely to recognize well enough to argue with. It might make you appear smart-not that I would ever try such a thing. It's just a thought.
<hr> Posted by S.Case (Member # 4115) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,16,20,52,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 17-03-2005 03:52<noscript>March 16, 2005 08:52 PM</noscript>:

Barrett,
Maybe the one who disagrees with you is a grumpy old, pill-popping curmudgeon with a heart of gold!
Sarah
<hr> Posted by S.Case (Member # 4115) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,16,21,7,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 17-03-2005 04:07<noscript>March 16, 2005 09:07 PM</noscript>:

Well, this week's show is about lies again. But we do get to see another side of Dr. House. It centers around a 32 year-old workaholic female CEO who is admitted for paralysis of her quadriceps muscles. Dr. Chase inadvertently does an angiograph of the wrong leg because he was flirting with a resident and while redoing the test, the patient goes into respiratory arrest due to CHF. House chastized Dr. Chase in front of his colleagues, and figured out that the patient had a cycle of control/shame behaviors, deducing that she was a bulimic. She was also a self-mutilator which is why she refused a colonoscopy to check for colon cancer. The patient's chronic use of ipecac syrup ruined her heart muscle and she needed a transplant. House decides to comceal the bulimia from the medical record and transplant committee, so that his patient will receive a donor organ.
Meanwhile, the new chairman wants House and his department eliminated because they don't do controlled trials (money makers), and House cures a guy who had vocal chord paralysis with a surprise shot of Botox to his larynx. House also lies to the young female doctor when she asked if he likes her and he says no. Kind of reminds me of Spiderman when M.J. asks Peter Parker if he loves her and he says no to protect her, after all..."with great power comes great responsibility".
Sarah
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,16,21,31,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 17-03-2005 04:31<noscript>March 16, 2005 09:31 PM</noscript>:

Sarah,

Very good. House and Spiderman-both tormented souls struggling to express themselves but still capable of saving others with remarkable efficiency. I think they both have bad haircuts as well. What do you suppose that means?

So, House won't do a controlled trial? Not even a simple case study? What is he, lazy or stupid? Maybe both? What's he trying to hide?

I demand an answer!
<hr> Posted by Jon Newman (Member # 3148) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,16,21,42,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 17-03-2005 04:42<noscript>March 16, 2005 09:42 PM</noscript>:

Here’s my interpretation of last night’s episode despite missing the beginning and exercising my usual lapses of attention while the TV is on. No obscure literary references since I don’t read obscure literature.

Lies, as usual, dominated the show. But also featured frequently in the show was the issue of ‘control’.

The show starts when an executive of a cosmetic company (or similar work) lies in pursuit of a business transaction. However, the lie has to be unexpectedly amplified when the board wants to hear more of her plan. During this discussion the executive starts to experience sudden leg pain. But in order to maintain the pretense of normalcy and control, the patient (to be) lies again to end the meeting and firstly admits her pain to her trusted secretary.

At the hospital the usual chit chat takes place where people guess at what’s wrong and start the process of figuring out if they are right. One of House’s apprentices seems to have taken a new controlling demeanor that she co-opted from some book she was reading. House advises her to read less; watch more TV. Hmmm.

After they run a number of tests the patient, as is typical in the show, refuses to submit to one of their suggestions, this time a colonoscopy. House notes that she isn’t disinterested in diagnostic tests, just the embarrassing ones.

As usual, we see House pondering and trying to make associations. At one point we see him writes “shame” and “control” on some flip chart paper. A psych diagnosis? As it turns out yes, but not as the most proximate diagnosis of her problems. Unfortunately for her she will need a heart transplant secondary to cardiomyopathy induced by syrup of ipecac. This patient was a long time bulimic… more control issues.

House ends up lying to the transplant board after trying to determine if this patient felt her life was worth living. He knows her psych diagnosis would likely make her ‘unworthy’ of the transplant and thus conceals this to help maintain the pretense of normalcy and thus ultimately save her life. He confides later that “she’s my patient” as a way to justify his decision. He knows whom he works for.

Other issues of control were introduced through the new President of the board. He tries to get House to wear a lab coat through strong suggestion to his superiors and he threatens House by suggesting House’s allies at the hospital are easily replaced. Oh, and this guy didn’t think House was productive enough.

The show ends with House walking out of the hospital to the tune of Baba O'Riley by The Who:

Out here in the fields
I fight for my meals
I get my back into my living
I don't need to fight
To prove I'm right
I don't need to be forgiven
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,16,22,0,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 17-03-2005 05:00<noscript>March 16, 2005 10:00 PM</noscript>:

Jon,

See? Isn't that fun?
<hr> Posted by Eric Matheson (Member # 2368) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,16,22,4,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 17-03-2005 05:04<noscript>March 16, 2005 10:04 PM</noscript>:

Great review Jon. How about the other story line involving the father of one of House's outpatients. This guy was living a lie in order to prove his disability and claim his compensation, big $$$. He feigned an inability to speak. His vocal cords were supposedly damaged during a knee surgery. House thin-sliced him pretty quick. As with the patient awaiting approval for heart transplant, House 'lied' once discovering the truth by not revealing the man's secret. The lie is not so much in what is said, but what goes unsaid I guess.

eric
<hr> Posted by Diane (Member # 1064) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,16,23,18,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 17-03-2005 06:18<noscript>March 16, 2005 11:18 PM</noscript>:

House had someone rifle through the young woman bulemic patient's belongings again.. that's how he knew she was bulemic. Found the syrup in her drawer.

I thought it was great though, that he ignored the 'system', went straight to the patient, laid out the whole deal, including all the politics, and asked her what she wanted, to live or to die, that he'd do what she wanted. She said live. Which put him into the position of having to lie. So he went and machinated the situation to have it come out as his patient wished. (I wonder, would a true sociopath bother doing that?) Guess I'll have to read that book about the sociopath next door..
<hr> Posted by S.Case (Member # 4115) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,17,7,44,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 17-03-2005 14:44<noscript>March 17, 2005 07:44 AM</noscript>:

Actually, I do think the man's vocal chords were paralyzed during intubation and no one could figure it out. House injected him with Botox, and in reality, cured him but the man continued to be mute because he didn't want the settlement money taken away...House deduced this and told the man that his secret is safe with him.
And House did not order Dr. Chase to refile through the woman's purse. Dr. Chase did that because for once, House had figured out something and didn't tell them how he did it. Plus, Chase was worried he would be fired for screwing up the angiogram, so now he has some ammunition against House.
Barrett, that's easy, tormented souls don't have time or concern for haircuts or controlled trials.
Sarah
<hr> Posted by Diane (Member # 1064) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,17,9,40,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 17-03-2005 16:40<noscript>March 17, 2005 09:40 AM</noscript>:

Sarah, I wasn't clear that Chase had done the pillaging on his own. I'm still fuzzy then why House confronted the patient with it.. did Chase tell House about the syrup?

On another more general level I think the whole episode was an exploration of House's boundaries. He seems to have huge thick prickly ones round him.. I think this character needs them, working around other people all day, his office even has glass walls.. (he escapes there anyway and plays, practices air drumming, works on his video games etc.) He does his best thinking alone gazing at his conference flipchart.

He adamantly maintains he dislikes people.
Each story line in this last episode seemed to be about him disliking someone, or even if he didn't, saying he did in order to hold his world steady on course.
When the new boss, a rich and bored megamillionarire who has bought himself the job of chairman of the board through his mega-donation to fight cancer etc., when this individual confronts House to tell him to wear a white jacket, House tells him it fell apart in the wash, furthermore that since they probably will never like each other it is likely best that they ignore one another.
When Cameron, who seems to have some sort of crush on him, asks him if he 'likes' her, he looks her straight in the eye, pauses, then says very distinctly, "No."

Yet he dissolves these boundaries completely at the patient's bedside. He tells her everything he knows about her, all her self-abusive little secrets, tells her he will lie to save her life if she wants to be saved, and keeps his promise after she has made up her mind. So his priorities are in strict order and his impenetrable boundaries protect his game plan.

He completely and deliberately violates the mute dad's boundaries, by walking up to him with a syringe, activates his mirror neurons by looking up and waiting until the target looks up, then jabbing the botox directly into his vocal cord. (Yeah, like he's so good he could hit a vocal cord dead on through all those layers of tissue...on a person standing up, without any palpation first. And how did he decide it was the left vocal cord in particular that needed the botox? Ludicrous, but it's only a TV show Diane, calm down..)

The difference between House and a true sociopath, in my mind, is that at his core House will do sociopathic things on behalf of a patient, an "other", whereas I think a true sociopath doesn't learn or know or care about 'other', even those who end up professionally trained. I think rather than a sociopath, this character is a strong INTP, maybe INTJ, who hasn't shown us yet that he has any access whatsoever to any other channels.

I think this new dominator chair of the board is likely the true sociopath, thrown in for contrast. He has the silkiness and charm, the ruthlessness, the manipulativeness.. he announces on the way out the door that he could easily fire Cutty and Wilson, so House shouldn't count on their support.

Check out how many similarities there are here between House and an INTP profile.
http://www.personalitypage.com/INTP.html There's even room for bad dressing/ bad haircut here.

Here's an INTJ profile. Lots of overlap here too.
http://www.personalitypage.com/INTJ.html
<hr> Posted by hmgross (Member # 2350) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,17,12,14,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 17-03-2005 19:14<noscript>March 17, 2005 12:14 PM</noscript>:

I would imagine "Abnormal Pysch" classes would have a field day dissecting House. I did my paper on the main character in "Clockwork Orange"--now thats a sociopath. I agree with you Diane. A true sociopath is not capable of empathy. If I had to chose the overall theme of the last episode, I would pick "control"--and I really have a personal aversion to white lab coats, much like I had for the white nurse's cap I was forced to wear. Forced to look the part, no matter how silly or uncomfortable.
<hr> Posted by S.Case (Member # 4115) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,18,14,54,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 18-03-2005 21:54<noscript>March 18, 2005 02:54 PM</noscript>:

Diane,
House figured out the bulimia without ever finding the Ipecac, he deduced it and then confronted the patient and she admitted to it. Chase searched her room after the request for the heart transplant was made because he wanted to know how House figured out she needed a transplant before the tests came back. Plus, he didn't want to get fired so now he has something to blackmail House with (House lied about the patient's psychological state).

I don't think House is a sociopath at all...far from it. He obviously cares about helping people, he is just realistic about people (they lie, play games, manipulate, etc) and very good at reading them. He is also ethical, as seen in this last episode when he stated that it is unethical to use patients from the hospital in controlled trials. And he knows right from wrong. He deliberately chooses not to be P.C., which makes him eccentric, not psychotic.

The new chairman seems to be trying to make up for how horribly he treated his own father, and the fact that his father now has late-stage Alzheimer's, so he wants to cure a disease or two to clear his conscience. I agree that control was a major theme in this episode.

I loved the scene where House was playing piano on his desk and air drumming....then the chairman turns off his music (control freak). The funniest part was when House said they might as well ignore each other, then went to turn his music back on in defiant punctuation of his last statement, but it was a dorky song instead.

You're right, the white lab coat represents conformity and social correctness, which is the antithesis of House.

I will check out the personality profiles, even though I don't put much stake in those anymore. I've taken that test about a dozen times and I always end up with different labels....usually an INFJ or ENSP (maybe I'm the sociopath!)
Sarah
<hr> Posted by S.Case (Member # 4115) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,18,15,5,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 18-03-2005 22:05<noscript>March 18, 2005 03:05 PM</noscript>:

Oops, nope it's ESTJ...that's my work personality I guess.
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,19,10,43,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 19-03-2005 17:43<noscript>March 19, 2005 10:43 AM</noscript>:

This concern regarding House's behavior and its connection to sociopathy has been interesting. Again, I'd recommend Stout's book "The Sociopath Next Door" for a clear description of this condition and its manifestation.

Among other things, being blunt and devious and seeming not to care about the feelings of others are not attributes confined to the sociopath. The sociopath is *unable* to care about the feelings of others, to feel remorse or guilt or shame though they often learn early in life to feign such things. They are often charming and very adept at eliciting pity for their own plight from others. This sure doesn't sound like House to me.

One in 25 in our culture is a sociopath, and these people are commonly bored with life so they go about fermenting trouble for others for entertainment. Not my opinion here-only the facts as careful study has revealed them. If this puts you on guard, you'll be better for it.

I should be awake for next week's episode while at a hotel in San Bernardino. Can't wait.
<hr> Posted by Jon Newman (Member # 3148) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,19,12,54,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 19-03-2005 19:54<noscript>March 19, 2005 12:54 PM</noscript>:

As always, consider the source when it comes from the internet. I don't know much about this site but there was some interesting discussion that seemed on target to this discussion

intro to sociopathy

jon
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,20,9,53,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 20-03-2005 16:53<noscript>March 20, 2005 09:53 AM</noscript>:

Jon,

Of special interest was the first part describing the sort of following an intelligent, ambitious and charismatic sociopath (not all sociopaths possess all of these qualities) will cultivate. All of this sounds quite familiar.

The tendency to avoid public and uncontrolled discussion of your ideas amongst your peers is also an attribute of the sociopathic personality. This would make regular participation on a site like this impossible. In a sense, Rehab Edge is the antidote for adherence to any cult-like following, and there are a few in our profession.

I had the top Upledger PT practitioner in Southern California in my class in Irvine this week. She often took notes furiously and I saw her nodding in agreement often though I'm certain I said a few things to which she must have objected.

But she never once opened her mouth, and I don't see her here though this site is heavily promoted at the course.

Makes you wonder.
<hr> Posted by Jon Newman (Member # 3148) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,20,15,34,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 20-03-2005 22:34<noscript>March 20, 2005 03:34 PM</noscript>:

I'm not suprised that Irvine student didn't say much. In this regard I doubt you can say she's unique. The dumbing down of PT's is well underway. For example, dissent was typically crushed and conformity expected in my PT school. Later, our PT director went on to hold a very high office at the APTA. Successful indeed.

I've always valued rehabedge and noi as venues for critical discussion. And while virtual cultures may form, they are open to critcism from anyone. And best of all, I don't have to work with any of you the next day. Who could ask for more?

jon
<hr> Posted by nari (Member # 2772) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,20,15,53,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 20-03-2005 22:53<noscript>March 20, 2005 03:53 PM</noscript>:

I am out of this interesting discussion as Australia does not have House...

Pity - I like the posts it is propagating.


Nari
<hr> Posted by Eric Matheson (Member # 2368) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,20,16,25,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 20-03-2005 23:25<noscript>March 20, 2005 04:25 PM</noscript>:

I'm reminded of the 'Borg collective' in Star Trek Next Generation when you talk about conformity and dissent being crushed. In my best monotone voice, "I am PT number 2368. You will be assimilated. Resistance is futile."
[IMG]smile.gif[/IMG]
eric
<hr> Posted by Diane (Member # 1064) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,20,17,34,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 21-03-2005 00:34<noscript>March 20, 2005 05:34 PM</noscript>:

Well, as I recall Pickard was assimilated and then rehabilitated. And who could ever forget "Seven of Nine" on Voyager? She was at least functionally if not completely rehabbed...
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,20,17,56,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 21-03-2005 00:56<noscript>March 20, 2005 05:56 PM</noscript>:

Jon,

It wasn't that she didn't say "much," she didn't say anything. Not a word.

Diane,

Seven of Nine? Should I remember her for any reason?
<hr> Posted by Eric Matheson (Member # 2368) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,20,18,20,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 21-03-2005 01:20<noscript>March 20, 2005 06:20 PM</noscript>:

7 of 9? If I remember correctly she exhibited what many would see as perfect posture, despite Star Fleets attempts to rehabilitate.

eric
<hr> Posted by Jon Newman (Member # 3148) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,20,18,57,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 21-03-2005 01:57<noscript>March 20, 2005 06:57 PM</noscript>:

Barrett,

Either she is very smart or not courageous. I mean what's she going to argue? That she can diagnose pathologic cranial rhythms and fix them? It's one thing to discuss these things in a groupthink setting and another to have the courage to defend your point of view. My guess is sociopathic leaders discourage courage. At least that's my experience. And courage does need to be cultivated. I know I don't have enough to lend anyone and few leaders I've met actively encourage this trait past lip service.

On the other hand, maybe you just weren't "approachable" despite your teddy bear demeanor.

jon
<hr> Posted by Diane (Member # 1064) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,20,19,19,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 21-03-2005 02:19<noscript>March 20, 2005 07:19 PM</noscript>:

Perhaps the student in question is working through cognitive dissonance. It can take awhile. If she is truly dissonant there is hope she will work her way out of the cult mentality, and who knows? She might even start her own disussion forum for others in recovery. I know one such deprogrammer who once was programmed..

For those who actually managed to forget 7 of 9, here is a blurb about her that I googled.
Seven of Nine
She was 'borg-ed' while still a child, so certain implants couldn't be removed without compromising her life, but still she re-humanized quite well.. I remember how she slept standing up in her borg cubicle that they rigged up on Voyager, and thinking, those human ankles look amazingly unpuffy in the morning.. (then thinking, c'mon Diane, it's just a stupid TV show..). About posture, I recall hearing the actress mentioning that her character's Barbie-shaped corset fit awfully tight..
The take home point is however, that if 7 of 9 can be rehabbed, there's hope for all..
<hr> Posted by Randy Dixon (Member # 3445) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,21,2,25,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 21-03-2005 09:25<noscript>March 21, 2005 02:25 AM</noscript>:

Check out how many similarities there are here between House and an INTP profile.
http://www.personalitypage.com/INTP.html There's even room for bad dressing/ bad haircut here.

Here's an INTJ profile. Lots of overlap here too.
http://www.personalitypage.com/INTJ.html


Nari,

As a fellow INTP can you defend us from the bad dressing/bad haircut dig. I would, but I'm afraid that I'm guilty.

House sounds like an INTJ to me. So does Barrett. Coincidence? I don't think so.
<hr> Posted by nari (Member # 2772) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,21,4,35,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 21-03-2005 11:35<noscript>March 21, 2005 04:35 AM</noscript>:

Hi fellow INTP

I have to admit I'm stuck on shore while all you guys are rushing off downriver in rubbery zodiacs.

I've never heard of 7 of 9, and I have never seen House ( maybe the Southern Hemisphere is exempt?)
So I really do not know the nuances of House or the Star-thing......sorry. Diane was kind enough to fill me in with a few details on the gist of the series.

Bad dressing..? Probably, I don't care for clothes much, and my hair admirably looks after itself most of the time. So,I am guilty, too.
Sorry Randy - I am a lousy defence.

I read that INTP profile, and as I have found over the last 10 years or so, when I have done these tests in courses and PD stuff, it is pretty accurate.
However, the INTJ profile sounds rather similar in some ways, and I agree - Barrett seems to be INTJ-inclined. Do I hear him protest....?

However. I read through the article on Sociopathy and that IS scary. The world's full of them......


Nari
<hr> Posted by Jon Newman (Member # 3148) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,21,7,21,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 21-03-2005 14:21<noscript>March 21, 2005 07:21 AM</noscript>:

I'm apparently being contrarian today. Here's an interesting read

mismeasure of man
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,21,9,11,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 21-03-2005 16:11<noscript>March 21, 2005 09:11 AM</noscript>:

Jon,

Great link, and precisely why I don't take or pay any real attention to such tests. Stout points out that even the sociopathic personality has a spectrum of expression. It's perfectly possible to be that way but not have the intelligence or ambition necessary to make your life hard on others to the extent that we sometimes see.

Ultimately, I wonder more about the followers.It makes sense for the sociopaths themselves to behave in this way because they gain a distinct benefit-what excuse do the followers have?
<hr> Posted by Jon Newman (Member # 3148) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,21,9,46,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 21-03-2005 16:46<noscript>March 21, 2005 09:46 AM</noscript>:

The excuse is their neurology. Of course this is coming from someone who doubts the existence of contracausal free will. But that's another thread. Perhaps the following link will shed some light

The experiment

jon
<hr> Posted by Diane (Member # 1064) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,21,10,19,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 21-03-2005 17:19<noscript>March 21, 2005 10:19 AM</noscript>:

We've all been through "The experiment." I believe it's called "high school." Some of us held our nose to get through it. Others loved it and seek to replicate it forever thereafter throughout adulthood.
<hr> Posted by Jon Newman (Member # 3148) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,21,11,0,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 21-03-2005 18:00<noscript>March 21, 2005 11:00 AM</noscript>:

Diane,

As long as we're alive I think we participate at some level in the experiment. How can we not?

Ever feel the need to drive a certain car or put a particular bumber sticker on it?

Ever feel pressure to perform one PT technique versus another?

Ever feel that you couldn't engage in a particular approach to patient care because you weren't in the right group?

As one popular Canadian sings,

"All these fences
are coming apart
at every nail"

jon
<hr> Posted by Jon Newman (Member # 3148) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,21,15,57,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 21-03-2005 22:57<noscript>March 21, 2005 03:57 PM</noscript>:

From the "intro to sociopathy" article above:

"These people tend to embrace a particular and often limited belief system to the exclusion of others. They have no doubts. Typically these belief systems have an internal logic. Actions based on the belief system often produces the desired and predicted outcomes. Their views do not stand up to criticism when alternative understandings are used. Views applicable to some activities in society may be given universal relevance and applied to activities where they are clearly inappropriate. These views or their application should not be acceptable to society but society frequently identifies uncritically with their logic and fails to challenge them."

I would imagine this would include political leaders that make decisions for political gain at the expense of society.

culture of life

jon
<hr> Posted by Eric Matheson (Member # 2368) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,21,18,31,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 22-03-2005 01:31<noscript>March 21, 2005 06:31 PM</noscript>:

Coming Apart at Every Nail

It's awful hard to find a job
On one side the government,
the other the mob
Hey, hey ain't that right
The workin' man's in
for a hell of a fight.

Oh, this country
sure looks good to me
But these fences are
comin' apart at every nail.

Way up on the old dew line
Some of the boys were feelin' fine
A big light flashed across the sky
But somethin' else went slippin' by
Meanwhile at the Pentagon
The brass was a wonderin'
what went wrong.

Oh, this country
sure looks good to me
But these fences are
comin' apart at every nail.

Hey hey, ain't that right
The workin' man's in
for a hell of a fight.

Oh, this country
sure looks good to me
But these fences are
comin' apart at every nail.

Neil Young
<hr> Posted by Jon Newman (Member # 3148) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,21,19,19,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 22-03-2005 02:19<noscript>March 21, 2005 07:19 PM</noscript>:

Ding, ding, ding,

Eric gives credit where credit is due. And this despite my misquote.

Thanks,

jon
<hr> Posted by Jon Newman (Member # 3148) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,22,12,30,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 22-03-2005 19:30<noscript>March 22, 2005 12:30 PM</noscript>:

I've been contemplating this "follower" behavior form some time. I've done some medline searches and google searches. It's all very fascinating.

Here's one link

link

and then there is this

true believers

jon
<hr> Posted by Diane (Member # 1064) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,24,7,9,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 24-03-2005 14:09<noscript>March 24, 2005 07:09 AM</noscript>:

House gave in a little and wore a white jacket to impress Vogler (the rich board chair). Cutty is facing being fired in 6 months and House is facing having to fire one of his three muskateers. Times are getting tough. Did anyone else know that Hugh Laurie is a Brit comedian? Talk about deception.. his American accent is quite good isn't it?
link to critique
Discussion of House is about half way down the page.
<hr> Posted by hmgross (Member # 2350) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,25,8,57,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 25-03-2005 15:57<noscript>March 25, 2005 08:57 AM</noscript>:

Diane, funny you should mention Hugh Laurie's brittish accent. Did anyone else see him on Jay Leno last night? He is polar opposite his House character! Very witty, charming and loved his take on driving in LA!
<hr> Posted by Diane (Member # 1064) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,26,13,7,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 26-03-2005 20:07<noscript>March 26, 2005 01:07 PM</noscript>:

Dang, I missed that Holly!

On a side note, I recently met a dermatologist who clearly is one of these not-naturally-warm, human computer types. He's a lot like the House character. I could almost see his brain ticking as he looked at a spot I went in for (which is fine BTW). What was interesting was that clearly, someone somewhere along the line had instructed him to make eye contact, that eye contact was a useful thing to do. He made it! It was clearly not part of his ordinary behavior, he was awkward with it, but he had patched it in as a behavior he should adopt to establish rapport! We can learn at any age and from any temperment to be socially intelligent humans.
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,26,15,11,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 26-03-2005 22:11<noscript>March 26, 2005 03:11 PM</noscript>:

I got to San Bernardino too late to see the first half of this last episode so I had to wait until after watching it this morning before I could write this.

House’s neurologic exam of a comatose gangster ends after he holds a portable video game up to the man’s ear and gets no response. “He’s really out of it,” he comments, knowing how powerful the popular culture is.

Chase, the young Australian doctor is actually struck in the face by the patient’s brother but does not retaliate in any way. Later he makes a mildly sarcastic comment to the man who assaulted him and simultaneously pats him on the arm. This response and exchange wasn’t emphasized in any way on the show but it haunts me. I wonder if I would have had the courage to behave as well.

I was struck by the parallel stories of the brothers, the one pair gangsters gaining the attention of House’s full team and the federal government and the others simply clinic attendees that House sees alone. They receive as much attention from House as he would give the VIPs though the problems presented are vastly different. As it turns out, the clinic patient has been attempting to solve his own problem (an object up his nose) in a way that made him more so ill. Seeing this, House realizes that his mobster patient has been doing something similar and begins to solve the riddle of his illness. He says thoughtfully, “…a nice grasp of concepts and relationships… (And) sometimes the simplest answer…”

As usual I’m left with a couple of questions. What’s with the yo yo? Why won’t House shift from third gear to fourth?
<hr> Posted by Jon Newman (Member # 3148) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,27,12,18,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 27-03-2005 19:18<noscript>March 27, 2005 12:18 PM</noscript>:

One scene in House that I found interesting was when House decided to wear a lab coat while announcing that the patient was better and could d/c. He did this out of respect for the effort Cuddy had been going through to keep him around and the fact that he wanted to stay around. Of couse his buddy had to enlighten him to these facts.

Anyway, shortly after demonstrating his new more doctorly look, his patient relapsed into coma. Apparently the jacket didn't help with what counts in medicine. He is who he is with or without the coat.


jon
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,30,13,43,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 30-03-2005 20:43<noscript>March 30, 2005 01:43 PM</noscript>:

Verbal deception takes a back seat to something else in this episode-the body’s deception.

By that I mean the ability to appear one way and actually exist in another. The pitfalls of attending mainly to the cosmetic become evident (again) in the parallel story lines in the primary patient and House’s clinic duty. The clinic again keeps House thinking of how one bit of problem solving might point him to a solution elsewhere. Perhaps this is what he means when he says to Cameron, “I’ll be in the clinic-warming up.”

Chase, the young Australian doctor, is openly disgusted at the appearance of an obese ten-year-old with multiple health issues. He seems confused however, equating slimness with attractiveness and health though he must know better, and then saying, “Have you ever met a plastic surgeon that was in their right mind?” Similarly, our culture is enamored of appearance while it claims to know better when it comes to what’s important about people. I’m firmly convinced that the epidemic of chronic pain gains a foothold n this very dichotomy and will continue to grow unless the therapy community pays attention to what it has largely become-Chase in the gymnasium.

In this instance, the patient’s appearance keeps the doctors from looking effectively for what might have produced it (a pituitary tumor). They’ve been listening to the subliminal, untrue but continuous message Morris mentions in “Illness and Culture in the Postmodern Age”: “The healthy looking body is the beautiful body, and the beautiful body is the healthy looking body.”

Vogel, the administrator, holds a tennis ball in his hand when House enters the room in the final scene, symbolically indicating he’s about to “play” with him-and he certainly does. I look forward to how the writers deal with this situation.

My favorite line? From House, “Physician-patient confidentiality protects me from annoying conversations.”

This week’s mystery-Why is this hospital’s interior almost entirely composed of glass walls?
<hr> Posted by Eric Matheson (Member # 2368) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,2,30,20,2,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 31-03-2005 03:02<noscript>March 30, 2005 08:02 PM</noscript>:

Walls keep people apart. You have the freedom to be yourself behind the relative security of a wall despite close proximity to others. This freedom is lost behind glass, which makes House’s character all that more unusual as he routinely appears to care less about the world beyond the glass wall of his office.
The transparency of glass walls also offers the viewer a privileged view of what typically goes on behind closed doors. Kind of like x-ray vision.
Thankfully, the shows producers are more concerned with glass walls than with glass ceilings although the hospitals new director may yet prove to transgress this rule…

Eric
<hr> Posted by Jon Newman (Member # 3148) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,3,12,22,4,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 13-04-2005 05:04<noscript>April 12, 2005 10:04 PM</noscript>:

After watching tonight's episode, I think the writers of the show introduced Vogler to draw the distinction between a sociopath and House. While the two have much in common, Vogler seems to have no moral compass. If House isn't a sociopath, how could he be characterized?

jon
<hr> Posted by hmgross (Member # 2350) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,3,13,8,27,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 13-04-2005 15:27<noscript>April 13, 2005 08:27 AM</noscript>:

I liked the theme. Think of the differences between lying to yourself, lying to others, being honest to yourself, honest to others. Many people confuse the verdict "not guilty" (Think OJ and Robert Blake) with innocent. Not the same. Are there "degrees" of honesty and lying, or is it clear cut, you are either lying or you are telling the truth. Oh and I guess honesty is not the same as truth--I don't think I had enough coffee to get this topic going!
<hr> Posted by Diane (Member # 1064) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,3,13,11,26,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 13-04-2005 18:26<noscript>April 13, 2005 11:26 AM</noscript>:

The pathological detective work House does in each episode seemed to me quite secondary to the psychological intrigue between House and Vogler, in this episode.

Vogler is unmasked by House during the speech House is forced to make at the dinner extolling the virtues of the new drug Vogler is backing. House tells the room that the new drug is good, mostly because the old one was, and this one is the same but with a new name so that it can be re-patented, so that Vogler can maintain his profit margin. No one claps. Cuddy looks down and shakes her head.

Vogler is the sociopath, IMO. He first told House to pick someone to fire, giving him a choice. When House finally picked Chase, Vogler vetoed his choice (because Chase has become his mole) and told House to choose between Cameron and Foreman. In other words, he's making up the rules/changing them arbitrarily according to his own whim, like any power-wielding dictator, setting up hoops for House to jump through, toying with him, trying to break his obstinacy, threatening him endlessly with his power to destabilize House's work life.

From the show's point of view we are seeing House forced to pare himself down to his essential self, getting close but not yet arrived at a place of being personally vulnerable. No rock bottom humiliation yet. In real life, House would be gone. In the show, without House there would be no show, so we will see the cat and mouse game prolonged until House prevails or it's a draw.

Cameron seems to want to take herself out of the picture to make it easier for House. She pointed out to him she likes that he does what he thinks is "right." Before she visits him at his home to tell him all this, he is sitting at the piano playing "He's got.. high hopes, he's got high hopes, he's got, high apple-pie, in- the- sky hopes.." Back to House being an INTP or J. If House were a sociopath he'd likely not worry enough to play such a song, even randomly/unconsciously.
<hr> Posted by chiroortho (Member # 2954) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,3,13,14,7,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 13-04-2005 21:07<noscript>April 13, 2005 02:07 PM</noscript>:

I watched my first episode of 'House' last evening and was taken by the obsessive 'people lie' tone. I see what you mean, Barrett. The Senator somehow convinces House that he could not have AIDS, resulting in a second (negative) test. Fact is, it is routine to test a second and even a third time for HIV (ELISA X 2, Western Blot - an orthopedic Boards question).

That said, I was fascinated that Dr. House was not punched in the nose by a few of his proteges, and I found myself appreciating his abruptness. I appreciate it when people don't take 5000 words to say what could be said in 50.

Lastly, I didn't understand his refusal of the lady's hand (sorry, don't recall her name) when House so clearly wanted to take it.

Great show, look forward to watching the next episode.

Greg
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,3,13,14,13,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 13-04-2005 21:13<noscript>April 13, 2005 02:13 PM</noscript>:

Diane,

Thank you so much for figuring out the name of that tune at the show’s end. It was driving me crazy. I do know that it was from a Frank Sinatra movie called “A Hole in the Head.” (1959) Can’t you just see Opie Taylor singing it along with Ol’ Blue Eyes? Well, okay, maybe that’s just me. Anyway, is this a tribute to the show’s fascination with centrally mediated neurologic processes? Who knows?

This episode is titled “Role Model” and, as it turns out, this might refer to both House and the politician who grows ill. If there was an Emmy category for “The Best Use of Projectile Vomiting by a Guest Star” it would have to be a safe bet to win this season.

Details drive this show. I love the way they showed House’s interest galvanized by the loss of a single patellar reflex and how that same reflex is used to announce the patient’s recovery. Then there’s Chase playing with the same ball Vogler was holding at the end of the last episode, further cementing their connection in our heads before Chase admits it.

For the first time I can recall House is changed by the comments of others. Cameron’s explanation of why she expresses gratefulness makes him pause and his oncologist friend (can’t remember his name) slows him further during this exchange: House: “I take chances all the time-it’s one of my worst qualities.” Friend: “On people?”

House’s attitudes toward two popular things again mirror my own. I say this with some confidence because I’ve been writing about this stuff for several years. You could look it up.

I don’t like “holism.” House says, “Whole body scans are useless.”

I have stated repeatedly that results aren’t as important as the underlying theory of care. House is asked about Vogler’s drug, “Does it work?” and he replies “That’s not the point!” He is also unmoved when Cuddy shouts “Vogler’s drug works!” though I sense that the writers were trying to get us to notice Vogler’s effect on her behavior. House certainly notices this.

I’m beginning to see House as a Victorian era character. Not posing or posturing or trying to please others. He’s completely inner-directed. And that is a direction he holds true to. No wonder Cameron loves him. And no wonder she must leave the series.

Of course, I also understand they need room for House’s old girlfriend to appear in a future episode (the actress Sela Ward).

As some of you already know, I, like House, learn most of what I need to know perusing the magazines at the checkout stand.
<hr> Posted by Diane (Member # 1064) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,3,13,15,9,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 13-04-2005 22:09<noscript>April 13, 2005 03:09 PM</noscript>:

quote: <hr> Details drive this show. I love the way they showed House’s interest galvanized by the loss of a single patellar reflex and how that same reflex is used to announce the patient’s recovery. <hr>

Don't forget that he also overheard the senator talk about the huge scar on his tongue, bitten in childhood, remarked on by Foreman during the initial exam. (As soon as they talked about the tongue bite I wondered if epilepsy would crop up further downstream. It did. The whole pathology revolved around an antiseizure drug that facilitated fungal growth, decades later.) House has an ex? Should be interesting.. Cameron will be back eventually however, I think.
<hr> Posted by S.Case (Member # 4115) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,3,13,16,39,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 13-04-2005 23:39<noscript>April 13, 2005 04:39 PM</noscript>:

I agree that Vogler is the sociopath, but I also think House is the hero. In every hero story the protagonist does what is right and he does so with honor and integrity, even if that means personal sacrifice. The hero never gloats in his role, in fact, he usually wishes it were someone else, but he perserveres because it would go against everything in his nature not to. The antagonist is society itself, including the institution of medicine and capitalism, with Vogler as the evil sidekick. The team of doctors represent people in society...those who sell out (Chase), those who want to ignore the issues and are reluctant to get involved (Foreman), those who will stand up for what they believe in (Cameron). I think Cameron picked the right role model/mentor to follow.
Sarah
<hr> Posted by chiroortho (Member # 2954) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,3,16,17,15,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 17-04-2005 00:15<noscript>April 16, 2005 05:15 PM</noscript>:

Been thinking about Dr. House. I've come to the conclusion that his tendency to be abrasive for the sake of being abrasive isn't something to admire or emulate just because (on TV) he's a good clinician. It seems to me that the guy would be a better teacher/doctor if he toned it down a bit. Surely he's jaded, that's understandable, but I think patients that are on the receiving end of his attitude don't benefit in any useful way from it, with the exception of those that simply out-and-out lie to him, and even then there's a human aspect of this that he fails to appreciate. In fact, in the case of the Senator, House made up his mind that the Senator had 'full-blown AIDS' and wasn't even going to trouble himself to test the guy and shoved antiretrovirals in his face. If the Senator hadn't forced the issue, he would have died with a wrong diagnosis, instead of being cured of his real disease.

It's not that doctors should or even can sit down for 45 minutes with each patient and psychoanalyze them or baby them to come to the truth. But routinely trashing patients, staff and the plants in the hallway doesn't seem to be a sensible way to deal with the fact that patients lie. So they lie. So do doctors, but I don't see the logic in patients greeting their doctor as he walks in the door with 'hey scumbag, don't even think about lying to me!!' Something tells me that that wouldn't be very productive.
<hr> Posted by S.Case (Member # 4115) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,3,19,22,7,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 20-04-2005 05:07<noscript>April 19, 2005 10:07 PM</noscript>:

I think tonight show was my all-time favorite episode so far. Riveting in fact. The storyline was based on the notion of whether the ends justify the means, and how much is a person's life (or career) worth? I finally like Dr. Cuddy because she stood up for what she believed in, and I was kind of surprised that Dr. Wilson stood up for House, since he seemed like he was working for the other side all along. Now the questions is, what will House do with the real traitor, Dr. Chase?
<hr> Posted by Diane (Member # 1064) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,3,20,7,32,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 20-04-2005 14:32<noscript>April 20, 2005 07:32 AM</noscript>:

I agree with your assessment of the theme Sarah.

I loved House' daydream sequence at the beginning of the episode, where he asserted control over Vogler by informing him in his best neutral doctor manner that he had serious liver cancer and watched him be humbled by his bodily processes. I wonder if sociopaths can possibly grow into humility, or be flattened into it, that way?
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,3,20,9,10,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 20-04-2005 16:10<noscript>April 20, 2005 09:10 AM</noscript>:

Diane,

My understanding is that sociopaths can't be made to feel anything they're not born capable of feeling though they might fake these things quite well.

I felt the writing was a bit off this week but should take into account my jet lag after flying to Tucson yesterday.

The scarlet and gray (Ohio State colors, coincidentally, I suppose) ball showed up again, warning us that Vogler was near but not yet visible. I see a parallel story line involving the death of the woman and the new life of her child. Perhaps Vogler's "death" will be rapidly followed by the birth of new relationships in the hospital. The naked cowardice of the board members willing to vote as they did purely for monetary concerns would certainly change my relationship with them.

The celebration at the end crashed by Cuddy seemed forced and not the sort of thing House would do. I would have written this differently. Of course, nobody asked.

Now that I think of it, maybe the writers were trying to connect the drunkeness at the beginning (the husband) with the use of alcohol at the end. Maybe they're making a point about how we deal with things by impairing ourselves, numbing our pain and reducing our sensation of fear.

Maybe not.
<hr> Posted by S.Case (Member # 4115) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,3,20,13,49,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 20-04-2005 20:49<noscript>April 20, 2005 01:49 PM</noscript>:

I have a patient right now who is a neuropsychologist, and she was talking about a sociopath she had in her office the other day. Very intriguing (and quite scary too). I suggested that she watch House, because I wanted her analysis of Dr. House and Vogler's characters. Now she won't be able to analyze Vogler, but I'm glad he's gone.
Barrett-- I noticed the ball this time. I thought the very last scene was weird too...I hope they are not going to be "jumping the shark" soon on that show. I half expected to see Cameron walk in and act like nothing happened. Do you think the writers will bring her back....I could relate to her.
Sarah
<hr> Posted by Diane (Member # 1064) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,3,20,14,50,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 20-04-2005 21:50<noscript>April 20, 2005 02:50 PM</noscript>:

quote: <hr> My understanding is that sociopaths can't be made to feel anything they're not born capable of feeling though they might fake these things quite well. <hr>

Hmmn. I'll have to read that book again in places. My understanding was that the author made a distinction between 'feeling' on the one hand and 'feeling for someone else' on the other. That sociopaths didn't have "conscience", or social feeling, in other words they had no ability to imagine what someone else might be feeling, or to anticipate that with regard to their own behavior and adjust their behavior as a result, in advance of the actual behavior, to feel sorry or badly on behalf of another stuck in a plight, or any of the usual emotional social shortcuts that most people make instantly and automatically to maintain social fabric. Instead they operate outside these socially interactive subroutines having not been born with the necessary wiring to feel connected. I don't remember reading that they had no feeling for themselves, i.e., ability to feel helplessness or dependence or need or fear. Maybe my own memory is selective. My book is out on loan. Anyone remember?

I completely missed the "ball" that signalled Vogler's approach. What was the ball?
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,3,23,8,41,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 23-04-2005 15:41<noscript>April 23, 2005 08:41 AM</noscript>:

Diane,

It's just a scarlet and gray ball-looks like a tennis ball only bigger. They are messing with our heads with this, I think.

I came across a "USA Today" feature on the show published last Monday, April 18. It's probably online somewhere as well.

They discuss the interest in the show and its renewal for next season. They didn't mention me however. Bummer.

Though the doctors watching often object to some of the medicine they seem especially interested in the Vogler situation. Having resolved that after the article the writers had better come up with something else. I'm hoping this will not include some sort of Desperate Housewives (in)sensibility but you never know. Our culture follows the money after all, and resistance to that is, well, futile.
<hr> Posted by Chris Adams (Member # 3013) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,3,27,7,42,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 27-04-2005 14:42<noscript>April 27, 2005 07:42 AM</noscript>:

What...no breakdown of last night's episode yet? I would provide one, but Barrett's is much more eloquent with his descriptions. [IMG]smile.gif[/IMG]

That one scene nearly had my wife and I gagging where the pseudo-schizo started throwing up blood. Man that was disturbing!
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,3,27,8,13,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 27-04-2005 15:13<noscript>April 27, 2005 08:13 AM</noscript>:

Chris,

I'm almost certain this episode (a repeat) was covered in December before I single handedly generated a massive interest in the show and saved it from cancellation. Not to sound grandiose. What the heck, here's a copy of what I wrote then.

I appreciate your looking for it.

Well, it’s Wednesday night and you know what that means-another detailed and fascinating examination of House, the show touted by Fox as a “hit series.” I’m not sure anybody from the network is actually reading this thread.

Anyway, this week begins with our hero seated in the waiting area of the emergency room because, as he says, “I like these chairs.” He overhears another doctor tell a young man that his mother is an alcoholic. When the boy objects, House intervenes, “This guy’s a professional doctor-he plays golf and everything. I’m sure he did all kinds of tests before telling you your mom’s an alcoholic.”

With these few words House reveals a great deal of what he knows to be true about typical medical practice. Of course, House makes the same mistakes with some regularity and would probably be willing to admit that with a disclaimer; that his mistakes are made with the patient’s best interest in mind-or something along those lines.

The mother’s combined diagnoses of pulmonary embolism and schizophrenia at the age of 38 intrigues House and he launches into an intricate diatribe about Socrates (“an untreated schizophrenic”), Galen (“the Marcus Welby of ancient Greece”), Isaac Newton and chainsaw juggling. All interesting subjects, to me anyway, though he was wrong about that Greek thing. Galen worked for the Romans.

His young charges discuss his sudden interest in a patient with a seemingly ordinary problem and one makes the point that it’s the schizophrenic behavior that catches House’s attention, not the odd confluence of findings. “(Schizophrenics) aren’t boring,” he says.

The theme in this week’s show that caught my attention was “maturity.” The patient’s son is only 15 (though pretending to be older) but House treats him as an equal of sorts, calling him “doctor,” treating his notebook as if it were a legitimate medical record and offering him his beeper. Almost always, some of my current reading connects me to my current writing and today is no exception. “The Rapture of Maturity” by Charles Hayes talks at length of how the mature individual isn’t created simply by aging but by interest and curiosity. He quotes Marcus Aurelius (Galen’s boss, in fact): “Life is what thinking makes of it,” and emphasizes the tendency or willingness to simply contemplate as House is often seen doing. He points out that empathy is “just a feeling” and that it should take a back seat to compassion, which he sees as “a property of life that gains substance as a form of action.” We see no empathy from House, but he’s full of compassion.

There are a number of enigmatic lines and puns in this episode:

The patient’s son says, “I don’t want to be ‘housed!’”

“Mets” and “meds” are confused, and the Mets lose.

House says, “I like to walk.”

One other thing. This week I never once saw House take a pain pill. What’s up with that?
<hr> Posted by Diane (Member # 1064) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,3,27,9,36,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 27-04-2005 16:36<noscript>April 27, 2005 09:36 AM</noscript>:

This episode was a repeat, however, I noticed the ball this time, sitting on House's desk. (Vogler won't appear in the series til several episodes later.) The scene where Cuddy follows House into the men's room for a chat is reminiscent of that lawyer series (the name of which escapes me) with Callista Flockhart.
(I rather enjoy the carefully paced, slow unfoldment of the intertwined lives in Desperate Housewives, even though I can't make out how Susan supports herself/home/daughter/life.)
<hr> Posted by Chris Adams (Member # 3013) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,3,27,12,41,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 27-04-2005 19:41<noscript>April 27, 2005 12:41 PM</noscript>:

Thanks Barrett! [IMG]smile.gif[/IMG]

I've only been watching the show for a little while now so I guess I'm behind.
<hr> Posted by tf8560 (Member # 3892) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,3,27,18,43,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 28-04-2005 01:43<noscript>April 27, 2005 06:43 PM</noscript>:

Because my 4 year old daughter rules the house, the only thing I get to watch is the Disney Channel...Anybody wanna talk about "That's So Raven?"
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,4,14,19,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 04-05-2005 21:19<noscript>May 04, 2005 02:19 PM</noscript>:

I’d call last night’s “The Gender Episode.” Here’s why:

The 12-year-old at the center of the diagnostic mystery is displayed as someone very unlike a young girl in that age group. Described as mature beyond her years and devoid of any obvious sexuality, she is the perfect warrior, enduring the physical risks of high diving while feeling badly and facing the possible humiliation of failure before large crowds of strangers. I’m not suggesting girls can’t or shouldn’t do this; just that it’s unusual at that age. When she grows emotional while faced with illness she immediately apologizes and says she doesn’t normally do that.

House’s world has recently lost two major characters, Cameron and Vogler. Whether he knows it or not, House himself replaces Vogler when he treats Chase in the way he does (“When I give you an order…”) but Cameron is not so easy. I firmly believe that the genders are equal but asymmetrical and what she brought to the team cannot be replaced by any man. As House says when at the final moment he must discover the underlying cause for the diver’s illness, “We’re missing something.” He says this to the remaining members of his staff-both men. Ironically, (or perhaps by design) a male’s presence in the young girl’s life resolves the mystery. Maybe Cameron would have seen this sooner. I don’t know.

As always, there’s more. House rejects an ideal applicant for the job and says it’s her shoes. I think it was because she was too much like a guy. The scarlet and gray ball shows up on his desk just then as well. You can make of that what you will. House also gestures in a certain way with his new cane while in the men’s room right after vanquishing Chase once again. Like I said, it’s The Gender Episode.

I also liked how they were forced to treat this girl in the midst of chaos. It was a HIPAA nightmare. Twice the young girl is tested painfully while assuming poses she commonly adopts while diving. I’m still wondering about that.

My favorite lines:

“Weird works for me.” And “Want to be a rebel? Try to stop being cool.”
<hr> Posted by Diane (Member # 1064) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,4,15,50,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 04-05-2005 22:50<noscript>May 04, 2005 03:50 PM</noscript>:

Looks like Cameron is back. Maybe the show will segue into Beauty and the Beast.

My favorite line was Wilson's.

After the ideal candidate with the green high heels has been sent away, House says he didn't like her shoes, that she must be a very shallow individual to wear shoes that are so obviously painful just to make a fashion statement.

Wilson, who liked the candidate and was bewildered when House sent her away, said something like, "Anyone who works around you would need to know how to endure pain."

Paininthebackside tension producing sociopath Vogler is gone along with all his cash, which is why the docs are all doing nursing duties out in the hallways.
<hr> Posted by JSPT (Member # 4845) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,10,17,35,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 11-05-2005 00:35<noscript>May 10, 2005 05:35 PM</noscript>:

Barrett had an interesting observation: "I firmly believe that the genders are equal but asymmetrical..". I have never heard it put that way, but have found it to be true.

As a young, male student, I was usually addressed before my more seasoned CI when we entered an exam room. Older patients (men and women) especially seemed to speak to me before my instructor. After a few such occurrences, I took to sitting off in a corner so attention was focused on the senior clinician asking the questions.

I think this may be a generational issue that I hope will continue to self-correct.
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,11,10,0,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 11-05-2005 17:00<noscript>May 11, 2005 10:00 AM</noscript>:

I’m in Fresno and the time change got to me half way through last night’s show, rendering me unconscious until it was time to wake up as I normally do 5:30 AM. Of course, that’s 2:30 here. You know, there’s some interesting stuff on at that time of night, and I’ve been awake since then. Class begins soon. My plan is to fall asleep again after I drive to Oakland this afternoon. I’m hoping that works out.

In any case, I gained a sense of predator/prey behavior in the portion of the program I saw. These roles shift about, and, I guess, this is reflected in several ways.

Anybody else get this? How did it end?
<hr> Posted by OaksPT (Member # 2776) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,11,10,41,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 11-05-2005 17:41<noscript>May 11, 2005 10:41 AM</noscript>:

Barrett,
Not sure where halfway was , so here's a brief synopsis:
The asian guy (Joe) had to have surgery secondary to a blocked carotid, which turned out to be clear. House had to tell his parents that he was dead in order to get them to come give consent for the surgery, they had disowned him secondary to his perversion. Anyway the carotids were clear so back to square one. The Dr from australia found a lot of breath mints at Joe's house, House got him to smell his breath which was putrid, they then figured out the jaw replacement was infected, and blocking blood flow to the brain, hence the continued strokes.
House went on a date with the returning female dr.which turned out to be a psych analysis, House told her that since her first project had ended(1st husband dying of cancer), she was in search of a new project to fix( House-twice her age , not particularly handsome or charming). when prodded by their colleagues, House said their would be no more dates, the female said she though maybe(she thinks she can fix him).
Anyway that's how it went, as an aside, you may have seen how when they were getting his previous visits to different practitioners, it was pretty much a laundry list of alternative medical practitioners, he went on a rant on eastern vs western medicine, and even questioned if the strokes were caused by chiropractic manipulation or an infection from the acupuncturists needle.
Somebody join in if I missed anything,
Scott
<hr> Posted by Diane (Member # 1064) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,11,10,56,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 11-05-2005 17:56<noscript>May 11, 2005 10:56 AM</noscript>:

We saw shifts in perspective. The show forced the "asymmety" you mentioned between the genders (which makes me think of lop-sided crab claws) out into the open.

The show was "Kinx" meets "Beauty and the Beast." The patient with the old jaw injury and metal plate, and mysterious life threatening illness that made him keep having strokes despite the bloodthinners and surgery to find clots, was a masochist who enjoyed being strangled. The show included a perfectly aware and completely attuned sadist, in the form of a woman who called herself his 'friend' who visited him and provided him this service. Chase was the one who spotted the SM relationship, remembered having met her at a few "parties" (more innuendos about Chase possibly being a bit of a sleaze).

She knew the patient well enough to know when he was himself and when he was stroking out. Through her, they learned about his "nominal aphasia" and "asphixophilia." First they kicked her out of the hospital, but later brought her back, and ended up relying completely on her discernment at one point.

Chase and Cameron were sent to 'visit' his house (broke in to gather clues yet again.) They found a leather head cover and other SM toys, and a huge number of full containers of tictacs, a few of which Chase lifted, which provided House with the idea to check the patient's breath; it was bad enough to make House decide that the patient's old jaw injury was leaking pus into his brain. When the jaw was removed, the patient recovered.

Cameron and House went out on their "date." House bought her a corsage, a gesture he figured was 'lame' enough that it might help him keep his distance from her, but which Wilson decided was something that Cameron would like; he said, "I think she likes 'lame'" which referred not just to the corsage but to House himself.

House told her over dinner (after complimenting her on her earrings and shoes, as instructed by Wilson) that he figured she "needed" him because he was 'damaged', the way she had "needed" her former husband who had cancer. His take on this was both accusatory and self-deprecatory at once. Cameron was clearly uncomfortable with this laser beam analysis, but took it because she had asked him for honesty. Cameron is impeccable in her own emotional honesty/lack of guile, which puts her in an excellent position to be "predator" if it's House she wants. He finds it rarely enough in people to make its occurrance in his life precious, perhaps.

Everyone the next day wondered how the date had gone. Everyone seemed to be juggling their perceptions of relationships with both people to handle this new arrangement, this prospect of them becoming an item, both before and after the date. Cuddy was definitely positive. Either Wilson or Cuddy, I can't remember which, told House that it was time to stop feeling sorry for himself. It was implied that this potential relationship might be his last chance ever to avoid terminal bitterness.

The show left the viewer wondering about what's next in that regard. Both seemed satisfied with the date. When asked if they'd be dating again, House told people "I don't think so." Cameron said "I don't know." The final scene was House in his office looking at an old photo of himself with his last wife.
<hr> Posted by Diane (Member # 1064) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,11,11,13,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 11-05-2005 18:13<noscript>May 11, 2005 11:13 AM</noscript>:

I just remembered another layer to the show that has to do with issues of "control". When caught strangling the patient (and before she is kicked out of the hospital) the sadist explains that when her 'friend' senses he is out of control he needs to be strangled so that "he can get back into control by feeling out of control." The hospital doesn't buy this paradox at first.

Later, realizing their have no legal "control" of the patient, they bring her back in, because they want her to "command" him to have surgery and sign a consent. She tries, but he has another stroke meanwhile, that only she spots as a stroke, and thus is more in "control" of the diagnosis than the doctors at that point.

In the other story line, Cameron's colleagues are trying to tell her she's out of line dating House, being an underling and all.. she replies, "He's my boss. I'm allowed to sexually harrass my boss." Again, the one who seems more overtly powerless in the relationship has more actual control.
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,11,14,16,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 11-05-2005 21:16<noscript>May 11, 2005 02:16 PM</noscript>:

Thank you. Knowing you guys are on the case I can sleep next week when my schedule again forces me across the country.

I'm a fan of Carl Jung's notion that we must go to our "shadow" (the ways that we are not) to find the answer to our most difficult questions. This is clearly displayed in "Silence of the Lambs" by agent Starling's relationship with Hannible Lecter and in "Backflash" when the DeNiro character goes to the guy played by Donald Sutherland. I think the "shadow" is pretty obvious in this episode.
<hr> Posted by Diane (Member # 1064) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,11,16,32,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 11-05-2005 23:32<noscript>May 11, 2005 04:32 PM</noscript>:

Funny, I was thinking about the Jungian angle all morning at work, and was kicking myself that I forgot to include shadow aspects in the posts above.

The show reveals the whole social shadow layer, where "society" gets to feel its sensibilities all shocked and put out by SM, by what it considers "perversion", yet conducts itself every day, UNconsciously, in multitudinous truly perverse every-day ways that are considered "normal", yet are systematically destructive and inequitable. The show allowed us to dip into both that usual kneejerk social response, then pulled us sideways to consider a diametrically opposed perspective when the sadist (the shadow-bearer) explained very clearly, matter of factly, what it was she did and why, and when it became clear the hospital needed her back for their own purposes. SM is shown to be the shadow of the hospital itself. (It is the shadow of our beloved therapy world too, in that it dishes out actual pain instead of trying to be about relieving it.)

Elsewhere in the worldview of Jung, people mate up with people who carry the projections of those aspects of ourselves of which we are the most unconscious and that we most need to integrate to become psychologically whole or completed.

As House and Cameron find their way toward each other, Cameron is looking to merge something Marion Woodman calls "the wounded animus", the "inner male" who is unthreatening, in order to feel more powerful as a female. House (if he is looking at all) is looking for "anima", the female side of himself that isn't cynical, bitter or twisted.

Whenever Cameron says something, House does a piercing inspection of her face, looking at her from within his own emotional landscape, a dry desert in which he seems to wander aimlessly. He checks closely; could she be an actual oasis? or is she just another mirage, another form of deception that would waste his ever decreasing lifespan of its remaining time and energy. He isn't allowing himself to dredge up any hope yet. He is just fulfilling his end of the deal, that she would come back to work for him if he would go on a date with her.
<hr> Posted by Jon Newman (Member # 3148) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,11,18,48,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 12-05-2005 01:48<noscript>May 11, 2005 06:48 PM</noscript>:

Maybe its just me but I'm starting to note a trend of portraying House as Sampson (not the cartoon). Anyone else see it?

jon
<hr> Posted by S.Case (Member # 4115) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,11,21,23,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 12-05-2005 04:23<noscript>May 11, 2005 09:23 PM</noscript>:

Jon,
Expound on that please.
Diane and Barrett, very interesting discussion of Jungian theory. I thought it was strange that Cameron chose to bring up Freud at dinner....no one really buys that Freud stuff anymore do they?
Sarah
<hr> Posted by Jon Newman (Member # 3148) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,11,22,24,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 12-05-2005 05:24<noscript>May 11, 2005 10:24 PM</noscript>:

Never mind Sarah, its probably just me but the jaw bone thing got me thinking. Then there is the Delilah--Cameron connection and Lion--Vogler connection. And of course the House versus philistines thing (small p not capital P). Anyway, like I said, its probably just me.

jon
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,12,9,6,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 12-05-2005 16:06<noscript>May 12, 2005 09:06 AM</noscript>:

Sarah,

You're right in assuming that Freud has fallen into disfavor among many theorists, but I'm reading "Why We Lie" by David Smith right now and he makes a very compelling case for a renewed understanding of what Freud proposed and actually thought. There is a resurgence in psychology in that direction.

As you may recall, I mention Freud at my course and his appreciation for the "surprising" speech from his clients. In the same way, I want my patients to move in surprising ways. After all, we both (Freud and I) go to the unconscious for the answer.
<hr> Posted by Jon Newman (Member # 3148) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,12,20,3,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 13-05-2005 03:03<noscript>May 12, 2005 08:03 PM</noscript>:

The thing you have to remember about Freud is that he formed his thoughts in the context of what we were able to detect and measure at the time. I mean think what this guy would have come up with an fMRI at his disposal. I see Lorimer Mosely is going to be getting his hands on one in the future--good luck, I can't wait.

Anway, this link might be of interest.

jon
<hr> Posted by Diane (Member # 1064) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,14,15,26,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 14-05-2005 22:26<noscript>May 14, 2005 03:26 PM</noscript>:

Here's a link to edge.org, and a discussion of the "equal but asymmetric" idea. Be sure to scroll up and start at the top, to get the original piece. Farther down the page, various sharp minds comment on it.
<hr> Posted by Chris Adams (Member # 3013) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,17,21,4,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 18-05-2005 04:04<noscript>May 17, 2005 09:04 PM</noscript>:

Okay...I saw the last 15-20 minutes of the episode and I was partly confused the whole time. Someone please re-cap tonight's episode with some detail. [IMG]smile.gif[/IMG]
<hr> Posted by JSPT (Member # 4845) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,17,21,16,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 18-05-2005 04:16<noscript>May 17, 2005 09:16 PM</noscript>:

Best....House.....Ever.

Favorite Line: 'I choose to live as though this is not a test'.

The underlying theme to House's dilemma makes me realize that the longer I practice, the less likely I have been to chalk unprovocable (is that a word?) pain up to psychosomatic origins. I have found myself thinking that, unless blatantly obvious, I have simply not ruled out every possible source of pain.

I'm not sure if sorting out the somatic versus psychosomatic gets easier as experience is accumulated. Can the two even be separated?

Whether pain originates from the periphery or centrally, the patient is in pain. When a PT is certain that pain is central in origin (for discussion, central being from the brain and not caused by a peripheral irritation), how do we approach the patient and to whom do we refer?

For those who answer "the referring physician", how would the physician react to a PT reporting findings consistent with psychosomatic pain to them? How much patient counseling is appropriate according to our practice act?
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,18,23,47,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 19-05-2005 06:47<noscript>May 18, 2005 11:47 PM</noscript>:

“Surrealist art reveals odd juxtapositions-visual and verbal non sequiturs that create a sense that ordinary life and dream are two sides of one very thin coin.”

I read this in “Utne” magazine on the plane flying west yesterday morning. The essay went on to suggest that surrealist expression is increasingly a large part of many disciplines and, as a way of getting a message across, it is remarkably popular ever since the advent of MTV. I agree. As it turns out, two of my favorite artists are Dali and Margritte.

I fell asleep after the first twenty minutes of House and wakened again sometime early in the second half. The dreamlike quality of my televiewing seemed to match whatever I wakened to. Anybody watching this show for the first time this week might wonder what the heck was going on, but veterans recognize House’s ability to turn within to solve the problem at hand. His lecture about the patients with the leg pain becomes a lecture about his own struggle, his failure, and his triumph. His animosity toward others is seen as a projection upon the worst patient he’s ever known-himself.

If ever I get another book published it will be titled “Dreamcatcher.” Like surrealism, my experience in the clinic is often an odd juxtaposition of seemingly disparate elements that all make sense and connect through an understanding of unconscious processes and expressions, most of them deceptive but without malice, like House’s lies designed to solve a diagnostic and treatment problem. He’s not playing chess, he’s playing poker-and brilliantly.

After all, when accused of being an “idiot” by his girlfriend he objects; “I’d say I was more of a jerk.”

It’s a fine distinction-and I think it’s the truest thing said in this episode.
<hr> Posted by Diane (Member # 1064) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,19,0,10,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 19-05-2005 07:10<noscript>May 19, 2005 12:10 AM</noscript>:

I missed House this week... we had a provincial election here that preempted everything on every channel.
<hr> Posted by james097 (Member # 4417) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,19,10,26,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 19-05-2005 17:26<noscript>May 19, 2005 10:26 AM</noscript>:

Diane, You did miss it. House was on at the usual time, you Sherwood have enjoyed it. Dr Who was preempted.
Jim McGregor
<hr> Posted by Diane (Member # 1064) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,19,11,29,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 19-05-2005 18:29<noscript>May 19, 2005 11:29 AM</noscript>:

You're right, Jim, I Sherwood have enjoyed it... I looked and found nothing but election coverage - What channel did you watch it on? Hi by the way. We seem to be neighbours.
[IMG]smile.gif[/IMG]
<hr> Posted by Diane (Member # 1064) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,21,11,36,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 21-05-2005 18:36<noscript>May 21, 2005 11:36 AM</noscript>:

I managed to see this episode after all thanks to a neighbour who taped it.

This episode's structure is a bit different. Usually the show has two storylines that oscillate around each other, caduceus-like. Usually the two story lines are a weaving of third-person (events as they unfold in present time) and first-person (from House's POV.) This time the storyline is singular and almost entirely first-person. The plot is the world of House from inside House's mind; the entire story is House in teaching mode, the style is impressionist. He teaches clinical reasoning to a room full of med students, confuses them by confusing three patients with leg pain (one of whom was himself) that he uses as teaching examples.

Various contextual bits are woven into the story: A visit and plea from his ex who is one of his main pain triggers apparently (to help figure out her new husband's ailment of all things..), a short five minute break where House sits in a tiny lounge talking with Wilson during the lecture, House prowling and trying to find some water to wash down all his pain pills while still lecturing, House finding some dusty crayons in the desk at the front and coloring a picture of what urine looks like when a muscle has died (brown).

The theme of this episode seems to be about time, as perceived by a person in chronic pain, and the new structure is "palimpsest."

Palimpsest: 1. a piece of writing material or manuscript on which the original writing has been effaced to make room for other writing; 2. a place, experience, etc., in which something new is superimposed over traces of something preceding it.

We see House's day unfold through House's painkiller assisted, slightly hazy point of view: this episode wanders between reality and fantasy; time is no longer chronological but stretches and shifts, characters merge and change places. House makes a comment about it when asked by a student to clarify, remarking that science has shown time isn't necessarily sequential.

Most lives are like palimpsests, and House's is no exception. In this episode he is in one of those troughs life gives us some days: he is under strong emotional stress: his ex has shown up in his life, it was she who, while he was in a chemically induced coma with his necrotizing leg at stake, decided for him that his dead muscle should be removed. This makes her the "bad guy" in his emotional brain (his brain feels "threatened" by her), even though rationally he knows her judgement was in line with medical judgement. If exacting medical protocol had been followed, in fact, the leg would have been sacrificed as was protocol for the other two patients. The women were trying to keep him alive AND leave him with his leg (he adamantly refused amputation), yet he can't help associating them with his pain state.

This no doubt adds to his pain burden, and affects his ability to centrally 'downregulate' his pain adequately in order to cope with the other huge stressor that day, having to give this diagnostics lecture. He whines about having to do it, but Cuddy/Cuddly/Cutty (the mother figure) makes him face his teaching responsibilities.

We see him struggle to retain control of himself, but he ends up barking at the med students anyway. One young woman remarks, "I can't think when you're in my face like that." To which House replies sharply, "If you think this is bad how will you be able to think when a dying patient is in your face?"

Several bits of House are revealed in this episode due to his personal stress and inability to contain all of it: His relationship to Cuddy becomes more clear; she is the one who in consult with the ex, removed the muscle from House's leg, taking away some functional aspect to spare him further pain and possible death from his body having to digest the decay on its own. (She is both 'good mommy' and 'bad mommy' combined.)

Even though he may well have ended up with a dysfunctional leg anyway, he guilt trips her all the time; in nearly every episode we see her sighing over his behavior yet not calling him on it, because she understands where it comes from. He is her burden to bear. The ex left because he was "hard to live with", as Wilson points out during their brief chat.

In general, his caustic attitude toward women is revealed as likely stemming from so much of what his emotional brain must perceive as betrayal/abandonment by women, (i.e., Cuddy and his ex), contributing to his life of chronic pain.

Another glimpse we are given into his story is that he experienced "near death" during a heart attack he had while his electrolytes were in disarray from his muscle death. He discusses it with his students in a third person way.. that's where the remark "I choose to think life is not a test" stems from. By that he means that he doesn't believe in afterlife. He says it catagorically, even though he is obviously always fully engaged in the test he is being given by his own life circumstances, another level of meaning that perhaps he hasn't considered.

The room has gradually filled. One by one, all the people he works with have entered the room, are sitting, and are respectfully listening to him, are having their own little private "aha" moments as it dawns on them he is using himself as an example without ever saying so. Everyone gets caught up, loses track of time. Near the end House realizes that he's gone twenty minutes over. Much to his annoyance.
<hr> Posted by Jon Newman (Member # 3148) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,21,21,4,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 22-05-2005 04:04<noscript>May 21, 2005 09:04 PM</noscript>:

Hi Diane,

Nice analysis. Although I'm thinking twice about meeting you now. I'll be Julianned by the end of the day (laugh).

While I enjoyed this episode only one inconsequential scene stood out for me. Near the very beginning, when House meets his ex, they are having a conversation in front of some glass doors. Right as she is asking him a favor (to dx her husband), someone needs to get through the door they are blocking causing a polite but awkward inconvenience at a critical moment in the conversation. Knowing that this was likely scripted I thought it was brilliant.

I guess one other thing stood out. Written on the dry erase board on the lecture stage were a list of organs and the affect the sympathetic and parasympathetic nervous system has on them. I couldn’t read what was on the chalkboard.

I’m not sure why, but these things were more intriguing to me than the story line.

jon
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,25,6,28,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 25-05-2005 13:28<noscript>May 25, 2005 06:28 AM</noscript>:

Season Finale!

House’s life has a certain edgy balance, like the interlocking tines of the forks he’s balancing on a glass in the opening scene. This balance is abruptly disturbed with the arrival of the woman he used to live with but not enough to keep him from drugging her husband. The initial exchange between these two men reveals that the husband is no match for House’s intellectual scheming. After all, he is tricked into gulping down the drug.

The strong melodrama concerning House’s former relationship with this woman and its potential effect on his judgment might have detracted a bit from the show’s normal focus but the writers get their shots in anyway. House comments that people sit in hospital waiting rooms “because the closer they sit to the operating room the more (they seem) to care.” He also says, “Lying is a creative process-telling the truth is much simpler.” I really like that one.

This old girlfriend indicates she’s changed in the years since their parting (“I like sugar now” she says of her coffee) but, apparently, House has not. When he says of the roof “I haven’t been up here in five years” it seems she’s driving him toward old patterns of behavior that are better left behind. It occurs to me that roofs are just for solitude-they’re also good for jumping off of.

I thought House’s injection of the husband despite the strong objections of his colleagues was an amazing scene. Probably not good medicine, but good television.

The final scene shows us how even House wants to appear normal. He tosses away his cane and attempts a step. When he can't do it he reverts to the pain pill, exchanging one sort of lie for another. I think he would appreciate what the contemporary philosopher Thomas Moore says: "The need to be normal is the predominant anxiety disorder in modern life."

As always, there is a parallel story of behavior here. The wife is asking House to do to her husband the same thing she had done to him. The irony is palpable but handled without too many words. As usual, the writers make us think. As long as that continues, I’ll love this show.
<hr> Posted by Diane (Member # 1064) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,25,8,45,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 25-05-2005 15:45<noscript>May 25, 2005 08:45 AM</noscript>:

Interesting dominance displays in this episode, between House and the husband, between Cameron and Stacy, between House and Stacy, between Cuddy and House..

When House sent his troops into Stacy and Mark's house to snoop, as usual, for clues to determine why Mark was sick, Stacy had left them a note and cookies. Does she know House or what? Maybe better than he knows himself. Still, what does this repetitive feature of the show say about boundaries?

In almost every episode House takes some opportunity to stab someone with a syringe and inject something into them without their permission, in this case, even despite intervention by his three underlings. And gets away with it, because he's always right and it's always retroactively in the best interest of the patient. What is this trying to say about the medical profession and its relationship to drugs? About drugs in general?

Interesting that he pocketed the amphetamines (and everyone noticed him do it) that Mark (the highschool counselor) had presumably confiscated from one of his students. Interesting also, that House popped one of them while "You Can't Always Get What You Want" by the Rolling Stones played.. Song aside, what does this say? Why the repetition of the drug theme?

He tried walking on his painful leg. Maybe he's going to try some graded exposure to painful movement. Why is this show disturbing/addictive?
<hr> Posted by S.Case (Member # 4115) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,25,12,58,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 25-05-2005 19:58<noscript>May 25, 2005 12:58 PM</noscript>:

Diane,
Ditto my thoughts/questions exactly.
Barrett, leave it to you to find the symbolism in every scene (balancing forks, rooftop). Of course, House went way over the ethical line this episode by stabbing the patient twice without his permission, but it does make for good entertainment!

I thought the exchange between Dr. Cameron and Stacey was interesting and I am wondering what kind of love triangle will form when Stacey starts working there again. And I just have to say, I am really getting to like Dr. Wilson (I didn't fully trust him before, but he is a good friend) I am going to miss this show over the summer!
Sarah
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,25,13,14,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 25-05-2005 20:14<noscript>May 25, 2005 01:14 PM</noscript>:

The song's final verse in interesting, given the new character, her relationships and her ways:

"I saw her today at the reception
In her glass was a bleeding man
She was practiced at the art of deception
Well I could tell by her blood-stained hands"

"You can't always..."

For those of you old enough (like me) flashing back to the 60s is understandable. It would be nice if I had the hair for it.

Diane,

I'm pretty certain House takes a pain pill, not the amphetamine but I agree that this is confusing.

The show's addictive quality is explained in my newest "Book Report."
<hr> Posted by Jon Newman (Member # 3148) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,4,25,19,19,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 26-05-2005 02:19<noscript>May 25, 2005 07:19 PM</noscript>:

Did anyone notice the "awkward moment" scene between House and Stacy again? This time it was while House was questioning Stacy about why she hasn't told her "old friends" that she was bringing her husband to House for dx. He asks, "Why would that be?" Just then someone comes to use the phone they're standing next to requiring them to move their conversation. I'm still not sure why I originally found the "awkward moment" interesting. But now I find it interesting because I've seen it again in a different 'color'. Not unlike when you think about buying a new car and start seeing the one your thinking about all over town or when you start noticing similar elements through all the different related approaches to therapy.

While the Rolling Stones certainly deserve high praise, my nod goes to the selection from Huddie Ledbetter (Leadbelly) for the short snippet

"Delia was a gambling girl, she gambled all around
Oh, she was a gambling girl, she would lay her money down

She's all I've got is gone..."

Here's a link to the full lyrics but I think the song was choosen for the first few lines myself.

Notice the name of gambling girl?

Since it is the finale I figure I can make a finale of an observation. In the last scene, one could consider House to be juggling for pain relief...and he didn't drop.

jon
<hr> Posted by S.Case (Member # 4115) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,5,8,14,55,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 08-06-2005 21:55<noscript>June 08, 2005 02:55 PM</noscript>:

I know last night's episode was a re-run, but I didn't see a review of it anywhere. Was House really watching his patient play Lacrosse or was he just imagining it? Loved how he handled the litigious patient, and the woman who didn't want to have her baby vaccinated. I agree with Barrett that House is really a story-teller, who "cures" people by telling him their own story because they are in denial or unaware of it. He was wrong about Cameron though, stating that she must be an only child because of her "it's all about me" attitude. She still respects him too much to rebuke his remarks...interesting.
Sarah
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,5,8,17,15,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 09-06-2005 00:15<noscript>June 08, 2005 05:15 PM</noscript>:

Sarah,

Check page one of this thread. On November 24th I wrote a bit specifically about this episode. The scene at the end is certainly interesting and I think it's discussed by a couple of others on that page as well.
<hr> Posted by pablo w (Member # 2185) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,5,12,4,59,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 12-06-2005 11:59<noscript>June 12, 2005 04:59 AM</noscript>:

It's been a bit difficult trying to follow any of this without having the opportunity to see the show. House is coming to Australia at last, and we will at last know what you are all talking about!

Pablo
<hr> Posted by nari (Member # 2772) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,5,12,16,42,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 12-06-2005 23:42<noscript>June 12, 2005 04:42 PM</noscript>:

I was about to post exactly the same comment but Pablo beat me to it,..

But I suspect that we will be 4389 episodes behind you guys..or is that a conservative estimate?


Nari
<hr> Posted by Jon Newman (Member # 3148) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,5,12,16,54,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 12-06-2005 23:54<noscript>June 12, 2005 04:54 PM</noscript>:

Actually, this was the show's first season.

It will be interesting to see what you think after reading all the plot lines.

I once listened to an episode of Star Trek (New Gen) on audio tape that someone had sent me as I was in an area without TV for some time. Upon returning I remembering seeing that episode and kept having repeated Deja Vu experiences. I had forgotten I listened to the show. Months later I had found a cache of audiotapes that were unlabelled and upon going through them I came across that episode and it suddenly dawned on me why I had those Deja Vu's. It was one of the more surreal TV watching moments I can remember.

jon
<hr> Posted by S.Case (Member # 4115) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,5,22,15,40,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 22-06-2005 22:40<noscript>June 22, 2005 03:40 PM</noscript>:

Jon,
I had that experience last night as I watched the nun episode for the first time, having already read about it in the thread.
Thoughts that stand out: 1) House's refusal to allow himself to be falsely accused of making a mistake. This was in regard to giving the patient 0.1cc of epinephrine vs. 1.0 cc. Notice, the only person who believed in him was Cameron.
2) Chase's admission that he went to seminary school, and lost his faith. Then the nun compared him to the prodigal son....hmmm, makes future episodes a little more intriguing.
3) House's comment that faith in spiritual things is perfectly fine, but he bets the patient looks both ways before crossing the street....I took this to mean that she is still subject to the same physical laws as everyone else, with or without faith.
4) Documentation will forever remain as the fourth circle of Hell in my mind!
Sarah
<hr> Posted by pablo w (Member # 2185) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,5,26,7,26,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 26-06-2005 14:26<noscript>June 26, 2005 07:26 AM</noscript>:

OK, just watched the first episode (we are a bit behind in Australia). After all the hype from reading some of the original posts I found it a bit disappointing. It may yet grow on me, so I'll have to give it another chance.
<hr> Posted by Jon Newman (Member # 3148) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,5,26,8,1,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 26-06-2005 15:01<noscript>June 26, 2005 08:01 AM</noscript>:

Ah the mischief making of expectation. I think it's true that high expectations can sometimes render something that's good or useful to being banal or worse. Ever have that happen with a therapeutic encounter?

jon
<hr> Posted by nari (Member # 2772) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,6,1,3,7,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 01-07-2005 10:07<noscript>July 01, 2005 03:07 AM</noscript>:

Well, I missed it altogether as I do not look much at TV timetables except for foreign movies.

I might get the gist in the next episode??

or i might not..


Nari
<hr> Posted by nari (Member # 2772) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,6,6,6,55,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 06-07-2005 13:55<noscript>July 06, 2005 06:55 AM</noscript>:

Second episode - the first I've seen, where a young guy is admitted with symptoms that don't add up to anything except maybe two simultaneous conditions. (Gout med vs cough med saga).
Parents and girlfriend watch everything including cardiac catheter and who knows what else. Weird!

I like House - he is enigmatic. Not sure about the rest of the caravanserai. Haven't got a feel for the series yet; maybe it takes time.

But I agree with Barrett -it makes you think. Full of hidden nuances, mainly from House.


Nari
<hr> Posted by Sarah C. (Member # 4115) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,8,5,10,19,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 05-09-2005 17:19<noscript>September 05, 2005 10:19 AM</noscript>:

The new season starts next Tuesday. I am psyched! [IMG]smile.gif[/IMG]
Sarah
<hr> Posted by Barrett (Member # 67) on <script language="JavaScript1.3" type="text/javascript"> document.write(timestamp(new Date(2005,8,5,11,44,0), dfrm, tfrm, 0, 0, 0, 0)); </script> 05-09-2005 18:44<noscript>September 05, 2005 11:44 AM</noscript>:

Yes, Houseparty tomorrow at 9PM on Fox. It is my intention to begin a new thread, "House-The Second Season" before then so we can begin again.

I'll be watching from a hotel room in Syracuse.