Dr. House: Impaired but Functional?
A subplot in the latest episodes of House deals with Dr. House's own problem, his addiction to the painkiller Vicodin. It began innocently enough - when House needed the meds to control his chronic pain - but quickly spiraled out of control. Even while showing off his diagnostic prowess, House still finds the time to feed his habit.
By introducing the concept of House as an impaired physician, the writers let the viewers in on a little secret: House (like all doctors) is a human being, with human weaknesses. And sadly, House's drug problem actually represents a condition more common than the majority of medical issues portrayed on the show. Estimates suggest that approximately 2% of all physicians have a current substance abuse problem, and that between 8 and 18% of physicians will be impaired as a result of substance abuse at some point in their lives. Alcohol is the most common substance abused by physicians, but prescription opioids (House's drug of choice) and anti-anxiety medications are also commonly abused by those in the medical profession.
The notion of a doc with a drug habit is not novel. In fact, drug abuse is considered by many to be an occupational hazard of practicing medicine, and physicians historically have had high addiction rates. Combine a stressful job with the relative accessibility of drugs in a person who may be genetically or otherwise predisposed to substance abuse or addition, and there's physician impairment waiting to happen.
But is House really impaired in the strictest sense of the word? The U.S. Federation of State Medical Boards defines an impaired physician as:
So far, House is probably still practicing within the limits of reasonable skill and safety, at least in terms of his usual performance. As with many addicts, outsiders likely would perceive him as functioning at a seemingly high level. And the numerous signs of drug addiction in physicians - the things colleagues are taught to watch out for - include bizarre behavior, mood swings, confrontational relationships, erratic habits, and inappropriateness. Fans of the series know where I'm going with this. Dr. House's unimpaired personality was, at best, unique and somewhat deviant from the norm. So at least some of the signs of addiction might simply go unrecognized in this character.
Is he going to defeat his addiction? Only the writers know for sure, but the odds are in his favor. Physicians are more likely than the general population to have a favorable outcome when treated for substance abuse, with recovery rates ranging up to 91% for docs in substance abuse treatment programs. Still, there's always the danger of relapse. We'll just have to wait for next season.
Related Topics:RX Drug Abuse: Common and Dangerous U.S. RX Painkiller Deaths Up
Technorati Tags: House, Vicodin, Painkiller Addiction
By introducing the concept of House as an impaired physician, the writers let the viewers in on a little secret: House (like all doctors) is a human being, with human weaknesses. And sadly, House's drug problem actually represents a condition more common than the majority of medical issues portrayed on the show. Estimates suggest that approximately 2% of all physicians have a current substance abuse problem, and that between 8 and 18% of physicians will be impaired as a result of substance abuse at some point in their lives. Alcohol is the most common substance abused by physicians, but prescription opioids (House's drug of choice) and anti-anxiety medications are also commonly abused by those in the medical profession.
The notion of a doc with a drug habit is not novel. In fact, drug abuse is considered by many to be an occupational hazard of practicing medicine, and physicians historically have had high addiction rates. Combine a stressful job with the relative accessibility of drugs in a person who may be genetically or otherwise predisposed to substance abuse or addition, and there's physician impairment waiting to happen.
But is House really impaired in the strictest sense of the word? The U.S. Federation of State Medical Boards defines an impaired physician as:
One who is unable to practice medicine with reasonable skill and safety because of a mental illness; a physical illness or condition that adversely affects cognitive, motor, or perceptive skills; or substance abuse.
So far, House is probably still practicing within the limits of reasonable skill and safety, at least in terms of his usual performance. As with many addicts, outsiders likely would perceive him as functioning at a seemingly high level. And the numerous signs of drug addiction in physicians - the things colleagues are taught to watch out for - include bizarre behavior, mood swings, confrontational relationships, erratic habits, and inappropriateness. Fans of the series know where I'm going with this. Dr. House's unimpaired personality was, at best, unique and somewhat deviant from the norm. So at least some of the signs of addiction might simply go unrecognized in this character.
Is he going to defeat his addiction? Only the writers know for sure, but the odds are in his favor. Physicians are more likely than the general population to have a favorable outcome when treated for substance abuse, with recovery rates ranging up to 91% for docs in substance abuse treatment programs. Still, there's always the danger of relapse. We'll just have to wait for next season.
Related Topics:
Technorati Tags: House, Vicodin, Painkiller Addiction
8 Comments:
Interesting -- an MD who admits to watching "House." You can't possibly be watching for the accurate and realistic portrayal of how medicine is practiced, right? And if you wanted sizzle with your medical drama, you'd watch "Grey's Anatomy." So, I'm guessing that you enjoy House's surly, misanthropic bedside manner, that watching him abuse some dying sap with a room-temperature IQ week after week give you some kind of twisted satisfaction or something.
In other words, I'm guessing you watch for same reason as non-physician viewers.
Sure, we get that doctors are human like the rest of us. They always have been, even back in the days before patients dared to ask questions or get a second opinion. But there used to be an unspoken covenant between doctors and patients: You guys do your best to be pompous and authoritative, and we'll meekly play along and trust that you know what's best.
See, when we inevitably wind up in the hospital, a result of our sedentary, fat-filled, drug-laden lifestyles, the last thing we want to think about is that the doctors we're counting on to save us are hung over, high on Vicodin, or otherwise fallible in any way. We liked the old arrangement where we followed our doctors' advice unquestioningly...and believed in them absolutely.
I think that's really the point of the series, myself. I think most patients would secretly prefer a physician who comes across as an arrogant, utterly unapproachable genius whose reasoning is both far beyond our comprehension and completely infallible.
You know. Like Gregory House, MD.
Maybe you didn't notice, but this blog is about real doctors reviewing what goes on in TV medical shows. I would imagine they watch the show in order to actually create the blog.
Genius, pure genius....
I knew math would be impaired someday!
"Combine a stressful job with the relative accessibility of drugs in a person who may be genetically or otherwise predisposed to substance abuse or addition, and there's physician impairment waiting to happen."
I love how you (the author of the first comment) use extravagant words with great feeling. It is of utmost pleasure to read your almost perfectly flowing paragraphs and attiude-driven response as you spit out your anger. Through the use of long words and philosophical views, you portray yourself as an intellectual genius who is better than everyone and knows what is right - sort of like Gregory House, M.D..
Unfortunately, and unlike House, your immature writing has one error immense error: there is absolutely no controlling purpose to tie together your post. It seems as if anything that sounded to make you authoritative was typed. So as you go on feeling superior and righteous, proud of you long and boring post, the rest of us are left confused as to your point and why you were such a jerk along the way.
Just wondering's comment was awsome. I love how so many people seem to presume that they know everything and can help but be a complete jerk through it all. I've found that those we protest against the most tend to be the most like us. Thanks just wondering.
"I think most patients would secretly prefer a physician who comes across as an arrogant, utterly unapproachable genius whose reasoning is both far beyond our comprehension and completely infallible."
Don't presume to speak for most patients, only for yourself. I am a partner in my care, along with my physician, and I wouldn't change that for anything.
I prefer a human, and humane, approachable person not some would-be demigod who doesn't know the limits of their knowledge or experience.
Everyone that cracks on Dr. House is just an ass. He still is able to perform his job under the scrutiny and the pain of his well being. I think that the people that negate him are just jelous of what he is really capable of.
Why can't people just enjoy House for what it is? Entertainment. Sure I'm going to get crucified because of his Vicodin use, but I also am a long term Vicodin patient, and believe me, I would trade the pain to get rid of the meds any day. As far as the real doctors who are operating under the influence of alcohol or any mind altering substance, I first pity them that life has stressed them to the point that they need the medicinal high just to get through the day. If we were all able to get our hands on that stuff, there are plenty of others who would be doing the same thing. My doctor who retired about 5 years ago was nearly the most cantankerous man on earth and I know that when he worked, he was straight as an arrow, but in his down time, he was able to kick back and have a few drinks with friends. Doctors aren't the only abusers of medications, they just have the easiest access which I think makes them hated by everyone else. Get a life and just kick back with the remote and watch House for it's entertainment value, and if it isn't that entertaining to you, then change the f**king channel you moron! Or go get a life complaining about something else. Do you all need some Premarin or something for this horrible PMS?
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