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HOUSE: Remote Possibilities
The story line in Episode 81 of House, 'Frozen,' reminds us of the peril involved when working in remote locales.
Did you know that in the real world personnel assigned to polar duty for the winter must have their appendix removed beforehand to prevent a similar crisis?
Cuddy assigns the emergency case to House and much of the drama occurs in the Princeton-Hillsboro teleconference suite. House quickly develops an emotional attachment to Dr. Cate Milton, a sharp-tongued, witty and highly intelligent patient who condemns House's shotgun style of medicine: speculate, test/treat, manage complications, regroup without apology. As a viewer, the confrontation between patient and doctor was far more instructive and compelling than all the other hoopla: urine tasting, self-performed thoracentesis, self-performed needle biopsy, Black & Decker craniotomy...ugghh!
Every time House wanted to begin empiric treatment for another unproven suspect diagnosis Dr. Milton challenged him. She refused to waste the outpost's limited medical supplies without valid justification. This woman was tough - we should be as tough with our own doctors! Granted, we essentially have unlimited access to diagnostic tests and medications, but that should not encourage lazy thinking or waste. Excessive procedures and prescriptions carry risks of severe complications. Doctors are expected to narrow the possibilities to clarify the real diagnosis.
An equally valuable lesson was saved for the final scene: You tend to find what you're searching for in the last place you look. Had House performed the complete 'video physical' as promised early in the episode he would've discovered the bruised, broken great toe on Dr. Milton's foot. Fat emboli from a the marrow of a non-healing bone fracture ended up being the true source of this patient's problems.
How can you apply these lessons in your own health care universe?
- Never hesitate to talk back:
- Please explain to me what you are saying.
- What other options are available?
- What kinds of problems will happen if I choose not to receive treatment?
- Never hesitate to ask direct questions:
- What did my MRI scan show?
- Did you receive my biopsy results yet?
- Is it time to get a second opinion?
Busy doctors can easily overlook previous orders and diagnostic studies. These oversights can lead to an unnecessary delay in getting you the help you need. On more than one occasion a gentle reminder from a cooperative patient saved the day for both of us.
You don't need to travel to the ends of the earth to benefit from these valuable lessons.
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