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Tuesday, May 13, 2008

HOUSE: Jarred Memories
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The fourth season of House concluded with a two-part finale. The first part (Episode 415, House's Head) has an amnesic Dr. House retracing his steps after realizing he had survived a bus crash four hours earlier. Many passengers sustained severe injuries. House is convinced that, moments before the crash, he recognized a person with diagnostic features for a life-threatening illness. But, which passenger and what illness?

House himself sustained a bone fracture involving the base of his skull with cerebral edema, yet he was able to mobilize his team and begin assembling clues. Most skull fracture survivors take to their bed and stay there. House underwent hypnosis in an effort to illuminate his misplaced memories and resolve his amnesia. Clever editing combined hypnotherapy and Vicodin-induced hallucinations. It was often hard to distinguish which events were recollections and which were fantasies.

A lot of time and energy was devoted to the bus driver. House theorized perhaps it was the bus driver who had an occult health condition that caused him to temporarily blackout. By the end of the episode House flushed the bus driver scenario - the passenger in greatest danger remained unidentified. Can you say 'cliffhanger'?

Now, don't worry about any spoilers because none are divulged in this blog post. Who knows what trivial plot details in this week's episode become the pillars of next week's closer?

What interested me most about this episode was the recognition that physicians often continue working despite illness or injury. Is it professional duty or fear of lost revenues? In my opinion it is a devotion to patient care that drives most physicians beyond their own sickness - even beyond the point of good judgment. I believe this is part of the reason why doctors make the worst patients. Watching the progressively disoriented House carry-on after sustaining serious head trauma, my wife quietly remarked, "...reminds me of February 1984".

Ouch, that hurt!

In February 1984 I was Ophthalmology Chief Resident: lots of patients, lots of surgery, lots of responsibility, not much money. For three days I kept working around the clock despite fever and abdominal pain. My wife repeatedly warned me that I needed to get help. I reassured her that I'd felt worse before. Denial reigns supreme! On the fourth day I collapsed from peritonitis due to my untreated ruptured appendix. Finally, I saw a doctor, had long-overdue surgery, and spent 10 days in a hospital bed hooked up to IV antibiotics. Had I gotten help sooner I never would have made myself so sick. Looking back at that experience I recall several hospitalized patients telling me, "Doc, you should be in this bed. You look worse than me!"

Professional journalists would howl that I have inserted myself into this story, which is supposed to be about House. What can I say? House's behavior is not unlike other doctors. You know, other doctors like me! It's great that I am not a professional journalist - just a medical blogger.

I dare not spill any beans regarding storyline specifics. Let's wait until Part 2 airs and we can wrap the entire season finale with one big ribbon (or head bandage!) TO BE CONTINUED...

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Posted by: Dr. Lloyd at 5/13/2008 01:21:00 AM

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