HOUSE: Pins and Needles

It's a good thing Fox aired 'Birthmarks' after the Olympics. There were many offensive concepts in this week's fictional medical drama specifically relating to Chinese culture. Do you think Chinese parents insert needles into their infant children's skulls? Excuse me, I'm getting ahead of myself.

Magnetism was the central theme: House's attraction to Wilson, House's polarization from his father, and the adopted Nicole's transcontinental search to be drawn closer to her birth family back in China. Nicole is a drug abuser and smokes like a chimney. It appears much of her hospitalization is related to problems with different forms of iron.

At one point House's team suspects genetically-impaired iron metabolism - maybe hemachromatosis. (Medical geek point: House wanted to know if Nicole's birth parents had bronze skin as a sign of a systemic iron disorder. House was a bit rusty with the facts. The bronze skin discoloration from iron overload is not melanin; it is accumulated granules of hemosiderin and hematoidin - a breakdown product from iron-rich blood).

Later in the story it is revealed that Nicole's biologic parents inserted metallic pins into her soft infant skull in an effort to kill her in compliance with China's one-child per family population control policy. Nice... wouldn't a blanket have been sufficient? Apparently this parental shish-kabob approach to family planning backfired. Those intracranial pins turned into some kind of mega-acupuncture with the needle tips stimulating the pleasure/addiction centers of Nicole's developing brain. Small detail, but most acupuncturists that I know apply their needles (or a therapeutic staple) to the earlobe to promote smoking cessation.

Enough! By this time the entire plot was as difficult to consume as a mercury-laced, rat-stuffed dim sum washed down with a glass of contaminated Chinese milk. How did Nicole travel from America to China and get past the airport security metal detectors?!? "Excuse me, ma'am, but would you please remove your head?"

Still stuck on the magnetism theme, had Nicole undergone the planned MRI she would be in deep trouble. MRI, magnetic resonance imaging, relies on powerfully energized magnetic fields that would turn those pins into lethal projectiles. Magnetic items are never allowed into the MRI suite but surprises do happen. Some women experience 'tingling, burning hair' during an MRI scanning procedure. Guess what? Many hairsprays contain small quantities of elemental iron that cause this uncomfortable phenomenon.

By the end of the show the team tells Nicole that all of her problems will disappear once those nasty needles are removed. I don't think they nailed it. Postsurgical scarring in her traumatized brain tissue (reactive gliosis) may actually make things worse over time. Again and again I try to hammer-home the importance of never making overly optimistic promises to surgical patients. Give things time... at least until the next episode.

I'm done with this. My head hurts!

Related Topics:

• WebMD Video: Relief From Pain With Accupuncture
• WebMD Video: Smaller MRI - A Better Alternative for Some