House S07EP18 “The Dig”

House, showing Thirteen the proper way to hold a 'shiv'

Must be getting close to Sweeps Week, as we welcome Thirteen back after a year’s absence.   Thirteen has been AWOL for the past year, “sent to prison for a crime she did not commit,”1 and House is waiting for her when she gets out.  This will encompass most of the episode as the “A” plot, leaving the science teacher in the hospital with mysterious respiratory symptoms as the “B” plot.

The science teacher turns out to be a hoarder, and House’s team turns up a shocking discovery at his home! My prediction prior to the episode is that this will turn out to be a fungal infection, which will be cleared up with Amphotericin B. Then at 8:55 PM, House will call in with the correct diagnosis.  Check back Tuesday AM for the after the fact recap! Update: actually got to it Monday evening.

1 OK, I am making that quote up.

Back on Monday evening, as I enjoyed this episode. The science teacher plot did occupy about 15 minutes of the hour, and was a relatively straightforward diagnostic plot. We started off with Serratia infection, progressed to my predicted fungal infection (Aspergillosis,) and finished up with Q-fever, a disease transmitted to humans from infected mammal feces and caused by a small, Gram negative bacterium: Coxiella burnetii. The disease was resolved by episode’s end, and quite frankly it deservedly took a back seat to the main plot between House and Thirteen.

Wow! The show surprised me, with it’s no-holds-barred discussion of euthanasia. A plot point from last season was the revelation that Thirteen’s mother had died of Huntington’s Disease, an incurable genetic disease that leads to progressive loss of muscle coordination with concurrent cognitive decline and dementia. It is a truly horrific condition, and is in many ways even worse for the families. Since it is genetic, Thirteen had 50-50 odds for acquiring the defect, and to no one’s surprise, Thirteen will succumb to the condition at an early age. How she will choose to face that reality some day was to some extent revealed in this week’s episode.

“House” this week will certainly be polarizing: euthanasia is not a topic that anyone feels particularly ambivalent about, and I think that it’s a reality that it’s one of the great, non-discussed issues in medicine in the United States. I personally feel that quality trumps other considerations in end of life care, but that’s a position I’m only willing to make for myself, and willing to defend for those close to me. Indeed, it’s a decision that all must make for themselves, but as health care workers we will be in a position where we might be asked to facilitate and aid those who might not be in a position to do so for themselves. And this is where thinking through how you feel might make deciding how you will react a bit easier.

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About ycpmicro

My name is David Singleton, and I am an Associate Professor of Microbiology at York College of Pennsylvania. My main course is BIO230, a course taken by allied-health students at YCP. Views on this site are my own.

Posted on April 10, 2011, in House Party!, Important. Bookmark the permalink. Comments Off on House S07EP18 “The Dig”.

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