@@JessTheMD Many of the cases on the show are real but rare cases drawn from a column about rare medical conditions that goes back decades. They really happen in the real world but most doctors might never even see one of them in a life time. It's established in the first season and some of the second season that most of the patients have already gone thru several other doctors who all failed to solve the problem so they arrive at House's door with all the easy/standard diagnoses haven been trailed and eliminated. After the first couple season they dropped that because it was taking 1-2 minutes per episode to establish that and the audience knew by then. So he usually looks for zebras because horses were not found already. Oh... also, he's in constant pain. All the time. And has been for *years* and there is no hope the pain will end. Everyone I know who has chronic pain are at least snippy. It turns me nasty and crabby in only about 3 weeks.
@@JessTheMD This show is acually a Sherlock Holmes show, even over a doctor proceedural. The medicine stands in for Sherlocks cases more than it does actual medicine and characters represent characters from the Sherlock Holmes books.
@@Buffy8Fan Which makes it even more confusing that they made a casting call specifically for a non-British actor to play House. But yeah, it has all the elements. The photographic memory, the encyclopedic knowledge, the rare cases that no other experts could solve, the dependence on opiates. Even his name is an amalgamation of Holmes and Gregson (who in Holmes' view is the smartest Scotland Yard has to offer). But who would be Moriarty in this scenario?
@@morphman86 Elias Kotas played a character named Jack Moriarty in the 2x24 episode _No Reason._ I don't think he was ever named in dialogue, but officially that was the character's name. It was the closest this show got; House being shot only to imagine Moriarty the rest of the time. This version's character has many fans speculating he's a hitman sent by a former patient as he's never caught and what we do know was all speculation and hallucination from House.
She doesn't consent to the surgery right away because the prognosis was not good and she wanted to share one Shabbat with her husband before dying. To speed things along, I think they closed her curtains and lied about sunset and her husband went along because he wanted his wife to have the surgery, because delaying could mean her death. I'm actually surprised House didn't get it sooner, because he is a board certified Nephrologist. (Also board certified in Infectious Disease. Do doctors actually do that? Get multiple certifications?) A lot of context is missed when you just rely on clips. Also, House has "a ha!" moments in the weirdest places.
House claims that "...He is a Board Certified DIAGNOSTICIAN with a double specialty of Infectious Disease and Nephrology." ("Occam's Razor (2004)". House, M.D. Season 1 Episode 3 at the 6 min 5 second mark) but I don't know if a "specialty" is the same as board certification.
Totally semantics in a TV show! LOL The fact that it's not *real* makes it hard to pinpoint one way or another. Regardless, he's definitely really entertaining!!! 😊
@kitty Huge fan of this series and I have seen the entire thing at least 5 times. House explains why he didn't get it sooner because all the tests are done while the patient is in bed not while they are standing.
I remember that, during the time of the show, there were online boards with doctors discussing the cases live during each episode -and after. The boards must be still posted out there. It was great to read those discussions during every episode.
Glad you gave House MD a watch doctor.. but there's important context missing. House is a diagnostician and a good one at that, so he don't deal with day to day cases. his speciality is in finding zebras and he gets referred to patients that are medical mysteries. second thing is his intelligence, i think the show has established this. he has a genius level intellect. but to balance things out he has many flaws. he often gets things wrong due to this. his team pitches in and nudge him the correct way. Hope you watch a full episode to understand the context because the episode is written in a way to provide clues.
Definitely! I have a few full House episodes on my list to watch too! Thank you 😊 if you have any other specific episodes you’d like to see, let me know!
😂 7:22 “I’m not sure which [organ], so I guess we should continue…” 7:55 “So, the ‘P’ is actually silent” 😂😂😂 Every English reference: P not silent when “ptosis” is used as a suffix 😂😂😂😂😂
@@JessTheMD no , Thank you! Even if we know that the show is made up, it really means a lot to us “ non medical ” guys that someone with the kind of “ power” and “knowledge “ you have , acknowledges a show that we all go home after work to watch and enjoy and hope that it’s a little bit true. Thank you very much for this . A very big kiss 🥰 thank you for work and passion
So I had Nephroptosis and had 2 nephropexies when my kidneys were knocked down, independently years apart, one in a car accident. The ureter can’t float with the fallen kidney, and it kinks under the weight of the fallen kidney, creating an obstruction whenever upright, and pain no different than an obstructing kidney stone. I mean, it’s agony. Then the kidney slides back in place lying down for a CT and the patient looks like a faker when it’s really an issue of positioning during imaging. My diagnosis was a nightmare, but nothing like this show, lol. We need more upright and dynamic imaging, I’ll say that. Only a positional IVP found mine. Most people with nephroptosis have Marfan, Ehlers Danlos, Loeys Dietz, etc so seeing POTS in nephroptosis patients isn’t terribly wild. A fair number of nephroptosis patients also have an unattached cecum that’s discovered in cecal volvulus (I did, I needed a cecopexy too). And yes, one side of my family has geneticist diagnosed EDS, myself included, so it’s all related however wild it all sounds. Anyway that’s my knock off TED talk about Nephrocoloptosis! I’m compelled to tell doctors to keep an eye out for this agonizing condition because without positional imaging, Nephroptosis and nephrocoloptosis often can’t be seen on supine imaging, aside from signs like hydronephrosis, hematuria etc and it goes missed, further feeding this “it’s so rare” belief while people suffer undiagnosed. Thanks for hearing me rant, and for this video!
I suffered from attention-ptosis in chemistry class in high school. The textbook had been written by a guy named Dull so the teacher, who was dull enough without help, would say upon entering the class, "Okay, get out the Dull book," and I was off in my own fantasy world for the hour.
@@Guardian582 Yep. He was indeed a droner. Amazing how speech, tone and cadence varies. If you remember The Wonder Years, they had a classic droner in there. Very funny!
I bet if you worked with House, you’d quit so fast due how his demeanor is, even if the world considered him the best of the world. But, the question is, would you respect him?
I don't think there's anyone out there that wouldn't respect his knowledge and expertise... But I might not respect his bedside manner for the most part 😉
Genuine medical question for you Doc. Is it possible, even in EXTREMELY SUPER-RAREST of cases, for someone who was diagnosed with chronic kidney disease at age 2, went into end stage renal failure at age 24, and has been a dialysis patient for 21 years since(is now 45 years old), to manage to come off of dialysis WITHOUT a kidney transplant? This patient originally started dialysis with 4 hour treatments every Monday, Wednesday & Friday(24 hours of treatment over every 2 weeks), and is now down to only 3 hour treatments on just Mondays & Fridays one week, and Wednesdays ONLY on alternating weeks(9 hours of treatment over every 2 weeks). The patient is thriving, bloodwork fluctuates but is able to level out within desired parameters with vigilant monitoring and changes in diet, fluid gains between treatments(even with 4 days between treatments) remains constant at less than 2kg. Any thoughts would be appreciated🤔
Hmmm I wouldn't imaging so. I have personally never seen someone in end stage renal disease manage without dialysis. That sounds somewhat miraculous! 😊
@@JessTheMD The patient was born with only 1 functioning kidney, which operated at around 25% until he turned 24 years old, when it went down to less than 10% and he started hemodialysis. He still has urine output, and that output has actually INCREASED over the last year. For the last 10 years, his diet has remained largely unchanged, though beginning this past February he has dramatically increased the amounts of garlic and mushrooms that he eats daily. His potassium has very rarely been high(maybe 4 times in 21 years, and was due to very specific foods that he immediately stopped eating, which immediately brought his potassium back down), and has more frequently been low(requiring him to increase his intake of more potassium-rich foods), and his calcium/phosphorus can wildly fluctuate, but is always brought back within parameters by immediate increases or decreases of milk or cheese. Because of how vigilant and knowledgeable he is, he has NO dietary restrictions(and has not been on any binders for over 10 years) other than what he chooses himself to avoid, and he keeps a mindful track of his fluids intake. He drinks between a quart to a half gallon of hot white tea with sugar and cream every day(which he hypothesized could contribute to his improving functionality, but there are no studies in the planning to prove or disprove this). His dry weight fluctuates over the course of each year between 50kg to 55kg depending on the seasonal climate(tends to gain weight in the warmer months and lose it during the colder months). His heart rate has always been high(100 to 120 bpm) due to his size(5 feet 4 inches and skinny) and metabolism, yet his blood pressure remains on the lower end of normal(with systolic dipping into the 80s when he sleeps). He has dealt with depression, chronic insomnia and chronic pain(due to a congenital malformation of the cervical vertebrae, which he had 2 separate surgeries to prevent further spinal cord damage), but is no longer on ANY medications for these problems(other than 500mg of acetaminophen twice a day). He received a kidney transplant from his mother in 2003(4 out of 6 antigen match), but it had to be removed after only 2 months due to irreversible rejection. And he has removed himself from the transplant list, as he does not want to risk wasting another kidney that could save someone else's life. When he began hemodialysis in July of 2002, he was at 4 hours of treatment every Monday, Wednesday and Friday, and felt very good, but then as the years went on, he felt more drained and lethargic. Due to weather circumstances and transportation difficulties in 2010, there were multiple times when he was forced to miss his Wednesday treatments, and he noticed that he actually felt better during those weeks when he only had treatments on Mondays and Fridays. So after a trial period of 3 months doing treatments only 2 days a week, it was decided that this was a better course of action, as his bloodwork was remaining within parameters, and the patient was feeling much better. This had been ongoing for 12 years(eventually decreasing his treatment time from 4 hours to 3½ hours). Then last year, due to the patient again feeling more drained and lethargic after each treatment, he suggested decreasing his time to only 3 hours, to which the patient then reported to again feeling much better after the shortened treatment time. In July 2022, when daily life complications caused him to be unable to come in for treatments on Monday and Friday one week, he was only available for a treatment on Wednesday, he again reported feeling MUCH better. He decided to test this by continuing to do a Wednesday only treatment week once every 4 weeks to see how he felt, and his physical and emotional well being continued to improve over that time. So, beginning in June, a new 3 month trial was implemented where he will receive 3 hours of dialysis on Monday and Friday one week, and 3 hours of dialysis on only Wednesday the following week. And it will go on like this until September when the situation, his bloodwork, and how he feels, will be reevaluated. And since he has gone down to only 9 hours of treatment over every 2 weeks, his fluid gains between treatments has actually decreased, averaging between NO gain, to only 0.5kg gain. This patient is boggling the minds of every nephrologist and dialysis expert that hears about him. If there are any other details that you're curious about, I'll be more than happy to fill in any additional blanks.
I do have to concur, were House a real person, it's patently obvious that no creature on the planet would have pleasure when he touched them. Yeah, got orthostatic hypotension at times myself since COVID. Well, that and mitral valve reflux. But, it's only a cold... What's a tilt table again? Had a 28 year old female soldier collapse in the field, she did lose her entire blood volume into her abdomen. Aorta ruptured, secondary to pheochromocytoma induced hypertension. She was in the field with her unit for training, was sitting on a log talking with her peers, when she collapsed asystole. Our unit was across the tank trail from hers and we had organic medical personnel, so we assisted. A tragic case, as she had just been diagnosed and really shouldn't have been in the field for any kind of training until the issue was resolved. Omni ptisosis, everything is drooping. AKA, aging. ;) I'll just get my coat...
House is so much fun and I love the show but diagnostically it always seems like they do things backwards. MRI's before blood work, etc etc. Still such a fun show. Love it so much.
Hahaha! I had that same thought at some point! There are definitely *some* times where you do imaging first (first thing that comes to mind is a trauma situation or a code stroke, etc)... But otherwise, yeah, usually labs are done first!! 😊
Not at all. 😊 I just never liked wearing glasses - mainly because everything in front of me was clear, but all around the edges was blurry, and I just didn’t like it (and it sometimes even triggered migraines). Before I got lasik, I wore my glasses whenever I needed and was definitely never embarrassed about them. I’m curious why you think that though.. 🤔
@@JessTheMD because I'm like that and it seems I project that onto other people. But I wasn't referring that you seem a vain person. Just trying my hunches awkwardly
